When you feel those first faint movements will vary widely from woman to woman and even from pregnancy to pregnancy.  Often times women will be able to recognize the faint flutters of movement earlier in second and subsequent pregnancies since they already know what to look for.  On average a pregnant woman can expect to feel her baby moving sometime around the 15 to 20 weeks of pregnancy.  The baby begins moving as early as 7-8 weeks but since it is still so tiny at that point you won’t yet be able to feel the movements.  Your size can also impact when you feel the first movements.  Larger women often don’t feel the first movements until closer to the 20th week of pregnancy or later.  While petite women may feel the baby move earlier.  When I was pregnant with Maya I felt her move for the first time during my 14th week of pregnancy.  It felt like tiny little flutters, sort of like popcorn popping inside my tummy.  It is definitely a very cool feeling.

As the baby continues to grow and take up more space inside your abdomen you will begin to feel stronger more regular kicks.  You’ll begin to recognize your baby’s cycles.  There will be certain times of the day when the baby is very active, like just after you’ve eaten or when you are relaxing or trying to sleep.  Other times of the day the baby will be very still.  Recognizing these patterns will help you identify if something is wrong.  If you haven’t felt the baby move at his or her regular times you’ll know to call your doctor.   A general role of thumb for fetal movements is at least 10 distinct movements in no more than 2 hours.  You don’t need to constantly count the movements but occasionally, during a regular active time for your baby, sit quietly or lay on your side and time how long it takes to feel 10 movements.   Call your doctor if you do not feel 10 movements in 2 hours.

Feeling those movements, even though they can sometimes be uncomfortable or keep you awake at night, is the best feeling.  Those little hands and feet moving away inside giving you a glimpse of the person you will meet on delivery day.  Enjoy those kicks, they are definitely one of the things you will miss about being pregnant.

Be sure to talk to your doctor if you are at all concerned about your baby’s movements.

Globally, 13 million babies are born premature and approximately 3.2 million stillbirths occur.  Preterm birth accounts for approximately 1 million infant deaths yearly and is the leading cause of infant death worldwide.   Though preterm births and stillbirths are more common in low and middle income countries they are growing problems in higher income countries, like the United States.  In the US approximately 1 in 8 babies is born prematurely and the health care costs associated with preterm births accounts for more than $26 billion annually making it the 7th leading healthcare expense in this country.

The Global Alliance to Prevent Prematurity and Stillbirths (GAPPS) recently funded a study conducted by maternal and child healthcare experts from around the world that looked at the causes of both premature and stillbirths and the possible interventions that could be used to help combat preterm and stillbirths globally.  The study found that not enough is known, globally, about what causes most preterm and stillbirths and calls for action, particularly in the area of research.  The more people know the greater the chances of preventing both stillbirths and preterm births will be.

However, researchers lack access to quality tissue samples in order to conduct the research necessary to determine the most common causes of preterm and stillbirths and ultimately what measures can be taken to help prevent them.  As a result, GAPPS is partnering with hospitals, research labs, universities both here in the United States and around the world to establish a tissue repository.  The hope is collect a large cross sample of specimens from pregnant women and newborns from around the world so researchers have access to the date they need.

Infant death is a tragic and heartbreaking issue that we need to talk about, think about and address.   The more we know the better off our children will be.  I hope one day we know enough to prevent these tragedies from occurring so every pregnant woman will know the joy of holding her healthy infant in her arms and every baby gets the best start at life.

Taking good care of your teeth during pregnancy is very important.  The hormonal changes caused by pregnancy increase your risk of developing gum disease.  As your hormones change during your pregnancy your can lead to additional swelling and bleeding of your gums.  Gum disease has been linked to an increased risk of premature labor and birth.

It is, of course, always important to practice good oral hygiene, but, given the risk that gum disease poses to your pregnancy it is even more important during pregnancy.  Making sure you brush and floss regularly, visit your dentist for regularly scheduled cleanings and check ups and avoiding sugary snacks and carbonated sodas that can lead to tooth decay are all ways that you can maintain good oral health.

Many women are concerned about visiting the dentist during pregnancy.  Regular dental care, such as regular check ups and cleanings, cavity fillings, etc are all safe during pregnancy.  It is safest to get dental work done during your second trimester due to comfort levels for you, as well as decreasing any potential risk on the growing fetus.

During the first trimester many women experience the ugly pregnancy symptom know commonly as morning sickness.  This feeling of nausea and sometimes vomiting make you want to avoid brushing your teeth, especially since the taste of toothpaste can often trigger the nausea and vomiting.  However, it is important to still continue brushing your teeth regularly, especially after vomiting as the acid in vomit can lead to tooth decay.  There are bland tasting toothpastes on the market that may making the deed of brushing your teeth during the early months of pregnancy that much easier.

Good oral hygiene and regular dental check ups during pregnancy are vital, however, there are a few things you should avoid during pregnancy.  They include: routine oral x-rays (unless necessary to deal with a dental emergency), dental procedures like fillings should be avoided during the first trimester and later half of the third trimester, although oral anesthesia is safe you should avoid high doses of the anesthesia so be sure to talk to your doctor and your dentist before having any dental treatments done that require anesthesia.

So, the bottom line is, brush, floss, check in with your dentist on your regular schedule and take care of those teeth.

If you are concerned about whether something is safe or not be sure to discuss it with your doctor and your dentist before proceeding.

The goal of the campaign is to reach as many expectant mothers as possible and to use these periodic “healthy pregnancy” text messages to keep women informed about the things they should and shouldn’t be doing during pregnancy in order to help keep themselves and their babies healthy.  The hope is that through these text messages women will be encouraged to eat healthier, exercises more and seek proper prenatal care, as well as provide encouragement and support to quit bad habits like smoking and drinking during pregnancy.  A woman who has a healthy pregnancy and partakes in a healthy lifestyle during her pregnancy is much less likely to give birth prematurely and is more likely to have a healthy baby.

In the United States over half a million babies are born prematurely every year and every year almost 30, 000 babies die before their first birthday.  Sadly, the United States ranks 30th worldwide in infant mortality, falling behind many other developed nations.  The hope is that programs like Text4Baby will help women, especially low income women and those without health insurance, get the information they need to keep themselves and their babies healthy during pregnancy which will hopefully translate into fewer premature births and a fewer infant deaths.

The program is completely free to sign up for, and as stated above most cell phone carriers are waiving the fees associated with receiving these text messages.  Visit Text4Baby.org to learn more about the program and sign up.

You wake in the middle of the night with incredible cramping pain in your legs.  Ugh, leg cramps.

Pregnant women are very susceptible to leg cramps, particularly during their second and third trimesters.  Leg cramps are a sudden tighten of the muscles that can cause intense pain.  When you are awoken in the middle of the night by this intense pain it can quickly make leg cramps one of the most aggravating complaints during pregnancy.  There are several things that cause leg cramps including:

• A lack of fluids
• Staying in the same position for too long
• Blood not circulating properly in the area
• An injury to the muscle, such as a muscle strain

Doctors are unsure what the exact cause of increased leg cramps during pregnancy, however, it is thought to be caused by a combination of the following:

• Changes in blood circulation during pregnancy
• Additional stress on the leg muscles from carrying the extra weight caused by the pregnancy
• The pressure of the growing baby and uterus on the nerves and blood vessels leading to the legs

Whatever the exact cause of leg cramps in pregnancy there are several things you can do in order to help prevent leg cramps and alleviate those that do occur.

To help prevent leg cramps pregnant women are encouraged to:

• Stretch.  Including stretching before, during and after exercising, stretching before bed or if you have been sitting in one position for long periods of time.  When stretching your legs you should avoid pointing your toes and stretch heal first.
• Exercise. Keeping your muscles moving and in shape helps with the blood circulation.  Always be sure to consult your doctor and get the okay before exercising during pregnancy.
• Change position frequently.  Don’t sit or stand still for too long.  Staying in the same position, be it sitting or standing, increases the likelihood of leg cramps.  Every so often get up and move around, stretch, take a little walk.
• Stay hydrated.    When your body is lacking fluids your muscles are more likely to cramp.  Be sure to drink plenty of fluids throughout the day.

If leg cramps do occur there are a few things you can do to help alleviate the cramp, including; massaging the affected muscle, stretching the muscle by pushing your heal down (do not point your toes as this causes further cramping), and applying heat to the affected muscle.

Leg cramps are no fun, but when added to all the other common complaints of pregnancy they become that much more annoying.  I was lucky enough to avoid leg cramps during my pregnancy (I count my lucky stars).  During my pregnancy I tried to exercise everyday and stretched my muscles often and I also drank plenty of fluids.  Taking care of yourself during your pregnancy is a great way to avoid many of the common complaints of pregnancy, including leg cramps.

If you suffer from leg cramps and they are being too bothersome or affecting your sleep too much be sure to talk to your doctor to see if there is anything you can do to alleviate your leg cramps.

Did you suffer from leg cramps during your pregnancy?  What helped you alleviate your leg cramps?

The conversation with your doctor will likely take place fairly early in your pregnancy. Your doctor will likely just simply provide you with your options and then advising on their recommendations on whether the test would be beneficial to you or not.  The actual decision on whether the testing is done is completely up to you.  Many things need to go into your decision including what you would do with the information.  For example, if you know that under no circumstances would you terminate the pregnancy than you may opt out of the screenings, or if you are one who feels better being prepared for what may be to come you may want to having the screening done so if you happen to get a positive on the screenings you can prepare for a special needs child.  Take the information your doctor provides you, ask lots of questions and discuss your choices with your partner.  There is no right or wrong decision, you have to do what is right for you.

There are a few different types of screening tests, some during your early pregnancy and some later in pregnancy.

During your first trimester your doctor may recommend an early ultrasound and some blood work.  Both these are used to determine if your baby is at and increased risk of having Down Syndrome or Trisomy 18 (another chromosomal defect).

Later in your pregnancy, during your second trimester, your doctor may recommend a triple or quad screening.  These are blood tests that look for three or four substances in your blood.  The measurements of these substances in your blood are then used to determine your baby’s risk of having Down syndrome, trisomy 18 and neural tube defects such as spina bifida.    Second trimester ultrasounds are also used as screening tools to determine the health of the baby and any risk of health issues or birth defects.

The results from the above screenings are not 100% and are often used to determine if further testing, such as an amniocentesis, should be done.  Your doctor will discuss the results of your screenings in detail with you and what your options are.  Be sure to talk to your doctor if you are unsure about what screenings you should have done or if you are unsure of what the screenings are for.

Coming down with something like a cold or the flu during pregnancy is probably the last thing you want.  Since you are likely already dealing with annoying pregnancy symptoms likes morning sickness, exhaustion, back pain, heartburn, you name it having a cold can just make you feel down right terrible.  And, because you are pregnant it isn’t as easy to treat your cold either.  You can’t just pick up any old over-the-counter cold medication to help alleviate your symptoms.  When you’re pregnant you have to be careful and only take medications that are safe to use during pregnancy.

There are a few things you can do to help get you through bug and feeling better again:

• Get lots of rest.  It is something you should be trying to do during your pregnancy anyway, but when you are feeling under the weather it is even more important to get enough rest.
• Drink plenty of fluids.  Keeping hydrated will help your body fight the cold virus.
• Eat a healthy balanced diet.  Chicken soup can do wonders for a cold since it provides a lot of nutrition and added fluids.
• If congestion is a big problem be sure to sleep propped up at night to help your sinus drain.  You could also try using a saline solution to help clear out your sinuses, some people swear by it, but it doesn’t work for everyone (you should not use over-the-counter nasal sprays).  You could also try Vick’s Vapor Rub or something similar.
• Stay home from work.  If you can, take a few days off to make sure you can get plenty of rest and aren’t over doing it.
• Take a hot shower or a warm bath to help relax your aching muscles and clear out your sinuses.
• If you feel like you need to take over-the-counter medication to help alleviate your symptoms call your doctor to find out which medications are safe to use.

There isn’t a lot you can do other than ride out the bug.  It will go away eventually.  The most important thing to remember is to rest and drink plenty of fluids, they are the best thing you can do for your body to help it fight the infection.

A healthy baby starts with a healthy pregnancy.  Staying healthy during your pregnancy isn’t always within your control.  Sometimes complications happen that you can’t control.  The things you can control include your diet, exercise, and prenatal care.  It can be hard to stay on top of all the recommendation during your pregnancy.  Here is information on a new recommendation regarding prenatal supplements.

Research has found that iodine is important to the neurological development of a growing fetus.  Iodine is a necessary component for producing thyroid hormone, a key building block for neurodevelopment.  A deficiency in thyroid hormone can cause mental retardation.

The American Thyroid Association recommends that pregnant and nursing mothers take a vitamin supplement that contains 150 micrograms (mcg) of iodine to help them reach the recommended daily intake of 220 mcg for pregnant women and 290 mcg for nursing mothers.  You can read the full write up from the ATA here.

Pregnant and nursing mothers will need to read the label of their prenatal vitamins careful as studies have found that only about 51% of prenatal vitamins contain the recommend amount of iodine.  This, of course, may change now that the ATA is out with their new recommendations.  If you are unsure if the prenatal vitamin you are taking contains the recommended amount of iodine talk to your doctor, and be sure to also talk to your doctor if you have questions about the recommendations.

The new pregnancy weight gain guidelines for women carrying a single fetus are:

• Underweight: 28-40 pounds
• Normal Weigh: 25-35 pounds
• Overweight: 15-25 pounds
• Obese: 11-20 pounds

If you are carrying multiples you should talk to your doctor about what the weight gain is appropriate for you given your weight before becoming pregnant and how many fetuses you are carrying.

The IOM also recommends that women schedule a prepregnancy consultation with their doctor to discuss their prepregnancy weight (among other things) and if it is safe to begin a pregnancy at their current weight.  Overweight women are more likely to experience complications during pregnancy and are more likely to need a c-section.  Your doctor may recommend that you begin to manage your weight with a healthy diet and exercise before you attempt to become pregnant.

The new guidelines are similar to the previous recommendation from the IOM with the exception of the recommendations for obese and overweight women.  The new guidelines show that women going into pregnancy already overweight need to take extra care during pregnancy to avoid excessive weight gain.

As any pregnant woman will tell you it can be difficult to maintain a good, healthy weight gain.  Excercise during pregnancy (if permitted by your doctor) is a great way to both control your weight gain and stay healthy during pregnancy.  Practicing healthy eating habits is a great way as well (although it isn’t always easy to turn down that extra donut or that whole bag of cookies!!!).

So what are the signs of depression?  You may have depression if you experience some of the following for more than 2 weeks.

• Persistent sadness
• Loss of concentration
• Sleeping too much or too little
• Loss of interest in normally enjoyable activities
• Recurring thoughts of death, suicide or hopelessness
• Anxiety
• Feelings of guilty or worthlessness
• Changes in your appetite
• Loss of energy

Women with a personal or family history of depression are at greater risk of suffering from depression during pregnancy, however, there are other risk factors as well, including:

• Problems in your relationship with your spouse or partner
• You had infertility treatments to conceive the pregnancy
• Prior loss of pregnancy
• Stressful life events
• Pregnancy complications
• A history of trauma or abuse

As stated earlier, depression during pregnancy can cause harm to both the mother and the baby if left untreated.  There are many treatment options available to women.  Talk to your health care provider about your options and choose a treatment plan that works best for you.  Some of your treatment options include:

• Private psychotherapy
• Support groups
• Medication

There are medications that have been used during pregnancy with no adverse effects.  Talk to your doctor about what, if any medications are right for you.  You may want to try talk therapy first, or your depression may be severe enough to warrant immediately going on anti-depressants.  It is a good idea to involve the health care provider who is treating during your pregnancy, your therapist, and even your child’s future pediatrician in your care.  By involving all parties you can ensure the best treatment for you with the best outcome for both you and your baby.

The most important thing is to talk to someone about your symptoms and how you are feeling.  If you don’t feel comfortable talking to your doctor find someone who you trust and who can help you.  The longer your depression goes untreated the bigger the risk to you and your baby.

Sources and other helpful websites:

• American Academy of Pregnancy
• March of Dimes
• US Department of Health and Human Services