Mayo Clinic Guide to a Healthy Pregnancy

611 Pages·2008·8.35 MB·english

by  Roger W. Harms

Roger W. Harms, M.D.
Editor in Chief
Associate Medical Editors
Robert V. Johnson, M.D.
Mary M. Murry, C.N.M.
About this book
To use Mayo Clinic Guide to a Healthy Pregnancy, you may find it helpful to under-
stand how the information is arranged. The book is divided into four parts:
Part 1: Pregnancy, Childbirth and Your Newborn
This section offers month-by-month insights into your baby’s development as
well as your own physical and emotional changes. It also gives detailed infor-
mation on labor, childbirth, and newborn and postpartum care.
Part 2: Decision Guides for Pregnancy, Childbirth and Parenthood
Each guide is designed to help you reach a decision that’s best for you and
your situation.
Part 3: Pregnancy Reference Guide
Here, you’ll find helpful self-care tips for heartburn, nausea, back pain, fatigue
and many more of the common concerns of pregnancy.
Part 4: Complications of Pregnancy and Childbirth
This section provides details on complications that can occur with pregnancy,
along with information on being pregnant when you have a health condition.
Throughout this book, the term health care provider covers the many kinds of
medical professionals who provide pregnancy care. When the term doctor is
used, it indicates that a doctor of medicine (M.D.) is likely the best type of
health care professional to provide this type of care.
About May o Clinic
Mayo Clinic evolved from the frontier practice of Dr. William Worrall Mayo
and the partnership of his two sons, William J. and Charles H. Mayo, in the
early 1900s. Pressed by the demands of their busy practice in Rochester,
Minn., the Mayo brothers invited other physicians to join them, pioneering the
private group practice of medicine. Today, with more than 2,000 physicians
and scientists at its three major locations in Rochester, Minn., Jacksonville, Fla.,
and Scottsdale, Ariz., Mayo Clinic is dedicated to providing comprehensive
diagnoses, accurate answers and effective treatments.
With this depth of medical knowledge, experience and expertise, Mayo
Clinic occupies an unparalleled position as a health information resource.
Since 1983 Mayo Clinic has published reliable health information for millions
of consumers through award-winning newsletters, books and online services.
Revenue from the publishing activities supports Mayo Clinic programs,
including medical education and research.
Editorial Staff
Editor in Chief Contributing Writers
Roger W. Harms, M.D. Rachel Bartony
Lee Engfer
Associate Medical Editors Julie Freeman
Robert V. Johnson, M.D. Kelly Kershner
Mary M. Murry, C.N.M. Jennifer Koski
Amy Michenfelder
Managing Editor
Paula Marlow Limbeck Copy Editor
Mary Duerson
Contributing Medical Editors
Kristi Boldt, M.D. Proofreading
Virginia Caspersen, R.N., M.S., I.B.C.L.C. Miranda Attlesey
Abimbola Famuyide, M.D. Louise Hutter Filipic
Jennifer Friedmann, M.D. Donna Hanson
Shari Frueh, R.N., B.S.N.
Robert Heise Jr., M.D. Illustration
Sasikala Hemkumar, M.D. Michael A. King
Keith Johansen, M.D. Kent McDaniel
Bruce Johnston, M.D. M. Alice McKinney
Thomas Kastner, M.D. James D. Postier
Elizabeth LaFleur, R.N., B.S.N., I.B.C.L.C Chris Srnka
Kathleen A. Mann, R.N.
Mary Marnach, M.D. Indexing
Dawn E. Nelson, R.N. Larry Harrison
Margaret Pfeifer, M.D.
Petra Polasek, M.D. Editor in Chief, Books/Newsletters
Susan Sobolewski, R.N. Christopher Frye
Charla Schultz, R.D., L.D.
Cheryl Stuhldreher, R.N., M.S.N, I.B.C.L.C. Editorial Director
Catherine Walsh Vockley, M.S., C.G.C. Sara Gilliland
Creative Director HarperCollins Publishers
Daniel Brevick Stephen W. Hanselman,
Senior Vice President, Publisher,
Art Director HarperResource
Stewart Koski Leah Carlson-Stanisic, Design Manager
Karen Lumley,
Editorial Research Senior Production Manager
Anthony Cook Donna Ruvituso,
Danielle Gerberi Executive Managing Editor
Deirdre Herman Toni Sciarra, Senior Editor
Michelle Hewlett
Stephen Johnson
Advisors
Anita DeAngelis
Daniel Goldman, J.D.
James Hale Sr.
Jacqueline Heying
Vicki Moore
Mayo Medical Ventures
Gregory Anderson, M.D.
Michael Casey
Marne Gade
Laura Long
S. Rebecca Roberts
Gayle Rock
Richard Van Ert
John Schmidt
Literary Agent
Arthur Klebanoff
Media Support Services
Nancy Moltaji
pre face
This book is for people who will soon be having a baby. If that is you, please
accept our warmest congratulations! There are few events in anyone’s life
that rival the importance — and the joy — of childbirth. This new person
will be so important to you as a parent that you will do anything to nurture,
protect and give love to this special baby. Undoubtedly, your desire to start
that care is reflected in your interest in this book, a guide to starting out a
new life in good health for both mother and baby.
Although pregnancy is a normal event, it is marvelously complex, involving
changes in mother’s anatomy and physiology and in the entire family’s rela-
tionships. These changes are tiny compared to the miracle of development of a
single cell formed from the sperm and egg to a brand-new, one-of-a-kind,
important human being. I know of nothing in medicine that is more exciting,
fascinating or satisfying to observe.
There has never been a time when there was a better opportunity to start a
life in good health, and wisdom dictates that you should seek information
from people you can trust. This book is a compilation of expertise from
many viewpoints and approaches to care. Mayo Clinic has at the core of
its greatness an approach to every medical issue by a team of caregivers,
each with special insight and gifts. This book reflects that philosophy. Not
only does it come to you from a team of obstetricians with specialized
medical knowledge related to problems of pregnancy, but Mary Murry,
C.N.M., is the principal co-editor, lending the wisdom and experience of a
scientifically grounded midwife to its pages. This team has brought its
multiple skills to bear to help you have a healthier, happier pregnancy.
It is our sincere wish that you find this book informative, helpful and
meaningful as you anticipate your new baby. It is our hope that your
need for solid information is met in its pages. It is also our hope that your
pregnancy will be a wonderful experience, and your new baby will have
the blessing of good health.
Roger W. Harms, M.D.
Editor in Chief
contents
Part 1: Pregnancy, childbirth and your newborn ......................................................1
Introduction Preparing to have a baby ......................................................................3
Before pregnancy: Giving baby the best ..............................................3
Nutrition: Make every bite count..........................................................4
Exercise: Pace it for pregnancy............................................................17
Lifestyle: Living for two ......................................................................20
Medications: Take with care ................................................................25
Work: Plan ahead ..................................................................................27
Pregnancy timing: Does age matter?..................................................35
Chapter 1 Month 1: Weeks 1 to 4..........................................................................43
Your baby’s growth ..............................................................................43
Your body................................................................................................48
Your emotions ........................................................................................52
Appointments with your health care provider ................................54
When to call a health care professional..............................................56
Chapter 2 Month 2: Weeks 5 to 8..........................................................................57
Your baby’s growth ..............................................................................57
Your body................................................................................................60
Your emotions ........................................................................................63
Appointments with your health care provider ................................65
When to call a health care professional..............................................70
Chapter 3 Month 3: Weeks 9 to 12........................................................................71
Your baby’s growth ..............................................................................71
Your body................................................................................................73
Your emotions ........................................................................................75
Appointments with your health care provider ................................76
When to call a health care professional..............................................77
Chapter 4 Month 4: Weeks 13 to 16......................................................................79
Your baby’s growth ..............................................................................79
Your body................................................................................................81
Your emotions ........................................................................................86
Appointments with your health care provider ................................86
When to call a health care professional..............................................88
Twins, triplets and quads — Oh my!........................................................90
Chapter 5 Month 5: Weeks 17 to 20......................................................................93
Your baby’s growth ..............................................................................93
Your body................................................................................................95
Your emotions ........................................................................................98
Appointments with your health care provider ................................99
When to call a health care professional............................................100
Chapter 6 Month 6: Weeks 21 to 24....................................................................103
Your baby’s growth ............................................................................103
Your body..............................................................................................105
Your emotions ......................................................................................108
Appointments with your health care provider ..............................109
When to call a health care professional............................................110
Chapter 7 Month 7: Weeks 25 to 28 ....................................................................113
Your baby’s growth ............................................................................113
Your body..............................................................................................114
Your emotions ......................................................................................117
Appointments with your health care provider ..............................117
When to call a health care professional............................................120
Chapter 8 Month 8: Weeks 29 to 32....................................................................123
Your baby’s growth ............................................................................123
Your body..............................................................................................124
Your emotions ......................................................................................128
Appointments with your health care provider ..............................129
When to call a health care professional............................................130
Chapter 9 Month 9: Weeks 33 to 36....................................................................133
Your baby’s growth ............................................................................133
Your body..............................................................................................134
Your emotions ......................................................................................140
Appointments with your health care provider ..............................141
When to call a health care professional............................................143
Chapter 10 Month 10: Weeks 37 to 40..................................................................145
Your baby’s growth ............................................................................145
Your body..............................................................................................147
Your emotions ......................................................................................150
Appointments with your health care provider ..............................151
When to call a health care professional............................................152
Chapter 11 Labor and childbirth ..........................................................................155
Making those final preparations ......................................................155
How your body prepares for labor ..................................................160
Is it time to go to the hospital?..........................................................166
The stages of labor and childbirth ....................................................167
What you can do as the labor coach ................................................180
Chapter 12 Caesarean birth ..................................................................................187
Why a Caesarean birth might be necessary ....................................187
Risks of Caesarean birth ....................................................................192
Managing anxiety about Caesarean birth........................................194
What you can expect during a Caesarean birth..............................195
Recovery from Caesarean birth ........................................................200
Post-Caesarean restrictions ................................................................204
Possible post-Caesarean complications............................................205
Chapter 13 Your newborn ......................................................................................207
Your baby’s appearance......................................................................208
Initial health care for the newborn ..................................................212
Common newborn problems ............................................................215
The premature newborn ....................................................................217
Chapter 14 Taking your baby home ....................................................................225
Your baby’s world ..............................................................................225
Baby-care basics ..................................................................................235
Bringing home babies: Twins or more..............................................250
Chapter 15 Postpartum care for moms ................................................................251
Breast care ............................................................................................251
Healing from an episiotomy or tear ................................................253
Fatigue ..................................................................................................254
Bowel and urination problems ..........................................................254
Afterpains ............................................................................................256
Other postpartum changes ................................................................257
Weight loss............................................................................................258
The postpartum checkup....................................................................259
Emotional and lifestyle changes........................................................260
Part 2: Decision guides for pregnancy, childbirth and parenthood ..................267
Understanding genetic carrier screening for prospective parents....269
Choosing your health care provider for pregnancy ............................277
Understanding prenatal testing ..............................................................289
Trying again after a pregnancy loss ........................................................315
Managing travel during pregnancy ........................................................321
Understanding pain relief choices in childbirth ..................................325
Considering vaginal birth after Caesarean birth ..................................345
Exploring elective Caesarean birth..........................................................351
Considering circumcision for your son ..................................................355
Choosing your baby’s health care provider ..........................................359
The breast or the bottle? ............................................................................363
Contraceptive choices after delivery ......................................................389
Returning to work ......................................................................................401
Thinking about when to have another child ........................................407
Part 3: Pregnancy reference guide............................................................................413
Alphabetical listing of the common concerns and questions
of pregnancy, including self-care tips and advice on when
to seek medical help............................................................................415
Part 4: Complications of pregnancy and childbirth ............................................505
Maternal health problems and pregnancy
Asthma..................................................................................................507
Cancer....................................................................................................508
High blood pressure............................................................................511
Depression ............................................................................................512
Diabetes ................................................................................................513
Epilepsy ................................................................................................515
Gallstones..............................................................................................517
Heart disease ........................................................................................518
Hepatitis B ............................................................................................519
Herpes ..................................................................................................520
HIV/AIDS ..............................................................................................521