What to expect when you're expecting (53 page)

As for whether or not your breasts will end up sagging, a lot of that’s up to genetics (if your mom drooped, you may, too), but some of it’s up to you. Sagging results not just from pregnancy itself but from a lack of support during pregnancy. No matter how firm your breasts are now, protect them for the future by wearing a supportive bra (though in that tender first trimester, you may want to avoid restrictive underwires). If your breasts are particularly large or have a tendency to sag, it’s a good idea to wear a bra even at night. You’ll probably find a cotton sports bra most comfortable for sleeping.

Not all women notice pronounced breast changes early in pregnancy, and some find the expansion takes place so gradually that it’s not perceptible. As with all things pregnancy, what’s normal is what’s normal for your breasts. And don’t worry: Though slower growth—or less substantial growth—means you won’t have to replace bras so often, it won’t have any impact on your ability to breastfeed.

“My breasts became very large in my first pregnancy, but they haven’t seemed to change at all in my second. Is that normal?”

Last time your breasts were newbies—this time, they entered pregnancy with previous experience. As a result, they may not need as much preparation—or react as dramatically to those surging hormones—as they did in your
first round of baby making. You may find that your breasts will enlarge gradually as your pregnancy progresses—or you may find that their expansion holds off until after delivery, when milk production begins. Either way, this slow growing is completely normal—and an early indication of how very different two pregnancies can be.

“I’ve been having a nagging feeling of pressure in my lower abdomen. Should I be worried?”

It sounds like you’re very tuned in to your body—which can be a good thing (as when it helps you recognize ovulation) or a not-so-good thing (when it makes you worry about the many innocuous aches and pains of pregnancy).

Don’t worry. A feeling of pressure or even mild crampiness without bleeding is very common, especially in first pregnancies—and is usually a sign that everything’s going right, not that something’s going wrong. Chances are, that sensitive body radar of yours is just picking up some of the many dramatic changes that are taking place in your lower abdomen, where your uterus is currently located. What you’re feeling may be the sensation of implantation, increased blood flow, the buildup of the uterine lining, or simply your uterus beginning to grow—in other words, your first growing pains (there will be many more to come). It could also be gas pains or bowel spasms that come with constipation (another common pregnancy side effect).

For further reassurance, ask your practitioner about the feeling (if you’re still having it) at your next office visit.

“I was using the toilet and noticed a small amount of blood when I wiped. Am I having a miscarriage?”

It’s definitely scary to see blood down below when you’re pregnant. But what’s not definite is that bleeding is a sign that something’s wrong with your pregnancy. Many women—about 1 in 5, in fact—experience some bleeding during pregnancy, and a very large majority go on to have a perfectly healthy pregnancy and baby. So if you’re only noticing light spotting—similar to what you see at the beginning or end of your period—you can take a deep breath and read on for a probable (and probably reassuring. explanation. Such light spotting is usually caused by one of the following:

Implantation of the embryo into your uterine wall.
Affecting 20 to 30 percent of women, such spotting (called “implantation bleeding” in the obstetrical business) will usually occur before (or in some cases around the time) you expected your period, around five to ten days after conception. Scantier than your monthly flow (and lasting anywhere from a few hours to a few days), implantation bleeding is usually light to medium pink or light brown in color and is spotty. It occurs when the little ball of cells you’ll one day call your baby burrows its way into the uterine wall. Implantation bleeding is not a sign that something is wrong.

Intercourse or an internal pelvic exam or Pap smear.
During pregnancy, your cervix becomes tender and engorged with blood vessels and can occasionally become irritated during intercourse or an internal exam, resulting in some light bleeding. This type of bleeding is common, can occur at any time during your pregnancy, and usually doesn’t indicate
a problem, but do tell your practitioner about any post-intercourse or-exam spotting for extra reassurance.

When to Call Your Practitioner

It’s best to set up a protocol for emergencies with your practitioner before an emergency strikes. If you haven’t, and you are experiencing a symptom that requires immediate medical attention, try the following: First call the practitioner’s office. If he or she isn’t available, leave a message detailing your symptoms. If you don’t get a call back within a few minutes, call again or call the nearest emergency room and tell the triage nurse what’s going on. If he or she tells you to come in, head to the ER and leave word with your practitioner. Call 911 if no one can take you to the ER.

When you report any of the following to your practitioner or to the triage nurse, be sure to mention any other symptoms you may be experiencing, no matter how unrelated they may seem to the immediate problem. Also be specific, mentioning when you first noticed each symptom, how frequently it recurs, what seems to relieve or exacerbate it, and how severe it is.

Call immediately if you experience:

Heavy bleeding or bleeding with cramps or severe pain in the lower abdomen.

Severe lower abdominal pain, in the center or on one or both sides, that doesn’t subside, even if it isn’t accompanied by bleeding.

A sudden increase in thirst, accompanied by reduced urination, or no urination at all for an entire day.

Painful or burning urination accompanied by chills and fever over 101.5°F and/or backache.

Fever over 101.5°F.

Very sudden and severe swelling or puffiness of hands, face, and eyes, accompanied by headache, vision difficulties, or sudden significant weight gain not related to overeating.

Vision disturbances (blurring, dimming, double vision) that persist for more than a few minutes.

A severe headache or a headache that persists for more than two or three hours.