Month: June 2018

After the second dark line appeared on my at-home pregnancy test, joy and excitement jolted through my veins.
But some worries snuck their way in, too: Would our baby make it to full term? Would he or she be healthy? Was I fit to be a mom?
I struggled to reconcile the doubts in my mind even though I was incredibly thankful for the new little life inside of me. And I’m not the only one! More than one in 10 women experience anxiety during pregnancy.
If you’ve experienced a miscarriage or dealt with infertility, the first trimester can be an emotional roller coaster. Even if you’ve had smooth-sailing baby-making in the past, getting through those first 12 weeks isn’t always easy.

The first 12? 13? 14? How long is the first trimester, anyway?

Surprisingly, there isn’t a consensus on how long the first trimester lasts. Based on various sources, 12 to 14 weeks is generally accepted. The most common definition seems to be that the end of your 12th week marks the conclusion of your first trimester. According to one pregnancy app, that means your baby will be the size of a lemon!
Because the highest percentage of miscarriages occur in the first trimester, it’s common (and understandable) to be nervous and take all the precautions you can. But if you’re in the thick of first trimester anxiety, there’s hope! There are plenty of ways to help you stay relaxed during these initial weeks so you can enjoy more of the journey with your new precious gift.

First Trimester Tip 1: Focus on what you can control.

Human beings tend to love being in the driver’s seat, but some things are entirely out of our hands.
“The statistics around first trimester miscarriages are tough,” admits certified nurse midwife Theresa Starr. It may be helpful to know, though, that approximately 50 percent of miscarriages in the first trimester are due to fetal chromosomal abnormalities, not anything the mother did.
While smoking, drinking, and using drugs can impact your chances of miscarriage, not much else does, thank goodness!
For instance, attending a regular aerobics class or missing one prenatal vitamin shouldn’t be cause for concern. (I’m even guilty of obsessing over having sniffed a lemongrass essential oil!)
“We usually don’t know why a first trimester miscarriage happens. We let women know that they couldn’t have prevented it—that there was nothing they did wrong, and that a miscarriage probably won’t affect their ability to get pregnant in the future,” explains Starr.
So rather than letting unnecessary worry occupy your headspace, focus your energy on what you can control: your diet, exercise, and the amount of rest you get each night.
“Eating healthy and participating in regular exercise will help you feel better both physically and mentally. Making small changes during pregnancy will help you and baby be as healthy as possible,” explains certified doula and childbirth educator Marisol Garcia.

Aim for a well-rounded first trimester diet.

Wondering what to eat in the first trimester? Focus primarily on receiving a breadth of nutrients.
A well-rounded diet of healthy fats, carbohydrates, proteins, fruits, and vegetables are recommended for expectant moms.
“Studies have shown that women who have a balanced diet and consume 80–100 grams of protein per day are less likely to feel morning sickness. Eating smaller and more frequent meals helps too,” shares Garcia.
But don’t worry if you miss a day of healthy eating; just get back on track tomorrow!

Practice light to moderate exercise during the first trimester.

The American College of Obstetricians and Gynecologists states that if you’re healthy and have been given the go-ahead from your doctor, it’s safe to continue or start most types of exercise. In fact, studies show that exercise benefits both you and your baby. Not too surprising, right?
But to ensure you’re getting in proper first trimester workouts, it’s helpful to know what’s safe and what’s not.
The most general recommendation is that you can continue any exercises you were doing previously. For instance, “if you lifted weights prior to getting pregnant, you can continue doing so. Just remember your center of gravity shifts, so take things a bit slower. Stay well hydrated and avoid activities where you have a risk of falling,” explains Starr.
[pullquote align=”center”]“When you’re taking care of your body, you’re likely to experience less anxiety, because you’re doing everything physically that you should be doing.”
—Theresa Starr[/pullquote]
Hiking and swimming have become my go-to pregnancy workouts—giving my skis (both downhill and water) a break for the season.
“When you’re taking care of your body, you’re likely to experience less anxiety, because you’re doing everything physically that you should be doing,” says Starr.

First Trimester Tip 2: Choose your sources for information wisely.

“I really encourage expectant moms to learn as much as they can—but in a healthy way,” says Galena Rhoades, PhD, research associate professor of psychology at the University of Denver and project director of MotherWise Colorado.
It’s convenient to pop every question into a search engine, but it can sometimes cause more harm than good if you’re not careful about which sites you’re visiting. Dr. Google isn’t actually a doctor—and it’s not your friend either.
Rhoades further explains that not all online sources should be avoided but that you should be mindful of the sources you choose. “If you’re reading an online forum, it’s hard to know how accurate that information is. You’re likely to find information that keeps you worried, because people typically don’t post about things that go well.”
As Starr notes, it’s best to “focus on factual information with scientific evidence.”
Outside of the internet, books written by professionals are another avenue for seeking reliable information, explains Rhoades. If you’re unable to find a definitive answer online or in a book, don’t hesitate to call up your OB provider.

First Trimester Tip 3: Establish a support system (even if you’re not sharing the news publicly yet).

Whether you’re feeling all of the lovely first trimester symptoms like fatigue and nausea or you’re one of the lucky few who aren’t, having support gives you strength when you need it most.
Many women fall into telling someone or not telling someone they’re pregnant based on what they feel they should do rather than what’s best for them. “Instead, make a mindful decision of who you want support from,” encourages Rhoades.
You may feel obligated to first share the news with your parents or sister, when perhaps having a best friend or co-worker by your side would be beneficial.
Form a plan with your partner regarding who you want to share your pregnancy news with and when, so you can get the support you need.
Unsure of who to lean on?
“Look for people who are supportive and in line with your beliefs,” suggests Garcia. Almost everyone has an opinion about pregnancy and parenthood, so “direct your energy to someone who carries similar views.”  
Rhoades also stresses the importance of building a community of women or couples who are going through the same experience. Sometimes this happens naturally if you have friends or family who are pregnant at the same time. Other times you may need to find a pregnancy support group or a studio that specializes in prenatal yoga.

First Trimester Tip 4: Practice self-care (and don’t be shy about pampering yourself!).

With so much focus on the baby, we can forget to take care of ourselves during pregnancy (surprise, surprise). But self-care is vital: It helps keep us healthy, sane, and energized.
Having worked with expectant moms for more than 20 years, Starr expresses the joy of pregnant women now having a range of self-care options: prenatal massages, prenatal yoga, and even guided meditation apps. Even something as simple as taking a bath (sounds amazing, right?) or asking your partner to make dinner can offer you the relief and care you need.
That’s right: Go ahead and put your feet up!
“It’s also important to release any tension and insecurities within you,” explains Garcia. If you’re experiencing problems with your loved ones, address insecurities and emotions before your baby’s arrival to help ensure healthier relationships both during pregnancy and parenthood. If you feel tension in your body, practice meditation, prenatal yoga, and relaxation exercises at home.
No matter how you decide to pamper yourself during your first trimester (which you should definitely do), just be sure it’s safe. The American Pregnancy Association recommends not elevating your body temperature to 101º F or above as it can cause concerns during pregnancy. So steer clear of hot tubs, saunas, and steam rooms to eliminate this risk.

First Trimester Tip 5: Bond with your baby daily.

Early on in the pregnancy, it can be tough to feel connected with your baby, says Starr, “especially if you’re not feeling well due to morning sickness and fatigue.”
I mean, come on, who’s feeling connected after perching over the toilet all morning?
[pullquote align=”center”]“When you take a moment to remind yourself that there’s a baby growing, you become more mindful of what your body’s doing, and that’s incredibly valuable.”
—Galena Rhodes, PhD[/pullquote]
But bonding with your baby for at least a few minutes each day can reduce your anxiety and stress while pregnant, says Rhoades. “Set aside time by yourself or with your partner to think about and talk through what you’re experiencing. When you take a moment to remind yourself that there’s a baby growing, you become more mindful of what your body’s doing, and that’s incredibly valuable.”
If you’re experiencing anxiety while pregnant, Rhoades recommends setting aside dedicated time to worry as well. Rather than letting fearful thoughts infiltrate your work day or distract you when you’re out with friends, you can say to yourself, “OK, I have time to think and worry about this tomorrow.” Devoting time to worry has long been a technique used by therapists to treat anxiety, and it can be particularly helpful to expectant moms.

First Trimester Tip 6: Connect with additional resources.

“Women feel increases and dips of hormonal changes during pregnancy and postpartum. It’s important to practice self-care and address any mental health issues with your medical professional,” explains Garcia. Even though you may be excited about the new baby, it’s still a huge life change, whether this is your first or fourth child.
So remember: You’re far from alone.
“It’s incredibly common to experience stress while pregnant,” Rhoades confirms. “If you’ve been feeling worried or anxious for several days or more in the last two weeks, it’s worth talking with your provider or therapist.” Professional assistance can be found in a counselor, therapist, or even books.
Processing what’s happening for you and learning techniques to manage your stress, anxiety, or depression will benefit you throughout your pregnancy—and after you welcome your beautiful new baby into the world.

Being pregnant—especially if it’s your first pregnancy—is like wandering into a whole new frontier with your phone’s map app open only to find out you’ve got spotty service. You’ll get all the information eventually, but it feels like it comes at you in bits and pieces. Case in point: the signs of labor.
Maybe your best friend told you she knew she was in labor the second she spotted some blood in her undies. But what about that woman in your prenatal yoga class who said she always knows she’s ready to deliver when she starts vomiting? And aren’t pregnant women in the movies always going into labor with dramatic gushes of amniotic fluid?
If all those stories (and over-the-top dramatic scenes) have you confused about what really happens when you go into labor, you’re not alone.
The truth is, everyone experiences labor differently, says Mary Fleming, MD, an OB-GYN and attending physician at Einstein Medical Center Montgomery in East Norriton, Pennsylvania.
“For some it is a gradual process that occurs over weeks; others may not perceive any discomfort until active labor ensues,” Fleming says.  
So how will you know when you’re in labor? And what signs of labor mean it’s time to call the doctor? Here’s what the experts have to say.

Signs Your Body Is Getting Ready for Labor

The goal of every pregnancy is to reach labor, that time when your body is readying for delivery, or the actual arrival of baby. For most folks, that happens sometime after the 37th week of pregnancy, which is what doctors call term labor or sometimes full-term labor.
That said, labor can happen any time after 20 weeks of pregnancy, says Jimmy Belotte, MD, PhD, interim medical director in the division of general OB-GYN at Montefiore Health System in New York. “When it occurs between 20 weeks and 36 weeks + 6 days, it is referred to as preterm labor.”
Just when it will happen is hard to say, Belotte explains, as every pregnancy is as different as the parent and baby involved.
But there are signs that your body is getting ready to go into labor.

Signs of Labor: When Baby Drops

With most pregnancies, especially those considered full-term, a baby will “drop” in the uterus. Typically this will happen near the end of the third trimester, Fleming says, as the fetus prepares for the labor process.
“The head will begin descending into the pelvis,” Fleming says. “Women will usually feel more fullness and pressure in the pelvis and sometimes in the vaginal area. This process helps to apply pressure to the cervix and is part of the early stages of the labor process.”
As a baby drops, the height of the fundus, which is a term a doctor uses to refer to the top of the uterus, will also shift downward, away from the chest. Depending on your body, that “drop” may be visibly apparent to friends and family.

Signs of Labor: Mucus Plug

Another sign your body is readying for labor? You might pass the mucus plug, which is literally a thick chunk (or plug) of mucus that dislodges from the cervix shortly before labor. The plug may be accompanied by pinkish vaginal discharge or spotting, akin to the breakthrough bleeding that can happen when you’re ovulating.
Just how long it will take from the time a baby drops or the mucus plug drops into the toilet is hard for doctors to say because these processes can vary widely. But they’re both things to mention to your OB-GYN or midwife, as they’re signs that something is beginning to happen!

Signs of Labor: Cervix Dilation

Your medical practitioner will likely check to see if your cervix has dilated or started to open up, which is yet another sign that the body is preparing for labor, Fleming says.
[pullquote align=”center”]You can walk around with a cervix that’s dilated an inch or two for days or even weeks without feeling it or going into full blown labor.[/pullquote]
This is not something that can typically be felt—in fact, you can walk around with a cervix that’s dilated an inch or two for days or even weeks without feeling it or going into full blown labor—but a cervical exam will allow your doctor or midwife to get a gauge of whether the cervix is readying for labor and just how much.
After 39 weeks, some providers may suggest stripping the membranes of the cervix. The optional process is considered a safe and simple way to induce the body to kickstart labor, if not always effective.
“If possible, the provider will use her/his finger to sweep along the inside of the cervix where the cervix and the bag of water/membranes meet,” Fleming says of membrane stripping. “The process may be uncomfortable but usually lasts for 20 seconds or less.”
It’s an optional procedure, Fleming says, and it’s one that should only be performed late in the third trimester by a medical professional.

The Sign That Labor Has Started: Contractions

While your body can start prepping for labor weeks (or sometimes months) in advance of the real thing, you won’t be in actual labor until you’ve started contractions, Fleming says.
“The definition of labor is consistent contractions that cause cervical change,” she explains. “We instruct women to contact their provider when they start having contractions that they can time, every 5 to 10 minutes over a two-hour time span.”
During that phone call, your healthcare provider can assess if it’s time to make a trip to their office or a hospital or whether it’s time for them to come to your home if you’re having a home birth.
[pullquote align=”center”]“The contractions have to be strong enough and consistent enough to cause the cervix to open before the diagnosis of labor can be given.”
—Mary Fleming, MD[/pullquote]
If it’s “go time,” a cervical exam will come next to determine whether the contractions are actually causing cervical dilation, meaning you’re in true labor, or if you’re having Braxton Hicks, a term for false contractions that don’t have any effect on the cervix.
“We know it is often frustrating for first-time mothers who have contractions to be told they are not in labor,” Fleming says, “but the contractions have to be strong enough and consistent enough to cause the cervix to open before the diagnosis of labor can be given.”

Wait, what’s a contraction?

Hey, if you’ve never given birth before, you’ve probably never felt a contraction either, so it’s no surprise most people don’t know the difference between a Braxton Hicks contraction and a “real” one.
Braxton Hicks contractions can start as early as the first trimester but may only be felt late in the second trimester, according to Belotte. “They are different from the labor contractions because they are sporadic, last longer than regular labor contractions, and tend to not be so painful,” he adds.
As for the “real” contractions, there is no one right way to experience contractions. They vary depending on the person feeling them.
“Some women will describe contractions as back pain and others as pelvic pressure,” Fleming explains. “Most will feel a tightening across their abdomen that intensifies for 30 seconds and up to one minute and then relaxes.”
Mild contractions are typically uncomfortable enough to be noticeable but don’t necessarily interrupt normal activities, while intense contractions can make it difficult to walk or carry on a conversation.
“Again, because all women experience pain in a different way, it is normal for some women to experience intense contractions in early labor and for others not to feel much intensity until closer to delivery,” Fleming says.

Isn’t water breaking a sign of labor?

Forget what you’ve seen on TV. Most women do not experience a giant gush of water flowing out between their knees, signaling that they’re suddenly in labor and need to get to the hospital stat.
It’s not typical for your water to break at the beginning of labor. In fact, “for most women, their water breaks during labor,” Fleming says.
Water can break spontaneously (on its own) or because your healthcare provider breaks it for you with a procedure called artificial rupture of membranes (AROM).
If your water does break before labor begins, it may be a big gush. Then again you may simply notice your clothes are wet or wake up to find a clear puddle of fluid in the bed. Water may “break” and leak out slowly over time as well, Fleming says, as the membranes of the amniotic sac do not reseal.
“For this reason, liquid will continue to drain from the vagina in small amounts until delivery,” she says.

Early Labor vs. Active Labor

Once your body is revved up and “in labor,” your provider still may say you’re not quite ready to be rolled into the delivery room. Sigh. That’s because labor is broken down into two parts: early labor and active labor.
“Early labor starts when regularly recurring, painful labor contractions are felt by the mother, leading to cervical changes including progressive shortening, thinning, and opening (dilatation) of the cervix up to a point of rapid acceleration of the rate of cervical dilatation,” Belotte says.
Typically, early labor is the longest phase. It can be just a few hours for some folks. Then again it can go on for days (literally) for others.
A mom-to-be is monitored during early labor to determine whether dilation is progressing; the baby’s heartbeat is monitored also to ensure that the baby is healthy and handling the pressure of getting ready for delivery well. It’s during early labor that practitioners typically decide whether a delivery may be done vaginally or require surgical intervention.
If the answer is the former, at around 6 centimeters of dilation, active labor typically begins. It’s shorter and faster than early labor, Belotte says, and is associated with the fetus moving lower and lower, while the cervix continues to dilate to 10 centimeters, which is the size needed for vaginal delivery. Active labor is what turns into delivery!