Inside the uterus, surrounding your growing baby, is a liquid called ‘amniotic fluid’. A long needle is inserted through the abdomen to extract a small sample of that fluid. Using it, doctors can perform tests that indicate potential problems and provide information about the health of the gestating fetus.

Test results typically arrive in a week or two and the test is sometimes referred to as an AFT (Amniotic Fluid Test).

Typically done around 15-20 weeks, an ‘amnio’ can examine possible genetic abnormalities, check for uterine infections, Rh (rhesus) sensitization and other possible problems. But it can be used as a general health check as well.

Only a small amount of fluid is withdrawn and is generally preceded by an ultrasound test. The fluid contains sloughed off skin and other cells from the developing fetus and these form the basis for part of the test.

Down syndrome is a rare condition, but amniotic fluid contains markers that can assist physicians in determining the odds that your child is affected. The test is about 99% accurate for Down’s and is usually combined with an ultrasound and other tests.

Other genetic disorders – such as sickle cell anemia, Huntington’s, Tay-Sachs or cystic fibrosis can all be diagnosed while the child is still in the womb. Only a small percentage of babies are afflicted with any of these conditions, but most women will want to perform this basic check.

Spina bifida is a neural condition that can lead to crippling and amniocentesis can test for this as well, along with other neural tube defects. Even among high risk women, the odds are less than 5% that a problem will be discovered. Still, some women choose to terminate a pregnancy if the condition is discovered.

As a side benefit of the genetic screening it’s possible to determine the baby’s sex, though ultrasound is the more common method now.

No single test is definitive, so women may want to consider multiple tests. Women 35 years or older are at higher risk of producing infants with some of the disorders discussed above. Combining amniocentesis with ultrasound or multiple marker tests can bring peace of mind.

Along with that peace of mind getting tested has other benefits. Certain in utero deficiencies can be treated to resolve problems before they become a major issue.

The test does have some minor risks of its own, however, and this should be borne in mind. Miscarriages can be induced by amniocentesis, for example. Great care is taken to ensure that the needle doesn’t puncture the baby. But, there is a small chance (about 1 in 1000) that the test will produce an uterine infection.

Few women experience any pain from the procedure, with about 1% having spotting or fluid leaking after the test. Avoiding stresses such as lifting or prolonged standing after the procedure can reduce the odds of any problems.

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There are a variety of tests that an expectant mother can have performed to gain information about the health of her growing fetus. Some, like amniocentesis, have been around for over 100 years. Ultrasound was introduced in the 1960s, though early tests had limited value. Modern tests are much clearer, some even in 3-D, many showing motion.

Today, ultrasound is clear, simple, and (as medical tests go) relatively inexpensive. Most are covered by standard insurance plans that cover pregnancy.

Also called sonography or just ‘a scan’, the woman’s abdominal area is exposed to harmless ultra-high frequency sound waves. The echoes are then recorded and interpreted by a computer program – then projected onto a screen. The basic principle is similar to that used in fishing boats, submarines and other applications.

Unlike X-rays they produce no ionizing radiation, though the sound waves still carry energy. Nevertheless, the procedure is safe and painless. It has the added advantage that it can examine soft tissues that don’t show up as clearly in x-rays, and the images are displayed in real-time. Since there are no ill-effects produced by the test, it can be repeated as often as desired as the fetus develops.

The technician (often your physician) uses a small, hand-held wand that travels over the surface of the skin. A clear gel is applied to the skin beforehand to eliminate air between the wand and the surface, producing improved results. Unlike amniocentesis and other tests, it’s non-invasive and the preliminary results are available immediately. It takes no more than half an hour.

More extensive analysis of the results can be performed by a trained specialist, if desired. A report is typically sent to your physician. From the results, doctors can detect physical abnormalities, tissue rupture, bleeding or simply whether problem implantation has occurred.

But apart from detecting potential problems, the test is used to provide useful information. It can reveal sex and age and record at the development process. It can also show the physical location of the baby within the womb. That helps determine if a breech birth is likely and other potential positioning issues. With that advanced look, delivery can be better planned.

The procedure has limitations, however. Ultrasound waves, unlike regular sound waves, don’t travel as efficiently through air. As a result, any areas where air pockets exist – such as the stomach itself – won’t yield as much information. Also, they don’t penetrate bone as well as x-rays and the waves are dampened as they pass through fatty tissue. The results may be less useful for obese women.

Those limitations can be overcome by supplementing ultrasound with other tests, such as amniocentesis and others that use chemical indicators to give useful data about the baby’s health.

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It can be difficult to know exactly when labor begins in earnest. But some signs are unmistakable. One such occurs when your new baby’s head exerts pressure on the amniotic sac and it breaks. When your ‘water breaks’ (the liquid isn’t just water, but amniotic fluid), labor is imminent.

Unfortunately, ‘imminent’ doesn’t mean ‘will occur within 10.5 hours’ or any exact amount of time. The time to the beginning of regular contractions and actual delivery, can vary enormously from woman to woman and even child to child.

Nevertheless, when you feel that trickle or gush of colorless fluid flow down your leg, it’s time to get ready. On average, labor will begin within 12 to 24 hours later. For some, the time is much sooner.

Note the time, wipe away the fluid and clean the vagina to minimize the risk of infection. Don’t bathe. Look for any green or brownish fluid, the meconium, which is from your baby’s bowel movement. That’s an indicator of fetal stress and should be reported to your physician immediately.

Contractions will follow shortly.

The uterus is a muscle and one of its roles is to force the baby out into the world through the birth canal. The contractions you feel are that muscle tensing. They will usually be preceded by dull cramps in the lower back or pelvis. When they happen regularly for an hour, lasting at least 30 seconds each, gaining in intensity, actual labor has started.

Since they can vary from woman to woman, try to verify that the contractions are labor by varying your position. Move around and sit. See if they still occur. Remember to keep a close eye on the clock or your watch. Timing the events is important.

First pregnancies will often take a little longer, so try to avoid any sense of panic. When contractions are coming five minutes apart for an hour, it’s time to head to the hospital. Err on the side of caution, though. The number is just an average and it’s best to avoid complications by being too early, rather than too late.

Severe pain, rather than regular (even if uncomfortable) contractions can be a sign of placenta previa. This is a condition in which the placenta can block the exit from the uterus. Or, the pain can be the result of placental abruption, where the placenta separates but limits the baby’s oxygen supply. Call your doctor.

Almost all labors proceed without incident. Stay calm, execute your plan and get ready for a healthy baby.

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Many women enjoy a healthy lifestyle that includes regular exercise and a good diet. It can be tough to maintain that lifestyle when she becomes pregnant, especially during the later stages. But it is possible, and in fact preferable, to maintain an exercise regiment at least up until the last month.

Pregnancy brings many changes. Hormone levels go wild, you gain weight and (later) movement becomes increasingly difficult. Changes in the level of progesterone, estrogen and others produce softening of the ligaments around joints. Strain on internal organs, the back and legs is inevitable. At the same time, you’ll put on almost 30 lbs. Go easy.

Sometimes a general malaise sets in. Regular, appropriate exercise can help relieve much of that and help put your body in the best shape possible for labor. That optimizes your comfort and your growing baby’s health.

The first step is to adopt a kind of Hippocratic Oath of Pregnancy: First, Do No Harm. That ancient principle from the Greeks is still valid, more so during pregnancy. Some women are used to running five miles, doing every station at the weight machine or performing Pilates an hour a day. That will have to change fairly quickly.

But maintaining a good exercise regimen is still possible, just change your workout to fit your changing body. Eliminate crunches or any other form of exercise that stresses the abdominals or back. Go with lighter weights. Avoid jerky movements and forego squats which can separate the placenta from the uterus.

Breathing properly during exercises performed while pregnant is essential. Correct breathing technique anytime is important, but you’re now breathing for two. The baby receives oxygen through the umbilical and keeping the blood fully oxygenated is imperative.

Keep in mind that your resting heartbeat will increase by about 8 beats per minute during the first few weeks. Blood volume increases substantially as you progress. Factor that in when you consider any cardio exercise.

Hydrate at an appropriate amount throughout the day. That means small sips over a longer time frame, rather than large intake at a given time. Eating should follow the same pattern – four to five small meals per day is preferable to three larger ones.

Before beginning a workout, warm up gently. Perform easy stretches and be prepared to rest often for a few minutes at a time. Light cardio is the key to a healthy circulatory system, so important during these months.

Pregnancy shifts your center of gravity forward, stressing the spine and back muscles. To ease that aching back, swimming is one of the best forms of exercises. It also gives a very low stress but active cardio workout.

Yoga is a favorite for many. It helps achieve peace of mind and provides gentle movements that provide the needed stretching, while building good leg and arm strength. It gives also low impact on the back.

With a good program, you’ll reduce cramps, improve circulation and increase energy. You’ll lower your resting heart rate and keep fit.

If you feel any dizziness, swelling or experience any kind of vaginal bleeding or discharge discontinue at once and consult a medical professional.

Before beginning any exercise regimen it’s vital that you talk with your physician. It’s great to get more than one opinion, but your OB/GYN (obstetrician/gynecologist) can help you devise a program that is great for you and your baby.

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