Mayo Clinic Guide to a Healthy Pregnancy: From Doctors Who Are Parents, Too!


PART 1 Enjoying a Healthy Pregnancy

Chapter 1 Preparing to become pregnant

Is the time right?

Questions to ask

Is your body ready?

Contraception  Immunization  Medical conditions  Medications and supplements  Prenatal vitamins  Sexually transmitted infections  Family history  Previous pregnancies  Lifestyle  Additional nutrients

How to get pregnant

When you’re most fertile  Maximizing your fertility  Healthy sperm  If you’re having trouble

Are you pregnant?

Early symptoms  Home pregnancy tests

Choosing a care provider

Obstetricians-gynecologists  Nurse midwives  Family physicians  Maternal-fetal medicine specialists  Choosing a birth location  How to decide

Delayed pregnancy and fertility

Issues to consider  Making healthy choices

Chapter 2 Healthy choices during pregnancy

Pregnancy diet

Making every bite count  Foods to avoid  Vegetarian tips  The good stuff  Taking supplements  Folate and folic acid  Calcium  Protein  Iron  Getting your D

Gaining weight

What’s healthy?  If you’re overweight  If you’re underweight  Slow and steady  Your weight goal  Determining your BMI  Where the weight goes

Staying active

Baby, let’s move!  When to use caution  Listen to your body  Working in workouts  Sports and pregnancy  Activities to approach with care  Pregnancy exercises

Playing it smart

Caffeine  Caffeine counter  Alcohol  Tobacco  Illicit drugs

Making sense of medications

What’s safe?  What’s not safe?  A medication guide  What about herbal products?  Birth control pills and pregnancy

Working while pregnant

Handling fatigue  Bending, lifting and standing  Proper way to lift  Avoiding harmful substances

Traveling wisely

Airplane travel  Destinations to avoid  Sea travel  Car travel  Proper seat belt use

Common questions

Falls  Flu shot and other vaccinations  Colds and allergies  Acne Lactose intolerance  Hair coloring  Hot tubs and saunas  X-rays Cell phones, computers and microwaves  Mosquito bites  Household cleaners Paint fumes  Litter boxes  Pregnancy and cavities  Water parks

Chapter 3 For dads and partners

How to take part

Getting through the first trimester together

Minimize nausea triggers  Your symptoms (you get them too)  Help combat fatigue  Ride out the mood swings  Remember it will pass

Sex during pregnancy

Staying intimate

Labor and delivery worries

Educate yourself about childbirth  Map your route  Install an infant car seat  Keep a copy of the birth plan  Pack your bags  Manage communications

Common anxieties

Take action  Stay involved

PART 2 Pregnancy Month by Month


Why 10 months?

Pregnancy calendar

A week-by-week checklist

How to respond

A guide to troublesome signs and symptoms

Chapter 4 Month 1: Weeks 1 to 4

Baby’s growth

Week by week  X and Y

Your body changes

What’s happening and where  Estimating your due date  Baby’s sex: Can parents choose?

Your emotions

Mixed feelings  Mood swings  Your partner’s reaction  Your relationship with your partner

Scheduling a prenatal checkup

Getting yourself prepped  Exercise of the month

Chapter 5 Month 2: Weeks 5 to 8

Baby’s growth

Week by week  Can stress cause miscarriage?  What to avoid

Your body changes

What’s happening and where  Spotting  Exercise of the month

Coping with morning sickness

Hormones and more  How to ease the queasiness  The ‘warmed up’ effect

Your emotions

Anticipation  Worries and concerns

Prenatal checkup

What’s going to happen?  First appointment checklist

Twins, triplets, quads and more

How multiples are made  Fraternal vs. identical  What it means for mom  Possible complications

Chapter 6 Month 3: Weeks 9 to 12

Baby’s growth

Week by week

Your body changes

What’s happening and where  That pregnancy glow

Your emotions

Dealing with body image

Prenatal checkup

Prenatal tests: Yes, no, not sure?  Boy or girl: Do you want to know?  Exercise of the month  Sex during pregnancy

Chapter 7 Month 4: Weeks 13 to 16

Baby’s growth

Week by week

Your body changes

What’s happening and where  ‘Congestion’ problems  Exercise of the month

Your emotions

Feeling productive

Time to go shopping

Prenatal checkup

Thinking ahead to child care

Child care options  Making your decision  Work and family balance

Chapter 8 Month 5: Weeks 17 to 20

Baby’s growth

Week by week

Your body changes

What’s happening and where  Exercise of the month

Your emotions

Baby on the move!  ‘Baby brain’

Prenatal checkup

What is centering pregnancy?

Cord blood banking

Public vs. private  Should you consider it?

Chapter 9 Month 6: Weeks 21 to 24

Baby’s growth

Week by week

Your body changes

What’s happening and where  Is it false or true labor?  Exercise of the month

Your emotions

Confronting your fears  Being intimate

Prenatal checkup

Childbirth classes

Different types  What to look for  Thinking ahead: Finding a care provider for your baby

Chapter 10 Month 7: Weeks 25 to 28

Baby’s growth

Week by week

Your body changes

What’s happening and where

Your emotions

Enjoy a little break

Prenatal checkup

Exercise of the month  Losing your personal space  Glucose challenge testing  Rh antibodies testing

The breast or bottle question

A tough decision for some women  Sagging breasts

Chapter 11 Month 8: Weeks 29 to 32

Baby’s growth

Week by week

Your body changes

What’s happening and where  Changes in baby’s movement  Exercise of the month  Watching out for preterm labor

Your emotions

Handling anxiety  Finding a comfortable sleep position

Prenatal checkup

Baby gear essentials

Buying a car seat  Buying a crib  Buying a baby carrier

Chapter 12 Month 9: Weeks 33 to 36

Baby’s growth

Week by week

Your body changes

What’s happening and where  Exercise of the month

Preparing your body for labor

Kegel exercises  Perineal massage

Your emotions

Preparing yourself for labor

Prenatal checkup

Strep test  Checking baby’s position

Your birth plan

Birth plan checklist  Pain control

Chapter 13 Month 10: Weeks 37 to 40

Baby’s growth

Week by week  How baby comes out

Your body changes

What’s happening and where  Where the weight is going

Your emotions

Time to relax

Techniques to keep you calm

Prenatal checkup

Exercise of the month  When to call  What to do when baby’s overdue

Chapter 14 Labor and childbirth

While you wait

Review your plan  Preregister at the hospital  Pack your bag Try to relax

How your body prepares

Common questions  Labor signals  Position and station  Signs you’re in labor  Can you kick-start labor?

It’s time! — or is it?

False alarms  What’s that for?

Stages of labor and childbirth

What does labor feel like?  Stage 1  Labor positions  Factors that can speed or slow labor  Back labor  How baby comes out  Stage 2  Stage 3

If you’re the labor coach

During early labor  During active labor  During transition and delivery  During pushing and delivery

Chapter 15 Cesarean birth

When is a C-section done?

Reasons why  What about elective C-sections?

The risks

Risks for you  Risks for your baby  Is there a limit?  Dealing with the unexpected

What you can expect

Preparation  The operating room  The recovery room

After surgery

Recovery  Your partner’s involvement  Restrictions  Possible complications

PART 3 Baby Is Finally Here

Chapter 16 Your newborn

Your baby’s appearance

Head  Skin  Hair  Eyes  Jennifer’s story

Newborn care

Examinations  Treatments and vaccinations  Screening tests


Issues to consider  How it’s done  Circumcision care

Newborn issues

Jaundice  Infection  Learning to eat

The premature newborn

The setting  The neonatal intensive care unit team  What baby may look like  Getting involved  Complications of prematurity  When your baby is hospitalized

Chapter 17 Taking baby home

Your baby’s world

Reflexes and senses  Crying  Swaddling baby  Coping with colic  Eating and sleeping  Developing good sleep habits  ‘Back’ to sleep  Peeing and pooping  First bowel movements

Baby-care basics

Holding your baby  Changing diapers  Diaper rash  Bathing Skin care  Cradle cap  Umbilical cord care  Nail care  Clothing

Twins, triplets or more

Getting through the first weeks

Chapter 18 Issues for mom

Breast care

Engorgement  Leaking milk  Sore or cracked nipples  Blocked ducts

Bowel and urination problems

Hemorrhoids  Bowel movements  Urine leakage  Difficulty urinating


Afterpains  Episiotomies and tears  Vaginal discharge

Getting back into shape

Fatigue  Hair and skin  Weight loss  Exercise

The baby blues

Causes  Dealing with the blues  Signs and symptoms  Is it more than the blues?

Baby bonding

Give it time

Chapter 19 Managing as parents

Early survival tips

Tackling transitional stress  Getting enough sleep  When sleep becomes a struggle  Negotiating household chores  Paying for baby

Parenting as a team

Common feelings after childbirth  The importance of support  Setting the tone  What makes a strong, healthy family?

Finding time for yourself and each other

Getting away on your own  Getting away together  Sex after pregnancy

Single parenthood

Hang in here

PART 4 Important Decisions of Pregnancy

Chapter 20 Genetic screening

What is it?

Different types of genetic tests

Issues to consider

8 key questions

Family history screening

Population-based screening  Genetic diseases

How it’s done

Understanding the results

Chapter 21 Prenatal testing

Issues to consider

6 key questions

The tests

Ultrasound  First trimester screening  Second trimester screening, or quad screening  Amniocentesis  Speeding up test results  Chorionic villus sampling  Percutaneous umbilical cord sampling  When the results indicate a problem

Late pregnancy tests

Fetal nonstress and stress tests  Biophysical profile testing  Doppler ultrasound

Chapter 22 Breast-feeding

5 key questions


Milk production  Benefits for baby  Benefits for mother  Pros vs. cons  When breast-feeding may not be an option  Getting started  Feeding positions  Nursing basics  Breast care  Keeping yourself healthy Breast-feeding multiples  Pumping your breasts  Storing breast milk  Going back to work  Introducing a bottle


Pros vs. cons  Bottle-feeding basics  Be flexible  Getting started  Preparing formula  Feeding tips  Getting into position

Chapter 23 Pain relief during childbirth

Issues to consider

Your options

Pain medications  Natural methods

Pain medications

Epidural block  Spinal block  Combined spinal epidural  Receiving an epidural block  Narcotics  Local anesthetic  Pudendal block  Tranquilizers

Natural methods

Breathing techniques  Relaxation techniques  Other techniques

Chapter 24 Elective cesarean birth

Issues to consider

Benefits vs. risks

Maternal benefits  Maternal risks  Fetal risks

Making your decision

Chapter 25 Vaginal birth after a cesarean birth

Benefits vs. risks

Benefits of VBAC  Risks of VBAC

Issues to consider

Previous incision  Reason for previous C-section  Who might not be a candidate

Tips for planning a VBAC

Chapter 26 Contraception after delivery

Issues to consider

Breast-feeding and contraception

Fertility  Hormones and breast milk  Vaginal dryness


Hormonal methods  Barrier methods  Intrauterine devices Permanent methods  Natural family planning methods  Emergency methods

Making your decision

PART 5 Symptoms Guide

Abdominal discomfort  Abdominal pressure  Abdominal tenderness  Acne  Allergies  Baby’s hiccups  Baby’s kicks  Backache  Black line  Bleeding gums  Blurry vision  Breast discharge  Breast enlargement Breast tenderness  Buttock and leg pain  Carpal tunnel syndrome  Clumsiness  Constipation  Contractions Cramping  Dizziness and faintness  Dreams  Enlarged veins  Excessive salivation Eye changes  Facial skin darkening  Fatigue  Feeling warm  Fluid leakage  Food aversions  Food cravings  Forgetfulness  Gas and bloating  Gum disease  Headaches  Heartburn  Hemorrhoids  Hip pain  Hunger  Increased heart rate  Insomnia  Irrational fears  Itchiness  Leg cramps  Mood swings  Morning sickness  Mucous discharge  Navel soreness  Nesting  Nipple darkening  Nosebleeds Pelvic pressure  Perineal aching Perspiration  Pubic bone pain  Rashes  Rectal bleeding  Red palms and soles  Rib tenderness  Round ligament pain  Sensitivity to smells  Shortness of breath  Skin tags Snoring  Stretch marks  Stuffy nose Swelling  Swollen feet  Thirst  Urinary tract infections  Urinating frequently  Urine leakage  Vaginal bleeding  Vaginal discharge  Varicose veins  Vomiting  Yeast infections

PART 6 Complications of Pregnancy and Childbirth

Chapter 27 Issues during pregnancy

Blood concerns

Rhesus factor incompatibility  Iron deficiency anemia


Early labor

Making the best of bed rest

Excessive vomiting

Gestational diabetes


Chickenpox  Cytomegalovirus  Fifth disease  German measles  Group B streptococcus  Herpes  HIV and AIDS  Listeriosis  Toxoplasmosis

Placental problems

Placental abruption  Placental previa


Slowed fetal growth

Chapter 28 Problems of labor and childbirth

Labor that fails to start

Inducing labor  Oxytocin

Labor that fails to progress

Prolonged early labor  Prolonged active labor  Assisted birth  Prolonged pushing

Baby in an abnormal position

Facing up  Awkward angle  Head too big  Breech  Lying sideways

Intolerance of labor

Umbilical cord prolapse  Umbilical cord compression  Decreased fetal heart rate

Chapter 29 Managing mom’s health concerns

Pre-existing health issues

Asthma  Cancer  Depression  Diabetes  Epilepsy  Heart disease  Hepatitis B  High blood pressure  Immune thrombocytopenic purpura  Inflammatory bowel disease  Lupus  Phenylketonuria Rheumatoid arthritis  Sexually transmitted infections  Sickle cell disease  Thyroid disease  Uterine fibroids

Postpartum concerns

Blood clots  Excessive bleeding  Infection  Postpartum depression  Self-care for postpartum depression

Chapter 30 Pregnancy loss


Signs and symptoms  Causes  What doesn’t cause miscarriage?  Types of miscarriages  Seeing a doctor  Treatment  Recovery  Recurrent pregnancy loss

Ectopic pregnancy

Signs and symptoms  Treatment  Future pregnancies

Molar pregnancy

Signs and symptoms  Treatment

Cervical incompetence

Signs and symptoms  Treatment  Coping with pregnancy loss

Trying again

Emotional recovery  Your partner  Physical recovery  Tips for future pregnancies

Additional resources