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your pregnancy diary

Health Tips

Prenatal Screening

Month-by-Month Diary

Birth Plan

Preface
Every child deserves a healthy 

and all others who use our products and

start in life. For almost a decade, the

services, JJPI was established in 1998.

Johnson & Johnson Pediatric Institute,

Its mission is to save babies lives and

L.L.C. (JJPI) has been devoted to

contribute to a healthy environment 

improving the lives of children and

for children.

their families. From their first breaths

Collaborating with worldwide

through their early years, children are

leaders from government, medicine,

challenged to survive and thrive in the

nongovernmental organizations and

world. Every country, every family

industry, JJPI addresses the local needs 

and every child face unique obstacles

of children and their families. With

to the promise of a healthy life. At

our partners, we develop high-impact

the forefront is JJPI continually

educational programs to:

addressing the challenges and priorities

in childrens health.

Ensure mothers have safe and 


healthy pregnancies

A commitment to mothers and

their babies has been at the heart of

Improve care for babies from 


birth through the early years

Johnson & Johnson for over 100 years.

Resources for professionals and parents

Reinforced by the Johnson & Johnson

are a vital part of the Johnson & Johnson

Credo that states, We believe our first

Pediatric Institutes programming. We

responsibility is to the doctors, nurses

hope you find the following educational

and patients, to mothers and fathers

material a valuable resource.

2006, 1998, Johnson & Johnson Pediatric Institute, L.L.C.

your pregnancy diary


Contents

Introduction............................................. 1

Y
 our Personal Details.............................. 3

Prepregnancy Planning........................... 6

Health Tips for Pregnant Women........... 7

Sex During Pregnancy........................... 10

Pregnancy Massage............................... 11

Prenatal Screening................................ 11

Prematurity/Preterm Birth...................... 15

First Trimester....................................... 17

Second Trimester.................................. 31

Third Trimester...................................... 45

Until the Birth...................................... 59

Breastfeeding........................................ 59

The Birth Plan....................................... 61

Checklist for Your Hospital Bag............. 63

Postpartum Plans.................................. 65

Your

Baby............................................. 66

Glossary............................................... 70

Acknowledgement
The Johnson & Johnson Pediatric Institute, L.L.C.
wishes to acknowledge Ann Haberman and
Dr. Jasmin Moshirpur for their contribution and
expertise in making this diary a must have for 
all expectant parents.

your pregnancy diary

f oreword
Congratulations on your pregnancy.

Overall, pregnancy, labor, delivery

The Johnson & Johnson Pediatric

and nurturing of your newborn baby

Institute, L.L.C. is pleased to take you

are the happy events you dreamed

on a guided tour of your pregnancy.

of and hoped for. By consulting

Our hope is that better understanding

with mothers and maternity care

will increase your acceptance and

specialists, we hope this booklet 

tolerance of the many physical,

will be a special information resource

mental and emotional changes

that will meet your expectations. A

that accompany pregnancy. Your

healthy, happy mother and a healthy,

obstetrician and healthcare team

contented baby are the goals for

will undoubtedly answer many of

which we all strive. Best wishes to

your questions, but this booklet will

you, your family and a host of friends

supplement their information, prompt

who wait with eager expectation for

some questions and may eliminate

the glorious event that is to come.

the need for some others. The


events, possible occurrences, tests,
procedures and delivery environment
are briefly reviewed.

Jasmin Moshirpur, MD, FACOG

your pregnancy diary

There are many books, videotapes


and computerized material about
pregnancy and what to expect when
you are expecting. Sometimes the
amount of information can seem a
little overwhelming. To help put this
information in a small, easy-to-use
package, we have gathered the most
important things you may want to
know about pregnancy and put them
into this diary for easy reference.
This diary provides a lot of

introduction

information about pregnancy, but


every pregnancy (and every baby) is
unique. If you have any questions
or concerns, contact your healthcare
professional whenever they arise.
Please do not wait until a time
recommended in this diary.

In the beginning pages of this diary

At the end of this diary, you can

are 2 charts, one on Health Tips for

write down a birth plan that covers

Pregnant Women and another on

your expectations for the actual

Prenatal Screening. The Health Tips

birth of your baby. While plans can

chart discusses nutrition and how

change, this will help organize your

to cope with morning sickness. The

priorities and feelings about the 

Prenatal Screening chart covers many

big day.

of the tests you may be asked to


consider during your pregnancy.
Following this section is a month-

It is important to try to get a


reasonable amount of rest during your
pregnancy. Even half an hours rest

by-month diary with spaces for

a day, just sitting with your feet up,

you to record your weight, any

can make a difference. Although this

sensations you feel, details of your

can be hard to do, especially if you

next appointment and any questions

are working or have a young family

you have. Dont forget to take your

to care for, your new baby and you

diary with you when you go see your

deserve a little rest.

healthcare professional. That way one


of you can write down the answers to
your questions, as well as any other
instructions or advice.

your pregnancy diary

Your Personal Details


Date of last menstrual period:___________________________________________
Expected delivery date: ________________________________________________
If you carry your baby to full term you will be pregnant for about 40 weeks.
However, only 4% of babies arrive on the day they are due. This is mainly
because due dates are calculated as 40 weeks from the first day of your last
period. This is 2 weeks before you ovulated and is still only an estimate. 
A baby may be born 3 weeks before or after this date and still be on time.
Your blood type: ________________ Rh: __________________________________
The fathers blood type: __________ Rh: __________________________________
(If you are Rh minus and the babys father is Rh plus, you will need special
medication to protect your baby at approximately 28 weeks [7 months] and .
after delivery.)
Current medical conditions: ____________________________________________
____________________________________________________________________
____________________________________________________________________
Current medications: __________________________________________________
____________________________________________________________________
____________________________________________________________________
Allergies (include allergies to medicines): _________________________________
____________________________________________________________________
____________________________________________________________________


Number of previous pregnancies: _______________________________________


Complications of previous pregnancies (if any):____________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Person to contact in case of an emergency:_ ______________________________ 
____________________________________________________________________
____________________________________________________________________
Relationship to you: ___________________________________________________
____________________________________________________________________
Phone number (day): __________________________________________________
(evening): _ __________________________________________________________
Pager: _______________________________________________________________
Cellular phone number: _______________________________________________
Person to contact in case of an emergency: _______________________________
____________________________________________________________________
____________________________________________________________________
Relationship to you: ___________________________________________________
____________________________________________________________________
Phone number (day): __________________________________________________
(evening): _ __________________________________________________________
Pager: _______________________________________________________________
Cellular phone number: _______________________________________________


Tests performed:

TESTS

results

TESTS

results

Important people and phone numbers:



Doctor
Midwife
Nurse practitioner
Childbirth educator
Doula (Labor coach)
Hospital
Birthing center
Lactation consultant
Pharmacy
Other important people

NAME

PH. NUMBER

Prepregnancy Planning
Prepregnancy planning is becoming

eat more folate-enriched


foods and/or take folic acid

increasingly important. There are

supplements or vitamins. The

many things you can do to help your

recommended daily intake of

baby develop in a healthy way. Some

folic acid is 400 g (micrograms).

of these are described in the following


section. All of these will also help
you become more physically fit and
healthy too.
If you plan to become pregnant, it
is important to ask your healthcare
professional about rubella (German
measles). If you have never had
German measles or if you were never
immunized against it, you should get
a rubella shot before you become
pregnant. This will help lower the risk
of complications, such as hearing loss,
heart disease or mental retardation,
in your new baby. You cannot be
immunized when you are pregnant.
Before you become pregnant, you
should also:

During Pregnancy
Before and during your pregnancy
it is important to take care of yourself
by eating a well-balanced diet. Your
intake of vitamins and minerals is
important for you and your baby.
Weight gain during pregnancy
is unavoidable and depends upon
your height and weight at the time of
your babys conception, how much
you exercise and your calorie intake
during pregnancy. The average weight
gain during pregnancy is about 25
to 35 pounds or 10 to 16 kilograms.
Your weight gain each week should
be around 3/4 of a pound or about
340 grams.
There are some foods that pregnant

stop smoking

women should avoid. The table on

stop drinking alcoholic beverages

diet recommendations (page 7) 


gives some guidance in these areas,
along with other health tips for
pregnant women.

Health Tips for Pregnant


Women

Eat a well-balanced diet of fruits,


vegetables, whole grains and
increased protein.

Your babys major organs develop


during the first 8 weeks of pregnancy.

You should drink 10 cups 

It is never too soon to take care of

(8 ounces/250 ml each) of liquids

yourself, eat the right foods and avoid

daily, including 3 cups of milk.

substances that can hurt your baby.


n

What foods should you avoid?

It is best to eat a variety of

Raw and slightly cooked eggs,

nutritious foods from different food

because there is a risk of food

groups.

contamination with salmonella

Wash or peel fruits and vegetables

bacteria.

before eating to avoid chemicals.

Your diet should include:

Carbohydrates

Proteins

Iron-Rich Foods

Bread

Milk

Green leafy vegetables

Potatoes

Cheese

Lentils

Rice

Yogurt

Eggs

Pasta

Lean meat

Dried fruit

Oats

Fish

Red meat

Tofu

Some types of fish

Nuts

Soybeans

Vitamin C-Rich Foods Folate-Rich Foods

Zinc-Rich Foods

Citrus fruit

Dark green leafy

Seafood

Tomatoes

vegetables

(especially fresh oysters)

Berries

Fruits

Meat

Cantaloupe

Yeast extract

Whole grains

Nuts

Soy linseed bread

Soft cheeses, such as Camembert,


feta, goat and brie; pat, sliced
meats or chopped chicken; raw
fish and any premade salads
that have been standing for a
while, because there is a risk of
food contamination with listeria
bacteria. This form of food
poisoning sometimes occurs 
with these types of refrigerated
foods.

While you are pregnant it is best 

should be avoided in the first


trimester, because vitamin A is stored

to eat only freshly prepared foods.

by the body and has been linked with

Can you take vitamins?

birth defects.

Most healthcare professionals


recommend a prenatal vitamin for

What is folate?
Folate or folic acid is one of the

the entire pregnancy. Many also

B vitamins. It is very important for

recommend you begin taking a folate

the normal development of a babys

(or folic acid) supplement before

central nervous system. It helps

you become pregnant and continue

protect against neural tube defects,

throughout your pregnancy. Even

such as spina bifida.

with vitamins, a healthy diet is an


important source for most of your
vitamins and minerals.

Why zinc?
Zinc is a mineral that helps the
immune system function properly.

Iron supplementation was once


considered necessary during
pregnancy but is usually no longer
required. Vitamin A supplements

treatments and solvents can have

Before you become pregnant

harmful fumes you may inhale.

Before you become pregnant, and if


possible throughout your pregnancy,

If you are in an area where there

you should avoid:

are fumes, ensure your exposure

X-rays.

Unnecessary medication do

is minimal and keep the area


well-ventilated. You should
also avoid places where strong

not take any medications (even

pesticides or weed killers are

ones you usually take) without

sprayed.

checking with your doctor,


pharmacist or midwife.
n

Heavy alcohol consumption

Tips for morning sickness


n

blood sugar level.

Illicit mood-altering drugs 


such as heroin, marijuana,

go to bed.

Contact with soiled cat litter 


and dog feces. These can infect

carbohydrate meals more

that can cause miscarriage.

frequently. Even simply eating a

Digging in the garden can also

banana will help maintain your

expose you to feces and should

blood sugar level.

be avoided.
Exposure to chemicals it is not
a good time to renovate. Old
paint may contain high levels
of lead. Even new paint, wood

Instead of eating 3 main


meals, try eating smaller, high-

you with toxoplasma bacteria

On the other hand, you could try


having a light snack before you

cocaine, ecstasy.
n

Eat some dry toast BEFORE you


get out of bed. This raises your

none is best.
n

Heavy lifting 20 pounds 


(9 kilograms) or more.

Smoking and second-hand


smoke.

Try reducing the amount of


fat in your diet while you are
experiencing morning sickness.
The amount of whole milk,

cheeses or eggs may affect your


nausea, so try to cut back.
n

Consume solids and liquids at


separate times.

Avoid spicy foods, strong odors,


stuffy rooms and smoky places.

Keep your stomach partially full


all day by snacking on dry crackers
between meals. Ask your mother or
friends what they did for morning
sickness and see if their ideas work 

about having sex during pregnancy,

for you. If you are vomiting frequently

dont hesitate to ask your healthcare

and find it difficult to keep anything

professional.

in your stomach, you should consult

Sexual positions may need to

your healthcare professional. There

change as your body changes. Many

are treatments, such as vitamin B6 

women find that lying on their side

and anti-emetics that your healthcare

is the most comfortable position for

professional may prescribe.

sex later in pregnancy. Fortunately,

Sex During Pregnancy

muscular contractions in the vagina

Many women wonder if it is


safe to have sex during pregnancy.
The answer is almost always yes.

and uterus during orgasm are not


likely to cause problems.
With all the hormonal changes

However, there are circumstances

going on, you may not feel like having

when healthcare professionals may

sex. Your partners libido may also be

advise against sexual intercourse, such

affected. Having a baby is a big life

as when there is vaginal bleeding or

event and affects people in different

when going into early labor is very

ways. The most important thing is to

likely. If you have any questions

talk to one another about how you

10

feel. You may become less focused


on sexual intercourse and enjoy being

Prenatal screening includes all the

intimate in other ways.

scans, tests and checks that are done

Pregnancy Massage

while you are pregnant. Some of

Pregnancy should be a wonderful 


and memorable experience. But it 
can be a demanding time both
physically and emotionally. Pay
attention to your body and take the 
time to care for yourself.
One way to care for yourself is
to receive a massage. Massage is a
wonderful way to relax and become
comfortable with the amazing 
changes in your body. Your partner
can give you a gentle massage with
light strokes and no deep kneading
movements.
The special attention an expectant
mother receives from touch and
massage has important benefits for
herself and her baby. Women who
are treated well while pregnant and
during delivery feel better about
themselves and are closer to their
infants. Massage is not recommended
in the first trimester.

11

Prenatal Screening

these are necessary and others may


be optional during your pregnancy.
Always ask your healthcare
professional if you are not sure
what your test results mean. Please
remember that no currently used test
can guarantee a healthy baby.
Blood tests
Blood will be taken for a number
of reasons. A blood work-up will be
performed that tells your doctor about
your blood type, the number of red
and white blood cells and several
other blood-related items.

Your blood will be tested to see if

important because they may reveal

you are immune to rubella (German

the presence of infection, protein or

measles). If you are not immune, you

sugar in your urine. Protein in your

will be advised to avoid contact with

urine may be a sign of pre-eclampsia,

people (mostly children) who may

and sugar may be a sign of gestational

have German measles.

diabetes.

Your blood will be tested for


hepatitis B, gonorrhea, syphilis

Pap smear
All women between the ages of

and often hepatitis C. All of these

20 and 70 should have a Pap smear

infections affect your health and may

every 1 to 2 years, depending on their

affect your babys health even after

history. A Pap smear is a screening

birth. Testing for HIV antibodies

test for cervical cancer. It is a

may be an optional test; this may be

relatively quick procedure that is not

valuable if treatment is available to

painful but may be uncomfortable. In

prevent transmission to the baby for

a Pap smear, your cervix is examined

women with HIV.

and a small sample of cells is taken.

Blood pressure

This sample is tested for the presence

Your blood pressure will be taken

of pre-cancerous cells. You may

each time you visit your clinic or

also request that your doctor test for

doctor. An increasing blood pressure

bacterial infections, such as gonorrhea

may be a sign of pre-eclampsia, a

or chlamydia, during your Pap smear.

dangerous condition for both pregnant


mothers and their unborn infants.
Urine test
Urine tests are done routinely
at each visit with your healthcare
professional. A urine test may be
performed to confirm an at-home

If you are due for your regular Pap


smear when you become pregnant,
your healthcare professional will
perform one at your first prenatal
visit. Check with your healthcare
professional to see if you need to 
have one.

pregnancy test. Urine samples are


12

First trimester screening

This test, usually done at 12 weeks of

CVS (chorionic villi sampling)

pregnancy, involves 2 parts: the first

The chorionic villi are a part of the


placenta made by the growing fetus

clear area behind the fetal neck and

that look like small roots or fingers.

the second is a sample of your blood

They are important in the exchange 

to measure 2 proteins: free beta human

of nutrients between the mothers 

chorionic gonadotropin (BhCG) and

body and her unborn baby. A sample

pregnancy-associated plasma protein

of villi can provide information

A (PAPP-A). This test will tell you if

about your babys genetic make-up

you are at risk for carrying a baby with

and can diagnose cystic fibrosis,

Down syndrome or other chromosome

muscular dystrophy, hemophilia and

abnormalities.

other genetic conditions. This test

Second trimester screening

is usually done between 9 and 12


weeks of pregnancy. It involves taking
a villi sample with a needle through
either your vagina or abdomen.
Many people prefer CVS because
it can provide answers sooner than
amniocentesis, which is usually done
at week 16 or 17 of pregnancy.
There are risks associated with this

Quad test (maternal serum


alpha-fetoprotein screening [MSAFP])
The quad test is a blood test
performed at 16 to 18 weeks of
pregnancy. This is a screening test to
detect if you are at a higher risk than
other women your age of carrying a
fetus with chromosomal abnormalities
or open neural tube defects. The test

procedure discuss them with your

measures the levels of 4 hormones

healthcare professional.

produced by the fetus and passed

Nuchal translucency
This first trimester screening
test may provide you with useful
information early in your pregnancy
without risking loss of pregnancy.
13

is an ultrasound measurement of the

into your blood. The hormones are


alpha-fetoprotein (AFP), estriol, human
chorionic gonadotropin (hCG) and
inhibin A. High levels of AFP can
indicate a defect in the nervous system

such as spina bifida. Abnormally low

can also provide useful information if

levels of AFP and estriol together with

bleeding occurs or if your doctor 

high levels of hCG suggest an increased

suspects a miscarriage.

risk of Down syndrome.


The results of this test are not

Ultrasound is helpful in checking


pregnancy in a different way. A trained

conclusive and there have been many

technician should do a basic ultrasound

cases of false positives. Your healthcare

examination. This will help to find out

professional will perform additional

the age of the fetus. The ultrasound will

tests to follow up any abnormal results.

also let your doctor see if there are any

Ultrasound
Using sound waves, ultrasound
enables your healthcare professional
to see your baby before birth.
Ultrasound is not painful and is
perfectly safe for your unborn child.
It is a fairly routine procedure and is
usually performed at 18 to 20 weeks of
your pregnancy to allow your doctor
to check on your babys development,
confirm your due date and possibly

problems with the fetus. Problems can


be found as early as 16 to 18 weeks into
the pregnancy. Pregnant women may
have several sonograms to check fetal
growth, to see if there is more than one
fetus, as a guide during amniocentesis
(a test your doctor may recommend to
check the genetics of the fetus), to locate
the placenta if there is vaginal bleeding
during pregnancy and to see how the
fetus is positioned.

determine the sex of your baby.


Ultrasound can also be done closer
to birth to determine where the baby
is lying and how the birth should be
managed. For example, it can indicate
that the placenta is lying in the lower
part of the uterus and that a cesarean

For some women pregnancy may be


difficult. Their age, their family medical
history or a concern about genetic defects
in their baby may mean undergoing more
invasive tests to ascertain the health status
of their baby. If you are considering (or
have been asked to consider) any of these
types of tests, you should discuss seriously
with your partner what you would do if .
the tests came back abnormal.

may be needed. An ultrasound

14

Amniocentesis
When recommended, amniocentesis

have blood drawn either 2 or more

is performed at 16 or 17 weeks of

hours after a meal, or 1 hour after

pregnancy. It can determine the

drinking a special very sweet liquid

babys sex as well as chromosome

called Glucola. If the initial screening

abnormalities which might indicate

test is positive, then a 3-hour glucose

problems such as Down syndrome and

challenge test is necessary to diagnose

spina bifida. Women over 35 are often

gestational diabetes.

encouraged to have this test because

Prematurity/Preterm Birth

they have an increased risk for having


infants with Down syndrome. There is a
risk of miscarriage with this procedure.
During the procedure, ultrasound

A premature or preterm infant is


an infant who is born prior to the
completion of 37 weeks gestation.
Among the risk factors associated with

is used to help guide a long needle

premature or preterm birth, maternal

through the abdominal wall and into

history of previously delivering a

the uterus. A sample of amniotic fluid

premature baby is the single most

containing some fetal cells is obtained

important risk factor. Other risk

with a syringe. The cells are then grown

factors include smoking, vaginal

in a laboratory and examined.

bleeding in more than one trimester

Third trimester screening

and, in some studies, excessively

Glucose tolerance test


This test is performed at 26 to 28
weeks of pregnancy and is used to
determine whether or not you have
gestational diabetes. Gestational
diabetes affects 2% to 3% of women,
including mothers with a strong family
history of diabetes and older mothers
having a greater risk.
15

The initial test requires that you

physically stressful jobs with long


periods of standing. Warning signs
of preterm labor may include regular
and painful uterine contractions
more than 5 in an hour, vaginal
bleeding and leaking of amniotic
fluid. If you experience any of these
symptoms, you should call your
doctor immediately. Your healthcare

professional has ways to monitor and

baby will spend time in the neonatal

treat preterm labor. In the event that

intensive care unit at your hospital.

you deliver a preterm infant, your

16

17

18

Most women do not


even realize that they are
pregnant at this stage.

Within 2 to 3 hours of fertilization the egg divides into 2 cells. In 3 days it will
split into 32 cells, and by the end of the fifth day it will have become 90 cells. The
cells travel as a cluster down the fallopian tubes towards your uterus. A week after
fertilization the cluster of cells has embedded itself into the lining of your uterus.
Weight:______________________ Blood Pressure:___________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________
New sensations Ive experienced (date and description):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Discomforts Ive experienced (date and description):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
19

Appointments date/time:_ ______________________________________________


____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
This question and answer section is included with each month. Many women have
questions about diet, exercise, sex, weight gain, permissible activities, discomforts,
medications, travel, nursing, labor and delivery. Dont be shy to ask.
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Answers: ____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
20

The 1st Month

Week 3 (Week 1 from conception)

Week 4*

Babys
Development

The ovum becomes 


fertilized, divides and 
burrows into the uterus.

The embryo (ectoderm, endoderm,


mesoderm) is formed. These 3
primitive cell layers 
will generate 
every organ and 
tissue in your 
babys body.

maternal
Events

Ovaries increase production of


pregnancy-maintaining hormone,
progesterone.

First missed period. If you suspect


that you are pregnant, contact your
healthcare professional. He/she will
let you know when to schedule
your first appointment.

common
Discomforts

remedies

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

* By convention, doctors call this week 4 weeks because they determine the date from the last normal menstrual period.
21

Week 5

Week 6

The first body segments appear, which


will eventually form the primitive
spine, brain and spinal cord.

Heart, blood circulation and digestive tract take


shape. The embryo is now about 3/8 inch 
(0.5 cm) long; the head is one-third of its 
total length.

Placenta grows to cover onefifteenth of the uterine interior.


Breasts may feel tender.

Morning sickness occurs 


because increased hormone
activity slows down your 
digestive system, apparently
to enhance the absorption of
nutrients for your baby.

Fatigue is thought to be caused by a change in the


ovarian hormones.

Eat a few dry crackers before


getting up in the morning.
Frequent, small, low-fat
meals during the day should
also help.

Exercise regularly and get plenty of sleep


with frequent naps during the day.

22

It is during this month that


most women start to suspect
they may be pregnant.

By 3 to 5 weeks after conception a pregnancy test will show positive. 


The pregnancy is usually indicated by a urine test that can be done at home 
and confirmed with a blood test carried out by your healthcare professional.
By the second month you will be noticing changes to your body as outlined on
the following pages. You may have already noticed that you are less sensitive to the
cold and that you are off coffee and tea.
Weight:______________________
Weight gain since 1st month:_ __________________________________________
Blood Pressure:_______________________________________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________
New sensations Ive experienced (date and description):
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
23

Discomforts Ive experienced (date and description):


____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Appointments date/time:_ ______________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Answers: ____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
24

The 2nd Month

Week 7

Week 8

Babys
Development

The heart starts to pump blood; 


limb buds appear. Major divisions of
the brain can now
be discerned.

Eyes begin to take shape; external 


ears develop from skin folds.

maternal
Events

Exchange of nutrients and waste matter


begins through the placenta the 2
circulations are completely separate.

Your first prenatal appointment 


with a healthcare professional 
should be around your 8th week 
of pregnancy.

common
Discomforts

Urinary frequency may be 


increased as the bladder is 
compressed against your pelvic 
bones, reducing its capacity.

remedies

You can decrease pressure on 


the bladder at night by sleeping 
on your side.

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

25

Week 9
Development is proceeding rapidly. 
The face is now complete with eyes,
nose, lips and tongue
even primitive milk teeth. 
Tiny bones and muscles 
appear beneath the 
thin skin.

Week 10
Once the organs are formed the baby is 
called a fetus. Weighing around 5/100 ounce 
or 1.5 gm and about 1 inch
or 2.5 cm long, its tiny
heart is beating at about
100 beats a minute.

The placenta now covers about one-third of the


uterus lining.

Breast heaviness / feeling


flushed / reddened palms due 
to an increase in blood supply.

Constipation as a result of the increase of


progesterone in your system. This hormone
softens muscles in your womb and intestine to
accommodate the embryo becoming a fetus.

Rest.

Increase the amount of fiber in your diet.


Increase fluid consumption to ten 8-ounce 
(250 ml) glasses daily.
If a chorionic villi sampling test (page 13) is
recommended it will take place this month.

26

If you havent seen your


healthcare professional by
your 12th week of pregnancy,
then now is the time.
During a normal pregnancy from this time on, most women see their healthcare
professional once a month until 28 weeks and then every 2 weeks until 36 weeks.
The visits then become weekly until birth.
You need to increase your intake of protein, vitamins and minerals from 
12 weeks on to support the growth of the baby.
At this stage of the pregnancy you will need to start thinking about the type
of care you want while you are pregnant and for the birth. There are a number
of options including hospitals or birthing centers. Home birth is also an option
for some people. Your healthcare professional will be able to help you with any
information required or provide you with contacts for the option you prefer.
Weight:______________________
Weight gain since 1st month:___________________________________________
Blood Pressure:_______________________________________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________

27

New sensations Ive experienced (date and description):


____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Discomforts Ive experienced (date and description):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Appointments date/time:_ ______________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Answers: ____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

28

The 3rd Month

Week 11

Week 12

Babys
Development

Genitals are now well defined.


Eyelids finish forming and seal shut.

The fetus assumes a more 


human shape, as the lower 
body rapidly develops. 
Blood and bone cells 
form. The first 
movements begin.

maternal
Events

Maternal blood volume has increased by


30% to 40%.

The sensation of these first 


movements has been described 
by some women as if something 
were blowing bubbles through a 
straw in their stomachs. Many 
mothers do not feel any 
movement yet.

common
Discomforts

Sleeplessness may result from 


the discomfort or anxieties of
pregnancy.

remedies

A glass of warm milk before bed 


can work wonders. Its also good 
for your baby!

expected
procedures/
tests

Schedule an ultrasound for the 


18th week to confirm the due 
date and check on your babys
development.

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

29

Week 13

Week 14

Organs begin to function. 


The pancreas is producing insulin;
the kidneys are
producing urine.

The lungs have taken shape; primitive breathing


motions begin. The swallowing reflex has been
mastered as the fetus sucks its 
thumb while floating weightlessly 
in the amniotic fluid. 
The fetus will weigh about 
2/10 ounce or 6 gms and 
measure about 1.5 inches or 4 cm.

2 to 3 lbs or 1 to 1.5 kg weight


gain over the past month on
average 3/4 lb or 340 gm a week.

The placenta has reached complete functional


maturity, acting as your babys lungs, kidneys, liver,
digestive and immune system.

Gum problems may result from an


increase in blood flow.

Possible increase in perspiration.

Visit your dentist now remember


to tell him you are pregnant.

Blood tests; Pap smear to check for


the presence of precancerous cells
or infections which could harm
you or your baby.

30

31

32

If youve been having morning


sickness its more than likely 
to end this month.
You will start to feel better and healthier. It will be more visibly obvious that
you are pregnant now.
Weight:______________________
Weight gain since 1st month:___________________________________________
Blood Pressure:_______________________________________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________
New sensations Ive experienced (date and description):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Discomforts Ive experienced (date and description):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
33

Appointments date/time:_ ______________________________________________


____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Answers: ____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
34

The 4th Month

Week 15

Week 16

Babys
Development

The musculoskeletal system has


matured. The nervous
system begins to
exercise some control
over the body, blood
vessels rapidly develop.

maternal
Events

Pregnancy becoming more visibly


evident. You may develop linea 
nigra, a dark line down the center 
of your abdomen. This line will take 
up to 6 months to fade after delivery.

common
Discomforts

Vaginal secretions are the result 


of an increased supply of blood 
and glucose to the vaginal mucosa.

remedies

If you are experiencing severe 


itching/irritation, an infection 
may be present. See your doctor.

expected
procedures/
tests

Urine test to check for the


presence of proteins and sugars
which can indicate diabetes.

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

35

Week 17

Week 18

With hands ready to grasp, the fetus,


now weighing about 
7 ounces or 200 gm, kicks 
against the amniotic sac. 
You will not feel this 
movement, however.

All organs and structures have been formed and a


period of simple growth begins. The fetus is now
about 6 inches or 16 cm long and
is developing bones.

2 to 3 lbs or 1 to 1.5 kg weight gain


over the past month on average 3/4 lb
or 340 gm a week.

The fetal heartbeat can now be heard with a


fetoscope. Placenta begins producing the fetal
estrogen. Some feel the baby move for the first time.

Massage is a wonderful way to relax and


become comfortable with the amazing
changes happening to your body.
Vaginal secretions are likely to
continue.

Headaches may occur while your body becomes


adjusted to changes in blood volume and vascular
tone. Stress/emotional tension may also be a
contributing factor.

The use of panty liners is recommended


from now until the end of your pregnancy.

Change body positions slowly. Resting with a 


damp cloth on the forehead helps some women.
Drinking milk and/or eating a small snack can also
provide relief.

The quad screen and amniocentesis may 


be performed during the 16th to 18th
weeks, if needed (pages 13 and 15).

36

If this is your first baby, you


may feel it moving now.
This movement is called Quickening. If this is not your first baby, you will
probably have been feeling your babys kicks for a few weeks.
Weight: _____________________
Weight gain since 1st month: ___________________________________________
Blood Pressure:_______________________________________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________
New sensations Ive experienced (date and description):
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Discomforts Ive experienced (date and description):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
37

Appointments date/time:_ ______________________________________________


____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Answers:_____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
38

The 5th Month

Week 19

Babys
Development

maternal
Events

Week 20
An oily coating develops to protect 
the fetus. Fine hair
covers the body and 
keeps the oil 
on the skin.

If you have not signed up for childbirth


classes, now is a good time to schedule
them. The classes begin around month 7
but often fill quickly.

common
Discomforts

Faintness or dizziness when 


standing suddenly. This is caused 
by reduced blood flow to the brain 
as your body adjusts to new 
circulatory patterns. You may also 
feel a little short of breath.

remedies

Try to sit down with your feet up


whenever possible; rise slowly 
and support yourself. Gentle exercise
such as walking, cycling, or swimming
are very helpful in stimulating your 
blood flow. Remember, your heartbeat 
should not exceed 140 beats a minute.

expected
procedures/
tests

Ultrasound this usually takes 


place in the 18th to 20th weeks 
(page 14).

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

39

Week 21

Week 22

Eyebrows, eyelashes and head hair


develop.

The fetus is now following a regular


schedule of sleeping, turning,
sucking and kicking and has
settled upon a favorite position 
with the uterus.

Breasts may begin secreting


colostrum in preparation for nursing.

The placenta reaches its largest size relative to


the fetus, covering one-half of the uterine lining.
There are 13 ounces or 40 ml of fluid now
present in the amniotic sac.

2 to 3 lb or 1 to 1.5 kg weight gain


over the past month on average 
3/4 lb or 340 gm a week.
Varicose veins are often the result 
of rising blood pressure in the lower
extremities. This is caused by the
enlarged uterus interfering with blood
flow between the legs and the heart.

Allergies, such as hay fever, are a common


problem for some people.

n When you sit down, rest your legs on

Air conditioning (with a clean filter) often helps.


There are also pollen masks you can wear to
screen out allergens.

a footstool with your feet elevated.


n Avoid pressure on lower thighs.
n Try not to cross your legs.
nS
 upport or compression stockings
may help.

You should sleep on your left side until


the baby is born. This helps provide an
adequate blood supply for the fetus.

40

Your tummy is growing, it


is easy to see that you are
pregnant now.
As a lot of your clothes wont fit anymore, you may need to consider maternity
wear. You will probably have more energy now than you had in the past few
months.
It is a good time to look further into the different options for the birth of your
baby. Begin to draw up your own birth plan in the space provided at the end of
this diary discuss this plan with your healthcare professional.
Weight:______________________
Weight gain since 1st month: ___________________________________________
Blood Pressure:_______________________________________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________
New sensations Ive experienced (date and description):
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
41

Discomforts Ive experienced (date and description):


____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Appointments date/time:_ ______________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Answers:_____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
42

The 6th Month

Week 23

Week 24

Babys
Development

The skeleton is developing rapidly 


as the bone-forming cells increase 
their activity.

maternal
Events

Skin changes such as darkened


nipples, stretch marks, splotches 
on cheeks and forehead, acne,
redness on palms of hands and 
soles of feet are mainly due to 
increased hormone levels in 
your blood.

common
Discomforts

Swollen feet are extremely common,


especially as pregnancy progresses. 
This is primarily due to increased plasma
blood volumes that naturally occur with
pregnancy. Swelling is typically worse in
the evening, after a long day of standing.

Dizziness is more common during


your first trimester, but it may 
occur at any time during your
pregnancy. Feeling dizzy is due
to rapid changes in your blood
pressure, especially going from a
lying down to an upright position.

remedies

You can minimize swelling by elevating


your feet, wearing compression
stockings and limiting your sodium 
(or salt) intake.

This is a normal occurrence and


can be avoided by plenty of
hydration and moving slowly 
from lying to standing positions.

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

43

Week 25
Eyelids begin to open and close.

Week 26
The fetus now weighs about 27 ounces
or 765 gm.

2 to 3 lb or 1 to 1.5 kg weight gain


over the past month on average 
3/4 lb or 340 gm a weeks.

The placenta becomes thicker rather


than wider. You will now be able to
sense when your baby is awake.

You may have trouble sleeping and


have vivid dreams.

Nosebleeds can sometimes occur


because of increased blood volume
and nasal congestion.

Apply a little petroleum jelly in each


nostril; a humidifier may also help. 
Do not irritate the nasal mucosa.

44

45
45

46
46

Your baby will be growing


quite rapidly at this stage.

You may have what is commonly referred to as the nesting instinct. This is
a description for preparing yourself, your family and your home for the arrival of
your baby. Remember that babies do sometimes arrive early, so it is a good idea
to have a bag packed and ready from this time onwards. To help you, we have a
checklist at the back of this booklet.
You should start childbirth education classes in the seventh month. Check with
your hospital about scheduling a tour of the labor and delivery unit. You should
also check to see how much your baby is moving on a daily basis. Choose a time
in the day when your baby is most active and count each movement of the baby.
If the baby does not move 10 times in an hour, call your healthcare professional.
Weight:______________________
Weight gain since 1st month: ___________________________________________
Blood Pressure:_______________________________________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________
New sensations Ive experienced (date and description):
_______________________________________________________________________
_______________________________________________________________________
47

Discomforts Ive experienced (date and description):


____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Appointments date/time:_ ______________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Answers:_____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
48

The 7th Month

Week 27

Babys
Development

To a certain extent, the baby can 


now breathe, swallow, and regulate 
its body temperature, but still 
depends greatly upon maternal support.

maternal
Events

You may experience Braxton Hicks


(rehearsal/mock) contractions which
are not painful but the abdomen 
may feel quite hard at these times.

Week 28

common
Discomforts

Leg and muscle cramps may be


caused by fatigue, by pressure
exerted on the nerves by the uterus
or by too little calcium or too much
phosphorous in your diet.

remedies

Exercise regularly, especially walking.


Elevate legs and flex toes when
resting. Increase your hydration,
especially with milk, sport-aid
beverages and water. Get plenty 
of sunshine.

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

49

Week 29

Week 30

A substance called surfactant forms


in the lungs, so they can function
independently at birth.

Your baby is now two-thirds of its birth size.


Your babys skin is changing from being 
quite transparent to opaque. It is very 
wrinkled.

Respiratory movements can be


detected by ultrasound. You may feel
your babys breathing as hiccups.

The volume of amniotic fluid decreases to make


room for the growing fetus.

2 to 3 lb or 1 to 1.5 kg weight gain


over the past month on average 
3/4 lb or 340 gm a week.

Heartburn often occurs as the stomach emptying


time is delayed, causing a burning sensation in
the throat.

Drink milk between small, frequent meals. 


This problem will disappear soon after your
babys birth.

50

You are nearly there!


By this month, you can actually see the baby move from the outside. Sometimes
you can even tell if a little foot or elbow is pushing outward. You may feel that
your baby is crowding your internal organs and even making it difficult to breathe.
Your baby is growing substantially at this stage, gaining about one-half pound 
(0.2 kg) per week. Some babies dont change position to have their head down
until 36 weeks and even then, 3% of babies are born in the breech, meaning feet
first, position. You should continue to check daily for the babys movements.
Weight:______________________
Weight gain since 1st month: ___________________________________________
Blood Pressure:_______________________________________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________
New sensations Ive experienced (date and description):
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Discomforts Ive experienced (date and description):
_______________________________________________________________________
_______________________________________________________________________
51

Appointments date/time:_ ______________________________________________


____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Fundal height:________________________________________________________
Presentation & position:________________________________________________
____________________________________________________________________
Estimated due date:____________________________________________________
Babys approximate weight (if you had a sonogram):________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Answers: ____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
52

The 8th Month

Week 31

Babys
Development

Fat deposits are building up 


underneath the skin to insulate 
the baby against the abrupt 
changes in temperature at birth.

maternal
Events

Week 32

Your joints and spine are softer 


than usual, so you will need to 
take extra care when moving 
things around. Get someone 
to help where possible. Avoid 
heavy lifting.

common
Discomforts

Swollen ankles may be caused by 


the pressure of the uterus on the 
large veins returning blood to the 
heart, inducing water retention.

remedies

Elevate legs so they are level with


your hips once or twice a day 
for an hour. Sleep on your left side.
Also, compression stockings may
be helpful to reduce the swelling 
in your feet and ankles.

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

53

Week 33

Week 34

The digestive tract and the lungs are


now nearly fully matured. The skin
becomes less red and wrinkled.

The baby has grown to about 14 inches or 36 cm.


The lungs are starting to mature.

The ligaments in your pelvic area


will be loosening and stretching, to
accommodate the baby. This may
result in backache or pelvic pain.
2 to 3 lb or 1 to 1.5 kg weight gain
over the past month on average 
3/4 lb or 340 gm a week.
Constipation is another result of
the decelerated digestive process.
As food moves slowly through your
intestines, more water is extracted,
leaving the stool drier and harder.

Eat food that is high in fiber, such


as fruit, vegetables and cereals
with bran. Drink liquids and
exercise regularly at a comfortable
pace. Strenuous exercise is not
recommended.

Fatigue You may begin to feel tired and


uncomfortable and your sleeping may be disturbed
because of your babys activity.
Hemorrhoids may also develop. These are
congested or swollen veins around your rectum.
They might feel uncomfortable or itchy.

Soaking in a warm bath or sitting on soft pillows


should soothe the symptoms of hemorrhoids.

54

You will probably feel your


babys movements as prods
during this month rather than
as swooping movements.
Your baby now takes up more space and there is less amniotic fluid. Babys
movements will feel different because he has less room to move around.
Your visits to your healthcare professional should now be weekly. Your blood
pressure will be checked, a urine sample taken and your general health and your
babys health will be monitored.
Continue checking fetal movements daily and contact your healthcare
professional immediately if you notice any changes.
Your baby will put on weight as it matures. You may still have to schedule a few
things for your new baby or organize child care for your other children. These
need to be in place before your baby arrives. Try to get as much rest as you can.
Weight:______________________
Weight gain since 1st month: ___________________________________________
Blood Pressure:_______________________________________________________
Urine: Protein________________ Sugar_ ____________ Ketones_______________

55

New sensations Ive experienced (date and description):


_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Discomforts Ive experienced (date and description):
____________________________________________________________________
____________________________________________________________________
Appointments date/time:_ ______________________________________________
____________________________________________________________________
____________________________________________________________________
Fundal height:________________________________________________________
Presentation & position:________________________________________________
____________________________________________________________________
Calculated gestation: __________________________________________________
____________________________________________________________________
Questions for my healthcare professional:_________________________________
____________________________________________________________________
____________________________________________________________________
Answers:_____________________________________________________________
____________________________________________________________________
____________________________________________________________________
Advice/Instructions:____________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

56

The 9th Month

Week 35

Week 36

Babys
Development

Virtually the entire uterus is now occupied


by the baby and its activity is restricted.

Maternal antibodies against measles,


mumps, rubella, whooping cough 
and scarlet fever are transferred to 
the baby, providing protection for
about 6 months until the infants 
own immune system can take over.

maternal
Events

Keep in mind the warning signs of preterm


labor, including regular and painful
uterine contractions (>5 per hour), vaginal
bleeding and leaking amniotic fluid. If
you experience these, contact your doctor
immediately.

The placenta is nearly 4 times as 


thick as it was 20 weeks ago, and
weighs about 20 ounces or 570 gm.

common
Discomforts

Backaches are often caused by 


muscles and ligaments relaxing 
in preparation for the stretching
required in delivery, and also by 
the added off-center weight of the
enlarged uterus.

remedies

Back exercise such as pelvic tilt 


can help strengthen back and 
abdomen muscles. Wear 
comfortable low-heeled shoes 
or flats. Always avoid heavy lifting.

Do not take any medications (even ones you usually take) without checking with your healthcare professional first.

57

Week 37

to term
At birth the average baby weighs about
7 pounds 8 ounces (3.4 kg) and 
is 18-21 inches (51 cm) long.

Preparing for birth, the baby descends


deeper into the mothers pelvis.
3 to 4 lb or 1.3 to 1.8 kg weight gain
over the past month on average 
3/4 lb or 340 gm a week.

Urinary frequency is increased for


the second time in your pregnancy
by the uterus compressing the
bladder against the pelvic bones,
thus reducing its capacity.

In 9 short months, the miracle is complete: you 


have transformed a single, microscopic fertilized 
cell into a six-thousand-billion-celled human being.

Uterine contractions become perceptible as 


the cervix and lower uterine segment prepare 
for labor.

You can decrease pressure on the


bladder at night by sleeping on 
your left side.

58

Until the Birth


You are probably tired of being

ways. The show may appear as

pregnant now. If your baby has

long as a week before the start of

turned head-down, the head will

labor. Your waters may break a few

usually become engaged and your

hours before labor begins. Contact

fundal height will drop to just below

your healthcare professional or the

your rib cage. This will probably help

hospital, and your partner and/or

with your breathing. If this is your

other birthing support person when

first pregnancy, this often happens 1 to

your waters break, so that they

2 weeks before delivery; if you have

know your baby is coming. Your

given birth before, this can happen

contractions may not be regular for a

after labor starts.

number of hours yet. Once they do

If your baby is lying in a breech


position, it may be possible for your
doctor to turn the baby before labor.
If this is not possible, it may mean

become regular at 5 minutes apart for


an hour, you know it is time.

Breastfeeding
As the birth of your baby is

that you will have to prepare for a

imminent, you might need to start

cesarean delivery. Discuss this with

really thinking about the days after

your healthcare professional.

your babys birth. Breastfeeding is

If you are overdue, an ultrasound


may be suggested. Biweekly nonstress
tests or biophysical profiles will be
performed. Sometimes induced 
labor is recommended. The baby 
will be delivered no later than 41 to
42 weeks.

59

Labor may start in a number of

encouraged in most hospitals and

around the world. The World Health


Organization recommends that babies

About the Birth Plan


Birth plans are a good idea even if

should be breastfed exclusively

it all changes at the last moment. By

for about 6 months because it has

thinking through the steps you wish

important benefits for your babys

to take during the birth, you prepare

health.

yourself, your healthcare professional

More and more mothers are


breastfeeding worldwide. Each year,
more studies show that breastfeeding

and your birthing partner(s) for the 


big day.
It is a good idea to talk to your

is important for both women and

healthcare professional about what is

their babies. Human milk helps

best for you and your baby because

babies develop, gives them nutrition

each womans needs and preferences

and keeps them from becoming ill.

are different. Once you have worked

Formula feeding does not do this as

out what options you want to take,

well as breastfeeding does.

share your plan with your healthcare

You should discuss breastfeeding


with your spouse and a healthcare
professional or lactation consultant

professional and discuss it with her


step by step.
Give some thought to whether you

before you give birth. There are many

would like pain relief or a natural

books available on breastfeeding; your

labor and discuss the options with

healthcare professional can guide you

your healthcare professional.

in the right direction. It will also be


helpful to talk to other women who
have breastfed to find out what it was
like for them.

You should find out all you would


like to know about birth by cesarean
delivery, even if you are not expecting
to have one, as sometimes mothers
need to have one unexpectedly.

60

the birth plan


Your name:___________________________________________________________
Name of your healthcare professional:____________________________________
____________________________________________________________________
Expected birth date of your baby:________________________________________

preparation for birth


Childbirth education classes taken:
Hospital tour:

Yes No
Yes No

Books about pregnancy and birth you have found the most helpful:
____________________________________________________________________
____________________________________________________________________
Names of those who will be with you during your labor and birth: partner, 
relative and/or friend. Most hospitals allow your partner and at least one other
birthing partner.
____________________________________________________________________
____________________________________________________________________
Do you wish to have photos taken, have music to listen to, or do you have any
special requests that should be noted?
____________________________________________________________________
____________________________________________________________________
Names of those you wish to contact after your baby is born:
____________________________________________________________________
____________________________________________________________________

61

If all goes as expected Write down anything that is important to you. You may
wish to include your plans for relief of discomfort or positions you might like to 
try for labor or birth.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Contingency plans Write down your thoughts about what you may want done 
if things dont go as expected. For example, if you have a long or difficult labor:
____________________________________________________________________
____________________________________________________________________
n

more pain relief than you anticipated___________________________________

____________________________________________________________________
n

a blood transfusion__________________________________________________

____________________________________________________________________
n

a forceps delivery_ __________________________________________________

____________________________________________________________________
n

an episiotomy_______________________________________________________

____________________________________________________________________
n

a cesarean delivery__________________________________________________

____________________________________________________________________
n

if your baby is born prematurely and needs special care

____________________________________________________________________
____________________________________________________________________
It is valuable to think about these issues ahead of time.

62

Checklist for Your Hospital Bag


Remember that babies do sometimes arrive early, 
so have your bag packed for the hospital. You may 
want to have 2 bags: 1 for labor and 1 for 
your stay in the hospital.
Labor bag

To assist you during labor: baby oil or 


moisturizer for gentle back massage

Relaxation tapes or CDs


Lollipops and/or ice pops to suck on during labor
Camera or video camera (most healthcare facilities 
will not allow you to videotape the actual birth)

Coins for telephone or a telephone card (you may not be able to use 
a cellular telephone in the hospital)

An up-to-date address book with telephone numbers of family and friends
An object to focus your attention on during labor
Postnatal bag

Nursing nightgowns
Robe
2 breastfeeding bras
Nursing pads
Underpants for a week (early discharge from hospital is common in many
hospitals; however, you may need to change underpants frequently or be
required to stay in the hospital longer)

Sanitary napkins
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Slippers or comfortable slip-on shoes


Your own toiletries
Hairbrush and shampoo
Your prenatal record card
Your birth and postnatal plan
Health insurance details
Comfortable clothes to come home in
Newborn diapers
Baby care products
Baby blanket
Baby sleeper or jumpsuit
Baby Onesies or singlets
THIS DIARY which is a record of your pregnancy
Anything else your healthcare professional may advise. 

You can check with the hospital or clinic to find out what they recommend

A newborn car seat when you are ready to go home


Other items to remember:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Try a practice run to the hospital to find the quickest route!

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postpartum plans
Baby care Please write down:
How you wish to feed your baby:________________________________________
____________________________________________________________________
Do you want or need assistance with breastfeeding?
If you have a boy, do you want him to be circumcised?
Is your car equipped with approved infant safety seating?
Have you planned for help at home during your first weeks?

Yes No
Yes No
Yes No
Yes No

What help would you like in the first month and how will you arrange for this
support?_ ____________________________________________________________
____________________________________________________________________
Write down any concerns you would like to discuss about caring for your baby.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Before you leave the hospital, have you filled out the papers needed for your 
babys identification such as birth certificate and Social Security card? 
They take approximately 4-6 weeks to receive by mail.

65

Yes No

your baby

Your babys picture

Babys name:_________________________________________________________
Birthdate:____________________________________________________________
Time:___________________________ Weight:_ _____________________________
Length:_________________________ Head Circumference:___________________
Apgar score: at 1 minute_________________ at 5 minutes___________________
Healthcare professional who assisted in the delivery________________________
Tests baby received:___________________________________________________
____________________________________________________________________
____________________________________________________________________
Medications baby received:_____________________________________________
____________________________________________________________________
66

about the birth

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

67

about the birth

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

68

about the birth

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

69

Glossary of terms used in this diary


Amniocentesis - a long thin needle, guided by ultrasound, is inserted through the
abdominal wall and into the uterus. A sample of amniotic fluid is taken and cells
from the fluid are grown in a laboratory. This test determines the chromosomal
count of the baby and is used to determine whether the fetus has genetic disorders
such as Down syndrome.
Prenatal Screening - routine tests undertaken for a number of reasons during
pregnancy. (See Prenatal Screening section of this diary.)
Blood Pressure - the pressure your blood exerts against all the blood vessels in
your body. If blood pressure becomes very high during pregnancy it needs to be
followed closely and controlled.
Braxton Hicks Contractions - these are contractions that occur late in pregnancy
almost as a rehearsal for the real thing.
Cesarean Delivery - a surgical incision of the walls of the abdomen and uterus
for delivery of an infant.
Chlamydia - a common sexually transmitted disease that can damage a womans
reproductive organs. Although symptoms are often mild, serious complications
including infertility can occur.
CVS (Chorionic Villi Sampling) - a prenatal screening procedure to test for some
abnormalities. It involves taking a small sample of villi cells from an area near the
placenta with a needle.
Down Syndrome - a chromosomal disorder that leads to intellectual impairment.
Testing for this occurs mainly in older women who are pregnant because the older
you are (over 35 years) the more likely you are to have a child with this disorder.
Epidural - an anesthetic given during labor which numbs your spine, usually
from the waist down. It is injected into the spine. This allows you to be awake
during labor without feeling pain.

70

Episiotomy - an incision to your perineum (area between vagina and anus) to


provide more space for the babys head during birth. A local anesthetic is given
into the perineum prior to the incision and is sewn after the birth. It is done to
avoid irregular tearing of your perineum.
Folate - a B group vitamin. A healthy intake of folate can protect against some
birth defects, particularly spina bifida.
Fundal Height - the height of your fundus; that is, the height of the uterus as the
baby develops.
Gestational Diabetes - this type of diabetes occurs while you are pregnant and
results from an increase in your blood sugar level. It does need to be managed but
usually disappears after the birth.
Gonorrhea - a sexually transmitted disease that can be harmful to babies.
Routine tests are carried out at your first visit to see if you have the infection.
Hepatitis B - a form of hepatitis which, although not directly harmful to your
baby during pregnancy, will require your baby being vaccinated postnatally.
Today, all children are vaccinated against hepatitis B.
Hepatitis C - a form of hepatitis that is particularly contagious. In some centers
testing for hepatitis C is routine and in others optional. If you are at risk of this
disease, it is important that you find out early in your pregnancy.
HIV (Human Immunodeficiency Virus) - a virus that affects your immune system.
It can travel across the placenta. If you are at risk for the disease you will be
offered a test early in your pregnancy. Some states require that all mothers be
tested during pregnancy.
Linea Nigra - a dark line that can appear down the middle of your stomach at
about week 14. It will usually fade after the birth.
Listeriosis - a serious form of food poisoning caused by a bacteria found in some
types of refrigerated foods.
Ovum - your unfertilized egg.

71

Pre-eclampsia - a condition that can be quite dangerous for both mother and
baby. It is caused by high blood pressure, protein in your urine and/or lower
extremity edema and, if not managed, may develop into eclampsia or toxemia.
Premature Birth or Prematurity - delivery of an infant before the completion of
37 weeks of gestation.
Protein - is required as a part of your diet and for the development of your baby.
Too much protein in your blood can be an indicator of pre-eclampsia and can be
detected via urine samples.
Quickening - the movements of your baby in the womb.
Swelling - of the ankles and feet is common in pregnancy, particularly in hot
weather. Sudden swelling or excessive swelling can be an indicator of high blood
pressure and you need to notify your healthcare professional.
Syphilis - a sexually transmitted disease that can be harmful to babies. Routine
tests are carried out at your first visit to see if you have the infection.
The Show - the bloody mucous cap of the uterus that may appear as soon as 
1 week before labor.
Toxemia - an abnormal condition of pregnancy characterized by high blood
pressure, swelling and/or protein in the urine. Toxemia of pregnancy is another
term for pre-eclampsia, also called blood poisoning.
Twins - occur in about 1 in 80 pregnancies. Only 1 in 5 sets are identical.
Identical twins are formed when the fertilized egg splits soon after conception.
The babies have the same genetic material. Non-identical twins are the result of 
2 eggs being fertilized by 2 different sperm and implanting in the uterus at the
same time.
Ultrasound - a scan usually used at 18 weeks to determine the development of
the baby and estimate the date of your babys birth.
Vitamins - supplements to your diet. Some may be dangerous for your babys
development, particularly in the first trimester; others are beneficial. See your
healthcare professional for advice.

72

for more information


VISIT www.jjpi.com
to access a full range of educational material that
can be ordered or downloaded to your computer.

pregnancy program: Other Resources

You and Your Body


After Childbirth
A Guide for
New Mothers

Your Wondrous
Journey
CD-ROM

Step-by-Step Cesarean

Birth of a Baby

First Impressions

Miracle of Life

Breast is Best

Teaching Posters
The materials available in our Pregnancy Care
Program provide information for parents, from
conception through the weeks following delivery, 
and for the professionals who care for them. 
This unique program is supported by research that
is reviewed in these materials and translated for
practical application. For downloadable versions,
visit www.JJPI.com.
Pregnancy Massage:
A Step-by-Step Guide
DVD

PP06-B1

www.jjpi.com