Pregnancy For Dummies, UK Edition

Dr Sarah Jarvis has been a GP for 20 years. She is the resident doctor on the BBC's The One Show, and a regular columnist for Good Housekeeping and My Weekly. Dr Roger Henderson has also been a GP for 20 years, and writes for The Sunday Times and the Sunday Mirror. He is also the medical consultant to the health website NetDoctor. Joanne Stone, MD, and Keith Eddleman, MD, are obstetrician-gynaecologists. Mary Duenwald is a veteran journalist.

• Introduction 1About This Book 1Conventions Used in This Book 2What You’re Not to Read 2Foolish Assumptions 3How This Book Is Organised 3Part I: The Game Plan 3Part II: Pregnancy: A Drama in Three Acts 4Part III: The Big Event: Labour, Delivery and Recovery 4Part IV: Special Concerns 4Part V: The Part of Tens 4Appendix 5Icons Used in This Book 5Where to Go from Here 6Part I: The Game Plan 7Chapter 1: From Here to Maternity 9Getting Ready to Get Pregnant: The Preconception Visit 9Taking a look at your history 10Evaluating your current health 11Answering Commonly Asked Questions 12Getting to your ideal body weight 12Reviewing your medications 13Considering herbal remedies and vitamin supplements 15Recognising the importance of vaccinations and immunity 16Quitting contraception 18Introducing Sperm to Egg: Timing Is Everything 19Pinpointing ovulation 20Taking an effective (and fun) approach 21Chapter 2: I Think I’m Pregnant! 23Recognising the Signs of Pregnancy 23Testing, Testing, 1, 2, 3 24Getting an answer at home 24Going to your GP for answers 25Antenatal and Labour Care – What’s Available? 25Where to have your baby 25Looking at your options: Private or NHS? 27Who’s Who? The Varying Roles of Health Care Professionals 28Your GP 28Your midwife 29Independent midwives 29Your obstetrician 29Maternal-foetal medicine specialists 30Your paediatrician 30Your health visitor 30Chapter 3: Preparing for Life during Pregnancy 31Working Out Your Due Date 32Planning Antenatal Visits 33Preparing for Physical Changes 36Spotting breast and bladder changes 36Coping with mood swings 36Living through leg cramps 37Noticing vaginal discharge 37Putting up with backaches 38Handling stress.38Understanding the Effects of Medications, Alcohol and Drugs on Your Baby 39Taking medications 39Smoking 40Drinking alcohol 41Using recreational/illicit drugs.41Looking at Lifestyle Changes 43Pampering yourself with beauty treatments 43Relaxing (or not) in hot tubs, saunas or steam rooms 44Travelling 45Getting dental care 46Having sex 47Working during Pregnancy: A Different Type of Labour 48Chapter 4: Checking Out Your Rights and Welfare Benefits 51Your Rights When You’re Having a Baby 52Discrimination against pregnant women 52Ordinary and additional maternity leave 52Financial Benefits during Pregnancy 53Statutory Maternity Pay 54Maternity allowances 54Sure Start Maternity Grants 55You and your Mat B1 55Entitlements as a New Parent 55Child Benefit 55Working Tax Credit 56Child Tax Credit 56Statutory Paternity Pay 56Chapter 5: Diet and Exercise for the Expectant Mother 57Looking at Healthy Weight Gain 57Determining how much is enough 58Avoiding weight obsession 59Understanding your baby’s weight gain 60Taking Stock of What You’re Taking In 61Using a healthy eating pyramid 61Supplementing your diet 63Determining Which Foods Are Safe 65Debunking popular food myths 65Identifying potentially harmful foods 65Considering Special Dietary Needs 68Eating right, vegetarian-style 68Combating constipation 68Dealing with diabetes 69Working Out for Two 69Adapting to your body’s changes 70Exercising without overdoing it 71Comparing forms of exercise 72Part II: Pregnancy: A Drama in Three Acts 75Chapter 6: The First Trimester 77A New Life Takes Shape 77Adapting to Pregnancy: Body Changes in the First Trimester 80Breast changes 81Fatigue 81Any-time-of-day sickness 82Bloating 83Frequent urination 84Headaches.84Constipation 85Cramps 85Booking Baby In: Your First Antenatal Appointments 86Understanding the consultation 86Considering the physical examination 90Looking at standard tests 90Your booking appointment – now it’s your turn! 93Recognising Causes for Concern 94Bleeding.94Miscarriage 95Ectopic pregnancy 97Chapter 7: The Second Trimester 99Discovering How Your Baby Is Developing 99Understanding Your Changing Body 101Forgetfulness and clumsiness 102Wind 102Hair and nail growth 102Heartburn 103Lower abdominal/groin pain 103Nasal congestion 105Nosebleeds and bleeding gums 105Skin changes 105Checking In: Antenatal Visits 107Recognising Causes for Concern 107Bleeding 107Foetal abnormality 108Incompetent cervix 108Identifying other potential problems 109Chapter 8: The Third Trimester 111Your Baby Gets Ready for Birth 111Movin’ and shakin’: Foetal movements 113Flexing the breathing muscles 113Hiccupping in utero 114Keeping Up with Your Changing Body 114Accidents and falls 114Braxton-Hicks contractions 114Carpal tunnel syndrome 116Fatigue 116Piles 117Insomnia 118Feeling the baby engage 118Pregnancy rashes and itches 119Preparing for breast-feeding 120Sciatica 121Shortness of breath 121Stretch marks 121Swelling 122Urinary stress incontinence 122Varicose veins 123Thinking about Labour 123Writing a birth plan 124Timing labour 124Using perineal massage 125Hitting the Home Stretch: Antenatal Visits in the Third Trimester 125Preparation for Parenthood Classes 126Recognising Causes for Concern 126Bleeding.127Breech presentation 127Decreased amniotic fluid volume 128Decreased foetal movement 128Foetal growth problems 128Leaking amniotic fluid 129Pre-eclampsia 130Preterm labour 130When the baby is late 130Getting Ready to Head to the Hospital 131Packing your suitcase131Choosing – and using – a car seat 132Chapter 9: Understanding Antenatal Testing 135Non-Invasive (Screening) Tests 136Screening for alpha-foetoprotein 136Screening for Down’s syndrome 137Screening with ultrasound scans 138Understanding screening accuracy 139Invasive Tests for Foetal Abnormalities 140Amniocentesis 141Chorionic villus sampling 144Other Antenatal Tests and Procedures 145Foetal echocardiogram 145Doppler studies 145Cardiotocography 145Doppler velocimetry 146Foetal blood sampling 146Part III: The Big Event: Labour, Delivery and Recovery 147Chapter 10: I Think I’m in Labour!      149Knowing When Labour Is Real – and When It Isn’t 149Noticing changes before labour begins 150Telling false labour from true labour 151Deciding when to call the labour ward or your practitioner 152Checking for labour with an internal examination 153Getting Admitted to the Hospital 154Monitoring Your Baby 155Foetal heart monitoring 155Other tests of foetal health 156Nudging Things Along: Labour Induction 156Inducing labour 158Augmenting labour 158Getting the Big Picture: Stages and Characteristics of Labour 159The fi rst stage 159The second stage 162The third stage 162Handling Labour Pain 163Breathing exercises 163TENS 164Gas and air 164Pethidine and meptid 164Epidural 164General anaesthetic 166Considering Alternative Birthing Methods 166Delivering without drugs – natural childbirth 166Giving birth at home 167Immersing yourself in a water birth 167Chapter 11: Special Delivery: Bringing Your Baby into the World   169Having a Vaginal Delivery 169Pushing the baby out 171Getting an episiotomy 173Handling prolonged second-stage labour 175The big moment: Delivering your baby 175Delivering the placenta 176Repairing your perineum 176Assisting Nature: Operative Vaginal Delivery 177Having a Caesarean Delivery 178Understanding anaesthetics 179Looking at reasons for caesarean delivery 180Recovering from a caesarean delivery 181Congratulations! You Did It! 182Shaking after delivery 182Understanding postpartum bleeding 182Hearing your baby’s first cry 183Cutting the cord 183Checking your baby’s condition 183Chapter 12: Hello, World! Your Newborn 185Looking at Your Bundle of Joy – Goo, Blotches and All 185Vernix caseosa 186Caput and moulding 186Black-and-blue marks 187Blotches, patches and more 187Baby hair 188Extremities 188Eyes and ears189Genitalia and breasts 189Umbilical cord 190Newborn size 190Baby begins to breathe 190Knowing What to Expect in the Hospital 191Preparing baby for life outside the womb 191Understanding baby’s developing digestive system 192Considering circumcision 192Spending time in the neonatal intensive care unit 193Checking In: Baby’s First Doctor’s Visit 194Considering heart rate and circulatory changes 194Looking at weight changes 195Bringing Baby Home 195Settling Baby in at Home 196Bathing 196Burping 197Sleeping and sudden infant death syndrome (SIDS) 198Crying 199C is for colic 200Newborn jaundice 200Dummies (For Dummies) 201Preventing newborn injuries 201Shopping for the baby 201Registering Your Baby’s Birth 202Recognising Causes for Concern 203Chapter 13: Taking Care of Yourself after Delivery 205Recuperating from Delivery 206Looking and feeling like a new mum206Understanding postnatal bleeding 206Dealing with perineal pain 207Surviving swelling 209Coping with your bladder 209Battling the haemorrhoid blues 210Understanding postnatal bowel function 210Continuing to recover at home 211Recovering from a Caesarean Delivery 211Going to the recovery room 211Taking it one step at a time 212Understanding post-caesarean pain 213Dealing with post-op pain 214Getting ready to go home 214Continuing to recover at home 214The Party’s Not Over: More Postnatal Changes 216Sweating like a new mum 216Dealing with breast engorgement 217Understanding hair loss 217Chasing away the baby blues 217Recognising postnatal depression 219Returning to ‘Normal’ Life 220Getting fi t all over again 220Losing the weight 221Pondering your postnatal diet 222Doing pelvic floor exercises 223Having sex again 223Choosing contraception 224Chapter 14 : Feeding Your Baby 225Deciding between Breast and Bottle 225Considering the advantages of breast-feeding 226Checking out the benefits of bottle-feeding 227Latching onto Breast-feeding 228Looking at the mechanics of lactation 229Checking out breast-feeding positions 230Getting baby to latch on 230Orchestrating feedings 232Maintaining your diet 234Looking at options for contraception 235Determining which medications are safe 235Handling common problems 235Bottle-feeding for Beginners 239Stopping milk production 239Choosing the best bottles and nipples 239Feeding your baby from a bottle 240Dealing with Baby’s Developing Digestive System 242Part IV: Special Concerns 245Chapter 15: Pregnancies with Special Considerations 247Figuring Out How Age Matters 247Over-35 (or older) mums 247Not-so-young dads 248Very young mums 250Having Twins or More 250Looking at types of multiples 251Determining whether multiples are identical or fraternal 251Down’s syndrome screening in pregnancies with twins or more 252Genetic testing in pregnancies with twins or more 252Keeping track of which baby is which 253Living day-to-day during a multiple pregnancy 254Going through labour and delivery with twins 255Covering special issues for mums with multiples 256Getting Pregnant Again 259Realising how each pregnancy is different 260Giving birth after a prior caesarean delivery 261Preparing Your Child (or Children) for a New Arrival 262Explaining pregnancy 263Making baby-sitting arrangements for your delivery 264Coming home 264Chapter 16: When Things Get Complicated 267Dealing with Preterm Labour 267Checking for signs of preterm labour269Stopping preterm labour 269Preventing preterm labour 269Delivering the baby early 270Handling Pre-eclampsia 270Understanding Placental Conditions 271Placenta praevia 272Placental abruption 273Recognising Problems with the Amniotic Fluid and Sac 274Too much amniotic fluid 274Too little amniotic fluid 275Rupture of the amniotic sac 275Describing Problems with Foetal Growth 276Smaller-than-average babies 277Larger-than-average babies 278Looking at Blood Incompatibilities 279Dealing with Breech Presentation 280Pondering Post-Date Pregnancy 281Chapter 17: Pregnancy in Sickness and in Health 283Getting an Infection during Pregnancy 283Bladder and kidney infections 283Chickenpox 285The common cold 286German measles (rubella) 287Herpes infections 287Human immunodeficiency virus (HIV) 287Tummy bugs (gastroenteritis) 288Vaginal infections.288Handling Pre-Pregnancy Conditions 289Asthma 289Chronic hypertension 290Deep-vein thrombosis and pulmonary embolus 290Diabetes 291Fibroids 293Seizure disorders (epilepsy) 293Thyroid problems 294Chapter 18: Coping with the Unexpected 297Surviving Recurrent Miscarriages 297Coping with Late-Pregnancy Loss 299Dealing with Foetal Abnormalities 299Finding Help 300Beginning to Heal 301Part V: The Part of Tens 303Chapter 19: Ten Things Nobody Tells You 305Pregnancy Lasts Longer than Nine Months 305Other People Can Drive You Crazy 306You Feel Exhausted in the First Trimester 306Round Ligament Pain Really Hurts 306Your Belly Becomes a Hand Magnet 307Piles Are a Royal Pain in the . . . 307Sometimes Women Poo While Pushing 307The Weight Stays On after the Baby Comes Out 308Hospital Towels are Relics from Your Mother’s Era 308Breast Engorgement Really Sucks 308Chapter 20: Ten (Or So) Old Wives’ Tales 309The Old Heartburn Myth 309The Mysterious Umbilical Cord Movement Myth 309The Curse Myth 310The Heart Rate Myth 310The Ugly Stick Myth 310The Coffee Myth 310The Myth of International Cuisine 310The Great Sex Myth 311The Round Face Myth 311The Ring Myth 311The Moon Maid Myth 312The Belly Shape Myth 312The Ultrasound Tells All Myth 312Chapter 21: Ten Landmarks in Foetal Development 313The Baby Is Conceived 313The Embryo Implants Itself 313The Heart Begins Beating 314The Neural Tube Closes 314The Face Develops 314The Embryonic Period Ends 314The Sexual Organs Appear 314Quickening Occurs 315The Lungs Reach Maturity 315A Baby Is Born 315Chapter 22: Ten Key Things You Can See on Ultrasound 317Measurement of Crown-Rump Length 317The Face 318The Spine 319The Heart 319The Hands 320The Foot 321The Foetal Profile 321The Stomach 322It’s a Boy! 322It’s a Girl! 323Appendix: The Pregnant Man: Having a Baby from a Dad’s Perspective  325Reacting to the News 325Knowing What to Expect from the First Trimester 326Watching Mum Grow – the Second Trimester 327Under Starter’s Orders – the Third Trimester 327Dad in the Delivery Room 328Home at Last – with Your New Family 330Index 331