Common Pregnancy Questions

During what part of the menstrual cycle is pregnancy most likely to occur?

In general, ovulation occurs about 14 days before the start of the next menstrual flow, for example, day 10 of a 24 day cycle or day 14 of a 28 day cycle. It is during your ovulation when you are most likely to conceive. If you are trying to conceive, it is a good idea to track your menstrual period over several months to determine when ovulation is occurring. For many women, menstrual periods may vary slightly from one month to the next; therefore, the precise day of ovulation may be variable from month to month. Day one is considered to be the start of your menstrual flow.

Some other ways to determine ovulation include:

Assessment of cervical mucus. Immediately following a menstrual period, there is usually no obvious vaginal discharge. But as a woman gets closer to ovulation, she begins to sense a feeling of wetness as her amount of mucus increases. Close to ovulation the mucus becomes watery, clear, and slippery. It is during this time that a woman is most fertile. Sperm deposited in this type of mucus can survive until ovulation occurs.

Measurement of basal body temperature. Some couples purchase a special thermometer that measures temperature in tenths of a degree. The women records her oral temperature each morning upon awakening. During the early part of the cycle a woman's temperature remains fairly constant, but just prior to ovulation her temperature falls about 0.3 of one degree. This fall in body temperature is followed by a rise in temperature of about 0.5-1.0 degree. Ovulation is likely to be occurring when the temperature first rises.

How soon can I tell if I am pregnant?

Pregnancy can be diagnosed in as little as 2 weeks after conception, which is about the time that your period is expected (note that if you wait an additional 3-4 days, you are more likely to get accurate results). When pregnancy occurs, the embryo releases a hormone called human chorionic gonadotrpohin (HCG) into your bloodstream. This hormone can be detected in your urine, and it is HCG that is detected by your typical home pregnancy test. Depending on the particular pregnancy kit, you can test for pregnancy between one and four days after your period was due. If a false reading is obtained, but your menstrual period does not follow, you should repeat the test, since you may have tested your urine before enough of the detectable hormone was present.

If I am pregnant, when should I begin seeing a doctor?

You should contact your doctor as soon as you know that you are pregnant. They will schedule a visit for somewhere between 6 to 8 weeks after your last menstrual period. In the meantime, you should start to take prenatal vitamins. During your first prenatal visit your Doctor will inquire as to your family and personal health history, to see if you are at risk for certain genetic issues. The Doctor will also perform a PAP smear and an internal examination to determine the size and contour of your uterus. Your Doctor will also measure your statistics including your weight and blood pressure as well as performing various laboratory tests. These results will be discussed with you on subsequent return visits. Generally, one visit per month is usually adequate in the early months of pregnancy but as you progress during your pregnancy, the visits will be increased to as often as every week during the last month of your pregnancy.

How can I determine when the baby is due?

You can approximately estimate your due date using the following formula- add 7 days to the first day of your last menstrual period, then add nine months. This formula assumes that the woman has a 28-day cycle and that the pregnancy occurred on day 14. Your practitioner may make an adjustment to this date if your cycles are longer or shorter than 28 days. Less than 10% of women deliver on their due date, but the majority of women will deliver in the period extending from 7 days before to 7 days after the due date.

How is the baby's sex determined?

A women's egg cells and a man's sperm cells each contain 23 single chromosomes, which are not paired until they meet their opposite number. Of the 23 single chromosomes, one is always a sex chromosome. Each egg always has an X (female) sex chromosome, but the sex chromosome present in any sperm can be either X (female) or Y (male). Hence, the sex of the baby is dependent on which type of sperm cell fertilizes the egg. The sex of the baby is determined at conception.

How much weight should I gain during pregnancy?

Most practitioners agree that a weight gain between 25 and 35 pounds is recommended during pregnancy. Your total weight gain in pregnancy is estimated as follows:

Weight gain in pregnancy begins slowly, only to pick up steadily later on. The timing of your total weight gain will be approximately:

• 0-12 weeks - little or no weight gain
• 12-20 weeks - 25% of weight gain
• 20-30 weeks - 50% of weight gain
• 30-36 weeks - 25% of weight gain
• 36-40 weeks - little or no weight gain

What bodily changes can I anticipate during pregnancy?

• Breast Changes- Breast changes begin early in pregnancy as a woman’s body begins to prepare for lactation (milk production). A woman’s nipples (areolae) become darker, blood vessels become more prominent and the breasts may feel tender and heavy.
• Nausea- Nausea is a common symptom during pregnancy, and generally occurs more commonly in the morning hours. Methods used to combat morning sickness include eating small snacks frequently throughout the day, as opposed to eating just a few heavier meals. See Morning Sickness article (link here) for more information.
• Chonic Fatigue- A woman’s body is undergoing significant changes to adjust to a growing baby, and during this time many women feel extreme tiredness. As her body adjusts to the pregnancy, many women report that fatigue starts to decrease..
• Abdominal Enlargement- The pregnancy may begin to "show" at approximately the 12th week, depending on the women's height, weight and previous pregnancies.
• Tenderness of the Gums- Gums often bleed and feel sore during pregnancy, even from mild irritation such as brushing your teeth.
• Constipation- Constipation is a common complaint in pregnancy. It is thought to caused by the slight constriction of the intestines and pressure on the rectum by the growing baby.
• Swelling- This commonly occurs in the feet and ankles toward the end of pregnancy, but swelling may also occur elsewhere due to the accumulation of fluid in the tissues.
• Mood Swings- Many women report mood swings and unusual sensitivity to their surrounding environment. For example, a woman may experience a crying episode with little or no provocation.
• Quickening- This refers to the active movements of the baby that are felt by the mother that usually begin about four months into the pregnancy. Also called fluttering.
• Fetal Heartbeat- With the aid of ultrasound techniques, the heartbeat of the baby can be detected as early as 8 weeks. Your practitioner will begin listening for the heartbeat during your routine office visits by the 3rd or 4th month.

How can I deal with the pain of labor?

Narcotics: These are the most widely used drugs during labor. They can be given intravenously or by injection and take effect in 2 to 15 minutes. They will "take the edge off" of the pain, and some women report that they help them to cope with the difficult contractions.

Local anesthetics :These drugs can either be injected into the area around the vagina and perineum, or given directly into the spinal region. When given into the spinal region, these drugs can provide complete relief of pain, while allowing you to remain conscious during the birth. Epidural anesthetics are commonly used during labor. It is wise to discuss your wishes about pain management with your practitioner before the onset of labor, keeping in mind that your actual labor experience may cause you to change your plan once labor is under way.

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