Pregnancy

Early Symptoms of Pregnancy
Are you pregnant? The proof is in the pregnancy test. But even before you miss a period, you may suspect — or hope — that you're pregnant. Consider these early symptoms of pregnancy, which may begin in the first few weeks after conception.

Tender, swollen breasts
Your breasts may provide one of the first symptoms of pregnancy. As early as two weeks after conception, hormonal changes may make your breasts tender, tingly or sore. Or your breasts may feel fuller and heavier.

Fatigue
Fatigue also ranks high among early symptoms of pregnancy. During early pregnancy, levels of the hormone progesterone soar. In high enough doses, progesterone can put you to sleep. At the same time, lower blood sugar levels, lower blood pressure and increased blood production may team up to sap your energy.

Slight bleeding or cramping
For some women, a small amount of spotting or vaginal bleeding is one of the first symptoms of pregnancy. Known as implantation bleeding, it happens when the fertilized egg attaches to the lining of the uterus — about 10 to 14 days after fertilization. This type of bleeding is usually a bit earlier, spottier and lighter in color than a normal period and doesn't last as long.
Some women also experience abdominal cramping early in pregnancy. These cramps are similar to menstrual cramps.

Nausea with or without vomiting
Morning sickness, which can strike at any time of the day or night, is one of the classic symptoms of pregnancy. For some women, the queasiness begins as early as two weeks after conception.
Nausea seems to stem at least in part from rapidly rising levels of estrogen, which causes the stomach to empty more slowly. Pregnant women also have a heightened sense of smell, so various odors — such as foods cooking, perfume or cigarette smoke — may cause waves of nausea in early pregnancy.

Food aversions or cravings
When you're pregnant, you might find yourself turning up your nose at certain foods, such as coffee or fried foods. Food cravings are common, too. Like most other symptoms of pregnancy, these food preferences can be chalked up to hormonal changes — especially in the first trimester, when hormone changes are the most dramatic.

Headaches
Early in pregnancy, increased blood circulation caused by hormonal changes may trigger frequent, mild headaches.

Constipation
Constipation is another common early symptom of pregnancy. An increase in progesterone causes food to pass more slowly through the intestines — which can lead to constipation.

Mood swings
The flood of hormones in your body in early pregnancy can make you unusually emotional and weepy. Mood swings are also common, especially in the first trimester.

Faintness and dizziness
As your blood vessels dilate and your blood pressure drops, you may feel lightheaded or dizzy. Early in pregnancy, faintness may also be triggered by low blood sugar.

Raised basal body temperature
Your basal body temperature is your oral temperature when you first wake up in the morning. This temperature increases slightly soon after ovulation and remains at that level until your next period. If you've been charting your basal body temperature to determine when you ovulate, its continued elevation for more than two weeks may mean you're pregnant.

Are you really pregnant?
Unfortunately, these symptoms aren't unique to pregnancy. Some can indicate that you're getting sick or that your period is about to start. Likewise, you can be pregnant without experiencing any of these symptoms.

Still, if you miss a period or notice any of the tip-offs on this list, you might want to take a home pregnancy test — especially if you're not keeping track of your menstrual cycle or if it varies widely from one month to the next. If your home pregnancy test is positive, make an appointment with your doctor, nurse practitioner or midwife. The sooner your pregnancy is confirmed, the sooner you can begin prenatal care.

Fetal development during 1st trimester
You're pregnant. Congratulations! You'll undoubtedly spend the months ahead wondering how your baby is growing and developing. What does your baby look like? How big is he or she? When will you hear the heartbeat?
Fetal development typically follows a predictable course. To help answer some of these questions, check out this weekly calendar of events for your baby's first three months in the womb.

Week 1: Getting ready
It may seem strange, but you're not actually pregnant the first week or two of the time allotted to your pregnancy. Yes, you read that correctly!

Conception typically occurs about two weeks after your period begins. To calculate your due date, your health care provider will count ahead 40 weeks from the start of your last period. This means your period is counted as part of your pregnancy — even though you weren't pregnant at the time.

Week 2: Fertilization
The sperm and egg unite in one of your fallopian tubes to form a one-celled entity called a zygote. If more than one egg is released and fertilized, you may have multiple zygotes.
The zygote has 46 chromosomes — 23 from you and 23 from your partner. These chromosomes contain genetic material that will determine your baby's sex and traits such as eye color, hair color, height, facial features and — at least to some extent — intelligence and personality.
Soon after fertilization, the zygote travels down the fallopian tube toward the uterus. At the same time, it will begin dividing rapidly to form a cluster of cells resembling a tiny raspberry. The inner group of cells will become the embryo. The outer group of cells will become the membranes that nourish and protect it.

Week 3: Implantation
The zygote — by this time made up of about 500 cells — is now known as a blastocyst. When it reaches your uterus, the blastocyst will burrow into the uterine wall for nourishment. The placenta, which will nourish your baby throughout the pregnancy, also begins to form.
By the end of this week, you may be celebrating a positive pregnancy test.

Week 4: The embryonic period begins
The fourth week marks the beginning of the embryonic period, when the baby's brain, spinal cord, heart and other organs begin to form. Your baby is now 1/25 of an inch long.
The embryo is now made of three layers. The top layer — the ectoderm — will give rise to a groove along the midline of your baby's body. This will become the neural tube, where your baby's brain, spinal cord, spinal nerves and backbone will develop.

Your baby's heart and a primitive circulatory system will form in the middle layer of cells — the mesoderm. This layer of cells will also serve as the foundation for your baby's bones, muscles, kidneys and much of the reproductive system.

The inner layer of cells — the endoderm — will become a simple tube lined with mucous membranes. Your baby's lungs, intestines and bladder will develop here.

Week 5: Baby's heart begins to beat
At week five, your baby is 1/17 of an inch long — about the size of the tip of a pen.
This week, your baby's heart and circulatory system are taking shape. Your baby's blood vessels will complete a circuit, and his or her heart will begin to beat. Although you won't be able to hear it yet, the motion of your baby's beating heart may be detected with an ultrasound exam.
With these changes, blood circulation begins — making the circulatory system the first functioning organ system.

Week 6: The neural tube closes
Growth is rapid this week. Just four weeks after conception, your baby is about 1/8 of an inch long. The neural tube along your baby's back is now closed, and your baby's heart is beating with a regular rhythm.

Basic facial features will begin to appear, including an opening for the mouth and passageways that will make up the inner ear. The digestive and respiratory systems begin to form as well.
Small blocks of tissue that will form your baby's connective tissue, ribs and muscles are developing along your baby's midline. Small buds will soon grow into arms and legs.

Week 7: The umbilical cord appears
Seven weeks into your pregnancy, your baby is 1/3 of an inch long — a little bigger than the top of a pencil eraser. He or she weighs less than an aspirin tablet.

The umbilical cord — the link between your baby and the placenta — is now clearly visible. The cavities and passages needed to circulate spinal fluid in your baby's brain have formed, but your baby's skull is still transparent.

The arm bud that sprouted last week now resembles a tiny paddle. Your baby's face takes on more definition this week, as a mouth perforation, tiny nostrils and ear indentations become visible.

Week 8: Baby's fingers and toes form
Eight weeks into your pregnancy, your baby is just over 1/2 of an inch long.
Your baby will develop webbed fingers and toes this week. Wrists, elbows and ankles are clearly visible, and your baby's eyelids are beginning to form. The ears, upper lip and tip of the nose also become recognizable.

As your baby's heart becomes more fully developed, it will pump at 150 beats a minute — about twice the usual adult rate.

Week 9: Movement begins
Your baby is now nearly 1 inch long and weighs a bit less than 1/8 of an ounce. The embryonic tail at the bottom of your baby's spinal cord is shrinking, helping him or her look less like a tadpole and more like a developing person.

Your baby's head — which is nearly half the size of his or her entire body — is now tucked down onto the chest. Nipples and hair follicles begin to form. Your baby's pancreas, bile ducts, gallbladder and anus are in place. The internal reproductive organs, such as testes or ovaries, start to develop.

Your baby may begin moving this week, but you won't be able to feel it for quite a while yet.

Week 10: Neurons multiply
By now, your baby's vital organs have a solid foundation. The embryonic tail has disappeared completely, and your baby has fully separated fingers and toes. The bones of your baby's skeleton begin to form.

This week, your baby's brain will produce almost 250,000 new neurons every minute.
Your baby's eyelids are no longer transparent. The outer ears are starting to assume their final form, and tooth buds are forming as well. If your baby is a boy, his testes will start producing the male hormone testosterone.

Week 11: Baby's sex may be apparent
From now until your 20th week of pregnancy — the halfway mark — your baby will increase his or her weight 30 times and will about triple in length. To make sure your baby gets enough nutrients, the blood vessels in the placenta are growing larger and multiplying.

Your baby is now officially described as a fetus. Your baby's ears are moving up and to the side of the head this week. By the end of the week, your baby's external genitalia will develop into a recognizable penis or clitoris and labia majora.

Week 12: Baby's fingernails and toenails appear
Twelve weeks into your pregnancy, your baby is nearly 3 inches long and weighs about 4/5 of an ounce. Your baby's head is nearly half the size of his or her entire body.
This week marks the arrival of fingernails and toenails. Your baby's chin and nose will become more refined as well.

Taking care of your baby
Healthy lifestyle choices — beginning even before conception — can support your baby's development. Consider these simple do's and don'ts:
Your baby is growing and changing every day. To give your baby the best start, take good care of yourself.

Fetal development during the second trimester?
Fetal development takes on new meaning in the second trimester. Your baby will begin to look like a newborn — and may even be able to hear you!

As your pregnancy progresses, your baby may begin to seem more real. You may hear the heartbeat at your prenatal appointments, and your enlarging abdomen may force your favorite jeans to the back of the closet.

While you're adjusting to the changes in your body, fetal development takes on new meaning. Two months ago, your baby was simply a cluster of cells. Now he or she has functioning organs, nerves and muscles. You may be amazed by how much your baby changes from week to week.

Week 13: Baby flexes and kicks
You can't feel it yet, but your baby can move in a jerky fashion — flexing the arms and kicking the legs. This week, your baby might even be able to put a thumb in his or her mouth.
Your baby's eyelids are fused together to protect his or her developing eyes. Tissue that will become bone is developing around your baby's head and within the arms and legs. Tiny ribs may soon appear.

Week 14: Hormones gear up
The effect of hormones becomes apparent this week. For boys, the prostate gland is developing. For girls, the ovaries move from the abdomen into the pelvis.

Meconium — which will become your baby's first bowel movement after birth — is made in your baby's intestinal tract. By the end of the week, the roof of your baby's mouth will be completely formed.

Week 15: Skin begins to form
Your baby's skin starts out nearly transparent. Eyebrows and scalp hair may make an appearance. For babies destined to have dark hair, the hair follicles will begin producing pigment.
The bone and marrow that make up your baby's skeletal system are continuing to develop this week. Your baby's eyes and ears now have a baby-like appearance, and the ears have almost reached their final position.

Week 16: Facial expressions are possible
Sixteen weeks into your pregnancy, your baby is between 4 and 5 inches long and weighs a bit less than 3 ounces. He or she can now make a fist.

Your baby's eyes are becoming sensitive to light. More developed facial muscles may lead to various expressions, such as squinting and frowning. Your baby may have frequent bouts of hiccups as well. For girls, millions of eggs are forming in the ovaries.

Week 17: Fat accumulates
Fat stores begin to develop under your baby's skin this week. The fat will provide energy and help keep your baby warm after birth.

Week 18: Baby begins to hear
As the nerve endings from your baby's brain "hook up" to the ears, your baby may hear your heart beating, your stomach rumbling or blood moving through the umbilical cord. He or she may even be startled by loud noises. Your baby can swallow this week, too.

Week 19: Lanugo covers baby's skin
Your baby's delicate skin is now protected with a pasty white coating called vernix. Under the vernix, a fine, down-like hair called lanugo covers your baby's body.

Your baby's kidneys are already producing urine. The urine is excreted into the amniotic sac, which surrounds and protects your baby.

As your baby's hearing continues to improve, he or she may pick up your voice in conversations — although it's probably hard to hear clearly through the amniotic fluid and protective paste covering your baby's ears.

Thanks to the millions of motor neurons developing in the brain, your baby can make reflexive muscle movements. If you haven't felt movement yet, you will soon.

Week 20: The halfway point
Halfway into your pregnancy, your baby is about 6 inches long and weighs about 9 ounces — a little over half a pound. You've probably begun to feel your baby's movements.
Under the protection of the vernix, your baby's skin is thickening and developing layers. Your baby now has thin eyebrows, hair on the scalp and well-developed limbs.

Week 21: Nourishment evolves
Although the placenta provides nearly all of your baby's nourishment, your baby will begin to absorb small amounts of sugar from swallowed amniotic fluid. This week, your baby's bone marrow starts making blood cells — a job done by the liver and spleen until this point.

Week 22: Taste buds develop
This week, your baby weighs in at about 1 pound.
Taste buds are starting to form on your baby's tongue, and your baby's brain and nerve endings can process the sensation of touch. Your baby may experiment by feeling his or her face or anything else within reach.

For boys, the testes begin to descend from the abdomen this week. For girls, the uterus and ovaries are in place — complete with a lifetime supply of eggs.

Week 23: Lungs prepare for life outside the womb
Your baby's lungs are beginning to produce surfactant, the substance that allows the air sacs in the lungs to inflate — and keeps them from collapsing and sticking together when they deflate. "Practice" breathing moves amniotic fluid in and out of your baby's lungs.
Your baby will begin to look more like a newborn as the skin becomes less transparent and fat production kicks into high gear.

Week 24: Sense of balance develops
By now, your baby weighs about 1 1/2 pounds. Footprints and fingerprints are forming.
Thanks to a fully developed inner ear, which controls balance, your baby may have a sense of whether he or she is upside-down or right side up in the womb. You may notice a regular sleeping and waking cycle.

With intensive medical care, babies born at 24 weeks have more than a 50 percent chance of survival. Complications are frequent and serious, however, such as bleeding in the brain and impaired vision.

Week 25: Exploration continues
Your baby's hands are now fully developed, although the nerve connections to the hands have a long way to go. Exploring the structures inside your uterus may become baby's prime entertainment.

Week 26: Eyes remain closed
Your baby weighs between 1 1/2 and 2 pounds. The eyebrows and eyelashes are well formed, and the hair on your baby's head is longer and more plentiful. Although your baby's eyes are fully developed, they may not open for another two weeks.

Week 27: Second trimester ends
This week marks the end of the second trimester. Your baby's lungs, liver and immune system are continuing to mature — and he or she has been growing like a weed. At 27 weeks, your baby's length will have tripled or even quadrupled from the 12-week mark.
If your baby is born this week, the chance of survival is at least 85 percent. However, serious complications are still possible.

Taking care of your baby
Healthy lifestyle choices throughout pregnancy will support your baby's development.

Pregnancy symptoms during the second trimester

second trimester of pregnancy often brings a renewed sense of well-being. The worst of the nausea has usually passed, and your baby isn't big enough to crowd your abdominal organs and make you uncomfortable. Yet dramatic pregnancy symptoms are on the horizon. Here's what to expect.

Your body
As your pregnancy progresses, you may notice physical changes from head to toe.

Larger breasts. Stimulated by estrogen and progesterone, the milk-producing glands inside your breasts get larger. Additional fat also may accumulate in your breasts. The result may be as much as 1 pound of extra breast tissue or up to two additional cup sizes. Although some of the initial breast tenderness may improve, nipple tenderness may continue throughout the pregnancy. A supportive bra is a must.

Growing belly. As your uterus becomes heavier and expands to make room for the baby, your abdomen expands — sometimes rapidly. Expect to gain up to 4 pounds a month until the end of your pregnancy.

Braxton Hicks contractions. Your uterus may start contracting to build strength for the big job ahead. You may feel these warm-ups, called Braxton Hicks contractions, in your lower abdomen and groin. They're painless and come and go unpredictably. Contact your health care provider if the contractions become painful or regular. This may be a sign of preterm labor.

Skin changes. As blood circulation increases, you may enjoy the healthy glow associated with pregnancy. Certain areas of your skin may become darker as well, such as the skin around your nipples, parts of your face and the line that runs from your navel to your pubic bone.

Nasal and gum problems. As pregnancy increases your circulation, more blood flows through your body's mucous membranes. This causes the lining of your nose and airway to swell, which can restrict airflow and lead to snoring, congestion and nosebleeds. Increased blood circulation can also soften your gums, which may cause minor bleeding when you brush or floss your teeth.

Dizziness. Your blood vessels dilate in response to pregnancy hormones. Until your blood volume expands to fill them, you may experience occasional dizziness. Lower blood pressure due to your rapidly expanding circulatory system also may play a role. Avoid prolonged standing, and rise slowly after lying or sitting down.

Leg cramps. Pressure from your uterus on the veins returning blood from your legs may cause leg cramps, especially at night. Stretch the affected muscle or walk your way through the cramps.

Heartburn and constipation. During pregnancy, the movements that push swallowed food from your esophagus into your stomach are slower. Your stomach also takes longer to empty. This slowdown gives nutrients more time to be absorbed into your bloodstream and reach your baby. Unfortunately, it may also lead to heartburn and constipation. It may help to eat small, frequent meals. To prevent or relieve constipation, include plenty of fiber in your diet and drink lots of fluids.

Shortness of breath. Your lungs are processing up to 40 percent more air than they did before your pregnancy. This allows your blood to carry more oxygen to your placenta and the baby — and may leave you breathing slightly faster and feeling short of breath.

Vaginal discharge. You may notice a thin, white vaginal discharge. This acidic discharge is thought to help suppress the growth of potentially harmful bacteria or yeast. You might want to wear panty liners for comfort. Contact your health care provider if the discharge becomes strong-smelling, green or yellowish or if it's accompanied by redness, itching or irritation. This may indicate a vaginal infection.

Bladder and kidney infections. Hormonal changes slow the flow of urine, and your expanding uterus may get in the way — both factors that increase the risk of bladder and kidney infections. Contact your health care provider if you need to urinate more often than usual, you notice a burning sensation when you urinate, or you have a fever, abdominal pain or backache. Left untreated, urinary infections increase the risk of preterm labor.

Your emotions
Pregnancy is a psychological journey as well as a biological one. During the second trimester, you may feel less moody and more up to the challenge of preparing a home for your baby. Strike while the iron is hot! Check into childbirth classes. Find a health care provider for your baby. Read about breast-feeding. If you plan to work outside the home after the baby is born, get familiar with your employer's maternity leave policy and investigate child care options.
As your pregnancy progresses, changes in your body's shape and function may affect your emotions. Some women feel a heightened sexuality during pregnancy. Others feel unattractive — especially as their bellies grow. If you're struggling with your body image, share your concerns with your partner. Express love and affection in ways that help you feel most comfortable.
While anticipation mounts, worries about labor, delivery or impending motherhood may preoccupy you. Remember that you can't plan or control everything about your pregnancy. Instead, learn as much as you can. Focus on making healthy lifestyle choices that will give your baby the best start.

Appointments with your health care provider
During the second trimester, your prenatal appointments will focus on your baby's growth, confirming your due date and detecting any problems with your health.
Your health care provider will begin by checking your weight and blood pressure. He or she may measure the size of your uterus by checking the fundal height — the distance from the top of the uterus (called the fundus) to your pubic bone. Pelvic exams are often unnecessary during the second trimester, unless something unusual needs to be explored.
At this stage, the highlight of your prenatal visits may be listening to your baby's heartbeat with a special device called a Doppler. Your health care provider may suggest an ultrasound or other screening tests this trimester.
Be sure to mention any signs or symptoms that concern you, even if they seem silly or unimportant. Talking to your health care provider is likely to put your mind at ease.

Fetal development during third timester

The countdown is on! See how fetal development continues as your due date approaches.
The end is in sight! By now, you may be tired of being pregnant — and eager to meet your baby face to face. But your uterus is still a busy place. See how fetal development continues as your due date approaches.

Week 28: Baby's eyes open
Your baby is about 15 inches long and weighs about 2 to 3 pounds.
Your baby's eyes are beginning to open and close. The color has been established, but the story's not over yet. Eye color may change within the first six months after birth — especially if your baby's eyes are blue or gray-blue at birth.

Your baby is now sleeping for about 20 to 30 minutes at a time. Fetal movement will be most obvious when you're sitting or lying down.

Week 29: Movement is more forceful
Your baby's bones are fully developed, but they're still soft and pliable. This week, your baby begins storing iron, calcium and phosphorus.
As your baby continues to grow, his or her movements will become more frequent and vigorous. Some of your baby's jabs and punches may even take your breath away.

Week 30: Baby packs on pounds
Your baby weighs about 3 pounds — but not for long. He or she will gain about 1/2 pound a week until week 37.

Your baby may practice breathing by moving his or her diaphragm in a repeating rhythm. If your baby gets the hiccups, you may feel slight twitches or spasms in your uterus.

Week 31: Reproductive development continues
If your baby is a boy, his testicles are moving from their location near the kidneys through the groin on their way into the scrotum. If your baby is a girl, her clitoris is now relatively prominent.

Your baby's lungs are more developed, but they're not fully mature. If your baby is born this week, he or she will probably need a ventilator to assist breathing. Complications such as bleeding in the brain are less likely than they were even a few weeks ago.

Week 32: Downy hair falls off
Your baby is between 15 and 17 inches long and weighs about 4 to 4 1/2 pounds. Nearly all babies born at this age survive the challenges of premature birth.
The layer of soft, downy hair that has covered your baby's skin for the past few months — known as lanugo — starts to fall off this week.
As space in your uterus becomes more cramped, your baby's kicks and other movements may seem less forceful. You may want to check on your baby's movements from time to time — especially if you think you've noticed decreased activity. If you count fewer than 10 movements in two hours, contact your health care provider.

Week 33: Baby detects light
Your baby's pupils now constrict, dilate and detect light. Your baby continues to gain about 1/2 pound a week, and his or her lungs are more completely developed. Babies born this week need extra attention, but almost all will be healthy.

Week 34: Protective coating gets thicker
The pasty white coating that protects your baby's skin — called vernix — gets thicker this week. When your baby is born, you may see traces of vernix firsthand, especially under the arms, behind the ears and in the groin area. The soft, downy hair that covered your baby under the vernix for the past few months is now almost completely gone.

Week 35: Rapid growth continues
Your baby continues to pack on the pounds and store fat all over his or her body. The crowded conditions inside your uterus may make it harder for your baby to give you a punch, but you'll probably feel lots of stretches, rolls and wiggles.

Week 36: Baby can suck
Your baby is between 16 and 19 inches long and weighs about 6 to 6 1/2 pounds. Recent fat deposits have rounded out your baby's face, and your baby's powerful sucking muscles are ready for action. To prepare for birth, your baby may descend into the head-down position.

Week 37: Baby is full-term
By the end of this week, your baby will be considered full-term. As fat continues to accumulate, your baby's body will slowly become rounder.

Week 38: Organ function continues to improve
Your baby weighs nearly 7 pounds. His or her brain and nervous system are working better every day. This developmental process will continue through childhood and adolescence.

Week 39: Placenta provides antibodies
Your baby has enough fat under the skin to maintain body temperature as long as there's a little help from you. The placenta continues to supply your baby with antibodies that will help fight infection the first six months after birth. If you breast-feed your baby, your milk will provide additional antibodies.

Week 40: Your due date arrives
Your baby may be 19 to 21 inches long and weigh 7 to 8 pounds.
Don't be alarmed if your due date comes and goes without incident. It's just as normal to deliver a baby a week or two late — or early — than it is to deliver right on time.

Taking care of your baby
Although your pregnancy is nearly over, healthy lifestyle choices remain important. Remember these simple do's and don'ts:

Do:
Take a prenatal vitamin
Maintain a healthy weight
Exercise regularly, with your health care provider's OK
Eat healthy foods
Manage stress and any chronic health conditions
See your health care provider for regular prenatal checkups — probably once a week for the last month of pregnancy

Don't:
Smoke
Drink alcohol
Use illicit drugs
Take medication without your health care provider's OK
Enjoy the final days of your pregnancy. This is it! The next chapter in your life is about to begin.

Pregnancy Symptoms during third trimester
You're in the home stretch! The last stage of pregnancy may bring new pregnancy symptoms — but relieve earlier ones.

The last few months of pregnancy can be physically and emotionally challenging. Your baby's size and position may make it hard for you to get comfortable. You may be tired of pregnancy and anxious to get it over with. If you've been gearing up for your due date, you may be disappointed if it comes and goes uneventfully.
Try to remain positive as you look forward to the end of your pregnancy. Soon you'll hold your baby in your arms! Here's what to expect in the meantime.

Your body
As your baby grows, his or her movements will become more obvious. These exciting sensations are often accompanied by increasing discomfort and other late pregnancy symptoms.

Backaches. As your baby continues to gain weight, pregnancy hormones relax the joints between the bones in your pelvic area. These changes can be tough on your back. Hip pain is common, too.

If you must stand, place one foot on a box or stool. Sit in chairs with good back support. Apply a heating pad or ice pack to the painful area. Ask your partner for a massage. If the back pain doesn't go away or is accompanied by other signs and symptoms, contact your health care provider.

Swelling. Swollen feet and ankles may become an issue at this stage of pregnancy. Your growing uterus puts pressure on the veins that return blood from your feet and legs. Fluid retention and dilated blood vessels may leave your face and eyelids puffy, especially in the morning. If you have persistent face or eyelid swelling, contact your health care provider.
To reduce swelling, use cold compresses on the affected areas. Lying down or using a footrest may relieve ankle swelling. You might even elevate your feet and legs while you sleep. It may also help to swim or simply stand in a pool.

Shortness of breath. You may get winded easily as your uterus expands beneath your diaphragm, the muscle just below your lungs. This may improve when the baby settles deeper into your pelvis before delivery. In the meantime, practice good posture and sleep on your side. As long as your health care provider says it's OK, aerobic exercise can help relieve this pregnancy symptom, too.

Heartburn. Your growing uterus may push your stomach out of its normal position, which can contribute to heartburn. To keep stomach acid where it belongs, eat small meals and drink plenty of fluids. If this doesn't help, ask your health care provider about antacids.

Spider veins, varicose veins and hemorrhoids. Increased blood circulation may cause small reddish spots that sprout tiny blood vessels on your face, neck, upper chest or arms, especially if you have fair skin. Varicose veins — blue or reddish lines beneath the surface of the skin — also may appear, particularly in the legs. Hemorrhoids — varicose veins in your rectum — are another possibility.

If you have painful varicose veins, elevate your legs and wear support stockings. To prevent hemorrhoids, avoid constipation. Include plenty of fiber in your diet and drink lots of fluids.

Stretch marks. You may notice pink, red or purple streaks along your abdomen, breasts, upper arms, buttocks or thighs. Your stretching skin may also be itchy. Moisturizers can help. Although stretch marks can't be prevented, eventually they fade in intensity.

Continued breast growth. By now, you may have an additional 1 to 3 pounds of breast tissue. As delivery approaches, your nipples may start leaking colostrum — the yellowish fluid that will nourish your baby during the first few days of life.

Frequent urination. As your baby moves deeper into your pelvis, you'll feel more pressure on your bladder. You may find yourself urinating more often, even during the night. This extra pressure may also cause you to leak urine — especially when you laugh, cough or sneeze.
Continue to watch for signs of a urinary tract infection, such as urinating even more than usual, burning during urination, fever, abdominal pain or backache. Left untreated, a urinary tract infection may damage your kidneys and trigger preterm labor.

Braxton Hicks contractions. These contractions are warm-ups for the real thing. They're painless and come and go unpredictably. True labor contractions get longer, stronger and closer together. If you're having contractions that concern you, contact your health care provider.

Weight gain. By your due date, you may weigh 25 to 35 pounds more than you did before pregnancy. Your baby accounts for some of the weight gain, but you also need to count the placenta, amniotic fluid, larger breasts and uterus, extra fat stores, and increased blood and fluid volume.

Vaginal discharge. Potentially heavy vaginal discharge is common at the end of pregnancy. If you saturate a panty liner within a few hours or wonder if the discharge is leaking amniotic fluid, contact your health care provider.

Your emotions
As anticipation grows, fears about childbirth may become more persistent. How much will it hurt? How long will it last? How will I cope?

If you haven't done so already, you may want to take childbirth classes. You'll learn what to expect — and meet other moms-to-be who share your excitement and concerns. Talk with women who've had positive birth experiences, and ask your health care provider what options you may have for pain relief. Tell yourself that you'll simply do the best you can. There's no right or wrong way to have a baby.

The reality of parenthood may start to sink in as well. You may feel anxious and overwhelmed, especially if this is your first baby. To stay calm, revel in the emotions and sensations of being pregnant.

Write your thoughts in a journal.
Listen to soft music.
Talk to your baby.
Take photos of your pregnant belly to share with your child one day.
It also may help to review your decisions about issues such as circumcision and breast-feeding. Knowing how you'll proceed once the baby arrives can give you a greater sense of control.

Appointments with your health care provider
During the third trimester, your health care provider may ask you to come in for more frequent checkups — perhaps every other week beginning at week 32 and every week beginning at week 36.

Like previous visits, your health care provider will check your weight and blood pressure and ask about any signs or symptoms you may be experiencing. You may need screening tests for various conditions, including:

Gestational diabetes. This is a temporary type of diabetes that sometimes develops during pregnancy. Prompt treatment and healthy lifestyle choices can help you manage your blood sugar level and deliver a healthy baby.

Anemia. Anemia is an abnormally low level of red blood cells or hemoglobin, a protein in red blood cells that contains iron. Severe anemia may slow your baby's growth or trigger preterm labor. To treat anemia, you may need to take iron supplements.

Group B strep. Group B strep is a type of bacteria that may live in your vagina or rectum. It won't make you sick, but it may cause a serious infection for your baby after birth. If you test positive for group B strep, your health care provider may recommend antibiotics while you're in labor.

Your health care provider will also check your baby's size and heart rate. Near the end of your pregnancy, vaginal exams may help your health care provider determine your baby's position inside your uterus. He or she may also check your cervix to see whether it's begun to soften or dilate in preparation for birth.

If you have specific desires or preferences for labor and birth — such as laboring in water or avoiding medication — you might want to define your wishes in a birth plan. Review the plan with your health care provider ahead of time to prevent any misunderstandings.

As your due date approaches, keep asking questions. How can I tell the difference between false labor and the real thing? When do I need to go to the hospital? Could I be too late for an epidural? Remember, there's no silly question. Understanding what's happening can help you have the most positive birth experience.