(This is the second in a series of prenatal information articles on how to have a healthy happy baby. The first one, "What Expectant Mothers Should Expect," appeared last July 10, 2001.) Last month, we visited our son Topo and our daughter-in-law Marjo in the United States. Marjo was then already on her fourth month of pregnancy. It is at that time, during the start of the so-called second trimester, that pregnant women begin to "show." Marjo’s blue jeans and dresses no longer fitted. Everybody was kidding her that she was getting fat. Of course, she was not. She was pregnant and it was time for her to wear maternity clothes!
| Baby’s Growth And Development |
At the beginning of the second trimester, your baby weighs about four ounces, and is about six to seven inches long. If you could see your baby, you could probably recognize his or her sex. The baby passes urine, and meconium (the baby’s first bowel movement) begins to collect in the intestines. Muscles are becoming more active, so the fetus begins to move around.
One of the most well-known tests done during pregnancy is ultrasonography, or ultrasound, or sonogram. Done at 18-20 weeks, ultrasound is used to examine the baby within the mother’s uterus. Ultrasound uses sound waves which are reflected off the baby and transformed into an image on the TV monitor. Ultrasound does not use X-rays and there are no known harmful side effects to either the mother or the baby. Ultrasound provides information about: 1) the age of the baby; 2) the size of the baby for its age; 3) the location of the placenta; 4) the number of babies; 5) some types of birth defects; and 6) the amount of amniotic fluid. It is not intended for the purpose of determining baby’s sex.
Ligament pain is a common discomfort of pregnancy. The round ligaments help support the uterus. As your pregnancy progresses, the abdominal muscles relax and the round ligaments are stretched. Before the pregnancy, these ligaments were used to support a uterus about the size of a fist. But now, your uterus is expanding. Ligament pain feels like a sharp pulling sensation on either side of the lower abdomen. It can occur with twisting motions such as turning over in bed or walking quickly. It can also occur with coughing or sneezing, and with position changes such as rising from sitting to standing.
To avoid round ligament pain, use your hands more to support the weight of your abdomen when changing positions. For example, when rising from bed, turn on your side; then using your hand to support your weight, push yourself to a sitting position. When rising from a sitting position, support your weight by placing your hands beside you on the chair, or slightly behind you and push to a standing position.
Changing positions more slowly also helps prevent pulling the round ligaments. When ligament pain occurs, lean back in a slant position supporting your back, with your knees bent. Tylenol may make you feel comfortable and applications of ice to the affected side may also help ease the pain. You can also take a warm bath or shower to help relax the muscles. Use a good flat shoe or athletic shoe for walking, non-binding clothing and, if necessary, an abdominal support binder.
| Quickening – First Baby Movements |
Most women describe "quickening" or the baby’s first movement as a "fluttering," like a butterfly, or as tiny bumps or nudges. It is often mistaken for gas pains or hunger pangs. Usually, you’ll feel quickening sometime between 18 and 22 weeks of pregnancy. Occasionally, you’ll feel it as early as 14 weeks or as late as 26 weeks. At this point in your pregnancy, the movements will be irregular. Later in pregnancy, the baby’s movements are more predictable. Your doctor can tell more about how the baby is doing by this activity. For now, enjoy these tiny movements when you feel them.
During the second trimester, a yellowish or whitish fluid called colostrum may leak from your nipples. Colostrum, the first breast milk, is a high-protein, low-fat substance perfectly suited to the baby’s early dietary requirements. Colostrum may continue to leak throughout your pregnancy. Breast pads may be worn, if necessary, to protect your clothing. Avoid harsh soaps, creams or ointments. Do not "prepare" your nipples by rolling, pulling or excessive handling. Manipulation of your nipples stimulates hormone production which may cause premature contractions.
Whitish vaginal discharge is normal throughout pregnancy. Good feminine hygiene is especially important now. Keep your panties clean and dry or change them during the day. Wash as usual during your bath and shower. Do not douche. Do not use feminine hygiene soaps or sprays as they can be irritating. (Do not use sanitary napkins or mini-pads. May use pantyliners, but change frequently.) Tell your doctor about any vaginal discharge that is yellow or greenish or thick and cheesy in appearance. Also tell your obstetrician if the discharge has a strong odor or if there is soreness, itching, or burning. Using cotton underwear is highly recommended.
Bleeding gums are common in pregnancy. Try switching to a soft toothbrush and floss gently. You should continue with your regular dental care. You may need to see a dentist if your gums are painful and swollen. A dental X-ray can be done after the fourth month without any problem as the dentist uses lead-shield apron to protect the baby.
| Nasal Congestion And Nosebleeds |
While you are pregnant, you may experience nasal congestion and feel like you have a persistent cold or allergy. This is a common response to increased hormones. The mucus membrane inside the nostrils and sinuses often swells during pregnancy. This may also be the cause of more frequent sinus headaches. The blood vessels can break with the slightest strain. The result is a nosebleed. Try putting petroleum jelly in each nostril. A saline nasal spray may be helpful.
Nosebleeds are not serious unless you cannot control the bleeding or if you bleed heavily. Call your doctor if your nosebleeds are frequent and difficult to control. The use of nasal decongestant spray is not recommended. It can actually make the congestion worse if you use it more than three days in a row. If your nasal congestion is troublesome, you can use Sudafed (up to 60 mg. each time) three times daily.
Many women experience cramps in their calves and feet, especially at night. When you get a cramp, stand up on a flat surface or point your ankles or toes as if you were standing. Try walking or curling your toes to release the cramp. As the cramp releases, lightly massage and apply heat to help with muscle aches. Ask your doctor for other measures.
Dizziness is a frequent complaint in pregnancy, especially, when you change position from lying or sitting to a standing position. As your blood supply increases to meet your baby’s growing needs, the dizziness you experience should decrease or disappear. In the meantime, be careful and move slowly when changing positions. You may also feel light-headed or actually faint if your blood sugar is low. Do not go too long between meals and carry healthy snacks with you to help relieve these symptoms. Heat and high humidity can also cause these symptoms. Avoid getting overheated and drink plenty of fluids – eight glasses or more – when you are in a hot environment. If you get light-headed and dizzy, lie down on your side or bend forward with your head down close to your knees. If this problem continues, notify your doctor.
Many women are able to work throughout their pregnancies. If you continue working, take frequent breaks if possible. Avoid standing or sitting for long periods. Don’t come home for work and immediately start cooking or cleaning. Consider lying down an hour when you get home.
Your body is working very hard. Feeling tired is Mother Nature’s way of telling you to pace yourself. Don’t ignore your increased need for rest and sleep. In that way, you will find your energy returning as you move through these exciting middle months of your pregnancy!