What to expect when you're expecting (55 page)

Mild cramps, achiness, or a pulling sensation in the lower abdomen or on one or both sides of the abdomen. This is probably caused by the stretching of ligaments that support the uterus. Unless cramping is severe, constant, or accompanied by significant bleeding, there’s no need to worry.

Slight spotting that isn’t accompanied by cramps or lower abdominal pain. There are plenty of reasons why pregnant women spot, and it often has nothing to do with a miscarriage. See
page 137
for more on spotting.

Of course, it’s not just symptoms that pregnant women worry about in early pregnancy—it’s a lack of symptoms, too. In fact, not “feeling pregnant” is one of the most commonly reported first-trimester concerns. And that’s not surprising. It’s hard to feel pregnant this early on even if you’re experiencing every early pregnancy symptom in the book—and it’s far harder still to feel pregnant if you’re relatively symptom-free. Without tangible proof yet of that baby-to-be growing inside you (a swelling belly, those first flutters of movement), it’s pretty easy to start wondering whether the pregnancy is going well—or whether you’re even still pregnant at all.

Once again, not to worry. A lack of symptoms—such as morning sickness or breast tenderness—is not a sign that something’s wrong. Consider yourself lucky if you’re spared these and other unpleasant early pregnancy symptoms—and also consider that you might be a late bloomer. After all, since every pregnant woman experiences pregnancy symptoms differently and at different times, these and other symptoms may be just around the corner for you.

”My doctor gave me the results of my blood test and it says that my hCG level is at 412 mIU/L. What does that number mean?”

It means you’re definitely pregnant! Human chorionic gonadotropin (hCG) is manufactured by the cells of the newly developing placenta within days after the fertilized egg implants in your uterine lining. HCG is found in your urine (you came face-to-stick
with hCG the day that positive readout showed up on your home pregnancy test) and in your blood, which explains why your practitioner ran a blood test to find out your expectant status for sure. When you’re very early in the pregnancy game (as you are), the level of hCG in your blood will be quite low (it’s just starting to show up in your system, after all). But within days, it’ll begin to soar, doubling every 48 hours (give or take). The rapid increase peaks somewhere between 7 and 12 weeks of pregnancy and then starts to decline.

But don’t start swapping your numbers with those of your pregnant best friend. Just as no two women’s pregnancies are alike, no two pregnant women’s hCG levels are alike either. They vary enormously from day to day, person to person, even as early as the first missed day of a period and continuing throughout pregnancy.

HCG Levels

Really want to play the hCG numbers game? The following are ranges of “normal” hCG levels based on date. Keep in mind that anywhere in that wide range is normal—your baby doesn’t have to be scoring off the charts for your pregnancy to be progressing perfectly—and that a slight miscalculation in your dates can throw the numbers off completely.

What’s more important and relevant to you is that your hCG level falls within the very wide normal range (see box, this page. and continues to increase over the coming weeks (in other words, look for a pattern of increasing levels instead of focusing on specific numbers). Even if your readings fall outside these ranges, don’t worry. It’s still quite likely that everything’s fine (your due date might just be off—a very common cause of hCG number confusion—or you might be carrying more than one baby). As long as your pregnancy is progressing normally and your hCG levels are increasing during the first trimester, you don’t have to obsess about these numbers or even try to find them out (plus, if your practitioner is happy with your numbers, then you can be, too). Ultrasound findings after five or six weeks of pregnancy are much more predictive of pregnancy outcome than are hCG levels. Of course, as always, if you are concerned, talk with your practitioner about your results.

“My job is a high-stress one. I wasn’t planning to have a baby now, but I got pregnant. Should I quit work?”

Depending on how you handle and respond to it, stress can be good for you (by sparking you to perform better, to function more effectively) or it can be bad for you (when it gets out of control, overwhelming and debilitating you). Research shows that pregnancy isn’t affected by typical stress levels—and if you’re able to cope well with your on-the-job stress (even if it’s more than most people could take on), then your baby will be able to cope just fine, too. But if the stress makes you anxious,
sleepless, or depressed, if it’s causing you to experience physical symptoms (such as headache, backache, or loss of appetite), if it’s causing you to turn to unhealthy behaviors (smoking, for instance), or if it is exhausting you, then it could eventually pose a problem.

Relaxation Made Easy

Is your growing bundle of joy making you a quivering bundle of nerves? Now’s a great time to learn some soothing relaxation techniques—not just because they can help you cope with pregnancy concerns, but because they’ll come in handy in your hectic life as a new mom. Yoga’s a fabulous destresser, if you have time to take a prenatal class or practice with a DVD. If you don’t, you can try this simple relaxation technique, which is easy to learn and to do anywhere, anytime. If you find it helpful, you can do it when anxiety strikes and/or regularly several times a day to try to ward it off.

Sit with your eyes closed and imagine a beautiful, peaceful scene (a sunset over your favorite beach, waves gently lapping the shore; a serene mountain vista, complete with babbling brook), or even your fantasized baby-to-be, wrapped in your arms on a sunny day in the park. Then, working your way up from your toes to your face, concentrate on relaxing every muscle. Breathe slowly, deeply, through your nose (unless it’s stuffed up) and choose a simple word (such as “yes” or “one”) to repeat aloud every time you exhale. Ten to 20 minutes should do the trick, though even a minute or two is better than nothing.

Since negative reactions to stress can take a toll, especially if they continue into the second and third trimesters—learning to handle the stress constructively, or cutting back on it, as needed, should become a priority now. The following should help:

Unload it.
Allowing your anxieties to surface is the best way of ensuring that they don’t get you down. Make sure you have somewhere to vent—and someone to vent to. Maintain open lines of communication with your spouse, spending some time at the end of each day (preferably not too close to bedtime, which should be as stress free as possible) sharing concerns and frustrations. Together you may be able to find some relief, some solutions—and ideally a good laugh or two. Is he too stressed to absorb enough of your stress? Find others who can lend an ear—a friend, another family member, coworkers (who will understand your workplace stress better?), or your practitioner (especially if you’re concerned about the physical effects of your stress). Empathy helps, too, so try to find other expectant moms who can relate, either in a pregnancy group or online. If you need more than a friendly ear, consider counseling to help you develop strategies to better deal with your stress.

Do something about it.
Identify sources of stress in your life and determine how they can be modified. If you’re clearly trying to do too much, cut back in areas that are not high priority (this is something you’re going to have to do big time anyway, once you have a bigger priority—a new baby—on the agenda). If you’ve taken on too many responsibilities at home or at work, decide which can be postponed or delegated. Learn to say no to new projects or activities before you’re overloaded (another skill you’re wise to cultivate pre-baby).

Sometimes, sitting down with a pad or PDA and making lists of the hundreds of things you need to get done (at home or at work), and the order in which you’re planning to do them, can help you feel more in control of the chaos in your life. Cross items off your list as they’re taken care of for a satisfying sense of accomplishment.

Sleep it off.
Sleep is the ticket to regeneration—for mind and body. Often, feelings of tension and anxiety are prompted by not getting enough shut-eye—and, of course, having too much tension and anxiety can also prevent you from getting enough shut-eye. If you’re having trouble sleeping, see the tips on
page 265
.

Nourish it.
Hectic lifestyles can lead to hectic eating styles. Inadequate nutrition during pregnancy can be a double whammy: It can hamper your ability to handle stress, and it can eventually affect your baby’s well-being. So be sure to eat well and regularly (six mini meals will best keep you going when the going gets tough). Focus on complex carbs and protein, and steer clear of excesses of caffeine and sugar, two staples of the stressed life that can actually leave you less able to cope.

Wash it away.
A warm bath is an excellent way to relieve tension. Try it after a hectic day; it will also help you to sleep better.

Run it off.
Or swim it off. Or prenatal yoga it off. You might think that the last thing you need in your life is more activity, but exercise is one of the best stress relievers—and mood boosters. Build some into your busy day.

CAM it.
Explore the many complementary and alternative therapies that can promise inner calm from CAM, among them biofeedback, acupuncture, hypnotherapy, massage (ask your spouse for a back or shoulder rub, or splurge on a professional pregnancy massage). Meditation and visualization can also melt the stress away (just close your eyes and picture a bucolic scene, or
keep them open and gaze at a soothing picture or photo placed strategically in your office). Practice relaxation techniques (see box,
page 142
), not just because they’ll come in handy during childbirth, but because they can help drain the strain anytime. See
page 85
for more on CAM techniques.

Expect the Best

It’s long been speculated that optimistic people live longer, healthier lives. Now it’s been suggested that an expectant mother’s optimistic outlook can actually improve the outlook for her unborn baby, too. Researchers have found that seeing the bright side reduces the chance of a high-risk woman delivering a preterm or low-birthweight baby.

A lower level of stress in optimistic women definitely plays a part in the lowered risk; high levels of stress, after all, have been implicated in a variety of health problems both in and out of pregnancy. But stress itself apparently doesn’t tell the whole story. Women who are optimistic, not surprisingly, are more likely to take better care of themselves—eating well, exercising right, getting regular prenatal care, not smoking, drinking, or using drugs. And these positive behaviors—fueled by the power of positive thinking—can, of course, have a very positive effect on pregnancy and fetal well-being.

Researchers point out that it’s never too late to start reaping the benefits of optimism, even if you’re already pregnant. Learning how to expect the best—instead of the worst—can actually help make those expectations come true: a good reason to start seeing that glass of milk as half full instead of half empty.

Get away from it.
Combat stress with any activity you find relaxing. Lose it in reading; a good movie; listening to music (take your iPod to coffee breaks and lunch, or even use it while you work, if you can); knitting (you can relax while you get a head start on those booties); window-shopping for baby clothes; lunching with a fun friend; keeping a journal (another good way to vent your feelings); browsing baby sites online; scrapbooking. Or walk away from it (even a quick stroll can be relaxing and rejuvenating).