According to ACOG:

• If you were underweight before becoming pregnant, you should gain between 28 and 40 pounds.
• If you were overweight before becoming pregnant, you should gain between 15 and 25 pounds.

Check with your doctor to find out how much weight gain during pregnancy is healthy for you.

You should gain weight gradually during your pregnancy, with most of the weight gained in the last trimester. Doctors suggest women gain weight at the following rate:

• 2 to 4 pounds during the first trimester
• 3 to 4 pounds per month for the second and third trimesters

Recent research shows that women who gain more than the recommended amount during pregnancy and who fail to lose this weight within six months after giving birth are at much higher risk of being obese nearly 10 years later.

Total weight gained during pregnancy includes six to eight pounds for the weight of the baby. The remaining weight consists of fluid, larger breasts, larger uterus, amniotic fluid, and the placenta. Make sure to visit your doctor throughout your pregnancy so he or she can check on your weight gain.

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Not all varicose and spider veins can be prevented. However, there are steps you can take that will reduce your chances of getting more. You should also find some relief from the discomfort of the veins you now have.

• Control your weight so that your legs are not carrying too much pressure.
• Do not cross your legs while sitting
• To improve your strength, as well as your vein’s strength, focus on exercises like walking or jogging.
• When possible, elevate your legs.
• Do not sit or stand for long periods of time. If you must, shift your weight from time to time. To
avoid sitting for prolonged periods of time, get up about every half hour and walk a bit.
• Avoid tight clothing that constricts your waist, groin, and legs.
• Wear support stockings.
• Eat high fiber foods. Restrict your salt intake. High fiber foods help fight constipation, which can lead to varicose veins. Too much salt in your diet can cause swelling and water retention.
• To protect your skin from harm rays of the sun, wear sunscreen. Don’t forget to protect your face.

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Gestational diabetes is a type of diabetes, or high blood sugar, that only pregnant women get.  In fact, the work gestational means pregnant.  If a woman gets high blood sugar when she is pregnant, but she never had high blood sugar before, she has gestational diabetes.  Nearly 200,000 pregnant women get the condition each year, making it one of the top health concerns related to pregnancy.  If not treated, gestational diabetes can cause problems for the mothers and the babies.  Some of these problems can be serious.

There is some encouraging news:

• Most of the time, gestational diabetes goes away after the baby is born. The changes in your body that cause gestational diabetes normally occur only when you are pregnant. After the baby is born, your body goes back to normal and the condition goes away.
• Gestational diabetes is treatable, especially if you find out about it early in your pregnancy. The best way to control gestational diabetes is to have it diagnosed early in your pregnancy and start treatment right away.
• Treating the gestational diabetes greatly lowers the baby’s chances of having related problems.

Should I get tested for gestational diabetes?

If you are at high risk your physician will test you as soon as you know you are pregnant.  If the first test is negative, you will likely get tested again when you are between 24 and 28 weeks along.

If you are average risk, a test may be given at 24 to 28 weeks.

If you are low risk, you will probably not be tested at all unless you start to display some symptoms.

Keep in mind that every pregnancy can be different.  Even if you didn’t have gestational diabetes in a previous pregnancy, you might get it in a following pregnancy.  Or, if you have it before, you may not get it during the following pregnancies.  Follow your physician’s advice about getting tested.

What does gestational diabetes testing involve?

Health care providers may use one of two approaches for testing for gestational diabetes.

• One step approach: After fasting (not eating or drinking anything except water) for 4 to 8 hours, a woman’s blood sugar level is measured (by a draw of blood) before and 2 hours after drinking a measured amount of a syrupy drink. This type of test is called an oral glucose tolerance test.
• Two step approach: A measure of a woman’s blood sugar is taken (through a blood draw) 1 hour after she drinks a measured amount of a syrupy drink. Women whose blood sugar level is normal after 1 hour probably do not have gestational diabetes. Those whose blood sugar level is high after 1 hour then get an oral glucose tolerance test to see if they have the diabetes.

What if I don’t get treated?

Most women with gestational diabetes have healthy pregnancies and healthy babies because they controlled their condition.  Without treatment, women are at risk for high blood pressure, preeclampsia (a sudden and dangerous increase in blood pressure), and fetal death during the last 4 to 8 weeks of pregnancy.  Women with untreated gestational diabetes usually have very high birth weight babies which can increase the risk of infection and prolong recovery time.

As babies, children whose mothers had gestational diabetes are at higher risk for breathing problems.  As they get older, these children are at higher risk for obesity, abnormal glucose tolerance, and diabetes.

Untreated women and their babies also have a higher lifetime risk for type 2 diabetes.  It may be possible to prevent type 2 diabetes through lifestyle changes, mainly dietary.  Always talk to your physician about any concerns and questions you may have.

Causes of Gestational Diabetes

Usually your body breaks down much of the food you eat into a type of sugar called glucose.  Because glucose moves from the stomach into the blood, sometimes the term blood sugar is used instead of glucose.  Your body makes a hormone called insulin that moves glucose out of the blood and into the cells of the body.  In women with gestational diabetes, the glucose cannot get into the cells, so the amount of glucose in the blood rises higher and higher.  This is called high blood sugar or diabetes.

Will the baby be affected?

Most women who have gestational diabetes give birth to healthy babies, especially when they control their blood sugar, eat healthy, exercise and control their weight.  In some cases however, gestational diabetes can affect the pregnancy and the baby.  Some potential risks include:

• Macrosomia – The baby’s body is larger than normal. In this case, a c-section may be called for.
• Hypoglycemia – The baby’s blood sugar is too low. Breasting feeding can help, but if not, tube feeding glucose into the baby’s blood may be needed.
• Jaundice – This is an increase of bilirubin in the blood. The condition is easily treated.
• Respiratory Distress Syndrome – The baby may have trouble breathing and require oxygen or other help.
• The baby may have low minerals in the blood. This can cause muscle twitching or cramping. It can be treated by giving the baby extra minerals.

What is the treatment for gestational diabetes?

Following a treatment plan laid out by your physician can nearly assure a healthy pregnancy and a healthy baby.  Here are some general ways to stay healthy with gestational diabetes:

• Know your blood sugar level and keep it under control
• Eat a healthy diet
• Do regular, moderate exercise
• Keep a healthy weight
• Keep daily records to help track how well treatment is working

In some instances, the mother will need to take insulin to help manage the gestational diabetes.  The extra insulin can help lower the blood sugar level.  In some cases, the woman may have to test their urine to see if they are getting enough glucose.

What happens after birth?

For most women, blood sugar levels return to normal after the baby is born.  Six weeks after giving birth, you should have a blood test to access where your blood sugar has leveled.  The test also assesses your risk of getting diabetes in the future.  If you know you plan on getting pregnant again, have a blood sugar test up to 3 months before becoming pregnant to make sure your blood sugar level is normal.

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Wow! You’ve begun the home stretch of pregnancy by reaching your third trimester. During the third trimester of pregnancy your baby (and yourself) will be packing on more pounds than in the entire first and second trimester combined. You may start to feel anxious, you may begin “nesting” or preparing your home and nursery for the arrival of the baby, and you may have an additional onset of unpleasant and uncomfortable pregnancy symptoms. Some of these symptoms will be reminiscent of your first trimester feelings, and some may be new and uncharted territory.

As your due date becomes more in sight, you may be considering different things that need to get taken care of before the big day comes!

Here are some suggestions of things to take care of while in your third trimester:

• Create your birthing plan and discuss it with your doctor.
• Organize and decorate the baby’s nursery.
• Finalize your maternity leave plans at work.
• Make a packing check list for your hospital bag.
• Shop for baby’s coming home outfit and blanket.
• Arrange for help during the first week if you have older children.
• Attend a birthing class and learn breathing techniques.
• Tour the hospital where you plan to deliver the baby.
• Know the types of pain management you may want to use during delivery.
• Pre-make and freeze meals that you can pop into the oven once baby is home.

Changes in Your Body

Some of the discomforts you experienced in the second trimester will continue into your third trimester. Additionally, many women find breathing even more difficult as the uterus is growing into the lungs and more frequent urination as the uterus pushing on the bladder.

You may experience some new  and some familiar aches and pains in the third trimester as well, including:

• Tender Breasts
• Hemorrhoids
• Trouble Sleeping
• Leg Cramps
• Swelling

Weight Gain

On average, it is normal to gain about one pound per week or three to four pounds per month, during the third trimester. At the end of your pregnancy it is normal to gain a total of 25 to 30 pounds, depending on your pre-pregnancy weight and your doctor’s recommendations. Of the weight you will gain, roughly 7 ½ pounds will be your baby.

Changes in Your Baby

Your baby is growing, moving, and packing on the fat. With rapid growth, your baby has less room in your uterus so you may not feel the circus like you did before but probably will feel more sharp jabs from the elbows and knees.

Even before your baby is born, it will be able to open and close its eyes, sucking its thumb, and taking in amniotic fluid to practice breathing.

At birth, most babies are 20 to 22 inches long and weigh 7 ½ pounds. However, newborns who are between 5 pounds, 11 ½ ounces and 8 pounds, 5 ¾ ounces are considered healthy babies.

Preparing for Birth

Near your due date, your cervix becomes thinner and softer, called effacing. This is a normal process that helps the birth canal (vagina) to open during the birthing process. At your doctor’s visits, your doctor will check your progress with a vaginal exam.

To help in preparation for the big day you may also begin to notice that your baby is beginning to move into the birth position. Dropping or moving down lower in your abdomen in the head down position is normal for you baby to do. Once your baby has moved, you may notice that is becomes easier to breathe.

Visiting Your Doctor or Midwife

As you have done throughout your pregnancy, continue to see your doctor or midwife regularly. Closer to your due date, around 38 weeks, you’ll even begin to make these visits on a weekly basis.

During these last few visits to your doctor or midwife, feel free to ask questions and share your concerns. Your doctor is there to listen and help ease your concerns and worries and it’s natural for you to have a lot of emotion running through you.

If you anticipate having a non-surgical, vaginal birth, talk to your doctor about the options you have for pain management and the pros and cons of each option. Some women choose to have a natural, medicine free delivery while others choose a pain management technique to help them through the process. It is important that you make the best choice for you after discussing your options with your doctor.

Inducing Labor

Only a small number of babies are actually born on their due dates, about 5%. This should help ease your concerns when you due date comes and goes and you’re still pregnant.

In some cases, with continued pregnancy, your doctor or midwife may have concerns about the health of you and your baby and for this reason; your doctor may choose to induce labor.

To induce labor means that your doctor will begin the labor process for your body by artificial means. Typically, your doctor will wait one to two weeks after the due date has passed before considering inducing labor.

Signs of Labor

• Contractions at regular and increasingly shorter intervals that also becomes stronger in intensity. Learn the difference between real labor contractions and Braxton Hicks.
• Your water breaks. This can be a large gush or a continuous trickle and you have contractions at regular intervals.
• Lower back pain that does not go away. This can also feel like cramps or premenstrual symptoms.
• Your cervix is dilating (opening) and becoming thinner and softer. This will be determined by your doctor during a pelvic exam.

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At 40 weeks, each newborn baby is different so at this point, it’s hard to say how big your baby is in weight and in length. On average, most newborns weigh about 7 1/2 pounds (and boys tend to be bigger than girls). The skull bones are not yet fused together which allows them to overlap since it’s a snug fit through the birth canal during labor. This so-called “molding” is the reason your baby’s head may look a little cone head after birth. Rest assured, it’s normal and only temporary.

Body Changes in the 40th Week of Pregnancy

After months of anticipation and waiting, your due date is rolling around. If you find that your due date comes and goes with no sign of baby, it’s common. But, you may not be as late as you think, especially if you’re relying solely on a due date calculated from the day of your last period because sometimes women ovulate later than expected. Even with reliable dating, some women have prolonged pregnancies for no apparent reason.

At your doctors, you may have a biophysical profile (BPP), which consists of an ultrasound to look at your baby’s overall movements, breathing movements, and muscle tone, and measure the amount of amniotic flud that surrounds baby. You may also have a fetal hear rate monitor also known as a non stress test (“NST”) performed as well or you may have what is known as a modified biophysical profile (“BPP”), which consists of an NST and an ultrasound to assess the amount of amniotic fluid.

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At 39 weeks pregnant, it’s almost the end and your baby is weighing in between 7 to 8 pounds; and your baby is measuring between 19 to 21 inches in length. And it’s likely that those measurements won’t change from here on out but, the baby’s brain is still growing and at an astonishing rate, a pace that will continue for the first three years of life. The pink skin has now turned more white (even babies who’ll have darker skin later appear whitish now as they haven’t yet developed pigment).

By now, babies head has probably also dropped into your pelvis, which makes your breathing easier but walking harder. Try to take it easy as the end of your pregnancy is within reach.

Body Changes in the 39th Week of Pregnancy

At your now weekly visits to your doctor, you will have an abdominal exam to check your baby’s growth and position. You may also have an internal exam to see whether your cervix has started softening, effacing, and dilating. But, even this information about your cervix won’t help your doctor predict exactly when baby is going to come! Even if your cervix is already soft, partially effaced and dilated, you can still carry your baby for another few weeks – and just before you’re 42 weeks pregnant your doctor will speak to you about options for induction if you haven’t gone into labor yet. And if you’re cervix is still completely closed, that doesn’t mean you still have weeks to go. Softening, effacing and dilating can happen quickly (within several hours) or very slowly (over many weeks). But if your cervix still isn’t showing signs of opening, you can ask your doctor about certain natural methods to help the process progress – such as taking evening primrose oil supplements.

Since you can go into labor and your baby can come anytime now, make sure you know the signs of labor, and have your hospital bag packed and ready to go at a moment’s notice.

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At 38 weeks pregnant your baby is already reaching 7 pounds, getting more and more plump these days. Your baby now has a firm grasp, which you’ll soon be able to test when you hold their hand for the first time. The organs have matured and are ready for life outside. For example, baby is producing more surfactant, a substance that prevents the air sacs in the lungs from sticking to one another once baby begins to breath.

Are you daydreaming about the color of your baby’s eyes? Don’t be discouraged when you can’t tell right away. If your baby is born with brown eyes, they’ll likely stay brown. But babies born with steel gray or dark blue eyes may stay gray, blue, or turn green, hazel or brown by the time baby is 9 months old. This happens because the child’s irises may gain more pigment in the months after birth, but they usually won’t get “lighter” or more blue.

Body Changes in the 38th Week of Pregnancy

Your body is tending to some final touches as well, one of which is getting the milk up and running for baby. Part of the process is producing colostrum, a thin yellowish liquid that’s the precursor to breast milk. Colostrum is full of antibodies that protect your newborn, and has more protein and less fat and milk sugar than the breast milk that arrives later. Chances are you’re leaking colostrum you might want to break out those nursing pads right about now. If you’re not leaking but you are curious about colostrum, you can gently squeeze your areola to express a few drops.

If you’re feeling as though you’re playing the waiting game, try to use this time to make some final touches for your home and family. Finish up the baby’s nursery, take care of necessary tasks you may not get around to for awhile, take naps, catch up on reading, and spend uninterrupted time with your partner while you can. In just a few weeks, everything will change.

In these last few weeks you may notice swelling in your feet and ankles, it’s normal. However, call your doctor right away if you notice excessive or sudden swelling of your feet or ankles, more than slight swelling of your hands, any swelling in your face or puffiness around your eyes, or have sudden weight gain. Additionally, if you have severe or persistent headaches, visual changes, intense upper abdominal pain or tenderness, or nausea and vomiting call your doctor as these symptoms are common of a serious condition known as preeclampsia.

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This week your baby is officially full term though your due date is still three weeks away. If your baby arrives after this point, the lungs should be fully mature and ready to adjust to life outside. In preparation for the big debt, baby is inhaling and exhaling amniotic fluid to get the lungs ready for the first breath, sucking the thumb to prepare for the first suckle of milk, blinking, and turning from side to side. Meanwhile, it’s still a busy time to pack on the pounds as the average baby is now weighing in at 6 1/2 pounds.

A large majority of babies come into the world with 1/2 inch to 1 1/2 inches of hair. And don’t be surprised if your baby’s hair isn’t the same color as yours. Fair-haired couples have been surprised by dark-haired babies and dark-haired couples are somethings thrown when their child comes out as blonds or redheads. While other babies, of course, come out with nothing more than peach fuzz.

Body Changes in the 37th Week of Pregnancy

Congratulations! You’ve reached full-term. A pregnancy is considered to be a “full term” pregnancy at 37 weeks pregnant.

Braxtion Hicks contractions may be coming more frequently and may be growing more uncomfortable. There’s also a chance you have noticed an increase in vaginal discharge. If by chance you see what is commonly referred to as the “bloody show,” (mucus with a tiny amount of blood) in the toilet or your panties, labor is probably only a few days away or less. However, if you have spotting or bleeding, call your doctor immediately.)

Typically by this point in pregnancy it’s become harder to get comfortable enough to get a good night’s sleep. If you find that you can’t sleep well try to take it easy through the day, it may be your last chance to do so for awhile. During periods of relation, continue to monitor your baby’s movements and let your doctor know immediately if you notice a decrease.

Your doctor will begin looking for signs of labor this week. The doctor’s checklist will include: baby’s position in relation to your pelvis (engagement) and whether effacement (thinning of the cervix) and dilation (opening of the cervix) have begun. You’ll also want to be sure to ask your doctor about the results of your Group B strep culture.

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Baby is busy packing on the pounds at almost 6 pounds now and putting it on at the rate of an ounce per day.

This week, your baby will begin to shed the downy covering of hair that covered the body as well as the vernix caseosa, the waxy substance that covered and protected the skin during baby’s growth in the womb. Your baby will swallow both of these substances, along with other secretions, resulting in the previously mentioned black sticky mixture, called meconium, which will form the contents of the first bowel movement.

Between 37 to 42 weeks, your baby is full term. Babies born before this week are considered preterm and babies born after the 42nd week are considered post-term. Your baby should be in the head down position ready for delivery but if by chance your baby is in another position, your doctor may schedule an appointment to coax your baby to turn into a head-down position by manipulating the baby from outside your belly.

Body Changes in the 36th Week of Pregnancy

Chances are good that you’re doing that pregnancy waddle as a result of the hormone-triggered loosening and softening of your connective tissue. This is your body’s way of getting ready to give birth to that big baby out of a very small space. The loosening of joints can lead to some pretty painful hip and pelvic pain but, hang in there… you’re nearly done!

With an almost full-term baby inside, you may find that you’re having a difficult time as your uterus is still taking up a lot of space in your body. Pushing against a lot of your organs, you may find that you’re visiting the bathroom more than ever and eating meals has become difficult.

Braxtion Hicks contractions may begin to be more frequent now. Make sure you that you know the signs of labor, especially if this is your first baby, so that you can easily tell the difference. As a general rule, if you’re full-term, your pregnancy is uncomplicated, and your water hasn’t broken, your doctor will have you wait to come in until you’ve been having contractions that last for about an minute each and come every five minutes for an hour.

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In the head down position and packing on the pounds, your baby is now about 5 1/2 pounds and could be as much as 20 inches. All this growth hasn’t made for much room left in your uterus so while you’re probably not feeling the tiny circus you used to feel, being kicked and elbowed by your baby should still be fairly prominent.

At this point, most of the basic physical development is now complete. The kidneys are fully developed, the liver can process some waste products, and your baby’s head is still soft which allows for an easier exit through the birth canal.

Body Changes in the 35th Week of Pregnancy

When you first conceived your uterus was tucked inside your pelvis but it now reaches up under your rib cage. Inside your womb there is now more baby than amniotic fluid.

Starting this week, you will probably begin to see your doctor every week. Your doctor will be doing a vaginal and rectal culture to check for bacteria called Group B streptococci (GBS). Typically harmless, GBS could pass from Mother to child during birth and cause complications such as pneumonia, meningitis, or a blood infection. Between 10 to 30% of pregnant women have the bacteria and don’t know, it’s vital to be screened. If by chance you are a GBS carrier, you’ll receive an IV of antibiotic during labor, which will reduce your baby’s risk of infection significantly.

If you haven’t already done so, now is a great time to start putting together your birth plan. A birth plan will help with the simple decisions that are made during labor like who will be present, what pain management techniques you want to try, and where you want your baby to stay once you have delivered. A birth plan is a great starting point for discussion with your doctor and the entire medical team present at delivery.

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