Trying to conceive

How do you figure out when you're fertile and when you're not? Wondering if you or your partner is infertile? Read on to boost your chances of conception and get help for fertility problems.
Fertility awareness: The menstrual cycle
Being aware of your menstrual cycle and the changes in your body that happen during this time can help you know when you are most likely to get pregnant. See how the menstrual cycle works.
The average menstrual cycle lasts 28 days. But normal cycles can vary from 21 to 35 days. The amount of time before ovulation occurs is different in every woman and even can be different from month to month in the same woman, varying from 13 to 20 days long. Learning about this part of the cycle is important because it is when ovulation and pregnancy can occur. After ovulation, every woman (unless she has a health problem that affects her periods or becomes pregnant) will have a period within 14 to 16 days.
Charting your fertility pattern
Knowing when you're most fertile will help you plan pregnancy. There are three ways you can keep track of your fertile times. They are:
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Basal body temperature method – Basal body temperature is your temperature at rest as soon as you awake in the morning. A woman's basal body temperature rises slightly with ovulation. So by recording this temperature daily for several months, you'll be able to predict your most fertile days.
Basal body temperature differs slightly from woman to woman. Anywhere from 96 to 98 degrees Fahrenheit orally is average before ovulation. After ovulation most women have an oral temperature between 97 and 99 degrees Fahrenheit. The rise in temperature can be a sudden jump or a gradual climb over a few days.
Usually a woman's basal body temperature rises by only 0.4 to 0.8 degrees Fahrenheit. To detect this tiny change, women must use a basal body thermometer. These thermometers are very sensitive. Most pharmacies sell them for about $10.
The rise in temperature doesn't show exactly when the egg is released. But almost all women have ovulated within three days after their temperatures spike. Body temperature stays at the higher level until your period starts.
You are most fertile and most likely to get pregnant:
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Two to three days before your temperature hits the highest point (ovulation)
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12 to 24 hours after ovulation
A man's sperm can live for up to three days in a woman's body. The sperm can fertilize an egg at any point during that time. So if you have unprotected sex a few days before ovulation, you could get pregnant.
Many things can affect basal body temperature. For your chart to be useful, make sure to take your temperature every morning at about the same time. Things that can alter your temperature include:
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Drinking alcohol the night before
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Smoking cigarettes the night before
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Getting a poor night's sleep
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Having a fever
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Doing anything in the morning before you take your temperature — including going to the bathroom and talking on the phone
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Calendar method – This involves recording your menstrual cycle on a calendar for eight to 12 months. The first day of your period is Day 1. Circle Day 1 on the calendar. The length of your cycle may vary from month to month. So write down the total number of days it lasts each time. Using this record, you can find the days you are most fertile in the months ahead:
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To find out the first day when you are most fertile, subtract 18 from the total number of days in your shortest cycle. Take this new number and count ahead that many days from the first day of your next period. Draw an X through this date on your calendar. The X marks the first day you're likely to be fertile.
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To find out the last day when you are most fertile, subtract 11 from the total number of days in your longest cycle. Take this new number and count ahead that many days from the first day of your next period. Draw an X through this date on your calendar. The time between the two Xs is your most fertile window.
This method always should be used along with other fertility awareness methods, especially if your cycles are not always the same length.
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Cervical mucus method (also known as the ovulation method) – This involves being aware of the changes in your cervical mucus throughout the month. The hormones that control the menstrual cycle also change the kind and amount of mucus you have before and during ovulation. Right after your period, there are usually a few days when there is no mucus present or "dry days." As the egg starts to mature, mucus increases in the vagina, appears at the vaginal opening, and is white or yellow and cloudy and sticky. The greatest amount of mucus appears just before ovulation. During these "wet days" it becomes clear and slippery, like raw egg whites. Sometimes it can be stretched apart. This is when you are most fertile. About four days after the wet days begin the mucus changes again. There will be much less and it becomes sticky and cloudy. You might have a few more dry days before your period returns. Describe changes in your mucus on a calendar. Label the days, "Sticky," "Dry," or "Wet." You are most fertile at the first sign of wetness after your period or a day or two before wetness begins.
The cervical mucus method is less reliable for some women. Women who are breastfeeding, taking hormonal birth control (like the pill), using feminine hygiene products, have vaginitis or sexually transmitted infections (STIs), or have had surgery on the cervix should not rely on this method.
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To most accurately track your fertility, use a combination of all three methods. This is called the symptothermal method. You can also purchase over-the-counter ovulation kits or fertility monitors to help find the best time to conceive. These kits work by detecting surges in a specific hormone called luteinizing hormone, which triggers ovulation.
Infertility
Some women want children but either cannot conceive or keep miscarrying. This is called infertility. Lots of couples have infertility problems. About one-third of the time, it is a female problem. In another one-third of cases, it is the man with the fertility problem. For the remaining one-third, both partners have fertility challenges or no cause is found.
Causes of infertility
Some common reasons for infertility in women include:
Age – Women generally have some decrease in fertility starting in their early 30s. And while many women in their 30s and 40s have no problems getting pregnant, fertility especially declines after age 35. As a woman ages, normal changes that occur in her ovaries and eggs make it harder to become pregnant. Even though menstrual cycles continue to be regular in a woman's 30s and 40s, the eggs that ovulate each month are of poorer quality than those from her 20s. It is harder to get pregnant when the eggs are poorer in quality. As a woman nears menopause, the ovaries may not release an egg each month, which also can make it harder to get pregnant. Also, as a woman and her eggs age, she is more likely to miscarry, as well as have a baby with genetic problems, such as Down syndrome.
Health problems – Some women have diseases or conditions that affect their hormone levels, which can cause infertility.
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Women with polycystic ovary syndrome (PCOS) rarely or never ovulate. Failure to ovulate is the most common cause of infertility in women.
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With primary ovarian insufficiency (POI), a woman's ovaries stop working normally before she is 40. It is not the same as early menopause. Some women with POI get a period now and then. But getting pregnant is hard for women with POI.
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A condition called luteal phase defect (LPD) is a failure of the uterine lining to be fully prepared for pregnancy. This can keep a fertilized egg from implanting or result in miscarriage.
Common problems with a woman's reproductive organs, like uterine fibroids, endometriosis, and pelvic inflammatory disease can worsen with age and also affect fertility. These conditions might cause the fallopian tubes to be blocked, so the egg can't travel through the tubes into the uterus.
Lifestyle factors – Certain lifestyle factors also can have a negative effect on a woman's fertility. Examples include smoking, alcohol use, weighing much more or much less than an ideal body weight, a lot of strenuous exercise, and having an eating disorder. Stress also can affect fertility.
Unlike women, some men remain fertile into their 60s and 70s. But as men age, they might begin to have problems with the shape and movement of their sperm. They also have a slightly higher risk of sperm gene defects. Or they might produce no sperm, or too few sperm. Lifestyle choices also can affect the number and quality of a man's sperm. Alcohol and drugs can temporarily reduce sperm quality. And researchers are looking at whether environmental toxins, such as pesticides and lead, also may be to blame for some cases of infertility. Men also can have health problems that affect their sexual and reproductive function. These can include sexually transmitted infections (STIs), diabetes, surgery on the prostate gland, or a severe testicle injury or problem.
When to see your doctor
You should talk to your doctor about your fertility if:
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You are younger than 35 and have not been able to conceive after one year of frequent sex without birth control.
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You are age 35 or older and have not been able to conceive after six months of frequent sex without birth control.
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You believe you or your partner might have fertility problems in the future (even before you begin trying to get pregnant).
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You or your partner has a problem with sexual function or libido.
Happily, doctors are able to help many infertile couples go on to have babies.
Options for infertile couples
If you are having fertility issues, your doctor can refer you to a fertility specialist, a doctor who treats infertility. The doctor will need to test both you and your partner to find out what the problem is. Depending on the problem, your doctor might recommend treatment. About 9 in 10 cases of infertility are treated with drugs or surgery. Don't delay seeing your doctor, as age also affects the success rates of these treatments. For some couples, adoption or foster care offers a way to share their love with a child and to build a family.
Infertility treatment
Some treatments include:
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Drugs – Various fertility drugs may be used for women with ovulation problems. It is important to talk with your doctor about the drug to be used. You should understand the drug's benefits and side effects. Depending on the type of fertility drug and the dosage of the drug used, multiple births (such as twins) can occur.
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Surgery – Surgery is done to repair damage to a woman's ovaries, fallopian tubes, or uterus. Sometimes a man has an infertility problem that can be corrected by surgery.
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Intrauterine insemination (IUI), also called artificial insemination – Male sperm is injected into part of the woman's reproductive tract, such as into the uterus or fallopian tube. IUI often is used along with drugs that cause a woman to ovulate.
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Assisted reproductive technology (ART) – ART involves stimulating a woman's ovaries; removing eggs from her body; mixing them with sperm in the laboratory; and putting the embryos back into a woman's body. Success rates of ART vary and depend on many factors.
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Third party assistance – Options include donor eggs (eggs from another woman are used), donor sperm (sperm from another man are used), or surrogacy (when another woman carries a baby for you).
Finding the cause of infertility is often a long, complex, and emotional process. And treatment can be expensive. Many health insurance companies do not provide coverage for infertility or provide only limited coverage. Check your health insurance contract carefully to learn about what is covered. Some states have laws that mandate health insurance policies to provide infertility coverage.
Adoption
If infertility is a problem for you, another option may be adoption. Adopting a baby or child can be one of the most rewarding experiences of your life. So many babies, children, and adolescents in the United States and around the world need a family. Some of these are healthy infants, and many are children with special needs, including physical, emotional, or mental disabilities. If you do adopt a child with special needs, there are both federal and state sources of financial assistance available to help you afford the child's care.
There are two types of adoptions:
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Open adoption – The birth mother, and possibly the birth father, know something about the adoptive parents. They might even meet and exchange names or addresses.
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Closed adoption – The birth mother and adoptive parents do not meet each other or know each others' names.
The laws of each state differ on whether, after a period of time, the files of a closed adoption can be opened later to reveal this information. State laws also differ on whether adoptions can be handled by an adoption agency or independently (such as through a doctor, lawyer, counselor or independent organization). Most adoption agencies carefully screen and study the adoptive parents. You can learn more about adoption through the resources at the end of this section.
Foster care
Another option for couples who have a lot of love to share with a child is foster care. Unlike adoption, foster care is a temporary service that responds to crises in the lives of children and families. But it also can be the first step to adopting a child. Many foster children have been abused or neglected, or removed by a court order. Foster families are people who take these children into their homes to provide day-to-day care and nurturing. Children in foster care may live with unrelated foster parents, with relatives, with families who plan to adopt them, or in group homes or residential treatment centers. Even though foster care is viewed as a temporary service, many children have to stay in foster care for long periods of time.
Each child in foster care should have a plan that will let him or her grow up in a permanent family. For many children, the plan is to return to the birth parents. In these cases, foster families may work with the birth parents and the child to help them both learn the skills they need to live together again. Foster parents need to be able to love the children who live in their home, and let go of them when it is time to send them back to their parents. For other children, going back to their parents will not be possible, and the foster parents may become adoptive parents. Or they can keep other kinds of formal or informal ties with the children they parent.
Every state has its own rules about foster parenting. But, the chances are good that you can be a foster parent in your state. There are many more children in need of care than there are foster parents available. To fill this gap, states are looking for people who want to help children and can share their time and their homes. States also give foster parents many different forms of support, like training and financial assistance.
Counseling and support groups
If you've been having problems getting pregnant, you know how frustrating it can feel. Not being able to get pregnant can be one of the most stressful experiences a couple has. Both counseling and support groups can help you and your partner talk about your feelings and help you meet other couples struggling with the same issues. You will learn that anger, grief, blame, guilt, and depression are all normal. Couples do survive infertility, and can become closer and stronger in the process. Ask your doctor for the names of counselors or therapists with an interest in fertility.
Knowing if you are pregnant

A missed period is often the first clue that a woman might be pregnant. Sometimes, a woman might suspect she is pregnant even sooner. Read on to learn when and how to test for pregnancy.
Pregnancy tests
A missed period is often the first clue that a woman might be pregnant. Sometimes, a woman might suspect she is pregnant even sooner. Symptoms such as headache, fatigue, and breast tenderness, can occur even before a missed period. The wait to know can be emotional. These days, many women first use home pregnancy tests (HPT) to find out. Your doctor also can test you.
All pregnancy tests work by detecting a special hormone in the urine or blood that is only there when a woman is pregnant. It is called human chorionic gonadotropin, or hCG. hCG is made when a fertilized egg implants in the uterus. hCG rapidly builds up in your body with each passing day you are pregnant.
Home pregnancy tests
HPTs are inexpensive, private, and easy to use. Most drugstores sell HPTs over the counter. The cost depends on the brand and how many tests come in the box. They work by detecting hCG in your urine. HPTs are highly accurate. But their accuracy depends on many things. These include:
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When you use them – The amount of hCG in your urine increases with time. So, the earlier after a missed period you take the test the harder it is to spot the hCG. Some HPTs claim that they can tell if you are pregnant one day after a missed period or even earlier. But a recent study shows that most HPTs don't give accurate results this early in pregnancy. Positive results are more likely to be true than negative results. Waiting one week after a missed period will usually give a more accurate result. You can take the test sooner. But just know that a lot of pregnant women will get negative test results during the first few days after the missed period. It's a good idea to repeat the test again after a week has passed. If you get two negative results but still think you're pregnant, call your doctor.
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How you use them – Be sure to check the expiration date and follow the directions. Many involve holding a test stick in the urine stream. For some, you collect urine in a cup and then dip the test stick into it. Then, depending on the brand, you will wait a few minutes to get the results. Research suggests waiting 10 minutes will give the most accurate result. Also, testing your urine first thing in the morning may boost the accuracy. You will be looking for a plus sign, a change in color, or a line. A change, whether bold or faint, means the result is positive. New digital tests show the words "pregnant" or "not pregnant". Most tests also have a "control indicator" in the results window. This line or symbol shows whether or not the test is working. If the control indicator does not appear, the test is not working properly. You should not rely on any results from a HPT that may be faulty.
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Who uses them – The amount of hCG in the urine is different for every pregnant woman. So, some women will have accurate results on the day of the missed period while others will need to wait longer. Also, some medicines affect HPTs. Discuss the medicines you use with your doctor before trying to become pregnant.
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The brand of test – Some HPT tests are better than others at spotting hCG early on.
The most important part of using any HPT is to follow the directions exactly as written. Most tests also have toll-free phone numbers to call in case of questions about use or results.
If a HPT says you are pregnant, you should call your doctor right away. Your doctor can use a more sensitive test along with a pelvic exam to tell for sure if you're pregnant. Seeing your doctor early on in your pregnancy can help you and your baby stay healthy.
Blood tests
Blood tests are done in a doctor's office. They can pick up hCG earlier in a pregnancy than urine tests can. Blood tests can tell if you are pregnant about six to eight days after you ovulate. Doctors use two types of blood tests to check for pregnancy:
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Quantitative blood test (or the beta hCG test) measures the exact amount of hCG in your blood. So it can find even tiny amounts of hCG. This makes it very accurate.
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Qualitative hCG blood tests just check to see if the pregnancy hormone is present or not. So it gives a yes or no answer. This blood test is about as accurate as a urine test.
Reading a home pregnancy test
This pregnancy test shows a positive result because you can see a pink line in the results window. The pink line in the control window shows that the test is working.
Unplanned pregnancy

Unplanned pregnancy is common. About 1 in 2 pregnancies in America are unplanned. Ideally, a woman who is surprised by an unplanned pregnancy is in good preconception health and is ready and able to care for a new child. But this sometimes isn't the case.
Options for unplanned pregnancy
If you have an unplanned pregnancy, you might not know what to do next. You might worry that the father won't welcome the news. You might not be sure you can afford to care for a baby. You might worry if past choices you have made, such as drinking or drug use, will affect your unborn baby's health. You might be concerned that having a baby will keep you from finishing school or pursuing a career. If you are pregnant after being raped, you might feel ashamed, numb, or afraid. You might wonder what options you have. Here are some next steps to help you move forward:
- Start taking care of yourself right away. Take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) folic acid every day. Stop alcohol, tobacco, and drug use.
- Make a doctor's visit to confirm your pregnancy. Discuss your health and issues that could affect your pregnancy. Ask for help quitting smoking. Find out what you can do to take care of yourself and your unborn baby.
- Ask your doctor to recommend a counselor who you can talk to about your situation.
- Seek support in someone you trust and respect.
Partner abuse and unplanned pregnancy
Unplanned pregnancy is common among abused women. Research has found that some abusers force their partners to have sex without birth control and/or sabotage the birth control their partners are using, leading to unplanned pregnancy. If you have an abusive partner, get help now. Violence can hurt you and your pregnancy and have long-lasting effects on your children. About 1 in 2 men who abuse their wives also abuse their children. And children who grow up with violence in the home are more likely to become abusers as adults and have physical and emotional problems.
To get help right now, call the National Domestic Violence Hotline (link is external) at 800-799-SAFE (7233) and 800-787-3224 (TTY). Spanish speakers are available.
You're pregnant: Now what?

So — you're pregnant! What's next? What should you eat? What kinds of tests will you and your baby need? What happens if problems come up? Get answers to these questions and more.
Stages of pregnancy

Pregnancy lasts about 40 weeks, counting from the first day of your last normal period. The weeks are grouped into three trimesters. Find out what's happening with you and your baby in these three stages.
First trimester (week 1–week 12)
During the first trimester your body undergoes many changes. Hormonal changes affect almost every organ system in your body. These changes can trigger symptoms even in the very first weeks of pregnancy. Your period stopping is a clear sign that you are pregnant. Other changes may include:
- Extreme tiredness
- Tender, swollen breasts. Your nipples might also stick out.
- Upset stomach with or without throwing up (morning sickness)
- Cravings or distaste for certain foods
- Mood swings
- Constipation (trouble having bowel movements)
- Need to pass urine more often
- Headache
- Heartburn
- Weight gain or loss
As your body changes, you might need to make changes to your daily routine, such as going to bed earlier or eating frequent, small meals. Fortunately, most of these discomforts will go away as your pregnancy progresses. And some women might not feel any discomfort at all! If you have been pregnant before, you might feel differently this time around. Just as each woman is different, so is each pregnancy.
Second trimester (week 13–week 28)
Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months.
You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move!
As your body changes to make room for your growing baby, you may have:
- Body aches, such as back, abdomen, groin, or thigh pain
- Stretch marks on your abdomen, breasts, thighs, or buttocks
- Darkening of the skin around your nipples
- A line on the skin running from belly button to pubic hairline
- Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. Patches often match on both sides of the face. This is sometimes called the mask of pregnancy.
- Numb or tingling hands, called carpal tunnel syndrome
- Itching on the abdomen, palms, and soles of the feet. (Call your doctor if you have nausea, loss of appetite, vomiting, jaundice or fatigue combined with itching. These can be signs of a serious liver problem.)
- Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.)
Third trimester (week 29–week 40)
You're in the home stretch! Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Don't worry, your baby is fine and these problems will lessen once you give birth.
Some new body changes you might notice in the third trimester include:
- Shortness of breath
- Heartburn
- Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.)
- Hemorrhoids
- Tender breasts, which may leak a watery pre-milk called colostrum (kuh-LOSS-struhm)
- Your belly button may stick out
- Trouble sleeping
- The baby "dropping", or moving lower in your abdomen
- Contractions, which can be a sign of real or false labor
As you near your due date, your cervix becomes thinner and softer (called effacing). This is a normal, natural process that helps the birth canal (vagina) to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited — the final countdown has begun!
Your developing baby
First trimester (week 1-week 12)
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At four to five weeks:
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At eight weeks:
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At 12 weeks:
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Second trimester (week 13-week 28)
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At 16 weeks:
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At 20 weeks:
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At 24 weeks:
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Third trimester (week 29-week 40)
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At 32 weeks:
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At 36 weeks:
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Weeks 37-40:
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Did you know?
For some women, body image is a huge concern during pregnancy. Learn what you can do to accept and love your pregnant body in our Pregnancy and body image section.
Prenatal care and tests

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 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. Your provider also should be willing and able to give you the information and support you need to make an informed choice about whether to breastfeed or bottle-feed.
Health care providers that care for women during pregnancy include:
- 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.
- 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.
- A certified nurse-midwife (CNM) and certified professional 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 back-up 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
- How the provider handles phone consultations and after-hour calls
What is a doula?
A doula is a professional labor coach, who gives physical and emotional support to women during labor and delivery. They offer advice on breathing, relaxation, movement, and positioning. Doulas also give emotional support and comfort to women and their partners during labor and birth. Doulas and midwives often work together during a woman's labor. A recent study showed that continuous doula support during labor was linked to shorter labors and much lower use of:
- Pain medicines
- Oxytocin (medicine to help labor progress)
- Cesarean delivery
Check with your health insurance company to find out if they will cover the cost of a doula. When choosing a doula, find out if she is certified by Doulas of North America (DONA) or another professional group.
Places to deliver your baby
Many women have strong views about where and how they'd like to deliver their babies. In general, women can choose to deliver at a hospital, birth center, or at home. You will need to contact your health insurance provider to find out what options are available. Also, find out if the doctor or midwife you are considering can deliver your baby in the place you want to give birth.
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Hospitals are a good choice for women with health problems, pregnancy complications, or those who are at risk for problems during labor and delivery. Hospitals offer the most advanced medical equipment and highly trained doctors for pregnant women and their babies. In a hospital, doctors can do a cesarean delivery if you or your baby is in danger during labor. Women can get epidurals or many other pain relief options. Also, more and more hospitals now offer on-site birth centers, which aim to offer a style of care similar to standalone birth centers.
Questions to ask when choosing a hospital:
- Is it close to your home?
- Is a doctor who can give pain relief, such as an epidural, at the hospital 24-hours a day?
- Do you like the feel of the labor and delivery rooms?
- Are private rooms available?
- How many support people can you invite into the room with you?
- Does it have a neonatal intensive care unit (NICU) in case of serious problems with the baby?
- Can the baby stay in the room with you?
- Does the hospital have the staff and set-up to support successful breastfeeding?
- Does it have an on-site birth center?
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Birth or birthing centers give women a "homey" environment in which to labor and give birth. They try to make labor and delivery a natural and personal process by doing away with most high-tech equipment and routine procedures. So, you will not automatically be hooked up to an IV. Likewise, you won't have an electronic fetal monitor around your belly the whole time. Instead, the midwife or nurse will check in on your baby from time to time with a handheld machine. Once the baby is born, all exams and care will occur in your room. Usually certified nurse-midwives, not obstetricians, deliver babies at birth centers. Healthy women who are at low risk for problems during pregnancy, labor, and delivery may choose to deliver at a birth center.
Women can not receive epidurals at a birth center, although some pain medicines may be available. If a cesarean delivery becomes necessary, women must be moved to a hospital for the procedure. After delivery, babies with problems can receive basic emergency care while being moved to a hospital.
Many birthing centers have showers or tubs in their rooms for laboring women. They also tend to have comforts of home like large beds and rocking chairs. In general, birth centers allow more people in the delivery room than do hospitals.
Birth centers can be inside of hospitals, a part of a hospital or completely separate facilities. If you want to deliver at a birth center, make sure it meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers. Accredited birth centers must have doctors who can work at a nearby hospital in case of problems with the mom or baby. Also, make sure the birth center has the staff and set-up to support successful breastfeeding.
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Homebirth is an option for healthy pregnant women with no risk factors for complications during pregnancy, labor or delivery. It is also important women have a strong after-care support system at home. Some certified nurse midwives and doctors will deliver babies at home. Many health insurance companies do not cover the cost of care for homebirths. So check with your plan if you'd like to deliver at home.
Homebirths are common in many countries in Europe. But in the United States, planned homebirths are not supported by the American Congress of Obstetricians and Gynecologists (ACOG). ACOG states that hospitals are the safest place to deliver a baby. In case of an emergency, says ACOG, a hospital's equipment and highly trained doctors can provide the best care for a woman and her baby.
If you are thinking about a homebirth, you need to weigh the pros and cons. The main advantage is that you will be able to experience labor and delivery in the privacy and comfort of your own home. Since there will be no routine medical procedures, you will have control of your experience.
The main disadvantage of a homebirth is that in case of a problem, you and the baby will not have immediate hospital/medical care. It will have to wait until you are transferred to the hospital. Plus, women who deliver at home have no options for pain relief.
To ensure your safety and that of your baby, you must have a highly trained and experienced midwife along with a fail-safe back-up plan. You will need fast, reliable transportation to a hospital. If you live far away from a hospital, homebirth may not be the best choice. Your midwife must be experienced and have the necessary skills and supplies to start emergency care for you and your baby if need be. Your midwife should also have access to a doctor 24 hours a day.
Prenatal checkups
During pregnancy, regular checkups are very important. This consistent care can help keep you and your baby healthy, spot problems if they occur, and prevent problems during delivery. Typically, routine checkups occur:
- Once each month for weeks four through 28
- Twice a month for weeks 28 through 36
- Weekly for weeks 36 to birth
Women with high-risk pregnancies need to see their doctors more often.
At your first visit your doctor will perform a full physical exam, take your blood for lab tests, and calculate your due date. Your doctor might also do a breast exam, a pelvic exam to check your uterus (womb), and a cervical exam, including a Pap test. During this first visit, your doctor will ask you lots of questions about your lifestyle, relationships, and health habits. It's important to be honest with your doctor.
After the first visit, most prenatal visits will include:
- Checking your blood pressure and weight
- Checking the baby's heart rate
- Measuring your abdomen to check your baby's growth
You also will have some routine tests throughout your pregnancy, such as tests to look for anemia, tests to measure risk of gestational diabetes, and tests to look for harmful infections.
Become a partner with your doctor to manage your care. Keep all of your appointments — every one is important! Ask questions and read to educate yourself about this exciting time.
Monitor your baby's activity
After 28 weeks, keep track of your baby's movement. This will help you to notice if your baby is moving less than normal, which could be a sign that your baby is in distress and needs a doctor's care. An easy way to do this is the "count-to-10" approach. Count your baby's movements in the evening — the time of day when the fetus tends to be most active. Lie down if you have trouble feeling your baby move. Most women count 10 movements within about 20 minutes. But it is rare for a woman to count less than 10 movements within two hours at times when the baby is active. Count your baby's movements every day so you know what is normal for you. Call your doctor if you count less than 10 movements within two hours or if you notice your baby is moving less than normal. If your baby is not moving at all, call your doctor right away.
Prenatal tests
Tests are used during pregnancy to check your and your baby's health. At your fist prenatal visit, your doctor will use tests to check for a number of things, such as:
- Your blood type and Rh factor
- Anemia
- Infections, such as toxoplasmosis and sexually transmitted infections (STIs), including hepatitis B, syphilis, chlamydia, and HIV
- Signs that you are immune to rubella (German measles) and chicken pox
Throughout your pregnancy, your doctor or midwife may suggest a number of other tests, too. Some tests are suggested for all women, such as screenings for gestational diabetes, Down syndrome, and HIV. Other tests might be offered based on your:
- Age
- Personal or family health history
- Ethnic background
- Results of routine tests
Some tests are screening tests. They detect risks for or signs of possible health problems in you or your baby. Based on screening test results, your doctor might suggest diagnostic tests. Diagnostic tests confirm or rule out health problems in you or your baby.
Test | What it is | How it is done |
---|---|---|
Amniocentesis (AM-nee-oh-sen-TEE-suhss) |
This test can diagnosis certain birth defects, including: It is performed at 14 to 20 weeks. It may be suggested for couples at higher risk for genetic disorders. It also provides DNA for paternity testing. |
A thin needle is used to draw out a small amount of amniotic fluid and cells from the sac surrounding the fetus. The sample is sent to a lab for testing. |
Biophysical profile (BPP) | This test is used in the third trimester to monitor the overall health of the baby and to help decide if the baby should be delivered early. | BPP involves an ultrasound exam along with a nonstress test. The BPP looks at the baby's breathing, movement, muscle tone, heart rate, and the amount of amniotic fluid. |
Chorionic villus (KOR-ee-ON-ihk VIL-uhss) sampling (CVS) |
A test done at 10 to 13 weeks to diagnose certain birth defects, including:
CVS may be suggested for couples at higher risk for genetic disorders. It also provides DNA for paternity testing. |
A needle removes a small sample of cells from the placenta to be tested. |
First trimester screen |
A screening test done at 11 to 14 weeks to detect higher risk of:
It also can reveal multiple births. Based on test results, your doctor may suggest other tests to diagnose a disorder. |
This test involves both a blood test and an ultrasound exam called nuchal translucency (NOO-kuhl trans-LOO-sent-see) screening. The blood test measures the levels of certain substances in the mother's blood. The ultrasound exam measures the thickness at the back of the baby's neck. This information, combined with the mother's age, help doctors determine risk to the fetus. |
Glucose challenge screening |
A screening test done at 26 to 28 weeks to determine the mother's risk of gestational diabetes. Based on test results, your doctor may suggest a glucose tolerance test. |
First, you consume a special sugary drink from your doctor. A blood sample is taken one hour later to look for high blood sugar levels. |
Glucose tolerance test | This test is done at 26 to 28 weeks to diagnose gestational diabetes. | Your doctor will tell you what to eat a few days before the test. Then, you cannot eat or drink anything but sips of water for 14 hours before the test. Your blood is drawn to test your "fasting blood glucose level." Then, you will consume a sugary drink. Your blood will be tested every hour for three hours to see how well your body processes sugar. |
Group B streptococcus (STREP-tuh-KOK-uhss) infection | This test is done at 36 to 37 weeks to look for bacteria that can cause pneumonia or serious infection in newborn. | A swab is used to take cells from your vagina and rectum to be tested. |
Maternal serum screen (also called quad screen, triple test, triple screen, multiple marker screen, or AFP) |
A screening test done at 15 to 20 weeks to detect higher risk of:
Based on test results, your doctor may suggest other tests to diagnose a disorder. |
Blood is drawn to measure the levels of certain substances in the mother's blood. |
Nonstress test (NST) | This test is performed after 28 weeks to monitor your baby's health. It can show signs of fetal distress, such as your baby not getting enough oxygen. | A belt is placed around the mother's belly to measure the baby's heart rate in response to its own movements. |
Ultrasound exam |
An ultrasound exam can be performed at any point during the pregnancy. Ultrasound exams are not routine. But it is not uncommon for women to have a standard ultrasound exam between 18 and 20 weeks to look for signs of problems with the baby's organs and body systems and confirm the age of the fetus and proper growth. It also might be able to tell the sex of your baby. Ultrasound exam is also used as part of the first trimester screen and biophysical profile (BPP). Based on exam results, your doctor may suggest other tests or other types of ultrasound to help detect a problem. |
Ultrasound uses sound waves to create a "picture" of your baby on a monitor. With a standard ultrasound, a gel is spread on your abdomen. A special tool is moved over your abdomen, which allows your doctor and you to view the baby on a monitor. |
Urine test |
A urine sample can look for signs of health problems, such as: If your doctor suspects a problem, the sample might be sent to a lab for more in-depth testing. |
You will collect a small sample of clean, midstream urine in a sterile plastic cup. Testing strips that look for certain substances in your urine are dipped in the sample. The sample also can be looked at under a microscope. |
Understanding prenatal tests and test results
If your doctor suggests certain prenatal tests, don't be afraid to ask lots of questions. Learning about the test, why your doctor is suggesting it for you, and what the test results could mean can help you cope with any worries or fears you might have. Keep in mind that screening tests do not diagnose problems. They evaluate risk. So if a screening test comes back abnormal, this doesn't mean there is a problem with your baby. More information is needed. Your doctor can explain what test results mean and possible next steps.
Avoid keepsake ultrasounds
You might think a keepsake ultrasound is a must-have for your scrapbook. But, doctors advise against ultrasound when there is no medical need to do so. Some companies sell "keepsake" ultrasound videos and images. Although ultrasound is considered safe for medical purposes, exposure to ultrasound energy for a keepsake video or image may put a mother and her unborn baby at risk. Don't take that chance.
High-risk pregnancy
Pregnancies with a greater chance of complications are called "high-risk." But this doesn't mean there will be problems. The following factors may increase the risk of problems during pregnancy:
- Very young age or older than 35
- Overweight or underweight
- Problems in previous pregnancy
- Health conditions you have before you become pregnant, such as high blood pressure, diabetes, autoimmune disorders, cancer, and HIV
- Pregnancy with twins or other multiples
Health problems also may develop during a pregnancy that make it high-risk, such as gestational diabetes or preeclampsia. See Pregnancy complications to learn more.
Women with high-risk pregnancies need prenatal care more often and sometimes from a specially trained doctor. A maternal-fetal medicine specialist is a medical doctor that cares for high-risk pregnancies.
If your pregnancy is considered high risk, you might worry about your unborn baby's health and have trouble enjoying your pregnancy. Share your concerns with your doctor. Your doctor can explain your risks and the chances of a real problem. Also, be sure to follow your doctor's advice. For example, if your doctor tells you to take it easy, then ask your partner, family members, and friends to help you out in the months ahead. You will feel better knowing that you are doing all you can to care for your unborn baby.
Paying for prenatal care
Pregnancy can be stressful if you are worried about affording health care for you and your unborn baby. For many women, the extra expenses of prenatal care and preparing for the new baby are overwhelming. The good news is that women in every state can get help to pay for medical care during their pregnancies. Every state in the United States has a program to help. Programs give medical care, information, advice, and other services important for a healthy pregnancy.
Learn more about programs available in your state.
You may also find help through these places:
- Local hospital or social service agencies – Ask to speak with a social worker on staff. She or he will be able to tell you where to go for help.
- Community clinics – Some areas have free clinics or clinics that provide free care to women in need.
- Women, Infants and Children (WIC) Program – This government program is available in every state. It provides help with food, nutritional counseling, and access to health services for women, infants, and children.
- Places of worship
More information on prenatal care and tests
Read more from womenshealth.gov
- Pregnancy and Medicines Fact Sheet - This fact sheet provides information on the safety of using medicines while pregnant.
Explore other publications and websites
- Chorionic Villus Sampling (CVS) (Copyright © March of Dimes) (link is external) - Chorionic villus sampling (CVS) is a prenatal test that can diagnose or rule out certain birth defects. The test is generally performed between 10 and 12 weeks after a woman's last menstrual period. This fact sheet provides information about this test, and how the test sample is taken.
- Folic Acid (Copyright © March of Dimes) (link is external) - This fact sheet stresses the importance of getting higher amounts of folic acid during pregnancy in order to prevent neural tube defects in unborn children.
- Folic Acid: Questions and Answers - The purpose of this question and answer sheet is to educate women of childbearing age on the importance of consuming folic acid every day to reduce the risk of spina bifida.
- For Women With Diabetes: Your Guide to Pregnancy - This booklet discusses pregnancy in women with diabetes. If you have type 1 or type 2 diabetes and you are pregnant or hoping to get pregnant soon, you can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy.
- Genetics Home Reference - This website provides information on specific genetic conditions and the genes or chromosomes responsible for these conditions.
- Guidelines for Vaccinating Pregnant Women - This publication provides information on routine and other vaccines and whether they are recommended for use during pregnancy.
- How Your Baby Grows (Copyright © March of Dimes) (link is external) - This site provides information on the development of your baby and the changes in your body during each month of pregnancy. In addition, for each month, it provides information on when to go for prenatal care appointments and general tips to take care of yourself and your baby.
- Pregnancy Information Center, CDC - If you're pregnant or planning to get pregnant, you probably have a lot of questions. This website will help you learn how to be healthy (before, during, and after pregnancy) and give your baby a healthy start to life.
- Pregnancy Registries - Pregnancy registries help women make informed and educated decisions about using medicines during pregnancy. If you are pregnant and currently taking medicine — or have been exposed to a medicine during your pregnancy — you may be able to participate and help in the collection of this information. This website provides a list of pregnancy registries that are enrolling pregnant women.
- Pregnancy, Breastfeeding, and Bone Health - This publication provides information on pregnancy-associated osteoporosis, lactation and bone loss, and what you can do to keep your bones healthy during pregnancy.
- Prenatal Care: First-Trimester Visits (Copyright © Mayo Foundation) (link is external) - This fact sheet explains what to expect during routine exams with your doctor. In addition, if you have a condition that makes your pregnancy high-risk, special tests may be performed on a regular basis to check the baby's health.
- Ten Tips for a Healthy Pregnancy (Copyright © Lamaze International) (link is external) - This easy-to-read fact sheet provides 10 simple recommendations to help mothers have a healthy pregnancy.
- Ultrasound (Copyright © March of Dimes) (link is external) - This fact sheet discusses the use of an ultrasound in prenatal care at each trimester.
Connect with other organizations
- American Academy of Family Physicians (link is external)
- American Association of Birth Centers (link is external)
- American College of Obstetricians and Gynecologists (link is external)
- Center for Research on Reproduction and Women's Health, University of Pennsylvania Medical Center (link is external)
- Dona International (link is external)
- March of Dimes (link is external)
- Maternal and Child Health Bureau, HRSA, HHS
- National Association for Down Syndrome (link is external)
- National Center on Birth Defects and Developmental Disabilities, CDC
- Public Information and Communications Branch, NICHD, NIH, HHS
Did you know?
Some hospitals and birth centers have taken special steps to create the best possible environment for successful breastfeeding. They are called Baby-Friendly Hospitals and Birth Centers. Women who deliver in a baby-friendly facility are promised the information and support they need to breastfeed their infants. Learn more about Baby-friendly hospitals and birth centers (link is external) from the Baby-Friendly Hospital Initiative.
Twins, triplets, and other multiples

If you are pregnant with more than one baby, you are far from alone. In the past two decades, the number of multiple births has climbed way up in the United States.
Information about multiples
In 2005, 133,122 twin babies and 6,208 triplet babies were born in the United States. In 1980, there were only 69,339 twin and 1,337 triplet births.
Why the increase? For one, more women are having babies after age 30. Women in their 30s are more likely than younger women to conceive more than one baby naturally. Another reason is that more women are using fertility treatments to help them conceive.
How twins are formed
Twins form in one of two ways:
Identical twins occur when a single fertilized egg splits into two. Identical twins look almost exactly alike and share the exact same genes. Most identical twins happen by chance.
Fraternal twins occur when two, separate eggs are fertilized by two, separate sperm. Fraternal twins do not share the exact same genes — they are no more alike than they are to their siblings from different pregnancies. Fraternal twins tend to run in some families.
Multiple births can be fraternal, identical, or a combination. Multiples associated with fertility treatments are mainly fraternal.
Pregnancy with multiples
Years ago, most twins came as a surprise. Now, thanks to advances in prenatal care, most women learn about a multiple pregnancy early. You might suspect you are pregnant with multiples if you have more severe body changes, including:
- Rapid weight gain in the first trimester
- Intense nausea and vomiting
- Extreme breast tenderness
Your doctor can confirm whether you are carrying more than one baby through ultrasound. If you are pregnant with twins or other multiples, you will need to see your doctor more often than women who are carrying only one baby because your risk of complications is greater. Women carrying more than one baby are at higher risk of:
More frequent prenatal visits help your doctor to monitor your and your babies' health. Your doctor will also tell you how much weight to gain, if you need to take extra vitamins, and how much activity is safe. With close monitoring, your babies will have the best chance of being born near term and at a healthy weight.
After delivery and once your babies come home, you may feel overwhelmed and exhausted. Ask for help from your partner, family, and friends. Volunteer help and support groups for parents of multiples also can ease the transition.
Related information
- Breastfeeding twins or multiples on our Common breastfeeding challenges page
Staying healthy and safe

Eat this. Don't eat that. Do this. Don't do that. Pregnant women are bombarded with do's and don'ts. Here is help to keep it all straight.
Eating for two
Eating healthy foods is more important now than ever! You need more protein, iron, calcium, and folic acid than you did before pregnancy. You also need more calories. But "eating for two" doesn't mean eating twice as much. Rather, it means that the foods you eat are the main source of nutrients for your baby. Sensible, balanced meals combined with regular physical fitness is still the best recipe for good health during your pregnancy.
Weight gain
The amount of weight you should gain during pregnancy depends on your body mass index (BMI) before you became pregnant. The Institute of Medicine provides these guidelines:
- If you were at a normal weight before pregnancy, you should gain about 25 to 30 pounds.
- If you were underweight before pregnancy, you should gain between 28 and 40 pounds.
- If you were overweight before pregnancy, you should gain between 15 and 25 pounds.
- If you were obese before pregnancy, you should gain between 11 and 20 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. Generally, doctors suggest women gain weight at the following rate:
- 2 to 4 pounds total 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. Findings from another large study suggest that gaining more weight than the recommended amount during pregnancy may raise your child's odds of being overweight in the future. If you find that you are gaining weight too quickly, try to cut back on foods with added sugars and solid fats. If you are not gaining enough weight, you can eat a little more from each food group.
Where does the added weight go?
- Baby – 6 to 8 pounds
- Placenta – 1½ pounds
- Amniotic fluid – 2 pounds
- Uterus growth – 2 pounds
- Breast growth – 2 pounds
- Your blood and body fluids – 8 pounds
- Your body's protein and fat – 7 pounds
Calorie needs
Your calorie needs will depend on your weight gain goals. Most women need 300 calories a day more during at least the last six months of pregnancy than they do pre-pregnancy. Keep in mind that not all calories are equal. Your baby needs healthy foods that are packed with nutrients — not "empty calories" such as those found in soft drinks, candies, and desserts.
Although you want to be careful not to eat more than you need for a healthy pregnancy, make sure not to restrict your diet during pregnancy either. If you don't get the calories you need, your baby might not get the right amounts of protein, vitamins, and minerals. Low-calorie diets can break down a pregnant woman's stored fat. This can cause your body to make substances called ketones. Ketones can be found in the mother's blood and urine and are a sign of starvation. Constant production of ketones can result in a child with mental deficiencies.
Foods good for mom and baby
A pregnant woman needs more of many important vitamins, minerals, and nutrients than she did before pregnancy. Making healthy food choices every day will help you give your baby what he or she needs to develop. ChooseMyPlate for pregnant and breastfeeding women can show you what to eat as well as how much you need to eat from each food group based on your height, weight, and activity level.
Talk to your doctor if you have special diet needs for these reasons:
- Diabetes – Make sure you review your meal plan and insulin needs with your doctor. High blood glucose levels can be harmful to your baby.
- Lactose intolerance – Find out about low-lactose or reduced-lactose products and calcium supplements to ensure you are getting the calcium you need.
- Vegetarian – Ensure that you are eating enough protein, iron, vitamin B12, and vitamin D.
- PKU – Keep good control of phenylalanine (FEN-uhl-AL-uh-NEEN) levels in your diet.
Food safety
Most foods are safe for pregnant women and their babies. But you will need to use caution or avoid eating certain foods. Follow these guidelines:
Clean, handle, cook, and chill food properly to prevent foodborne illness, including listeria and toxoplasmosis.
- Wash hands with soap after touching soil or raw meat.
- Keep raw meats, poultry, and seafood from touching other foods or surfaces.
- Cook meat completely.
- Wash produce before eating.
- Wash cooking utensils with hot, soapy water.
Do not eat:
- Refrigerated smoked seafood like whitefish, salmon, and mackerel
- Hot dogs or deli meats unless steaming hot
- Refrigerated meat spreads
- Unpasteurized milk or juices
- Store-made salads, such as chicken, egg, or tuna salad
- Unpasteurized soft cheeses, such as unpasteurized feta, Brie, queso blanco, queso fresco, and blue cheeses
- Shark, swordfish, king mackerel, or tile fish (also called golden or white snapper); these fish have high levels of mercury.
- More than 6 ounces per week of white (albacore) tuna
- Herbs and plants used as medicines without your doctor's okay. The safety of herbal and plant therapies isn't always known. Some herbs and plants might be harmful during pregnancy, such as bitter melon (karela), noni juice, and unripe papaya.
- Raw sprouts of any kind (including alfalfa, clover, radish, and mung bean)
Fish facts
Fish and shellfish can be an important part of a healthy diet. They are a great source of protein and heart-healthy omega-3 fatty acids. What's more, some researchers believe low fish intake may be linked to depression in women during and after pregnancy. Research also suggests that omega-3 fatty acids consumed by pregnant women may aid in babies' brain and eye development.
Women who are or may become pregnant and nursing mothers need 12 ounces of fish per week to reap the health benefits. Unfortunately, some pregnant and nursing women do not eat any fish because they worry about mercury in seafood. Mercury is a metal that at high levels can harm the brain of your unborn baby — even before it is conceived. Mercury mainly gets into our bodies by eating large, predatory fish. Yet many types of seafood have little or no mercury at all. So the risk of mercury exposure depends on the amount and type of seafood you eat.
Women who are nursing, pregnant, or who may become pregnant can safely eat a variety of cooked seafood, but should steer clear of fish with high levels of mercury. Keep in mind that removing all fish from your diet will rob you of important omega-3 fatty acids. To reach 12 ounces while limiting exposure to mercury, follow these tips:
-
Do not eat these fish that are high in mercury:
- Swordfish
- Tilefish
- King mackerel
- Shark
- Eat up to 6 ounces (about 1 serving) per week:
Canned albacore or chunk white tuna (also sold as tuna steaks), which has more mercury than canned light tuna -
Eat up to 12 ounces (about 2 servings) per week of cooked* fish and shellfish with little or no mercury, such as:
- Shrimp
- Crab
- Clams
- Oysters
- Scallops
- Canned light tuna
- Salmon
- Pollock
- Catfish
- Cod
- Tilapia
* Don't eat uncooked fish or shellfish (such as clams, oysters, scallops), which includes refrigerated uncooked seafood labeled nova-style, lox, kippered, smoked, or jerky.
- Check before eating fish caught in local waters. State health departments have guidelines on fish from local waters. Or get local fish advisories at the U.S. Environmental Protection Agency. If you are unsure about the safety of a fish from local waters, only eat 6 ounces per week and don't eat any other fish that week.
- Eat a variety of cooked seafood rather than just a few types.
Foods supplemented with DHA/EPA (such as “omega-3 eggs”) and prenatal vitamins supplemented with DHA are other sources of the type of omega-3 fatty acids found in seafood.
Vitamins and minerals
In addition to making healthy food choices, ask your doctor about taking a prenatal vitamin and mineral supplement every day to be sure you are getting enough of the nutrients your baby needs. You also can check the label on the foods you buy to see how much of a certain nutrient the product contains. Women who are pregnant need more of these nutrients than women who are not pregnant:
Nutrient | How much pregnant women need each day |
---|---|
Folic acid | 400 to 800 micrograms (mcg) (0.4 to 0.8 mg) in the early stages of pregnancy, which is why all women who are capable of pregnancy should take 400 to 800 mcg of folic acid daily. Pregnant women should continue taking folic acid throughout pregnancy. |
Iron | 27 milligrams (mg) |
Calcium | 1,000 milligrams (mg); 1,300 mg if 18 or younger |
Vitamin A | 770 micrograms (mcg); 750 mcg if 18 or younger |
Vitamin B12 | 2.6 micrograms (mcg) |
Women who are pregnant also need to be sure to get enough vitamin D. The current recommendation for all adults younger than 71 (including pregnant and breastfeeding women) is 600 international units (IU) of vitamin D each day. Talk to your doctor about how you can be sure to get enough vitamin D and other important vitamins and nutrients.
Keep in mind that taking too much of a supplement can be harmful. For example, very high levels of vitamin A can cause birth defects. For this reason, your daily prenatal vitamin should contain no more than 5,000 IU (International Units) of vitamin A. Some supplements contain much more. Only take vitamins and mineral supplements that your doctor recommends.
Don't forget fluids
All of your body's systems need water. When you are pregnant, your body needs even more water to stay hydrated and support the life inside you. Water also helps prevent constipation, hemorrhoids, excessive swelling, and urinary tract or bladder infections. Not getting enough water can lead to premature or early labor.
Your body gets the water it needs through the fluids you drink and the foods you eat. How much fluid you need to drink each day depends on many factors, such as your activity level, the weather, and your size. Your body needs more fluids when it is hot and when you are physically active. It also needs more water if you have a fever or if you are vomiting or have diarrhea.
The Institute of Medicine recommends that pregnant women drink about 10 cups of fluids daily. Water, juices, coffee, tea, and soft drinks all count toward your fluid needs. But keep in mind that some beverages are high in sugar and "empty" calories. A good way to tell if your fluid intake is okay is if your urine is pale yellow or colorless and you rarely feel thirsty. Thirst is a sign that your body is on its way to dehydration. Don't wait until you feel thirsty to drink.
Alcohol
There is no known safe amount of alcohol a woman can drink while pregnant. When you are pregnant and you drink beer, wine, hard liquor, or other alcoholic beverages, alcohol gets into your blood. The alcohol in your blood gets into your baby's body through the umbilical cord. Alcohol can slow down the baby's growth, affect the baby's brain, and cause birth defects.
Find out more about the dangers of drinking alcohol during pregnancy in our section on substance abuse.
Caffeine
Moderate amounts of caffeine appear to be safe during pregnancy. Moderate means less than 200 mg of caffeine per day, which is the amount in about 12 ounces of coffee. Most caffeinated teas and soft drinks have much less caffeine. Some studies have shown a link between higher amounts of caffeine and miscarriage and preterm birth. But there is no solid proof that caffeine causes these problems. The effects of too much caffeine are unclear. Ask your doctor whether drinking a limited amount of caffeine is okay for you.
Cravings
Many women have strong desires for specific foods during pregnancy. The desire for "pickles and ice cream" and other cravings might be caused by changes in nutritional needs during pregnancy. The fetus needs nourishment. And a woman's body absorbs and processes nutrients differently while pregnant. These changes help ensure normal development of the baby and fill the demands of breastfeeding once the baby is born.
Some women crave nonfood items such as clay, ice, laundry starch, or cornstarch. A desire to eat nonfood items is called pica. Eating nonfood items can be harmful to your pregnancy. Talk to your doctor if you have these urges.
Keeping fit
Fitness goes hand in hand with eating right to maintain your physical health and well-being during pregnancy. Pregnant or not, physical fitness helps keep the heart, bones, and mind healthy. Healthy pregnant women should get at least 2 hours and 30 minutes of moderate-intensity aerobic activity a week. It's best to spread your workouts throughout the week. If you regularly engage in vigorous-intensity aerobic activity or high amounts of activity, you can keep up your activity level as long as your health doesn't change and you talk to your doctor about your activity level throughout your pregnancy.
Special benefits of physical activity during pregnancy:
- Exercise can ease and prevent aches and pains of pregnancy including constipation, varicose veins, backaches, and exhaustion.
- Active women seem to be better prepared for labor and delivery and recover more quickly.
- Exercise may lower the risk of preeclampsia and gestational diabetes during pregnancy.
- Fit women have an easier time getting back to a healthy weight after delivery.
- Regular exercise may improve sleep during pregnancy.
- Staying active can protect your emotional health. Pregnant women who exercise seem to have better self-esteem and a lower risk of depression and anxiety.
- Results from a recent, large study suggest that women who are physically active during pregnancy may lower their chances of preterm delivery.
Getting started
For most healthy moms-to-be who do not have any pregnancy-related problems, exercise is a safe and valuable habit. Even so, talk to your doctor or midwife before exercising during pregnancy. She or he will be able to suggest a fitness plan that is safe for you. Getting a doctor's advice before starting a fitness routine is important for both inactive women and women who exercised before pregnancy.
If you have one of these conditions, your doctor will advise you not to exercise:
- Risk factors for preterm labor
- Vaginal bleeding
- Premature rupture of membranes (when your water breaks early, before labor)
Best activity for moms-to-be
Low-impact activities at a moderate level of effort are comfortable and enjoyable for many pregnant women. Walking, swimming, dancing, cycling, and low-impact aerobics are some examples. These sports also are easy to take up, even if you are new to physical fitness.
Some higher intensity sports are safe for some pregnant women who were already doing them before becoming pregnant. If you jog, play racquet sports, or lift weights, you may continue with your doctor's okay.
Keep these points in mind when choosing a fitness plan:
- Avoid activities in which you can get hit in the abdomen like kickboxing, soccer, basketball, or ice hockey.
- Steer clear of activities in which you can fall like horseback riding, downhill skiing, and gymnastics.
- Do not scuba dive during pregnancy. Scuba diving can create gas bubbles in your baby's blood that can cause many health problems.
Tips for safe and healthy physical activity
Follow these tips for safe and healthy fitness:
- When you exercise, start slowly, progress gradually, and cool down slowly.
- You should be able to talk while exercising. If not, you may be overdoing it.
- Take frequent breaks.
- Don't exercise on your back after the first trimester. This can put too much pressure on an important vein and limit blood flow to the baby.
- Avoid jerky, bouncing, and high-impact movements. Connective tissues stretch much more easily during pregnancy. So these types of movements put you at risk of joint injury.
- Be careful not to lose your balance. As your baby grows, your center of gravity shifts making you more prone to falls. For this reason, activities like jogging, using a bicycle, or playing racquet sports might be riskier as you near the third trimester.
- Don't exercise at high altitudes (more than 6,000 feet). It can prevent your baby from getting enough oxygen.
- Make sure you drink lots of fluids before, during, and after exercising.
- Do not workout in extreme heat or humidity.
- If you feel uncomfortable, short of breath, or tired, take a break and take it easier when you exercise again.
Stop exercising and call your doctor as soon as possible if you have any of the following:
- Dizziness
- Headache
- Chest pain
- Calf pain or swelling
- Abdominal pain
- Blurred vision
- Fluid leaking from the vagina
- Vaginal bleeding
- Less fetal movement
- Contractions
Work out your pelvic floor (Kegel exercises)
Your pelvic floor muscles support the rectum, vagina, and urethra in the pelvis. Toning these muscles with Kegel exercises will help you push during delivery and recover from birth. It also will help control bladder leakage and lower your chance of getting hemorrhoids.
Pelvic muscles are the same ones used to stop the flow of urine. Still, it can be hard to find the right muscles to squeeze. You can be sure you are exercising the right muscles if when you squeeze them you stop urinating. Or you can put a finger into the vagina and squeeze. If you feel pressure around the finger, you've found the pelvic floor muscles. Try not to tighten your stomach, legs, or other muscles.
Kegel exercises
- Tighten the pelvic floor muscles for a count of three, then relax for a count of three.
- Repeat 10 to 15 times, three times a day.
- Start Kegel exercises lying down. This is the easiest position. When your muscles get stronger, you can do Kegel exercises sitting or standing as you like.
Oral health
Before you become pregnant, it is best to have dental checkups routinely to keep your teeth and gums healthy. If you are pregnant and have not had regular checkups, consider the following:
- Have a complete oral exam early in your pregnancy. Because you are pregnant, you might not receive routine x-rays. But if you must have x-rays for a dental problem needing treatment, the health risk to your unborn baby is small.
- Dental treatment during pregnancy is safe. The best time for treatment is between the 14th and 20th weeks. During the last months of pregnancy, you might be uncomfortable sitting in a dental chair.
- Do not avoid necessary dental treatments — you may risk your and your baby's health.
- Use good oral hygiene to control your risk of gum diseases. Pregnant women may have changes in taste and develop red, swollen gums that bleed easily. This condition is called pregnancy gingivitis. It can be caused by both poor oral hygiene and higher hormone levels during pregnancy. Until recently, it was thought that having gum disease could raise your risk of having a low birth weight baby. Researchers have not been able to confirm this link, but some research is still under way to learn more.
After you give birth, maintain good oral hygiene to protect your baby's oral health. Bacteria that cause cavities can transfer from you to your child by:
- A kiss on the mouth
- Letting your baby put her fingers in your mouth
- Tasting food on your baby's spoon
- Testing the temperature of a baby bottle with your mouth
You also should find a dentist for your child by age 1.
Using medicine and herbs
Related information: Pregnancy and medicines fact sheet.
You and your baby are connected. The medicines you use, including over-the-counter, herbal, and prescription drugs or supplements, might get into your baby's body, too. Many medicines and herbs are known to cause problems during pregnancy, including birth defects. For some medicines, we don't know that much about how they might affect pregnancy or the developing fetus. This is because medicines are rarely tested on pregnant women for fear of harming the fetus.
Mothers-to-be might wonder if it's safe to use medicines during pregnancy. There is no clear-cut answer to this question. Your doctor can help you make the choice whether to use a medicine. Labels on prescription and over-the-counter drugs have information to help you and your doctor make this choice. In the future, a new prescription drug label will make it easier for women and their doctors to weigh the benefits and risks of using prescription medicines during pregnancy.
Always speak with your doctor before you start or stop any medicine. Not using medicine that you need may be more harmful to you and your baby than using the medicine.
Weighing benefits and risks
When deciding whether to use a medicine in pregnancy, you and your doctor need to talk about the medicine's benefits and the risks.
- Benefits – what are the good things the medicine can do for me and my growing baby?
- Risks – what are the ways the medicine might harm me or my growing baby?
There may be times during pregnancy when using medicine is a choice. For example, if you get a cold, you may decide to "live with" your stuffy nose instead of using the "stuffy nose" medicine you use when you are not pregnant.
Other times during pregnancy, using medicine is not a choice — it is needed. For example, you might need to use medicine to control an existing health problem like asthma, diabetes, depression, or seizures. Or, you might need a medicine for a few days, such as an antibiotic to treat a bladder infection or strep throat. Also, some women have a pregnancy problem that needs medicine treatment. These problems include severe nausea and vomiting, earlier pregnancy losses, or preterm labor.
Using herbal or dietary supplements and other "natural" products
You might think herbs are safe because they are "natural." But, except for some vitamins, little is known about using herbal or dietary supplements while pregnant. Some herbal remedy labels claim they will help with pregnancy. But, most often there are no good studies to show if these claims are true or if the herb can cause harm to you or your baby. Also, some herbs that are safe when used in small amounts as food might be harmful when used in large amounts as medicines. So, talk with your doctor before using any herbal or dietary supplement or natural product. These products may contain things that could harm you or your growing baby.
Travel
Everyday life doesn't stop once you are pregnant. Most healthy pregnant women are able to continue with their usual routine and activity level. That means going to work, running errands, and for some, traveling away from home. To take care of yourself and help keep your baby safe, consider these points before taking a long trip or traveling far from home:
- Talk to your doctor before making any travel decisions that will take you far from home. Ask if any health conditions you might have makes travel during pregnancy unsafe. Also consider the destination. Is the food and water safe? Will you need immunizations before you go? Is there good medical care available in the event of an emergency? Will your health insurance cover medical care at your destination?
- Avoid sitting for long periods during car or air travel. Prolonged sitting can affect blood flow in your legs. Try to limit driving to no more than 5 or 6 hours each day. Take frequent breaks to stretch your legs. Stand up, and move your legs often during air travel. Wearing support pantyhose also can help blood flow.
- Occasional air travel is safe for most pregnant women, and most airlines will allow women to fly up to 36 weeks of pregnancy. Make sure to wear your seatbelt during the flight, and take steps to ease the discomforts of prolonged travel and sitting. Frequent air travel during pregnancy increases the risk of fetal exposure to cosmic radiation. If you are a pregnant pilot, aircrew member, or other frequent flier, check with your employer about flying restrictions.
- Bring a copy of your medical record and find out about medical care at your destination so you will be prepared in the event of an emergency.
- If you suspect a problem with your pregnancy during your trip, don't wait until you come home to see your doctor. Seek medical care right away.
Buckle up!
Wearing a seatbelt during car and air travel is safe while pregnant. The lap strap should go under your belly, across your hips. The shoulder strap should go between your breasts and to the side of your belly. Make sure it fits snugly.
Environmental risks
The environment is everything around us wherever we are — at home, at work, or outdoors. Although you don't need to worry about every little thing you breathe in or eat, it's smart to avoid exposure to substances that might put your pregnancy or unborn baby's health at risk.
During pregnancy, avoid exposure to:
- Lead – found in some water and paints, mainly in homes built before 1978
- Mercury – the harmful form is found mainly in large, predatory fish.
- Arsenic – high levels can be found in some well water
- Pesticides – both household products and agricultural pesticides
- Solvents – such as degreasers and paint strippers and thinners
- Cigarette smoke
Keep in mind: We don't know how much exposure can lead to problems, such as miscarriage or birth defects. That is why it's best to avoid or limit your exposure as much as possible. Here are some simple, day-to-day precautions you can take:
- Clean in only well-ventilated spaces. Open the windows or turn on a fan.
- Check product labels for warnings for pregnant women and follow instructions for safe use.
- Do not clean the inside of an oven while pregnant.
- Leave the house if paint is being used, and don't return until the fumes are gone.
If you are exposed to chemicals in the workplace, talk to your doctor and your employer about what you can do to lower your exposure. Certain industries, such as dry cleaning, manufacturing, printing, and agriculture, involve use of toxins that could be harmful. If you are concerned about the safety of your drinking water, call your health department or water supplier to ask about the quality of your tap water or how to have your water tested. Or, call the Environmental Protection Agency's Safe Drinking Water Hotline at (800) 426-4791. Don't assume that bottled water is better or safer. Usually, bottle water offers no health benefits over tap water.
Quitting smoking
Smoking cigarettes is very harmful to your health and could also affect the health of your baby. Not only does smoking cause cancer and heart disease in people who smoke, smoking during pregnancy increases the risk of low birth weight. Low birth weight babies are at higher risk of health problems shortly after birth. Also, some studies have linked low birth weight with a higher risk of health problems later in life, such as high blood pressure and diabetes. Women who smoke during pregnancy are more likely than other women to have a miscarriage and to have a baby born with cleft lip or palate, types of birth defects. Also, mothers who smoke during or after pregnancy put their babies at greater risk of sudden infant death syndrome (SIDS).
Mothers who smoke have many reasons to quit smoking. Take care of your health and your unborn baby's health: Ask your doctor about ways to help you quit during pregnancy. Intensive counseling has been shown to increase a pregnant woman's chances of quitting success. We don't know whether the drugs used to help people quit are safe to use during pregnancy. But we do know that continuing to smoke during pregnancy threatens your and your baby's health. Quitting smoking is hard, but you can do it with help!
Substance abuse
Using alcohol and illegal drugs during pregnancy threatens the health of your unborn baby. So does using legal drugs in an inappropriate way. When you use alcohol or drugs, the chemicals you ingest or breathe into your lungs cross the placenta and enter your baby. This puts your baby at risk for such problems as stillbirth, low birth weight, birth defects, behavioral problems, and developmental delays.
Alcohol
When you drink alcohol, so does your baby. Pregnant women should not drink alcohol to eliminate the chance of giving birth to a baby with fetal alcohol spectrum disorder (FASD). FASD involves a range of harmful effects that can occur when a fetus is exposed to alcohol. The effects can be mild to severe. Children born with a severe form of FASD can have abnormal facial features, severe learning disabilities, behavioral problems, and other problems.
You might think a drink now and then won't hurt your baby. But we don't know how much alcohol it takes to cause harm. We do know that the risk of FASD, and the likely severity, goes up with the amount of alcohol consumed during pregnancy. Also, damage from alcohol can occur in the earliest stages of pregnancy — often before a woman knows she is pregnant. For this reason, women who may become pregnant also should not drink.
Illegal drugs
Many women who use illegal drugs also use tobacco and alcohol. So, it's not always easy to tell the effects of one drug from that of alcohol, tobacco, or other drugs. We do know that using illegal drugs during pregnancy is very dangerous. Babies born to women who use drugs such as cocaine, heroine, and methamphetamine are likely to be born addicted and must go through withdrawal. Mothers who inject drugs are at higher risk of getting HIV, which can be passed to an unborn baby. Some studies suggest that the effects of drug use during pregnancy might not be seen until later in childhood.
Getting help for alcohol or drug use
If you drink alcohol or use drugs and cannot quit, talk to your doctor right away. Treatment programs can help pregnant women with addiction and abuse. To find help near you, go to the Substance abuse treatment facility locator. You can quit using and give your baby a good start to life.
Abusive relationships
It's hard to be excited about the new life growing inside of you if you're afraid of your partner. Abuse from a partner can begin or increase during pregnancy and can harm you and your unborn baby. Women who are abused often don't get the prenatal care their babies need. Abuse from a partner also can lead to preterm birth and low birth weight babies, stillbirth and newborn death, and homicide. If you are abused, you might turn to alcohol, cigarettes, or drugs to help you cope. This can be even more harmful to you and your baby.
You may think that a new baby will change your situation for the better. But the cycle of abuse is complex, and a baby introduces new stress to people and relationships. Now is a good time to think about your safety and the safety and wellbeing of your baby. About 50 percent of men who abuse their wives also abuse their children. Think about the home environment you want for your baby. Studies show that children who witness or experience violence at home may have long-term physical, emotional, and social problems. They are also more likely to experience or commit violence themselves in the future.
Prenatal exams offer a good chance to reach out for help. It's possible to take control and leave an abusive partner. But for your and your baby's safety, talk to your doctor first. Let motherhood prompt you to take action now.
If you're a victim of abuse or violence at the hands of someone you know or love, or you are recovering from an assault by a stranger, you and your baby can get immediate help and support.
- The National Domestic Violence Hotline (link is external) can be reached 24 hours a day, 7 days a week at 800-799-SAFE (7233) and 800-787-3224 (TTY). Spanish speakers are available. When you call, you will first hear a recording and may have to hold. Hotline staff offer crisis intervention and referrals. If requested, they connect women to shelters and can send out written information.
- The National Sexual Assault Hotline (link is external) can be reached 24 hours a day, 7 days a week at 800-656-4673. When you call, you will hear a menu and can choose #1 to talk to a counselor. You will then be connected to a counselor in your area who can help you. You can also visit the National Sexual Assault Online Hotline (link is external).
When to call the doctor
When you are pregnant, do not hesitate to call your doctor or midwife if something is bothering or worrying you. Sometimes physical changes can be signs of a problem.
Call your doctor or midwife as soon as you can if you:
- Are bleeding or leaking fluid from the vagina
- Have sudden or severe swelling in the face, hands, or fingers
- Get severe or long-lasting headaches
- Have discomfort, pain, or cramping in the lower abdomen
- Have a fever or chills
- Are vomiting or have persistent nausea
- Feel discomfort, pain, or burning with urination
- Have problems seeing or blurred vision
- Feel dizzy
- Suspect your baby is moving less than normal after 28 weeks of pregnancy (if you count less than 10 movements within 2 hours. Learn how to count your baby's movements on our Prenatal care and tests page.)
- Have thoughts of harming yourself or your baby
Related information
Body changes and discomforts

Everyone expects pregnancy to bring an expanding waistline. But many women are surprised by the other body changes that pop up. Get the low-down on stretch marks, weight gain, heartburn and other "joys" of pregnancy. Find out what you can do to feel better.
Body aches
As your uterus expands, you may feel aches and pains in the back, abdomen, groin area, and thighs. Many women also have backaches and aching near the pelvic bone due the pressure of the baby's head, increased weight, and loosening joints. Some pregnant women complain of pain that runs from the lower back, down the back of one leg, to the knee or foot. This is called sciatica. It is thought to occur when the uterus puts pressure on the sciatic nerve.
What might help:
- Lie down.
- Rest.
- Apply heat.
Call the doctor if pain does not get better.
Breast changes
A woman's breasts increase in size and fullness during pregnancy. As the due date approaches, hormone changes will cause your breasts to get even bigger to prepare for breastfeeding. Your breasts may feel full, heavy, or tender.
In the third trimester, some pregnant women begin to leak colostrum from their breasts. Colostrum is the first milk that your breasts produce for the baby. It is a thick, yellowish fluid containing antibodies that protect newborns from infection.
What might help:
- Wear a maternity bra with good support.
- Put pads in bra to absorb leakage.
Tell your doctor if you feel a lump or have nipple changes or discharge (that is not colostrum) or skin changes.
Constipation
Many pregnant women complain of constipation. Signs of constipation include having hard, dry stools; fewer than three bowel movements per week; and painful bowel movements.
Higher levels of hormones due to pregnancy slow down digestion and relax muscles in the bowels leaving many women constipated. Plus, the pressure of the expanding uterus on the bowels can contribute to constipation.
What might help:
- Drink eight to 10 glasses of water daily.
- Don't drink caffeine.
- Eat fiber-rich foods, such as fresh or dried fruit, raw vegetables, and whole-grain cereals and breads.
- Try mild physical activity.
Tell your doctor if constipation does not go away.
Dizziness
Many pregnant women complain of dizziness and lightheadedness throughout their pregnancies. Fainting is rare but does happen even in some healthy pregnant women. There are many reasons for these symptoms. The growth of more blood vessels in early pregnancy, the pressure of the expanding uterus on blood vessels, and the body's increased need for food all can make a pregnant woman feel lightheaded and dizzy.
What might help:
- Stand up slowly.
- Avoid standing for too long.
- Don't skip meals.
- Lie on your left side.
- Wear loose clothing.
Call your doctor if you feel faint and have vaginal bleeding or abdominal pain.
Fatigue, sleep problems
During your pregnancy, you might feel tired even after you've had a lot of sleep. Many women find they're exhausted in the first trimester. Don't worry, this is normal! This is your body's way of telling you that you need more rest. In the second trimester, tiredness is usually replaced with a feeling of well being and energy. But in the third trimester, exhaustion often sets in again. As you get larger, sleeping may become more difficult. The baby's movements, bathroom runs, and an increase in the body's metabolism might interrupt or disturb your sleep. Leg cramping can also interfere with a good night's sleep.
What might help:
- Lie on your left side.
- Use pillows for support, such as behind your back, tucked between your knees, and under your tummy.
- Practice good sleep habits, such as going to bed and getting up at the same time each day and using your bed only for sleep and sex.
- Go to bed a little earlier.
- Nap if you are not able to get enough sleep at night.
- Drink needed fluids earlier in the day, so you can drink less in the hours before bed.
Heartburn and indigestion
Hormones and the pressure of the growing uterus cause indigestion and heartburn. Pregnancy hormones slow down the muscles of the digestive tract. So food tends to move more slowly and digestion is sluggish. This causes many pregnant women to feel bloated.
Hormones also relax the valve that separates the esophagus from the stomach. This allows food and acids to come back up from the stomach to the esophagus. The food and acid causes the burning feeling of heartburn. As your baby gets bigger, the uterus pushes on the stomach making heartburn more common in later pregnancy.
What might help:
- Eat several small meals instead of three large meals — eat slowly.
- Drink fluids between meals — not with meals.
- Don't eat greasy and fried foods.
- Avoid citrus fruits or juices and spicy foods.
- Do not eat or drink within a few hours of bedtime.
- Do not lie down right after meals.
Call your doctor if symptoms don't improve after trying these suggestions. Ask your doctor about using an antacid.
Hemorrhoids
Hemorrhoids are swollen and bulging veins in the rectum. They can cause itching, pain, and bleeding. Up to 50 percent of pregnant women get hemorrhoids. Hemorrhoids are common during pregnancy for many reasons. During pregnancy blood volume increases greatly, which can cause veins to enlarge. The expanding uterus also puts pressure on the veins in the rectum. Plus, constipation can worsen hemorrhoids. Hemorrhoids usually improve after delivery.
What might help:
- Drink lots of fluids.
- Eat fiber-rich foods, like whole grains, raw or cooked leafy green vegetables, and fruits.
- Try not to strain with bowel movements.
- Talk to your doctor about using products such as witch hazel to soothe hemorrhoids.
Itching
About 20 percent of pregnant women feel itchy during pregnancy. Usually women feel itchy in the abdomen. But red, itchy palms and soles of the feet are also common complaints. Pregnancy hormones and stretching skin are probably to blame for most of your discomfort. Usually the itchy feeling goes away after delivery.
What might help:
- Use gentle soaps and moisturizing creams.
- Avoid hot showers and baths.
- Avoid itchy fabrics.
Call your doctor if symptoms don't improve after a week of self-care.
Leg cramps
At different times during your pregnancy, you might have sudden muscle spasms in your legs or feet. They usually occur at night. This is due to a change in the way your body processes calcium.
What might help:
- Gently stretch muscles.
- Get mild exercise.
- For sudden cramps, flex your foot forward.
- Eat calcium-rich foods.
- Ask your doctor about calcium supplements.
Morning sickness
In the first trimester hormone changes can cause nausea and vomiting. This is called "morning sickness," although it can occur at any time of day. Morning sickness usually tapers off by the second trimester.
What might help:
- Eat several small meals instead of three large meals to keep your stomach from being empty.
- Don't lie down after meals.
- Eat dry toast, saltines, or dry cereals before getting out of bed in the morning.
- Eat bland foods that are low in fat and easy to digest, such as cereal, rice, and bananas.
- Sip on water, weak tea, or clear soft drinks. Or eat ice chips.
- Avoid smells that upset your stomach.
Call your doctor if you have flu-like symptoms, which may signal a more serious condition.
Call your doctor if you have severe, constant nausea and/or vomiting several times every day.
Nasal problems
Nosebleeds and nasal stuffiness are common during pregnancy. They are caused by the increased amount of blood in your body and hormones acting on the tissues of your nose.
What might help:
- Blow your nose gently.
- Drink fluids and use a cool mist humidifier.
- To stop a nosebleed, squeeze your nose between your thumb and forefinger for a few minutes.
Call your doctor if nosebleeds are frequent and do not stop after a few minutes.
Numb or tingling hands
Feelings of swelling, tingling, and numbness in fingers and hands, called carpal tunnel syndrome, can occur during pregnancy. These symptoms are due to swelling of tissues in the narrow passages in your wrists, and they should disappear after delivery.
What might help:
- Take frequent breaks to rest hands.
- Ask your doctor about fitting you for a splint to keep wrists straight.
Stretch marks, skin changes
Stretch marks are red, pink, or brown streaks on the skin. Most often they appear on the thighs, buttocks, abdomen, and breasts. These scars are caused by the stretching of the skin, and usually appear in the second half of pregnancy.
Some women notice other skin changes during pregnancy. For many women, the nipples become darker and browner during pregnancy. Many pregnant women also develop a dark line (called the linea nigra) on the skin that runs from the belly button down to the pubic hairline. Patches of darker skin usually over the cheeks, forehead, nose, or upper lip also are common. Patches often match on both sides of the face. These spots are called melasma or chloasma and are more common in darker-skinned women.
What might help:
- Be patient — stretch marks and other changes usually fade after delivery.
Swelling
Many women develop mild swelling in the face, hands, or ankles at some point in their pregnancies. As the due date approaches, swelling often becomes more noticeable.
What might help:
- Drink eight to 10 glasses of fluids daily.
- Don't drink caffeine or eat salty foods.
- Rest and elevate your feet.
- Ask your doctor about support hose.
Call your doctor if your hands or feet swell suddenly or you rapidly gain weight — it may be preeclampsia.
Urinary frequency and leaking
Temporary bladder control problems are common in pregnancy. Your unborn baby pushes down on the bladder, urethra, and pelvic floor muscles. This pressure can lead to more frequent need to urinate, as well as leaking of urine when sneezing, coughing, or laughing.
What might help:
- Take frequent bathroom breaks.
- Drink plenty of fluids to avoid dehydration.
- Do Kegel exercises to tone pelvic muscles.
Call your doctor if you experience burning along with frequency of urination — it may be an infection.
Varicose veins
During pregnancy, blood volume increases greatly. This can cause veins to enlarge. Plus, pressure on the large veins behind the uterus causes the blood to slow in its return to the heart. For these reasons, varicose veins in the legs and anus (hemorrhoids) are more common in pregnancy.
Varicose veins look like swollen veins raised above the surface of the skin. They can be twisted or bulging and are dark purple or blue in color. They are found most often on the backs of the calves or on the inside of the leg.
What might help:
- Avoid tight knee-highs.
- Sit with your legs and feet raised.
More information on body changes and discomforts
Explore other publications and websites
- First Trimester Pregnancy: What to Expect (Copyright © Mayo Foundation) (link is external) - This fact sheet discusses the physical changes and symptoms experienced in the first three months of pregnancy.
- Second Trimester Pregnancy: What to Expect (Copyright © Mayo Foundation) (link is external) - This fact sheet discusses how the changes that began in the first weeks of pregnancy increase and accelerate during the second trimester. Of these, your growing uterus is probably the most obvious. But many other, unseen events are also taking place.
Connect with other organizations
- American Academy of Family Physicians (link is external)
- American College of Nurse-Midwives (link is external)
- American College of Obstetricians and Gynecologists (link is external)
- Center for Research on Reproduction and Women's Health, University of Pennsylvania Medical Center (link is external)
- Hyperemesis Education and Research Foundation (link is external)
- March of Dimes (link is external)
Pregnancy complications

Complications of pregnancy are health problems that occur during pregnancy. They can involve the mother's health, the baby's health, or both. Some women have health problems before they become pregnant that could lead to complications. Other problems arise during the pregnancy. Whether a complication is common or rare, there are ways to manage problems that come up during pregnancy.
Health problems before pregnancy
Before pregnancy, make sure to talk to your doctor about health problems you have now or have had in the past. If you are receiving treatment for a health problem, your doctor might want to change the way your health problem is managed. Some medicines used to treat health problems could be harmful if taken during pregnancy. At the same time, stopping medicines that you need could be more harmful than the risks posed should you become pregnant. Be assured that you are likely to have a normal, healthy baby when health problems are under control and you get good prenatal care.
Condition | How it can affect pregnancy | Where to learn more |
---|---|---|
Asthma | Poorly controlled asthma may increase risk of preeclampsia, poor weight gain in the fetus, preterm birth, cesarean birth, and other complications. If pregnant women stop using asthma medicine, even mild asthma can become severe. | |
Depression | Depression that persists during pregnancy can make it hard for a woman to care for herself and her unborn baby. Having depression before pregnancy also is a risk factor for postpartum depression. | |
Diabetes | High blood glucose (sugar) levels during pregnancy can harm the fetus and worsen a woman's long-term diabetes complications. Doctors advise getting diabetes under control at least three to six months before trying to conceive. | |
Eating disorders | Body image changes during pregnancy can cause eating disorders to worsen. Eating disorders are linked to many pregnancy complications, including birth defects and premature birth. Women with eating disorders also have higher rates of postpartum depression. | |
Epilepsy and other seizure disorders | Seizures during pregnancy can harm the fetus, and increase the risk of miscarriage or stillbirth. But using medicine to control seizures might cause birth defects. For most pregnant women with epilepsy, using medicine poses less risk to their own health and the health of their babies than stopping medicine. | |
High blood pressure | Having chronic high blood pressure puts a pregnant woman and her baby at risk for problems. Women with high blood pressure have a higher risk of preeclampsia and placental abruption (when the placenta separates from the wall of the uterus). The likelihood of preterm birth and low birth weight also is higher. | |
HIV | HIV can be passed from a woman to her baby during pregnancy or delivery. Yet this risk is less than 1 percent if a woman takes certain HIV medicines during pregnancy. Women who have HIV and want to become pregnant should talk to their doctors before trying to conceive. Good prenatal care will help protect a woman's baby from HIV and keep her healthy. | |
Migraine | Migraine symptoms tend to improve during pregnancy. Some women have no migraine attacks during pregnancy. Certain medicines commonly used to treat headaches should not be used during pregnancy. A woman who has severe headaches should speak to her doctor about ways to relieve symptoms safely. | |
Overweight and Obesity | Recent studies suggest that the heavier a woman is before she becomes pregnant, the greater her risk of a range of pregnancy complications, including preeclampsia and preterm delivery. Overweight and obese women who lose weight before pregnancy are likely to have healthier pregnancies. | |
Sexually transmitted infections (STIs) | Some STIs can cause early labor, a woman's water to break too early, and infection in the uterus after birth. Some STIs also can be passed from a woman to her baby during pregnancy or delivery. Some ways STIs can harm the baby include: low birth weight, dangerous infections, brain damage, blindness, deafness, liver problems, or stillbirth. | |
Thyroid disease | Uncontrolled hyperthyroidism (overactive thyroid) can be dangerous to the mother and cause health problems such as heart failure and poor weight gain in the fetus. Uncontrolled hypothyroidism (underactive thyroid) also threatens the mother's health and can cause birth defects. | |
Uterine fibroids | Uterine fibroids are not uncommon, but few cause symptoms that require treatment. Uterine fibroids rarely cause miscarriage. Sometimes, fibroids can cause preterm or breech birth. Cesarean delivery may be needed if a fibroid blocks the birth canal. |
Pregnancy related problems
Sometimes pregnancy problems arise — even in healthy women. Some prenatal tests done during pregnancy can help prevent these problems or spot them early. Use this chart to learn about some common pregnancy complications. Call your doctor if you have any of the symptoms on this chart. If a problem is found, make sure to follow your doctor's advice about treatment. Doing so will boost your chances of having a safe delivery and a strong, healthy baby.
Problem | Symptoms | Treatment |
---|---|---|
Anemia – Lower than normal number of healthy red blood cells |
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Treating the underlying cause of the anemia will help restore the number of healthy red blood cells. Women with pregnancy related anemia are helped by taking iron and folic acid supplements. Your doctor will check your iron levels throughout pregnancy to be sure anemia does not happen again. |
Depression – Extreme sadness during pregnancy or after birth (postpartum) |
|
Women who are pregnant might be helped with one or a combination of treatment options, including:
A mother's depression can affect her baby's development, so getting treatment is important for both mother and baby. Learn more about depression during and after pregnancy. |
Ectopic pregnancy – When a fertilized egg implants outside of the uterus, usually in the fallopian tube |
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With ectopic pregnancy, the egg cannot develop. Drugs or surgery is used to remove the ectopic tissue so your organs are not damaged. |
Fetal problems – Unborn baby has a health issue, such as poor growth or heart problems |
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Treatment depends on results of tests to monitor baby's health. If a test suggests a problem, this does not always mean the baby is in trouble. It may only mean that the mother needs special care until the baby is delivered. This can include a wide variety of things, such as bed rest, depending on the mother's condition. Sometimes, the baby has to be delivered early. |
Gestational diabetes – Too high blood sugar levels during pregnancy |
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Most women with pregnancy related diabetes can control their blood sugar levels by a following a healthy meal plan from their doctor. Some women also need insulin to keep blood sugar levels under control. Doing so is important because poorly controlled diabetes increases the risk of:
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High blood pressure (pregnancy related) – High blood pressure that starts after 20 weeks of pregnancy and goes away after birth |
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The health of the mother and baby are closely watched to make sure high blood pressure is not preeclampsia. |
Hyperemesis gravidarum (HG) – Severe, persistent nausea and vomiting during pregnancy — more extreme than "morning sickness" |
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Dry, bland foods and fluids together is the first line of treatment. Sometimes, medicines are prescribed to help nausea. Many women with HG have to be hospitalized so they can be fed fluids and nutrients through a tube in their veins. Usually, women with HG begin to feel better by the 20th week of pregnancy. But some women vomit and feel nauseated throughout all three trimesters. |
Miscarriage – Pregnancy loss from natural causes before 20 weeks. As many as 20 percent of pregnancies end in miscarriage. Often, miscarriage occurs before a woman even knows she is pregnant |
Signs of a miscarriage can include:
* Spotting early in pregnancy doesn't mean miscarriage is certain. Still, contact your doctor right away if you have any bleeding. |
In most cases, miscarriage cannot be prevented. Sometimes, a woman must undergo treatment to remove pregnancy tissue in the uterus. Counseling can help with emotional healing. See our section on Pregnancy loss. |
Placenta previa – Placenta covers part or entire opening of cervix inside of the uterus |
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If diagnosed after the 20th week of pregnancy, but with no bleeding, a woman will need to cut back on her activity level and increase bed rest. If bleeding is heavy, hospitalization may be needed until mother and baby are stable. If the bleeding stops or is light, continued bed rest is resumed until baby is ready for delivery. If bleeding doesn't stop or if preterm labor starts, baby will be delivered by cesarean section. |
Placental abruption – Placenta separates from uterine wall before delivery, which can mean the fetus doesn't get enough oxygen. |
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When the separation is minor, bed rest for a few days usually stops the bleeding. Moderate cases may require complete bed rest. Severe cases (when more than half of the placenta separates) can require immediate medical attention and early delivery of the baby. |
Preeclampsia – A condition starting after 20 weeks of pregnancy that causes high blood pressure and problems with the kidneys and other organs. Also called toxemia. |
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The only cure is delivery, which may not be best for the baby. Labor will probably be induced if condition is mild and the woman is near term (37 to 40 weeks of pregnancy). If it is too early to deliver, the doctor will watch the health of the mother and her baby very closely. She may need medicines and bed rest at home or in the hospital to lower her blood pressure. Medicines also might be used to prevent the mother from having seizures. |
Preterm labor – Going into labor before 37 weeks of pregnancy |
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Medicines can stop labor from progressing. Bed rest is often advised. Sometimes, a woman must deliver early. Giving birth before 37 weeks is called "preterm birth." Preterm birth is a major risk factor for future preterm births. |
Infections during pregnancy
During pregnancy, your baby is protected from many illnesses, like the common cold or a passing stomach bug. But some infections can be harmful to your pregnancy, your baby, or both. This chart provides an overview of infections that can be harmful during pregnancy. Learn the symptoms and what you can do to keep healthy. Easy steps, such as hand washing, practicing safe sex, and avoiding certain foods, can help protect you from some infections.
Infection | Symptoms | Prevention and treatment | ||||
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Bacterial vaginosis (BV) A vaginal infection that is caused by an overgrowth of bacteria normally found in the vagina. BV has been linked to preterm birth and low birth weight babies. |
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How to prevent BV is unclear. BV is not passed through sexual contact, although it is linked with having a new or more than one sex partner. Women with symptoms should be tested for BV. Antibiotics are used to treat BV. |
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Cytomegalovirus (CMV) A common virus that can cause disease in infants whose mothers are infected with CMV during pregnancy. CMV infection in infants can lead to hearing loss, vision loss, and other disabilities.
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Good hygiene is the best way to keep from getting CMV. No treatment is currently available. But studies are looking at antiviral drugs for use in infants. Work to create a CMV vaccine also is underway. |
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Group B strep (GBS) Group B strep is a type of bacteria often found in the vagina and rectum of healthy women. One in four women has it. GBS usually is not harmful to you, but can be deadly to your baby if passed during childbirth. |
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You can keep from passing GBS to your baby by getting tested at 35 to 37 weeks. This simply involves swabbing the vagina and rectum and does not hurt. If you have GBS, an antibiotic given to you during labor will protect your baby from infection. Make sure to tell the labor and delivery staff that you are a group B strep carrier when you check into the hospital. |
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Hepatitis B virus (HBV) A viral infection that can be passed to baby during birth. Newborns that get infected have a 90 percent chance of developing lifelong infection. This can lead to liver damage and liver cancer. A vaccine can keep newborns from getting HBV. But 1 in 5 newborns of mothers who are HBV positive don't get the vaccine at the hospital before leaving. |
There may be no symptoms. Or symptoms can include:
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Lab tests can find out if the mother is a carrier of hepatitis B. You can protect your baby for life from HBV with the hepatitis B vaccine, which is a series of three shots:
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Influenza (flu) Flu is a common viral infection that is more likely to cause severe illness in pregnant women than in women who are not pregnant. Pregnant woman with flu also have a greater chance for serious problems for their unborn baby, including premature labor and delivery. |
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Getting a flu shot is the first and most important step in protecting against flu. The flu shot given during pregnancy is safe and has been shown to protect both the mother and her baby (up to 6 months old) from flu. (The nasal spray vaccine should not be given to women who are pregnant.) If you get sick with flu-like symptoms call your doctor right away. If needed, the doctor will prescribe an antiviral medicine that treats the flu. |
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Listeriosis An infection with the harmful bacteria called listeria. It is found in some refrigerated and ready-to-eat foods. Infection can cause early delivery or miscarriage.
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Avoid foods that can harbor listeria. Antibiotics are used to treat listeriosis. |
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Parvovirus B19 (fifth disease) Most pregnant women who are infected with this virus do not have serious problems. But there is a small chance the virus can infect the fetus. This raises the risk of miscarriage during the first 20 weeks of pregnancy. Fifth disease can cause severe anemia in women who have red blood cell disorders like sickle cell disease or immune system problems. |
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No specific treatment, except for blood transfusions that might be needed for people who have problems with their immune systems or with red blood cell disorders. There is no vaccine to help prevent infection with this virus. | ||||
Sexually transmitted infection (STI) An infection that is passed through sexual contact. Many STIs can be passed to the baby in the womb or during birth. Some effects include stillbirth, low birth weight, and life-threatening infections. STIs also can cause a woman's water to break too early or preterm labor. |
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STIs can be prevented by practicing safe sex. A woman can keep from passing an STI to her baby by being screened early in pregnancy. Treatments vary depending on the STI. Many STIs are treated easily with antibiotics. |
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Toxoplasmosis This infection is caused by a parasite, which is found in cat feces, soil, and raw or undercooked meat. If passed to an unborn baby, the infection can cause hearing loss, blindness, or intellectual disabilities.
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You can lower your risk by:
Medicines are used to treat a pregnant woman and her unborn baby. Sometimes, the baby is treated with medicine after birth. |
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Urinary tract infection (UTI) Bacterial infection in urinary tract. If untreated, it can spread to the kidneys, which can cause preterm labor. |
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UTIs are treated with antibiotics. | ||||
Yeast infection An infection caused by an overgrowth of bacteria normally found in the vagina. Yeast infections are more common during pregnancy than in other times of a woman's life. They do not threaten the health of your baby. But they can be uncomfortable and difficult to treat in pregnancy. |
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Vaginal creams and suppositories are used to treat yeast infection during pregnancy. |
When you are pregnant, don't wait to call your doctor or midwife if something is bothering or worrying you. Sometimes physical changes can be signs of a problem.
Call your doctor or midwife as soon as you can if you:
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Are bleeding or leaking fluid from the vagina
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Have sudden or severe swelling in the face, hands, or fingers
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Get severe or long-lasting headaches
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Have discomfort, pain, or cramping in the lower abdomen
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Have a fever or chills
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Are vomiting or have persistent nausea
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Feel discomfort, pain, or burning with urination
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Have problems seeing or blurred vision
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Feel dizzy
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Suspect your baby is moving less than normal after 28 weeks of pregnancy (If you count less than 10 movements within two hours. Learn how to count your baby's movements on our Prenatal care and tests page.)
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Have thoughts of harming yourself or your baby
All material contained on these pages are free of copyright restrictions and may be copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated.
Page last updated: June 06, 2018.
Source: Office on Women's Health, HHS