How Soon After Implantation

Everyone’s body is different, and you may not experience pregnancy symptoms right away. Here are some signs that you should take a pregnancy test.

Getting a positive pregnancy test result is an exciting thing. Many women want to know when they can take a pregnancy test and get a positive result. Read this post to understand when your body will have detectable levels of hCG

A home pregnancy test can be an accurate way to find out if you’re pregnant, but only if you use it correctly. A positive result is almost certainly correct. But a negative result is less reliable. If you get a negative result, you should test again in a few days, making sure to follow the instructions and use first morning urine. The earlier after a missed period that you take a home pregnancy test, the harder it is for the test to detect HCG. This means you could get a false-negative result.

For a pregnancy test to be most accurate, it is important to wait until your period would normally be due. If you think you are pregnant and are not ready for everyone to know, there are discreet options for taking a test. The most common way to take a pregnancy test is by using urine; this is considered the best method for home use.

You’re probably eager to know whether you’re pregnant or not. The patience required to wait until you miss your period or until you take a home pregnancy test is often difficult. An online profile for a nursing organization explains the importance of waiting for an accurate test result, highlighting that this process can take time.

Positive pregnancy test only after 10 minutes; I am pregnant now what? Never take a pregnancy test before 7 DPO; otherwise a false negative may result. This is because it takes 7 days for implantation to occur.

Think you might be pregnant?

Even with the most effective birth control methods, there’s always a chance for error. After all, it takes just one sperm to fertilize the egg. Finding out whether or not that’s happened is as easy as taking an over-the-counter (OTC) pregnancy test.

OTC pregnancy tests typically test your urine for a hormone called human chorionic gonadotropin (HCG). HCG is only present if you’re pregnant. The hormone is only released if a fertilized egg attaches outside the uterus or to your uterine lining.

There are different ways to collect your urine for the test. Depending on the test you choose, you may have to:

  • collect your urine in a cup and dip a testing stick into the liquid
  • collect your urine in a cup and use an eyedropper to move a small amount of fluid into a special container
  • place the testing stick into the area of your expected urine stream so that it will catch your urine midstream

According to Cleveland Clinic, most tests are 99 percent effective if taken after a missed period. The best part is that you can do it in the privacy of your own home. Simply open the test, follow the instructions, and wait for the recommended amount of time to view the results.

After the recommended waiting time has passed, the tests will display your results in one of the following ways:

  • a change in color
  • a line
  • a symbol, such as plus or minus
  • the words “pregnant” or “not pregnant”

What Do Pregnancy Test Results Mean?

If pregnancy test results are positive, it means a woman is pregnant. If they’re negative, it means a woman is not pregnant.

When Can A Pregnancy Test Be Taken?

Pregnancy tests may be taken any time after a woman’s menstrual period is late.  

A woman may also choose to test after implantation bleeding has occurred. Implantation bleeding is an early sign of pregnancy. It occurs when a 6 to 12-day-old fertilized egg attaches to the inner lining of the uterus, causing light vaginal bleeding or spotting. About one-third of women experience implantation bleeding, which is normal and typically happens near the time of a woman’s next expected menstrual period.

About four to five days after implantation bleeding, HCG levels in the body reach detectable levels in the blood. For at-home urine pregnancy tests, it may take up to 7 days for HCG levels in the urine to reach detectable levels for testing.

How Soon Will A Pregnancy Test Read Positive?

While some pregnancy tests claim to work a few days before a missed period, the results are usually less accurate at that point. Some tests may be able to detect pregnancy hormones in urine as early as 10 days following unprotected sex, but the results are not very reliable, and women may get a false positive or false negative test result.

For women who have irregular periods or who do not get periods at all, testing about 3 weeks after unprotected sex may yield more reliable results.

If a test reads positive, a woman may want to check with her doctor for a blood pregnancy test to confirm the results. 

Most women who have a positive pregnancy test should wait a week or two before calling the doctor for a blood test. 

Why Might A Pregnancy Test Produce the Wrong Result?

There are 2 types of inaccurate results:

  • False negative – the test indicates a woman is not pregnant but she is
  • False positive – the test shows a woman is pregnant but she’s not

There are several reasons for inaccurate results:

  • Urine is too dilute – this can occur if a woman drinks too much water or tests later in the day
  • Testing too soon after unprotected sex – the body may not have produced enough HCG to be detectable 
  • Using a test that does not detect lower levels of HCG – check package labels for which tests are more sensitive
  • Using an expired test
  • Not using a test right away after opening
  • Use of infertility medications such as clomiphene (Clomid), menotropins (Pergonal, Humegon, Repronex) can cause false positives 
  • The manufacturer of Clomid suggests waiting three days between the last Clomid dose and the first day testing for ovulation

How Soon After Implantation can I Test

Ovulation & Fertility Facts to Help You Get Pregnant

Reviewed on 2/2/2021

Understanding Your Monthly Cycle

Understanding your menstrual cycle can help increase your chances of conceiving.

Understanding your menstrual cycle can help increase your chances of conceiving, if you desire to become pregnant. The menstrual cycle begins with the first day of menstrual bleeding (the menstrual period). The body releases hormones that encourage maturation of eggs inside follicles of the ovaries. From the 2nd to 14th day of the cycle, these same hormones cause the lining of the uterus to thicken and prepare for implantation of a fertilized egg. These events are referred to as the follicular stage of the menstrual cycle.

What Happens During Ovulation

Ovulation, or the release of an egg, usually occurs between the 11th and 21st day of the cycle.

Ovulation, or the release of an egg, usually occurs between the 11th and 21st day of the cycle. Ovulation is triggered by a surge in levels of the hormone luteinizing hormone (LH). The cervical mucus changes in consistency and becomes slippery, like egg whites, to facilitate the progress of sperm toward the egg. The average length of the menstrual cycle is 28 to 32 days.

It’s All About Timing

Progress of ovum as it floats down Fallopian tube.

At birth, females have about 1 to 2 million eggs. Over a woman’s lifetime, only 300 to 400 of them will be released through ovulation. Typically, one egg is released with every menstrual cycle. After release, the egg travels into the Fallopian tube and toward the uterus. Eggs can live about 12 to 24 hours after release, and sperm can live for 3 to 5 days. Knowing when you are due to ovulate can therefore help you plan sex with your partner for the times when you are most likely to conceive.

Tracking When You’re Most Fertile

Chances for pregnancy are usually best when sexual intercourse occurs 1 to 2 days before you ovulate.

Chances for pregnancy are usually best when sexual intercourse occurs 1 to 2 days before you ovulate. You can try to predict this time by counting backwards for 14 days from when you expect your next period, if you have a regular 28-day cycle. You should try to have sex every other day (such as on days 12 and 14) around the time you expect to ovulate. Having sex daily can reduce a man’s sperm count. If your cycle is longer or shorter, you can use an online ovulation calculator to help predict your day of ovulation.

Tracking Ovulation by Temperature

The release of progesterone causes an increase in the body temperature.

After ovulation, the empty follicle (called the corpus luteum) produces the hormone progesterone to help prepare the lining of the uterus for pregnancy. The release of progesterone causes an increase in the body temperature. Checking your basal body temperature every morning before getting out of bed is one way to try to determine when ovulation occurs. The thermometer used for this test costs about $10 at drugstores, so the test is inexpensive. However, it’s not as accurate as other ovulation tests.

Predicting Ovulation by Hormone

The surge in LH is the trigger of ovulation, so this measurement can help identify the day of ovulation.

Home ovulation kits (ranging from $15 to $60) measure the hormone LH in urine. The surge in LH is the trigger of ovulation, so this measurement can help identify the day of ovulation. Some kits allow for daily testing, and they are about 99% accurate.

The Last Phase of Your Monthly Cycle

Progesterone released in the second half of the menstrual cycle prepares the uterine lining for pregnancy.

Progesterone released in the second half of the menstrual cycle prepares the uterine lining for pregnancy. If this does not occur, the egg disintegrates, and progesterone levels fall. About 12 to 16 days later, tissues from the lining of the uterus are expelled as menstrual bleeding. This usually takes 3 to 7 days, and then the cycle begins again.

How to Boost Ovulation

Increasing research suggests that environmental influences may decrease fertility.

Increasing research suggests that environmental influences may decrease fertility. Leading a healthy lifestyle may improve your chances of getting pregnant. This includes eating folic acid-rich foods, avoiding alcohol and caffeine, maintaining a healthy weight, and consuming more organic fruits and vegetables.

Weight Does Affect Fertility

Women whose body mass index (BMI) was above normal took twice as long to conceive as those with a normal BMI in one study.

Women whose body mass index (BMI) was above normal took twice as long to conceive as those with a normal BMI in one study. Weight loss for those who are overweight can improve both fertility and pregnancy outcomes. Even a 5% to 10% weight loss can improve ovulation and pregnancy rates. Obesity in men can also cause low testosterone levels, which can be a cause of infertility.

Age Affects Conception Success

A woman's age also affects her chances of getting pregnant.

A woman’s age also affects her chances of getting pregnant. For example, a healthy 30-year-old woman has about a 20% chance of getting pregnant each month. This chance drops to 5% for a healthy 40-year-old woman. According to experts, a woman under age 35 who has been trying to conceive unsuccessfully for a year should discuss the condition with her doctor. A woman over 35 years of age should seek medical advice after 6 months of trying to conceive.

Fertility Declines in Older Men, Too

In contrast to women, there is no maximum age at which a man is unable to father a child.

In contrast to women, there is no maximum age at which a man is unable to father a child. However, a man’s sperm count and motility of sperm both decrease with age. Men over age 45 have been shown to take longer to achieve a pregnancy when trying to conceive. You may wish to discuss with your doctor ways to enhance your chances for conception if your partner is older.

How Men Can Boost Fertility

Some lifestyle modifications may be able to boost male fertility, like maintaining a healthy weight, managing stress, and avoiding tobacco and alcohol use.

Some lifestyle modifications may be able to boost male fertility, like maintaining a healthy weight, managing stress, and avoiding tobacco and alcohol use. Eating a diet high in zinc (meats, whole grains, eggs, and seafood), vitamin E, and selenium (meats, seafood, mushrooms, Brazil nuts, and cereals) may also help. Keeping the testicles cool can improve male fertility; hot tubs, hot baths, and saunas can all reduce sperm count.

Infertility Treatments

A thorough evaluation is the first step in managing infertility, since there are so many potential causes.

A thorough evaluation is the first step in managing infertility, since there are so many potential causes. Treatments can include fertility drugs to stimulate ovulation and assisted reproductive technologies like in vitro fertilization (IVF). IVF involves removal of eggs from the ovaries, fertilizing them with partner sperm, and then inserting them back into the woman’s uterus.

How Home Pregnancy Tests Work

Home urine pregnancy tests can often tell if you're pregnant as early as five days before your expected period.

Home urine pregnancy tests can often tell if you’re pregnant as early as five days before your expected period. These are based on detecting the “pregnancy hormone” or human chorionic gonadotropin (hCG) that is produced after implantation of a fertilized egg. If you test too early, you may get a false negative result, so you should repeat the test if you suspect you are pregnant. A blood test at the doctor’s office can provide even more accurate results.

Five Early Signs of Pregnancy

Five early signs of pregnancy.

Five early signs of pregnancy include:

  1. a missed menstrual period,
  2. feeling easily tired,
  3. feeling nauseous in the morning or at other times,
  4. needing to urinate frequently, and
  5. tenderness and enlargement of the breasts.

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What Are the Signs of Not Being Able to Have a Baby?

Reviewed on 9/30/2021

How Common Is Infertility?

Infertility is a common condition affecting approximately 12% to 15% of couples trying to have a baby.

While some people seem to have an easy time having a baby, others struggle. Infertility is quite common, though. About 12% to 15% of people struggle to have a baby, and infertility affects around 1 in 8 heterosexual couples. How do you know if you’re not able to have a baby? There are some signs of infertility that you should see your doctor about.

Trying to Get Pregnant for 12 Months Without Results

The term infertility means that you are unable to get pregnant after 12 months of having regular sex with a consistent partner and no birth control methods.

The term infertility means that you are unable to get pregnant after 12 months of having regular sex with a consistent partner and no birth control methods. For females, after age 35, infertility is considered after 6 months of regular sex without contraceptives.

Some women get pregnant in one cycle, but this isn’t very common. On average, it takes couples 4 months to conceive. If you’ve just started out or are in this range, it might not be time yet to see the doctor, especially if everything else is normal and you’re having regular sex.

Heavy Periods

Examples of heavy periods occur when your period lasts longer than 8 days, you soak a tampon or a pad within one hour, or you have large blood clots.

Heavy periods happen when your period lasts longer than 8 days, you soak a tampon or a pad within one hour, or you have large blood clots. Many women have heavy periods and don’t think about it as a sign of infertility because they’re still getting a period, but you shouldn’t ignore it. Heavy periods can be a sign of an underlying condition and could be a symptom of endometriosis, which is linked to infertility.

Irregular Periods

Irregular periods are defined as a period that is longer than 38 days or shorter than 24 days as compared to the normal 28 day menstrual cycle.

The average menstrual cycle is 28 days long. You might have a period that is longer or shorter, which is normal as long as it consistently stays that way and isn’t shorter than 24 days or longer than 38 days. If your periods start to change to where you no longer can predict or expect them consistently, you have irregular periods. This could be caused by a disorder called polycystic ovarian syndrome, ovulation problems, or hormone problems, all of which can cause infertility.

Ejaculation Problems

Emotional, psychological, diseases, injuries, and medications can cause men to experience ejaculation problems where the sperm can’t meet up with the egg inside the uterus.

Men can also experience infertility and ejaculation problems might be a sign. Ejaculation is the release of semen and sperm cells following an orgasm. If you can’t ejaculate or you ejaculate too early, sperm can’t meet up with the egg inside the uterus. Sometimes these problems happen for emotional or psychological reasons, but it can also be a side effect of a testicle injury or surgery, certain medications like antidepressants or blood pressure pills, or from some diseases like diabetes. If you have trouble ejaculating, it’s a good idea to see your doctor.

Pain During Sex

Pain during sex can be a sign of a condition like an infection or endometriosis, which can cause infertility.

Pain during sex can be a sign of a condition like an infection or endometriosis, which can cause infertility. If you’ve always had painful sex, you might think it’s normal. Sometimes women have pain when the penis first enters the vagina, but having deep pain during sex is a sign of a problem. Make sure to talk to your doctor about this symptom.

Trouble Keeping an Erection

Erectile dysfunction (ED), or impotence, is a condition where men have trouble keeping or getting an erection to have sex.

Erectile dysfunction (ED), also called impotence, is a condition where you have trouble keeping or getting an erection hard enough for sex. While impotence can be emotional or psychological, it’s usually caused by other health problems like high blood pressure, diabetes, stress, and hormones. Low testosterone can cause infertility, so it’s a good idea to have erection problems assessed.

A Woman’s Age

Age can play a factor for women because ovulation naturally slows and fewer eggs are produced with age.

As women age, the chances for infertility get higher. This is because ovulation naturally slows down and stops with age. As you get closer to menopause, your body has fewer eggs, and your chances for infertility are higher.

Testicle Swelling or Pain

Testicle swelling or pain can be a sign of a physical problem like torsion, infection, injury, or cancer, which can lead to infertility.

Swelling or pain in your testicles can be a sign of a physical problem like torsion, infection, injury, or cancer, which can lead to infertility. It can also lead to problems making testosterone, which can affect fertility, too.

What About Recurrent Pregnancy Loss?

Recurrent pregnancy loss is defines as having two or more miscarriages.

Recurrent pregnancy loss happens when you have two or more miscarriages. Miscarriages are common and can occur for many different reasons, including genetic irregularities, hormone changes, uterus disturbances, and autoimmune problems. Most people who have recurrent pregnancy loss don’t have fertility problems. Having one or two miscarriages doesn’t mean you’ll have issues with infertility in the future.

If you’ve had repeated miscarriages, talk to your doctor. Testing can help you find and treat the cause, which can help you towards a healthy pregnancy. Sometimes it’s not always clear why there is repeated pregnancy loss, and, in these cases, some people choose to use assisted fertility treatments to help have a baby.

When to See a Doctor

You should see your doctor in the planning stages of having a baby to get a health check. You should also see your doctor if you and your partner have been trying for 12 months without a pregnancy.

If you plan to have a baby, it’s a good idea to get a check-up with your doctor before you start having regular unprotected sex. Your doctor can run some bloodwork and make sure you’re in good health and adjust any medications. If you’re having sex every 2 to 3 days for 12 months and you don’t have a pregnancy, it’s a good time to talk to your doctor.

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Fertility Options: Types, Treatments, and Costs

Reviewed on 2/10/2021

Infertility Treatments That Work

It's untrue that simply waiting it out will put an end to infertility.

It’s untrue that simply waiting it out will put an end to infertility. Like other medical conditions, there are treatments available for those experiencing infertility. At least half of couples undergoing infertility treatments will conceive, and technologies such as in vitro fertilization have brought about many pregnancies. More than 1 million babies were born in the U.S. from 1987 through 2015 through this technique, and each year more are born than in previous years.

Symptoms of Infertility

The main symptom of infertility is failure to conceive after a year of unprotected sex.

The main symptom of infertility is failure to conceive after a year of unprotected sex. This is the point at which most doctors recommend seeking fertility care. For women over age 35 who did not conceive after 6 months of trying or who have irregular menstrual cycles, seeing a fertility doctor as soon as possible is recommended. Male infertility is just as common as female infertility, so it’s important that both partners be evaluated.

Male Infertility

Male factors are responsible in about 40% of infertile couples.

Male factors are responsible in about 40% of infertile couples. Male factors can include low sperm count, abnormal sperm appearance, blocked sperm ducts, or poor motility of the sperm.

Female Infertility

An additional 40% of infertile couples have problems traced to the female partner.

An additional 40% of infertile couples have problems traced to the female partner. These can include irregular or absent ovulation, blockages in the Fallopian tubes, or abnormalities in the reproductive organs.

In the remaining 20% of infertile couples, no specific cause can be found.

Tracking Ovulation

Bad timing can contribute to a failure to conceive.

Bad timing can contribute to a failure to conceive. Over-the-counter ovulation tests can help you figure out the time of ovulation (egg release) and determine the best time for sex. The tests measure levels of a hormone that increases 12 to 36 hours before ovulation. If the test results are unclear or consistently negative, consult your doctor. About one-third of all cases of infertility are related to irregular ovulation.

Fertility Drugs

Medications are available to help women who do not ovulate regularly.

Medications are available to help women who do not ovulate regularly. Clomiphene citrate (Clomid or Serophene) is the most common of these medications. It is relatively effective and inexpensive, and about half of women who take it will conceive, usually within three cycles. Clomiphene may cause the release of more than one egg at a time, so there is an increased risk of a multiple pregnancy (a pregnancy of two or more fetuses).

Injectable Hormones

After trying clomiphene for 6 months, women who have not conceived may be prescribed injections of hormones to stimulate ovulation.

After trying clomiphene for 6 months, women who have not conceived may be prescribed injections of hormones to stimulate ovulation. Several different hormonal preparations are available. As with clomiphene, the chances of a multiple pregnancy are increased with hormone injections.

Surgery for Blocked Fallopian Tubes

Blockage or scarring of the Fallopian tubes prevents pregnancy in some women.

Blockage or scarring of the Fallopian tubes prevents pregnancy in some women. This may be due to endometriosis (overgrowth of uterine lining tissue outside the uterus), previous surgeries, or damage as a result of previous pelvic infections. Laparoscopic surgery can remove scar tissue in some women, increasing their chances for pregnancy.

Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is used to treat different kinds of infertility.

Intrauterine insemination (IUI) is used to treat different kinds of infertility. In this technique, sperm is placed directly into the uterus at the time of ovulation, reducing the distance the sperm must travel to reach the egg. IUI is often used together with drugs to stimulate ovulation. Pregnancy rates are lower than with IVF, but this procedure is less expensive and less invasive, so it may be attempted first.

IUI With Donor Sperm

IUI can also be performed using sperm from a donor if the male partner has a low number of healthy sperms.

IUI can also be performed using sperm from a donor if the male partner has a low number of healthy sperms. Counseling is typically recommended prior to this choice since the child will be biologically unrelated to the father. IUI with donor sperm is very successful in fertile women, with a cumulative pregnancy rate of over 80%.

In Vitro Fertilization (IVF)

IVF combines the egg and sperm in a laboratory, and can be an option when other treatments have failed.

IVF combines the egg and sperm in a laboratory, and can be an option when other treatments have failed. Embryos created in the lab are placed inside the uterus. IVF involves hormone injections and a surgical procedure to retrieve eggs from the female partner, and it can be costly. However, success rates are improving. Pregnancy rates per cycle range from 10% in women aged 43 to 44 to 46% in women under 35. Several cycles of treatment may be necessary.

IVF With ICSI

When problems have been identified with a man's sperm, a procedure called intracytoplasmic sperm injection (ICSI) may be recommended along with IVF.

When problems have been identified with a man’s sperm, a procedure called intracytoplasmic sperm injection (ICSI) may be recommended along with IVF. This is a laboratory-assisted fertilization that involves inserting a single sperm directly into an egg. The embryos that form are transferred to the uterus in the same way as IVF embryos. Most IVF cycles now also use ICSI.

IVF With Donor Eggs

Women who have poor egg quality, are older, or who have not had success with previous IVF cycles, may choose to consider IVF with donor eggs and her partner's sperm.

Women who have poor egg quality, are older, or who have not had success with previous IVF cycles, may choose to consider IVF with donor eggs and her partner’s sperm. The resulting baby is biologically related to the father and not the mother, although the mother carries the pregnancy. IVF using fresh embryos from donor eggs has a high success rate, resulting in live births 55% of the time.

IVF and Multiples

When embryos are transferred to the uterus in IVF, it is typical to transfer 2-4 embryos at once, increasing the likelihood of pregnancy but also increasing the likelihood of a multiple pregnancy.

When embryos are transferred to the uterus in IVF, it is typical to transfer 2-4 embryos at once, increasing the likelihood of pregnancy but also increasing the likelihood of a multiple pregnancy. It’s important to discuss this possibility with your fertility specialist, since a multiple pregnancy is associated with increased risks, such as premature birth, high blood pressure, anemia, miscarriage, and other complications.

IVF with Blastocyst Transfer

Blastocyst transfer is a relatively new IVF technology.

Blastocyst transfer is a relatively new IVF technology. Traditionally, IVF embryos were transferred to the uterus when they were at a stage of having 2 to 8 cells. In this procedure, the embryos grow for five days until they reach a later stage of development known as the blastocyst stage. Then, one or two blastocysts are transferred to the uterus. This eliminates the possibility of triplets and retains the high success rate of IVF.

Donor Embryos

Donor embryos are embryos donated by couples who have completed the IVF process.

Donor embryos are embryos donated by couples who have completed the IVF process. Transferring donor embryos is less costly than standard IVF or IVF with donor eggs. This procedure allows the experience of pregnancy. The baby will be biologically unrelated to either parent.

Surrogate Pregnancy

Surrogacy can be an option for women who have trouble carrying a pregnancy to term.

Surrogacy can be an option for women who have trouble carrying a pregnancy to term. Traditional surrogacy involves insemination of the surrogate with the male partner’s sperm. Gestational surrogacy is another option that involves using IVF to create embryos from both partners and transferring these embryos to the uterus of the surrogate. This option allows the baby to be biologically related to both the male and female partners.

Choosing Your Fertility Clinic

The Centers for Disease Control (CDC) keeps records comparing IVF success rates for clinics around the nation, but these should not be your only factor in choosing a fertility treatment clinic.

The Centers for Disease Control (CDC) keeps records comparing IVF success rates for clinics around the nation, but these should not be your only factor in choosing a fertility treatment clinic. Ask questions about procedures and costs when choosing a clinic, and be sure you feel comfortable with your choice.

Boost Fertility With Natural Methods

A few lifestyle changes can increase your chance of a healthy pregnancy, no matter where you are in the treatment process.

A few lifestyle changes can increase your chance of a healthy pregnancy, no matter where you are in the treatment process. Both partners, if smokers, should quit. Smoking reduces fertility and is known to reduce pregnancy rates. A study of sperm counts showed dramatic increases in men who stopped smoking. Eat a nutritious diet, and ask your doctor if dietary supplements might be recommended for you.

Using Acupuncture for Infertility?

An acupuncture treatment.

Some couples are trying acupuncture to boost fertility. There is research to indicate acupuncture might improve uterine blood circulation, help regulate ovulation, increase sperm count, and improve rates of success with IVF.

Moving On

Fertility treatments can become a physical, financial, and emotional burden.

Fertility treatments can become a physical, financial, and emotional burden. If you have reached your limit, you can talk with an infertility counselor about other options, including living without children or adoption. The costs of adoption vary widely, and foster care adoption can be an inexpensive option, while some private adoptions may cost around $40,000.

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What Vitamins and Supplements Should I Take to Increase

Reviewed on 9/16/2021

Health and Fertility

Nutrition is an important part of health and fertility.

Nutrition is an important part of health and fertility. Your body uses vitamins and minerals to help keep your body working properly. They are important for ovulation and menstruation, thyroid function, immune system function, energy production, and sperm and egg development. A lack of certain nutrients can lead to risks of infertility, disorders during pregnancy, and birth defects.

Folic Acid

Folic acid converts to folate in the body, which plays a role in general sexual health.

Folic acid converts to folate in the body, which plays a role in general sexual health. While there isn’t a lot of research on its impacts on fertility, folate helps in the DNA creation and replication process. This DNA process is important for egg or sperm cell development, which means folate is an important nutrient for fertility.

Folic acid is also a critical vitamin in early pregnancy, as it protects against spine and brain defects in babies. If you’re planning to have a baby, you should take 400 mcg of folic acid every day before you get pregnant and every day after you get pregnant for at least the first 12 weeks. You might need to take a higher dose if you:

  • Have diabetes
  • Take HIV medications
  • Take anti-seizure medications
  • Have a neural tube defect

Zinc

Zinc is an essential mineral needed for normal sperm growth, male sexual health, and the prostate gland.

Zinc is an essential mineral needed for normal sperm growth, male sexual health, and the prostate gland. But the research is mixed on zinc supplements.

Some studies say that not enough zinc leads to poor sperm quality and count, but other studies show that taking zinc supplements didn’t improve sperm.

There’s not a lot of research on zinc and female fertility, but some research shows that low zinc levels are linked to taking a longer time to conceive.

Zinc plays a role in so many processes, it’s important to get the recommended amount daily. Men should take 11 grams daily and women should take 8 grams daily.

Selenium

Selenium is another important mineral for immune function, thyroid function, and protection against oxidative stress.

Selenium is another important mineral for immune function, thyroid function, and protection against oxidative stress. It is also important for making and using testosterone and for sperm quality and function.

Low selenium levels are linked to male infertility. Men should get 55 micrograms daily and women should get 55 micrograms daily and 60 micrograms daily while pregnant.

B12

B12 is an essential vitamin for red blood cell formation and DNA synthesis.

B12 is an essential vitamin for red blood cell formation and DNA synthesis. Low B12 levels can cause certain types of anemia, birth defects, and infertility. Some studies report that more than half of women with infertility have low B12.

Supplementing with B12 might help during fertility treatments. Women who have higher blood levels of B12 while having assisted fertility treatments also have higher rates of pregnancy and healthy births. The daily recommended intake for B12 during pregnancy is 2.6 micrograms.

Vitamin D

Vitamin D is an important vitamin for immune function, healthy teeth and bones, cell growth, and lowering inflammation.

Vitamin D is an important vitamin for immune function, healthy teeth and bones, cell growth, and lowering inflammation. The role of vitamin D in fertility is not fully clear, but in women who have polycystic ovarian syndrome, low vitamin D can lead to poor ovary stimulation and infertility. You should get at least 600 international units of vitamin D every day.

Iron

Iron is an essential part of hemoglobin, a protein that helps carry oxygen from your lungs into your body's tissues.

Iron is an essential part of hemoglobin, a protein that helps carry oxygen from your lungs into your body’s tissues. It’s important for overall growth, brain growth, and basic cell function.

Not enough iron can cause ovulatory infertility, which happens when you can’t conceive because of an ovulation disorder. Studies show that women who took iron supplements had lower rates of ovulatory infertility than those who didn’t. Women with heavy periods tend to have lower levels of iron due to blood loss, so supplementation can help restore iron levels.

Vitamin C

Vitamin C is an antioxidant that protects against free radicals.

Vitamin C is an antioxidant that protects against free radicals. Your body makes free radicals as part of its normal processes, but too many free radicals can cause inflammation and damage to DNA. Vitamin C and other antioxidants neutralize free radicals and limit their damage. Studies show that women with endometriosis have lower vitamin C levels than women without infertility. Supplementing with vitamin C might help with infertility, but more research is needed.

Prenatal Vitamins and Fertility

Eating a healthy diet will give you most of the vitamins you need.

Eating a healthy diet will give you most of the vitamins you need. There are times, though, when you might not be getting everything you need. The birth control pill, for example, causes lower vitamin levels and you might need to take a multivitamin to replenish your body as you prepare for pregnancy.

It’s also generally recommended to take a prenatal vitamin if you plan to get pregnant. It should have:400 micrograms of folic acidIronB12No vitamin A

Some vitamins can interact with your medications and certain diseases, and taking too much of some vitamins like iron can also cause health problems. Make sure to talk to your doctor about your health and what is right for you.

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Conception Pictures: Journey from Egg to Embryo

Reviewed on 1/15/2021

Conception: From Egg to Embryo

A sperm cell penetrating and fertilizing an egg.

This slideshow will illustrate the incredible process of conception, beginning with the moment a sperm fertilizes an egg.

Ovulation

Ovum emerges surrounded by the corona radiate.

Each month, one of a woman’s two ovaries releases a mature egg in a process known as ovulation. Ovulation occurs about two weeks after the start of a woman’s last menstrual period.

Moving Into the Fallopian Tube

The released egg travels into the Fallopian tube, where it is fertilized by a single sperm.

The released egg travels into the Fallopian tube, where it is fertilized by a single sperm.

The Sperm’s Long Journey

When a man ejaculates, 40 to 150 million sperm may be contained in the fluid.

When a man ejaculates, 40 to 150 million sperm may be contained in the fluid. The sperm start swimming upstream in the women’s reproductive tract toward the Fallopian tubes. The time it takes for sperm to reach an egg is very variable – some may reach their target in half an hour, while others may take days. Sperm can live for up to 48 to 72 hours. Of the millions of sperm, only a few hundred even come close to the egg.

Fertilization: Sperm Penetrates Egg

The process of fertilization takes about 24 hours.

The process of fertilization takes about 24 hours. Once a sperm has penetrated the egg, the egg surface changes, preventing entry of other sperm. Fertilization completes the genetic makeup of the baby, including whether it will be a girl or boy.

The Cells Start to Divide

Once the egg is fertilized, a rapid process of division begins.

Once the egg is fertilized, a rapid process of division begins. The fertilized egg leaves the Fallopian tube and enters the uterus 3 to 4 days after fertilization. A tubal or ectopic pregnancy results in the rare cases in which the fertilized egg does not properly enter the uterus. An ectopic pregnancy poses serious health risks to the mother.

Implantation

Implantation is the process by which the fertilized egg attaches to the endometrium.

Implantation is the process by which the fertilized egg attaches to the endometrium (lining tissues of the uterus). The cells in the fertilized egg continue to divide.

Pregnancy Hormones

A hormone called human chorionic gonadotrophin (HCG) is produced by the cells that will eventually form the placenta.

A hormone called human chorionic gonadotrophin (HCG) is produced by the cells that will eventually form the placenta. It can be found in the mother’s blood within about a week of conception and is detected in pregnancy tests done on blood or urine.

Fetal Development

After implantation in the uterus, some of the cells form the placenta while others form the embryo.

After implantation in the uterus, some of the cells form the placenta while others form the embryo. The heartbeat begins during the fifth week of gestation. At the eighth week the developing embryo is now called a fetus. The fetus at eight weeks is about ½ inch long and constantly growing.

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Fetal Development Pictures: Month by Month

Reviewed on 2/22/2021

Your Baby’s Growth: Conception to Birth

 We are sure you are curious about how your pregnancy will progress, and how your baby will develop week to week over the next few months.

Congratulations on becoming pregnant! We are sure you are curious about how your pregnancy will progress, and how your baby will develop week to week over the next few months. In this slideshow we will look inside the womb to see how a baby develops through the first, second, and third trimesters.

Conception

Step one of conception is when the sperm penetrates the egg to complete the genetic make-up of a human fetus.

Step one of conception is when the sperm penetrates the egg to complete the genetic make-up of a human fetus. At this moment (conception), the sex and genetic make-up of the fetus begins. About three days later, the fertilized egg cell divides rapidly and then passes through the Fallopian tube into the uterus, where it attaches to the uterine wall. The attachment site provides nourishment to the rapidly developing fetus and becomes the placenta.

Baby’s Development at 4 Weeks

After 4 weeks, the basic structures of the embryo have begun to develop into separate areas that will form the head, chest, abdomen, and the organs contained within them.

After 4 weeks, the basic structures of the embryo have begun to develop into separate areas that will form the head, chest, abdomen, and the organs contained within them. Small buds on the surface will become arms and legs. A home pregnancy test should be positive at this stage of development (most tests claim positive results one week after a missed period).

Baby’s Development at 8 Weeks

At 8 weeks, the fetus is about a half-inch long (1.1cm).

At 8 weeks, the fetus is about a half-inch long (1.1cm). Facial features such as developing ears, eyelids, and nose tip are present. The limb buds are now clearly arms and legs, while the fingers and toes are still developing.

Baby’s Development at 12 Weeks

At 12 weeks, the fetus has grown to about 2 inches (4.4cm) in length and may begin to move by itself.

At 12 weeks, the fetus has grown to about 2 inches (4.4cm) in length and may begin to move by itself. The fingers and toes are discernible, and the fetal heartbeat may be audible by Doppler ultrasound. The developing sex organs may be identified by ultrasound techniques.

Baby’s Development at 16 Weeks

At 16 weeks, the fetus is about 4 and one-half inches long and resembles an infant.

At 16 weeks, the fetus is about 4 and one-half inches long and resembles an infant; the eyes blink, the heartbeat is easier to locate, facial features (nose, mouth, chin and ears) are distinct, and the fingers and toes are clearly developed; the skin on the fingers and toes even has distinct patterns (fingerprints!). Women should be able to feel the uterus at about 3 inches (6.6 cm) below the belly button; this is the beginning of the “baby bump” (abdominal swelling due to an expanding uterus) in some women.

Baby’s Development at 20 Weeks

At 20 weeks, the developing fetus is about 6 inches long (13.2 cm) and may weigh about 10 ounces.

At 20 weeks, the developing fetus is about 6 inches long (13.2 cm) and may weigh about 10 ounces. The baby may begin to make movements that the mother can feel at about 19 to 21 weeks; this baby movement is termed “quickening”. The baby at this stage of development can move its facial muscles, yawn, and suck its thumb. The expanding uterus at 20 weeks is felt at the level of the belly button.

It’s Time for an Ultrasound

In the US, women that have prenatal care usually have an ultrasound done at 20 weeks to determine that the placenta is attached normally and that the baby is developing without any problems.

In the US, women that have prenatal care usually have an ultrasound done at 20 weeks to determine that the placenta is attached normally and that the baby is developing without any problems. The baby’s movements can be seen with Doppler imaging, and usually the sex of the baby can be determined at this time, so if you want to be surprised about the sex of your baby at delivery, let your doctor know before the Doppler ultrasound is started!

Shown here is a 2D ultrasound (inset) contrasted with a 4D ultrasound, both at 20 weeks.

Baby’s Development at 24 Weeks

At 24 weeks, the baby may weigh 1.4 pounds and can respond to sounds.

At 24 weeks, the baby may weigh 1.4 pounds and can respond to sounds. Doppler studies show the sound response by measuring movement and heartbeat rates. Sometimes the baby will develop hiccups that the mother can feel! The baby’s inner ear canals are developed at 24 weeks, so researchers speculate the fetus can sense its position in the uterus.

Baby’s Development at 28 Weeks

At 28 weeks, the baby normally weighs about 2 and one-half pounds and has developed to the point that if the baby is birthed prematurely for any reason, the chances are good that the infant will survive, but usually would require a hospital stay.

At 28 weeks, the baby normally weighs about 2 and one-half pounds and has developed to the point that if the baby is birthed prematurely for any reason, the chances are good that the infant will survive, but usually would require a hospital stay. Your doctor may discuss signs of premature labor and suggest you (and your partner) take classes on what to do at the time of delivery of your full-term baby.

Baby’s Development at 32 Weeks

At 32 weeks, many babies weigh about 4 pounds, and have movements that the mother can feel.

At 32 weeks, many babies weigh about 4 pounds, and have movements that the mother can feel. Your doctor may ask you to make notes about the baby’s movements and discuss breastfeeding and other options along with scheduling visits every two weeks until you deliver the baby. Some women begin to leak a yellowish fluid from their breasts around this time; this is normal. This fluid is termed colostrum, and its presence indicates the breasts are primed to start producing milk for the newborn baby.

Baby’s Development at 36 Weeks

At 36 weeks the baby is about ready to be delivered and has reached an average length of 18.5 inches from head to heel length and weighs about 6 pounds.

At 36 weeks the baby is about ready to be delivered and has reached an average length of 18.5 inches from head to heel length and weighs about 6 pounds. However, a baby’s weight and length are quite variable and are influenced by the baby’s genetics, the baby’s sex, and many other factors. During this time, the baby has begun to rotate itself into the delivery position of head first into the pelvis. At 37 weeks, the baby has completed development of all organ systems to a level that should allow it to survive and continue its growth outside the uterus without the close hospital monitoring that is usually done with premature babies; consequently, the pregnancy is considered “at term” at 37 weeks and beyond.

Birth!

Delivery, due or birth date is calculated by estimating a 40 weeks delivery date, calculated after the first day of the mother's last period.

Delivery, due or birth date is calculated by estimating a 40 weeks delivery date, calculated after the first day of the mother’s last period. This is an estimated date; the normal vaginal delivery birth can occur easily between 38 and about 42 weeks and is considered an early or late term pregnancy. However, most babies are delivered before 42 weeks. Depending on various circumstances and complications, the doctor may need to induce labor and delivery in some women, while others may require a surgical delivery (Caesarean section or C-section). For most people, especially first-time parents, birth of an infant is a life-changing event!

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How Do I Know If I’m Pregnant or If My Period Is Late?

Reviewed on 7/16/2021

What Is a Period?

A period (menstruation) is the time in a woman or girl's monthly cycle in which her unfertilized egg leaves her body, along with blood and uterine tissue lining (endometrium).

A period (menstruation) is the time in a woman or girl’s monthly cycle in which her unfertilized egg leaves her body, along with blood and uterine tissue lining (endometrium). This normally takes about five days. Periods usually first begin (menarche) at or around age 12 in the US. They may begin between the ages of 10 and 15, though some may also start sooner or later than this. A period begins Day 1 of the menstrual cycle.

Understanding the Menstrual Cycle

The menstrual cycle is the process by which your body prepares an egg for fertilization, and also the period in time when your body removes the egg to prepare for the next egg.

The menstrual cycle is the process by which your body prepares an egg for fertilization, and also the period in time when your body removes the egg to prepare for the next egg. This is sometimes called a “monthly cycle,” and while 28 days is an average menstrual cycle length, it can range from about 24 days to 34 days.

Menstrual Cycle Timeline (approximated)

  • Day 1: Your menstrual cycle begins with the start of your period. The tissue lining around your uterus (endometrium) breaks down and an unfertilized egg begins to leave through your vagina along with blood. The bleeding of a period usually lasts 4-8 days, averaging 5 days for US women.
  • Day 5: Your estrogen levels rise once bleeding has stopped, and this does several things. These include:
    • The lining of your uterus thickens, preparing it for a new egg.
    • Ovarian sacs that contain eggs grow and mature, preparing one for ovulation.
  • Ovulation: Starting around day 12-14, an egg releases from your ovary. On this day, and up to three days prior, you are most likely to become pregnant if you have sex. There are subtle ways to help detect that you are ovulating, including body temperature and urine tests. If the egg is not fertilized, the cycle begins again with hormones that tell your uterine lining to break down again.

What Is a Late Period?

Many women know if they have a late period, and some keep a calendar to make sure.

Many women know if they have a late period, and some keep a calendar to make sure. A late period can turn into a missed period if pregnancy has occurred. But it can also be very normal because women’s periods can develop at unpredictable intervals.

Late Period Signs You May Be Pregnant

A woman's body might offer several clues that she is pregnant.

A woman’s body might offer several clues that she is pregnant. There are also tests available that offer more conclusive proof.

Missed Period

Missed periods are often the first clue that you have become pregnant.

Missed periods are often the first clue that you have become pregnant. But you might continue to have lighter and briefer spotting in some cases.

Fatigue

Your body makes more of the hormone progesterone for the first 13 weeks of pregnancy, which can make you feel tired and sluggish.

Your body makes more of the hormone progesterone for the first 13 weeks of pregnancy, which can make you feel tired and sluggish.

Spotting

Some women also experience cramps at this time.

When a fertilized egg reaches your uterine wall (about 6-12 days after conception), very light bleeding called “spotting” can sometimes result. Some women also experience cramps at this time.

Breast Changes

Your breasts may be tender, swollen, and sore, with a feeling of fullness, as early as one to two weeks after conception.

Your breasts may be tender, swollen, and sore, with a feeling of fullness, as early as one to two weeks after conception.

Nausea (Morning Sickness)

Some women are nauseous, and might even experience vomiting between weeks two and 14 of pregnancy.

Some women are nauseous, and might even experience vomiting between weeks two and 14 of pregnancy. This is called morning sickness, and while it is often worse in the morning, this sickness can occur at any time of the day.

Frequent Urination

You may need to pee more frequently starting at 6-8 weeks of pregnancy.

You may need to pee more frequently starting at 6-8 weeks of pregnancy. This need to urinate more frequently can last the duration of the pregnancy.

Headaches

Some women experience mild headaches caused by hormones and blood flow even before their period is missed.

Some women experience mild headaches caused by hormones and blood flow even before their period is missed.

Diagnosis and Tests for a Late Period and Pregnancy

There are both at-home tests and blood tests available to determine if pregnancy has occurred.

There are both at-home tests and blood tests available to determine if pregnancy has occurred. Both are considered safe methods of detecting pregnancy.

  • At-home tests: These test your urine for a pregnancy hormone called hCG. At-home tests are easy, quick, and convenient. However, they are not able to detect pregnancy as early as blood tests. They are most accurate if you wait one week after a missed period to use them.
  • Blood tests: Blood tests require a visit to your doctor. But they can detect pregnancy much earlier than at-home tests.

Treatments for a Late Period and Pregnancy

A missed period without pregnancy does not necessarily need medical treatment.

A missed period without pregnancy does not necessarily need medical treatment. However, you should visit the doctor if:

  • Your cycle has stopped (despite being regular before).
  • You’ve had unexpected bleeding.
  • Your last period was more than 90 days ago.
  • Your periods are regularly more than 35 days apart (oligomenorrhea).
  • Your periods become unusually heavy, painful, or long lasting, or you bleed between periods.

Depending on your diagnosis, your doctor might recommend lifestyle changes or medication such as birth control hormone therapy.

Other Causes of Why Your Period is Late

Late and missed periods can have many causes other than pregnancy.

Late and missed periods can have many causes other than pregnancy. These include:

  • Stress
  • Medications, including some anti-epileptics and antipsychotics
  • Uncontrolled diabetes
  • Medical conditions such as anorexia, bulimia, hyperprolactinemia, PCOS (polycystic ovary syndrome), and premature ovarian failure.

See your doctor if you have any questions about late and/or missed periods.

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16 Early Signs of Pregnancy: Could You Be Pregnant?

Reviewed on 12/10/2019

Introduction to Pregnancy Symptoms

A missed menstrual period is often the first recognizable sign of a possible pregnancy, but there are other signs and symptoms of early pregnancy as well

A missed menstrual period is often the first recognizable sign of a possible pregnancy, but there are other signs and symptoms of early pregnancy as well. Some subtle signs appear in the first week, and more may be apparent in the weeks before your first missed period.

Keep in mind that not all women have all symptoms or experience them in the same way. Some of the most common first trimester pregnancy symptoms are discussed in the following slides.

Missed Period

The first sign many women recognize as an early sign of pregnancy is a missed menstrual period.

The first sign many women recognize as an early sign of pregnancy is a missed menstrual period (amenorrhea). Some women may experience lighter-than-normal periods, and they may also have spotting that can occur 1 to 2 weeks following conception.

A missed menstrual period can be caused by other conditions aside from pregnancy, so it is not always a definitive sign.

Breast Swelling, Tenderness, and Pain

 You may notice tenderness or swelling in your breasts in the first or second week after you conceive.

Breast enlargement, tenderness, or pain similar to premenstrual symptoms can occur early in pregnancy. The breasts may feel full or heavy, and the area around the nipple (areola) may darken. A dark line called the linea nigra that runs from the middle of the abdomen to the pubic area may appear. You may notice tenderness or swelling in your breasts in the first or second week after you conceive.

When Does Morning Sickness Start?

A woman experiences nausea and vomiting due to morning sickness.

“Morning sickness” is nausea and vomiting that typically come in the morning in early pregnancy. This usually happens between weeks two and eight of pregnancy. It’s somewhat a misnomer because the nausea and vomiting can actually happen at any time. It’s thought that changes in levels of estrogen may play a role in developing nausea.

Another early pregnancy sign may be food cravings or aversions. Women may have an unusual urge to eat a particular food, even one she previously did not like, or she may be completely repulsed by a food she used to love. This is common, and usually the food aversions fade at the end of the first trimester.

Fatigue and Tiredness

The extra progesterone in a woman's body during pregnancy may cause her to feel fatigued and tired, and her need for naps increases.

The extra progesterone in a woman’s body during pregnancy may cause her to feel fatigued and tired, and her need for naps increases. By the second trimester, energy levels usually rise again.

Is Bloating an Early Sign of Pregnancy?

The rise in progesterone during pregnancy can also cause abdominal bloating, fullness, and gas.

The rise in progesterone during pregnancy can also cause abdominal bloating, fullness, and gas. The weight gain in the first trimester is usually minimal, but swelling and fluid retention may make you feel as if you have gained more than the typical one pound per month.

Frequent Urination

The urge to urinate more frequently starts about six weeks into pregnancy.

The urge to urinate more frequently starts about six weeks into pregnancy, thanks to the hormone human chorionic gonadotrophin (hCG), which causes increased blood flow to the pelvic area and can stimulate the urge to urinate. Later in pregnancy, the urge to urinate may be increased by the growing baby in the enlarging uterus putting pressure on the bladder.

Basal Body Temperature in Pregnancy

The basal body temperature usually rises around ovulation and lasts until the next menstrual period.

Many women hoping to become pregnant will chart their basal body temperature (the lowest body temperature in a 24-hour period, usually first thing in the morning after waking). The basal body temperature usually rises around ovulation and lasts until the next menstrual period. If the basal body temperature stays high for longer than that, this may indicate pregnancy.

Pregnancy Mask (Melasma)

During the first trimester, the skin on your forehead, bridge of your nose, upper lip, or cheekbones may darken.

During the first trimester, the skin on your forehead, bridge of your nose, upper lip, or cheekbones may darken. This is often referred to as the “mask of pregnancy,” and the medical term is melasma or chloasma. It is more common in darker skinned women and those with a family history of melasma.

Early Pregnancy Mood Swings

Rapid changes in hormone levels during pregnancy may be responsible for mood swings and feelings of stress.

Rapid changes in hormone levels during pregnancy may be responsible for mood swings and feelings of stress. Newly pregnant women may feel emotional, anxious, or depressed, and have crying spells. Mood swings may be worst in the first trimester, easing up somewhat in the second, and coming back as the pregnancy nears the end in the third trimester.

Pregnancy Headaches

Headaches are common in early pregnancy.

Headaches are common in early pregnancy. They may be caused by the surge of hormonal changes that begin soon after conception. Or they may be sinus headaches brought on by nasal congestion, which may also be a symptom of early pregnancy.

Bleeding, Spotting, or Discharge (Leukorrhea)

You may also experience light bleeding following a pelvic exam, Pap test, or after sex.

About 15% to 25% of pregnant women experience light bleeding or spotting in early pregnancy. This symptom can begin as soon as one week after conception. You may also experience light bleeding following a pelvic exam, Pap test, or after sex. This is common and usually not concerning, although if bleeding occurs later in pregnancy it can be serious.

Thin, milky, vaginal discharge is normal throughout pregnancy, and it may occur every day that you are pregnant. This is called “leukorrhea,” and it is caused by the extra estrogen your body is now producing. This discharge may be white or clear, and it may have a mild odor or none at all, all of which is normal. This is a necessary side effect of pregnancy, so there is no medical treatment for leukorrhea. However, it may be distressing for some women. Panty liners can help. But avoid tampons, which may cause infections.

Constipation

Many pregnant women become constipated.

Many pregnant women become constipated. Possibly more than 35% of pregnant women develop this discomfort according to some experts. This may be due to the hormonal changes that pregnancy causes, including an increase in progesterone.

If you have constipation, your doctor may tell you to drink more fluids, eat more fiber, and get enough exercise to move things along. But if these safe remedies don’t work, with a doctor’s guidance you may find other helpful treatments that are safe during pregnancy, such as certain types of laxatives. Do not take any medication while pregnant without your doctor’s recommendation.

Pregnancy: Multiple Births, Twins, Triplets, and More

Reviewed on 11/8/2021

What Are Multiple Births?

The number of multiple births is on the rise thanks to fertility treatments.

When a woman carries more than one infant in her uterus during pregnancy, they are called “multiples.” When a mom gives birth to twins, triplets, quadruplets, quintuplets, sextuplets, or even more babies, it is termed a multiple birth. The babies may be genetically identical or genetically different (fraternal). It is becoming more common for women to carry and give birth to many infants at one time due to assisted reproductive technology (ART). Multiple pregnancy also occurs naturally without the help of medical intervention.

What Are Identical Multiple Births?

Identical twins are born genetically identical.

An embryo consists of one single egg fertilized by one sperm. Sometimes, the egg splits in two, resulting in genetically identical twins. If one of these eggs splits again, triplets result. Four or more identical babies may result from eggs that split, but this is much more rare than twins or triplets. However many times an egg splits, the babies will be 100% genetically identical and will be the same gender. Approximately 3 or 4 of every 1,000 live births are identical.

What Are Fraternal Multiple Births?

Fraternal twins are siblings that are not genetically identical.

If a woman releases more than one egg per month, it is possible for multiple eggs to become fertilized at the same time. Each egg has distinct genes and is fertilized by different sperm. This results in multiples that are genetically unique, or fraternal. The babies may be different genders. They may appear as alike or dissimilar as any other genetically unique brothers and sisters. Fraternal multiples are more common than identical ones.

Is It Possible for Multiples to Have Different Dads?

It is possible for multiples to have different dads.

A woman is fertile for a certain amount of days every month. If a woman releases two or more eggs during this fertile period, the eggs may be fertilized at different times. If a woman has more than one sexual partner around the time of ovulation, it is even possible for the eggs to be fertilized by different men. Multiples may be conceived at different times by different fathers in the same pregnancy.

Communication Begins in the Womb

Parents of twin siblings notice their special bond.

Many parents of twins notice the children have unique ways of communicating with each other. They may even have their own secret language. One study of twins in utero found that by the 14th week of gestation, the infants make specific movements towards each other. The movements are intentional and not accidental. Additional studies are needed to see if the same behavior occurs with triplets, quadruplets, and other multiples.

Giving Birth to Multiples

Multiple pregnancy babies are often born via C-section.

Women who are pregnant with two or more babies may give birth via a cesarean section, or C-section. The doctor makes an incision in the lower abdomen and uterine wall to deliver the babies. Women who carry two or more infants at a time may experience more potential complications by trying to give birth vaginally. In cases in which the health of the mother or the infants is at risk, C-section birth may be necessary. Many twins and most triplets and greater numbers of multiples are born via C-section.

What Is Fertility Treatment?

Fertility drugs increase the chance of twin pregnancy and multiple pregnancy.

Fertility treatment increases the chance that a woman may conceive more than one baby at a time. Some fertility drugs increase the number of eggs released by the ovaries. More eggs mean a female has more chances to get pregnant. It also means she is more likely to get pregnant with fraternal multiples.

What Is In Vitro Fertilization?

In vitro fertilization is more popular in recent years.

This is a type of assisted reproductive technology (ART) in which a female is first given fertility drugs. Eggs are then harvested and fertilized with sperm in a laboratory procedure. The resulting embryos are then implanted within the female’s uterus. Sometimes, two or more embryos are placed within the uterus to increase the chance of a successful pregnancy. With this procedure, a female may end up carrying more than one embryo if more than one implant successfully.

Do the Age and Race of the Mom Matter?

More twins are born from African-American women than from females of other races.

African-American females have twins more often than women of other races. Asian females are least likely to have twins. A little more than one-third of American females over the age of 30 have babies. Women over the age of 30 are more likely to release two or more eggs during ovulation, so older females are more likely to become pregnant with more than one baby. This is a natural phenomenon that occurs without infertility treatment. Hormonal factors are likely responsible for the effect.

Does the Height of the Mom Matter?

Tall moms have hormones that increase fertility and the chance of multiple births.

Mothers who carry more than one baby at a time are an average of 1 inch taller than moms who carry single babies. Tall women tend to have higher levels of insulin-like growth factor (IGF), a hormone that may be responsible for the effect. This hormone stimulates the ovaries to release many eggs at once.

Milk Increases the Chance of Multiples

Dairy consumption increases the likelihood of multiple pregnancy.

Ovarian Stimulation

One study found that women who consumed milk and dairy products were more likely to have a multiple pregnancy than women who were vegan. Vegan females had twins at one-fifth the rate that vegetarian and omnivorous females did. The effect was especially pronounced in regions where the cattle were treated with growth hormones. Consuming dairy products from cows treated with growth hormone is supposed in the study to increase insulin-like growth factor, a hormone that stimulates the ovaries to release more eggs. However a different study concludes there is no difference in the level of hormones found in milk from treated cows compared to conventional milk.

Other Factors for Multiple Pregnancy

High BMI increases the chance of pregnancy and multiple births.

Multiple pregnancy runs in families. A woman who has a sister or mother who has fraternal twins is approximately twice as likely to have fraternal twins herself. Females who have a higher body mass index (BMI) are also more likely to have fraternal twin pregnancies. BMI is an indicator of body fat. Having a BMI that is higher than ideal is bad for your overall health.

What’s the Risk of Preterm Delivery?

It is more common for multiples to be born preterm.

When a mom is pregnant with more than one baby, preterm delivery is very common. Newborns who are delivered under 37 weeks are considered preterm and likely to have low birth weight. Early delivery is a common risk of multiple pregnancy. Infants delivered at 39 or 40 weeks of gestation are considered full-term. Newborns born before 32 weeks of are more likely to suffer from long-term health problems including vision issues, hearing loss, cerebral palsy, and potentially brain damage. During pregnancy, doctors watch for signs of fetal distress and monitor for the possibility of preterm birth.

What Is Preeclampsia?

Preeclampsia rates are higher in females carrying more than one fetus.

Preeclampsia is a condition in which pregnant mothers develop high blood pressure and possibly vision problems, headaches, vomiting, and nausea. Any pregnant mom can develop the condition but it is more common in multiple pregnancy. The condition is treatable with medication. Preeclampsia typically goes away after delivery. Frequent and adequate prenatal care decreases the risk that mom and babies will develop complications due to preeclampsia.

Prenatal Care Is Vital

Females pregnant with multiples need special medical care.

Moms with multiple pregnancy have a higher risk of potential complications, so frequent check-ups are necessary. Fetuses are also at increased risk in multiple pregnancy. The doctor will track fetal growth and development. The physician will monitor mom’s weight, blood pressure, blood sugar, and other factors. The doctor will also look for signs of early labor.

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How to Get Rid of Hemorrhoids: Causes and Treatments

Reviewed on 1/11/2022

What Are Hemorrhoids?

Hemorrhoids are clumps of dilated (enlarged) blood vessels in the anus and lower rectum.

Do you know what a hemorrhoid is? Hemorrhoids are clumps of dilated (enlarged) blood vessels in the anus and lower rectum. The rectum is the last area of the large intestine before it exits to the anus. The anus is the end of the digestive tract where feces leaves the body.

Sometimes hemorrhoids swell when the veins enlarge and their walls become stretched, thin, and irritated by passing stool. Hemorrhoids are classified into two general categories:

  • internal, originating in the rectum, and
  • external, originating in the anus.

Hemorrhoids (also termed piles) have caused pain and irritation throughout human history. The word comes from Greek, “haimorrhoides,” meaning veins that are liable to discharge blood. If you’ve had a bout of hemorrhoid pain, you’re not alone. It’s estimated that three out of every four people will have hemorrhoids at some point in their lives. Even Napoleon suffered from hemorrhoids, which distracted him with severe pain during his defeat at Waterloo.

Enlarged Hemorrhoid Symptoms

Enlarged hemorrhoids are associated with symptoms such as

  • itching,
  • mucus discharge,
  • burning at the anus,
  • severe pain,
  • a sensation that the bowel is not really empty, and
  • bleeding without pain.

In this article, our medical experts will explain where hemorrhoid pain comes from, what hemorrhoids feel like, and how they are diagnosed. Then you will discover the various treatments for hemorrhoids both at home and at a hospital, along with the pros and cons of each hemorrhoid treatment.

Internal Hemorrhoids

Internal hemorrhoids sit in the inside lining of the rectum.

Internal hemorrhoids sit in the inside lining of the rectum and are not obvious unless they are substantially enlarged. If they are greatly enlarged, they can be felt. Internal hemorrhoids are usually painless and become apparent because they cause rectal bleeding with a bowel movement.

Sometimes internal hemorrhoids prolapse or protrude outside the anus. If so, you may be able to see or feel them as moist pads of skin that are pinker than the surrounding area. These fallen hemorrhoids may hurt because the anus is dense with pain-sensing nerves. Such slipped hemorrhoids usually recede into the rectum on their own. If they don’t, they can be gently pushed back into place.

External Hemorrhoids

External hemorrhoids are located underneath the skin that surrounds the anus.

External hemorrhoids are located underneath the skin that surrounds the anus, and are lower than internal hemorrhoids. They can be felt when they swell, and may cause

  • itching,
  • pain, or
  • bleeding with a bowel movement.

If an external hemorrhoid prolapses to the outside (usually in the course of passing a stool), you can see and feel it.

Blood clots sometimes form within this type of fallen hemorrhoid, which can cause an extremely painful condition called a thrombosis. If a hemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and could possibly bleed.

Despite their appearance, thrombosed hemorrhoids usually are not serious, though they can be very painful. They will resolve on their own in a couple of weeks. If the pain is unbearable, your doctor or colorectal surgeon usually can remove the blood clot from the thrombosed hemorrhoid, which stops the pain.

Whom Do Hemorrhoids Affect?

Although most people think hemorrhoids are abnormal, everyone has them.

Although most people think hemorrhoids are abnormal, almost everyone has them. Hemorrhoids help control bowel movements. Hemorrhoids cause problems and can be considered abnormal or a disease only when the hemorrhoidal clumps of vessels enlarge.

Hemorrhoids occur in almost everyone, and an estimated 75% of people will experience enlarged hemorrhoids at some point. However only about 4% will go to a doctor because of hemorrhoid problems. Hemorrhoids that cause problems are found equally in men and women, and their prevalence peaks between 45 and 65 years of age.

What Causes Hemorrhoids?

Hemorrhoids are caused by swelling in the anal or rectal veins.

Hemorrhoids are caused by swelling in the anal or rectal veins. This makes hemorrhoids susceptible to irritation.

This swelling can be caused by several things, including

  • obesity,
  • pregnancy,
  • standing or sitting for long periods,
  • straining on the toilet,
  • chronic constipation or diarrhea,
  • eating a low-fiber diet,
  • coughing,
  • sneezing,
  • vomiting, and
  • holding your breath while straining to do physical labor.

How Do Foods Influence Hemorrhoids? Diet

People who consistently eat a high-fiber diet are less likely to get hemorrhoids.

Diet is believed to have a big impact in causing—and preventing—hemorrhoids. People who consistently eat a high-fiber diet are less likely to get hemorrhoids, while those people who prefer a diet high in processed foods face a higher hemorrhoid risk.

A low-fiber diet can leave you constipated, which can contribute to hemorrhoids in two way. For one, it promotes straining on the toilet. It also aggravates the hemorrhoids by producing hard stools that further irritate the swollen veins.

Painless Bleeding

The most common hemorrhoids symptom is painless bleeding.

The most common hemorrhoids symptom is painless bleeding. A hemorrhoid sufferer may notice bright red blood on the outside of the stools, on the toilet paper, or dripping into the toilet.

The bleeding usually resolves itself without treatment. Nevertheless, rectal bleeding with a bowel movement is never normal and should prompt a visit to a health care professional. While hemorrhoids are the most common cause of bleeding with a bowel movement, there may be other reasons for bleeding, including the following:

  • inflammatory bowel disease,
  • blood clotting problems,
  • fistulas and/or fissures (abnormal passages between a hollow organ and body surface)
  • infection, and
  • tumors.

Severe Hemorrhoids vs. Mild Hemorrhoids: Stages

Many physicians use a grading system to categorize hemorrhoids along four stages.

Do you know the stages of hemorrhoids? Many physicians use a grading system to categorize hemorrhoids along four stages:

  • First-degree hemorrhoids: Hemorrhoids that bleed, but do not prolapse. These are slightly enlarged hemorrhoids, but they do not protrude outside the anus.
  • Second-degree hemorrhoids: Hemorrhoids that prolapse and retract on their own (with or without bleeding). These may come out of the anus during certain activities like passing stool, and then return back inside the body.
  • Third-degree hemorrhoids: Hemorrhoids that prolapse and must be pushed back in by a finger.
  • Fourth-degree hemorrhoids: Hemorrhoids that prolapse and cannot be pushed back in the anal canal. Fourth-degree hemorrhoids also include hemorrhoids that are thrombosed (containing blood clots) or that pull much of the lining of the rectum through the anus.

Symptoms of Prolapsed Internal Hemorrhoids

Hemorrhoids prolapse when their blood vessels swell and extend from their location in the rectum through the anus.

Hemorrhoids prolapse when their blood vessels swell and extend from their location in the rectum through the anus. In your anal canal, your hemorrhoid is exposed to the trauma of passing stool, particularly hard stools associated with constipation. The trauma can cause bleeding and sometimes pain when stool passes.

The presence of

  • stool,
  • inflammation, and
  • constant moisture

can lead to anal itchiness (pruritus ani), and occasionally the constant feeling of needing to have a bowel movement. The prolapsing hemorrhoid usually returns into the anal canal or rectum on its own or can be pushed back inside with a finger, but falls out again with the next bowel movement.

Symptoms of Thrombosed External Hemorrhoids

External hemorrhoids can be felt as bulges at the anus, but they usually cause few of the symptoms that are typical of internal hemorrhoids.

External hemorrhoids can be felt as bulges at the anus, but they usually cause few of the symptoms that are typical of internal hemorrhoids.

External hemorrhoids can cause problems, however, when blood clots inside them. This is referred to as thrombosis. Thrombosis of such a hemorrhoid causes an anal lump that is

  • very painful,
  • tender, and
  • often requires medical attention.

The thrombosed hemorrhoid may heal with scarring, and leave a tag of skin protruding in the anus. Occasionally, the tag is large, which can make anal hygiene (cleaning) difficult or irritate the anus. Even after such a hemorrhoid goes away, a residual skin tag may remain, and this may need to be surgically removed.

How Long Do Hemorrhoids Take to Heal?

For many people, hemorrhoidal pain returns years after treatment.

For many people, hemorrhoids last and last. Ongoing pain is especially common for people over age 50. For many people, hemorrhoidal pain returns years after treatment, and for many others the condition comes and goes, becoming more common over time.

Do Hemorrhoids Ever Go Away on Their Own?

Sometimes they do. Smaller hemorrhoids are apt to go away in just a few days. It’s a good idea during this time to avoid further irritating your rectal area by keeping the area as clean as you can.

How Can You Make Hemorrhoids Go Away?

Tougher cases of hemorrhoids may not go away on their own. After trying home remedies and over-the-counter options without success, you will need to talk to your doctor about other treatment options.

How to Get Rid of Hemorrhoids: Diagnosis and Treatments

With a history of symptoms, a physician can begin diagnosis on the basis of a careful examination of the anus and anal area.

Most individuals who have hemorrhoids discover them by either

  • feeling the lump of an external hemorrhoid when they wipe themselves after a bowel movement,
  • noting drops of blood in the toilet bowl or on the toilet paper, or
  • feeling a prolapsing hemorrhoid (protruding from the anus) after bowel movements.

With a history of symptoms, a physician can begin diagnosis on the basis of a careful examination of the anus and anal area. Although the physician should try his or her best to identify the hemorrhoids, it is perhaps more important to exclude other causes of hemorrhoid-like symptoms that require different treatment such as

  • anal fissures,
  • fistulae,
  • bowel disorders like ulcerative colitis,
  • blood coagulation disorders,
  • perianal (around the anus) skin diseases,
  • infections, and
  • tumors.

Seeing a Doctor About Hemorrhoids

Many people are embarrassed to go to their doctor about their hemorrhoid problems, which is probably why only an estimated 4% of people see the doctor even if 75% of us experience enlarged hemorrhoids at some point in time. Despite the embarrassment, hemorrhoids should always be examined professionally. Getting a medical exam will help your doctor recommend an effective treatment, and will also help to rule out more serious causes for your symptoms. When you visit your doctor, you will probably be asked to describe your symptoms. The doctor will perform an examination to see whether your anus is inflamed, and whether enlarged hemorrhoids are present.When you visit your doctor, you will probably be asked to describe your symptoms. The doctor will perform an examination to see whether your anus is inflamed, and whether enlarged hemorrhoids are present.

The doctor will want to know if you have found blood in your stool, which may prompt a bowel endoscopy examination. The doctor will likely feel for anything unusual through a digital rectal examination.

Remember that while this might be a little embarrassing and uncomfortable, hemorrhoid exams are usually painless. Also, your doctor is accustomed to caring for this sort of problem, which is very common.

If you seem to have enlarged hemorrhoids, the doctor will probably recommend a proctoscopy. During a proctoscopy, a short tube with light and a lens will be used to examine the membranes lining your rectum. This will let your doctor see the enlarged hemorrhoids and determine their size. Again, this procedure is usually painless.

Can Hemorrhoids Be a Sign of Cancer?

Hemorrhoids themselves are rarely life-threatening.

Can hemorrhoids kill you? First of all, hemorrhoids have no relationship at all to colorectal cancer; hemorrhoids themselves are rarely life-threatening. But they share some of the symptoms of more serious diseases, including some rare anal cancers. That’s why a doctor’s diagnosis is so important.

How to Cure Internal Hemorrhoids: Diagnosis

The diagnosis of an internal hemorrhoid is easy if the hemorrhoid protrudes from the anus. Otherwise a s anoscope used to a more thorough exam.

The diagnosis of an internal hemorrhoid is easy if the hemorrhoid protrudes from the anus. Although a rectal examination with a gloved finger may uncover deep hemorrhoids, the rectal examination is more helpful in excluding rare cancers that begin in the anal canal and adjacent rectum.

A more thorough examination for internal hemorrhoids is done visually using an anoscope, which is similar to a proctoscope, but smaller. If there has been bleeding, the colon above the rectal area needs to be examined to exclude other important causes of bleeding other than hemorrhoids such as

  • colon cancer,
  • polyps, and
  • colitis.

This is true whether or not hemorrhoids are found during anoscopy.

How Do You Treat External Hemorrhoids? Diagnosis

External hemorrhoids appear as bumps and/or dark areas surrounding the anus.

External hemorrhoids appear as bumps and/or dark areas surrounding the anus. If the lump is tender, it suggests that the hemorrhoid is thrombosed. Any lump needs to be carefully followed, however, and should not be assumed to be a hemorrhoid since there are rare cancers of the anal area that may masquerade as hemorrhoids.

Who Removes Hemorrhoids? Treatment

Treating enlarged hemorrhoids is important, because they tend to get worse over time.

Treating enlarged hemorrhoids is important, because they tend to get worse over time. Hemorrhoids are treated with a variety of measures including diet, over-the-counter medicine like

  • anti-inflammatory pain killers,
  • creams,
  • lotions,
  • gels,
  • pads, and
  • wipes,

and various treatment options are available, like

  • sclerotherapy,
  • rubber band ligation, and
  • surgery.

Who Removes Hemorrhoids?

Most hemorrhoid complaints begin with a trip to a family doctor. Your doctor may then refer you to a specialist: either a gastroenterologist or a proctologist (also known as a colorectal surgeon). Proctologists specialize in surgical treatments, while gastroenterologists are experts in digestive diseases.

What Should I Eat if I Have Hemorrhoids? Diet

Individuals with hemorrhoids should soften their stools by increasing the fiber in their diets.

People with hemorrhoids should soften their stools by increasing the fiber in their diets.

Fiber is found in numerous foods, including

  • fresh and dried fruits,
  • vegetables,
  • whole grains, and
  • cereals.

In general, 20 to 30 grams of fiber per day is recommended, whereas the average American diet contains less than 15 grams of fiber. Fiber supplements, like psyllium, methylcellulose, and calcium polycarbophil, also may be used to increase the intake of fiber.

Stool softeners and increased drinking of liquids also may be recommended, as well as bulk-forming laxatives. Nevertheless, the benefits of fiber, liquids, and stool softeners have not been well-tested with respect to hemorrhoidal control in scientific studies.

How to Heal Hemorrhoids: Over-the-Counter Medications

When used around the anus, ointments, creams, and gels should be applied as a thin covering.

Products used to treat hemorrhoids are available as

  • ointments,
  • creams,
  • gels,
  • suppositories,
  • foams, and
  • pads.

When used around the anus, ointments, creams, and gels should be applied as a thin covering. When applied to the anal canal, these products should be inserted with a finger or a “pile pipe.” Pile pipes are most efficient when they have holes on the sides as well as at the end. Pile pipes should be lubricated with ointment prior to insertion. Suppositories or foams do not have advantages over ointments, creams, and gels.

Hemorrhoid Home Remedies: Warm Sitz Bath

A woman soaks in a sitz bath to treat her hemorrhoids.

A sitz bath refers to sitting in a few inches of warm water three times a day for 15 to 20 minutes. Taking a sitz bath may help decrease the inflammation of hemorrhoids. Drying off the anal area completely after each sitz bath is important for minimizing moisture that irritates the skin surrounding your rectal area.

Hemorrhoids Treatment: Stool Softeners

A woman shops for stool softeners to treat her hemorrhoids.

Stool softeners may help, but once hemorrhoids are present, even liquid stools may cause inflammation and infection of the anus. Your health care professional and pharmacist are good resources for discussing the use of stool softeners as hemorrhoid treatments.

Hemorrhoids Treatment: Sclerotherapy

In sclerotherapy treatment for hemorrhoids, a liquid is injected into the hemorrhoid that causes inflammation and scarring.

Sclerotherapy is one of the oldest forms of treatment for hemorrhoids. During this office-based procedure, a liquid (phenol or quinine urea) is injected into the base of the hemorrhoid.

The veins thrombose, inflammation sets in, and ultimately scarring takes place. Sclerotherapy causes the hemorrhoid to shrink. Pain may occur after sclerotherapy, but usually subsides by the following day. Symptoms of hemorrhoids frequently return after several years and may require further treatment.

Hemorrhoids Treatment: Rubber Band Ligation

In rubber band ligation, a rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.

The principle of rubber band ligation is to encircle the base of the hemorrhoidal clump with a tight rubber band. The tissue cut off by the rubber band dies, and is replaced by an ulcer that heals with scarring.

A similar procedure was described in 460 BC by the Greek physician Hippocrates:

“And hemorrhoids … you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application, and do not foment until they drop off, and always leave one behind; and when the patient recovers, let him be put on a course of Hellebore.”

Rubber band ligation can be used with first-, second-, and third-degree hemorrhoids, and may be more effective than sclerotherapy. Symptoms frequently recur several years later, but usually can be treated with further ligation.

The most common complication of ligation is pain. However, bleeding one or two weeks after ligation or bacterial infection in the tissues surrounding the hemorrhoids (cellulitis) may occur.

Doppler-Guided Artery Ligation

Another minimally-invasive treatment for hemorrhoids is found in Doppler-guided artery ligation.

Another minimally-invasive treatment for hemorrhoids is found in Doppler-guided artery ligation. Instead of removing the hemorrhoids themselves, artery ligation cuts off their blood supply. This treatment works best for grade II-III hernias, and while it is meant to reduce postoperative pain, 20% of patients still report pain after the procedure, particularly when pooping.

Hemorrhoid Treatment: Heat Coagulation

Electrocoagulation treatment for hemorrhoids.

There are several treatments that use heat to destroy hemorrhoidal tissue, and promote inflammation and scarring, including

  • bipolar diathermy,
  • direct-current electrotherapy, and
  • infrared photocoagulation.

Such procedures destroy the tissues in and around the hemorrhoids and cause scar tissue to form. They are used with first-, second-, and third-degree hemorrhoids. Pain is frequent, though probably less frequent than with ligation, and bleeding occasionally occurs. Other methods such as laser and radiowave ablation have been done. Non-surgical treatments are usually done on hemorrhoids graded I to II and some grade III; you should discuss the treatment and its projected outcome and recurrence rates with your doctor.

Hemorrhoids: Surgery

Surgical removal of hemorrhoids known as a hemorrhoidectomy and a stapled hemorrhoidectomy is reserved for patients with third- or fourth-degree hemorrhoids.

The vast majority of people can manage their symptom-causing hemorrhoids with non-surgical techniques. Non-operative treatment is preferred because it is associated with less pain and fewer complications than operative treatment. It is estimated that fewer than 10% of patients require surgery if the hemorrhoids are treated early.

Surgical removal of hemorrhoids, known as a hemorrhoidectomy or stapled hemorrhoidectomy, is reserved for patients with third- or fourth-degree hemorrhoids.

History of Hemorrhoid Surgeries

Surgery for hemorrhoids dates back to ancient times. Ancient Greeks, Romans, and Indians all described surgeries used to alleviate the pain and discomfort of enlarged hemorrhoids. These procedures improved greatly by the 13th century, and surgical treatments accelerated once again in the 19th century.

Getting Rid of Hemorrhoids: Excisional Hemorrhoidectomy

Examples of an open and closed hemorrhoidectomy.

During an excisional hemorrhoidectomy, the internal hemorrhoids and external hemorrhoids are cut out. The wounds left by the removal may be sutured (stitched) together (closed technique) or left open (open technique). The results with both techniques are similar.

A proctoplasty may also be performed. This procedure extends the removal of tissue higher into the anus so that redundant or prolapsing anal lining is also removed. Postoperative pain is a major problem with hemorrhoidectomy, and potent pain medications (narcotics) are usually required.

Stapled Hemorrhoidectomy (“Stapled Hemorrhoidopexy”)

Illustrations show the steps in performing a stapled hemorrhoidectomy.

The stapled hemorrhoidectomy (“stapled hemorrhoidopexy”) is a newer surgical technique that is rapidly becoming the treatment of choice for third-degree hemorrhoids. This surgery does not remove the hemorrhoids, but rather the expanded hemorrhoidal supporting tissue that has allowed the hemorrhoids to slip downward.

This procedure involves several steps:

  • A circular, hollow tube is inserted into the anal canal and a suture (a long thread) is placed through it and woven circumferentially within the anal canal above the internal hemorrhoids.
  • The ends of the suture are brought out of the anus through the hollow tube.
  • The stapler is placed through the hollow tube and the ends of the suture are pulled, expanding the hemorrhoidal supporting tissue into the jaws of the stapler.
  • The hemorrhoidal cushions are pulled back up into their normal position within the anal canal.
  • The stapler is then fired, cutting off the circumferential ring of expanded hemorrhoidal supporting tissue trapped within the stapler.
  • At the same time staples bring together the upper and lower edges of the cut tissue.

Stapled hemorrhoidectomy is less painful and faster than a traditional hemorrhoidectomy. It takes approximately 30 minutes to perform.

Hemorrhoids: Prevention

Eating a high-fiber diet and drinking plenty of fluids can help you stay regular, lowering your risk of developing hemorrhoids.

The best way to prevent hemorrhoids is to keep your stools soft so they are easy to pass and don’t require straining. Eating a high-fiber diet and drinking plenty of fluids (six to eight glasses each day) can help you stay regular and keep your stools soft, and may reduce constipation and the need to strain on the toilet, lowering your risk of developing new hemorrhoids.

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Stages of Pregnancy: Week by Week

Reviewed on 2/8/2022

Overview

Image of a human fetus.

How long does it take for a baby to be born? A typical pregnancy lasts 40 weeks from the first day of your last menstrual period (LMP) to the birth of the baby. It is divided into three stages, called trimesters: first trimester, second trimester, and third trimester. The fetus undergoes many changes throughout maturation.

How Soon Can You Tell If You Are Pregnant?

A missed period is often the first sign that you may be pregnant

A missed period is often the first sign that you may be pregnant, but how do you know for sure? Many women use home pregnancy tests to tell if they are pregnant; however, these tests are more likely to be accurate when used at least one week after a woman’s last period. If you take the test less than 7 days before your last menstrual period, it may give you a false result. If the test is positive, it is more likely that you actually are pregnant. However, if the test is negative, there is an increased chance that the test is wrong. Your doctor can do a blood test to detect pregnancy sooner than a home pregnancy test can.

Pregnancy Weight Gain

The amount of weight a woman should gain during pregnancy depends on her body mass index (BMI) prior to becoming pregnant.

The amount of weight a woman should gain during pregnancy depends on her body mass index (BMI) prior to becoming pregnant. Women who are a normal weight should gain between 25 and 35 pounds. Women who are underweight prior to pregnancy should gain more. Women who are overweight or obese prior to pregnancy should gain less. The recommended caloric intake for a normal weight woman who exercises less than 30 minutes per week is 1,800 calories per day during the first trimester, 2,200 calories per day during the second trimester, and 2,400 calories during the third trimester.

Pregnancy Weight Gain Distribution

Women gain weight all over their bodies while they are pregnant.

Women gain weight all over their bodies while they are pregnant. Fetal weight accounts for about 7 1/2 pounds by the end of pregnancy. The placenta, which nourishes the baby, weighs about 1 1/2 pounds. The uterus weighs 2 pounds. A woman gains about 4 pounds due to increased blood volume and an additional 4 pounds due to increased fluid in the body. A woman’s breasts gain 2 pounds during pregnancy. Amniotic fluid that surrounds the baby weighs 2 pounds. A woman gains about 7 pounds due to excess storage of protein, fat, and other nutrients. The combined weight from all these sources is about 30 pounds.

Pregnancy Complications

Pregnant women may experience certain complications and symptoms as the fetus grows.

Pregnant women may experience certain complications and symptoms as the fetus grows. Anemia, urinary tract infection, and mood changes may occur. An expectant mother may experience high blood pressure (preeclampsia), which increases the risk of preterm delivery and other potential dangers for the baby. Severe morning sickness or hyperemesis gravidarum causes persistent nausea and vomiting, particularly during the first 12 pregnancy weeks. This may lead to first trimester symptoms of weight loss and dehydration, requiring IV fluids and antinausea medication. Pregnant women should be aware of the possibility of developing gestational diabetes. It causes symptoms like excessive thirst and hunger, frequent urination, and fatigue. Obesity and excessive weight gain are possible, especially as the pregnancy progresses. Women are supposed to gain weight during pregnancy, but excessive weight gain may be associated with symptoms that put mother and baby at risk. Ask your doctor how much weight you should gain during your pregnancy.

The Three Stages of Pregnancy
(1st, 2nd, and 3rd Trimester)

Illustration examples of the first, second, and third trimesters of pregnancy.

Conception to about the 12th week of pregnancy marks the first trimester. The second trimester is weeks 13 to 27, and the third trimester starts about 28 weeks and lasts until birth. This slide show will discuss what occurs to both the mother and baby during each trimester.

First Trimester

First Trimester

First Trimester: Week 1 (conception) – Week 12

First Trimester: Early Changes in a Woman’s Body

A woman with a home pregnancy test examines her stomach in the mirror.

The early changes that signify pregnancy become present in the first trimester. A missed period may be the first sign that fertilization and implantation have occurred, ovulation has ceased, and you are pregnant. Other changes will also occur.

First Trimester: Physical and Emotional Changes a Woman May Experience

An exhausted woman (top left), woman with morning sickness (top right), woman eating a pickle with ice cream (bottom left), and woman weighing herself (bottom right).

Hormonal changes will affect almost every organ in the body. Some signs of early pregnancy in many women include symptoms like:

  • Extreme fatigue
  • Tender, swollen breasts. Nipples may protrude.
  • Nausea with or without throwing up (morning sickness)
  • Cravings or aversion to certain foods
  • Mood swings
  • Constipation
  • Frequent urination
  • Headache
  • Heartburn
  • Weight gain or loss

First Trimester: Changes in a Woman’s Daily Routine

A pregnant mom letting her son touch her belly.

Some of the changes you experience in your first trimester may cause you to revise your daily routine. You may need to go to bed earlier or eat more frequent or smaller meals. Some women experience a lot of discomfort, and others may not feel any at all. Pregnant women experience pregnancy differently, even if they’ve been pregnant before. Pregnant women may feel completely differently with each subsequent pregnancy.

First Trimester: The Baby at 4 Weeks

Development of embryo at approximately 4-6 weeks.

At 4 weeks, your baby is developing:

  • The nervous system (brain and spinal cord) has begun to form.
  • The heart begins to form.
  • Arm and leg buds begin to develop.
  • Your baby is now an embryo and 1/25 of an inch long.

First Trimester: The Baby at 8 Weeks

An eight week old human embryo.

At 8 weeks, the embryo begins to develop into a fetus. Fetal development is apparent:

  • All major organs have begun to form.
  • The baby’s heart begins to beat.
  • The arms and legs grow longer.
  • Fingers and toes have begun to form.
  • Sex organs begin to form.
  • The face begins to develop features.
  • The umbilical cord is clearly visible.
  • At the end of 8 weeks, your baby is a fetus, and is nearly 1 inch long, weighing less than ⅛ of an ounce.

First Trimester: The Baby at 12 Weeks

Human fetus in utero at twelve weeks.

The end of the first trimester is at about week 12, at this point in your baby’s development:

  • The nerves and muscles begin to work together. Your baby can make a fist.
  • The external sex organs show if your baby is a boy or girl.
  • Eyelids close to protect the developing eyes. They will not open again until week 28.
  • Head growth has slowed, and your baby is about 3 inches long, and weighs almost an ounce.

Second Trimester

Second Trimester

Second trimester: Week 13 – Week 28

Second Trimester: Changes a Woman May Experience

A pregnant woman starting to show.

Once you enter the second trimester you may find it easier than the first. Your nausea (morning sickness) and fatigue may lessen or go away completely. However, you will also notice more changes to your body. That “baby bump” will start to show as your abdomen expands with the growing baby. By the end of the second trimester you will even be able to feel your baby move!

Second Trimester: Physical and Emotional Changes in a Woman

A pregnant woman with back pain (left), pregnant woman with stretch marks and line running down her belly (center), and woman with melasma (pregnancy mask) on her cheek (right).

Some changes you may notice in your body in the second trimester include:

  • Back, abdomen, groin, or thigh aches and pains
  • Stretch marks on your abdomen, breasts, thighs, or buttocks
  • Darkening of the skin around your nipples
  • A line on the skin running from belly button to pubic hairline (linea nigra)
  • Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. This is sometimes called the mask of pregnancy (melasma, or Chloasma facies).
  • Numb or tingling hands (carpal tunnel syndrome)
  • Itching on the abdomen, palms, and soles of the feet. (Call your doctor if you have nausea, loss of appetite, vomiting, yellowing of skin, or fatigue combined with itching. These can be signs of a liver problem.)
  • Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight quickly, call your doctor immediately. This could be a sign of a serious condition called preeclampsia.)

Second Trimester: The Baby at 16 Weeks

The human fetus at about four months showing the head and upper limbs and the umbilical cord which connects the fetus (at the navel) to the placenta.

As your body changes in the second trimester, your baby continues to develop:

  • The musculoskeletal system continues to form.
  • Skin begins to form and is nearly translucent.
  • Meconium develops in your baby’s intestinal tract. This will be your baby’s first bowel movement.
  • Your baby begins sucking motions with the mouth (sucking reflex).
  • Your baby is about 4 to 5 inches long and weighs almost 3 ounces.

Second Trimester: The Baby at 20 Weeks

Human fetus near his fifth month of development.

At about 20 weeks in the second trimester, your baby continues to develop:

  • Your baby is more active. You might feel movement or kicking.
  • Your baby is covered by fine, feathery hair called lanugo and a waxy protective coating called vernix.
  • Eyebrows, eyelashes, fingernails, and toenails have formed. Your baby can even scratch itself.
  • Your baby can hear and swallow.
  • Now halfway through your pregnancy, your baby is about 6 inches long and weighs about 9 ounces.

Second Trimester: The Baby at 24 Weeks

Human fetus at approximately 24 weeks showing details of his closed eyes, nose, mouth, and facial hair.

By 24 weeks, even more changes occur for your growing baby:

  • The baby’s bone marrow begins to make blood cells.
  • Taste buds form on your baby’s tongue.
  • Footprints and fingerprints have formed.
  • Hair begins to grow on your baby’s head.
  • The lungs are formed, but do not yet work.
  • Your baby has a regular sleep cycle.
  • If your baby is a boy, his testicles begin to descend into the scrotum. If your baby is a girl, her uterus and ovaries are in place, and a lifetime supply of eggs has formed in the ovaries.
  • Your baby stores fat and weighs about 1½ pounds, and is 12 inches long.

Third Trimester

Third Trimester

Third Trimester: Week 29 – Week 40 (birth)

Third Trimester: Changes a Woman May Experience

A pregnant woman stretching her back while sitting.

The third trimester is the final stage of pregnancy. Discomforts that started in the second trimester will likely continue, along with some new ones. As the baby grows and puts more pressure on your internal organs, you may find you have difficulty breathing and have to urinate more frequently. This is normal and once you give birth these problems should go away.

Third Trimester: Emotional and Physical Changes a Woman May Experience

A pregnant woman holding her stomach.

In the third and final trimester you will notice more physical changes, including:

  • Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of a serious condition called preeclampsia.)
  • Hemorrhoids
  • Tender breasts, which may leak a watery pre-milk called colostrum
  • Your belly button may protrude
  • The baby “dropping,” or moving lower in your abdomen
  • Contractions, which can be a sign of real or false labor
  • Other symptoms you may notice in the third trimester include shortness of breath, heartburn, and difficulty sleeping

Third Trimester: Changes as the Due Date Approaches

A doctor examines a pregnant woman's belly.

Other changes are happening in your body during the third trimester that you can’t see. As your due date approaches, your cervix becomes thinner and softer in a process called effacement that helps the cervix open during childbirth. Your doctor will monitor the progress of your pregnancy with regular exams, especially as you near your due date.

Third Trimester: The Baby at 32 Weeks

The human fetus at 8 months, almost full term.

At 32 weeks in the third trimester, your baby’s development continues:

  • Your baby’s bones are soft but fully formed.
  • Movements and kicking increase.
  • The eyes can open and close.
  • Lungs are not fully formed, but practice “breathing” movements occur.
  • Your baby’s body begins to store vital minerals, such as iron and calcium.
  • Lanugo (fine hair) begins to fall off.
  • Your baby is gaining about ½ pound a week, weighs about 4 to 4½ pounds, and is about 15 to 17 inches long.

Third Trimester: The Baby at 36 Weeks

Human fetus in utero at approximately 36 weeks.

At 36 weeks, as your due date approaches, your baby continues development:

  • The protective waxy coating (vernix) thickens.
  • Body fat increases.
  • Your baby is getting bigger and has less space to move around. Movements are less forceful, but you will still feel them.
  • Your baby is about 16 to 19 inches long and weighs about 6 to 6½ pounds.

Third Trimester: The baby at 37 to 40 Weeks

A mom looks at her newborn child.

Finally, from 37 to 40 weeks the last stages of your baby’s development occur:

  • By the end of 37 weeks, your baby is considered full term.
  • Your baby’s organs are capable of functioning on their own.
  • As you near your due date, your baby may turn into a head-down position for birth.
  • Average birth weight is between 6 pounds 2 ounces to 9 pounds 2 ounces and average length is 19 to 21 inches long. Most full-term babies fall within these ranges, but healthy babies come in many different weights and sizes.

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What Foods Should I Eat During My First Trimester?

Reviewed on 8/24/2021

How Important Is Nutrition in First Trimester?

The first trimester of pregnancy is the first 12 weeks you are pregnant.

The first trimester of pregnancy is the first 12 weeks you are pregnant. While you may not yet be outwardly showing that you are pregnant, this is a crucial time for you and your baby. This is because both your body and your baby’s body will be rapidly changing.

The first trimester is the most sensitive time in your pregnancy. You must eat foods that nourish your body, and you should stay away from drugs, alcohol, and tobacco.

What Happens During the First Trimester?

Your baby's embryo will begin to attach to the uterine wall, and the following organs will form.

Your baby’s embryo will begin to attach to the uterine wall, and the following organs will form:

  • The amniotic sac. This is a sac that fills with fluid and surrounds the fetus. This sac encases the fetus throughout your pregnancy. In addition, the amniotic sac helps to protect and balance the temperature of the fetus.
  • The umbilical cord. The umbilical cord connects your fetus to the placenta. It allows blood to flow through two arteries and a vein. The blood that flows through the umbilical cord provides your fetus with nutrients.
  • Placenta. This small, flat organ is unique to pregnancies and lies against the uterine wall. It separates your blood supply from the blood supply to the fetus. It is crucial for transporting nutrients and taking away waste.

What to Eat During Pregnancy

During this time, you should be thinking about the food you eat as a source of support for your body and your fetus.

During this time, you should be thinking about the food you eat as a source of support for your body and your fetus. Everything you eat, your baby eats as well, so it’s also good to include various tastes and foods into your diet to give them variety.

You should eat food that is organic, local, and, as much as possible, free from chemicals. It’s also good to eat food that is unprocessed and does not contain too many chemicals.

We’ll look at some of the foods you should be eating on the following slides.

Leafy greens

Greens such as salad greens, kale, spinach, broccoli, bok choy, and mustard leaves benefit your body in many ways.

Greens such as salad greens, kale, spinach, broccoli, bok choy, and mustard leaves benefit your body in many ways. Specifically, these vegetables are chock-full of:

  • Vitamins A, B, C, E, and K
  • Antioxidants
  • Fiber
  • Iron
  • Magnesium
  • Potassium
  • Calcium

However, in the first trimester of pregnancy, the most significant benefit is undoubtedly the folic acid naturally contained in greens. Folic acid is usually in prenatal vitamins, and it helps to boost heart health as well as preventing birth defects.

Leafy greens have all of these fantastic benefits and nutrients while being low in carbohydrates, cholesterol, and sodium. Thus, eating greens during pregnancy is great for you and your fetus.

Colored Vegetables

To fuel your body with the best possible foods, you have to eat as many nutrients as you can and avoid other, less beneficial ingredients.

To fuel your body with the best possible foods, you have to eat as many nutrients as you can and avoid other, less beneficial ingredients. Usually, this means you should eat a lot of brightly colored vegetables. Eating the following vegetables will really help you throughout your pregnancy but especially in your first trimester:

  • Artichokes
  • Asparagus
  • Cauliflower
  • Celery
  • Peppers
  • Cucumbers
  • Squash
  • Corn
  • Sweet Potato

All of these vegetables contain the vital nutrients and vitamins that will most likely be in your prenatal vitamins — and more besides. For double the benefits, make sure you eat the right foods as well as taking your vitamins.

Healthy Proteins

Protein is an essential energy source for your body.

Protein is an essential energy source for your body. It supports both you and your growing fetus, and it helps your baby’s heart and brain development. The fats from animal proteins are also highly beneficial for both you and your baby.

Focus on eating healthy proteins, which means fish, meat, and meat alternatives that are fresh, unprocessed, and clean. It is doubly important to make sure that all your food is safe and free of contamination. This is especially true for raw meat and fish.

Some great sources of protein during your first trimester are:

  • Fish
  • Chicken
  • Turkey
  • Pork
  • Lamb
  • Eggs
  • Peanut Butter
  • Nuts
  • Legumes
  • Plant-based proteins like Tofu

Whole Grains

Whole grains are grains that look brown as opposed to white.

Whole grains are grains that look brown as opposed to white. Foods that contain whole grains include brown rice, whole-wheat pasta, cereals, and oatmeal. They are extremely healthy. They contain high amounts of:

  • Fiber
  • Iron
  • B Vitamins
  • Folic acid

All of these nutrients help your baby’s development and growth. They can also help aid or prevent constipation and/or hemorrhoids, which are common symptoms of pregnancy.

Colorful Fruits

One camp of people believe that fruit is too sugary to eat while you are pregnant, but this is untrue.

One camp of people believe that fruit is too sugary to eat while you are pregnant, but this is untrue. Fruits have significant nutritional benefits and help you to curb sugar cravings.

You should still be somewhat careful, though. Make sure you don’t eat too much juiced or sweetened fruit. Also, check in with how you feel after you eat fruit. If you are eating too much of it, you may notice a weight gain or a spike in your blood sugar. If so, cut back.

However, in moderation, the following fruits should be excellent for both you and your baby:

  • Bananas
  • Strawberries
  • Apples
  • Citrus
  • Mangoes
  • Pear
  • Avocados
  • Pomegranates
  • Grapes

Dairy Products

Dairy is a fantastic source of protein and calcium.

Dairy is a fantastic source of protein and calcium. These two things help the baby’s overall development and also, specifically, bone development. The best dairy sources are cheese, yogurt, and milk. However, make sure the dairy you buy is pasteurized.

Pasteurization helps kill bacteria to which you are more susceptible while pregnant. Usually, pasteurized products are carefully marked as pasteurized in the supermarket, so just look for information on the label.

Foods to Avoid

There are some foods and substances you should cut down on or avoid entirely in your first trimester and during pregnancy generally.

There are some foods and substances you should cut down on or avoid entirely in your first trimester and during pregnancy generally:

  • Tobacco
  • Alcohol
  • Raw meat
  • More than 200 milligrams of coffee in one day
  • Unpasteurized milk and its by-products
  • Deli meats
  • Raw or undercooked seafood
  • Pâté
  • Smoked seafood

In Summary

If you are in the first trimester of pregnancy, you should be taking care of yourself generally.

If you are in the first trimester of pregnancy, you should be taking care of yourself generally. This involves getting enough sleep, eating healthy foods, drinking lots of water, and listening to your body. This is an exciting and crucial period for you and your fetus, and you should take the time to fully experience the immense changes that are happening within you.

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Dos and Don’ts During the Second Trimester of Pregnancy

Reviewed on 10/1/2021

The Second Trimester

The second trimester, which occurs during the 13th to 28th week of pregnancy, is sometimes referred to the 'golden period' as many women enjoy this time of their pregnant journey.

Many women are delighted to reach the second trimester, during the 13th to the 28th weeks of pregnancy. Your baby bump may be starting to show and unpleasant symptoms like extreme fatigue and morning sickness may be going away.

Lots of women report that this is their favorite time of their pregnancy journey — it’s even called the “golden period” by some people. With less nausea, better sleep, and more energy, who can blame them?

There are some easy tips to keep in mind when it comes to the do’s and don’ts of the second trimester of pregnancy.

Things To Do During the Second Trimester

Follow your health team's recommendations on diet, exercise, and rest throughout your second trimester.

The short version? If you’ve been following your medical team’s recommendations surrounding diet, exercise, and rest throughout your first trimester, keep up the good work.

Here are the most important things to keep in mind as you navigate the second trimester of your pregnancy.

Do: Go To Your Doctor’s Appointments

It is important that you keep regular doctor visits during the second trimester to monitor your baby's progress as well as any undergo any recommended tests.

Over the course of your second trimester, you’ll have regular visits with your doctor. Usually, these happen about every four weeks.

During these visits, you can expect your doctor to check:

  • Your baby’s growth and measurements.
  • Your baby’s heartbeat using a Doppler instrument.
  • Your baby’s movement or kicks (after around week 18 or so).

Your doctor may also check if you’re due to update any of your vaccinations.

You may also be offered some choices around prenatal testing including genetic testing, ultrasounds, and blood tests. Talk to your doctor about what the benefits and risks of these tests might be for you and your baby.

Do: Eat Healthy Foods

Eating a healthy diet can help provide you and your growing baby with all of the nutrients you need during the second trimester.

Your healthy diet can help provide you and your growing baby with all of the nutrients you need. During your second trimester of pregnancy, you may notice that your appetite has increased. Resist the urge to “eat for two,” and prioritize getting plenty of healthy fruits, vegetables, and other important food groups. Experts agree that while your caloric need does go up in the second trimester, it only increases by around 340 calories — for example, an extra half sandwich and apple.

Some good choices to integrate into your diet include:

  • Vegetables: Dark, leafy greens, carrots, tomatoes, sweet potatoes, and red bell peppers are high in vitamin A and potassium.
  • Fruits: Melons, mangoes, apricots, oranges, bananas, and apples have lots of good fiber, are hydrating, and vitamin C.
  • Dairy: Eating low-fat yogurt, drinking reduced-fat milk, and small amounts of cheese products provide calcium, potassium, and vitamins.
  • Whole Grains: Many whole grains provide both iron and folic acid in addition to healthy fiber.
  • Proteins: Beans, peas, seeds, nuts, low-mercury fish like trout and salmon, lean beef, lamb, pork, and tofu all provide important protein.

Some healthy and satisfying snack choices during the second trimester include:

  • Smoothies with yogurt, fruit, and leafy greens.
  • Raw nuts including almonds, pecans, walnuts, and cashews.
  • Vegetables dipped in hummus.
  • Fresh fruit.

Do: Take Prenatal Vitamins

Prenatal vitamins are different from daily multivitamins and are needed for your changing body during pregnancy as well as for your baby's needs.

Prenatal vitamins are different from everyday multivitamins. Your body’s needs change when you’re pregnant, and your growing baby has specific vitamin needs, too. Just like during the first trimester of your pregnancy, your body and your baby need these important vitamins.

Prenatal vitamins include all of the calcium, iron, zinc, and folate that you need. Folate is important because it helps to prevent some common and serious birth defects including spina bifida and anencephaly.

Do: Stay Active

If you were exercising before pregnancy and during the first trimester, it's important to continue your activity in the second with exercise such as walking, yoga, swimming, and lifting weights..

If you had a regular exercise habit before your pregnancy and through the first trimester, it’s important to keep your level of activity up. The benefits of exercising through your second trimester of pregnancy — and beyond — include:

  • Decreased stress level
  • Balanced mood
  • Reduced fatigue
  • Reduced excess weight gain and gestational diabetes
  • Improved sleep and minimized insomnia
  • Reduced back pain

Some safe and healthy choices for exercise during your second trimester include:

  • Walk
  • Jog or run (if you practiced this prior to pregnancy)
  • Yoga
  • Swim
  • Lift light weights

Do: Stay Hydrated

Staying hydrated throughout your pregnancy can help you prevent many conditions including headaches, dizziness, kidney stones, constipation, and even preterm labor.

Hydration is important for everybody, whether you’re pregnant or not. Staying hydrated throughout your pregnancy can help you prevent many conditions including headaches, dizziness, kidney stones, constipation, and even preterm labor.

How much water should you drink during the second trimester? Doctors recommend drinking between 8-12 cups of water each day.

Other hydrating choices include sparkling water, herbal tea, juices, soups, and many kinds of fruit. Avoid drinks with caffeine or lots of sugar.

Do: Get a Flu Shot

The CDC recommends that all pregnant women get a flu shot as influenza can be harmful to your heart and lungs as well as your baby's development.

If you weren’t able to get a flu shot during your first trimester, now is the time.

The CDC recommends that all pregnant people get a flu shot — not a nasal spray version of the vaccine. Influenza can be harmful to a developing baby and can have serious impacts on a mother’s heart and lungs during pregnancy. Get a flu shot during pregnancy as a safe and easy way to protect yourself and your baby.

Do: Get Plenty of Sleep

It is important that you aim for at least 8-9 hours of high quality sleep during your second trimester of pregnancy.

Though you may not feel as exhausted as you did during the first trimester, it’s still important to get as much high-quality sleep at night as you can — aim for 8-9 hours.

Additionally, setting aside time to nap or rest during the afternoon can be helpful, too. The key is to listen to your body, and rest when you feel like you need it.

Things Not To Do During Your Second Trimester

Some foods, drinks, activities, and lifestyle choices are critical to avoid during the second trimester of pregnancy.

Recommendations largely include the same overall tips for health throughout your first trimester of pregnancy: eat a healthy diet, drink plenty of water, exercise safely, and get plenty of sleep. During your second trimester, like through the first, some foods and drinks to activities and lifestyle choices are critical to avoid during pregnancy.

Keeping these recommendations in mind can help your pregnancy progress smoothly and keep you and your baby safe and healthy.

Don’t: Drink Alcohol

Any amount of alcohol can seriously damage a baby's developing brain (Fetal Alcohol Syndrome) and should be avoided during pregnancy.

During your second trimester of pregnancy, your baby’s brain and body develop quickly. Alcohol can cause serious damage to a baby’s developing brain. There is no known safe amount of alcohol to consume during pregnancy.

Possible symptoms of Fetal Alcohol Syndrome include:

  • Abnormal facial features
  • Small head size
  • Low body weight
  • Poor coordination
  • Poor memory
  • Difficulty with attention
  • Hyperactive behavior
  • Learning disabilities
  • Poor reasoning and judgment skills
  • Sleep problems
  • Vision or hearing problems
  • Problems with heart, kidney, or other organs

Don’t: Smoke or Use Drugs

Smoking and other controlled substances and drugs put your baby at increased risk of birth defects, premature birth, learning disabilities, death and Sudden Infant Death Syndrome (SIDS).

Smoking during and after pregnancy puts you at an elevated risk for miscarriage. It also puts your baby at an increased risk of birth defects, premature birth, low birth weight, infant death, and learning disabilities. It’s also considered one of the most significant risk factors for Sudden Infant Death Syndrome (SIDS).

Other controlled substances and drugs — including some kinds of prescription medications — can cause serious harm to your baby during pregnancy. Avoid all opioids and street drugs during all trimesters of your pregnancy. Before using any medication, confirm with your doctor or pharmacist that it is approved for safe use while you’re pregnant.

Don’t: Drink (Too Much) Caffeine

Experts suggest cutting caffeine completely out of your diet, but many agree that small amounts (150mg - the equivalent of one cup of brewed coffee or three cups of black or green tea) are ok.

While experts suggest cutting caffeine out of your diet entirely, many agree that small amounts are safe. Caffeine, found in coffee, tea, chocolate, and energy drinks, is a diuretic — it causes you to urinate more and makes you vulnerable to dehydration, It can also increase your heart rate or blood pressure, both of which could have a negative impact on your pregnant body.

The general consensus is that the less caffeine you consume, the better. Keeping your daily intake to around 150mg (the equivalent of one cup of brewed coffee or three cups of black or green tea) is generally believed to be safe.

Don’t: Eat Dangerous Foods

Foods such as unpasteurized dairy, processed meat, raw or undercooked seafood, raw eggs, raw meat, unwashed fruits and vegetables are considered dangerous to eat anytime during pregnancy.

Some foods are considered dangerous during the first trimester of pregnancy (and beyond). Experts recommend avoiding:

  • Any form of unpasteurized dairy
  • Processed meat (like hot dogs or lunch meat) unless thoroughly heated before eating
  • Raw or undercooked seafood, eggs, or meat
  • Cold pate or meat spreads
  • Cold smoked seafood
  • Unwashed fruits or vegetables

Don’t: Engage in Risky Behavior

Experts recommend avoiding risky behavior such as dieting or trying to lose weight, hot tubs, saunas, cat littler box and feces, tattoos, piercings, and rough contact sports as things to avoid during pregnancy.

If you’re ever unsure if a choice is safe or not at any point during your pregnancy, call your doctor to find out more.

Experts also recommend avoiding risky behavior during pregnancy including:

  • Diet or try to lose weight. Restricting calories or exercising too much can harm your baby.
  • Use hot tubs or saunas. If your core temperature gets too high, it can cause birth defects or a miscarriage.
  • Clean your cat’s litter box. Cat feces can carry a dangerous parasite that causes toxoplasmosis. (Don’t worry — holding and petting your feline friend is perfectly safe.)
  • Get tattoos or piercings. The risk of infection (including Hepatitis B or HIV) could affect your baby’s health.
  • Play rough contact sports. Activities that put you at increased risk of overheating or getting injured should be avoided. (Examples: “hot yoga,” martial arts, horseback riding, hockey, boxing, soccer, basketball, off-road cycling, skiing, surfing, gymnastics, scuba diving, etc.)

Enjoy Your Second Trimester

Keep up the habits of eating well, staying active, staying hydrated, and avoiding dangerous foods, drinks, and sports, and your second trimester of pregnancy and beyond will be an enjoyable one.

Many pregnant people enjoy the second trimester very much. With nausea and fatigue in the rearview mirror, and not yet navigating the world with a fully pregnant belly, it can be quite enjoyable.

Keep up the habits that you developed in your first trimester — eat well, stay active, keep yourself hydrated, and avoid the foods, drinks, and sports that could be dangerous — and you will sail into your third and final trimester of a healthy pregnancy.

If you stay away from alcohol, smoking, drugs, and risky activities, you’ll be more likely to enjoy a healthy pregnancy and baby. During your first trimester — or beyond — don’t hesitate to ask your doctor any questions you have about what you should or shouldn’t do while you’re pregnant.

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Ulcerative Colitis Causes, Diagnosis and Treatment

Reviewed on 11/11/2020

What is Ulcerative Colitis?

Ulcerative colitis is a disease in which there is chronic inflammation of the inner lining of the colon.

Ulcerative colitis is a disease in which there is chronic inflammation of the inner lining of the colon. The inflammation can cause the lining tissue to break down, forming ulcerations that can bleed. Inflammation can involve the entire colon or only parts of it. Almost always, ulcerative colitis requires treatment.

Warning Sign: Abdominal Pain

The main symptoms caused by ulcerative colitis are abdominal pain and diarrhea, usually bloody.

The main symptoms caused by ulcerative colitis are abdominal pain and diarrhea, usually bloody. Symptoms vary in severity from mild to severe. The photograph shows the typical pattern of ulcerative colitis with ulcerations covered by white pus.

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