What to expect when you're expecting (82 page)

Though it might offend your esthetic sensibilities (and possibly your partner’s, during oral sex), and make you feel a little icky and sticky on occasion, this discharge is nothing to worry about. Keeping yourself clean, fresh, and dry will help, of course, but do not douche. Douching upsets the normal balance of microorganisms in the vagina and can lead to bacterial vaginosis (BV; see
page 500
). For information on vaginal infection and its symptoms, see
page 499
.

“My blood pressure was up a little bit at my last visit. Should I be worried?”

Relax. Worrying about your blood pressure will only send the readings higher. Besides, a slight increase at one visit is probably nothing to worry about. Maybe you were stressed because you were caught in traffic on the way to your appointment or because you had a pile of papers to finish back at work. Maybe you were just nervous—you were afraid you’d gained too much weight or not enough, or you had some strange symptoms to report, or you were anxious to hear the baby’s heartbeat. Or maybe medical settings just make you edgy, giving you what is known as “white coat hypertension.” An hour later, when you were relaxed, your pressure might very well have been perfectly normal. To make sure anxiety doesn’t do a number
on those numbers again, try to do some relaxation exercises (see
page 142
) while you’re waiting for your next appointment—and, especially, while your blood pressure’s being taken (think happy baby thoughts).

Even if your blood pressure remains slightly elevated at your next reading, such transient high blood pressure (which about 1 to 2 percent of women develop during pregnancy) is perfectly harmless and disappears after delivery (so you can still relax).

Most expectant mothers will see a slight drop in blood pressure readings during the second trimester as blood volume increases and the body starts working long hours to get that baby-making factory up to speed. But when you hit the third trimester, it usually begins to rise a bit. If it rises too much (if systolic pressure—the upper number—is 140 or more or the diastolic pressure—the lower number—is over 90) and stays up for at least two readings, your practitioner will monitor you more closely. That’s because if such mildly elevated blood pressure is also accompanied by protein in the urine, swelling of the hands, ankles, and face, and/or sudden weight gain, it may turn out to be preeclampsia; see
page 548
.

“At my last office visit, the doctor said that there was sugar in my urine, but that it wasn’t anything to worry about. Isn’t it a sign of diabetes?”

Take your doctor’s advice—don’t stress. Your body is probably doing just what it’s supposed to do: making sure that fetus of yours, which depends on you for its fuel supply, is getting enough glucose (sugar).

The hormone insulin regulates the level of glucose in your blood and ensures that enough is taken in by your body cells for nourishment. Pregnancy triggers anti-insulin mechanisms to make sure enough sugar remains circulating in your bloodstream to nourish your fetus. It’s a perfect idea that doesn’t always work perfectly. Sometimes the anti-insulin effect is so strong that it leaves more than enough sugar in the blood to meet the needs of both mother and child—more than can be handled by the kidneys. The excess is “spilled” into the urine. Thus “sugar in the urine” is not uncommon in pregnancy, especially in the second trimester, when the anti-insulin effect increases. In fact, roughly half of all pregnant women show some sugar in the urine at some point in their pregnancies.

Get Your Flu Shots

The Centers for Disease Control and Prevention recommends that every woman who will be pregnant during flu season (generally October through April) be given the flu shot. The shot will not affect your baby and is unlikely to cause you any side effects. (The worst that can happen is you’ll develop a mild fever and feel more tired than usual for a few days.) Ask if you can get the thimerosal-free (or reduced) vaccine, if available. Pregnant women should not get FluMist, the nasal spray flu vaccine. FluMist, unlike the flu shot, is made from live flu virus and could actually give you a mild case of the flu.

In most women, the body responds to an increase in blood sugar with an increased production of insulin, which usually eliminates the excess sugar by
the next office visit. This may well be the case with you. But some women, especially those who are diabetic or have tendencies toward diabetes (because of a family history or because of their age or weight), may be unable to produce enough insulin at one time to handle the increase in blood sugar, or they may be unable to use the insulin they do produce efficiently. Either way, these women continue to show high levels of sugar in both blood and urine. In those who were not previously diabetic, this is known as gestational diabetes (see
page 546
).

You—like every pregnant woman—will be given a glucose screening test around the 28th week to check for gestational diabetes (those at higher risk may be screened earlier). Until then, don’t give the sugar in your urine another thought.

“A friend of mine became anemic during pregnancy—is that common?”

Iron-deficiency anemia is common during pregnancy—but it’s also incredibly easy to prevent. And when it comes to prevention, your practitioner has your back. You were already tested for anemia at your first prenatal visit, though it’s unlikely you were low on iron then. That’s because iron stores are quickly replenished once those monthly periods stop.

As your pregnancy progresses and you hit the halfway mark (around 20 weeks, coming right up), your blood volume expands significantly and the amount of iron needed for producing red blood cells dramatically increases, depleting those stores once again. Fortunately, filling those stores up again—and effectively preventing anemia—is as easy as taking a daily iron supplement (in addition to your prenatal vitamin), which your practitioner may prescribe starting midway through pregnancy. You should also pump up your diet by eating foods loaded with iron (though dietary sources, such as the ones listed on
page 100
, may not do the job alone, they provide a great backup for your supplement). For extra absorption, chase your iron down with vitamin C–rich foods (your morning OJ instead of your morning java, which will actually reduce the amount of iron absorbed).

Symptoms of Anemia

Pregnant women with mild iron deficiency rarely have symptoms. But as oxygen-carrying red blood cells are further depleted, an anemic mother-to-be becomes pale, extremely weak, easily tired or breathless, and might even experience fainting spells. This may be one of the few instances where fetal nutritional needs are met before Mom’s, since babies are rarely iron deficient at birth.

Though all pregnant women are susceptible to iron-deficiency anemia, certain groups are at particularly high risk: those who have had several babies in quick succession, those who have been vomiting a lot or eating little because of morning sickness, and those who came to pregnancy undernourished (possibly because of an eating disorder) and/or have been eating poorly since they conceived. Daily iron supplementation, as prescribed by your practitioner, should prevent (or relieve) anemia.

“I haven’t felt the baby moving yet; could something be wrong? Or could I just not be recognizing the kicking?”

Forget that positive pregnancy test, the early ultrasound, that expanding belly, or even the lub-dub of a baby’s heartbeat. Nothing says you’re pregnant like fetal movement.

That is, when you finally feel it. And you’re sure you felt it. However, few expectant moms, particularly first timers, feel the first kick—or even the first flutter—in the fourth month. Though the embryo begins to make spontaneous movements by the seventh week, these movements, made by very tiny arms and legs, don’t become apparent to mom until much later. That first momentous sensation of life, or “quickening,” can occur anywhere between the 14th and 26th weeks, but generally closer to the average of the 18th to 22nd week. Variations on that average are common. A woman who’s had a baby before is likely to recognize movement earlier (both because she knows what to expect and because her uterine and abdominal muscles are more lax, making it easier to feel a kick) than one who is expecting her first child. A very slender woman may notice very early, weak movements, whereas a woman who’s sporting lots of padding on her belly may not be aware of movements until much later, when they’ve become more vigorous. The position of the placenta can also play a role: If it’s facing front (an anterior placenta), it can muffle the movements and make the wait for those kicks weeks longer.

Sometimes, fetal movements aren’t noticed when expected because of a miscalculated due date. Other times, mom doesn’t recognize the movement when she feels it—or mistakes it for gas or other digestive gurgles.

So what do early movements feel like? They’re almost as hard to describe as they are to recognize. Maybe it’ll feel like a flutter (sort of like the “butterflies” you can get when you’re nervous). Or a twitch. Or a nudge. Or even like the growling of hunger pangs. Maybe it’ll feel like a bubble bursting—or that upside-down, inside-out sensation you get on a roller coaster. No matter what it feels like, it’s bound to put a smile on your face—at least once you figure out for sure what it is.

“I’ve always watched my weight—and now when I look in the mirror or step on a scale, I get so depressed. I look so fat.”

When you’ve watched your weight your whole life, watching the numbers on the scale creep up can be unnerving—and maybe a little depressing, too. But it shouldn’t be. If there’s one place where thin is never in, it’s in pregnancy. You’re supposed to gain weight when you’re pregnant. And there’s an important difference between pounds added for self-indulgent reasons (just too many midnight dates with Ben and Jerry) and pounds gained for the best and most beautiful of reasons: your child and its support system growing inside you.

In the eyes of many beholders, a pregnant woman isn’t just beautiful inside but outside as well. Many women and most spouses (and others who ogle) consider the rounded pregnant silhouette the most lovely—and sensuous—of feminine shapes. So instead of longing for the thin old days (you’ll have them back soon enough), try getting on board with your expectant body. Embrace those new curves (which will become even more fun to embrace as they grow). Celebrate your new shape. Relish being rounder. Enjoy the pounds
you pack on, instead of dreading them. As long as you’re eating well and not exceeding the recommended guidelines for pregnancy weight gain, there’s no reason to feel “fat”—just pregnant. The added inches you’re seeing are all legitimate by-products of pregnancy and will disappear soon enough after the baby is born.

A Pregnant Pose

If you’ve been dodging the camera lately (“no need to put yet another 10 pounds on me!”), consider striking a pregnant pose. Even if you may prefer to forget what you look like pregnant, your child-to-be will definitely relish seeing his or her first “baby” pictures one day—and so will you, eventually. To preserve your pregnant progress for posterity, have someone take a photo of your profile each month. Dress in something form-fitting (or belly-baring) for more dramatic documentation of your silhouette, and compile your photos in a pregnancy album or post them in an online photo gallery for easy sharing with family and friends, alongside the ultrasound shot, if you have one.

If you are exceeding the guidelines, feeling depressed about it won’t keep you from getting fatter (and, if you’re a typical estrogen producer, will only send you to the freezer for that vat of mint chocolate chip more often), but taking a good look at your eating habits might. Remember, the idea isn’t to stop the weight gain (that’s unsafe during pregnancy)—only to slow it down to the right rate if it’s adding up a little too quickly. Instead of cutting back on the Pregnancy Diet requirements, just become more efficient in filling them (a smoothie made with yogurt to fill a Calcium serving instead of a pint of ice cream).

Watching your weight gain isn’t the only way to give your appearance an edge. Exercise will definitely help, too, by ensuring that the weight you do gain ends up in all the right places (more belly, less hips and thighs). Another workout plus: It’ll give you a mood lift (it’s hard to feel depressed when you’ve got an exercise-induced endorphin high going).

Being maternity fashion-forward can also help you make friends with your mirror. Instead of trying to squeeze into your civilian wardrobe (nothing flattering about the muffin-top look, especially when buttons keep popping), choose from the vast selection of creative maternity styles that accentuate the pregnant shape, rather than trying to hide it. You’ll like your mirror image better, too, if you get a hairstyle that’s slimming, pamper your complexion, and experiment with new makeup routines (the right techniques can take pounds off your pregnancy-rounded face; see
page 149
).

“I can’t squeeze into my jeans anymore, but I dread buying maternity clothes.”

There’s never been a more styling time to be pregnant. Gone are the days when pregnancy wardrobes were limited to tentlike muumuus intended to hide the expectant shape under yards and yards of polyester. Not only are today’s maternity clothes a lot more fashion- forward and practical to wear, but they’re designed to hug (and highlight) your beautiful baby-filled belly. Visit a nearby maternity store (or shop one online) and you’ll likely be filled with excitement, instead of dread.

Looking Slim When You’re Bulking Up

Big is beautiful when you’re expecting, but that doesn’t mean you can’t try some tricks of the trim. With the right fashion choices, you can highlight your belly while slimming your overall silhouette. Here’s how to show in all the right places: