1. Healthy Pregnancy & Labor and Delivery

2. *Signs of Pregnancy Missed period Fullness or mild ache in lower abdomen Feeling tired, drowsy or faint Frequent urination Breast tenderness Nausea

3. Signs of Pregnancy Pregnancy tests Urine test- accurate as early as 2 weeks after conception Blood test- accurate within days of conception Look for the presence of the hormone Human Chorionic Gonadotropan or HCG

4. Medical Care During Pregnancy Who Will Deliver the Baby? Obstetricians: doctors who specialize in prenatal and postnatal care of the mother and baby. They are qualified to handle any emergencies or special situations that may arise.

5. Medical Care During Pregnancy Family Doctors: some general practice doctors deliver babies and provide prenatal and postnatal care. If complications arise during pregnancy or delivery, a family doctor may need to call an obstetrician.

6. Medical Care During Pregnancy Licensed Midwives: Two types of licensed midwives 1. nurse-midwife—registered nurse with advanced training in normal pregnancy and birth. Must pass a special licensing exam before they can practice.

7. Medical Care During Pregnancy 2. Lay Midwife—have special training in the care of pregnant women and normal delivery. Do not have a nursing degree, but must pass a special exam.

8. Medical Care During Pregnancy When a pregnancy has been confirmed, the woman has a thorough examination. Check blood pressure—it is important to monitor this throughout pregnancy to avoid pre-eclampsia Pre-eclampsia is high blood pressure during pregnancy. The high blood pressure can restrict blood flow to the placenta which can affect the development of the fetus. Blood pressure will be checked at each visit

9. Medical Care During Pregnancy Weight—want to get a baseline to monitor how much is gained Weight will be checked at each visit Medical history Pap smear—check for changes in cervix as well as STIs Urine test—checking for protein in urine You will need to bring a urine sample to each visit

10. Medical Care During Pregnancy Blood test anemia blood type—Rh factor is important to know Measure fundal height Doctors will measure the distance from the pubic bone to the top of the uterus. This will monitor the size of the uterus. This will be done at each visit starting in the 20 th week.

11. Medical Care During Pregnancy

12. Gestational Diabetes Screening At about 28 weeks, they will do a Glucose Tolerance Test You will drink a sweet liquid and wait one hour. Then have blood drawn to check blood sugar levels. It is important to monitor blood sugar levels

13. Medical Care During Pregnancy Glucose Tolerance Test

14. Medical Care During Pregnancy Alpha-fetoprotein or Quadruple Screen Blood Testing Checks for a protein produced by the fetus that can indicate problems like down syndrome, spina bifida. It shows the need for further testing to confirm any birth defect. Checks for 4 hormones produced by the placenta that can indicate the need for further testing for birth defects.

15. Medical Care During Pregnancy Amniocentesis- done between 15-20 weeks Only done if it is medically necessary Chorionic Villus Sampling- done during first trimester Only done if it is medically necessary Ultrasound- done between 18-20 weeks Can be done at other times if medically necessary

16. Medical Care During Pregnancy Due date is calculated by taking the date that the last menstrual cycle began and adding 40 weeks.

17. Discomforts of Pregnancy Discomforts are quite common during pregnancy. Pregnant women can experience no discomforts or they may experience one or more of the following: Nausea Fatigue Heartburn Shortness of breath Varicose veins Muscle cramps in legs Lower back pain

18. Complications During Pregnancy If a pregnant woman experiences any of the following, she should see her doctor: Vaginal bleeding Unusual weight gain Excessive thirst Reduced or painful urination Severe abdominal pain

19. Complications During Pregnancy Persistent headaches Severe vomiting Fever Swelling of face, hands or ankles Blurred vision or dizziness Prolonged backache Increased vaginal mucous

20. Weight Gain During Pregnancy Baby7-8 pounds Placenta1-2 pounds Amniotic fluid1 ½ -2 pounds Increased size of uterus and supporting muscles2 pounds Increase in breast tissue1 pound Increase in blood volume1 ½ - 3 pounds Increase in fat stores5 pounds Increase in body fluids5-7 pounds TOTAL24-30 pounds **Doctors are recommending 30-35 pound weight gain**

21. Weight Gain During Pregnancy 5 pounds 18 pounds 1 pound 2 pounds 8 pounds

22. Childbirth Choices Prepared Childbirth: method of giving birth in which pain is reduced through the elimination of fear and the use of special conditioning exercises. Bradley Method http://www.bradleybirth.com/Main.aspx http://www.youtube.com/watch?v=cuxKvrKpeOU Lamaze Method http://www.lamaze.org/WhoWeAre/AboutLamaze/t abid/105/Default.aspx http://www.lamaze.org/WhoWeAre/AboutLamaze/t abid/105/Default.aspx http://www.youtube.com/watch?v=4Lbsejq0eY4

23. More Childbirth Choices Hypnosis - http://www.youtube.com/watch?v=jHm7 1ldNEzU http://www.youtube.com/watch?v=jHm7 1ldNEzU Brio Method – an updated version of Bradley method.

24. Childbirth Choices Labor: the process by which the baby gradually moves out of the uterus and into the vagina. Delivery: the birth itself. http://www.youtube.com/watch?v=duPxBXN4 qMg&feature=related http://www.youtube.com/watch?v=duPxBXN4 qMg&feature=related Postpartum: time after the baby is born

25. Childbirth Choices Some hospitals offer: LDRP—the woman labors, delivers, recovers and spends postpartum stay in the same room. LDR—the woman labors, delivers, recovers and then moves to another room to spend the postpartum stay.

26. *Labor and Delivery SIGNS OF LABOR Lightening Baby drops into pelvic cavity Lose mucous plug Sometimes called “bloody show” Not always bloody; may look like a glob of mucous Water breaks Contractions Muscles of uterus contract and cervix dilates

27. *Labor and Delivery

28. Labor and Delivery FALSE LABOR Signs of false labor Contractions are not regular or rhythmic (Called *Braxton – Hicks Contractions) Do not become increasingly stronger End if the woman walks around