Having a Healthy Pregnancy

If you've decided to have a baby, the most important thing you can do is to take good care of yourself so you and your baby will be healthy. Girls who get the proper care and make the right choices have a very good chance of having healthy babies.

Prenatal Care

See a doctor as soon as possible after you find out you're pregnant to begin getting prenatal care (prenatal care is medical care during pregnancy). The sooner you start to get medical care, the better the chances that you and your baby will be healthy.

If you can't afford to go to a doctor or clinic for prenatal care, social service organizations can help you. Ask a trusted adult, like a parent or school counselor, to help you find low-cost or free care in your community.

During your first visit, the doctor will ask you lots of questions, including the date of your last period. This helps the doctor work out how long you have been pregnant and your due date.

A baby's due date is only an estimate. In fact, women don't usually deliver exactly on their due dates. Most babies are born between 38 and 42 weeks after the first day of a woman's last period, or 36 to 40 weeks after conception (when the sperm fertilizes the egg).

Timelines

A pregnancy is divided into three phases called trimesters. The first trimester is from conception to the end of week 13. The second trimester is from week 14 to the end of week 26. The third trimester is from week 27 to the end of the pregnancy.

The doctor will examine you and do a pelvic exam. Your doctor may also do blood tests, a urine test, and tests for sexually transmitted diseases (STDs). Doctors do this because some STDs can cause serious medical problems in newborns, so it's important to get treatment to protect the baby.

The doctor will probably recommend that you get some immunizations, like a Tdap vaccine to protect your baby against pertussis (whooping cough).

Your doctor will explain the types of physical and emotional changes you can expect during pregnancy. He or she will also teach you to how to recognize the signs of possible problems during pregnancy (you might hear your doctor call problems "complications"). Teens are more at risk for certain problems during pregnancy, such as anemia, high blood pressure, and giving birth earlier than usual (called premature delivery).

Your doctor will want you to start taking prenatal vitamins that contain folic acid, calcium, and iron as soon as possible. The doctor may prescribe the vitamins or recommend a brand that you can buy over the counter. These vitamins and minerals help ensure the baby's and mother's health as well as prevent some types of birth defects.

Ideally, you should see your doctor once each month for the first 28 weeks of your pregnancy, then every 2 weeks until 36 weeks, then once a week until you deliver the baby. If you have a medical condition such as diabetes that needs careful monitoring during your pregnancy, your doctor will probably want to see you more often.

During visits, your doctor or nurse will check your weight, blood pressure, and urine. The doctor or nurse will measure your abdomen to keep track of the baby's growth. After the baby's heartbeat can be heard with a special device, the doctor will listen for it at each visit. Your doctor will probably also send you for some other tests during the pregnancy, such as an ultrasound, to make sure that everything is OK with your baby.

One part of prenatal care is attending classes where moms to be can learn about having a healthy pregnancy and delivery. You can also learn the basics of caring for a new baby. These classes may be offered at hospitals, medical centers, schools, and colleges in your area.

It can be difficult for adults to talk to their doctors about their bodies and even more difficult for teens to do so. Your doctor is there to help you stay healthy during pregnancy and have a healthy baby — and there's probably not much he or she hasn't heard! So don't be afraid to ask questions.

Be frank when your doctor asks questions, even if they seem embarrassing. A lot of the issues the doctor brings up could affect your baby's health. Think of your doctor not just as someone who can help, but also as someone you can confide in about what's happening to you.

Changes to Expect in Your Body

Pregnancy causes lots of physical changes in the body. Here are some common ones:

Breast Growth

An increase in breast size is one of the first signs of pregnancy, and the breasts may continue to grow throughout the pregnancy. You may go up several bra sizes during the course of your pregnancy.

Skin Changes

Don't be surprised if people tell you your skin is "glowing" when you are pregnant — pregnancy causes an increase in blood volume, which can make your cheeks a little pinker than usual. And hormonal changes increase oil gland secretion, which can give your skin a shinier appearance. Acne is also common during pregnancy for the same reason.

Other skin changes caused by pregnancy hormones may include brownish or yellowish patches on the face called chloasma and a dark line on the midline of the lower abdomen, known as the linea nigra.

Also, moles or freckles that you had prior to pregnancy may become bigger and darker. Even the areola, the area around the nipples, becomes darker. Stretch marks are thin pink or purplish lines that can appear on your abdomen, breasts, or thighs.

Except for the darkening of the areola, which can last, these skin changes will usually disappear after you give birth.

Mood Swings

It's very common to have mood swings during pregnancy. Some girls may also experience depression during pregnancy or after delivery. If you have symptoms of depression such as sadness, changes in sleep patterns, thoughts of hurting yourself, or bad feelings about yourself or your life, tell your doctor so he or she can help you to get treatment.

Pregnancy Discomforts

Pregnancy can cause some uncomfortable side effects. These include:

• nausea and vomiting (especially early in the pregnancy)
• leg swelling
• varicose veins in the legs and the area around the vaginal opening
• hemorrhoids
• heartburn and constipation
• backache
• fatigue
• sleep loss

If you have one or more of these side effects, keep in mind that you're not alone! Ask your doctor for advice on how to deal with these common problems.

If you are pregnant and have bleeding or pain, call the doctor immediately, even if you are not planning to continue the pregnancy.

Things to Avoid

Smoking, drinking alcohol, and taking drugs when you are pregnant put you and your baby at risk for a number of serious problems.

Alcohol

Doctors now believe that it's not safe to drink any amount of alcohol when you are pregnant. Drinking can harm a developing fetus, putting a baby at risk for birth defects and mental problems.

Smoking

When a woman smokes while she is pregnant, she can have a miscarriage or stillbirth. Her baby might be premature (born early), and sudden infant death syndrome (SIDS). SIDS is the sudden, unexplained death of an infant who is younger than 1 year old.

Drugs

Using drugs such as cocaine or marijuana during pregnancy can cause miscarriage, prematurity, and other medical problems. Babies can also be born addicted to some drugs.

Ask your doctor for help if you are having trouble quitting smoking, drinking, or drugs. Check with your doctor before taking any medication while you are pregnant, including over-the-counter medications, herbal remedies and supplements, and vitamins.

Unsafe Sex

Talk to your doctor about sex during pregnancy. If your doctor says it's OK to have sex while you're pregnant, you must use a condom to help prevent getting an STD. Some STDs can cause blindness, pneumonia, or meningitis in newborns, so it's important to protect yourself and your baby.

Taking Care of Yourself During Pregnancy

Eating

Many girls worry about how their bodies look and are afraid to gain weight during pregnancy. But now that you are eating for two, this is not a good time to cut calories or go on a diet. Both you and your baby need certain nutrients so the baby can grow properly. Eating a variety of healthy foods, drinking plenty of water, and cutting back on high-fat junk foods will help you and your developing baby to be healthy.

Doctors generally recommend adding about 300 calories a day to your diet to provide adequate nourishment for the developing fetus. You should gain about 25 to 35 pounds during pregnancy, most of this during the last 6 months — although how much a girl should gain depends on how much she weighed before the pregnancy. Your doctor will advise you based on your individual situation.

Eating additional fiber — 25 to 30 grams a day — and drinking plenty of water can help to prevent common problems such as constipation. Good sources of fiber are fresh fruits and vegetables and breads, cereals, or muffins that have lots of whole grain in them.

You'll need to avoid eating or drinking certain things during pregnancy, such as:

• certain types of fish, such as swordfish, canned tuna, and other fish that may be high in mercury (your doctor can help you decide which fish you can eat)
• foods that contain raw eggs, such as mousse or Caesar salad
• raw or undercooked meat and fish
• processed meats, such as hot dogs and deli meats
• soft, unpasteurized cheeses, such as feta, brie, blue, and goat cheese
• unpasteurized milk, juice, or cider

It's also a good idea to limit food or drinks that contain caffeine and artificial sweeteners.

Exercise

Exercising during pregnancy is good for you as long as you are having an uncomplicated pregnancy and choose appropriate activities. Doctors generally recommend low-impact activities such as walking, swimming, and yoga. Contact sports and high-impact aerobic activities that pose a greater risk of injury should generally be avoided.

Also, working at a job that involves heavy lifting is not recommended for women during pregnancy. Talk to your doctor if you have questions about whether particular types of exercise are safe for you and your baby.

Sleep

It's important to get plenty of rest while you are pregnant. Early in your pregnancy, try to get into the habit of sleeping on your side. Lying on your side with your knees bent is likely to be the most comfortable position as your pregnancy progresses. Also, it makes your heart's job easier because it keeps the baby's weight from applying pressure to the large vein that carries blood back to the heart from your feet and legs.

Some doctors recommend that girls who are pregnant sleep on the left side. Because of where some of your major blood vessels are, lying on your left side helps keep the uterus from pressing on them. Ask what your doctor recommends — in most cases, lying on either side should do the trick and help take some pressure off your back.

Throughout your pregnancy, but especially toward the end, you may wake up often at night to go to the bathroom. While it's important to drink enough water while you're pregnant, try to drink most of it during the day rather than at night. Use the bathroom right before going to bed.

As you get further along in your pregnancy, you might have a difficult time getting comfortable in bed. Try positioning pillows around and under your belly, back, or legs to get more comfortable.

Stress can also interfere with sleep. Maybe you're worried about your baby's health, about delivery, or about what your new role as a parent will be like. All of these feelings are normal, but they may keep you up at night. Talk to your doctor if you are having problems sleeping during your pregnancy.

Vaccines

Your doctor may recommend that you get several vaccines during pregnancy. The flu shot can lessen the awful effects of that illness. And the vaccine is safe — studies show no harmful effects to a fetus. It also helps protect a mother and her baby from getting the flu (and other viruses) in the baby's first year of life. Pregnant women should only get the shot made with the inactivated virus. The flu vaccine previously also came in a nasal spray (or mist) form, but it contained live strains of the virus and was never safe for moms-to-be. Currently, the nasal spray is not recommended for anyone because it didn't prevent cases of the flu between 2013 and 2016.

The Tdap vaccine (against tetanus, diphtheria, and pertussis) is now recommended for all pregnant women in the second half of each pregnancy, regardless of whether they've gotten it before or when it was last given. This recommendation is in response to a rise in pertussis (whooping cough) infections, which can be fatal in newborns who have not yet had their routine vaccinations.

Emotional Health

It's common for pregnant teens to feel a range of emotions, such as fear, anger, guilt, confusion, and sadness. It may take a while to adjust to the fact that you're going to have a baby. It's a huge change, and it's natural for pregnant teens to wonder whether they're ready to handle the responsibilities that come with being a parent.

How a girl feels often depends on how much support she has from the baby's father, from her family (and the baby's father's family), and from friends. Each girl's situation is different. Depending on your situation, you may need to seek more support from people outside your family. It's important to talk to the people who can support and guide you and help you share and sort through your feelings. Your school counselor or nurse can refer you to resources in your community that can help.

Sometimes girls who are pregnant have miscarriages and lose the pregnancy. This can be very upsetting and difficult to go through for some girls, although it may bring feelings of relief for others. It is important to talk about these feelings and to get support from friends and family — or if that's not possible, from people such as counselors or teachers.

School and the Future

Some girls plan to raise their babies themselves. Sometimes grandparents or other family members help. Some girls decide to give their babies up for adoption. It takes a great deal of courage and concern for the baby to make these difficult decisions.

Girls who complete high school are more likely to have good jobs and enjoy more success in their lives. If possible, finish high school now rather than trying to return later. Ask your school counselor or an adult you trust for information about programs and classes in your community for pregnant teens.

Some communities have support groups especially for teen parents. Some high schools have child-care centers on campus. Perhaps a family member or friend can care for your baby while you're in school.

You can learn more about what to expect in becoming a parent by reading books, attending classes, or checking out reputable websites on child raising. Your baby's doctor, your parents, family members, or other adults can all help guide you while you are pregnant and after the baby is born.

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