Leap year babies

Last night one of my lovely coworkers delivered what I believe was the first leap year baby in our area.  I haven’t seen any news yet if any of the other local hospitals beat us, but with a baby born one minute after midnight, I think we might have this one in the bag.  Woohoo Norton Hospital Downtown, a very warm welcome to the new baby and congratulations to the parents!

Why do we have leap years?

Although most years of the modern calendar have 365 days, a complete revolution around the sun takes approximately 365 days and 6 hours. Every four years, during which an extra 24 hours have accumulated, one extra day is added to keep the count coordinated with the sun’s apparent position.  The Gregorian calendar repeats itself every 400 years, which is exactly 20,871 weeks including 97 leap days. Over this period, February 29 falls on Sunday, Tuesday, and Thursday 13 times each; 14 times each on Friday and Saturday; and 15 times each on Monday and Wednesday.

Tidbits about Leaplings and Leap Years

A person who is born on February 29 may be called a “leapling” or a “leap year baby”. In non-leap years, some leaplings celebrate their birthday on either February 28 or March 1, while others only observe birthdays on the authentic intercalary dates.

In the United Kingdom and Hong Kong a person born on February 29 legally attains the age of 18 on March 1 in the relevant year.  In cases of New Zealand citizens, the NZ Parliament has decreed that if a date of birth was February 29, in non-leap years the legal birth date date shall be the preceding day, February 28. Here in the States, most people celebrate February 28th.

There is a popular tradition in some countries that a woman may propose marriage to a man on February 29. If the man refuses, he then is obligated to give the woman money or buy her a dress. In upper-class societies in Europe, if the man refuses marriage, he then must purchase 12 pairs of gloves for the woman, suggesting that the gloves are to hide the woman’s embarrassment of not having an engagement ring. In Ireland, the tradition is supposed to originate from a deal that St. Bridget struck with Saint Patrick.

In Greece it is considered unlucky to marry on Leap Day, and even during a leap year.

For some, having a baby on a leap year is an exciting and super unique event.  For others, it is dreaded and avoided at all costs.  I don’t know how the parents who delivered at my hospital felt about delivering their baby on February 29th, but I hope they were excited.  I think it would be cool to have a such a unique birthday, but not everyone shares that opinion.

Taken from fit pregnancy.com

Dr. Laura Riley, an OB-GYN at Massachusetts General, had one expectant mother who refused to schedule her induction for the 29th, despite being past her due date.

“I suggested Wednesday because she’s 41-and-a-half weeks, and I will be on call that day,” Riley said.

The patient’s response? Absolutely not, even if it means having her baby delivered by a different, less familiar doctor.

“To her, it was far more important to not have that date,” Riley said.

So what’s with the aversion to leap day? For Jenni Nibbelink, of Normal, Ill., it stems from concerns about her child technically not having a birthday every year. Nibbelink, who is expecting a baby boy, said her doctor gave her the choice between being induced on Feb. 29 or March 1. She put out a call for opinions on Twitter and the responses came back 50-50, but she and her husband, Darren, decided to start her induction at midnight on the 29th.

“I don’t think personally I would want to have a birthday on leap day, if I put myself in the shoes of the baby,” said Nibbelink, whose husband was more opposed to the idea than she was. “He doesn’t want it to be something that makes our child stand out or unique in a weird way.”

According to Raenell Dawn, the biggest leap day complications are computers and websites that won’t recognize Feb. 29 as a valid birth date. Doctors offer parents the option to switch birth certificate dates to Feb. 28 or March 1, but she abhors this practice. “Who are they to say someone’s real birth date isn’t worth putting in ink?”

HuffPost’s executive lifestyle editor Lori Leibovich’s son, Carlos Kanter, is a leapling who, according to his robot-themed party invitations, is celebrating his “8th/2nd Birthday” on Wednesday. Leibovich said that when her doctor gave her the due date Feb. 29, 2004, it didn’t seem like a big deal.

“The doctor told me, ‘Don’t worry, no one has their baby on their due date. Then, as it got closer I started worrying a little bit, like what kid wants to have a birthday every four years? How am I going to explain this one?” Leibovich said.

 

Power Positions

I just found this article from http://www.fitpregnancy.com, and it was one of those “Yes, Yes, Yes!” moments.  Every shift I work, I have docs insisting patients deliver in a dorsal lithotomy position (on your back), and it drives me crazy.  I delivered my last baby in a crazy cock-eyed on my side position.  I also pushed in between my contractions, but that’s besides the point.  The point is, I love this article and wanted to share it.

Women all over the world give birth squatting, leaning or even standing. We lie down. What do they know that we don’t?

If your car stalled at the bottom of a hill, you certainly wouldn’t try to push it uphill. So why does it make sense to fight gravity by lying down during labor? This is just one reason why the standard hospital labor position—semi- or fully reclining—is not ideal. For one thing, when you’re lying on your back, your uterus compresses major blood vessels, potentially depriving the baby of oxygen and making you feel dizzy or queasy. “Most women feel better when they are not lying on their back during labor,” says certified nurse-midwife Katy Dawley, Ph.D., C.N.M., director of the Institute of Midwifery at Philadelphia University in Pennsylvania. In addition, when you’re reclining, the baby’s head puts pressure on pelvic nerves in your sacrum, increasing pain during contractions. Remaining upright and leaning forward reduces this pressure while allowing the baby’s head to constantly bear down on your cervix. As a result, dilation tends to occur more quickly.

“Lying on your side, standing, sitting, walking, rocking—anything that keeps you active can help decrease pain and speed up labor,” says Dawley. Just be aware that a prenatal visit is the time to discuss with your doctor or midwife the different positions you think you’d like to try. “In the throes of labor, you’re not going to be able to advocate for yourself,” she explains.

Seven soothing labor positions

Here’s another reason to be open to the possibilities: Fetal heart monitoring during labor can help determine which positions you can sustain without impairing circulation to the baby, so it’s best to have a repertoire available. Some options:

1. Get on all fours This position eases back pain and helps the baby rotate into the optimal position for delivery—facedown. (When the baby is faceup, the result is the dreaded “back labor.”)

2. Lean forward This can help make uterine contractions more effective in bringing the baby down. Drape your chest over a table, bed, countertop, pillow or exercise ball.

3. Lie on your left side This may increase blood flow to your baby and can help reduce back pain. Support your belly and legs with pillows.

4. Lunge Place one foot on a sturdy chair or footstool and lean into that foot during contractions.

5. Rock Sit on an exercise ball, the edge of the bed or a chair and gently rock back and forth.

6. Sit and lean Sitting in a chair, prop up one foot and lean forward into it during contractions.

7. Sway Put your arms around your partner’s neck and sway back and forth; pretend you’re slow dancing.

Ready, set, push! While the position may be less convenient for hospital personnel, squatting is especially effective when you’re ready to push. In fact, squatting is sometimes called the “midwife’s forceps” because of its ability to work with, not against, gravity, enlarge the pelvic opening and speed the pushing phase of labor.

(FYI, I just want to draw a big red line through this pic)

The Deal with the Due Date

For most women, after the positive pregnancy test, the next order of business is figuring up their due date.  For some, the due date is highly coveted, revered even.  They can now start counting down the day when they can hold their little bundle of joy for the first time.  And while pregnancy is a wonderful, joyous, miraculous event, it’s a long event of life altering experiences.  Nausea.  Vomiting.  Constipation.  Fatigue.  Sleepless nights.  A changing figure.  Constant body aches.  For some women, the due date is the light at the end of the tunnel, a reminder that pregnancy won’t last forever.

Figuring out your due date

There are dozens upon dozens of web sites out there to help you to figure your due date based on your last menstrual period (LMP).  This would be the easiest route.  Or, you can do it the old fashion way with paper and pencil and a slightly whacky formula.

• Figure out your the day your LMP began (example, November 20th)
• Take this date and subtract three whole months (putting us at August 20th)
• Add seven days-why seven, I don’t know.  That’s just how it is, and that date is your due date (in this scenario, August 27th).

If you don’t have any idea when you last had a period, or if your periods are very irregular, calculating the due date becomes even more difficult. On the other hand, if you were undergoing treatments for infertility, you may have an exact conception date and this will make calculating the due date easier.

Again, there are so many due date calculators online, and that’s just as easy.  They work on the same basic principal as the formula above, but they can be fun. Some offer additional information such as the estimated conception date. For this information, you will be asked to enter the length of your typical cycle. The reason for this is that ovulation generally occurs fourteen days before the date of your next menstrual period. For a 28 day cycle, this would be on day 14. For a 30 day cycle, it would be on day 16.

Even easier, make an appointment with your doctor or midwife.  It’s becoming general practice to do ultrasounds as a part of your first office visit (or sometimes a few days after the initial visit depending on the availability of the office ultrasonagrapher).  This initial ultrasound, especially if done within the first 10 weeks or so of pregnancy, will give you your most accurate due date.  Measuring the baby is most accurate for confirming the due date in the early weeks of pregnancy. as the baby grows, there can be some difficulty in getting an accurate date, since babies range in size from small to large.  You’ll hear about women who get ultrasounds later in their pregnancy and suddenly have a new estimated due date based on that ultrasound.  The OB doesn’t go by that due date.  They go by the original due date.  A baby that will be born large may be mistakenly estimated as older than the actual gestational age. The same mistake can be made with a baby that will be born on the smaller side, making that baby appear younger than the gestational age. In the first seven or eight weeks of pregnancy, all babies are approximately the same size and this makes dating the pregnancy easier than it will be later in pregnancy.

LMP’s are a great start, but women can ovulate later than would be expected based on the LMP, sometimes up to a week late.  Some women say they know when they actually conceived (women like me), but the reality is, with the potential late ovulations and the fact that sperm can potentially survive up to a week in a women’s body, the conception date isn’t always the date the pregnancy begins.  This is one reason there are so many women insisting they’re further along then the due date they’re given by their OB.

The Due Date “Lie”

The truth?  Us medical people refer to the due date as EDD, estimated delivery date.  Estimated.  Only about five percent of babies are actually born on the due date. This means there is a ninety five percent chance that your baby will not be born on that date. Most babies are born in a range of two weeks either before or after the date.  Perhaps it would be more helpful to think, rather than due date, due month.  Typically, babies will come when they’re supposed to.

That being said, sometimes inductions are medically necessary for the well being of the baby or the mom.  Severe preeclampsia, infections of the amniotic fluid, severe intrauterine growth restriction (when the baby doesn’t grow for whatever reason), just to name a few, all indicate the need for delivery.  “Tired of being pregnant” is not a medically warranted induction.  Sorry.  Many hospitals follow AWHONN (Association of Women’s Health, Obstetrics and Neonatal Nurses), which advise to not induce under 39 weeks unless there is a medical indication.  When I first started as a labor and delivery nurse, anyone 37 weeks and greater was considered “term” and could be induced.  The thought process now is 37 and 38 weeks are “early term” and typically will do well if born at this gestation.  Spontaneous labor at this gestation is more than fine, but most OBs will not induce you at 37-38 weeks because you’re tired of being pregnant.  Sorry.

Fetal Kick Counts

A Word About Fetal Kick Counts

Most mothers-to-be eagerly await that first reassuring flutter (also known as quickening), just to know their baby is growing and developing. Sometime between 18-25 weeks into pregnancy, moms will begin to feel movement. For first time moms, it may occur closer to 25 weeks, and for second or third time moms, it may occur closer to 18 weeks.  Believe it or not, some moms report feeling flutters as early as 14-15 weeks.  These early signs of fetal movement may at first be confused as simply gas, but actually your growing baby is rocking and rolling inside your belly.  It’s an amazing feeling when you recognize what you’re feeling as your baby wiggling around.

Don’t panic if you’re not sure what you’re feeling. For a couple of weeks it may be difficult to distinguish between gas and the real thing, but very soon, you will notice a pattern. You will gradually learn your baby’s sleeping and waking cycles, when he or she is most active, and what seems to trigger activity.

Being attentive to your baby’s movements will help you notice any significant changes. Setting aside time every day when you know your baby is active to count kicks, swishes, rolls, and jabs may help identify potential problems and could help prevent stillbirth. Though strongly recommended for high risk pregnancies, counting fetal movements beginning at 28 weeks may be beneficial for all pregnancies.

Generally, moms find their babies are most active after eating a meal or something sweet, drinking something very cold, or after physical activity. You may also find your baby to be more active between 9:00 pm and 1:00 am, as your blood sugar level is declining.

Taking time to do your kick counts will encourage you to rest and bond with your baby. Start by finding a comfortable position during a time when your baby is usually most active. Some moms prefer sitting in a well supported position with their arms holding their bellies. Other moms prefer lying on their left sides, which they find most comfortable and most effective for monitoring their babies. Lying on your left side also allows for the best circulation which could lead to a more active baby.

Counting your baby’s movements

There are numerous ways to count your baby’s movements and numerous opinions on how many movements you are looking for within a certain amount of time. The American Congress of Obstetricians and Gynecologists (ACOG) recommends that you time how long it takes you to feel 10 kicks, flutters, swishes, or rolls. Ideally, you want to feel at least 10 movements within 2 hours. You will likely feel 10 movements less than that.

There are plenty of online printable charts to help you keep track of your baby’s movement, or you can use a simple notebook.

Record the time you feel the first movement, place a check mark for each movement you feel until you reach 10, then record the time of the tenth movement. This will help you observe patterns and discover how long it normally takes for your baby to move 10 times. Keep in mind that you are looking for significant deviations from the pattern. It can become easy to expect an exact amount of time every time you do your kick counts; however, there can be a wide range of time differences. So remember to look for significant deviations from the pattern over the course of a few days.

Fetal Kick Counts (in a nutshell)

• Lie on your left side and focus on your baby’s movements: rolls, kicks or flutters.
• Use the chart below to record the number of minutes it takes to feel your baby move ten (10) times.
• You may stop counting after your baby has moved ten (10) times.
• Do this once a day at approximately the same time each day. (Babies’ activity levels are usually higher in the evening after dinner.)

Visit here for a free printable Fetal Kick Count Chart:  http://www.baby2see.com/medical/kick_count_chart.html

When should I call my physician or midwife?

• If you have followed the above recommendations and have not felt 10 kicks by the end of the second hour, wait a few hours and try again  Have a bite to eat or drink some juice.  This will give you and your growing baby an energy boost.  If after trying a second time, you do not feel 10 movements within 2 hours you should contact your health care provider.
• If you notice a significant deviation from the pattern over the course of 3-4 days (i.e., it takes longer and longer to feel the total ten movements).

Examples for Recording your Kick Counts

Week #28
Monday 9:00 XXXXXXXXXX 9:32 Total: 32 min
Tuesday 12:00 XXXXXXXXXX 12:45 Total: 45 min
Wednesday 9:00 XXXXXXXXXX 10:00 Total: 1 hr.
Thursday 9:00 XXXXXXXXXX 11:15 Total: 2 hrs. 15 min.
(This is an example of significant change. In a case like this you should notify your health care provider.)

If you are ever concerned about your baby’s well being, seek out medical attention.  Either call your doctor or midwife or head in to be evaluated in your hospital’s triage.  I’ve seen mamas come into triage to be evaluated after having not really feeling their baby move for several days simply because they didn’t want to be a bother.  Unfortunately, sometimes they’ve come in too late.  You are never a bother, and your health care, like you, wants nothing but the best for your baby.

 

Round ligament pain

Believe it or not, abdominal pain is quite common during pregnancy and, quite often, normal.  Painful yet normal.  Round ligament pain (RLP) is most common during the second trimester and can continue to rear it’s ugly head up until delivery, although you can experience it at any point during your pregnancy.    Round ligament pain is considered a normal part of pregnancy as your body goes through many different changes, namely an expanding uterus and growing baby.

• Sudden pain in the lower abdomen, usually in the right side of the pelvic area that can extend to the groin.
• Shooting abdominal pain when performing sudden movements or physical exercise. Pain is sudden, intermittent and lasts only for a few seconds

What causes round ligament pain?

The round ligament supports the uterus and stretches during pregnancy. It connects the front portion of the uterus to the groin. These ligaments contract and relax like muscles, but much more slowly. Any movement (including going from a sitting position to standing position quickly, laughing, or coughing) that stretches these ligaments, by making the ligaments contract quickly, can cause a woman to experience pain. Round ligament pain should only last for a few seconds, although I’ve cared for many women experiencing persistent RLP that just doesn’t want to fully let up until after they’ve rested for several minutes.

What can be done to alleviate round ligament pain?

Rest is one of the best ways to help with this kind of pain. Changing positions slowly allows the ligaments to stretch more gradually and can help alleviate any pain.  Whenever possible, avoid sudden movements that can cause spasms of the ligament. If you know that you are going to sneeze, cough, or laugh you can bend and flex your hips, which can reduce the pull on the ligaments. If you are having consistent round ligament pain your health care provider may recommend daily stretching exercises. The most common exercise is done by placing your hands and knees on the floor, lowering your head to the floor, and keeping your bottom in the air.  The so-called pelvic (hip) tilt exercise also appears to help in reducing pain intensity and duration.  Warm showers/baths or applying a hot compress can help relief RLP.  Tylenol can also help provide some relief.

When should I call my health care provider?

If the pain persists after resting, or it is accompanied by severe pain, you would want to notify your health care provider. If the pain lasts for more than a few minutes you should contact your health care provider immediately. You would also want to notify your health care provider if the pain is accompanied by any bleeding, cramping, fever, chills, nausea, vomiting, or change in vaginal discharge.  Any time you have any questions regarding your pregnancy, please never hesitate to contact your doctor or midwife.

 

Back pain and pregnancy

Oy.  Back pain.  Common and the majority of the time, perfectly normal, back pain is easily one of the biggest complaints I see mamas to be in our triage for.  About 99% of the time, I send those mamas home with recommendations of warm showers, heating pads to the back, tylenol and maternity belts.  Every now and then, it’s labor related.  Or UTI related.  But again, about 99% of the time it is perfectly normal.  That being said, if you have any concerns about back pain, or anything else for that matter, you need to call your doctor.  Even if it’s three am.  Most doctors have an answering service that will take care of getting you in touch with your OB.  Or, you can call your local hospital and ask to be connected with the labor and delivery ward where you can speak to the nurses who will evaluate you in triage if you need advice.

So, a word about back pain.  Causes, relief and treatment, when it’s serious and how to try to prevent it long term.

How common is back pain during pregnancy?

You are not alone if you are experiencing back pain during your pregnancy.  The prevalence varies with reports, showing between 50 to 70 percent of all pregnant women having back pain.  50-70%!

What causes back pain during pregnancy?

Back pain during pregnancy is related to a number of factors. Some women begin to experience lower back pain with the onset of pregnancy.  Women who are most at risk for back pain are those who are overweight or had back pain prior to pregnancy. Here is a list of potential causes of back pain or discomfort during pregnancy:

• Increase of hormones – hormones (ah, hormones-they cause so much havoc during your pregnancy) released during pregnancy allow ligaments in the pelvic area to soften and the joints to become looser in preparation for the birthing process of your baby; this shift in joints and loosening of ligaments may affect the support your back normally experiences.  This can also make you a little clumsier as you get further along, so be cautious when choosing what shoes to wear.
• Center of gravity – your center of gravity will gradually move forward as your uterus and baby grow, which causes your posture to change.  This too can add to the clumsiness as you get further along, so be cautious in all you do.  It’s not fun to fall when you’re preggo.
• Additional weight – your developing pregnancy and baby create additional weight that your back must support, especially at the end when you’ve got a 6-7 lb baby and all that amniotic fluid to lug around.
• Posture or position – poor posture, excessive standing, and bending over can trigger or escalate the pain you experience in your back.  Have you ever noticed how pregnant women stand?  With a swayed back to help compensate for the growing belly.  It might feel better as you’re standing that way, but long term, it’s bad for your back.
• Stress – stress usually finds the weak spot in the body, and because of the changes in your pelvic area, you may experience an increase in back pain during stressful periods of your pregnancy.  I mean, really, who doesn’t get stressed out when they’re expecting.

 

How can you prevent or minimize back pain during pregnancy?

Sadly, back pain may not be prevented completely, but there are things that you can do to reduce the severity or frequency.

• Use exercises approved by your health care provider that support and help strengthen the back and abdomen.  Always, always, always talk to your doctor or midwife before introducing new exercises to your lifestyle.

• Squat to pick up something versus bending over
• Avoid high heels and other shoes that do not provide adequate support (this will also help with the clumsy thing)
• Avoid sleeping on your back.  Get one of those body pillows and sleep on your side.
• Wear a support belt under your lower abdomen
• Make sure your back is aligned using a chiropractor.  Again, check with your doctor or midwife before seeing a chiropractor.
• Get plenty of rest. Elevating your feet is also good for your back

 

How can you treat back pain during pregnancy?

There are a number of things you can do to treat back pain during pregnancy. Some of the steps you take to avoid back pain may also be used to treat current back pain.

• Ice or heat
• Maternity belts, sold at places like Baby R Us and maternity clothing stores.
• Sleep on your left side and use a support pillow under your knees.  Or a body pillow.  It’ll be your best friend throughout your pregnancy.
• Medications used to treat inflammation, namely Tylenol.  Talk your doctor or midwife first.
• Use a licensed health care professional such as a chiropractor or massage therapist.  In case you didn’t catch this earlier, talk to your doctor first!

 

When to contact your health care provider?

Experiencing back pain itself is usually not a reason to contact your health care provider, but there are situations where contacting your provider is necessary. You want to contact your health care provider if you are experiencing any of the following:

• Severe back pain
• Increasingly severe or abrupt-onset of back pain
• Rhythmic cramping pains; this could be a sign of preterm labor
• Severe flank pain (pain on the side of your back) as this could indicate an out of control UTI or pylonephritis, which left untreated can lead to preterm labor.

 

Severe back pain may be related to pregnancy-associated osteoporosis, vertebral osteoarthritis, or septic arthritis. These are not common, but it is something your health care provider will examine if you are experiencing severe back pain.

Your Next Steps:

• Begin an approved exercise program to support your back and abdomen (talk to your doctor or midwife first)
• If at all possible, set aside a couple of times a day where you can take a nap or at least get off your feet
• Find a chiropractor in your area (with your doctor or midwife’s approval)
• Purchase a maternity belt
• Purchase a sleep aid pillow

Caffeine and pregnancy

As a night shift nurse, I couldn’t make it through a 12 hour shift when I was pregnant with my last baby.  About 2 am, I would hit a wall, and I couldn’t recover.  My first pregnancy, I diligently avoided caffeine.  It was on the “no-no” list, so I cut it out of my diet.  My second…I tried to be good.  Tried to take my prenatal vitamin and folic acid daily.  Tried to drink my 8-10 12 oz glasses of water.  Tried to cut out caffeine.  But then I fell asleep at the desk one night.  I woke up to a doctor gently shaking my arm asking, “Ani, are you alright?”  I was dazed, confused, and was the only nurse at the desk.  I was so embarrassed and quickly checked my patient’s fetal monitoring strips.  After that, I reintroduced caffeine.  It was the only way I could make it through my shift.  I ignored all the reasons you’re supposed to go without caffeine when you’re pregnant and started having a large Dr. Pepper from McDonald’s every shift I worked around 1am.

So, why is is you’re supposed to go without caffeine when you have a bun in the oven?  Taken from the American Pregnancy Association’s website:

Facts About Caffeine:

Caffeine is a stimulant and a diuretic.Because caffeine is a stimulant, it increases your blood pressure and heart rate, both of which are not recommended during pregnancy. Caffeine also increases the frequency of urination. This causes reduction in your body fluid levels and can lead to dehydration.

Caffeine crosses the placenta to your baby. Although you may be able to handle the amounts of caffeine you feed your body, your baby cannot. Your baby’s metabolism is still maturing and cannot fully metabolize the caffeine. Any amount of caffeine can also cause changes in your baby’s sleep pattern or normal movement pattern in the later stages of pregnancy. Remember, caffeine is a stimulant and can keep both you and your baby awake.

Caffeine is found in more than just coffee. Caffeine is not only found in coffee but also in tea, soda, chocolate, and even some over-the-counter medications that relieve headaches. Be aware of what you consume.

Fact or Myth?

Statement: Caffeine causes birth defects in humans.

Facts: Numerous studies on animals have shown that caffeine can cause birth defects, preterm delivery, reduced fertility, and increase the risk of low-birth weight offspring and other reproductive problems. There have not been any conclusive studies done on humans though. It is still better to play it safe when it comes to inconclusive studies.

Statement: Caffeine causes infertility.

Facts: Some studies have shown a link between high levels of caffeine consumption and delayed conception.

Statement: Caffeine causes miscarriages.

Facts: In 2008, two studies on the effects of caffeine related to miscarriage showed significantly different outcomes. In one study released by the American Journal of Obstetrics and Gynecology, it was found that women who consume 200mg or more of caffeine daily, are twice as likely to have a miscarriage as those who do not consume any caffeine.

In another study released by Epidemiology, there was no increased risk in women who drank a minimal amount of coffee daily ( between 200-350mg per day.)

Due to conflicting conclusions from numerous studies, the March of Dimes states that until more conclusive studies are done, pregnant women should limit caffeine intake to less than 200 mg per day. This is equal to about one 12 oz cup of coffee.

 Bottom line, a little caffeine is acceptable.  My large McDonald’s Dr. Pepper had 112 mg of caffeine.

The first trimester

There are many wonderful joys to be had when you first find out that you’re pregnant, especially when you’ve planned and hoped for baby.  And even when baby is a surprise, for most of us, it’s a welcomed surprise.  First, there’s the feeling of expectation and excitement as you begin to notice the signs.  A late period, that feeling that you can’t get enough sleep, tender breasts, the ever infamous nausea and/or vomiting.  Some women are aware enough of the changes taking place in their body before they ever miss a period and wonder “What if?”   Then you finally take that plunge, buy a pregnancy test, and pee the stick.  Positive!   And now you know that you’re pregnant and the excitement takes over fully.  Congratulations!

The first trimester of your pregnancy can certainly be overwhelming.  You might be spending the bulk of your time in the bathroom with bouts of nausea and vomiting.  You might not have enough energy to get off the couch to do…well, anything.  Hormones are running rampant causing an abundance of physiological changes.  Your emotions might be in overdrive.  It’s a constant roller coaster of worrying about the future, your baby’s health, finances, etc.  Then rolls in excitement, planning out potential, nursery themes, thinking about names, planning out a fun and unique way to announce that you’re expecting.  Fatigue hits.  Nausea hits.  It’s no picnic feeling sick and run down, and perhaps you’re wondering how you’re going to get through this.  Then you remember why you feel so lousy (yeah, baby on the way) and excitement kicks in again.  You’re in a whirlwind tizzy of making plans, making doctor appointments, and struggling to keep your eyes open.  Again, congratulations.

So let’s talk about what’s happening the first three months of your pregnancy.  A lot of changes are taking place in your body, and a fair amount of them are invisible.  Your body is working in overdrive as your baby develops.  For your reading enjoyment, a brief overview of what’s happening week to week.

Reprinted with permission from American Pregnancy Association

Week 1 & 2 – Gestational Age:

The menstrual period has just ended and your body is getting ready for ovulation. For most women, ovulation takes place about 11 – 19 days from the first day of the last period. During intercourse, several hundred million sperm are released in the vagina. Sperm will travel through the cervix and into the fallopian tube. If conception takes place, the sperm will penetrate an egg and create a single set of 46 chromosomes called a zygote – the basis for a new human being. The fertilized egg spends a couple days traveling through the fallopian tube toward the uterus, dividing into cells and is called a morula. The morula becomes blastocysts and will eventually end up in the uterus. Anywhere from day 6 – 10 since conception, the blastocysts will imbed into the uterine lining and begin the embryonic stage.

Week 3 – Gestational Age (Fetal Age – Week 1):

The embryo is going through lots of basic growth at this time, with the beginning development of the brain, spinal cord, heart and gastrointestinal tract.

Week 4 & 5 – Gestational Age (Fetal Age – Weeks 2 & 3):

Arm and leg buds are visible, but not clearly distinguishable. The heart is now beating at a steady rhythm. The placenta has begun to form and is producing some important hormones including hCG. There is movement of rudimentary blood through the main vessels. The early structures that will become the eyes and ears are forming. The embryo is ¼ inch long by the end of these weeks.

Week 6 – Gestational Age (Fetal Age – Week 4):

The formation of the lungs, jaw, nose and palate begin now. The hand and feet buds have webbed looking structures that will become the fingers and toes. The brain is continuing to form into its complex parts. A vaginal ultrasound could detect an audible heartbeat at this time. The embryo is about a ½ inch in length.

Week 7 – Gestational Age (Fetal Age – Week 5):

At 7 weeks gestation, every essential organ has begun to form in the embryo’s tiny body even though it still weighs less than an aspirin. The hair and nipple follicles are forming, and the eyelids and tongue have begun formation. The elbows and toes are more visible as the trunk begins to straighten out.

Week 8 – Gestational Age (Fetal Age – Week 6):

The ears are continuing to form externally and internally. Everything that is present in an adult human is now present in the small embryo. The bones are beginning to form and the muscles can contract. The facial features continue to mature and the eyelids are now more developed. The embryo is at the end of the embryonic period and begins the fetal period. The embryo is about 1 inch long and is the size of a bean.

Weeks 9 thru 12 – Gestational Age (Fetal Age – Weeks 7 thru 10):

The fetus has grown to about 3 inches in length and weighs about an ounce. The genitalia have clearly formed into male or female, but still could not be seen clearly on an ultrasound. The eyelids close and will not reopen until the 28th week of pregnancy. The fetus can make a fist and the buds for baby teeth appear. The head is nearly half the size of the entire fetus.

Pregnancy discrimination

With more than 70% of women with children in the work force, pregnancy discrimination is the fastest growing type of discrimination in the U.S., and in 2006 represented approximately 6.5% of all discrimination claims filed.  Recent EEOC statistics reveal that the number of claims for pregnancy discrimination has increased by 30%, while claims of all other types of employment discrimination has increased by 25%.   😦

The Pregnancy Discrimination Act is an amendment to Title VII of the Civil Rights Act of 1964 passed in 1978. Discrimination on the basis of pregnancy, childbirth, or related medical conditions constitutes unlawful sex discrimination under Title VII, which covers employers with 15 or more employees, including state and local governments. Title VII also applies to employment agencies and to labor organizations, as well as to the federal government. Women who are pregnant or affected by related conditions must be treated in the same manner as other applicants or employees with similar abilities or limitations.

Title VII’s Pregnancy-Related Protections:

Hiring:

An employer cannot refuse to hire a pregnant woman because of her pregnancy, because of a pregnancy-related condition, or because of the prejudices of co-workers, clients, or customers.

Pregnancy and Maternity Leave:

An employer may not require a woman with a pregnancy-related condition to follow special procedures to determine her ability to work. However, if an employer requires its employees to submit doctors’ statements concerning their inability to work before granting leave or paying sick benefits, the employer may require employees affected by pregnancy-related conditions to submit such statements.

If an employee is temporarily unable to perform her job due to pregnancy, the employer must treat her the same as any other temporarily disabled employee. For example, if the employer allows temporarily disabled employees to modify tasks, perform alternative assignments, or take disability leave or leave without pay, the employer also must allow an employee who is temporarily disabled due to pregnancy to do the same.

Pregnant employees must be permitted to work as long as they are able to perform their jobs. If an employee has been absent from work as a result of a pregnancy-related condition and recovers, her employer may not require her to remain on leave until the baby’s birth. An employer also may not have a rule that prohibits an employee from returning to work for a predetermined length of time after childbirth.

Employers must hold open a job for a pregnancy-related absence the same length of time jobs are held open for employees on sick or disability leave.

Health Insurance:

Any health insurance provided by an employer must cover expenses for pregnancy-related conditions on the same basis as costs for other medical conditions. Health insurance for expenses arising from abortion is not required, except where the life of the mother is endangered.

Pregnancy-related expenses should be reimbursed exactly as those incurred for other medical conditions, whether payment is on a fixed basis or a percentage of reasonable-and-customary-charge basis.

The amounts payable by the insurance provider can be limited only to the same extent as amounts payable for other conditions. No additional, increased, or larger deductible can be imposed.

Employers must provide the same level of health benefits for spouses of male employees as they do for spouses of female employees.

Fringe Benefits:

Pregnancy-related benefits cannot be limited to married employees. In an all-female workforce or job classification, benefits must be provided for pregnancy-related conditions if benefits are provided for other medical conditions.

If an employer provides any benefits to workers on leave, the employer must provide the same benefits for those on leave for pregnancy-related conditions.

Employees with pregnancy-related disabilities must be treated the same as other temporarily disabled employees for accrual and crediting of seniority, vacation calculation, pay increases, and temporary disability benefits.

It is also unlawful to retaliate against an individual for opposing employment practices that discriminate based on pregnancy or for filing a discrimination charge, testifying, or participating in any way in an investigation, proceeding, or litigation under Title VII.

Pregnancy Discrimination Statistics:

In Fiscal Year 2010, the Equal Employment Opportunity Commission (EEOC) received 6,119 charges of pregnancy-based discrimination. EEOC resolved 6,293 pregnancy discrimination charges in FY 2010 and recovered $18.0 million in monetary benefits for charging parties and other aggrieved individuals (not including monetary benefits obtained through litigation). ¹

---

¹ Entire document is cited from 29CFR 1604.10, “Employment Policies Relating to Pregnancy and Childbirth.

Fatigue!

Fatigue…  

Fatigue ranks high among early symptoms of pregnancy.  Most women experience more fatigue during the first trimester, when their body is just becoming used to the idea of being pregnant.  During early pregnancy, levels of the hormone progesterone soar, which can put you to sleep. At the same time, lower blood sugar levels, lower blood pressure and increased blood production might team up to sap your energy. 

And let’s not forget about growing a bun in the oven.  The most dramatic changes and development occur during the first trimester.  During the first eight weeks, a fetus is called an embryo.  The embryo develops rapidly and by the end of the first trimester it becomes a fetus that is fully formed, weighing approximately 1/2 to one ounce and measuring, on average, three to four inches in length.  That’s a lot of work, mamas! 

Coping with fatigue.

1. Nap and sleep when you’re able.  Listen to your body.  When the extreme fatigue strikes, if you’re able, grab a cat nap.  Forget about doing the laundry. 
2. Do your best to eat well and make good food choices.  Try opting for a piece of fruit rather than a piece of candy.  You’re body will thank you.
3. Take your prenatal vitamins which can help raise your energy levels.  If your prenatal vitamins don’t set will with your stomach, consider taking a “food based” vitamin.  They’re easier to digest.
4. Light to moderate exercise can also help boost your energy level.  Think of it like this.  You spend 1 unit of energy to exercise but get 2 units of energy back in the long run.

Coping with extreme fatigue during pregnancy isn’t an easy task.  Just keep in mind, fatigue  is just your body’s way of telling you that it needs more rest.  Remember your body is working twenty four hours a day seven days a week creating a new life inside.  Also remember the extreme fatigue usually only lasts through the first trimester.