May 2016

Countdown (or Rather Up) to Baby

Author: Becca Edwards

If this is your first pregnancy, it’s likely you’re encountering a wide range of thoughts and emotions. One day you feel tremendous joy whenever you look into your partner’s eyes; the next you can’t believe he did this to you. You’re suddenly clumsy and you forgot whether you turned 31 or 32 this year. And if you could just not urinate every 30 minutes and sleep on your belly one last time you would be forever grateful. If this is your second or, God love you, third or more pregnancy, you also are experiencing the same aforementioned baby bump shenanigans—plus you have the added bonus of chasing, carpooling and canoodling with your other offspring. The chances of you sleeping through the night soundly, wearing something that doesn’t double as pajamas, and shaving your legs with the frequency they probably deserve are—unlike your burgeoning belly—slim.

Here’s where I come in. Combining what I’ve learned as a prenatal yoga instructor and birth doula with insight from some experts, I’m here to lullaby first time moms’ fear away and remind repeat “preggo-fenders” about all the awesomeness that’s going on inside their bodies and their babies’ bodies. Starting from week one, let’s countdown (or rather up) to baby and highlight all the baby-making magic milestones.

Conception and the First Trimester: Weeks 1-16
Technically, your baby’s birth story began two weeks before conception. Dr. Lynn Norton of Riverside Women’s Care explained, “The due date is based on the first day of your last menstrual cycle. It’s a benchmark, but really an ultrasound will let us know exactly when you got pregnant.” During conception, in addition to having hopefully a very fulfilling and loving sexual experience, something extraordinary happens. After traveling the six- to-nine-inch journey up the fallopian tubes, one out of several hundred million sperm breaks through the egg’s protective membrane and then sheds its tail. Once the egg is fertilized, no other sperm can enter it. At this point, your baby’s sex, eye and hair color and all other inherited characteristics are determined.

A week after conception, the fertilized egg implants into the uterine wall and your baby is called an embryo; albeit a fairly un-cute word, rest assured this is the beginning of something super cute—and expensive. By week four, you have missed your period and a pregnancy test will confirm your good news. (Note: First Response sells an early detection test that you can take six days before your expected period. On its website, however, First Response states, “It is important to note that some women may not have detectable amounts of pregnancy hormone in their urine until after the missed period. This is because hCG levels vary between women, and because some women sometimes have difficulty predicting the exact date of their next period.”)

Even before you get a positive pregnancy test, though, Norton advises her patients to seek preconception counseling. “That way we can start you on a prenatal vitamin, look at what medications you are taking and/or talk about any medical problems you may have and see if they need to be treated differently.” Unless someone has a history of miscarriage, Norton also encourages her patients to schedule an ultrasound appointment by week six or eight. “Once you get the heartbeat, the chance of miscarriage is low,” she assured.

By two months, organogenesis has started and, by week nine your baby is about one inch long (or the size of a grape) from head to bottom, has developed eyelids that will remain closed for several weeks, and the ends of the arms and legs start to look like hands and feet as they begin to form. According to Dr. Gregory Miller, a board-certified OB/GYN with Beaufort Memorial Obstetrics & Gynecology Specialists in Bluffton and Beaufort, so much is also happening in your body. “During the first trimester, there’s not a lot of outward physical change. More of the changes are internal and are not noticeable to the partner,” Miller said. “For some, these changes, like nausea, cramping and headaches, are the most difficult and can bring on a lot of anxiety. Some also experience spotting. But there is so much to look forward to, especially when the partner can see the tummy and you start to feel the baby kick [in the second trimester].”

Janna Jones Kersh, who is a certified nurse midwife, practices with Miller and instructs the free prenatal classes that are open to the public at Beaufort Memorial on Wednesdays from 6 to 8 p.m. “The first trimester is a great time to start learning about the pregnancy process,” Jones Kersh said. “You can learn about breastfeeding, baby care and childbirth.” Education is a big component of being a midwife. “As a midwife, I am able to spend more time with my clients than most physicians, and I’m able to focus on preventive medicine and tell my clients what to anticipate.” Jones Kersh also takes a more natural approach to pregnancy and childbirth, which doesn’t mean she is anti-intervention, but that she views the prenatal and delivery process as a normal, beautiful experience. “It’s easy to get scared if you watch childbirth on TV, but I want to empower women.”

Jones Kersh also talked about morning sickness and holistic ways to remedy it. “I tell my moms to eat small frequent meals, not getting too hungry or too full. Keep a light snack like a cracker by the bedside table to eat upon waking. Also, try ginger or vitamin B6, and make sure you have the right prenatal vitamin, because the ones with iron can upset the stomach.” (Note: I would also add that several of my prenatal yoga clients use papaya enzyme for nausea and acid reflux.)

Second Trimester: Weeks 16-28
Congratulations. You are now entering what Norton calls the “golden trimester.” “You’re getting your energy back, the nausea has subsided, you’re far enough along to not worry about miscarrying, but not so far along that you are miserable,” she said. “This is the time to take a babymoon, shop for the baby and make home improvements.”

At 16 weeks, your baby has started developing ears, eyelashes and fingernails, and his or her fingers can open and close. At 18 weeks, expect to start to feel a little bend it like Beckham in your belly. At 20 weeks, your baby is covered with fine hair called lanugo, practices sucking, is about seven inches long and you get your first real sneak peak during the anatomy scan. At 24 weeks, eye movement begins, lungs continue to mature and surfactant is produced, which is essential to breathing air. At 28 weeks, your baby practices breathing movements, can open and close his or her eyes, and is about 10 inches long.

The critical tests during the second trimester include the dreaded glucose test (taken between weeks 24 and 28), which screens for gestational diabetes and requires drinking a nasty sugary concoction. There are two versions of this test: the one-hour and, if you fail that one, the three-hour. Remember not to eat anything high glycemic like fruit, cereal or creamer in your coffee before taking this test, as you might get an inaccurate result and fail—and trust me you don’t want to do this because the three-hour is mis-er-able.

Miller talked about advancements in prenatal testing and described a fairly new but fascinating test called the cell-free fetal DNA test. “Testing has become so much more sophisticated and the cell-free, for example, is a blood test used with high-risk patients (which includes women over 35 years of age), or patients with irregular test results or a history of genetic abnormalities. This test replaces the amniocentesis and can be done at 10 weeks gestation.” Also at 28 weeks, you will also receive the RhoGAM injection if you are Rh(-) so that your immune system doesn’t go all Rambo on your baby.

(Note: Your last test is not until you’re 36 weeks and your healthcare provider will check for chlamydia, gonorrhea and group B strep.)

About now, you might be feeling like a science experiment, but rest easy—and not because these are the last few weeks you will sleep, but because your second trimester is also a great time to treat yourself. And I don’t mean just a pedicure. Go ahead and register for baby gifts at specialty boutiques like Island Child—Senny Powell the owner has seven kids and is a pro. Also, try booking a maternity photoshoot with a photographer like Nicole Roberts of She and He Photography. “The best window of time is between 27 to 33 weeks along,” explained Roberts. “That way the mother’s bump is big and beautiful without them feeling large, uncomfortable and swollen.” Roberts also advised, “It’s best to contact a photographer to book a maternity session around six months’ gestation,” and to wear fitted clothes “for accentuating a mother’s belly; long flowing dresses also look beautiful on beach photography sessions.” Also, celebrate how far you’ve come by hiring a party planner, which brings us to the third trimester and party planning guru Molly Kennedy of Celebrations Catering and Events.

Third Trimester: Weeks 28-40
“Baby showers have really turned into couple’s showers with party concepts both men and women can enjoy like a luau, barbecue or sports-theme,” said Kennedy, who also talked about reveal parties. “There are so many ways to reveal the baby’s gender, whether through getting a special cake made that has either blue or pink inside or opening the envelope.” From diaper raffles to cocktails and mocktails, Kennedy was a wealth of party information about showering “both mom and dad with love.” Her fun ideas remind us that brewing a baby should not just be medically focused, but we should enjoy the process with our partner and our friends and family.

As a sign of relief, also know that by 28 weeks your little bundle of joy is becoming quite sufficient. Now that you’re in the home stretch, you can start doing exercises to prepare your body for delivery. I always encourage my birth doula clients to get a yoga ball and practice simple exercises like hip circles; try Kegel exercises to strengthen the pelvic floor, and experiment with different yoga breathing techniques for relaxation and to gain a better understanding of the mind-body connection. Also, consider drawing up a birth plan—and this is not because you will necessarily follow it but as Jones Kersh pointed out, “A birth plan starts a conversation with your partner and practitioner so that everyone is on the same page.” I also like it because it allows you to start to visualize your birth, which can be a very valuable tool.

At 36 weeks, I usually encourage my clients to pack the hospital bag, which includes essentials like chap stick, lotion or essential oils for massage, phone chargers, and an outfit for the baby like a onesie. You and your partner should also make a birth playlist or Pandora station.

Even though you probably feel like Jabba the Hut, try to embrace the final weeks of your pregnancy. I know I wish I had. As Norton, who has six children and has been delivering for nearly three decades so eloquently said, “It’s a miracle every time. Cherish it.” 

Becca Edwards is a wellness professional, freelance writer & owner of b.e.WELL+b.e.CREATIVE (bewellbecreative.com).

Foods High in Folate (for a Healthy Pregnancy)
Bananas
Cantaloupes
Oranges
Strawberries
Asparagus
Beets
Broccoli
Cauliflower
Spinach
Eggs
Canned salmon
Chickpeas
Lentils
Almonds
Cashews

Things to Avoid
Raw fish or oysters
Soft cheeses and lunch meats
Alcohol
Aspirin or non-aspirin pain medications
Cigarettes
Hot tubs and saunas
Changing the cat litter
Oil-based paints, furniture stripping solutions and spray paints
Aerosol sprays
Pesticides, flea/tick treatments for pets and exterminator solutions
Note: Limit caffeine consumption to two servings a day and fast food, artificially flavored foods and foods high in sugar.

Ideal Weight Gain
1st Trimester = 2-5 lbs.
2nd Trimester = 10-12 lbs.
3rd Trimester = 10-15 lbs.
Total = 20-40 lbs.

Weight Breakdown
Baby = 7-8 lbs.
Placenta = 1 lb.
Amniotic fluid = 2-4 lbs.
Enlarged breasts = 1-2 lbs.
Enlarged uterus = 2 lbs.
Increased blood volume = 4 labs
Increased water/fluid/muscle = 7-10 lbs.

What is Zika? And should we be worried?
Article by Marie McAden

With summer upon us, it won’t be long before the Lowcountry is buzzing with mosquitoes, including the Aedes aegypti, the species responsible for the spread of Zika in South America and the Caribbean. While infected mosquitoes have yet to turn up in the U.S, experts fear it’s only a matter of time before they arrive on the shores of susceptible states like South Carolina, where warm temps and recent heavy rains provide an ideal breeding ground.

Last month, U.S. health officials confirmed Zika can be spread from a pregnant woman to her fetus, causing severe brain damage to the infant. While there is no immediate risk in the Lowcountry, said Kent Stock, an infectious disease specialist at Beaufort Memorial and Charleston’s Roper St. Francis hospitals, “the best advice we can give is not to travel to endemic countries.”

If you have to travel to an area with Zika, the Centers for Disease Control & Prevention recommends you wear long-sleeved shirts and long pants and use insect repellant with DEET when you go outdoors. The same precautions should be taken here in the Lowcountry.

In addition, use preventative measures to minimize mosquitoes around your home: Clean out rain gutters and other areas where mosquitoes tend to breed; make sure items in the yard are not accumulating water; check windows and door screens to be sure they are in good repair.

Pregnant women who have traveled to an area with Zika should talk to their doctor even if they don’t have any symptoms of the virus, which include fever, rash, joint pain and red eyes.

Zika also can be transmitted sexually from an infected man to his partner. “Based on rough estimates, we believe a pregnant woman bitten by an infected mosquito has a 28 percent chance of having a baby with birth defects,” Stock said. “But we don’t know what the risk is for pregnant women who contract the virus sexually.” Until more is known, men who have traveled to an area with Zika should abstain from having sex with a pregnant woman or use a condom.

“Women who want to conceive should wait at least eight weeks after traveling to a Zika affected country,” said Beaufort Memorial OB-GYN Dr. Claude Tolbert. “If your sexual partner has been exposed, wait at least six months to have unprotected sex.”

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