My pregnancy Weeks 1 —20 Table of contents The stages of pregnancy 2 Your healthy pregnancy 3 The nurse-midwife difference 4 Normal discomforts in pregnancy 5 Medication use during pregnancy 8 Exercise during pregnancy 9 Nutrition during pregnancy 10 Fish: what pregnant women and parents should know 12 Congratulations on your pregnancy Thank you for trusting UCLA Health with your maternity care. We look forward to supporting you and your family through every step of this exciting journey. It is our goal to provide safe, high-quality care for you, your newborn and your family. Our team of skilled and caring doctors, midwives, nurses and staff is committed to providing you with the best possible birth experience. UCLA Health offers maternity care through a fully integrated BirthPlace program. Our locations include Ronald Reagan UCLA Medical Center and UCLA Medical Center, Santa Monica, both of which feature state-of-the-art, family-centered birthing and neonatal care facilities. UCLA Health offers the most advanced, specialized maternity and pediatric care, 24/7. You will have access to world-class neonatologists (newborn-infant specialists), surgeons, pediatric anesthesiologists, medical intensivists (critical-care physicians) and highly skilled support staff. Most newborns stay in postpartum rooms with their mothers. However, some babies need more advanced care. In these cases, moms remain in their postpartum rooms while their babies are cared for in the neonatal intensive care unit (NICU). Both Ronald Reagan UCLA Medical Center and UCLA Medical Center, Santa Monica have top-quality NICUs. We staff our NICUs with neonatology experts who work closely with your obstetrician or midwife. In most cases, you know in advance at which UCLA location you will deliver your baby. While we anticipate that your baby’s birth will be complication-free, it is important to be prepared if a higher level of care is necessary. If you or your unborn baby needs specialized care, we may transfer you to a different UCLA medical center. If this happens, don’t worry. Be assured that: • Transferring mother and baby between hospitals is in the interest of providing the safest and most optimal care. • You and your family will be partners in your transfer decision. • We will help make the transition as seamless and stress-free as possible for you. This is of utmost importance to us. Your obstetrician or midwife will discuss possibilities like a hospital transfer with you during your prenatal sessions. To simplify any necessary hospital transfers, please complete the enclosed consent admission forms and return them to your obstetrician or midwife’s office at your next appointment. Thank you again for choosing UCLA Health for your maternity care. We are honored to serve you during this important time in your family’s life! Sincerely, Your UCLA Health care team 1 The stages of pregnancy The average pregnancy lasts approximately 40 weeks, as Determining your baby’s timed from the first day of your last menstrual period (LMP). estimated due date Fertilization and implantation do not actually begin until conception. Conception is typically about two weeks after the The day your child is scheduled to be born is called the first day of your LMP, during ovulation. These additional two estimated due date (EDD), and it is determined from the first weeks are added to the beginning of your pregnancy — before day of your LMP. Only about 5 percent of women actually you are technically pregnant. These added weeks explain deliver on their estimated due dates. However, the EDD helps why your pregnancy officially lasts 40 weeks, or 10 months. your health care team establish your baby’s gestational age so The stages of pregnancy are divided into three trimesters. they can monitor and record the baby’s growth during your Each trimester spans approximately three months, or pregnancy. The EDD also serves as a reference point so your 12 to 13 weeks. Each stage is described in terms of weeks. health care provider can create a schedule for required tests For example, a “33 and 2/7 weeks” pregnancy indicates that throughout your pregnancy. the woman is 33 weeks and two days into her pregnancy. If you can’t provide a reliable LMP (which some women can’t, The following outlines the common breakdown: so don’t worry), your provider may use an ultrasound exam • First trimester: 0 – 13 and 6/7 weeks (months 1 – 3) during your first trimester to better determine your baby’s EDD. If you have undergone in vitro fertilization (IVF), a • Second trimester: 14 – 27 and 6/7 weeks (months 4 – 6) fertility procedure for women who need support getting • Third trimester: 28 – 40 and 6/7 weeks (months 7 – 9) pregnant, your provider will use the embryo’s age and date of uterine transference (the date your health care provider transferred your embryo to your uterus) to determine your EDD. 2 Your healthy pregnancy One of your main responsibilities while pregnant is to take good care of your health. Maintaining a healthy lifestyle can help you feel more comfortable as your body changes. Even more important, staying healthy can help reduce the chances of you and your baby developing serious medical problems. Here are some of the most essential health issues to consider before and while you are pregnant. Your provider will guide you through your pregnancy, step by Harmful substances step. It is most important you make and keep all appointments as recommended by your provider. This includes office Do all you can to avoid exposure to toxic and chemical appointments, routine lab testing and any specialized testing. substances such as lead and pesticides. Exposure to these toxins could damage your baby’s health. Radiation exposure (e.g., through abdominal X-rays) could also Diet and exercise put your baby at risk for certain health concerns. Eating a balanced diet before and during pregnancy boosts your overall health and is essential for nourishing your Domestic violence growing baby. Exercising regularly and maintaining a proper body weight is also important before and during pregnancy. Women whose partners physically abuse them before they Your health care provider can advise you about your ideal are pregnant may risk more abuse while they’re carrying pregnancy weight. Overweight women risk developing their babies. Have a plan to protect yourself and your baby. medical problems like high blood pressure and diabetes. Your physician or midwife is ready and willing to assist you Underweight women may deliver low-birth-weight babies. find social, legal and community resources to help you deal with domestic violence. Daily vitamins Avoid alcohol and drugs Your physician or midwife will recommend daily prenatal vitamins. These vitamins provide you with the nutrients Consuming alcohol and/or drugs, including marijuana, necessary to properly nourish your baby. while pregnant can greatly harm your baby’s health. Also be sure to tell your health care provider about any medications (prescription and over the counter) you currently take. Ongoing health conditions Some medicines are unsafe for your developing baby. If you have a pre-existing health condition, such as diabetes or high blood pressure, it could affect your health while you’re Stop smoking pregnant. Talk to your health care provider about getting any current or pre-existing medical issues under control. If you’re a smoker, stop smoking now. Numerous studies show that smoking mothers are more likely to have premature and low-birth-weight babies. Both of these factors can increase Prevent infection a baby’s chance of developing long-term medical problems. Don’t eat undercooked meat or raw eggs while you’re pregnant. Smokers’ babies also are more likely to die from sudden infant These foods could contain dangerous bacteria and parasites. death syndrome (SIDS) than nonsmokers’ babies. Even being You should also avoid all contact with cat feces (poop) and cat exposed to secondhand smoke (from someone physically litter while pregnant. Flies and other insects in contact with near you who smokes) can increase your chance of having cat feces can also carry infections. Feces and litter can contain a low-birth-weight baby. You may also face dangers from a parasite that causes a health condition called toxoplasmosis, “third-hand” smoke — tobacco particles, chemicals and which can make your developing baby seriously ill or even gasses left on hair, clothing and furnishings. cause death. Your provider can order a simple blood test before or while you’re pregnant to determine whether you’ve been Ask us for help exposed to the parasite. Do you have questions about these or any other health issues? Avoid travel to Zika-affected areas. If travel is unavoidable, Talk to your UCLA Health provider. We want to help you have consult with your provider. Visit cdc.gov/zika/geo for a healthy, happy pregnancy! more information. 3 The nurse-midwife difference UCLA’s nurse-midwives partner with women to provide the Personalized care care and support they need to achieve their preferred birthing experiences in the safety of a hospital setting. UCLA midwives UCLA’s nurse-midwives spend time getting to know you view childbirth as a natural physiological process, and that and your family during your pregnancy. We talk extensively process can be a little different for every mother. We provide with you about your labor and birth preferences. During a midwifery model of care that utilizes: your pregnancy, you will have an opportunity to meet all of our team members. • Watchful waiting and nonintervention in normal processes We encourage you to take childbirth preparation classes, • Shared decision-making, acknowledging that many times consider hiring a doula and write a birth plan. Your midwife women and their families know what is best for their team will serve as a strong advocate for you throughout pregnancy and birthing experience your pregnancy, birth and after your baby is born.