Inova BabyNET Pregnancy
Trusted Links BabyFit American Baby BabyCenter Parenting.Ivillage				Topics Physical and emotional changes Preparing for baby Exercise and nutrition Office visits and testing Bed Rest
My 9 Months The March of Dimes has generously supported Inova BabyNET by creating My 9 Months, to help you have a healthy pregnancy and baby.  Information includes: a due date calculator    exercise and nutrition education preterm labor warning signs      month-by-month fetal growth More My 9 Months information
Trusted Links plus size pregnancy skin changes pregnancy pain relief		Physical  &  Emotional Changes	Questions stress & depression swelling sleep position
Trusted Links car safety preparing siblings for dads to be		Preparing for Baby	Questions   traveling   toiletries for myself and baby   Apgar score for baby   signs of labor   cough and cold medicines for baby   safety in the nursery   birth plan
Trusted Links vegetarian diets food for morning sickness when not to exercise healthy weight gain Inova HealthSource Prenatal Fitness Classes		Exercise & Nutrition	Questions cravings safe fish to eat exercise during pregnancy
Trusted Links 1st trimester visits and tests 2nd trimester visits 3rd trimester visits the ultrasound choosing a pediatrician		Office Visits & Testing	Questions AFP testing STD awareness
Trusted Links www.americanpregnancy.org www.sidelines.org www.parents.com www.whattoexpect.com		Bed Rest Have you recently been put on bed rest?  This online class is an exclusive benefit for Inova BabyNET participants and will tell you the basics you need for bed rest	Questions Do you have any questions about bed rest that you'd like to have answered?  E-mail us your questions and we'll post the answers here. BabyNET@inova.org
Q. I'm feeling depressed and stressed now while I'm pregnant and worried about post-partum depression.  What should I do? MATERNAL DEPRESSION Depression during pregnancy and after the birth of a child is very common, affecting hundreds of thousands of women.  Stress, hormones and genetics all play a role.  The good news is depression can be short lived and most people improve significantly with support.  To take a depression screening test and find additional resources, click here. Back to top Q. I seem to have a lot of swelling, while I'm pregnant.  Is that normal?  Is there anything I can do about it? SWELLING DURING PREGNANCY During pregnancy, your body produces up to 50% more blood and body fluids. A certain amount of swelling, or edema, is normal during pregnancy due to these additional fluids. Edema is generally felt in your hands, ankles, feet, face and legs. It might feel uncomfortable to you, but this retention of fluid helps to soften the body so it can expand as the baby develops. This extra fluid prepares your pelvic joints and tissues for opening up to allow the baby to be born. This fluid can account for up to 25% of your weight gain during pregnancy. In addition, swelling can be worsened by (1) summertime heat, (2) standing for long periods of time, (3) diets low in potassium, and (4) higher levels of caffeine and/or sodium intake. Try to stay off your feet whenever possible and keep your feet elevated. Drink lots of fluids, especially when it's hot. Good foods to eat that contain potassium are apricots, bananas, cantaloupe, figs, avocados, pumpkin and squash. If you experience sudden swelling, it may be pre-eclampsia, which is a serious condition, Severe pre-eclampsia is characterized by headaches, blurred vision, inability to tolerate bright light, nausea/vomiting, urinating small amounts, and pain in the upper right abdomen. Contact your health care professional immediately if you experience any of these symptoms. Back to top Q. I'm having trouble getting comfortable while sleeping. Is there any position that's best for me and my baby? BEST SLEEPING POSITION As your baby grows and increases the size and weight of your uterus, finding a comfortable sleeping position can be a challenge. You should avoid lying on your back due to pressure on the inferior vena cava, a major vein that returns blood from the lower body to the heart. Long-term pressure on this vein may limit the blood flow to the placenta. In addition, this position can increase pressure on your back and intestines and may be uncomfortable. You also should avoid sleeping on your stomach during pregnancy, because of pressure on the fetus.   The best sleeping position for a pregnant woman is on her side, especially the left side. This allows for maximum blood flow to the baby and improves kidney function in the mother. Improved kidney flow helps to reduce any swelling. To get more comfortable on your side, try placing a pillow between your knees and one behind your back. Don't panic if you wake up and find you are on your back, just turn over to one side. Back to top Q. What kinds of products and toiletries should I have at home for myself after the baby is born? What about for the baby? WHAT SHOULD A NEW MOM HAVE AT HOME WHEN SHE RETURNS FROM THE HOSPITAL? You've probably given a lot of thought to your baby's needs, but what items should you have at home when YOU return home from the hospital? The following items aren't as exciting as decorating a nursery, but will make you feel much more comfortable: *  Peri-pads (sanitary pads) *  Peri-bottle (hand held squirt bottle) *  Stool softener *  Ice packs *  Breast pads *  Pain reliever (acetaminophen, and/or other medicines your doctor asks you to take) In order to heal properly and avoid infection, it is important to take good care of yourself after the birth of your baby. For the first three weeks after giving birth, it is recommended you clean the perineal area (the area which includes the vagina and the rectum) using a peri-bottle filled with warm water every time you use the toilet by rinsing the area, front to back. Blot the area gently, don't wipe. The operative words here are "clean" and "gentle." Keeping the area clean can both be soothing and help prevent infection. You will also need to use sanitary-pads and not tampons for the blood and discharge (lochia) from the vagina after birth which may last up to six weeks. Your doctor may suggest a stool softener to reduce stress on your rectum. Drinking plenty of water will also help keep your system moving regularly. Breast pads prevent milk from seeping onto your clothing and are either washable or disposable. If you buy disposable pads, be sure they don't contain plastic backing, which can trap moisture and cause yeast infections. Washable pads actually move moisture away from your body and are often softer. Infant Toiletries There are so many products on the market now geared towards your newborn. You can buy special soaps, shampoos, hooded towels, baby washcloths, etc. Once home from the hospital, what do you really need to have in the form of toiletries for your baby? The answer is - not much. The following is a list of items to have on hand:  2 - 3 packs of disposable diapers (newborns can spoil up to 10 diapers a day)  1 pack of disposable wipes  1 tube diaper rash ointment  1 bottle of gentle head to toe baby wash  Baby nail clippers  Digital baby thermometer  10 cloth diapers (very absorbent, work great for burping baby and cleaning spills)  5 - 8 bottles (if your bottle feeding)  Regular washcloth & towel Back to top Q. I'm planning some trips while I'm pregnant.  Is there anything special I should do or know? TRAVELING WHILE PREGNANT While it is generally safe to travel while pregnant, be sure to check with your physician/midwife to see what their parameters for travel are, and to be sure that you do not have any conditions which would make travel unsafe. The second trimester is usually the best time to plan a vacation. The first trimester often leaves people feeling exhausted and some women have problems with nausea and vomiting...which can make it hard to enjoy your vacation. The second trimester is usually accompanied by an increase in energy and the return of your appetite, which both make vacation more enjoyable. During your third trimester of pregnancy, your growing body can make travel more uncomfortable, and many OBs prefer that you do not stray too far from home towards the end of your third trimester. When traveling by air... * Be sure to double check with the airline before purchasing your plane ticket to see how far along you can be when flying on their airline...different airlines have different limits. (For example, according to their website, Continental allows women to fly at any point in their pregnancy, as long as they don't appear to be in labor. American Airlines will allow travel up to a week before your due date in domestic flights, but requires a doctor's note for any time after 36 weeks). * You might want to try and choose an aisle seat so that you can have room to stretch your legs...and easier access to the aisle, to get to the bathroom. * Wear loose and comfortable clothing. * Do leg exercise every half hour or so...rotate your ankles and flex and extend your feet. * Don't worry about the metal detectors used at the security checkpoint...they are safe to pass through during pregnancy. When traveling by ship... * Be sure to double check with the cruise line to see what their limitations are on cruising while pregnant, like the airlines, the cruise lines have different limits... (Princess Cruise lines, for example, wants you to be less than 28 weeks...Norwegian Cruise lines wants you to be less than 24 weeks). * Be prepared for seasickness in advance. Ask your physician/midwife what medications you can safely take for seasickness before leaving on your trip. No matter how you travel, you may want to consider taking a copy of your medical records with you, in case emergency care is needed. And, be sure to drink your water and stay hydrated during your journey. Back to top Q. Some of my friends are suggesting I do a birth plan for my delivery but I'm not sure how my doctor will feel about it. Should I do a birth plan? Is there anything that will make it more appealing to my doctors? BIRTH PLAN TIPS Birth plans were very popular for a while and have become less so more recently. They are a good way to begin thinking about what is important to you with this birth and can serve as a good communication tool between you and your health care providers. There are a few things you should keep in mind when considering whether to do a birth plan and what should be in it.  Keep It Simple! No plan should be more than a page.  Watch your wording. Many people refer to them as Birth Preferences or Birth Priorities.  Start by thinking about what is most important to you as you experience this birth. A great example is decorating. You'd never go out and buy pillows and paint without first thinking about what kind of a room you want: Modern? Relaxing? Elegant? Cozy? It's the same with your birth. Ask yourself:  What do I want the emotional feel of the labor room to be? Relaxing? Warm? Stimulating?  Do I want to stay physically active or would I rather be resting and more comfortable?  Is decision making important, so I need to keep a clear head?  What role is my birth partner interested in and able to take?  Once you've narrowed down a few priorities, just put them together in a few sentences. For example, if feeling included in decision making is important you may want to say: "For the birth of our baby, we'd like to keep a positive, light environment, and it's important for us to feel a part of the process. We value your input and so may need extra time to understand all our options and what they mean." Or if being physically comfortable is important, "We'd like this birth to be a comfortable and peaceful. Please keep us informed about what medications and other ideas might make this birth comfortable."  Always discuss your birth plan with your birth partner and your health care provider ahead of time. Make sure you've edited it down to just your main priorities and then bring it with you to a visit. You can introduce the topic by thanking them for supporting you with the birth and for their care thus far. Ask for suggestions and see if they have any questions.  Be clear that your biggest priority is a healthy baby and that you would never ask them to do anything that would compromise that.  Don't bog down your birth plan with a long list of details that you do or don't want, eg, IV, internal vs external monitor etc. Discuss these with your provider well before the birth and come to some decisions together, recognizing that things change while you are in labor.  Finally, it can be a good idea to let another birth professional review your plan before you discuss it with your healthcare provider. Your Care Manager is an excellent resource. She will know if what you are asking for is reasonable and make some suggestions based on what is important to you, individually. Back to top Q. I've heard of Apgar scores, can you tell me what it means? APGAR SCORE One of the newborn first health checks is the Apgar test. This is a scoring system designed by Dr. Virginia Apgar, an anesthesiologist, to evaluate the condition of a newborn at 1 minute and 5 minutes after birth. The physician and nurses will evaluate the following signs and assign a point value: A: Activity; muscle tone P: Pulse rate G: Grimace; reflex irritability A: Appearance; skin color R: Respiration A score of 7 to 10 is considered normal. A score of 4 to 6 may indicate that the baby needs some resuscitation measures (oxygen) and careful monitoring. A score of 3 or below indicates that the baby requires immediate resuscitation and lifesaving techniques. Back to top Q. I'm starting to feel like I'm in labor. What are the signs? SIGNS OF LABOR During the last few weeks of pregnancy, your body is changing and getting ready for labor. Labor is a series of continuous, progressive contractions of the uterus that help the cervix to open (dilate) and to thin (efface), allowing your unborn baby to move through the birth canal. Labor usually starts two weeks before or after the estimated date of delivery. However, no one knows exactly what triggers the onset of labor. The signs of labor vary from woman to woman. During the weeks just prior to birth, you may notice some subtle signs such as nesting, lightening, or loss of your mucus plug. Nesting is the term given to the sudden urge and burst of energy some women have to prepare everything at home for the baby - like a mother bird readying her nest! Lightening is when your baby drops or settles down into your pelvis. You may find you are not as short of breath but you will probably feel more pressure on your bladder and pelvic area. The mucus plug, which seals the cervix during pregnancy, will begin to dislodge as the cervix opens. You may notice whitish, stringy, or lumpy mucus in your vaginal discharge. Some signs of labor occur closer to the actual onset of labor and are usually unmistakable: Bloody show is a small amount of mucus, slightly mixed with blood, and is expelled from the vagina. Some women have diarrhea or loose bowel movements. Contractions (uterine muscle spasms) occurring at intervals of less than 10 minutes are usually an indication that labor has begun. Contractions tend to become more frequent and severe as labor progresses. Labor sometimes begins with amniotic fluid gushing or leaking from the vagina. If you experience a rupture of your amniotic sac, you should contact your physician immediately. The majority of women with ruptured membranes go into labor within 24 hours. If labor still has not begun after 24 hours, a woman may be hospitalized for labor to be induced. This step is often taken to prevent infections and delivery complications. It's natural to be unsure if your labor is beginning, so always check with your physician if you are experiencing any of the signs listed above. Back to top Q. Should I buy cough and cold medicines ahead of time for my baby? COUGH AND COLD MEDICINES FOR BABY In the winter, the cold and flu season is in full force. But, if your newborn or baby under age two has a cough and the sniffles, be sure to check with your baby's provider before giving any medicine. During 2004 and 2005, approximately 1500 children less than 2 years old were treated in emergency departments for adverse events related with cough and cold medicines. Back to top Q. What should I be aware of for safety in the home? BABY SAFETY IN THE HOME Take this time to review some of the items in your home.  Safety in the nursery is especially important, and a few infant products are anything but safe.  Do a nursery check and ensure the following are not in your little one's reach: 1.  Outlet covers - the plastic ones are a choking hazard.  Best bet = Install outlet covers that slide shut when the outlet isn't in use.  2.  Suction cup bath seats - they can topple over and cause a drowning risk. Best bet = Use a small plastic bathtub instead, and stay with baby at all times.  3.  Wipe warmers - many are a fire risk and have been recalled.  Best bet = Warm the wipe in your hand for a few minutes.  4.  Crib bumpers - the soft padding is a suffocation risk.  Best bet = Don't use them.  5.  Sleep positioners - designed to keep baby on their back but poses a suffocation risk.  Best bet = Avoid them all together.   6.  Syrup of Ipecac - a medicine that induces vomiting if a poison is ingested but can cause even more damage when the poison is vomited.  Best bet = Throw out the Ipecac and lock all hazardous substances.  Call Poison Control if baby ingests a poison.  Be prepared with this free Poison Control toolkit.  7.  Rearview Mirror for Baby - while comforting to see baby, it takes your eyes and attention off the road.  Suction cup models can also become a projectile in the event of an accident.  Best bet = Purchase a mirror model with straps and attach firmly.  Check on baby only while stopped. Click here to read more about Child Safety Back to top Q. How do I handle cravings during pregnancy and still meet my nutrition needs? Do you just have to eat cheese doodles right now?  Cravings for certain foods during pregnancy is often cited as a common symptom in pregnancy. The cause for such strong urges for certain foods is unknown, and some in the medical community even consider them to be simply a product of societal influence to indulge during pregnancy.  Whatever the cause, food preferences during pregnancy can be incorporated into the diet as long as they are done so in moderation.  Choosing a healthier alternative is also an option, while still eating healthy, but satisfy that nagging urge for a certain food.   For example, if you are craving chocolate, perhaps a glass of chocolate milk will satisfy that chocolate urge while also meeting baby's need for calcium.  Grab fresh fruit if you've got  a sweet tooth.  Consider pretzels as a low-fat alternative to chips when only salty foods will work.  Back to top Q. How much fish is it safe to eat while I'm pregnant and breastfeeding? Fish is an important part of a healthy diet because it contains good protein, omega-3 fatty acids and is low in fat.  However, because of the high mercury content of some fish, it's best to limit intake of certain fish.  The FDA and EPA have put out easy to understand guidelines on what fish should be eaten and in what quantities.  For the brochure and guidelines, click here. Back to top Q. What do you suggest for exercise while I'm pregnant and after I've delivered? Yoga can be en excellent way to learn gentle stretches and breathing techniques as well as improve posture.  Inova HealthSource offers prenatal and post-partum yoga as well as aerobics and toning for new moms.  To find the schedule, click here. Back to top
Q. I'm scheduled to have an AFP test and I'd like to know why it's done and what I should know ahead of time. The AFP test is a blood test that is done between 16 and 18 weeks of pregnancy to screen for neural tube defects (such as spina bifida) and Down's Syndrome. Offering this test is part of routine standard of care for all pregnant women. It is not a mandatory test for you to take, so it's a good idea to think about it in advance, and decide if you want to have it done. The test results come back with a risk ranking, which determines if your baby has an increased risk of neural tube defects or Down Syndrome, but does not tell you definitively one way or the other. If your test comes back showing an increased risk factor, the next step in the testing process is then a Level II ultrasound and/or amniocentesis. However, the AFP test can have up to an 80% false positive rate, where the results indicate a possible problem but the baby is fine. This is definitely a personal decision. Some women are uncomfortable with the test because of the high rate of "false positives" (where normal babies are shown to be at increased risk) and don't want to worry about further invasive testing, such as amniocentesis, and choose not to have the test done. Some women know that they would not terminate a pregnancy regardless of the results, and choose not to have the test done. Others know that should there be a problem, they'd like to know ahead of time to prepare. Some women feel reassured by a normal result, even though it's not a 100% guarantee that the baby is perfectly fine, and choose to have the test done to get that reassurance. For more about the AFP or triple screen testing, click here. Back to top Q.  My doctor routinely checks for STDs during pregnancy, are these tests I really need to have done? STDs can be spread from a pregnant woman to her fetus before or during delivery.  Left untreated, STDs can cause infertility.  Genital herpes and the human papillomavirus (HPV) can even be spread when symptoms are not present. Even if you and your partner have been tested, get tested again.  Some STDs, such as HIV, can take up to 6 months before they can be detected in the blood. Watch for symptoms of STDs, such as: - A thick, discolored, or foul-smelling vaginal discharge. - Pain, burning, or itching while urinating for longer than 24 hours - Pain during sexual intercourse - Pain or a feeling of heaviness in the pelvis or lower abdomen - Itching, tingling, burning, or pain in the genitals - Sores, lumps, blisters, rashes, or warts on or around the genitals - Vaginal spotting or bleeding after sexual intercourse - Other symptoms of an infection, such as fever and fatigue or lack of energy "Even people who believe they have done all the right things can be very susceptible," confirms Fred Wyand of the American Social Health Association. "People may say, 'We look and we feel fine. We don't have any rashes or drips or pain or anything like that. Why is this stuff relevant to us?' But STDs can, and do, happen to anyone - even people who have very few partners." Remember that you may be under a mistaken impression about your vulnerability. We all assume our risk is too low to even take a test, but nearly all sexual activity is associated with some risk. One in five women who reported only one lifetime sexual partner had an STD. Among women with an STD, 15 percent had more than one infection. Protect yourself and be screened for these infections. For more information, read CDC fact sheets on STDs. Back to top