Symptoms and Issues of Pregnancy

Early Symptoms of Pregnancy
The earliest symptoms of pregnancy are breast changes and fatigue. These alone shouldn't make you think you are pregnant, as they are very common. More specifically, the breasts become tender or some women describe a tingling sensation.

Next, of course, is a missed period. This occurs at about 2 weeks after fertilization. Obviously, the more regular your periods are, the more reliable having no period is as a sign.

Nausea may begin at about 4 to 6 weeks. This is euphemistically called Morning Sickness. As many women can attest, it can occur at any time of the day. Increased breast size and nodularity or "lumpiness" can be noticed as early as the second month. Darkening of the area around the nipples will follow. Needing to urinate more often will also occur. This is due to enlarging womb, which presses on the bladder early on, before it further enlarges and moves into the abdomen. Some women may also have an aching sensation or heaviness in the pelvis.

Bleeding or a "Period" does NOT mean you can't be pregnant
More importantly, though, the presence of bleeding does not mean you are not pregnant. About 25% of all pregnant women have some bleeding or spotting in the first three months of pregnancy. Many women mistake this bleeding for their period and underestimate their due dates by a month or so. The question to ask yourself is "Is this bleeding exactly the same as my usual period? Is it at the same time of the month, the same number of days? am I using the same number of pads or tampons?" Again, the more regular your periods are, the more reliable a sign of pregnancy any noticed changes will be.

Though pregnancies that have early bleeding do have a higher rate of spontaneous abortion, most continue on without problems. A small amount of bleeding without pain is not a cause for alarm. Pain or heavy bleeding, and especially both, is more concerning.

Taking the Pill does NOT mean you can't be pregnant
Getting pregnant while on the pill, when used according to instructions, in ideal situations, is extremely rare. However, real life is not standard. Common situations that increase the chance of failure of the pill are: certain antibiotic use, illness involving vomiting or diarrhea (both lead to lack of absorption), missing pills, and even taking the pill at different times on different days.

Pregnancy Tests
Home pregnancy tests are pretty accurate, if you follow the instructions exactly and are at least 10-14 days late on your period. Be aware that proteins in your urine can cause urine pregnancy tests to turn positive, when you are not pregnant. Very active, athletic women, like distance runners, and triathletes, typically have proteins in their urine.

In general, a positive result (telling you that you are pregnant) is less likely to be an error than a negative result. So, in other words if it says you are pregnant, you are probably pregnant. If it says you are not pregnant, but you still think you might be, re-take the test later. Unclear results often occur for pregnant women who used the test earlier than it was designed for, or women who make minor procedural errors in developing the test, or those who have proteins in the urine.

Blood pregnancy tests can detect pregnancy as early as 8 days after conception. They are more precise than the urine pregnancy tests. These are not typically done before a missed period, unless there are other medical reasons.

What to do in the Meantime
There may be a few weeks in between the first suspicions of pregnancy and actual confirmation. So, what should you do in the meantime?

Just take good care of yourself. You deserve it anyway.

Stop taking any over the counter medications. If you smoke, drink alcohol, or use any recreational drugs, stop those too. If you are taking any prescriptions, call the doctor who prescribed them and find out if they are OK to continue. Doctors often tell women of childbearing age if a medication should be discontinued, if the woman thinks she might be pregnant, at the time the prescription is written. So it is unlikely that you would have a medication like this, and not know it.

If you are taking the pill, and think you might be pregnant anyway, discontinue the pill. Use alternative birth control methods, like condoms, until you are sure, one way or the other. Your doctor will give you instructions on re-starting the pill, if you are not pregnant.

If you are trying to conceive, well, just keep trying. Intercourse does not pose any risk to early pregnancy.

Get lots of rest and eat a well balanced diet. Let your appetite be your guide as to how much. Although, if you get nauseated, try to eat something bland, like plain bread or crackers. Eat them slowly and in small, frequent portions until the nausea passes. Drink lots of fluids. You may continue to exercise as you have been, as tolerated.

Two nutrients that are very important in pregnancy are folic acid and iron. Folic acid has shown to be important in preventing birth defects. It does this in early pregnancy. It is commonly found in leafy green vegetables, peanuts, dried beans, liver, and some citrus fruits. Pregnancy also increases the body's need for iron and young women often have low levels of iron due to menstruation from before the start of their pregnancy. The iron in animal products is most easily absorbed--all types of beef, poultry and fish. It is also found in potatoes, beans, and raisins. Vegetable iron is harder to absorb. Eating these foods in combination with others that contain vitamin C helps increase absorption. Vitamin C is in things like tomatoes, oranges and orange juice, strawberries, green pepper, broccoli, and Brussels sprouts. Caffeine decreases the absorption of iron, so try to avoid this, around meals.

Also a standard multivitamin never hurts, as a back up. Look for one that has at least 400 micrograms (mcg) of the Folic acid. Sometimes this is listed as 0.4 mg. Be careful with iron supplements or vitamins with extra iron. They can cause stomach upset, and constipation. Both of these are unpleasant and might decrease your calorie intake. Once the pregnancy is confirmed, doctors often put pregnant women on special formulation, pre-natal vitamins.

Getting coverage for Pre-natal care
Check your insurance coverage. Unfortunately, some plans will not cover any pregnancy that has started before you have been on the plan for six months or so.

But don't worry. If that is the case, call your local health or welfare departments for information on what programs or clinics are available for low or no cost. One program is called WIC (women, infants, and children). You are likely eligible for Medicaid or other government programs, if you are pregnant, and can't afford medical care. The laws, at least for right now, are very good about covering medical care for pregnant women, no matter what. This is true even if you work, are married to someone who works, or if you have health insurance that covers other things but not pregnancy. Planned Parenthood is also a good starting place for initial confirmation of pregnancy and medical care.

Avoid places that advertise themselves as "crisis pregnancy centers" or the like. Check out any potential private sources of information or assistance. Call and ask specifically, if they have licensed doctors and nurses working on the premises. If the person on the other end of the phone is the least bit evasive, don't go there. These places are run by organizations that oppose abortion. Many try to keep women out of the medical system in the first three months because that is the time when they would get an abortion, if they were to do so. These groups substitute their own naive, misguided advice on medicine for that of a physician's. Some women have had very serious medical complications by taking these groups' advice. Later, you might take maternity clothes and baby items from them. But see a doctor or mid-wife, now, and for everything medical.

You want to be seen by someone as soon as possible, but at least starting in the first three months.

Some closing thoughts/Words of encouragement.
Recently, I was at a meeting with other women doctors. We were asked to name the most empowering moment of our lives. Guess what the most common answer was? Giving birth.

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