Pregnancy and Birth Sourcebook Part 10

Get excited-the final countdown has begun!

Your Developing Baby First Trimester (Week 1Week 12) At 4 Weeks * Your baby's brain and spinal cord have begun to form.

* The heart begins to form.

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Pregnancy and Birth Sourcebook, Third Edition * Arm and leg buds appear.

* Your baby is now an embryo and 1/25 of an inch long.

At 8 Weeks * All major organs and external body structures have begun to form.

* Your baby's heart beats with a regular rhythm.

* The arms and legs grow longer, and fingers and toes have begun to form.

* The s.e.x organs begin to form.

* The eyes have moved forward on the face and eyelids have formed.

* The umbilical cord is clearly visible.

* At the end of 8 weeks, your baby is a fetus and looks more like a human. Your baby is nearly 1 inch long and weighs less than 1/8 of an ounce.

At 12 Weeks * The nerves and muscles begin to work together. Your baby can make a fist.

* The external s.e.x organs show if your baby is a boy or girl.

* A woman who has an ultrasound in the second trimester or later might be able to find out the baby's s.e.x.

* Eyelids close to protect the developing eyes. They will not open again until the 28th week.

* Head growth has slowed, and your baby is much longer. Now, at about 3 inches long, your baby weighs almost an ounce.

Second Trimester (Week 13Week 28) At 16 Weeks * Muscle tissue and bone continue to form, creating a more complete skeleton.

* Skin begins to form. You can nearly see through it.

* Meconium develops in your baby's intestinal tract. This will be your baby's first bowel movement.

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The Three Trimesters of Pregnancy: You and Your Baby * Your baby makes sucking motions with the mouth (sucking reflex).

* Your baby reaches a length of about 4 to 5 inches and weighs almost 3 ounces.

At 20 Weeks * Your baby is more active. You might feel slight fluttering.

* Your baby is covered by fine, downy hair called lanugo and a waxy coating called vernix. This protects the forming skin underneath.

* Eyebrows, eyelashes, fingernails, and toenails have formed.

* Your baby can even scratch itself.

* Your baby can hear and swallow.

* Now halfway through your pregnancy, your baby is about 6 inches long and weighs about 9 ounces.

At 24 Weeks * Bone marrow begins to make blood cells.

* Taste buds form on your baby's tongue.

* Footprints and fingerprints have formed.

* Real hair begins to grow on your baby's head.

* The lungs are formed, but do not work.

* The hand and startle reflex develop.

* Your baby sleeps and wakes regularly.

* If your baby is a boy, his t.e.s.t.i.c.l.es begin to move from the abdomen into the s.c.r.o.t.u.m. If your baby is a girl, her uterus and ovaries are in place, and a lifetime supply of eggs have formed in the ovaries.

* Your baby stores fat and has gained quite a bit of weight. Now at about 12 inches long, your baby weighs about 1 1/2 pounds.

Third Trimester (Week 29Week 40) At 32 Weeks * Your baby's bones are fully formed, but still soft.

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Pregnancy and Birth Sourcebook, Third Edition * Your baby's kicks and jabs are forceful.

* The eyes can open and close and sense changes in light.

* Lungs are not fully formed, but practice "breathing" movements occur.

* Your baby's body begins to store vital minerals, such as iron and calcium.

* Lanugo begins to fall off.

* Your baby is gaining weight quickly, about 1/2 pound a week.

* Now, your baby is about 15 to 17 inches long and weighs about 4 to 4 1/2 pounds.

At 36 Weeks * The protective waxy coating called vernix gets thicker.

* Body fat increases. Your baby is getting bigger and bigger and has less s.p.a.ce to move around. Movements are less forceful, but you will feel stretches and wiggles.

* Your baby is about 16 to 19 inches long and weighs about 6 to 6 1/2 pounds.

Weeks 3740 * By the end of 37 weeks, your baby is considered full term.

* Your baby's organs are ready to function on their own.

* As you near your due date, your baby may turn into a head-down position for birth. Most babies "present" head down.

* At birth, your baby may weigh somewhere between 6 pounds, 2 ounces and 9 pounds, 2 ounces and be 19 to 21 inches long.

* Most full-term babies fall within these ranges. But healthy babies come in many different sizes.

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Part Three

Staying Healthy during Pregnancy

Chapter 16.

Choosing a Pregnancy Health Care Provider Chapter Contents.Section 16.1-How to Choose an Obstetrician/Gynecologist .... 134 Section 16.2-What Is a Midwife? .............................................. 136 133.

Pregnancy and Birth Sourcebook, Third Edition Section 16.1 How to Choose an Obstetrician/Gynecologist Excerpted from "Choosing a Prenatal Care Provider," by the Office of Women's Health (www.womenshealth.gov), part of the U.S. Department of Health and Human Services, March 2009.

Medical checkups and screening tests help keep you and your baby healthy during pregnancy. This is called prenatal care. It also involves education and counseling about how to handle different aspects of your pregnancy. During your visits, your doctor may discuss many issues, such as healthy eating and physical activity, screening tests you might need, and what to expect during labor and delivery.

Choosing a Prenatal Care Provider You will see your prenatal care provider many times before you have your baby. So you want to be sure that the person you choose has a good reputation, and listens to and respects you. You also will want to find out if the doctor or midwife can deliver your baby in the place you want to give birth, such as a specific hospital or birthing center.

Health care providers that care for women during pregnancy include: * Obstetricians (OB) Obstetricians (OB) are medical doctors who specialize in the care of pregnant women and in delivering babies. OBs also have special training in surgery so they are also able to do a cesarean delivery. Women who have health problems or are at risk for pregnancy complications should see an obstetrician. Women with the highest risk pregnancies might need special care from a maternal-fetal medicine specialist. are medical doctors who specialize in the care of pregnant women and in delivering babies. OBs also have special training in surgery so they are also able to do a cesarean delivery. Women who have health problems or are at risk for pregnancy complications should see an obstetrician. Women with the highest risk pregnancies might need special care from a maternal-fetal medicine specialist.

* Family practice doctors Family practice doctors are medical doctors who provide care for the whole family through all stages of life. This includes care during pregnancy and delivery and following birth. Most family practice doctors cannot perform cesarean deliveries. are medical doctors who provide care for the whole family through all stages of life. This includes care during pregnancy and delivery and following birth. Most family practice doctors cannot perform cesarean deliveries.

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Choosing a Pregnancy Health Care Provider * A certified nurse-midwife (CNM) and certified profes- A certified nurse-midwife (CNM) and certified profes- sional midwife (CPM) are trained to provide pregnancy and postpartum care. Midwives can be a good option for healthy women at low risk for problems during pregnancy, labor, or delivery. A CNM is educated in both nursing and midwifery. Most CNMs practice in hospitals and birth centers. A CPM is required to have experience delivering babies in home settings because most CPMs practice in homes and birthing centers. All midwives should have a backup plan with an obstetrician in case of a problem or emergency. are trained to provide pregnancy and postpartum care. Midwives can be a good option for healthy women at low risk for problems during pregnancy, labor, or delivery. A CNM is educated in both nursing and midwifery. Most CNMs practice in hospitals and birth centers. A CPM is required to have experience delivering babies in home settings because most CPMs practice in homes and birthing centers. All midwives should have a backup plan with an obstetrician in case of a problem or emergency.

Ask your primary care doctor, friends, and family members for provider recommendations. When making your choice, think about: * reputation; * personality and bedside manner; * the provider's gender and age; * office location and hours; * whether you always will be seen by the same provider during office checkups and delivery; * who covers for the provider when she or he is not available; * where you want to deliver; and * how the provider handles phone consultations and after-hour calls.

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Pregnancy and Birth Sourcebook, Third Edition Section 16.2 What Is a Midwife?

"What Is a Midwife?" Journal of Midwifery and Women's Health, Journal of Midwifery and Women's Health, September/October 2006. 2006 American College of Nurse-Midwives (www.midwife.org). Reprinted with permission. September/October 2006. 2006 American College of Nurse-Midwives (www.midwife.org). Reprinted with permission.

Certified nurse-midwives (CNMs) are licensed health care providers educated in nursing and midwifery. Certified midwives (CMs) are licensed health care providers educated in midwifery. CNMs and CMs have graduated from college; they have pa.s.sed a national examination; and they have a license to practice midwifery from the state they live in. Most of the midwives in the United States are CNMs or CMs.

What do midwives do?

CNMs/CMs help over 300,000 women give birth each year in the United States. Most of these births are in hospitals. CNMs/CMs also care for women who decide to have their baby in freestanding birth centers and/or at home. CNMs/CMs provide health care to women all through life, including: prenatal care, birth, care after birth, care for the new baby, annual exams, birth control planning, menopause, and health counseling.

Why would I choose a midwife for care during my pregnancy?

CNMs/CMs believe you need time and special attention so you can be healthy and able to take care of your baby. Midwives specialize in providing support, regular health care, and in helping you get any additional care needed. Midwives are experts in knowing the difference between normal changes that occur during pregnancy and symptoms that require extra attention.

What if I have a high-risk pregnancy or complication dur- ing labor?

Your CNM/CM will prescribe medicine and order treatment for any common illness that you might get during pregnancy. Midwives work 136 Choosing a Pregnancy Health Care Provider with doctors who specialize in illness during pregnancy. If you have a medical problem during pregnancy or complication during labor, your midwife will work with a doctor to make sure you get the best and safest care for you and your baby. Your midwife will also work with other health care providers: nurses, social workers, nutritionists, doulas, childbirth educators, physical therapists, and other specialists to help you get the care you need.

What if I want pain medicine during labor?

If you think you want pain medicine during labor, your midwife will give you information about the medicines available so you can decide what is right for you. Midwife means "with woman." If you decide you want pain medicine during labor, your midwife can prescribe it for you.

Should I see a midwife if I am not pregnant?

Many women go to their CNM or CM for annual check ups, family planning, and to get care for common infections that happen to women.

For example, your midwife can answer questions about all the methods of birth control, help you decide what is best and safest for you, and prescribe it for you.

Questions to Ask When Choosing a Health Care Provider during Pregnancy Questions to ask any health care provider: * Do you practice alone or with others? Do they share your beliefs and manner of practice?

* Who attends births for you when you are away? How can I reach you?

* What kind of childbirth preparation do you recommend?

* Do you provide labor support and stay with women throughout labor?

* How do you feel about doulas or family and friends being with me during labor?

* Do you allow moving around and eating or drinking during labor?

* Can I hold my baby right after birth, breastfeed, and not be separated?

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Pregnancy and Birth Sourcebook, Third Edition * When do you recommend IVs [intravenous], fetal heart rate monitoring, Pitocin, or episiotomy?

* Do you care for women who want a v.a.g.i.n.al birth after a previous Cesarean (C) section?

* How much do you charge? Is your care paid for by my insurance?