This module helps prepare expectant parents for the events that will occur during labor and delivery at UAMS. The course covers the definition of labor; the signs and symptoms of labor; coping with the pain of labor and the physical and emotional changes associated with early, active and transition labor; and the birth of the baby. Relaxation and breathing techniques are introduced during class.

Welcome to UAMS. We are glad you have chosen to have your baby here. Come on in and we will get started.

Hello, we here at UAMS would like to congratulate you on your pregnancy and thank you for choosing us for your delivery. I will be your instructor for this course. We will also meet some other medical staff that will be helping us along the way.

This module helps prepare expectant parents for the events that will occur during labor and delivery at UAMS. The course covers the definition of labor; the signs and symptoms of labor; coping with the pain of labor and the physical and emotional changes associated with early, active and transition labor; and the birth of the baby. Relaxation and breathing techniques are introduced during class.

We will take a look at:

The development of your baby
The varying changes that take place in your body
Proper nutrition for you and your baby
Warning signs that you will need to be aware of
The definition of preterm labor and what takes place during it
and
We will investigate the benefits of Kegel exercises

Now, let's get started. Please click on the topic that you would like to look at first.

When you find out that you are pregnant, it is an exciting and scary time. We are going to make this time a little less scary. Now, let's look at the different changes that are going to happen to you, the mother, along the way. We will break this down by trimester, so that you have an idea what to expect.

In this section, we will look at the trimesters individually and what you can expect during these times. Keep in mind, these are not always the most pleasant of experiences, but it is all worth it. This is not to say that all of the situations discussed will happen to you, but it is always best to be prepared.

First Trimester

During the first trimester, your body goes through many changes. Hormones cause numerous changes to almost every organ system in your body. These changes can present in different forms.

Extreme Tiredness is definitely a possibility. There are times when you will feel completely drained.
Upset stomach, constipation, and the need to urinate more frequently can also occur.
And, yes, there is a tendency to have weird cravings for different foods, and there will also be foods that you will want nothing to do with.
Mood swings can also happen in the first trimester, so be sure and warn those around you.

Other changes you might see include tender, swollen breasts, headaches, heartburn, and weight gain or loss.

Do not be alarmed if any of these happen. It is all part of the process. You might need to adjust your daily routine, sleep patterns, and frequency of meals during this time. These instances should go away as your pregnancy progresses.

2nd Trimester

For most women, the second trimester is easier than the first. The good news is that your nausea and fatigue are most likely beginning to subside. In their place, other changes will begin to take place. Your abdomen will begin to grow as your baby does. And, before the end of the second trimester, you will feel your baby begin to move. To make room for your growing baby, there will be many more changes taking place to your body.

You may experience body aches such as back, abdomen, groin, or thigh pain.
You will also begin to see stretch marks in various places.
There may also be a darkening of the skin on your face and around your nipples.
You might begin to see a dark line that runs down the center of your abdomen as well.

You could also experience numb or tingling hands, itching on the abdomen, palms, and the soles of the feet. Swelling of the ankles, fingers, and face may also occur.
If you have nausea, loss of appetite, vomiting, jaundice, or fatigue associated with itching, call your doctor as this can be a sign of a serious liver problem that needs to be addressed. If the swelling is sudden or extreme, you also need to call your doctor right away. This could be a sign of preeclampsia.

Third Trimester

Welcome to the 3rd trimester. You're almost there. The excitement and anticipation is building. Your baby will soon be here.

In this final trimester, you will find yourself using the bathroom more, and you may experience shortness of breath because the baby is growing and pressing against your organs. The heartburn and swelling will remain as well. Your breasts will be tender and they may leak a watery pre-milk called colostrum. At this point, your belly-button may stick out. You could also develop hemorrhoids.

It is also during this trimester that your baby begins to drop or moves lower in your abdomen. Contractions begin which can be a sign of real or false labor. As you get closer to your due date, your cervix will begin to efface, or thin and soften. This allows your vagina, or birth canal, to open during the birthing process. This progress will be monitored by your doctor with vaginal exams as you near your delivery.

Conclusion

Congratulations! You are nearing the end of your pregnancy. It is a long journey, but one that is definitely worth making. You will have gone through quite a bit at this point. I can assure you. Now, let's take a short quiz to see what we have learned in this section.

In this section, we will take a look at the development of your baby throughout the trimesters.

During your pregnancy, there will be questions about how your baby is developing. This is something all mothers go through. Please click on the computer screen to begin.

Please click on the "Fetal Development" button to see your baby during the first trimester.

First Trimester

Your first trimester is the first 12 weeks of your pregnancy. At four weeks, your child's brain and spinal cord have begun to form. The heart also begins to form, and arm and leg buds appear. At this point, your baby is now an embryo and is 1/25-inch long.

At eight weeks, all of the major organs and external body structures have begun to take shape. Your baby's heart begins to beat with a regular rhythm. The arms and legs grow longer, and fingers and toes have begun to form. The sex organs also begin to form at this stage in the pregnancy. The eyes have moved forward on the face and the eyelids are now present. The umbilical cord is visible. At the end of eight weeks, your baby is a fetus and looks more like a human. Your baby is nearly one inch long and weighs less than 1/8 of an ounce.

At twelve weeks, the nerves and muscles begin to work together. Watch out, because your baby can now make a fist. This is also the earliest possible time to see if you are having a boy or a girl as the external sex organs are apparent. His or her eyelids now close to protect the developing eyes; they will not open again until the 28th week. Head growth has slowed, and he or she is much longer. Now, at about 3 inches long, your baby weighs almost an ounce, which is about the same as a AA battery, to put it in perspective.

Now, let's see what happens to your baby in the Second Trimester.

During the second trimester, we see incredible changes in your baby as he or she develops.

At 16-weeks gestation, muscle tissue and bone continue to form, creating a more complete skeleton. His or her skin begins to take shape; you can almost see through it at this phase in the process. Meconium develops in your baby's intestinal tract - this will be your baby's first bowel movement. Your baby will also to start making sucking motions with the mouth. He or she will now be approximately 4 to 5 inches long and weighs about 3 ounces.

When you reach 20-weeks, your baby will become more active, an you may feel some fluttering. Now, there is a waxy coating called vermix that is there to protect the developing skin. There is also a covering of fine, downy hair called lanugo to help with this. Eyebrows, eyelashes, fingernails, and toenails have formed. He or she can now hear and swallow. You are now halfway through your pregnancy, and your baby is about 6 inches long and weighs about 9 ounces.

At 24-weeks, the bone marrow begins to make blood cells. Taste buds, footprints, fingerprints, and hair will have formed at this point as well. Your baby's lungs have formed, but they do not work yet. You may also begin to feel your baby make sudden movements as the hand and startle reflex develops. He or she will begin to sleep and wake regularly. Unfortunately, this may not coincide with your patterns. If you are having a boy, his testicles begin to descend from the abdomen to the scrotum. If your baby is a girl, her uterus and ovaries are in place, and a lifetime supply of eggs have formed in the ovaries. Your baby has begun to store fat and has gained a substantial amount of weight. Now, at about a foot long, your baby weighs about 1 1/2 pounds.

Congratulations! You have made it to the third trimester. You are now in the homestretch. Only a few more weeks, and you will get to meet your baby. Here is what to expect during this time...

At 32 weeks, your baby's bones are fully formed, but they are still soft. It may also feel like your baby has been taking martial arts classes as the kicks and jabs have become more forceful. The eyes can open and close, and they can also sense changes in the light. "Practice" breathing takes place, yet the lungs are not fully formed. Your baby begins to store vital minerals such as iron and calcium. The lanugo begins to fall off. Your baby is starting to gain weight rapidly (about 1/2 a pound per week). Now, he or she is about 15 to 17 inches long and weighs 4 to 5 pounds.

When your baby reaches 36 weeks, the body fat increases and he or she is getting bigger. This means that there is less room to move around and the movements are less forceful. However, you will still feel the occasional stretches and wiggles. The vernix gets thicker at this time. Your baby is about 16 to 19 inches long and weighs about 6 pounds.

By the end of 37 weeks, your baby is now full-term. Organs can now function on their own. As you get closer to your due date, your baby my move into a head-down position. Most babies present head-down. The average size of a baby at birth can be anywhere from 6 pounds-2 ounces to 9 pounds-2 ounces, and may be 19 to 21 inches long. That is not to say that all babies will fall within this range; healthy babies come in many different sizes.

Now, let's take a short quiz over what we have learned regarding the development of your baby.

During your pregnancy, you will notice many different things about the way you eat. There will be the occasional cravings along with increased hunger. It is important to realize that you are already providing for your baby, and therefore you must choose your food with that in mind. Let's look at some wise, and not so wise, food choices.

Eating healthy is especially important during pregnancy. There is a greater need for foods higher in protein, iron, calcium, and folic acid during this time. You will also need more calories, but it is imperative that these calories are chosen wisely. The foods that you eat are the main source of nutrients for your child.

There are foods that are good for both you and your baby. Making healthy food choices every day will help you give your baby what he or she needs to develop.

There are some foods that it is a good idea to choose often...

·Grains - fortified, cooked, or ready-to-eat cereals; wheat germ
·Vegetables - carrots, sweet potatoes, pumpkin, spinach, cooked greens, winter squash, tomatoes, red pepper
·Fruits - cantaloupe, honeydew melon, mangoes, prunes or prune juice, bananas, apricots, oranges or orange juice, grapefruit, avocado
·Dairy - nonfat or low-fat yogurt; nonfat milk (skim milk); low-fat milk (1 percent milk)
·Meat and Beans - cooked beans and peas; nuts and seeds; lean beef, lamb, and pork; shrimp, clams, oysters, and crab; cod, salmon, polluck, and catfish

You may need to talk to your doctor if you have certain dietary restrictions, such as diabetes, lactose intolerance, you are a vegetarian, or PKU.

Most foods are safe for pregnant women and their babies. That is not to say that being cautious is not necessary. It is important to clean, handle, cook, and chill food properly to prevent foodborne illness, including listeria and toxoplasmosis.

There are definitely some foods that you need to avoid...

·Refrigerated smoked seafood like whitefish, salmon, and mackerel
·Hot dogs or deli meats unless steaming hot
·Refrigerated meat spreads
·Unpasteurized milk or juices
·Store-made salads such as chicken, egg, or tuna salads
·Unpasteurized soft cheeses such as feta, brie, queso fresco, queso blanco, and bleu cheeses
·Fish that have high mercury levels like shark, swordfish, king mackerel, or tile fish
·More than 6 ounces per week of white (albacore) tuna
·Herbs and plants used as medicines without doctor approval
·Raw sprouts of any kind
·Uncooked fish

However, it is safe to eat up to 12 ounces of cooked fish or shellfish per week. These fish must contain little or no mercury. In fact, it is a good idea to eat a variety of cooked seafood.

Keep in mind that alcohol use is passed on to the baby through the umbilical cord. Alcohol can slow the baby's growth, affect his or her brain, and could possibly cause birth defects. Caffeine is ok in moderation, which is less than 200 mg per day.

It is necessary to consume an additional 300 calories a day when you are pregnant. However, it is wise to make sure that these are good calories. Calories come in all shapes and sizes; how you choose is extremely important. Please drag the good calorie items into your lunch bag. Click "Submit" when your bag contains all of the healthy items.

It's time for a quiz over what is necessary for proper nutrition.

There are some warning signs that you should look out for during your pregnancy. We will go over some of these so that you will know what to be aware of and what to do should they arise. If an of these scenarios should present during your pregnancy, it is time to call the doctor.

Some of these signs that you need to look for are:

·vaginal bleeding
·a fever of over 100 degrees Fahrenheit
·pain or burning during urination
·sudden swelling in your face or hands
·problems with your vision
·recurring headaches
·vomiting or diarrhea lasting more than 24 hours
·major change in your baby's movements (moving substantially less)
·sudden pain in your abdominal area

You can never be too careful when it comes to your health and the health of your baby. If, at any point, you ever feel like something is wrong, please call your healthcare provider.

Please take the following short quiz over the warning signs.

Preterm labor is labor that happens too early. This occurs prior to 37 weeks gestation. Preterm labor can lead to preterm delivery, also known as premature birth. Babies born at this stage can experience serious health problems. Nearly half a million babies are born prematurely in the United States. Here is what you need to look for regarding pre-term labor.

You may experience a change or an increase in vaginal discharge.
You may also feel pelvic or lower abdominal pressure, and abdominal cramps
There is also the possibility that you will experience constant, low, dull backache
Another sign is that your water could break either in a trickle or a gush
And, having more than 4 contractions within an hour could be an indication of pre-term labor

If any of these symptoms occur, consult your doctor.

Here are three helpful tips to reducing the risk of preterm labor.

1. Make sure that you go to all of your prenatal appointments. These appointments are crucial in monitoring the progress of you and your baby during your pregnancy.
2. Take proper precautions to prevent infections. This is especially important when it comes to using good dental hygiene.
3. Make a conscious effort to reduce the amount of stress in your life. Added stress can elevate the risk of pre-term labor.

Abiding by these suggestions is imperative during your pregnancy.

Now, let's take a look at what we have learned so far.