Choosing a Car Seat
Buy a car seat for your baby early so she can have a safe ride home from the hospital. Remember to read and follow both the seat manufacturer's and the car manufacturer's recommendations for use. Always keep your baby buckled up for safety and follow these car safety guidelines from the American Academy of Pediatrics:

• The safest place in any car is the back seat.
• Infants should ride in a rear-facing infant seat in the back seat until they are at least one year old and weigh at least 20 pounds.
• Never place a rear-facing child seat in a seat protected by an airbag.
• Children older than one year and weighing at least 20 pounds may ride in forward-facing car seats secured in the back seat.
• Children weighing 40 to 80 pounds should ride in a booster seat in the rear seat of the vehicle until the vehicle's lap and shoulder belt fit them properly.

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Pregnancy Complications
Creating a new life is a complicated process. While some women go through pregnancy almost without noticing it, most experience some common side effects. These problems usually can be treated at home. Some women, however, experience complications that require medical attention. Identifying and treating them early are often vital to completing a full-term pregnancy and delivering a healthy baby.

The information in this section will help you recognize and deal with some of the common pregnancy complications.

These are the topics we'll cover in this section:
Common Side Effects of Pregnancy
Incompetent Cervix/Cerclage
Chronic High Blood Pressure
The Miscarriage Threat
Premature Rupture of Membranes
Preeclampsia
Bed Rest
Diabetes during Pregnancy
Recognizing and Dealing with Preterm Labor

Common Side Effects of Pregnancy
Here are some common discomforts of pregnancy and what you can do to help: Tender Breasts Wear a support bra. It may help to wear a bra 24 hours a day.

Leaking Breast
Wear nursing pads or tissues in your bra.

Frequent Urination
Limit fluids before bedtime. Avoid fluids with caffeine, such as coffee, tea, and soda

Fatigue
Fatigue is common early and late in pregnancy. If advised, try to exercise each day to help keep your energy level up.
Lie down at least once a day.

Low Backache
Rest often. Use good posture. Move around. Do not stand in one place too long. Use a footstool for your feet when sitting. Keep your knees higher than your hips. Wear low-heeled shoes. Use the pelvic-rock exercise.

Vaginal Discharge, Itching, Odor
Bathe the outer vaginal area often. Use soap without perfume. Do not use vaginal sprays, powders or feminine hygiene products. Do not use colored or perfumed toilet paper. Wear cotton panties.
Avoid pantyhose, girdles and tight pants. If these hints do not help, talk with your health care provider.

Dizziness
Change your position slowly. Get up slowly after you have been lying down. Eat regular meals and drink plenty of liquids. Do not stay in the sun. Report any dizziness to your health care provider.

Varicose Veins
Avoid stockings or girdles with elastic bands. You may use support hose. Put support hose on while lying down. Take short rests with legs raised. Raise your legs when you sit down; do not cross your legs.

Shooting Pains Down Legs
Change positions; if you are sitting, stand up; if you are standing, sit down.

Lower Leg Cramp
Elevate legs often during the day. Point toes upward and press down on kneecap. Apply a heating pad or hot-water bottle for relief. Avoid heavy meals at bedtime.

Increased Secretions (Mucus—nose/throat/mouth)
Take care of these problems as best you can without using drugs. Do not use over-the-counter medicine without first checking with your health care provider.

Feel Faint While Lying on Back
Lie on your left side.

Feet and Hand Swelling
Lie on your left side for 30 minutes, three to four times a day.
Exercise often. Drink more fluid. Eat three servings of protein each day. If you wake up in the morning with swelling, tell your health care provider.

Bleeding Gums
Use a soft toothbrush and brush gently. Drink more orange juice and eat more foods high in vitamin C.

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Incompetent Cervix/Cerclage
Cerclage is a stitch put in the cervix (neck of the uterus) to prevent it from opening (dilating) early. If the cervix does not stay closed until you are ready to deliver your baby, a miscarriage or a premature birth may occur. Cerclage is done under anesthesia in the hospital during the second trimester of pregnancy (14 to 24 weeks). You may stay in the hospital 1 to 2 days after the surgery or go home the same day.

What causes the cervix to open early?
Early dilation of the cervix usually happens when labor begins before the baby is full-term. If labor begins early, medicine is used to stop the contractions and prevent further dilation. In some women, the cervix may dilate painlessly without contractions. This condition may be caused by a weak cervix ("incompetent cervix"). This weakening usually occurs between 16 and 24 weeks of pregnancy.

Women at risk of developing a weak cervix include:
• Women with a history of D&C (dilation and curettage) for abortion, miscarriage or other reason.
• Daughters of women who took DES, a hormone used to prevent
miscarriages.
• Women who have had surgery on the cervix.
• Women with damage to the cervix from previous births.

How will my prenatal care be different if I have cerclage?
Your doctor may recommend you do some or all of the following:
• Lie down on your left side for 1 hour twice a day. Your doctor may want you to have more bed rest.
• Discontinue physical sports or activities. This includes jogging, running, tennis, long walks, heavy lifting or frequent trips up and down stairs. Avoid heavy cleaning, including scrubbing floors, changing curtains and moving furniture. Ask your doctor about long trips by car or other means of transportation.
• Sexual activity may often be limited or stopped.
• Your visits to your doctor will be every 1 to 3 weeks. Your cervix will be checked at each visit. It is important to come to every appointment.

When should I call my doctor?
Call your doctor if you have:
• Symptoms of preterm labor, such as cramping, low backache,
contractions or tightening of the abdomen, pressure in lower back,
abdomen or thighs, increase or change in vaginal discharge
• Any vaginal spotting or bleeding
• Breaking or leaking of the bag of waters
* Any foul-smelling vaginal discharge

When will the cerclage be removed?
For some types of cerclage, your doctor will remove the stitch around 37 weeks into your pregnancy. This will allow you to have a vaginal delivery. The stitch can be removed in the doctor's office. You will not need anesthesia. You may go into labor within a few hours after the stitch is removed, or your pregnancy may continue for 2 to 3 weeks. If you are planning to have another baby, another cerclage will be placed during that pregnancy.

For other types of cerclage, the stitch may be left in place and the baby delivered by cesarean section. The same cerclage may be used for another pregnancy. Ask your doctor which type of cerclage is best for you.

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Chronic High Blood Pressure
Controlling high blood pressure (hypertension) is important when you are pregnant. If you have high blood pressure and are pregnant, get lots of rest. Continue to take your blood-pressure medicine as prescribed by your doctor, even if you feel good. Hypertension often has no symptoms. You can still feel good with a blood pressure that is dangerously high.

Effects of High Blood Pressure on You and Your Baby
Uncontrolled high blood pressure can cause the placenta to work improperly. This may result in having a small baby who may be ill. For these reasons your doctor will be checking your baby closely with special tests when you are 8 months pregnant.

Stroke, heart, lung and kidney problems can occur if high blood pressure is uncontrolled. It is very important to control your high blood pressure by following your plan of care.

Ways to Help Control Your High Blood Pressure
Get plenty of rest. Rest 1 to 2 hours mid-morning and 1 to 2 hours mid- afternoon. Lying on your left side allows your baby to get the most oxygen and nutrients. Taking long rest periods can be difficult, especially if you have small children at home or if you work. If this is a problem, ask your health care professional for helpful suggestions.

Learn to take your own blood pressure at home so that you can check how you are doing. A nurse can help you learn this skill. You may need medicines to control your high blood pressure even if you feel good. DO NOT STOP taking your medicines without first talking to your doctor.

Eat well-balanced meals that are high in protein. Examples of high-protein foods are meats, fish, eggs, peanut butter, milk and dried beans. Also, do not add salt to your diet. A dietitian can help you plan meals for your high blood pressure and pregnancy. Keep all your doctor appointments to know how well you are doing.

Medicines
A medicine is often given for chronic high blood pressure in pregnancy. This medicine may cause drowsiness. It may also cause dizziness if you stand up too quickly. Stand up slowly and avoid standing for a long time.

Diuretics (water pills) are usually not used during pregnancy.

Other medicines or a change in your medicines may be necessary as your pregnancy progresses. Follow your doctor's orders carefully.

Complications of Chronic High Blood Pressure
When you have chronic high blood pressure, there is more chance of developing pregnancy-induced hypertension (PIH, or toxemia). You will be checked for signs that PIH may be developing.

These signs include:
• Protein in your urine
• An increase in your blood pressure
Call your doctor immediately if you notice any of the following symptoms or
have any questions or concerns:
• Rapid weight gain (greater than 2 lb. a week)
• Swelling of the face, eyes, feet, or hands
• Severe headache
• Severe stomach pain
• Blurry vision or seeing spots
• Seizures

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The Miscarriage Threat

A miscarriage, or "spontaneous abortion" in medical terms, is the loss of pregnancy before 20 weeks. Fifteen to twenty percent of all pregnancies end in miscarriage during the first 13 weeks (first trimester). Most miscarriages cannot be prevented.

Causes of Miscarriage
The cause of miscarriage is often not known.

Factors causing miscarriage can be:
• Genetic—at least half of miscarriages are caused by problems with the
chromosomes of the fetus (developing baby). This may be nature's way of ending a pregnancy in which the fetus was not developing normally and would not have been able to survive.
• Mother’s health—if a woman has a chronic disease such as high blood pressure or diabetes, she may have higher risk for miscarriage. Infections of the female organs (especially sexually transmitted diseases) often cause no symptoms but may affect the uterus and fetus, ending pregnancy. Problems with the mother's hormones or cervix (opening to the uterus) could increase the risk of miscarriage.
• Lifestyle—women who smoke, drink alcohol frequently or use illegal drugs, especially cocaine, increase their risk of miscarriage.
• Trauma—accidents and physical abuse can cause miscarriage. Most aspects of daily living do not cause miscarriages. A miscarriage usually does not mean a woman cannot have more children or that there is something wrong with her health.

The following are helpful actions your doctor may suggest to help speed your recovery:
• Rest as much as possible.
• Avoid heavy lifting.
• Do not douche, use tampons, or have sexual intercourse until your doctor recommends.
• Keep track of the number of sanitary pads you use.
• Be sure to keep regular prenatal visits with your doctor. Women who have had a threatened miscarriage have found that the support of husbands, families, and friends can be helpful in getting through
this stressful time.

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Premature Rupture of the Membranes (PROM)
Premature rupture of the membranes is the early leaking of fluid from the membrane (sac) around the baby. This leaking of fluid may be a gush or trickle. The fluid comes out of your cervix (opening of the uterus) and down your vagina. The leaking may come and go. You cannot stop or control the leaking.

If you have leaking from your vagina, call your doctor immediately. Your doctor will explain the possible problems and will encourage you to participate in the decision about your treatment.

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Preeclampsia
Preeclampsia ("pre-ee-clamp-see-ah"), which is also called toxemia, is a problem that occurs in some women during pregnancy. It usually occurs in the second half of pregnancy. Your doctor will look for these signs of preeclampsia: high blood pressure, swelling that doesn't go away and large amounts of protein in your urine.

Who is at risk for preeclampsia?
Preeclampsia is more common in a woman's first pregnancy and in women whose mothers or sisters had preeclampsia. The risk of preeclampsia is higher in women carrying multiple babies, in teenage mothers and in women older than 40 years. Other women at risk include those with high blood pressure, diabetes or kidney disease. The cause of preeclampsia isn't known.

My doctor says my blood pressure is high. Does that mean I have preeclampsia?
Not necessarily. If your doctor sees that your blood pressure is high, he or she will watch you closely for changes that could mean you have preeclampsia. In addition to hypertension, preeclampsia often has two more related problems, protein in the urine and excessive swelling. But many women with high blood pressure during pregnancy don't have protein in their urine or extreme swelling and don't develop preeclampsia.

Swelling alone doesn't necessarily mean you have preeclampsia. Some swelling is normal during pregnancy. For example, your rings or shoes might become too tight. Swelling is more serious if it doesn't go away after resting, if it's very obvious in your face and hands or if it's a rapid weight gain of 2 or more pounds in a week.

What tests can show if I have preeclampsia?
No single test diagnoses preeclampsia. Your blood pressure will be checked at each doctor's visit. A big rise in your blood pressure can be an early sign that you might have preeclampsia. A urine test can tell if there is protein in your urine. If you have signs of preeclampsia, your doctor may check frequently for these problems.

What are the risks of preeclampsia to the baby and me? Preeclampsia can prevent the placenta (which gives air and food to your baby) from getting enough blood. If the placenta doesn't get enough blood, your baby gets less air and food. This can cause low birth weight and other problems for the baby.

Most women with preeclampsia deliver healthy babies. A few develop a condition called eclampsia (seizures caused by toxemia), which is very serious for the mother and baby, or other serious problems. Fortunately, preeclampsia is usually detected early in women who get regular prenatal care, and serious problems can be prevented.

What is the treatment for preeclampsia?
If you have preeclampsia, delivery of the baby is the best way to protect both you and your baby. This isn't always possible, because the baby may be too little to live outside of the womb.

If delivery isn't possible, steps can be taken to manage the preeclampsia until the baby can be delivered. These steps include lowering your blood pressure, with bed rest or medicines, and keeping a close eye on you and your baby. In some cases, hospitalization may be necessary.

One way to control high blood pressure when you're not pregnant is to cut the amount of salt you eat. This isn't a good idea if you have high blood pressure during pregnancy. Your body needs salt to keep up the flow of fluid in your body, so you need a normal intake of salt. Your doctor will tell you how much salt to eat each day and how much water you should drink each day. Your doctor might tell you to lie on your left side while you are resting to increase the flow of urine and take weight off your large blood vessels. Often a 1- to 2-hour nap midmorning and one mid-afternoon nap are recommended.

If my doctor decides to deliver the baby early, do I have to have a cesarean delivery?
This is up to your doctor and you. A cesarean section (an operation to deliver the baby) is more likely if your health or your baby's health is in danger. If things aren't this serious, your doctor may use medicine to start your labor, and you can deliver your baby vaginally.

Symptoms of Preeclampsia

If you have any of these symptoms, call your doctor right away:
Severe headache
Pain in the abdomen (tummy)
Excessive swelling of the face, eyes, feet, and hands
Blurry vision or seeing spots
Blood in the urine
Seizures

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Bed Rest
If your doctor prescribes bed rest during your pregnancy, a physical therapist will review with you the value of energy conservation, proper body mechanics and posture. He or she may also help you simplify your self-care and daily activities to meet your restrictions. You may be given a simple exercise program to help keep your muscles toned and improve your circulation.

Saving Energy and Moving in a Hospital Bed
• To avoid overusing your abdominal muscles, be aware of how you move in bed, onto the bedpan or commode, and how you get in and out
of bed during self-care.
• To move from side to side in bed, keep your head on the pillow and roll like a log.
• To sit up in bed, keep your head on the pillow and use the up button on your electric hospital bed. Roll to one side. Use both arms to push yourself up to a sitting position while you swing your legs over the edge of the bed. Never sit straight up without using your hands or turning to one side first.
• To get onto and remove a bedpan, lie flat on your back in bed and keep your head on the pillow. Bend both knees, put both your feet flat on the bed, and then lift your hips. Slide the bedpan underneath you. To use the bedpan more comfortably, slightly raise the head of the electric bed. Remove the bedpan in the same way, with the bed flat.

If you are allowed to get out of bed to use the bathroom or sit in a chair, remember not to stand up quickly, because you may feel dizzy and weak.
Sit on the side of your bed for a few minutes and try:
• Chin tucks
• Shoulder circles
• Ankle pumping
• Taking two or three deep breaths
• Asking for help to get up

Comfort Measures While on Bed Rest To prevent muscle discomfort while staying in bed, use pillows and the electric bed controls, if available, to reduce muscle strain and over- stretching. Be aware of how you are positioned in bed. If you are comfortable while you are on bed rest, you will feel better about your pregnancy.

Avoid positions that can cause over-stretching and strain of muscles and ligaments at any of your joints. You can feel strain in your shoulders, neck, hips, pelvis or stomach.

While you are in bed, no matter what position, try to keep your spine as straight as possible. Twisting or sagging of your spine can cause muscle strain. Keep your joints supported.

To make yourself more comfortable when lying flat, place a small towel roll at your lower back to provide added support.

Lying on your left side is the best position for the most blood flow to your uterus and the baby. Place a pillow under your stomach, between your knees, or behind your back to avoid strains. Ask your nurse for extra pillows.

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Diabetes During Pregnancy

Diabetes (onset before pregnancy)
Diabetes can trigger several pregnancy complications. If you are diabetic and become pregnant, the best way to avoid these complications is by closely monitoring and controlling your blood sugar levels before, during, and after your pregnancy. Because of physical and hormonal changes in your body during pregnancy, your diet and insulin needs will change as your pregnancy progresses.

First trimester: Your insulin needs may drop during the first trimester (3 months) because your baby will be using some of your blood sugar. You also may have morning sickness and eat less than usual. Because of this, you must take care to prevent hypoglycemia (low blood sugar). Be sure not to skip meals or snacks because of nausea—eating frequent, small meals may actually help ease the nausea associated with morning sickness. To help prevent hypoglycemia, keep a snack with you at all times and watch for these signs:

• Nervousness
• Drowsiness
• Sweating
• Weakness
• Hunger
• Headache
• Fast heartbeat

You will become familiar with your own signs of low blood sugar. When you begin to experience symptoms, eat a carbohydrate, such as crackers
and fruit, or drink a glass of milk.

Second trimester: Around the fourth month, your insulin needs may increase, because the placenta begins to make hormones that affect how insulin works in your body. Your doctor can tell you how to adjust the dose and types of insulin that you need.

Third trimester: Your baby will grow quickly during your last three months of pregnancy. Placental hormones, along with the additional food you need to eat to support your baby's rapid growth, may cause your insulin needs to increase. In fact, if you have Type 1 diabetes, your insulin requirements at this time may be double or triple your prepregnancy needs. Your doctor can help you determine the level that is right for you.

Gestational Diabetes
Gestational diabetes—or high blood sugar during pregnancy—usually develops in the last six months of pregnancy and usually goes away after your baby is born. Some women develop gestational diabetes because their bodies cannot produce enough insulin to handle the higher blood sugar levels stimulated by the placental hormones during pregnancy. Like mothers with Type 1 or Type 2 diabetes, mothers with gestational diabetes can help avoid pregnancy complications by keeping their blood sugar under control during pregnancy. This is done by closely monitoring your blood sugar levels and following the diet and exercise plan prescribed by your doctor.

You May Be Wondering...

Can I still have a healthy baby if I have diabetes?
Yes, you can have a healthy baby. The most important thing is to keep your blood glucose level as close to normal as possible. Carefully follow your doctor's advice about diet and exercise. Frequent checks on both you and your baby will help ensure a healthy pregnancy.

Will I have complications?
In general, keeping your blood glucose levels under control before and during pregnancy will help limit the potential for complications.

What are the chances of my baby having diabetes?
The chances of your baby having diabetes at birth are very small. Most children of mothers with Type 1 diabetes or gestational diabetes never develop diabetes. Babies whose mothers have Type 2 diabetes could possibly develop diabetes later in life. Discuss concerns you might have about your baby and diabetes with your doctor.

Will I be able to breastfeed my baby?
Absolutely! Most mothers with gestational diabetes will have normal blood sugar levels soon after delivery. In mothers with insulin-dependent diabetes, insulin requirements will need to be adjusted as breastfeeding becomes established.

The good news is that whatever type of diabetes you have, adjustments in diet and medication can be made so that you can offer your baby your own breast milk. Your doctor, nurse, or dietitian will help you adjust your diet and insulin doses to meet your nutritional needs and those of your baby.

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Recognizing and Dealing With Preterm Labor

Sometimes babies surprise us right from the start and arrive well before their due date. While most women give birth within the 2 weeks before or after their baby's due date, approximately 7 to 11 percent of births in the United States are early orpreterm (premature). The cause of preterm labor is unknown. It can happen to any woman during any pregnancy. Births are considered premature or preterm if a baby is born between the 20th and 37th weeks of pregnancy. An early delivery can cause the baby to have problems with breathing, eating, and keeping normal body temperature. The birth of a premature baby can affect you and your child for many years to come. Early treatment of preterm labor may prevent preterm birth.

Who is at risk for preterm labor?
The following conditions may increase your risk of preterm labor:
• A history of preterm labor or preterm delivery in a past pregnancy
• Multiple births expected with the current pregnancy
• Having an abnormally shaped uterus
• If your mother took a hormone called DES to prevent miscarriages
• Two or more second-trimester abortions or miscarriages
• A weak or incompetent cervix
• Previous surgery on the cervix, such as a cone biopsy
• Severe kidney or bladder infections
• Bleeding problems with this pregnancy (after 14 weeks)
• Cervical dilation (opening) or thinning before 30 weeks
• Frequent uterine contractions before 30 weeks

If you are at risk of having preterm labor, your doctor will see you more often. You will be asked about symptoms of preterm labor and your cervix will be checked on each visit. These findings will be discussed with you. Suggestions will be made, if necessary, to change your daily activities.

What are the symptoms of preterm labor?
Each of the following may be a sign of preterm labor:

Uterine contractions, which are the tightening and relaxing of the muscle of the uterus. Contractions occur normally throughout pregnancy as the uterus stretches and grows. These "normal" contractions happen a few times a day and when you change your position. Uterine contractions that cause preterm labor occur in a regular pattern and are more frequent (every 10 minutes or less). They may be painless, but can cause your cervix to open.

Low, dull backache. The backache may come and go or be constant. It can be felt below the waist and is not relieved after lying down.

Menstrual-like cramps. The cramping feeling occurs in the lower abdomen just above the pubic bones. It may come and go or be constant. It may feel like the beginning of your menstrual period.

Pressure in the lower abdomen, back or thighs. This pressure may feel like a heaviness in the pelvis or like the baby is pushing down.

Increase or change in vaginal discharge. Vaginal discharge is normally thick and white during pregnancy. It may increase in amount or become more watery or lightly bloody.

Intestinal cramping. You may have the feeling of "gas pains," and cramping may be with or without diarrhea.

A general feeling that something is not right or you are not feeling well.

How will I know if I'm having contractions?
Because the early warning signs of preterm labor may not be painful, check your uterus every day for contractions. Twice a day for 30-minute periods, lie down on your left side and place both of your hands on your abdomen. If your uterus is contracting, you will feel your entire abdomen get tight (hard) and then relax (soften). Note the time each contraction starts, how long it lasts and when the tightening occurs. Check for any of the other warning signs of preterm labor.

What should I do if I'm having uterine contractions or other symptoms of preterm labor?
• Lie down on your left side for 1 hour.
• Drink 4 to 5 cups of fluid during that hour.
• Feel your abdomen for contractions and check for other signs of preterm labor.

If you have four or more contractions in one hour or any of the other
warning signs after rest and fluids, call your doctor or hospital. Do not wait
any longer than one hour for the symptoms to go away. You need to go to
the hospital to get medicine to stop preterm labor.

Call your doctor or hospital immediately if you have:
• Bleeding
• Fluid leaking from your vagina
• Change in vaginal discharge
• Frequent contractions (every 5 minutes or less)

Can I prevent preterm labor?
The following measures may be helpful in preventing preterm labor:
• During your pregnancy, lie down on your left side for one hour twice a day. Your doctor may want you to have more bed rest if needed.
• Drink 8 to 10 cups of water or juice each day. If you are having contractions or symptoms of preterm labor, drink 4 to 5 more cups of fluid.

If your doctor feels you are at risk for preterm labor:
• Do not participate in physical sports or activities including jogging, bicycling, tennis, long walks or frequent trips up and down stairs.
• Do not lift heavy grocery bags or laundry baskets.
• Do not do heavy cleaning, including mopping or scrubbing floors, vacuuming, changing curtains or moving furniture.
• Discuss long trips by car or other means of transportation with your doctor.
• Sexual activity may have to decrease or stop, depending on your medical condition. Report any symptoms of preterm labor that continue for more than one hour after sexual activity.
• You can attend childbirth education classes unless your doctor has ordered complete bed rest. However, do not do the physical exercises except for the breathing activities.
• Avoid excessive breast stimulation. Breast stimulation releases hormones that may cause contractions.
• Stress may cause preterm labor in some women. Discuss stressful or anxious situations with your support person, doctor or nurse. Referrals for help can be made if needed.
* Work outside the home may have to decrease, change, or be stopped.

This depends on the type of job you have and your risk of preterm
labor. Discuss your job with your doctor early in your pregnancy.

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A portion of the information contained within this page has been taken from patient education material from www.medicalcenter.osu.edu. © the Ohio State University Medical Center, Columbus, Ohio. All rights reserved.

The information contained in the www.medicalcenter.osu.edu website is provided as a public service by The Ohio State University Medical Center. It is posted for informational and educational purposes only. This information should not be construed as personal medical advice. Because each person’s health needs are different, a physician should be consulted before acting on any information provided in these materials. Although every effort is made to ensure that this material is accurate and up-to-date, it is provided for the convenience of the user and should not be considered definitive.

Sex During Pregnancy

Physical and emotional changes are part of pregnancy. If this is your first child, you may not know that this may be a time of mood swings—for you and the father of the baby. You may feel tired, excited, happy, depressed, hopeful, scared, motherly and beautiful or uncomfortable and unattractive. The father, on the other hand, may feel proud at having fathered a child or may be anxious about new responsibilities. He may feel protective toward you and the growing baby or jealous of your new concentration on the pregnancy.

These mood changes may affect how you feel about each other and your desire for sex. The most important thing is not what you feel, nor how silly you think it is, but sharing those feelings with each other.

These are the topics we'll cover in this section:
Questions that May Trouble Pregnant Women
A Question that May Trouble Expectant Fathers

Questions That May Trouble Pregnant Women

Will my desire for sex be lessened during pregnancy?
No two women feel the same way during pregnancy. For most women, pregnancy does not change their interest in sex. For some women, birth control was an interruption, and pregnancy may be a period of freedom. At certain times, some women may feel they are "losing their figure and looks" during pregnancy. They may shy away from lovemaking, feeling less desirable. Or they may want sex more often than usual as reassurance that their partner still loves them and finds them attractive.

Occasionally, a woman does not want to make love while pregnant. This may be due to a fear of hurting the baby. These feelings usually go away after the baby is born.

Can vigorous (energetic) sex harm the baby?
It is almost impossible to harm the baby in the uterus by having sex. The water that the baby floats in, the membranes that hold the water, the womb, the abdominal wall and the bony pelvis serve to protect the baby from being hurt.

Is it harmful to have a climax (orgasm) during pregnancy?
Orgasm is not harmful to your baby.

How often is it safe to have sex during pregnancy?
How often you have sex will not affect you or your baby, unless you have high-risk problems and you have been told not to have sex. Couples make love at different rates and even vary from month to month. Some women are not interested in sex during the first few months of pregnancy. This may be due to tiredness and changes in hormones. These feelings often change after the first trimester, when your energy level and desire for sex may increase.

Can I have sex anytime during pregnancy?
Sex is usually allowed throughout pregnancy until the last few weeks. Some doctors feel that during the last few weeks, sex may cause premature rupture of the membranes. Many doctors have strong feelings
about the answer to this question. It is best for you to follow your own doctor's advice.

Sex should be stopped and you should call your doctor if:
• Your water leaks or bag of waters breaks.
• You have vaginal bleeding, itching or discharge.
• You feel pain in the vagina or abdomen.
• You have tightening in your uterus, contractions or premature labor.

The pressure during sex makes me uncomfortable, but I do not have pain. What should I do?
If your partner's weight is what is causing your discomfort, position changes will help. For instance, your partner may kneel over you, or approach you from the side or back, or you may sit on top of him. If you
feel pressure inside, do not allow your partner to move deeply into you. Position changes or putting pillows under you will change the way you are entered, which may also help. Using cream or jelly may help any vaginal discomfort.

I feel ugly and undesirable. My partner never tells me otherwise, and he does not cuddle me. What should I do?
Occasionally, some men are physically "turned off" during their partner's pregnancy. Usually this feeling is only temporary, and it should not be seen as a rejection. Your partner may have some other concerns and mixed feelings about this pregnancy, which may make him act indifferent and less caring. You also may be so involved with the life inside you that he may feel you are not interested in him. Talk to each other about these feelings.

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A Question That May Trouble Expectant Fathers

I have a need for sex, but since the pregnancy my partner is not interested in sex. This causes tension between us. What can we do?
Some form of compromise is the best solution. Talk about the problems and your feelings. Having sex less often or finding pleasure in a way that requires less complete participation on her part may be a solution. It is sometimes hard for a woman to feel interested in sex when she does not feel desirable. Tell her that she is still attractive and loved despite her bulging belly. This may increase her interest in sex.

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A portion of the information contained within this page has been taken from patient education material from www.medicalcenter.osu.edu. © the Ohio State University Medical Center, Columbus, Ohio. All rights reserved.

The information contained in thewww.medicalcenter.osu.edu website is provided as a public service by The Ohio State University Medical Center. It is posted for informational and educational purposes only. This information should not be construed as personal medical advice. Because each person’s health needs are different, a physician should be consulted before acting on any information provided in these materials. Although every effort is made to ensure that this material is accurate and up-to-date, it is provided for the convenience of the user and should not be considered definitive .

Alcohol, Drugs and Caffeine

These are the topics we'll cover in this section:
Alcohol
Cigarettes and Tobacco Products
Cocaine, "Crack" and Other Street Drugs
Medications and Caffeine
Other Precautions

Alcohol

The Surgeon General of the United States has recommended that women who are pregnant or are trying to become pregnant not drink alcoholic beverages. Especially in the early weeks and months of pregnancy, drinking alcohol increases the risk of birth defects and other abnormalities.

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Cigarettes and Tobacco Products
The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists (ACOG), and public health and lung associations all strongly support the warning that smoking may complicate pregnancy. According to the ACOG, smoking during pregnancy increases your risk of:

• Ectopic pregnancy
• Miscarriage
• Vaginal bleeding
• Placental attachment abnormalities
• Stillbirth
• Preterm delivery
• A low-birth-weight baby
• Deformed limbs and mental defects
And smoking around your baby after he's born puts him at higher risk to
develop asthma and for Sudden Infant Death Syndrome (SIDS). SIDS is a
term used to describe the unexplained death of babies in their sleep for no
known reason.
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Cocaine, "Crack" and Other Street Drugs
Don't take any street drugs. Some drugs can cause your baby to be born with an addiction, or to have birth defects. Babies need good food and oxygen to grow. If a pregnant woman uses any form of cocaine, including crack, she cuts the food and oxygen supply to the fetus. Severe lack of oxygen and food can stunt the growth of or even kill a fetus. If you're pregnant and have already used cocaine or other street drugs, stop now and talk to your doctor or nurse.

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Medications and Caffeine
Don't take any medicines while you are pregnant, including aspirin and laxatives, without your doctor's approval. This is particularly important in the first 12 weeks of pregnancy, when so many of your baby's organs are developing. Also, discuss the effects of caffeine with your doctor. Caffeine is found in coffee, tea, colas and other soft drinks, chocolate and some pain medicines. Your doctor may advise you to drink as little as possible of these beverages and to limit the amount of chocolate you eat.

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Other Precautions
• Avoid having x-rays taken during pregnancy.
• Avoid changing a cat's litter box and touching stray cats, to prevent a condition called toxoplasmosis.
• Always wash your hands after preparing meat for cooking, and do not eat raw or very rare meats.
• Make sure you take the prenatal vitamins prescribed by your doctor. Getting the proper balance of vitamins and minerals (especially folic acid) is important before and during pregnancy.

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