16 Weeks Pregnant: Traveling While Pregnant

16 Weeks Pregnant

In this article

• Pregnancy Week 16: All About You
• Pregnancy Week 16: All About Baby
• How Big Is Baby?
• Most Common Pregnancy Questions
• Multiple Madness
• For Your Partner
• Fun Fact

There's no better time to plan a trip than right around 16 weeks pregnant. Find out what you need to know to make your vacation fun, safe, and healthy.

Now that it's finally sinking in that this baby thing is really going to happen, it's time to think about where it's going to happen! Plan your trip to the local hospitals and birth centers—and it's not too soon to think about your birthing plan.

Speaking of trips ... this is a great time to plan a get-a-way, too!

Pregnancy Week 16: All About You

In the coming weeks you should start to feel your baby move. You'll only feel a flutter at first, but before long you'll be able to distinguish kicks and hiccups, too. As your baby-to-be gets bigger, expect more soreness in your abdomen and back. Your breasts may also feel sore and larger as the tissue fills in and readies for milk production. As pregnancy hormones continue to pulse through your system to direct your body in baby production, you may experience headaches, dizziness, and even mood changes.

Travel while Pregnant

Your second trimester starts a window of weeks when you're feeling better than you have in a long time (goodbye nausea, hello baby bump). Your pregnancy glow is in full bloom, and your rounded belly fits beautifully into maternity pants. If you're going to travel at any point in your pregnancy, now is the time.

Physicians advise against travel in the first trimester due to the increased risk of miscarriage. According to the American College of Obstetricians and Gynecologists (ACOG), travel during the third trimester is also discouraged because of the chance of going into early labor (no one wants to go into preterm labor on the beach in Oahu). With a few safety precautions in mind you can head off for some R&R before your days and nights are filled with feedings and diapers.

Talk to your healthcare provider: Before you make any plans, discuss travel with your healthcare provider. While you may be feeling good, she needs to evaluate your health before you go. Have a few destinations in mind when you talk to her about your travel plans. For example, if you've had problems with water retention, she may advise you against a humid locale, which may aggravate your condition. Also, ask her to copy your prenatal records so that you can bring them with you—just in case. And don't forget to make sure that you have her number handy on those records if you need to call her.

Bring an approved first aid packet: You should pack a basic first aid kit, filled with medicines that come in handy when traveling (for instance Tylenol, anti-diarrhea, heartburn, and cold medicines). Review with your physician any over-the-counter and prescription medications that you plan to bring on your trip. Not all over-the-counter medicines are safe for pregnancy.

Plan on some restrictions: Keep in mind while making your travel arrangements that you won't be able to do everything, even with a physician's OK. Resorts, theme parks, and other travel providers may have restrictions on pregnant women for insurance reasons—they don't want you going into preterm labor or having complications any more than you do. Plan on sitting out the thrill rides and skipping scuba diving in favor of more relaxing vacation pursuits, such as time at the spa.

While you're there: Pregnancy is not the time for adventure travel. Keep a leisurely pace during your travels and take care or yourself. You might be tempted to do everything available and be out all day, but this can cause problems. Walking too much can lead to uncomfortable swelling.

Staying hydrated is key, too. Dehydration can cause preterm labor pains. So, be sure to drink plenty of water and take frequent potty breaks. (Avoiding bathroom breaks can aggravate your bladder and lead to urinary tract infections.)

Don't hesitate to contact your healthcare provider at any time during your trip. If you have questions about how you're feeling or medications that you plan on taking, give your physician a quick call.

Where to go: Where you choose to travel depends on your physician's guidelines. An hour-long car ride might be preferable over a long plane trip if you've had concerns during your pregnancy.

You may also want to choose US beaches over foreign locales. Some foreign destinations, especially those in third world countries, have amazing resort facilities but few medical care options if you were to have a problem.

Pregnancy Week 16: All About Baby

By week 16, your baby-to-be's body is doing more to support itself. Her kidneys function and produce urine that then passes through the umbilical cord. Within her stomach, bile is secreted, although she relies on you for all of her nutrients. Her appearance changes as her scalp hair grows and may even have color. Her developing facial muscles make it possible for her to open and close her mouth, maybe even give you a smile or two.

How Big Is Baby?

This week, your little one is around 4.5 inches long (crown to rump) and weighs in around 3 ounces. Baby is about the size of an avocado.

Most Common Pregnancy Questions

Should I opt for an amnio? Are they safe?

An amniocentesis is a special pregnancy diagnostic test most commonly preformed between week 16 and week 20 of pregnancy. This test is done by taking a small sample of the amniotic fluid (the fluid your unborn baby is floating in) to check on your baby's development and to screen for certain chromosomal abnormalities, including Down syndrome.

This is not a routine test. It is suggested primarily to women who are at risk of having a baby with abnormalities. Factors considered when deciding on the need for an amniocentesis include:

• Your age (if you're over 35)
• Your family history
• If you've had positive results from a nuchal fold test done before week 14 of pregnancy.

The test is done using ultrasound to guide your doctor as she inserts a very thin needle into your abdomen. The needle enters the uterus and withdraws a small amount of amniotic fluid. The fluid obtained from this test is then sent to a laboratory for testing. It can take up to 10 to 12 days for the results to be available. This is an invasive test, so it does carry with it a small risk of miscarriage. However, according to ACOG (the American College of Obstetricians and Gynecologists), the risk of miscarriage is about one percent, and complications are uncommon. Cramping, spotting, or leaking of amniotic fluid may occur after the procedure.

If you have questions or concerns, talk with your doctor before deciding on whether or not you want to have this test.

Multiple Madness

Twin Travel during Pregnancy

In a singleton pregnancy, most women are able to travel well into the third trimester. In a twin pregnancy, however, chances are you won't have that luxury.

Before you embark on a rip-roaring vacation while pregnant with multiples, check with your doctor. According to Dr. Susan Warhus, MD, author of Countdown to Baby, "The biggest concern is preterm labor." Women with low-risk singleton pregnancies can usually travel until 36 weeks, but women pregnant with multiples will need to stay closer to home sooner. "Every pregnancy differs, but a general guideline to stop traveling for twin pregnancies might be 24 to 26 weeks," says Dr. Warhus.

If your doctor does clear you for take off, Dr. Warhus suggests the following tips:

• Get a note from your doctor allowing you to travel and get on an airplane, if applicable.
• While traveling, walk around and stretch your legs every few hours. Prolonged sitting increases your risk for developing potentially life-threatening blood clots.
• Empty your bladder often. Holding in urine contributes to urinary tract infection, which can be uncomfortable and might also trigger preterm labor.
• Drink lots of water to avoid dehydration. Dehydration can cause increased heart rate for you and the babies, and can also contribute to preterm labor.
• When traveling by car and plane, always use your seat belt. If your belly has become too big for it to fit comfortably, call your car dealership and request a seat belt extender or ask a flight attendant for assistance.
• Bring along a copy of your prenatal medical records. That way, if you need to visit an unfamiliar hospital or medical clinic, the medical staff there will have your blood type, ultrasound, and other important information available about you and your pregnancy.

For Your Partner

The Power of Involved Fathers

Because the focus of pregnancy is primarily on the woman and unborn baby, many men enter fatherhood not understanding the importance of their roles. However, fathers are incredibly vital in their families' lives, as current research clearly points out. Recent findings have shown that when fathers believe that they're essential to the lives and health of their children, they become more involved.

But what difference does your presence as a dad really make?

Children of fathers who are involved in their lives are more likely to perform better in school, display higher levels of social competence, and experience fewer behavioral problems, according to studies performed by the US Department of Health and Human Services. These lucky kids are more likely to have healthy self concepts and be equipped to deal with life's challenges, experience better about their lives as adults, and also tend to have healthier marriages. Even more incredibly, daughters of involved fathers have higher self-esteem and begin sexual activity later in life than girls of less involved fathers.

One of the biggest reasons for this remarkable difference between children of delinquent fathers and children of dotting fathers is that being loved, adored, attended to, and stimulated by two people increases a child's sense of self, her intellect and social skills, and so much more.

This certainly doesn't negate the power of mothers, but rather reminds you that father involvement makes a significant difference in the life of your baby. Don't ever forget how much of a positive effect your involvement has on your child … no matter how old he or she is.

Fun Fact

According to the Travel Industry Association, married couples love to travel, married couples are the largest group of travelers at 62 percent, as cited in the 2004 Domestic Travel Report. No doubt many of these couples are taking babymoons (akin to a honeymoon, a trip aimed at giving you togetherness time with your partner before baby)!

17 Weeks Pregnant: Your Weight Gain

17 Weeks Pregnant



In this article

• Pregnancy Week 17: All About You
• Pregnancy Week 17: All About Baby
• How Big Is Baby?
• Most Common Pregnancy Questions
• Multiple Madness
• For Your Partner
• Fun Fact
• Follow The Chronicles of a Real-Life Pregnancy
• Join Your Due Date Club

At 17 weeks pregnant, chances are, you're not just starting to show but you're gaining some pregnancy weight as well. Here are important tips to keep you on the healthy track.

Each time you go to the doctor or clinic, they dip a strip of paper in a cup of your urine to measure your blood sugar level. What's with that blood sugar test, anyway? It's to make sure you're not developing gestational diabetes, a condition that affects around one to two percent of all pregnant women. When blood sugar levels are controlled (through diet and sometimes medication), women can have normal pregnancies and normal, healthy babies.

Pregnancy Week 17: All About You

Pregnancy Weight Gain and Other Symptoms
Daily, your body's changing inside and out to accommodate your baby-to-be. As your skin stretches, your breasts and abdomen may become itchy. Your baby bump will begin to change your posture so that your back may ache. Inside your body, your stomach is getting more cramped, sometimes leading to heartburn, indigestion, and flatulence. You may also notice mood swings as pregnancy hormones continue to play with your emotions.

Unsightly Pregnancy Signs
Your body undergoes many changes to give your baby-to-be enough room to grow. Some of these changes are comforting—your rounded belly and your full breasts, for example—while other signs can be troubling. Keep in mind that many of these physical changes will last only until your baby arrives.

• Bleeding gums: Your blood volume has increased dramatically to provide nutrients to your baby-to-be. This increase, along with swelling caused by pregnancy hormones, might make your gums bleed.
• Stretch marks: Whether or not you have stretch marks is a matter of genetics. No amount of specialty abdominal creams or Vitamin E pills are going to prevent stretch marks (despite claims to the contrary), but most women find that these stretch marks fade over time after the baby's birth.
• Weight gain: You should expect to gain 25 to 35 pounds during your pregnancy. As distressing as weight gain can be for some women, those pounds are necessary for your growing baby. Much of the weight is extra fluids (such as blood), tissues (like your breasts), and of course, your baby. (Find out how it all adds up here.) If you eat a sensible pregnancy diet and stay fit, you should be able to lose much of your pregnancy weight after your baby's birth. (Some women are able to shed pounds in a matter of weeks; others need as much as a year to get their bodies back in shape).
• Dark line (linea nigra): As your abdominal muscles stretch to make room for your growing uterus, you may notice a dark line extending from your belly button to your vaginal area. After birth, this line will disappear.
• Swelling (edema): Your body retains water to provide the necessary fluids for your growing baby-to-be. You can prevent much of this swelling from drinking plenty of fluids and keeping your legs up. You may also want to purchase socks designed to improve the circulation in your feet.
• Skin spots: The skin's pigmentation may deepen around certain parts of your body during pregnancy, such as your nipples and freckles. You may also notice spots of color on your face, called the mask of pregnancy or chloasma. These pigmentation changes will fade after your baby's born.

Pregnancy Week 17: All About Baby

Around this time your baby's ears pop from his head and Baby-to-be can now sense sounds. After all, he has plenty to listen to in utero! He's accustomed to the strong beating of your heart, blood rushing through your veins, and your stomach grumbling. He can also discern sounds outside the uterus, like your voice and music. Although, according to the Mayo Clinic, whether he can distinguish the sound of your voice versus other sounds is not yet clear.

On average, most moms are feeling fetal movement by week 17. Kick, little one, kick!

How Big Is Baby?

This week your little one weighs in at around 5 ounces and stretches to just over 5 inches (crown to rump). He is about the size of a red onion.

Most Common Pregnancy Questions

When can I find out the sex of my baby? Do the ultrasound technicians ever make mistakes?
Ultrasounds are used to help screen for abnormalities or deformities during pregnancy. While checking on the well-being of your baby, the ultrasound technician may also be able to determine the gender of your baby as early as week 16 or week 17 of pregnancy (however, between weeks 18 and 26 is best). If you're looking forward to this ultrasound as a chance to find out the sex of your child, be prepared; babies do not always cooperate. Many times babies aren't in the optimal position for visualizing the genitals.

Generally during one of these prenatal appointments and ultrasound checkups, your technician will be measuring the head, femur, abdomen, and amount of amniotic fluid as you're hoping to get a glimpse of your baby's gender. These are his or her priorities, and having an ultrasound simply for determining the sex of the baby is not recommended. In fact the ACOG (American College of Obstetricians and Gynecologists) has recommended not offering ultrasounds exclusively for determining the sex of a child. Long-term studies on high exposure to ultrasound are not known, and it is best to be prudent and keep your exposure to the minimum.

Although the quality and accuracy of gender detection during ultrasound is improving, amniocentesis or chorionic villus samplings are more accurate. Your technician will do his/her best to determine gender, if your baby cooperates. However, mistakes can and do happen (so, you can't ask your technician to repaint the nursery!).

To know or not to know … that is the question. This is a choice that you will have to make with your partner. But keep in mind that knowing ahead of time will not make your delivery any less exciting or your baby any less precious.

Multiple Madness

Mothering Twins Must-Haves
In the world of parenting, there are a few products one cannot be without. In the world of parenting twins, these must-have items are so critical that they should be acquired before the babies make their entrance.

• A headset phone. You'll want to talk to people but will need both hands (and you'll wish for a third) free to care for your babies. A headset phone allows you to have hands-free conversations.
• A voice recorder. There will be many moments when you'll need to write something down, but won't be able to find a pen (or will be driving).
• A page-a-day calendar. This will help to remind you that it isn't always Monday … or Wednesday … or Friday. It also gives you something fun and unique to look forward to each morning.
• Cute and comfy PJs. You'll wear them a lot. Get at least two pair so you'll have a fresh one to change into when the first needs washing.
• A selection of frozen meals and take-out menus. When it's 8 PM and you can't handle the thought of cereal for dinner (again!), you'll appreciate being able to quickly select something from the freezer or peruse a local take-out menu and decide upon your evening's sustenance.
• A handmade sign advising visitors to not ring your doorbell. This will ensure that those at your front door will make a quiet entrance and not disturb sleeping babies.

With these six items on hand for yourself, you'll be off to a great start!

For Your Partner

Your Job as Coach
One of the hardest things for many fathers-to-be is the sense of helplessness they feel. Men can't chip in by carrying their growing baby, giving their partners a break by going to the bathroom every 15 minutes, or by struggling to sleep at night. No, expecting dads just have to watch their partners cope with certain aspects of pregnancy all by themselves.

Some men respond to this situation by becoming Nervous Nellies. They worry over everything, afraid the slightest change means something might be wrong with their unborn child. In these cases, they mean to be helpful but may only end up stressing their partners out!

Some men disengage from the pregnancy experience, leaving their partners to manage the pregnancy alone. Others act out against their partners, even calling them fat or ridiculing them for eating too much. These reactions stem from the same out-of-control feelings. It can be difficult for men who want to step in and help but are instead be relegated only to sit back, watch, and cheer from the sidelines.

The best thing you can to do at this point is to focus on supporting your partner in any way she needs it. Help her reduce her worry, her responsibilities, her load, literally and figuratively. Think of your job as being her coach. Here are some tips:

• Make her snacks or buy her a water bottle so she never is without food or drink
• If you aren't already, help out more at home so she can get more rest
• Give her foot or back massages

In essence, pamper your partner now more than ever because in doing so you will also be pampering and feeding your unborn baby as well as building even more intimacy between you and your partner. If you can remember that everything you do for her you are also doing for your baby, you will feel more connected, more a part of this incredible process of pregnancy.

Fun Fact

While this fact isn't necessarily fun, it might be comforting to know that 90 percent of all women get stretch marks. You're not alone! Take heart—your stretch marks should fade after your baby's arrival.

18 Weeks Pregnant: Understanding Prenatal Tests

18 Weeks Pregnant

In this article

• Pregnancy Week 18: All About You
• Pregnancy Week 18: All About Baby
• How Big Is Baby?
• Most Common Pregnancy Questions
• Multiple Madness
• For Your Partner
• Fun Fact

Wondering what's going on with all the prenatal tests your healthcare provider is ordering? Find answers here.

Did you know that studies have shown that a full 60 percent of all expectant fathers show some symptoms of pregnancy? They may experience nausea, mood swings, weight gain, and odd cravings.

Pregnancy Week 18: All About You

By now you're feeling your baby-to-be wiggle inside you. The excitement surrounding her first movements will probably help you forget some of your pregnancy woes. As your tummy continues to expand you may notice stretch marks and have itchy skin. Your back will ache as your body adjusts to its new alignment. Thankfully, nausea is mostly likely a distant memory.

Understanding Pregnancy Tests
Between your sixteenth and twentieth weeks of pregnancy you'll be offered a series of tests to determine if your baby-to-be is at risk for certain genetic problems. Notice that these tests are offered but not required. Before you submit to the tests, it's important to understand what each entails and what the results will tell you about your developing baby.

Risk Assessments, Not Tests
Rather than view genetic tests as pass/fail, physicians see them as risk assessments, looking at whether your baby-to-be has a greater risk for certain genetic problems. For instance, a "positive" result doesn't necessarily indicate a problem with your baby, but that you might consider additional—and more definitive testing—to determine your baby's health. "The way I describe it to my patients is that these tests are like casting a wide net," explains Dr. Joanne Motino Bailey, PhD, a certified nurse midwife and a professor of women's studies at the University of Michigan. "You have plenty of healthy babies that are caught in the net" along with a handful of babies with genetic concerns.

Non-Invasive Tests
The main reason for so many false positives, according to Dr. Motino Bailey, is that physicians want to offer the safest, most non-invasive way to test your unborn baby for certain genetic disorders. These tests involve a simple blood test with virtually no risk to your baby-to-be.

• Quad test/triple screen: Your healthcare provider will draw your blood and test it for elevated levels of certain hormones and proteins, which may indicate your unborn baby has a genetic problem. The quad tests for Down syndrome, spina bifida, and other genetic problems. Keep in mind that this test has a high false positive and a high false negative rate.
Depending on your healthcare provider, you may be offered the triple screen, which includes looking at two hormone levels and one protein, or the quad test (quickly becoming the norm), which tests for an additional protein that may indicate genetic problems.
• Nuchal translucency screening (NTS): A more recent test option combines a blood test with an ultrasound to look for risk factors that may indicate that your unborn baby has Down syndrome. The test is highly specialized, however, so it may not be available in your area.
• Cystic fibrosis: Your blood sample will also be tested for cystic fibrosis. The test will determine if you are a CF carrier. If you are, your partner may then be tested. Because this is a recessive disorder, both you and your partner must be carriers for your unborn baby to be at risk. If both parents are carriers, according to ACOG, your unborn baby has a one in four chance of developing the disease.
• Ethnicity-based blood tests: Certain genetic disorders tend to appear in certain ethnicities. Your physician will ask a series of questions about your background to determine whether these tests are necessary for you.

Invasive Tests

If your first round of screening comes back with positive results (again, not meaning that your baby has a problem, but that she might be at a risk) you will be offered additional tests to give you a definitive answer about your unborn baby's genetic makeup. While these tests offer the yes/no answers you may be looking for, they do carry a risk of miscarriage.

• Amniocentesis: With an amnio, your healthcare provider inserts a long needle through your abdomen and into the uterus to collect a small sample of amniotic fluid. The fluid is then tested for genetic problems, such as Down syndrome, neural tube defects, and other disorders. The test is done between pregnancy weeks 16 and 20.
• Chorionic villus sampling (CVS): In CVS, a needle placed through your abdomen or through your vagina withdraws a tiny portion of the placenta. The sample can then be tested for Down syndrome, sickle-cell anemia, and cystic fibrosis. The test is performed between pregnancy weeks 10 and 12.

Note: CVS, a first-trimester test, provides parents with an earlier diagnosis than amniocentesis, a second-trimester test. Until recently, CVS had been associated with a slightly higher rate of miscarriage, but findings published in the September 2006 issue of Obstetrics & Gynecology show that the miscarriage rate is actually the same for both CVS and amnio, below two percent.

These tests are not to be taken lightly, advises Dr. Bailey. Take time to ask your healthcare provider about each test.

Pregnancy Week 18: All About Baby

At week 18, your baby-to-be's senses are maturing. She's able to hear sounds within her own comfortable environment, such as the sound of your heart beating, as well as external sounds, such as your voice. She may become more active for certain sounds, and you'll feel her movements. At this point in her development she's still small enough that she has plenty of room to wiggle.

How Big Is Baby?

Your little one is about 6 ounces and 5 to 6 inches long (crown to rump). Baby is about the size of a grapefruit.

Most Common Pregnancy Questions

Now that I know the sex of my baby, should I be doing anything differently?
There has been a lot in the news about phytoestrogens being a problem with women who are dealing with infertility and also report of lavender oils causing temporary increase in breast tissue (gynecomastia) for boys. Foods high in phytoestrogens (soy beans, tofu, tempeh, soy beverages, flax, sesame seeds) are those whose effects may mimic estrogen. Phytoestrogens act like weakened estrogen. There are some studies that hypothesize that these foods can affect infertility in women and in some cases men. One study, published in the January 2000 issue of The British Journal of Urology points out the possible correlation in the increased occurrence of hypospadius (the opening to the penis instead of being located at the tip of the penis may be on the underside). This increase is noted in babies of women who consume more phytoestrogens in a vegetarian diet.

When researchers look at the effects of diets high in soy as it relates to infertility, the studies done within labs with mice and rats involved ingestion of very large quantities. The quantities used in research were higher than what most women, even those who eat diets high in foods containing phytoestrogens, would normally consume.

How does all this relate to your pregnancy? The tried-and-true practice of everything in moderation is really the best approach here. Eating too much of one type of food can lead to not having enough room to eat other things that you need. So eat a colorful, varied diet. Take in a balance of fruits, veggies, grains, proteins, and fats. Talk to your doctor or a dietitian if you'd like help planning a healthy pregnancy diet.

Once your baby boy is born, talk with your pediatrician about the use of lavender oils or bath. There are boys who have experienced an increase in breast tissue after using lavender products, but this was only temporary (the tissue went back to its normal size after discontinuing use of the lavender).

Multiple Madness

Prepping the Nursery (Times Two!)
A woman expecting a singleton may not begin to decorate the nursery until she is at least 24 weeks along in her pregnancy. But when expecting multiples, it's important to get the nursery ready earlier rather than later. You simply have no way of knowing if, or when, you might be relegated to bed rest or restricted activity. Should that happen, you certainly don't want to be panicked over an unfinished nursery.

If your babies do arrive before the nursery is finished, it's not the end of the world. Your twins may spend some time in the neonatal intensive care unit, which will give you extra days to prepare. Also, your new little ones can always sleep in your room for the first few days or weeks. (With a crib or Pack 'n Play, babies can sleep anywhere).

Don't stress out too much about decorating your babies' room. For the first few months, the wall borders and other decorative touches are more for you than for the babies; they can barely see them!

However, to alleviate undo stress, it is a good idea to get together your nursery furniture and establish a general theme. Also, purchase your bouncy seats or portable cribs/playards so you have somewhere safe to put the babies when they aren't in their crib(s) or your arms. Have a few packages of newborn and size one diapers on hand and a few sets of comfortable clothing for each baby.

There aren't yet larger cribs designed for twins, and the philosophies on keeping twins in the same crib are mixed, for both medical and psychological reasons (that's a separate article to itself!) Logistically, keeping your twins in one room is tricky: there's often not space for more than twins cribs, one dresser, and a rocking chair. This is where planning ahead can help. Map out the room and try different furniture configurations before your babies come.

It's a good idea to maintain a checklist of things you need. Should the babies come early, your husband or another relative or friend can take that checklist to the store and purchase any necessities you missed before you and the babies come home.

For Your Partner

Beginning to Build Your Bond
As a dad-to-be, you don't have the same connection to your baby as your partner does. If you're looking for a fun way to build a connection with your unborn child, one of the best ways to get started is to talk to or read to your baby.

You might think talking to your partner's belly is a little embarrassing. Don't! Reading to baby can become a very special time between you and your partner; a new form of intimacy and sharing (and some quiet time that will be harder to come by after your baby is born).

But maybe even more importantly, reading to your unborn baby helps you relate to your baby as a person, giving you a head start for when your little one arrives in person.

In addition, your baby can now hear sounds and voices from the womb. This means you have a unique opportunity to help your little baby begin to recognize your own voice. Of course, your baby has a good chance of recognizing your partner's voice because she is with your baby all of the time. Reading, talking, and singing are all ways to share your voice with your baby.

After my twins were born, I stood next to my daughter in the hospital and called her name … and she turned her head to me, confirming all the time I had spent communicating with her while she was in the womb was worth it.

Fun Fact

All of your organs are working hard to help your baby-to-be develop, but perhaps the hardest working organ during pregnancy is your heart. Your blood volume increases by 50 percent during your pregnancy, meaning your heart has to work that much harder to pump the blood throughout your body.

19 Weeks Pregnant: Celebrity Baby Bumps

19 Weeks Pregnant

In this article

• Pregnancy Week 19: All About You
• Pregnancy Week 19: All About Baby
• How Big Is Baby?
• Most Common Pregnancy Questions
• Multiple Madness
• For Your Partner
• Fun Facts

Do you find yourself seeking out magazines with pregnant celebrities? You're not alone. A lot of expecting women find themselves seeking out connections with fellow pregnant women.

Pregnancy Week 19: All About You

Your belly is getting rounder by the day. You may find that you need to rest more to keep your energy up. Your back and abdomen may be achy with the added weight. Expect to have some uncomfortable pregnancy symptoms fade and others get worse—your nausea has probably ended while heartburn and indigestion have taken its place. Continue to plan on plenty of bathroom breaks.

Celebrity Baby Bumps
Quick—name three pregnant celebrities. Chances are you can name more than that! You can probably even name a handful of celebrities who've given birth over the past year. Why are we so obsessed with celebrity baby bumps? "I think a big part of the fascination with celebrities' pregnancies is it humanizes them in our eyes," explains Dr. Joanne Motino Bailey, a certified nurse midwife and a woman's studies professor at the University of Michigan. Seeing a star go through pregnancy—by means of candid pictures—makes them seem more like the rest of us. After all, what could make your favorite round-bellied starlet more endearing than seeing snapshots of her downing a Big Mac in a track suit? But as with all things Hollywood, some effects of the celebrity baby boom may leave you with unrealistic expectations for your own pregnancy.

Maternity Fashions
Pregnancy clothing options used to be little more than raiding your partner's closet for shirts. Yet the celebrity baby boom has brought designers running to make pregnant women look their best. Gone are the days of ugly elastic-waist jeans and tent-like dress jumpers. You can now find maternity fashions on any budget.

The downside: We can't all afford a completely new wardrobe for a few months of use. But if you're sensible with your selection of maternity clothes, you can dress up simple shirts with stylish accessories.

Baby Bump Behavior
Back in the 1950s, pregnancy seemed almost indecent. Women wore bulky clothes to hide their bumps and spent a fair amount of time at home. This is no longer the case. Many women are often just as active and outgoing during their pregnancies as they were before conception. You can find pictures of celebrities still going to the gym, enjoying (many) a night out, and working until delivery day.

The downside: You never see the pictures of the celebrities taking naps or passing off daily tasks to their assistants. Expect to slow down and simplify your schedule during your pregnancy. Your body needs extra energy to fuel your growing baby-to-be.

Celebrity's Birth Options
Water birth, at-home birth, doula, midwife … pregnant women have many options for how they're going to deliver their babies. Celebrities made public the very private topic of pregnancy. As a result, some birth options—like home births—that were once taboo, aren't anymore.

The downside: Celebrities have an entourage of medical help to make some of their more far-flung birth requests possible. Delivering a baby in a third-world country may not be the safest option for you. And elective C-sections carry real risks.

Post-Pregnancy Body
How many times have you seen magazine covers boasting titles such as, "How [insert a celebrity's name] got her body back"? Losing post-pregnancy pounds can be extremely difficult. Some celebrities openly discuss their battles with the bulge. Knowing it's not easy for them might help you stick to your own post-pregnancy diet plan.

The downside: Many celebrities go to extremes when it comes to losing weight fast. Some even get surgical help to lose a few pounds. Others are just blessed with forever slender shapes. Watching a celebrity walk the red carpet a week after delivery can give you false sense of how quickly you'll realistically be back into your pre-pregnancy jeans.

Celebrity baby bump watching can be fun. You may feel some kinship to a once svelte siren who's now packed on the pounds, but don't compare your own experience or your body to your favorite celebrities'.

Pregnancy Week 19: All About Baby

In your 19th week of pregnancy, your unborn baby's organs continue to grow. His body is covered with lanugo soft hairs and a sticky protective coating that keeps his skin from drying out in the amniotic fluid. Your baby is moving frequently, and by now you should be able to feel those movements. Your physician can hear your baby-to-be's heartbeat with a stethoscope placed on your abdomen.

Baby is covered in vernix, a white, cheesy "cream" that protects her skin from the long bath in amniotic fluid. Preemies are covered in vernix at birth "posties" have almost none.

How Big Is Baby?

Your little one weighs in at around 7 to 8 ounces and he's between 5 and 6 inches long (crown to rump).

Most Common Pregnancy Questions

I'm 19 weeks pregnant and worried about my weight gain. How do I know if I'm gaining just the right amount? Could I be gaining too much or too little weight?
An important consideration when determining how much weight is appropriate for you is your pre pregnancy weight and your body mass index or BMI. BMI is a measurement of body fat based on your height and weight. There are some general guidelines to follow, and your healthcare provider should work with you to get you on the right track.

Most women will gain between four and six pounds during the first trimester. The weight gain in the second and third trimesters depends on what category you fall into based on your pre-pregnancy weight.

Don't try to lose weight during pregnancy or try to stay within the parameters for your pre-pregnancy weight. Too much weight gain puts you at risk for high blood pressure and diabetes. Also having a large baby can cause complications at delivery. Too little weight gain may put your baby at risk for being underweight. A woman who is underweight pre-pregnancy should gain between 28 and 40 pounds. Try to gain slightly over a pound a week in the second and third trimesters.

A woman with a normal pre-pregnant weight should gain between 25 and 35 pounds. Many women may not gain much weight during the first trimester due to nausea. But the average is four to six pounds for a healthy weight gain for your first 12 weeks of pregnancy. After the first trimester, you should gain about a pound a week. If you are overweight pre-pregnancy the recommended weight gain is 15 to 25 pounds. You should put on about one pound every two weeks in the second and third trimesters.

Don't ever try to lose weight during pregnancy.

Where Does All The Weight Go?

• Baby: 7 to 8 pounds
• Larger breasts: 1 to 3 pounds
• Larger uterus: 2 pounds
• Placenta: 1 1/2 pounds
• Amniotic fluid: 2 pounds
• Increased blood volume: 3 to 4 pounds
• Increased fluid volume: 2 to 3 pounds
• Fat stores: 6 to 8 pounds pregnancy.

Talk with your healthcare provider about what weight gain is the best for you and try to stick within those recommended parameters. Eat well! When you are feeling hungry (and you will!) try to make healthy food choices, doing so will not only help you feel better, it provides the best nutrition for your growing baby.

Multiple Madness

Famous Baby Bumps
The number of celebrities who've recently welcomed twins into the world is staggering. It's almost as though having twins is the newest PR strategy!

It's fun to watch the Hollywood crowd anticipate the arrival of stardom's newest multiples, but it's also important to keep a few things in mind.

Women sometimes get a bit frazzled when they see a celebrity who has 8-week-old twins looking slim and svelte. Don't discount that many celebrities, especially the most photographed ones, have access to dieticians, chefs, personal trainers, and airbrushing! And most have nannies who tend their children while they eat properly and run five miles each morning!

Rather than staring enviously at the latest new mom on the cover of People magazine each time you're in the checkout line, strive to emulate the celebrities who do things on their terms—or on terms that resonate with you as "real." Focus on how much they are enjoying this time. Consider moms like Jennifer Garner or Kate Hudson who openly relished time with their new babies and publicized that weight loss was not their first priority.

And remember that we see celebrities on the covers of magazines, but we don't see what goes on beyond closed doors. Nannies, chefs, and trainers aside, celebrity new moms are still new moms. They, too, experience the emotional ups and downs of new motherhood (case in point: Brooke Shields and her public battle with postpartum depression).

Take it easy on yourself. And be thankful you don't have to worry about the possibility of being photographed and critiqued each time you head to Starbucks!

For Your Partner

Famous Dads
Many women find themselves scoping out pregnant celebrities while they are also expecting. The unique sense of connection with these Hollywood figures stems from them experiencing the same things at the same time. Famous dads-to-be are harder to spot, but more and more celebrity men are "coming out" to extol the exciting, life-altering, and amazing nature of fatherhood.

Our society is changing, giving men more of a voice to be honest and open about how fatherhood feels and how it is changing their lives. And as a result, dads in the spotlight are sharing their stories.

In a society where motherhood is revered and fatherhood is seen more as a supporting actor's role, it is fun to see male stars come out and freely state how fatherhood is affecting them. Brad Pitt has been quoted several times stating fatherhood is the greatest role in his life so far. Tiger Woods talks about changing diapers and getting less sleep. "It's an awakening," says Philip Seymour Hoffman, who reports that when you become a parent everything changes; you look at your own parents differently, and at your own childhood differently. "When you have a child, as anyone knows who has them, that's basically all you want to talk about," he adds.

Take a note from these Hollywood dads and make a point to share with your spouse how you feel and what you think about your impending fatherhood. She'll appreciate the insight! The more involved you become in the lives of your children, the more likely they are also to experience benefits from being involved.

Fun Facts

Pregnancy on TV has come a long way. When Lucille Ball was pregnant during her run on I Love Lucy, TV censors thought using the term "pregnancy" on air would be in appropriate. Instead, the script called for the actors to refer to Lucy as "expecting."

20 Weeks Pregnant: Let's Talk About Gender



20 Weeks Pregnant



In this article

• Pregnancy Week 20: All About You
• Pregnancy Week 20: All About Baby
• How Big Is Baby?
• Most Common Pregnancy Questions
• Multiple Madness
• For Your Partner
• Fun Facts

Boy or girl? Right around your 20th week of pregnancy, an ultrasound can answer that big question for you.

Sex and more sex! Remember that unless you've been advised against it by your healthcare provider because of bleeding or risk of miscarriage, sex is fine, a good stress reliever, and a great way to "touch bases" with your partner. Don't feel up to it? That's OK, too. Read Sex and Pregnancy and remember that cuddling is a good thing, too.

Pregnancy Week 20: All About You

The Gender Ultrasound
You're finally comfortable in your maternity clothes—your protruding baby bump proudly declaring you're going to be a mom, soon. In fact, you're halfway there! By now you're feeling your unborn baby wiggle and kick—which may be caused by your baby experiencing hiccups. Along with your progressing pregnancy, you may also notice more aches and pains. Your lower back and abdomen may be sore from your growing belly. Heartburn, indigestion, and flatulence are frequent as your expanding uterus allows less space for your stomach. Swelling, called edema, may make your hands and feet uncomfortable, too.

The Big Ultrasound
This week you'll get a sneak peak at your unborn baby! At 20 weeks, most physicians request that you receive an ultrasound to determine that your baby-to-be is developing normally, that your due date is accurate, and—if you're interested—whether there are pink or blue baby booties in your future.

Ultrasound BasicsUltrasound is a safe, relatively comfortable procedure that gives physicians more information about your developing baby. An ultrasound technician will apply a topical gel to your abdomen so that the high-frequency sound waves can travel easily through your belly. The technician then moves a transducer, a handheld device that looks something like a grocery store scanner, around your abdomen, sending sound waves as it goes. These waves, once translated through the ultrasound machine, generate a picture. The ultrasound technician will take several measurements of different parts of your unborn baby's body to make sure her development is on track.

Don't be surprised if you're asked to arrive for your ultrasound with a full bladder. A full bladder constricts your baby-to-be's wiggle room, making for easier imaging. But because things are so crowded in there, the ultrasound technician may have to prod your unborn baby into resituating so that all the measurements can be made. With a full bladder and pressure from the transducer on your abdomen, the ultrasound may be slightly unpleasant—but don't worry, the pictures will be worth it!

The ultrasound usually lasts around 30 minutes. Depending on the office where you receive your ultrasound, you may be able to receive a recording of the session or at least several pictures to show off your baby-to-be. Not all lab offices offer recordings of the ultrasound for moms-to-be so call beforehand to check what the lab offers. You can also ask if you can take home a picture or two.

Your baby's gender: In most cases, your ultrasound technician will be able to tell you if you're having a girl or boy. If you don't want to know, tell the technician before you begin so that you don't inadvertently see or hear something you shouldn't. (Try your hand at predicting Baby's gender with our Gender Predictor!)

For those women who do want to know the baby's sex, the results are usually accurate. Usually. The accuracy rates for determining your unborn baby's gender by ultrasound are about 80 to 90 percent. Keep in mind, the ultrasound technician needs to get a clear picture of your unborn baby's "parts" to be certain. For girls, the technician will be looking for three small lines between her legs indicating the female labia. For little boys, the technician will be looking for a developed penis and scrotum. Be forewarned some babies do not cooperate for this look at their private parts and wiggle and squirm to the point that the technician may not be able to say with any degree of certainty whether you're having a boy or a girl.

Take a look at our great collection of second trimester ultrasounds—and see if you can tell boys from girls.

Is ultrasound necessary? While the 20-week ultrasound is traditional, it's not necessary. "There's no advantage to performing an ultrasound if a woman's pregnancy is otherwise normal and healthy," explains Dr. Joanne Motino Bailey, PhD, CNM. "While it has become standard practice, there's no medical evidence that shows that performing standard ultrasounds improves a baby's outcome." That said, Dr. Bailey points out that most mothers find the ultrasound to be a comfort, getting a chance to finally see their unborn babies. In other countries, such as Japan, many women receive an ultrasound at every office visit, notes Dr. Bailey. This is also the case for many moms experiencing high-risk pregnancies, were trips to the ultrasound technician may occur once or twice each week.

Pregnancy Week 20: All About Baby

By week 20, your baby-to-be is gearing up for the next phase in his development—filling out. His organs are getting into their proper places. His kidneys are now in position with their familiar bean shape. His testes (or ovaries for girls) have reached their position. His brain continues to form and grow. His teeth are beginning to appear, and he can swallow. If you haven't been able to feel him move, chances are you'll be feeling him move more and more over the coming weeks.

How Big Is Baby?

Baby is about 10 inches long (crown to heel) and around 10 ounces.

Your belly button may become an "outie" as the uterus presses on it from behind. Some women swear that putting a Band-Aid on it helps keep it from brushing painfully against their clothes. Worth a try!

Most Common Pregnancy Questions

I'm afraid of getting stretch marks. What can I do to avoid them or help them go away?
Stretch marks (or striae) are an unpleasant by product of pregnancy for many women. Rapid stretching of the skin causes these initially red or purple marks. In time your stretch marks will diminish and become silvery or white in appearance. They should also become smaller or less pronounced, but won't ever completely go away.

Seeing these red or purple lines creating a road map on your belly, hips, or breasts can be more than a little disconcerting for most women. There are many factors involved in determining whether or not you end up with stretch marks. Here's what you need to know:

• Ethnicity is one of the strongest factors. Although no matter what your ethnic background is, 50–90 percent of you will end up with them. Almost 90 percent of Caucasian women will end of up with some amount of stretch marks. Darker skinned women tend to experience less stretch marks.
• Genetics are another big factor. Talk to your mother and see if she experienced stretch marks during her pregnany.
• Weight gain plays a big part in the stretch mark game. Excessive weigh gain will increase your risks of ending up with stretch marks.
• Hydration is another factor, and one that you can control. Drink plenty of water and use moisturizers to help keep your skin supple.
• Take your prenatal vitamins and eat welll, there is no substitute for good nutrition in taking care of your skin, hair, and nails.

If you do end up with stretch marks, try to keep in mind it is a small price to pay for your wonderful baby. And after giving birth, you can nourish your skin with creams and oils to help your skin bounce back. You can also talk to a dermatologist or in some cases a plastic surgeon, for advice on how to help your skin's appearance improve.

Multiple Madness

Must-Have Gadgets for Twins
We've discussed must-have equipment for moms of twins. Now it's time to profile the top must-have (and often overlooked) products for the babies themselves.

1. Many parents-to-be of twins purchase two bouncy seats. If you can manage it, I recommend four; they are cheaper than swings and playyards, and much easier to move around. (Scour garage sales or check eBay, Craig's List or Freecycle to find low-cost and free gently-used items; but be sure to check our recall list for products to steer clear of) It's helpful to have two bouncy seats in your family room and two in your bedroom so that when you need to shower, fold clothes, or just doze off for a few moments in the afternoon, you don't have to lug bouncy seats back and forth throughout your house.
2. A sling or front-pack baby carrier can be great for your twins. Two options that have received strong reviews for use with twins, especially newborns, are the Baby K'Tan and the Moby Wrap. Both products have detailed instructions on their respective sites on how to use the slings with twins.
3. Using a backpack as a diaper bag is a lifesaver. It allows you to hold all of your gear hands-free! Be sure to choose one with pockets on the outside which provide a convenient place to stash bottles, burp cloths, and formula containers.

Another tool many parents of twins swear by (even though they initially shy away from it) is a bottle prop. Not intended to replace your presence, the prop helps parents who, for one reason or another, need two hands to feed one baby but both babies need to eat at the same time. The Bottle Bundle by Little Wonders is a great product, an many moms of twins have had wonderful luck with it." Other essential items on your shopping list, whether you're having twins or not, should be:

• Diaper rash cream. The moms in my group found that all creams are not created equal! Boudreaux's Butt Paste, while also having a hilarious name, works like a charm when your baby's bottom is in bad shape.
• Cool-mist vaporizer. When the babies are stuffed up, this product adds moisture to their room's air and helps keep their nasal passages from getting too dry.
• Rectal thermometer. Four o'clock in the morning isn't the best time to hear that your pediatrician wants to know a baby's temperature and you don't have a thermometer in the house! A rectal thermometer is the best way to get an accurate temperature on a newborn.
The need for car seats, cribs, and diapers is obvious. But if you have the above items in your house prior to your little ones arrival, you'll be well prepared for your first few weeks at home.

For Your Partner

Boy or Girl? That's the Question! Do you want to know whether you are having a boy or a girl? This can be a big decision to make, with lots to consider. How does your partner feel? How will you decide?
Many parents opt not to learn their babies' genders because they want to be surprised at birth. It is hard to argue with the suspense that builds throughout pregnancy; finding out your little one's gender when you meet for the first time is a once-in-a-lifetime event. What a dramatic moment!
For other moms- and dads-to-be, knowing if a boy or girl is on the way can help the bonding process begin sooner. Because a man doesn't have a physical connection with his developing baby, finding out may help Dad-to-be develop a more concrete picture of what Baby will be like.
When pondering which path you and your partner will take, consider that this is not only about discovering the sex of your baby; you'll need to contemplate whether or not knowing might help you bond with Baby and better envision what your new life.

Fun Facts

At one time, physicians thought that the fetal heart rate might show whether unborn babies were boys or girls. Supposedly, girls' heart rates were faster than boys'. There's no medical evidence to support this claim, although researchers have noticed that an unborn baby's heart rate can help physicians determine the gestational age.

21 Weeks Pregnant: Bonding With Baby-to-Be

21 Weeks Pregnant

In this article

• Pregnancy Week 21: All About You
• Pregnancy Week 21: All About Baby
• How Big Is Baby?
• Most Common Pregnancy Questions
• Multiple Madness
• For Your Partner
• Fun Fact

You don't have to wait until your baby arrives to begin bonding. Try these simple ideas to feel closer to your little one during your 21st week of pregnancy, and beyond.

Pregnancy Week 21: All About You

Now that your body is accustomed to your new addition, you'll notice several pregnancy symptoms disappear: Nausea becomes a distant memory and fatigue more manageable. Your breasts and abdomen are less tender, but you may experience itchiness and see stretch marks as your body continues to expand. As your internal organs are pushed aside to make room for the growing fetus, you may have heartburn, indigestion, and bloating. Your mood swings lessen, but you may have more anxiety about labor and motherhood as the reality of your baby's birth draws closer.

Bonding with Your Baby-to-Be

You don't have to wait until your baby arrives to begin bonding. Throughout your pregnancy you may have thoughts and impressions about your baby-to-be's personality. Maybe she constantly wiggles at a certain time of day, or her movements become less frequent when you're listening to particular kinds of music. Try these simple ideas to feel closer your little one.

Talk to your baby-to-be: According to a 2005 study by Barbara Kisilevsky, a nursing professor at Queens University in Ontario, Canada, babies prefer their mothers' voices even before they're born. Kisilevsky, who conducted the research with a team of psychologists from Queens and obstetricians in Hangzhou, China, found that babies' heart rates in utero accelerated at the sound of their mothers' voices. You can help your baby get to know your voice by talking to him. Sing to him in the car, rattle off the ingredients as you cook dinner, or read to him. Let other family members in on the fun; your partner or other children can talk to your tummy, too!

Start a library for your little one: If this is your first child, you may not have any baby books in your home. Before your baby arrives, pick out stories you can share with her. You'll be reading these stories over and over again, so choose carefully. (And remember, you don't have to wait she's born to start reading to her.)

Listen to music together: Your baby can hear sounds, including music, in utero (how well she hears it is still a matter of scientific study). While you may not convert your baby-to-be to your preferred bands, you'll feel a connection to her as she kicks during your favorite tunes. Try picking an anthem for your baby—maybe a Beatles classic, a country ballad, or a calming lullaby.

Ready the nursery: Preparing your child's room can help you envision what life will be like once he arrives. Choosing colors, picking out crib sheets, and adding decorations to plain walls may make your impending motherhood feel all the more real.

Buy baby clothes: Shopping for a little one can be fun. Just look at how small those newborn socks are! Display your finds on hangers in the nursery.

Blog your pregnancy: Help your family and friends know more about how you're feeling through a website designed around your pregnancy. Post ultrasound pictures or—if you're brave enough—pictures of your growing baby bump. Friends and family can offer support and share in your excitement. (Or use our tools to create your own online pregnancy journal!)

Keep a journal of your thoughts: Take time to reflect on what it means to be carrying your child. Record these thoughts in a diary so that you'll never forget how you felt during your pregnancy. You may even share this journal with your child once he gets older.

Pregnancy Week 21: All About Baby

Your little one will begin to fill out over the next few weeks. Fat layers form throughout your unborn baby's body. These layers will eventually keep him warm and insulated once outside the womb. Soft hair, called lanugo, covers his body, too. His eyelids are still closed, making him appear like he's sleeping, but frequent wiggles will let you know he's awake. You may also feel Baby hiccupping.Those jerky motions you feel in your belly are a result of little lungs practicing the important task of breathing.

How Big Is Baby?

Your little one is about 10.5 inches long (crown to heel) and weighs in around 12 ounces.

Most Common Pregnancy Questions

My back really hurts! What's going on? What can I safely do to help alleviate this pain?

Lower back pain or discomfort is a common pregnancy symptom for many women. As you gain weight and hormones loosen joints to accommodate the size of your baby, many women will complain of aches, fatigue, or even moderate to severe pain in the lower back.

There are some things you can do to lessen the severity and improve the symptoms:

• Wear comfortable, supportive shoes
• Continue to exercise if you have been doing so
• Sleep on your left side with pillows to provide good spine alignment
• Sit in comfortable, supportive chairs
• Bend your knees when lifting (never lift heavy objects)
• Take acetaminophen as prescribed by your doctor
• Use heat or ice on your lower back
• Have a massage or see a chiropractor (make sure they are trained and specialize in working with pregnant women)

And, yes, you should lie on your left side. Here's why. There is a large vessel that runs behind the uterus called the vena cava. If you lay on your back, this may compress the vena cava, compromising blood flow, which can result in dizziness or nausea. It also decreases the efficiency of blood flow to the placenta. The vena cava tends to shift to the right side of the uterus, so getting on your left side will maximize blood flow and keep you comfortable. If you have always slept on your belly, back or right side, it may feel uncomfortable at first, but you will adjust to this position quickly. Don't panic if you wake up on your back, just readjust and get back to dreamland.

Just because it is an expected symptom of pregnancy, don't take back pain lightly. Constant dull, low back pain can sometimes be a symptom of labor. Severe pain along with other symptoms like dizziness, vaginal bleeding, or rupture of membranes (breaking of water) should be reported to your doctor.

Multiple Madness

Coping with Bed Rest

Bobby McFerrin said (er, sang!) it best: "Don't worry, be happy." If you try hard enough, you'll find many reasons to worry during a multiple pregnancy. But it's in everyone's best interest to let your pregnancy unfold as it will and deal with unplanned events as they occur. Worrying about what may or may not happen is not the best use of your energy right now.

However, it is a good idea to proactively plan ahead. This can be especially helpful when it comes to bed rest, a relatively common multiple pregnancy detour. Some women never experience it, but for those who do, it can be frustrating and stressful. Bed rest may be recommended by your doctor at any time and for a variety of reasons.

So, what can you do to prepare yourself for the possibility of going on bed rest? Try these tips:

The biggest concern women have regarding bed rest is who will care for the other children. Plan in advance and map out a strategy for your older kids. Is there a family member nearby or who could travel to your home and help? Would you need to hire someone? Is there someone in the neighborhood who could lend a hand? Or do you have a daycare facility in the area that you could use on a short-term basis?

It can be hard to lie in bed all day either at home or in the hospital. Find a support system. You can find great online support through the non-profit organization Sidelines, which provides support for families experiencing complicated pregnancies and premature births.

Make this time as positive and productive as you can. Purchase baby necessities online, work on baby albums, assemble quilts, or learn to knit and make some booties.

Bed rest will end. (And you may find yourself thinking a few weeks into parenting twins, "Now what exactly about being stuck in bed all day was so bad?")

For Your Partner

When Something Goes Wrong

Lugging an extra 10 to 20 pounds or more can be terribly exhausting for some pregnant women. Combine that weight with the rigors of day-to-day life, and your spouse's body is now working harder than it ever has before to simply walk from the car to the front door, up and down stairs at the office, or around the grocery aisles. The truth is, pregnancy affects every woman differently, and it is hard—if not impossible—to determine how it is going to affect your partner. If your spouse begins to feel ill at this point in her pregnancy, experiences complications, or is ordered onto partial or complete bed rest, it becomes your job to do everything in your power to help her.

When the unplanned occurs during pregnancy, it is stressful for both you and your spouse. In order to help her, you'll need to be as flexible and creative as possible. She may need to have more food or water with her wherever she goes (equipping her with a Camelbak or other low-weight, ergonomic water carrier can be key). She may need to remain lying down as much as possible (try rearranging areas in your home so she is never far from anything she needs). You can help by setting up a little snack and water tray by the bed or couch. Get her good books to read, videos to watch, or music to listen to.

Remember, taking care of your partner gives her a better chance of carrying to full-term and delivering a healthy baby for you both.

But to take care of yourself, you'll also need to think creatively. You can't afford to be overwhelmed by stress but like many expecting dads, the added stress and worry affects you, too, and you don't want to burden your partner more than she already is. Yet it is extremely important that you find some way to manage your increased stress. Try talking to friends and family, seek out the advice of fathers who have already been through this. Check out resources on the Web to help you feel more connected, less isolated, less alone.

When things get tough, it is even more important that you two find special time together, time where you can push aside the stress and anxiety and remember that it was the love you two have for each other that brought you here today, that your love for each other, your ability to communicate, to share, to love will be what helps you both get through all of this together.

Fun Fact

According to Kisilevsky, research shows that a newborn can discriminate different sounds in virtually all languages. She reports that over the course of baby's first year, she will lose discrimination ability, then only be able to understand sounds within the language she hears daily. "It seems that infants really are set up to learn language, and it doesn't really matter which language it is," Kisilevsky says.

C-section

What is a cesarean section?

A cesarean section, or c-section, is the delivery of a baby through a surgical incision in the mother's abdomen and uterus. In certain circumstances, a c-section is scheduled in advance. In others, it's done in response to an unforeseen complication.

According to the Centers for Disease Control and Prevention, about 30 percent of American women who gave birth in 2005 had a cesarean delivery, up from 6 percent in 1970, 17 percent in 1980, and 23 percent in 1990.

 C-section is major abdominal surgery, so it is riskier than a vaginal delivery. Moms who have c-sections are more likely to have an infection, excessive bleeding, blood clots, more postpartum pain, a longer hospital stay, and a significantly longer recovery. Injuries to the bladder or bowel, although very rare, are also more common.

C-section

In addition, if you plan to have more children, each c-section you have increases your future risk of these complications as well as placenta previa and placenta accreta. That said, not all c-sections can, or should be prevented. In some situations, a c-section is necessary for the well-being of the mother, the baby, or both.

Why would I have a planned c-section?

Sometimes it's clear that a woman will need a cesarean even before she goes into labor. Conditions that may require a planned c-section include:

You've had a previous cesarean with a "classical" vertical uterine incision or more than one previous c-section. (If you've had only one previous c-section with a horizontal incision, you may be a good candidate for a vaginal birth after cesarean, or VBAC.If you're not trying for a VBAC, your practitioner will schedule your c-section for no earlier than 39 weeks to minimize the risk that the baby's lungs are still immature.)

You've had some other kind of invasive uterine surgery, such as a myomectomy (the surgical removal of fibroids).

You're carrying more than one baby. (Some twins can be delivered vaginally, but all higher-order multiples require a c-section.)

Your baby is expected to be very large (a condition known as macrosomia). This is particularly true if you're diabetic or you had a previous baby of the same size or smaller who suffered serious trauma during a vaginal birth.

Your baby is in a breech (bottom first) or transverse (sideways) position. (In some cases, such as a twin pregnancy in which the first baby is head down but the second baby is breech, the breech baby may be delivered vaginally.)

You have placenta previa (when the placenta is so low in the uterus that it covers the cervix).

The baby has a known illness or abnormality that would make a vaginal birth risky.

You're HIV-positive, and blood tests done near the end of pregnancy show that you have a high viral load.

Why would I have an unplanned cesarean delivery?

You may need to have a c-section if problems arise that make continuing or inducing labor risky. These include the following:
Your cervix stops dilating or your baby stops moving down the birth canal, and attempts to stimulate contractions to get things moving again haven't worked.


Your baby's heart rate gives your practitioner cause for concern, and she decides that your baby can't withstand continued labor or induction.

The umbilical cord slips through your cervix (a prolapsed cord). If that happens, your baby needs to be delivered immediately because a prolapsed cord can cut off his oxygen supply.

Your placenta starts to separate from your uterine wall (placental abruption), which means your baby won't get enough oxygen unless he's delivered right away.

You have a genital herpes outbreak when you go into labor or when your water breaks (whichever happens first). Delivering your baby by c-section will help him avoid infection.

What happens right before a c-section?

First, your practitioner will explain why she believes a c-section is necessary, and you'll be asked to sign a consent form. If your prenatal practitioner is a midwife, you'll be assigned an obstetrician for the surgery who will make the final decision and get your consent.

Typically, your husband or partner can be with you during most of the preparation and for the birth. In the rare instance that a c-section is such an emergency that there's no time for your partner to change clothes — or you need general anesthesia, which would knock you out completely — your partner might not be allowed to stay in the operating room with you.

An anesthesiologist will then come by to review various pain-management options. It's rare these days to be given general anesthesia, except in the most extreme emergency situations or if you can't have regional pain relief for some reason.


More likely, you'll be given an epidural or spinal block, which will numb the lower half of your body but leave you awake and alert for the birth of your baby.

If you've already had an epidural for pain relief during labor, it'll be used for your c-section as well. Before the surgery, you'll get extra medication to ensure that you're completely numb. (You may still feel some pressure or a tugging sensation at some point during the surgery.)

A catheter is then inserted into your urethra to drain urine during the procedure, and an IV is started if you don't have one already. The top section of your pubic hair is shaved, and you're moved into an operating room.

Anesthesia will be administered, and a screen will be raised above your waist so you won't have to see the incision being made. (If you'd like to witness the moment of birth, ask a nurse to lower the screen slightly so you can see the baby but not much else.) Your partner or husband, freshly attired in operating room garb, may take a seat by your head.

How is a c-section done?

Once the anesthesia has taken effect, your belly will be swabbed with an antiseptic, and the doctor will most likely make a small, horizontal incision in the skin above your pubic bone (sometimes called a "bikini cut").

The doctor will cut through the underlying tissue, slowly working her way down to your uterus. When she reaches your abdominal muscles, she'll separate them (usually manually rather than cutting through them) and spread them to expose what's underneath.

When the doctor reaches your uterus, she'll probably make a horizontal cut in the lower section of it. This is called a low transverse incision.

In rare circumstances, the doctor will opt for a vertical or "classical" uterine incision. This might be the case if your baby is very premature and the lower part of your uterus is not yet thinned out enough to cut. (If you have a classical incision, it's much less likely that you'll be allowed to attempt a vaginal delivery with your next pregnancy.)

Then the doctor will reach in and pull out your baby. You'll have a chance to see the baby briefly before he's handed off to a pediatrician or nurse. While the staff is examining your newborn, the doctor will deliver your placenta and then begin the process of closing you up.

After your baby has been examined, the pediatrician or nurse may hand him to your partner, who can hold him right next to you so you can admire, nuzzle, and kiss him while you're being stitched up, layer by layer. The final layer — the skin — may be closed with stitches or staples, which are usually removed three days to a week later. Closing your uterus and belly will take a lot longer than opening you up, usually about 30 minutes.

After the surgery is complete, you'll be wheeled into a recovery room, where you'll be closely monitored for a few hours. If your baby is fine, he'll be with you in the recovery room and you can finally hold him.

If you plan to breastfeed, give it a try now. You may find nursing more comfortable if you and your newborn lie on your sides facing each other.

You can expect to stay in the hospital for three or four days before going home.