For centuries giving birth was strictly an affair between the pregnant woman and a midwife. Though not always present, a mid-wife would frequently aid in the birthing process. The role was often performed by an older woman who had previously experienced birth herself. She gave comfort, medical knowledge based on real experience and a second pair of hands at a critical time.

With the rise of obstetrics in the 19th century, midwifery became much less common, almost disappearing from birthing practice in the U.S., except in circumstances of deep poverty or geographic isolation. In recent decades, it has risen again in a new form in which midwives are often licensed nurses with considerable traditional medical experience.

Though midwifing was historically carried out in the home, modern practitioners carry out their work in hospitals almost entirely today. Many women want to have the services of a midwife, but still avail themselves of the advantages of modern medicine in a traditional hospital setting.

In the overwhelming majority of births, the midwife has to take little active part in the process. She provides assurance, a hand to hold and ‘insurance’ in the form of letting the woman know that, should the need arise, an expert is at hand. But their presence and practice goes far beyond or rather before labor.

Midwives are available for pre-natal visits, and they offer one-on-one advice, much as an obstetrician will do – though frequently at lower rates. They are often there for much more of the time during the entire process, too, once labor starts. Many obstetricians have more patients than any single person can care for, even working 14 hour or longer days (as many of them do). A midwife can usually devote exclusive attention to a woman during labor.

They will be there at the beginning of the birthing process, continuously up to and after the completion of birth. Having a trusted and experienced medical expert at the bedside for the entire time is a great comfort to many. That’s especially true for first time mothers, for whom the experience can be naturally a bit scary.

Midwives have the medical knowledge and the available technology to handle any situation. Breech births, preclampsia and other potential complications are nothing new to a good midwife. They can carry out needed tests – for iron levels, blood pressure and the like. And they can seek additional help, acting as an expert liaison when a woman may have other things on her mind. All midwives have an active working relationship with an obstetrician.

Midwives can be found through recommendations from friends or you can seek one by contacting the American College of Nurse Midwives in Washington, DC. The ACNM website (http://www.acnm.org/) is a good place to start your search.

In days past it would often take weeks to get the results of a pregnancy test, after a visit to your doctor. Today, you can have the answer in minutes.

Home pregnancy tests work much the same way as those carried out by professional labs. Both test for the presence and level of a hormone called hCG (Human Chorionic Gonadotropin) in blood or urine. Blood samples are considered more reliable, but certainly less pleasant, particularly for home tests. Most of them test urine.

Two criteria chiefly determine the worth of a home pregnancy test: readability and sensitivity.

Readability is partly a subjective issue, though some tests are definitely easier to interpret than others. Some show you a number, others match a color strip against a stated result. Many these days just say ‘Pregnant’ or ‘Not Pregnant’ in some form. Which you choose depends largely on personal taste.

The time to get a result is no longer a factor. In fact, if you wait too long to read the results the indicator becomes unreliable. Also, contemporary over-the-counter products from any major manufacturer are reliable. False negatives and false positives aren’t completely absent, but they affect fewer than 5% of cases.

One major component of that reliability score lies as much in the two criteria as in the quality of the test. As tests have become more and more sensitive, the level of false positives has a tendency to go up. For example, women who have recently given birth or miscarried may have elevated levels of hCG present even when they are not pregnant. Certain medications can increase the level as well.

As a result, tests which measure low levels can give a misleading result. Keep in mind that no HPT (Home Pregnancy Test) measures pregnancy directly. The only way to do that is to actually examine the implantation of the fertilized egg into the womb, a procedure that (so far) can’t be carried out at home. So, an indicator is measured as a proxy and that indicator can be high for other reasons, such as those above.

Some HPTs can measure hCG levels as low as 25 mIU/ml (milli International Units per milliliter). The abbreviated unit after the number is complicated, but not important to the home consumer. Just look at the sensitivity rating of the test and compare. In order to reduce false positives, tests can be designed not to give a ‘Pregnant’ indication until higher levels are reached. Many measure levels at 50 mIU/ml or even at or above 100 mIU/ml.

But raising those levels to be less sensitive means introducing two potential problems.

One, if the test detects hCG only at higher levels, you have to be pregnant longer before the body builds up to that level. That reduces the value of a home test, many of which are labeled EPT (EARLY Pregnancy Test) for a reason. The other potential problem is closely related. It can introduce false negatives, you really are pregnant, but the test tells you that you’re not.

For most women, these issues are not major. A home pregnancy test is a great convenience, but once you get a positive result it should be followed up with another from your physician. Also, many HPTs come with multiple strips. Test once, then test again a week later. If you get the same result, the odds are much higher that the test is valid.

Follow the instructions carefully and you can be confident that the test is telling you the truth, in 95% or more of cases. Those are pretty good odds, all things considered.

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.

The most common symptom you’ll hear about and may experience during the first trimester is morning sickness. Your body is undergoing so many changes, it’s really quite impossible not to have any symptoms. Not all women will experience morning sickness, while others have a hard time with it. Everyone’s different, and you won’t know what your symptoms will be like until you experience them yourself.

Also, expect to feel tired and fatigued a lot of the time. Again, your body is reacting to the many changes going on. Don’t fight these changes. If you get tired, rest and go easy on yourself. You’re not pregnant the rest of your life, just for nine months or so! One way to help with the fatigue is to make sure to drink a lot of water. This will also help with any constipation you might have to deal with. And yes, you most likely will experience that and other unpleasant symptoms!

Your breasts might become extra sensitive or even swollen. This is normal. It’s a natural progression for your breasts to develop more fully and prepare for breastfeeding after the baby is born. Whether you decide to breastfeed or not, your body will prepare for it.
After your first trimester, that tiny being growing inside of you will now have developed their main organs. It’s truly amazing to realize the phenomenal growth process that’s going on. Just wait until you get to have your first ultrasound, and actually SEE inside the womb!

For centuries giving birth was strictly an affair between the pregnant woman and a midwife. Though not always present, a mid-wife would frequently aid in the birthing process. The role was often performed by an older woman who had previously experienced birth herself. She gave comfort, medical knowledge based on real experience and a second pair of hands at a critical time.

With the rise of obstetrics in the 19th century, midwifery became much less common, almost disappearing from birthing practice in the U.S., except in circumstances of deep poverty or geographic isolation. In recent decades, it has risen again in a new form in which midwives are often licensed nurses with considerable traditional medical experience.

Though midwifing was historically carried out in the home, modern practitioners carry out their work in hospitals almost entirely today. Many women want to have the services of a midwife, but still avail themselves of the advantages of modern medicine in a traditional hospital setting.

In the overwhelming majority of births, the midwife has to take little active part in the process. She provides assurance, a hand to hold and ‘insurance’ in the form of letting the woman know that, should the need arise, an expert is at hand. But their presence and practice goes far beyond or rather before labor.

Midwives are available for pre-natal visits, and they offer one-on-one advice, much as an obstetrician will do – though frequently at lower rates. They are often there for much more of the time during the entire process, too, once labor starts. Many obstetricians have more patients than any single person can care for, even working 14 hour or longer days (as many of them do). A midwife can usually devote exclusive attention to a woman during labor.

They will be there at the beginning of the birthing process, continuously up to and after the completion of birth. Having a trusted and experienced medical expert at the bedside for the entire time is a great comfort to many. That’s especially true for first time mothers, for whom the experience can be naturally a bit scary.

Midwives have the medical knowledge and the available technology to handle any situation. Breech births, preclampsia and other potential complications are nothing new to a good midwife. They can carry out needed tests – for iron levels, blood pressure and the like. And they can seek additional help, acting as an expert liaison when a woman may have other things on her mind. All midwives have an active working relationship with an obstetrician.

Midwives can be found through recommendations from friends or you can seek one by contacting the American College of Nurse Midwives in Washington, DC. The ACNM website (http://www.acnm.org/) is a good place to start your search.

Everyone is familiar with the nausea and other conditions that sometimes accompany pregnancy. How common are they, and is there anything an expectant mom can do to relieve them?

Early pregnancy nausea and vomiting occurs in about half of pregnant women, beginning about two weeks after the first missed period. This lasts usually no longer than the first trimester, but that can feel like a very long time under these circumstances.

Mild nausea is common, but any extreme condition may be a sign of hyperemesis gravidarum. That can lead to dehydration and electrolyte imbalance. Discuss the possibility with your physician so you can be tested, if needed. Late pregnancy nausea can occur as well, from twisted or obstructed bowels.

Eating small, frequent meals is preferable to larger ones three times per day. Certain fruits can help, such as berries, peaches and cantaloupe. Taking needed liquids between, rather than with, meals is helpful. That will produce less stomach expansion. Avoid carbonated drinks.

Heartburn is another common condition. As a result of hormonal and other changes, the odds of experiencing it are higher during pregnancy. Increased levels of progesterone are thought to be a prime culprit, since it causes loosening of the sphincter, driving acid up into the esophagus. It also slows the emptying of stomach contents, which can be a contributing factor.

Changes in nutrition can help alleviate the problem. Avoid high fat foods, chocolate (yes, that’s a tough one to give up) and fried foods. Foods high in raffinose, such as cabbage, broccoli and lettuce should be reduced as they tend to produce gas. Cutting down on caffeine and alcohol and quiting smoking are essential lifestyle changes, at least for the duration.

Common antacids, such as TUMS (also a good source of calcium) are a good idea. Not only is the material helpful, but sucking on them contracts the esophagus, which helps reduce the problem.

Constipation is a common problem, both during and immediately after pregnancy. Medically, constipation is defined as an inability to move the bowels more than three times per week. But most women will regard themselves as constipated if they can’t eliminate at least once per day.

The condition can occur from many causes, including psychological ones. If rectal tearing occurred during delivery as a result of straining, the rectum takes a while to heal. Women, many unconsciously, try to hold stool to avoid the pain of defecation. After a C-section the bowel can be temporarily paralyzed, a condition called an ‘ileus’.

Walking can help relieve symptoms, since it often eases tension and loosens the bowels. Drinking the right kinds and amounts of fluid will also help. Some vitamin and mineral supplements can be beneficial, such as extra, easily digested calcium. Commercial laxatives should be avoided, but there are special types that physicians sometimes prescribe, such as Docusate.

Eat right, engage in a regular, appropriate exercise program and your difficulties can be minimized.

Making the right choice of doctor to deliver your baby is one of the most worrisome things for any newly pregnant woman. But you can reduce that anxiety by dividing your questions into two sets. One list will involve objective factors, the other will cover issues that are not so easy to quantify.

You’ll want to investigate some immediate practical matters, such as whether a physician you are considering is part of your insurance company’s list. You’ll want to find out whether the doctor has a good relationship with the hospital you intend to use and whether that hospital accepts the same insurance coverage. As part of that research, you’ll want to find out whether billing, co-pay and other issues can be handled simply.

You’ll want a doctor that is likely to be available when and as you need him or her. The best physician is of no use to you if they can’t see you on short notice. Most pregnancies go from start to finish without a hitch, but when a doctor is needed, he or she is generally needed right away. If that person isn’t available, they should have a backup you trust in emergency situations.

You should ask any physician you’re considering how long they’ve been in practice, and what their C-section percentage is. Most are between 15-20%. This gives you some idea of their views on risk. You should ask also about their views on the use of anesthesia and other factors surrounding pain control.

Talking to nurses they’ve worked with (those at the hospital, not the ones employed by the doctor) is a good way to get some opinions. Be sure to ask more than one. Even the best physician won’t necessarily be the favorite of every nurse.

You’ll want to ensure that the physician you see regularly is the one who will deliver your baby. Avoiding surprises is near the top of any prospective mother’s list and a doctor who knows your history personally is essential. And, you’ll want to ensure that they will be present during the entire process. Doctors who flit in and out during labor don’t inspire confidence during stressful times.

But there are other, less cut and dried topics that you’ll want to explore, too.

It’s not necessary that the physician be Mister Rogers and a friend to all womankind. But they should treat you with respect and show genuine concern for your welfare. They should be willing to answer questions without being patronizing. You should feel at ease talking to them. That helps build confidence in their medical judgment.

They should be honest with you, without being unfeeling. Given a choice, most mothers would naturally want someone with excellent medical skills. That’s absolutely basic. But those skills can be exercised in many ways. Finding a physician that treats you as a complete person, not just a laboratory experiment to be properly completed, will put you more at ease.

Exploring a little bit about their general philosophy is not a bad idea. They don’t have to share your religion, your political views or your beliefs in general. But knowing they are someone you can ‘work with’ on a nearly year-long effort with such a hugely important outcome will make things go much smoother for all concerned.

Morning sickness can be one of your first signs that you are pregnant.  This doesn’t always mean that you’ll get sick only in the morning. This can happen, morning, noon or night. It will normally occur in the first trimester or your pregnancy and end by the second, this isn’t the case in all pregnancies though. Some women will continue with it until the very end of term.

Nausea can happen immediately or you may get lucky and have no morning sickness at all. No one is for certain what causes morning sickness, it is a change in the body that happens during pregnancy. Many women seem to get sick after taking the prenatal pill, try taking it later in the day. Your doctor may even advise you to take some other form of vitamin instead of the pill. Always find out first with your doctor before taking anything new or taking yourself off medication, even prenatal pills. Read the rest of this entry »

The First Trimester of Pregnancy is loosely defined as the first three months of pregnancy from the point of conception. During trimester you are going to experience a number of physical and emotional changes as well as some symptoms of pregnancy. One of the most common symptoms you will experience during this stage of pregnancy is morning sickness.

Although this is a common symptom of pregnancy not all women experience morning sickness. Every pregnancy is different, just because you experienced morning sickness with your first child doesn’t mean you will with the next. You will know what your symptoms will be until you experience them yourself. Read the rest of this entry »

The First Trimester of Pregnancy is loosely defined as the first three months of pregnancy from the point of conception. During trimester you are going to experience a number of physical and emotional changes as well as some symptoms of pregnancy. One of the most common symptoms you will experience during this stage of pregnancy is morning sickness. Although this is a common symptom of pregnancy not all women experience morning sickness. Every pregnancy is different, just because you experienced morning sickness with your first child doesn’t mean you will with the next. You will know what your symptoms will be until you experience them yourself.

Another common symptom during the first trimester is feeling tired. Make sure you get plenty of sleep and learn to relax. As your pregnancy progresses you will be glad that you did. If you feel tired rest, don’t try to over exhort yourself; remember it takes a lot of energy to create a new life. ? And remember to drink plenty of water. This will also help with constipation, yet another symptom you can expect to experience in the first trimester.

Many women also experience tenderness, swelling of the breasts and increased sensitivity during the first trimester and throughout there pregnancy. As your pregnancy progresses your breasts will naturally grow fuller as your body prepares for breasting feeding after your baby is born. In may be necessary to buy bra extenders to accommodate your growing breasts. It is important to make sure that you have a properly fitting bra throughout your pregnancy as your breasts change.