Sleep Tips For Pregnant Women

The hormonal changes and physical discomfort associated with pregnancy can affect a woman's quality of sleep. Each trimester brings its own unique changes, including changes in sleep. According to the National Sleep Foundation, the following are the most common sleep changes that might occur in each trimester:

1st Trimester

During the first trimester, a woman can go through a range of emotions from scared to ecstatic. Adding the new hormones in the loop, and she can go from happy to horrible in record time. Sleep challenges are very common due to the body's reaction to all the hormones. The rise in progesterone that sustains a pregnancy causes many women to feel tired continuously. The rise in HCG might also trigger the tired response too, which would explain why women tend to be more tired in the first trimester and feel much better in the second. Sore breasts and a blossoming bust line may also make getting comfortable difficult. If you are a tummy sleeper, you might find your breasts are getting in the way or hurt when you lay on them. Constipation and the ever-expanding uterus also make for discomforting nights. Add in frequent bathroom breaks per day and it is surprising that any pregnant woman sleeps at all. Progesterone is just a wonder hormone, not only does it make you sleepy; it makes you have to urinate all the time by increasing your kidney function. Nausea, also called "morning sickness", also makes sleep a challenge. This nausea can and does strike at all hours of the day and night, especially when lying down or is triggered by smell.

First Trimester Survival Tips

• Get as much rest as possible and sleep in when you can. Getting extra rest will help you stay out of the sleep debt that can cause your symptoms to worsen.
• Stay hydrated, but drink most of your liquids during the day and avoid them later in the evening so you can cut down on nighttime bathroom visits.
• Combat nausea with crackers or small bland snacks. Eat often and in small amounts to prevent getting sick from an empty tummy. Keep crackers at your beside for when nausea hits you in bed or in the morning.
• Sleep on your left side as much as you can. This is the best position for good circulation. Use extra pillows between your knees or under your belly to help keep you more comfortable.
• Have a night light in the bathroom so you don't have to turn on the light and wake yourself fully.
• Make sure you try to go to bed at the same time every night. This puts your body on a schedule.
• Take naps. If you are tired then go sleep, you body is telling you to do something.

2nd Trimester

Many pregnant ladies are happy to hit that 2nd trimester mark. Not only does it mean there is a less risk of a miscarriage, but also the nausea, frequent urination, and sleepiness have pretty much gone away. Women usually feel their best and have a boost of energy during this time. They are starting to show, but aren't too big for comfort. There are plenty of maladies to plague sleep during this time. To make room for the enlarging uterus, the diaphragm is restricted and breathing becomes shallower. This causes the infamous heartburn. Many women only have to eat or drink anything and get it. Many women notice their dreams become increasingly frightening as pregnancy develops. Many women have dreams that they left or lost the baby. Plus, dreams become extremely vivid.

Second Trimester Survival Tips

• In order to avoid heartburn; try to avoid spicy, fatty, or fried foods
• Sleep with your head and neck elevated to keep the stomach acid down
• Eat frequent small meals throughout the day
• Use antacids, they are effective and safe.
• Enjoy your 2nd trimester and better sleep, but keep sleeping. Extra rest is still a good thing
  When sleeping, lie on your side with your knees and hips bent. Place pillows between your knees, under your tummy and behind your back. This can help take pressure off your lower back.
• To avoid nightmares try not to eat too much before bed and talk out any fears you might have with your partner or a therapist.

3rd Trimester

The third trimester is the most sleep challenged stage of pregnancy. With the frequency of urination, inability to get comfortable, extra weight, and preparing for the new baby, some women find themselves struggling to stay awake. Rigorous fetal movements and fetal hiccups can also impede sleep. Aches and pains of many kinds can be expected at this time. The joints are loosening and preparing for birth, the body is carrying all the extra weight, and even walking can be tough. Many women during pregnancy wake frequently during the night for no reason, which can cause her to be sleepy in the morning. Many women find that they have begun snoring. During the later stages of pregnancy, many women find that their nasal passages have swollen and have more nasal congestion. Many women complain of leg cramps during the 3rd trimester as well. The muscles of the legs are carrying a lot of weight and tend to get stiff. Once relaxed at night they can tense up or spasm, causing great pain and keeping some women awake.

Third Trimester Survival Tips

• Sleep on your left side. This allows for the best blood flow to the fetus, your uterus and kidneys. It also improves circulation of blood back to the heart.
• Try using a body pillow to help you sleep better.
• Avoid sodas and other carbonated drinks, they can cause leg cramps.
• If you're getting a lot of swelling and begin snoring, call you doctor
• If you develop Restless Legs Syndrome, talk to your doctor about an iron deficiency.
• If you can't sleep get up and do something else. Read, watch T.V., listen to music, clean,
• you may get tired enough to want to go back to bed.
• If you are getting leg cramps, straighten your leg and flex your foot upwards, this will help get the kink out. Do these several times before going to bed as a stretching routine to avoid the cramps all together.

Feel sleepy all the time during pregancy

A woman's body goes through huge changes during pregnancy, so it is expected that you feel sleepy and tired. Most mums-to-be find they need a lot more sleep. Allow yourself to go to bed earlier so that you get sufficient rest. If possible, make time for a quick nap during your lunch break.

 

You should cut back on caffeine, which may interfere with sleep patterns. Have small but frequent meals during the day to stabilise your blood sugar level and prevent that sleepy feeling after a heavy meal. Also, avoid excessive junk food, as sweets may lead to a temporary energy boost and then a crash.

 

Try to do the more difficult tasks when you have the most energy, and leave the easier ones for when you're tired. Taking a short walk or doing some stretches at your workplace will also perk you up.

 

Getting enough sleep during pregnancy
If your sleep disturbances are severe, do not hesitate to ask your doctor to help you find solutions that will work for you. One or more of the following might help you get the sleep you need during pregnancy:

 

Pillows — Pillows can be used to support both the tummy and back. A pillow between the legs can help support the lower back and make sleeping on your side easier. Some specific types of pillows include the wedge-shaped pillow and the full-length body pillow.

Nutrition — Drinking a glass of warm milk might help bring on sleep. Foods high in carbohydrates, such as bread or crackers, can promote sleep. A snack high in protein can keep blood sugar levels up, and could help prevent bad dreams, headaches, and hot flashes.
Relaxation techniques — Relaxation techniques can help calm your mind and relax your muscles. These techniques include stretching and yoga, massage, and deep breathing.

Exercise — Regular exercise during pregnancy promotes your physical and mental health. Exercise also can aid in helping you sleep more deeply. Vigorous exercise within four hours of bedtime should be avoided.

Prescription and over-the-counter medicines — Ideally, all medicines should be avoided during pregnancy. Some medicines can hurt the developing baby. You should never take any medicines, including over-the-counter drugs, without first talking to your doctor.

How to Run Safely Through Pregnancy

The recent research, as well as stories of pregnancy from the best of the best in women's running, serve as testaments to the fact that running through pregnancy can be both safe and beneficial for most running mothers and their babies. That being said, it is no jog in the park. As the research elucidates, pregnant runners encounter plenty of changes and physiological surprises as they run through their nine months. Consider a few of the following common issues associated with running during pregnancy and always consult your doctor before entering into a running regimen.

 

Overall Fatigue

While all pregnant women experience low energy, it can serve as a major roadblock to a pregnant runner's regular routine. "Fatigue is the first thing you'll notice when trying to get out the door to run," says Dr. Nadya Swedan M.D., author of The Active Woman's Health and Fitness Handbook. Especially during the first few months of the pregnancy, the decision to take a nap versus going for a run can get more and more difficult. In addition to a rise in the hormone progesterone, changing sleep habits can contribute to exhaustion.

 

Setting realistic running goals during pregnancy is of the utmost importance. Rather than trying to increase fitness when you're feeling worn out, simply focus on maintaining. "Even if you are running only half as much as you did before the pregnancy because you're exhausted, after the pregnancy you'll be back to where you were before," she explains. As a result of the heart muscle pumping more blood to accommodate the baby, pregnancy can actually assist in improving your cardiovascular system. Although some of the newest research says that more than 30 minutes of exercise a day is safe for most pregnancies, it takes less work to maintain the same level of fitness, so it may not be necessary.

Aching Bones

With added weight and a shifted center of gravity, many pregnant runners worry about stress fractures. Goucher recently blogged about a stress fracture that her doctor thought might be linked to the positioning of the baby. Paula Radcliffe experienced a stress fracture in her sacrum soon after giving birth to her first child. To be sure, mom is sharing everything with the baby, including her calcium stores.

 

Tollefson assuaged her stress fracture fears by doing much of her pregnancy mileage on an underwater treadmill, thereby lightening the load by 80 percent. "When I was on that underwater treadmill, I knew I could run as hard as I wanted to without getting a stress fracture or hurting the baby," she says.

Loose Ligaments

Since a pregnant woman experiences a ten-fold increase in the hormone relaxin during pregnancy, she is at a higher risk for ligament injuries. Beginning at the fourth month of pregnancy, joints loosen up and shift more than usual. It is most common to feel this in the pelvis and the knees. "Some people describe it as a slipping or shifting in their pelvis when they run," Dr. Swedan explains.

Marathon of Birth

As Tollefson suggests, pregnancy is akin to training in many ways. "It was kind of like I was getting ready for a big race," she explains. As her due date neared, she tapered, the same way she would for a world championship race. "You have to let your body rest," she says.

 

As the research suggests, in most cases, runners are encouraged to run through much of pregnancy, but not to set any big training goals. While more than 30 minutes may be safe, this is not the time to hog mileage. Smart training will ward off stress fractures and sprains, as well as keep the baby healthy. Like a monster hill at mile 25 of a marathon, knowing what to expect can make all the difference.

 

General Pregnancy Running Tips

Although many of these are tips you should keep in mind all the time, they're especially important when you're pregnant.

• Make sure you are well hydrated before, during and after the run. Dehydration can decrease blood flow to the uterus, which can cause premature contractions.
• Make sure you warm up properly before you run, and cool down and stretch at the end of your run. Proper stretching can help prevent injuries, but be careful-gentle, easy stretches are best. Relaxin, a hormone produced during pregnancy, loosens joints and ligaments, making you more susceptible to injury and overstretching.
• Because of the increased pressure on your bladder, it's a good idea to plan your outdoor runs around a bathroom stop (or two!).
• Invest in a good sports bra because it's important to give your growing breasts the support they need. As your pregnancy progresses, you might need to go up another size.
• Make sure you're wearing shoes that fit well and give your feet plenty of support. Your best bet is to visit a specialty running store where a professional can fit you for shoes specific to your foot and stride
• If you're going for an outdoor run, always let someone know your route and when you expect to return. Try not to run in isolated areas or on high-traffic routes if you're running on the street. Safety should be your top priority, so bring a cell phone in case of an emergency or always run with a buddy.

Can I run while pregnant?

Going for a run is a quick and effective way to work your heart and body, giving you a mental and physical boost when you feel tired. Plus, like walking, it's easy to fit into your schedule.

At 10-weeks of pregnancy, your womb is still safely enclosed within the bony shell of your pelvis so it is perfectly safe to ride a bike.

Even if you fall off, you and your baby are going to come to no harm. Riding a bike is good exercise and when you are pregnant, exercise is especially important.

 

It would be good for you to go out on your bike and enjoy the fresh air until you find that it is physically too uncomfortable to do so.

With regards to your running; you can take this up at a slower pace and there are many female marathon runners who have continued competing well into their pregnancies.

However, some women find that, from about sixteen weeks onwards, running or jogging can cause painful tightening of the womb, so most doctors advise against vigorous running once the bump is well established.

Swimming is a good activity to take up in pregnancy as the water supports your weight. This relieves the stress on your ligaments.

Is it safe for me to run during pregnancy?It depends. If you ran regularly before getting pregnant, it's fine to continue — as long as you take some precautions and first check with your doctor or midwife.

 

But pregnancy isn't the time to start a running routine, according to Julie Tupler, a registered nurse, certified personal trainer, and founder of Maternal Fitness, a fitness program for pregnant women and new moms in New York City.

 

Pregnancy's also not the time to start training for a marathon, a triathlon, or any other race, cautions Tupler. "The first trimester is when the baby's major organs are forming, and overheating's a real issue. If a woman's core temperature gets too high, it could cause problems with the baby, so why risk it? Instead, train for the marathon of labor by strengthening your abdominals and pelvic floor muscles," she says.

 

Whether you're pregnant or not, running can be hard on your knees. During pregnancy, your joints loosen, which makes you more prone to injury. So unless you're an avid runner, you should probably steer clear of this form of workout at least until after your baby arrives. For now, focus on exercises that are safe for pregnancy.

 

DHA supplements during pregnancy

During pregnancy, developing babies rely on their mothers to get needed DHA. Since DHA is derived from the foods we eat, the content of DHA in a mother's diet determines the amount of DHA passed on to her developing baby. Unfortunately, the majority of pregnant women in the U.S. fail to get the recommended amount of DHA in their diets and DHA is not found in most prenatal vitamins. The good news is leaders in maternal health are beginning to educate women about the importance of DHA and some food manufacturers are starting to come up with creative ways to help people - pregnant and non-pregnant to get the DHA they need. Current research suggests adequate levels of DHA may help increase a developing baby's cognitive functioning, reduce the risk of pre-term labor and decrease the risk of postpartum depression.
Why do pregnant and lactating women, who so critically need DHA, find it difficult to get the recommended amount of this crucial nutrient in their diets? There are two primary reasons. First, during pregnancy the daily requirements of DHA increase from 220 mg to somewhere between 300 and 1,000 mg (depending on which expert you consult). Second, DHA isn't easy to get in your diet ? especially when you are pregnant. Significant amounts of DHA are found in animal organ meats and fatty fish.

 

Not the typical menu for most pregnant women! Liver does not hold mass appeal and we're told to limit our intake of fish due to concerns over toxins. No wonder a recent study of 112 pregnant or lactating women found that fewer than 2 percent met the FDA's current guidelines for adequate daily DHA consumption.
 
So what should pregnant women do to safely increase the DHA in their diets? A friend of mine began grinding flax seed onto her cereal every morning. Unfortunately putting flax seed on your cereal is probably a waste of time. Despite popular belief DHA is not found in flax seed. Flax seed (and green leafy vegetables) are sources of alpha-linolenic acid which may convert to DHA, but the process is inefficient and according to some experts may not happen at all. Alternatively you might choose to eat some of the "safer" fish choices such as pollock, haddock and cod. But according to Dr. Barbara Levine, associate professor of nutrition in medicine at Weill Medical College of Cornell University, "the purest source of DHA is not the fish itself, but rather what fish consume: the ocean's vegetarian plant algae. Taking DHA supplements produced from marine algae is therefore a safe way for pregnant women to boost their fatty acid stores," Levine says.
 

Derived mostly from plants, Omega-3 PUFAs have alpha-linolenic acid (ALA). Fish oils are comprised of eicosapentenoic acid (EPA) and docosahexaenoic acid (DHA). The omega-6 PUFAs come mainly from whole grains, vegetables, eggs and cereals and contain linoleic acid (LA) and arachidonic acid (AA).

 

During the 3rd trimester your baby's brain growth is at its peak. This is when these supplements were supposed to have had an effect. What seems to be more important is the ratio of the omega-3 and omega-6 fatty acids. For example, if you increase the omega-3 PUFAs, you may decrease the arachidonic acid (AA), an omega-6 PUFA, which may slow infant growth and development. DHA alone, without AA may also have negative side effects. Though it appears that real fish is what makes the difference and not artificial DHA.

 

 

This does not mean that the omega-3 PUFAs don't have a chance. In fact some recent observational studies have shown that there may be a correlation in preterm birth, precclampsia as well as hypertension in pregnancy with the Omega-3 PUFAs. Women with a history of preterm labor had a 50% reduction in preterm labor rates with omega-3 PUFAs, though the general population did not seem to benefit. Though more quality studies are needed for all of these cases.

 

So before you buy supplements for yourself during pregnancy or feed supplements to your baby after birth, be sure to talk to your doctor or midwife about the potential benefits for you and your baby and how they may or may not outweigh the risks. Remember, it's about a good ratio and timing. Because when all is said and done, no expert has the answer as to the appropriate amount or type of supplement that works well in pregnancy.

Something about Omega-3 Fatty Acids in Pregnancy

Omega-3 fatty acids, in particular DHA, help a pregnant woman give her developing baby every advantage in life starting in-utero. In general the omega-3 fatty acids found in fish help the cardiovascular system, the brain (including moods), and even the brain and eyes of a developing baby. Yet only about 68% of women know about the benefits of DHA, an essential fatty acid. More than two-thirds of women say their doctor has never told them anything about DHA, and 72% have no idea how to get DHA into their diet.

Consumer DHA consumption is well below recommended amounts in the United States and the United Kingdom, and is only a little better in Australia and Canada. Yet still the consumption in these countries is not even half of the consumption of DHA in Japan or Norway where fish and seafood are eaten regularly.

 

Neglecting to supplement the diet with DHA is risky for infant neurological development while in-utero because so much of the brain and eyes are made up of omega-3 fatty acids, specifically DHA. Babies of mothers who were deficient in DHA while pregnant performed more poorly on vision tests than babies of mothers who supplemented with DHA. The vision test measures the babies' ability to differentiate between the width of lines.

 

The risk of pre-term delivery and low birth weight is three and a half times higher when mothers are deficient in DHA.Premature babies (preemies) are prone to have many health problems including high risk of eye and brain damage, and some need speech therapy as they grow older. Advances in newborn medical care have greatly reduced the frequency of deaths related to low birth weight. However, of those who survive, a small percentage may develop mental retardation, learning problems, cerebral palsy, and vision and hearing loss.In the year 2005, pre-term births nationwide represented 12.7% of all births.That's about a half a million premature babies a year.

 

 

There are many different reasons for a premature birth, and not all of them are within the mothers' control, so it is impossible to say that simply supplementing with prenatal vitamins and omega-3s are enough to prevent one. However, within the list of causes that are in a mothers' control, such as lifestyle choices, a proper diet and supplementation is the first line of defense. Mothers who supplement with fish oil tend to have longer pregnancies by about four days than those who are deficient in DHA.

 

Unfortunately, low birth weight is now known to be associated with increased adult rates of coronary heart disease, stroke, hypertension and non-insulin dependent diabetes. Preventing disease really does start in the womb. Also consider that the womb is where the baby learns how life on the outside might be. If the mother is poorly nourished she signals to her unborn baby that the environment it is about to enter will probably be harsh. The baby responds to these signals by adaptations, such as reduced body size and altered metabolism, which help it to survive a shortage of food after birth, but which also set the stage for health problems later on in life.

 

Conversely, the higher the child's blood level of omega-3, as determined by the supplement the mother took while pregnant, the better eye-hand coordination the child may possess. It is more likely that language and motor skills and problem-solving ability will be more strongly developed in children whose mothers' levels of DHA were high. One small scale double blind study found that the babies of women who were given DHA supplements in functional food during the last trimester of pregnancy could out-perform other babies in problem solving tests at nine months of age. Curiously, there was no difference between the test and control groups in tests of memory, but DHA-rich babies could find a toy hidden under a cloth more often than the babies of moms in the control group.

 

During prenatal development, the fetus takes all available DHA if the mother is deficient. That leaves nothing left over for the mother. Nutritional science studies point to a correlation between low levels of omega-3s and depression in people. A pregnant or lactating woman has higher needs for omega-3 with current recommendations at 300 milligrams per day for intake of DHA. To compare numbers, consider that the average non-pregnant Japanese woman consumes 571 milligrams per day of DHA.

 

Doctors have taken detailed diet diaries of women during pregnancy and found that those who develop gestational diabetes tend to eat more omega-6 fatty acids than omega-3s.Omega-6 fats are found in many common vegetable oils. In Western countries omega-6 intake well exceeds the recommended levels, and the median intake of omega-3 is well below recommended amounts. There is evidence that DHA modulates insulin resistance! Those prone to gestational diabetes are strongly urged to replace omega-6 fats with omega-3s.

Chinese Superstitions during and after Pregnancy

China is a good country to be pregnant. With the one child policy, people treat you really well. They offer you seats on the subway or bus. They talk about how radiant you look. They don't let you carry anything heavy and are generally very considerate.


This year is a good year to be pregnant, because everyone in China want to have a dragon baby, me too. But you know, when we go out no matter to have a walk or go shopping, we will meet lots of pregnant women this year. It is boring to go to hospital because I have to wait a whole morning for a simple check. May be my choice to have a baby in this year is quite unwise. 


We have quite a few superstitions too, sharing a few I came across...


Dragon Babies
Everywhere you look this year, you can find pregnant women. The chinese believe that the year of the dragon is a good year to have babies, as the baby will have similar qualities of a dragon. The dragon also symbolises the emperor in Chinese mythology.


Don't move your bed
If you are pregnant, don't move the bed you are usually using, the older will tell you that your baby will be not well if  you change the position of the bed.
But unfortunately, I moved house twice during my pregnancy, and I have no other choice.


Cold drinks/food during the first trimester:

The chinese believe that your womb is an incubator for your baby.
The hens sit on their eggs to keep it warm so they can hatch. Similarly during pregnancy you must eat hot / warm food and avoid cold drinks or food.


Eating white colored food:
Milk, egg white and other light colored food will help you having a fair skinned baby.


Don't attend a funeral ceremony:
If your wife is pregnant, you should not attend a funeral ceremony no matter the one is your best friend. Because it is unlucky.


Post natal care:
The first month after delivery is called the "sitting month". Women who just had a baby are not allowed to do any sort of activity including taking a bath. The belief is, as their body is weak they may catch cold.
Also, bird's nest and other health boosting soup has to be consumed by the new mother . (including eating your own placenta)
The women are also not allowed to sit or sleep in rooms with the air conditioner on.
The women cut their hair to chin length after delivery as long hair is considered to weaken your baby.


In my opinion, those sayings may be right, but it is not absolute, for example, don't move your bed, because a pregnant woman need rest and avoid to carry anything heavy, if you feel tired, your baby will be not well, it is easy to know.


Whether you follow these or not, the main thing is to just enjoy this phase and not worry too much. Having a baby is a blessing and can only bring you joy!

Superstitions and maths about pregnancy

They are not supported by science;
There is no definitive answer to if they are true;
They are based on cultural beliefs;
Your mother and grandmother generation most likely made it up.


Having a Boy:
You didn’t experience morning sickness in early pregnancy;
Your baby’s heart rate is less than 140 beats per minute;
You are carrying the extra weight out front;
Your belly looks like a basketball;
Your areolas have darkened considerably;
You are carrying low;
You are craving salty or sour foods;
You are craving protein — meats and cheese;
Your feet are colder than they were before pregnancy;
The hair on your legs has grown faster during pregnancy;

Your hands are very dry;
Your pillow faces north when you sleep;
Dad-to-be is gaining weight, right along with you;
Pregnancy has you looking better than ever;
Your urine is bright yellow in color;
Your nose is spreading;
You hang your wedding ring over your belly and it moves in circles;
You are having headaches;
You add your age at the time of conception and the number for the month you conceived and the sum is an even number.


Having a Girl:
You had morning sickness early in pregnancy;
Your baby’s heart rate is at least 140 beats per minute;
You are carrying the weight in your hips and rear;
Your left breast is larger than your right breast;
Your hair develops red highlights;
You are carrying high;
Your belly looks like a watermelon;
You are craving sweets;
You are craving fruit;
You crave orange juice;
You don’t look quite as good as normal during pregnancy;
You are moodier than usual during pregnancy;
Your face breaks out more than usual;
You refuse to eat the heel of a loaf of bread;
Your breasts have really blossomed!
Your pillow faces south when you sleep;
Your urine is a dull yellow color;
You hang your wedding ring over your belly and it moves from side to side;
You add your age at the time of conception and the number for the month you conceived and the sum is an odd number.

Symptoms and knowledge of Ectopic pregnancy

Ectopic pregnancy can be difficult to diagnose because symptoms often mirror those of a normal early pregnancy. These can include missed periods, breast tenderness, nausea, vomiting, fatigue, or frequent urination.

The first warning signs of an ectopic pregnancy are often pain or vaginal bleeding. There might be pain in the pelvis, abdomen, or, even the shoulder or neck (if blood from a ruptured ectopic pregnancy builds up and irritates certain nerves). The pain can be mild or crampy early on, and can become sharp and stabbing. It may concentrate on one side of the pelvis.

Any of these additional symptoms can be seen with an ectopic pregnancy:

• vaginal spotting
• dizziness or fainting (caused by blood loss)
• low blood pressure (also caused by blood loss)
• lower back pain

1. Diagnosis

If you arrive in the emergency department complaining of abdominal pain, you'll likely be given a urine pregnancy test. Although these tests aren't sophisticated, they are fast — and speed can be crucial in treating ectopic pregnancy.

If you already know you're pregnant, or if the urine test comes back positive, you may have a quantitative hCG test. This blood test measures levels of the hormone human chorionic gonadotropin (hCG), which is produced by the placenta.

You may also have an ultrasound to look for a developing fetus in the uterus or elsewhere. Early in pregnancy, the ultrasound may be done using a wand-like device in your vagina. The doctor might give you a pelvic exam to locate the areas causing pain; to check for an enlarged, pregnant uterus; or to find any masses outside of the uterus.

Even with the best equipment, it's hard to see a pregnancy less than 5 weeks after the last menstrual period. If your doctor can't diagnose ectopic pregnancy but can't rule it out, he or she may ask you to return every few days for blood work and an ultrasound until it is clear whether or not there is an ectopic pregnancy.

2. What Causes an Ectopic Pregnancy?

An ectopic pregnancy results from a fertilized egg's inability to work its way quickly enough down the fallopian tube into the uterus. An infection or inflammation of the tube might have partially or entirely blocked it. Pelvic inflammatory disease (PID), which can be caused by gonorrhea or chlamydia, is a common cause of blockage of the fallopian tube.

Endometriosis (when cells from the lining of the uterus implant and grow elsewhere in the body) or scar tissue from previous abdominal or fallopian surgeries can also cause blockages. More rarely, birth defects or abnormal growths can alter the shape of the tube and disrupt the egg's progress.

3. Options for Treatment

Treatment of an ectopic pregnancy varies, depending on how medically stable the woman is and the size and location of the pregnancy.

An early ectopic pregnancy can sometimes be treated with an injection of methotrexate, which stops the growth of the embryo.

If the pregnancy is farther along, you'll likely need surgery to remove the abnormal pregnancy. In the past, this was a major operation, requiring a large incision across the pelvic area, and this can still be necessary in cases of emergency or extensive internal injury.

But sometimes ectopic tissue can be removed using laparoscopy, a less invasive surgical procedure. The surgeon makes small incisions in the lower abdomen and then inserts a tiny video camera and instruments through these incisions. The image from the camera is shown on a screen in the operating room, allowing the surgeon to see what's going on inside of your body without making large incisions. The ectopic tissue is then surgically removed and any damaged organs are repaired or removed.

Whatever your treatment, the doctor will want to see you regularly afterward to make sure your hCG levels return to zero. This may take several weeks. An elevated hCG could mean that some ectopic tissue was missed. This tissue may have to be removed using methotrexate or additional surgery.

4. When to Call Your Doctor

If you believe you're at risk for an ectopic pregnancy, meet with your doctor to discuss your options before you become pregnant. You can help protect yourself against a future ectopic pregnancy by not smoking and by always using condoms when you're having sex but not trying to get pregnant. Condoms can protect against sexually transmitted infections (STDs) that can cause PID.

If you are pregnant and have any concerns about the pregnancy being ectopic, talk to your doctor — it's important to make sure it's detected early. You and your doctor might want to plan on checking your hormone levels or scheduling an early ultrasound to ensure that your pregnancy is developing normally.

Call your doctor immediately if you're pregnant and experiencing any pain, bleeding, or other symptoms of ectopic pregnancy. When it comes to detecting an ectopic pregnancy, the sooner it is found, the better.

5. What About Future Pregnancies?

Many women who have had an ectopic pregnancy will go on to have normal pregnancies in the future, but some will have difficulty becoming pregnant again. This difficulty is more common in women who also had fertility problems before the ectopic pregnancy. Your prognosis depends on your fertility before the ectopic pregnancy, as well as the extent of any damage incurred.

The likelihood of a repeat ectopic pregnancy increases with each subsequent ectopic pregnancy. Once you have had one ectopic pregnancy, you face an approximate 15% chance of having another.

6. Who's at Risk for an Ectopic Pregnancy?

While any woman can have an ectopic pregnancy, the risk is higher for women who are over 35 and those who have had:

• PID
• a previous ectopic pregnancy
• surgery on a fallopian tube
• infertility problems or medication to stimulate ovulation
• Some birth control methods also can affect a woman's risk of ectopic pregnancy. Those who become pregnant while using an intrauterine device (IUD) might be more likely to have an ectopic pregnancy. Smoking and having multiple sexual partners also increase the risk of an ectopic pregnancy.

HIV Protection during pregnancy, labour and breastfeeding

1. If I suddenly go into labour and I am not taking any ARVs, are there any drugs I can take to help my baby?

There are several ARVs you can take during labour. The question of which ones to take and how long to take them for will depend upon drug availability.

WHO recommended in 2006 a combination of single-dose nevirapine + AZT + 3TC for the woman during labour and delivery, followed by a seven-day tail of AZT and 3TC. Immediately after delivery, it is recommended that the baby is given a single-dose of nevirapine, followed by a course of AZT for four weeks.

If drug availability is very limited, a single-dose of nevirapine for the mother during labour and a single-dose of nevirapine for the baby will probably be recommended as a minimum.

2. Is it really safe to take HIV drugs during pregnancy?

Pregnant women are often advised not to take any medications during their pregnancy, so it can seem strange that HIV positive women are advised to take ARVs when pregnant. However, thousands of women have taken HIV drugs during pregnancy without it causing harm to their babies, and it has resulted in many babies being born HIV negative who might otherwise have been infected.

It cannot be guaranteed that HIV drugs taken when a woman is pregnant will not harm her baby. If a woman is not already taking ARVs then as explained above she will probably be advised to wait until after the first trimester before starting treatment. There are specific recommendations and guidelines (see the sources at the end of the page), about certain antiretroviral drugs and which ones are more of a concern than others. The Antiretroviral Pregnancy Registry

3. What else can I do to prevent my baby becoming infected with HIV?

• Is a pre labour caesarean section (PLCS) better than a natural vaginal delivery?

A caesarean section is an operation used to deliver a baby through its mother's abdominal wall. When a mother is HIV positive it is done to protect the baby from direct contact with her blood and other bodily fluids.

Research suggests that with many women now taking ARV combination therapy during pregnancy, having a caesarean isn't a significant factor in preventing the transmission of HIV from mother to baby. Unless you are ill with HIV or have a detectable viral load it usually won't be recommended by your health care provider, as having a caesarean does itself have some risks for the woman. One exception to this is if you are taking AZT on its own, when a PLCS may still be recommended.

• Should I breastfeed?

HIV is found in breast milk, and if you breastfeed there is a significant chance of passing HIV to your baby. So if you have access to safe breast milk substitutes (formula) then you are advised to not breastfeed.

If you live in a country where safe water isn't available, the risk of life-threatening conditions from formula feeding may be higher than the risk from breastfeeding. Formula can also be too expensive to use regularly in some countries. If you are in this situation it is better to feed your baby breast milk alone.

Mixed feeding is when a baby is fed with breast milk and other liquids such as formula, glucose water, gripe water or traditional medicine. It is now thought that there is a higher risk of a baby becoming HIV positive from mixed feeding than exclusive formula feeding alone or breastfeeding. Mixed feeding may damage the lining of the baby's stomach and intestines making it easier for HIV in breast milk to infect the baby but when taking ARVs to prevent mother to child transmission, the risk is reduced and is currently recommended by the WHO.

4. What drugs should I take and when should I take them?

The drugs that can reduce the risk of HIV transmission from a mother to her baby are called antiretroviral (ARV) drugs. ARVs are the drugs that are taken by people living with HIV to prevent them from becoming ill.

The most important time for an HIV positive pregnant woman to take ARVs to prevent her baby becoming infected is during labour. Depending on your particular circumstances it may be suggested that you take ARVs at other times as well.

Deciding exactly which ARVs to take and when to take them can be quite difficult, because there is a need to balance a number of different things, including:

• Your health as an HIV positive pregnant woman
• Reducing the risk of HIV being passed from you to your baby
• The possibility of developing ARV side effects
• The possibility of drugs causing harm to your baby.
• There may also be a difference between which drugs you would ideally take and which ones it is actually possible for you to take, as there is considerable variation worldwide in the cost of ARVs and their availability.

Can HIV be transmitted from a mother to her baby and how to avoid?

If a pregnant woman is infected with HIV, she can transmit the virus to her baby during pregnancy, labour and delivery, or breastfeeding. Without treatment, around 15-30 percent of babies born to HIV-infected women will become infected with HIV during pregnancy and delivery. A further 5-20 percent will become infected through breastfeeding.

Modern drugs are highly effective at preventing mother-to-child transmission of HIV. When combined with other interventions, including formula feeding, a complete course of treatment can cut the risk of transmission to below 2 percent. Even where resources are limited, a single dose of medicine given to mother and baby can cut the risk in half.

A woman who knows that she or her partner is HIV positive before she becomes pregnant can find out about interventions that may be able to protect herself, her partner or her baby from becoming infected with HIV. Doctors will be able to advise which interventions are best suited to her situation, and whether she should adjust any treatment she is already receiving if she is HIV positive.

There are a number of interventions that can reduce the risk of HIV transmission between a couple when attempting to conceive a child. If a couple decide they want to conceive a child through unprotected sex, they should first seek advice on how to limit the risk to each other and to their baby. It is worth noting that someone is less likely to transmit HIV if they are receiving effective antiretroviral treatment, and also if neither they nor their partner has any other sexually transmitted infections.

• If the woman is HIV positive and the man is HIV negative

An HIV positive woman and an HIV negative man can conceive without HIV transmission occurring by using artificial insemination (the process by which sperm is placed into a female's genital tract using artificial means rather than by natural sexual intercourse). This simple technique provides total protection for the man, but does nothing to reduce the risk of HIV transmission to the baby.

• If the man is HIV positive and the woman is HIV negative

Sperm washing is a process used to prevent HIV transmission from an HIV positive man to his partner during conception. Sperm washing involves separating sperm cells from seminal fluid, testing these cells for HIV, then inserting the cells into the woman's womb (intrauterine insemination), or directly into the egg (in vitro fertilisation or intracytoplasmic sperm injection). Sperm washing is a very effective way to reduce the risk of HIV transmission during conception, but it is not widely available and can be difficult to access, even in well resourced countries. Alternatives to sperm washing have been researched, such as the method of using pre-exposure prophylaxis and timed intercourse when the HIV-positive male partner is taking antiretroviral drugs.

• If both man and woman are HIV positive

When both partners are HIV positive, it might still be sensible for them not to engage in frequent unprotected sex, because there might be a small risk of one re-infecting the other with a different strain of HIV.

Consumption of Fish and Seafood During Pregnancy

Sushi

Certain types of cooked sushi such as eel and California rolls are safe to eat when pregnant.

The FDA reports the greatest risk of seafood-borne illnesses is from raw or undercooked shellfish, particularly clams, oysters and mussels from contaminated waters. Bacteria such as Salmonella, Staphylococcus aureus, and viral infections (including hepatitis A) have all been found in raw seafood.

 

Mercury in Fish and Seafood

Fish and seafood can be an important part of a balanced diet for pregnant women and those of childbearing age who may become pregnant. Indeed low consumption of fish was found to be a strong risk factor for preterm delivery and low birth weight in one study . In addition maternal consumption of low levels of seafood may have a detrimental effect on child development . Nonetheless, some large long-lived fish contain high levels of a form of mercury called methyl mercury that may potentially harm an unborn baby's developing nervous system.

 

Small fish absorb methylmercury from water as they feed on aquatic organisms. The longer the fish lives the more methylmercury the fish accumulates in its body. Large, long-lived, larger fish that feed on other fish (high in the food chain) accumulate the highest levels of methylmercury . In the United States the limit for methyl mercury in commercial marine and freshwater fish is 1.0 parts per million (ppm). In Canada the limit for total mercury content is 0.5 (ppm) . Although the mercury levels found in most commonly consumed fish and seafood are well below these limits, the mercury levels found in several predator species frequently exceed 1.0 ppm

 

Food and Drug Administration (FDA) Recommendations

The FDA advises that pregnant women, women who may become pregnant, nursing mothers, and young children should avoid eating shark, swordfish, king mackerel and tilefish due to high levels of mercury in these fish.

 

The FDA also recommends that pregnant women can safely eat an average of 12 ounces of other types of COOKED fish each week You may eat up to 6 ounces (one average meal) of albacore tuna per week. Emphasis is placed on choosing a variety of  fish low in mercury such as shrimp, canned light tuna, salmon, pollock, and catfish.So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.

If no local advisories about the safety of fish caught by family and friends are  available, eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don't consume any other fish during that week."

 

How to eat fish during pregnancy?

Been reading the headlines lately? Then chances are your head's swimming with fish stories. Fish is heart healthy! But wait, it's also full of mercury! Fish is loaded with baby-friendly DHA! But not so fast — it's also loaded with PCBs!

Food is a bit of a minefield when you are pregnant or breastfeeding - you are trying your very hardest to give your baby-to-be the very best start in life by eating a balanced, nutritious diet. But with so much advice flying about, it can be difficult to know what you can and can't eat.

One major minefield is fish and in particular, fish containing mercury as high levels of mercury could potentially harm the development of a baby's central nervous system. So is fish safe to eat during pregnancy or when breastfeeding? Which fish can I eat and which have high levels of mercury? How often should I eat fish?

Avoid: Shark, swordfish, king mackerel, fresh tuna, sea bass, tilefish, mahimahi, grouper, amberjack, and fish from contaminated waters

Limit to six ounces per week: Canned (or packaged) albacore tuna and freshwater fish caught by family and friends

 

Limit to 12 ounces per week: Shellfish, canned (or packaged) light tuna, smaller ocean fish, farm-raised fish, and store-bought freshwater fish

 

Safely eat: Wild salmon, sole, flounder, haddock, halibut, ocean perch, pollack, cod, and trout

 

What's the dish on fish?

 It's a first-rate source of lean, baby-building protein — an essential ingredient throughout the making of your amazing baby, but an especially important one in the third trimester, when brain growth is fast and furious. What's more, fish, especially the fattier varieties, is an excellent source of DHA, the fabulous fat that's known to boost baby brain power. At 28 weeks pregnant, it benefits your brain power, too — getting enough omega-3s can improve your memory (remember when you had one of those?) and your mood (a low intake of DHA during pregnancy is linked to postpartum depression). Plus, fish deserves those heart healthy headlines — a diet rich in fish lowers the risk of cardiac disease by stabilizing heart rhythms, reducing blood clotting, and lowering blood pressure.

 

The dark side to the fish story.

It's true that some fish, particularly large ocean-faring fish (and especially predator types) contain high levels of mercury, a distinctly baby-unfriendly toxin. Others, especially those that frequent polluted lakes and rivers, are laden with PCBs, a chemical you definitely don't want to be feeding a fetus — or an infant. To play it safe, you'll need to keep all those fish off your dish while you're pregnant, as well as when you're nursing. And to play it extra safe, you'll have to limit other kinds of fish as well. 

 

Fish is a very important component of a balanced diet and pregnant and breastfeeding women shouldn't reduce their consumption - it's just a question of eating the right type of fish.

Late Pregnancy Discomforts

One of the main rules of writing is to write about what you know best. Right now, what I know best is about how uncomfortable the end of pregnancy can be!

While I'll tell anyone that there are certainly many joys of pregnancy, like feeling the baby move, there are also the down sides. Last night while I continually got up to go to the bathroom, it suddenly occurred to me (even half asleep) that my urinary frequency was setting the pace of once every hour and eight minutes. And that's just for starters!

So here's a list of common complaints at the end of pregnancy and what you can do about them!

• Insomnia

Not being able to sleep is really annoying. It comes in a couple of forms: being exhausted and not able to sleep and just not able to sleep but feeling fine. At least with the latter you can be productive. Advice is to try some form of exercise earlier in the day, avoid caffeine after early evening, relax before bed and even the old standard of a glass of warm milk.

More: 5 Tips for Pregnancy Insomnia

• Back Pain 

OUCH! Seriously, try the massage route, if you can't find anyone to help here, pelvic tilts work really well. I also find that stretching and the use of warm compress, like a rice sock or warm bath work really well. Another thing to try is to shower on hands and knees allowing the water to hit you in the back.

More: Pregnancy Back Pain

• Leg Cramps

Stretching prior to bed and not pointing your toes are great starts. Some also claim that nutritional deficiencies like lack of potassium contribute to this problem.

More: Leg Cramps in Pregnancy

• Shortness of Breath

As the baby grows and compresses your diaphragm you have less room to breathe. Stretching and doing pelvic tilts to allow baby to settle works for some women. Another good piece of advice is to try sleeping sitting up. I just double fold my body pillow and lean it on the headboard. Other women find that a recliner or other chair is better for them.

• Exhaustion

Believe it or not growing a baby takes a lot of energy. My best advice is hard to follow, but a gem...nap! Seriously if you can get in a brief nap or rearrange your schedule to allow you to sleep when you are the most sleepy, life will be much easier. Add insomnia to the mix and it's killer.

• Heartburn & Other Gastrointestinal Delights

Heartburn, belching and gas, all very lovely and all a result of the baby growing healthy! Avoid offending foods, staying upright after meals and just a plain old sense of humor are about all you can do here. Sometimes a glass of milk with honey will help with heartburn and sometimes your practitioner can recommend something to help as well.

• Contractions

These delightful things are great for practicing everything you learned in childbirth class, and even give you a run for your money at times. My best advice is to ignore them as much as possible. Real labor won't let you sleep. Try napping, changing positions, taking a bath and relaxation. Usually these will help. Sometimes women will have periods of contractions that return at a certain point each day or some will seem to have non-stop contractions for the last few weeks. Both are fairly normal. Talk to your practitioner if you're concerned.

More: Readers Share: What do contractions feel like?

• Pubic Bone Pain

First off, it's not really a bone, but it sure can hurt. I've often described this feeling as being a plastic doll and getting my legs ripped off sideways. You can no longer stand on one leg to put your pants on and even lifting a leg to get into the tub becomes interesting. A rice sock or other warm compress can feel really good for this odd sore spot.

• Urinary Frequency

You remember this from the beginning? Well the goods news is that as the baby prepares to be born s/he comes down further into the pelvis. The bad news is that this means more time in the bathroom. I try to watch what I drink just before bed and to always know where the restroom is located.

• Pressure

Another delight of baby dropping down into the pelvis is the feeling of constant pressure. Short of hanging upside down there's not a lot to do but take comfort in the fact that it's a good sign that baby will be here soon. Swimming or simply being in deeper water can help, as can pelvic tilts.

• Kicks in Odd Places

While feeling baby move is great, it's also a pain at times. Some babies find your ribs and delight in kicking you until you're sore. Some women have reported bruising from their babies. I usually place my hand firmly on the sore spot and have a little conversation with baby. It goes something like this: "Baby, don't kick your mommy there!" kick*kick*kick Pelvic tilts can be effective in getting baby to shift a bit, as can creative positioning of your body. Some moms choose the route of using ice on the sore spots.

• Balance Problems

Umm, don't use it! Seriously, balance problems can be quite annoying. I've fallen a lot this pregnancy, and even more annoying as you become larger, is the not being able to get off the floor or get out of the tub. Try to avoid positions where you know you'll be stuck, unless you have help around. And just laugh when you have to have someone pick you up off the floor. In the event of a spill, remember that the baby is really well cushioned in the amniotic sac. Calling your practitioner for reassurance is a great thing too!

Face to the Heat of Pregnancy

Along with pregnancy comes a lot of joy, excitement and a lot of symptoms you probably weren't prepared for. Every woman knows about the morning sickness, the swelling, and the cravings but one symptom a lot of women aren't prepared for including myself is the hot flashes, the sweating and the overall feeling of being hot all the time. Obviously the cause for this is the hormones a woman has surging through her body during these nine months and for some, this symptom may come and go or may just present itself for one of the three trimesters. Unfortunately for me, mine kicked in within the first few weeks of finding out I was pregnant and continued through the entire pregnancy. It's an uncomfortable symptom to experience and depending on the level of severity you have you may or may not be able to ignore it. I realized early on I was going to need to find some way of beating this heat- otherwise it was going to be a very long nine months.

My pregnancy was planned and I thought long and hard about what time of the year I would want to be pregnant. I live in New York so I knew I didn't want to be at the end of my pregnancy in the middle of winter (The last thing I wanted was to deliver a baby at home in the middle of a snow storm) and based on the fact that I hate the extreme heat of summer I didn't want to be nearing the end of my pregnancy in the summer months of July or August when New York weather can reach the high 90's with high levels of humidity. After contemplating it, it made perfect sense to try for a spring baby. That way the bulk of my pregnancy would take place in the fall and winter, and by the time it was warming up, baby would be arriving any day. Everything went as planned and my due date was set for April 12th. Unfortunately a few weeks into my pregnancy the constant feeling of being hot kicked in even though it was the end of summer and the weather was starting to cool off. I was spared from themorning sickness bug (luckily) so I figured the hot flashes were just a substitute and they would go away by the time I was entering my second trimester.

Unfortunately I wasn't as lucky as I had hoped and when I began my second trimester of pregnancy things just got hotter. In November the weather changed to cold with snow and icy rain and you would find me driving to work with the window open and walking from my car to the building wearing a thin shirt, carrying my coat along with me. Maybe it wasn't the healthiest thing for me and baby, but I felt if I put that coat on, I was likely to suffocate and sweat to death before making it into the building. Sitting at work during the day other employees would comment on how chilly it was in the building and I would laugh, sitting there in a little t-shirt, sweating with rosy cheeks, disagreeing and stating it was likely close to 100 degrees in the building.

Pregnancy is no quick trip so I knew I had to find ways to deal with this feeling of being hot all the time, especially since it was obvious this pesky symptom wasn't going away any time soon. The first thing I had to do was break myself of my normal habits. I'm normally someone who's always cold so my wardrobe consists of heavy pants, heavy sweaters, long sleeved shirts and heavy socks. I also have an arsenal of winter coats, scarves, gloves and hats so I can battle the New York winters without freezing to death. After about 3 days of wearing my fall sweaters and heavier pants, I switched back over to my summer wardrobe and began wearing t-shirts, tank tops with a thin cover-up, and paper thin long sleeved shirts. I even wore my open toe shoes long into the fall until I feared my toes would eventually get frostbitten and turn blue. Even then I wore my lightest shoes with thin cotton socks. My feet weren't going to see those heavy wool socks this year. Everyone thought I was crazy for not being cold and covering up, but they just didn't understand. In my world, I was living in a heat wave. The change in wardrobe helped a lot, and while I made sure I always carried a coat along with me in case I needed to keep warm, I eventually switched over to wearing a sweatshirt as my coat and bringing along gloves and a scarf in case it was chilly out. I abandoned hats all together that year and probably only needed to wear a headband to cover my ears 2 or 3 times and that was during our worst winter weather. I stashed away my flannel pajamas and continued wearing shorts and tank tops to bed. When my belly got larger and I wasn't fitting into my pre-pregnancy clothing I wore thin, sleeveless cotton nightgowns to bed that didn't leave me overheated at all.

Fortunately when you're pregnant you make the rules whenever you possibly can so instead of keeping my house heated as warm as I normally did each year, I dropped the thermostat down to a chilly 55 degrees. This was my first pregnancy so I didn't have any other children to keep warm, and I figured my husband was tough enough that he could throw on an extra layer of clothing to keep himself warm. Finally around the third trimester he realized asking if we could turn up the heat was a lost cause, and that bedroom window was most definitely staying cracked open during the night for cool, fresh air. Not only did the cooler house help my hot flashes but we saved quite a bit of money on our gas bill that winter.

Unfortunately just because you're pregnant, that doesn't mean the rest of the world is pregnant along with you. Sure I came up with some easy fixes in my own home that helped a lot, but I still had to leave the house to go grocery shopping, run errands, visit family and friends at their homes, and eat out at restaurants. Not everyplace I went kept their thermostat at 55 degrees like my house, so I had to find ways to adapt to their climates. Dressing in layers helped. That way I could be covered up in a sweater if I was cold, or I could minimize my outfit to a t-shirt if I was hot. If my body temperature went up and down I could keep switching back and forth between layers to make sure I was comfortable. I also made sure I constantly carried a big bottle of cold water with me- ice cubes included. Sipping on the cold water in a warm store refreshed me enough until I could finish my shopping and get back to the car, not to mention keep me nice and hydrated. When you're hot throughout your pregnancy you sweat, and sweating can leave you dehydrated and that's not healthy for you or the baby. Lastly something I carried in my purse with me at all times was a little battery operated handheld fan that I found at Wal-Mart for around $2. I had originally bought it for my wedding in case it was a hot day and I was getting overheated in my gown but never ended up using it. I found it at one point during my pregnancy and realized what a great idea it would be to keep it with me at all times. When I would be in an extremely hot store or restaurant I became so overheated it was hard for me to breathe because the air felt so thick. If I switched on the little fan (Which was not only small but quiet) I found some relief in the cool air blowing on me. I know I've seen little fans that are attached to spray bottles as well, so if you really need to cool down you might want to spend a little time looking for one of those.

I abandoned showers very early on in my pregnancy and switched over to baths. Showering created too much steam; I got too overheated and didn't feel refreshed afterwards. I refused to take a cold shower so a tepid bath did wonders for me. Actually, until the very end of my pregnancy when there was no hope at keeping me cool or comfortable, baths were my cure all for back pain, leg cramps, and any other ache or pain I experienced. The water didn't need to be scorching hot so if I was having a very hot day, a luke-warm bath did the trick perfectly. Also taking numerous baths a day was a big help. In between them I would constantly sweat and feel clammy and gross, so not only did the bath make me feel cleaner and fresher, but it also cooled me off for a bit. Resting a cold washcloth on my forehead or chest also helped cool me down and kept me feeling fresh throughout the day.

Beating the heat of pregnancy is tough because while internally you feel hot like a heat wave, your outer-self like your feet, hands and skin can feel cool to the touch. Pay attention to your entire body and make sure you are adequately taking care of yourself. You can find ways to keep yourself cool when you're suffering and keep the other areas of your body warm that may feel slightly chilled. With the feeling of being hot may come some swelling so make sure you keep an eye open for that and mention any swelling to your Dr. Excessive sweating or hot flashes could indicate your blood pressure is going up and that can be a sign of bigger issues you'll want to address. The good news is that while pregnancy may feel like an eternity, once it's all over, your body will start to go back to normal within a few weeks. You can start dressing according to seasons again, and you will feel like your old self once again. Not to mention you'll now have a lovely little baby as a reward for all those months of suffering.

How to get enough nutrition During Pregnancy for Vegetarians

Many pregnant women who eat a vegetarian diet worry that they're not getting enough protein
Somer says it's actually pretty easy to fulfill your protein needs just by drinking cow's milk or soy milk. Other good vegetarian sources include whole grains, beans, cheese, tofu, and yogurt.
Of bigger concern, she says, are omega-3 fatty acids (which play an important role in your baby's brain and vision development), zinc, iron, vitamin B12, vitamin D, folate, and calcium. Most of these essentials are easy enough to find in vegetarian foods (and even vegan foods, which contain no animal products at all, not even eggs or milk). Omega-3s may be an exception, though.

Types of vegetarians
Vegan -- This diet includes fruits, vegetables, beans, grains, seeds, and nuts. All animal sources of protein — including meat, poultry, fish, eggs, milk, cheese, and other dairy products — are excluded from the diet.
Lactovegetarian -- This diet includes dairy products in addition to the foods listed above in the vegan diet. Meat, poultry, fish, and eggs are excluded from the diet.
Lacto-ovovegetarian -- This diet includes dairy products and eggs in addition to the foods listed above in the vegan diet. Meat, poultry, and fish are excluded from the diet.
Pescatarian -- This diet includes dairy products and eggs in addition to the foods listed above in the vegan diet. Meat and poultry are excluded from the diet, but fish is permitted, focusing on the fattier omega-3 rich varieties.

Vegetarian nutrition
Your baby can receive the nutrition needed to grow and develop while you follow a vegetarian meal plan. During pregnancy, it is important to choose a variety of foods that provide enough protein and calories for you and your baby. Depending on the type of vegetarian meal plan you follow, you might need to adjust your eating habits. Follow the guidelines below for healthy vegetarian eating during pregnancy.

Goals for healthy eating
During pregnancy, you don't need extra calories for the first 3 months. During the last six months, normal weight women need an extra 300 calories from nutrient-rich foods to help your baby grow.

Eat a variety of foods to get all the nutrients you need. The "Vegetarian Foods to Choose" chart below provides the number of servings to eat from each food group every day. If you do not eat meat, poultry, fish, eggs, or dairy products, you will need to include other sources of protein in your daily diet. Other protein sources include nuts, peanut butter, legumes, soy products, quinoa, and tofu.

Choose foods high in starch and fiber such as whole-grain breads, cereals, pasta, rice, fruits, and vegetables.

Eat and drink at least four servings of calcium-rich foods a day to help ensure that you are getting 1200 mg. of calcium in your daily diet. Sources of calcium include dairy products, seafood, leafy green vegetables, dried beans or peas, and tofu.

Vitamin D will help your body use calcium. Adequate amounts of vitamin D can be obtained through exposure to the sun and in fortified milk, eggs, and fish. Vegans should receive 10 to 15 minutes of direct sunlight to the hands, face, or arms three times per week or take a supplement as prescribed by their health care providers.

Eat at least three servings of iron-rich foods per day to ensure you are getting 27 mg. of iron in your daily diet. Sources of iron include enriched grain products (rice), eggs, leafy green vegetables, broccoli, Brussels sprouts, sweet potatoes, dried beans and peas, raisins, prunes, and peanuts.

Choose at least one source of vitamin C every day. Sources of vitamin C include oranges, grapefruits, strawberries, honeydew, broccoli, cauliflower, Brussels sprouts, green peppers, tomatoes, and mustard greens.

Choose at least one source of folic acid every day. Sources of folic acid include dark, green, leafy vegetables, and legumes such as lima beans, black beans, black-eyed peas, and chickpeas.

Choose at least one source of vitamin A every other day. Sources of vitamin A include carrots, pumpkins, sweet potatoes, spinach, squash, turnip greens, beet greens, apricots, and cantaloupe.

Choose at least one source of vitamin B 12 a day. Vitamin B 12 is found in animal products including fish and shellfish, eggs, and dairy products. Vegans are at risk of not consuming enough vitamin B 12. Your health care provider might recommend a vitamin B 12 supplement.

Avoid alcohol during pregnancy. Alcohol has been linked to premature delivery and low birth weight babies. If you think you might have a problem with alcohol use, please talk to your health care provider so he or she can help protect you and your baby.

Limit caffeine to no more than 300 mg. per day (two 5-ounce cups of coffee, three 5-ounce cups of tea, or two 12-ounce glasses of caffeinated soda). Remember, chocolate contains caffeine -- the amount of caffeine in a chocolate bar is equal to 1/4 cup of coffee.

The use of non-nutritive or artificial sweeteners approved by the Food and Drug Administration (FDA) is acceptable during pregnancy. These FDA-approved sweeteners include aspartame and acesulfame-K. The use of saccharin is strongly discouraged during pregnancy because it can cross the placenta and might remain in fetal tissues. Talk with your health care provider about how much non-nutritive sweetener is acceptable during pregnancy.

Limit salty foods -- Salt causes your body to retain water. Although there is no documented risk to mother or baby, you might want to limit extra salty foods to avoid feeling overly bloated. Do not restrict salt unless prescribed by your health care provider.

Decrease the total amount of fat you eat to 30 percent or less of your total daily calories. For a person eating 2000 calories a day, this would be 65 grams of fat or less per day.

Limit cholesterol intake to 300 milligrams (mg) or less per day.

DO NOT DIET or try to lose weight during pregnancy. -- Both you and your baby need the proper nutrients in order to be healthy. Keep in mind that you will lose some weight the first week your baby is born.