Having a Healthy Pregnancy

If you've decided to have a baby, the most important thing you can do
is to take good care of yourself so that you and your baby will be
healthy. Girls who get the proper care and make the right choices have a
very good chance of having healthy babies.

Prenatal Care



See a doctor as soon as possible after you find out you're pregnant
to begin getting prenatal care (medical care during pregnancy). The
sooner you start to get medical care, the better your chances that you
and your baby will be healthy.

If you can't afford to go to a doctor or clinic for prenatal care,
social service organizations can help you. Ask your parent, school
counselor, or another trusted adult to help you locate resources in your
community.

During your first visit, the doctor will ask you lots of questions,
including the date of your last period. This helps the doctor estimate
how long you have been pregnant and your due date.

Doctors measure pregnancies in weeks. A baby's due date is only an
estimate, though: Most babies are born between 38 and 42 weeks after the
first day of a woman's last menstrual period, or 36 to 40 weeks after
conception (when the sperm fertilizes the egg). Only a small percentage
of women actually deliver exactly on their due dates.Timelines



A pregnancy is divided into three phases, or trimesters.
The first trimester is from conception to the end of week 13. The
second trimester is from week 14 to the end of week 26. The third
trimester is from week 27 to the end of the pregnancy.

The doctor will examine you and perform a pelvic exam. He or she may also perform blood tests, a urine test, and tests for sexual transmitted disease
including a test for HIV, which is on the rise in teens. (Some STDs can
cause serious medical problems in newborns, so it's important to get
treatment to protect the baby.)

The doctor will explain the types of physical and emotional changes
you can expect during pregnancy. He or she will also teach you to how to
recognize the signs of possible problems during pregnancy (called
complications). This is especially important because teens are more at
risk for certain complications, such as anemia, high blood pressure, and
delivering a baby earlier than usual (called premature delivery).

Your doctor will want you to start taking prenatal vitamins that
contain folic acid, calcium, and iron as soon as possible. The doctor
may prescribe the vitamins or recommend a brand that you can buy over
the counter. These vitamins and minerals help ensure the baby's and
mother's health as well as prevent some types of birth defects.

Ideally, you should see your doctor once each month for the first 28
weeks of your pregnancy, then every 2 weeks until 36 weeks, then once a
week until you deliver the baby. If you have a medical condition such as
diabetes that needs careful monitoring during your pregnancy, your
doctor will probably want to see you more often.

During visits, your doctor will check your weight, blood pressure,
and urine, and will measure your abdomen to keep track of the baby's
growth. Once the baby's heartbeat can be heard with a special device,
the doctor will listen for it at each visit. Your doctor will probably
also send you for some other tests during the pregnancy, such as an
ultrasound, to make sure that everything is OK with your baby.

One part of prenatal care is attending classes where expectant
mothers can learn about having a healthy pregnancy and delivery and the
basics of caring for a new baby. These classes may be offered at
hospitals, medical centers, schools, and colleges in your area.

It can be difficult for adults to talk to their doctors about their
bodies and even more difficult for teens to do so. Your doctor is there
to help you stay healthy during pregnancy and have a healthy baby — and
there's probably not much he or she hasn't heard from expectant mothers!
So don't be afraid to ask questions.

Be upfront when your doctor asks questions, even if they seem
embarrassing. A lot of the issues the doctor brings up could affect your
baby's health. Think of your doctor both as a resource and a friend who
you can confide in about what's happening to you.Changes to Expect in Your Body



Pregnancy causes lots of physical changes in the body. Here are some common ones:

Breast Growth



An increase in breast size is one of the first signs of pregnancy,
and the breasts may continue to grow throughout the pregnancy. You may
go up several bra sizes during the course of your pregnancy.

Skin Changes



Don't be surprised if people tell you your skin is "glowing" when you
are pregnant — pregnancy causes an increase in blood volume, which can
make your cheeks a little pinker than usual. And hormonal changes
increase oil gland secretion, which can give your skin a shinier
appearance. Acne is also common during pregnancy for the same reason.

Other skin changes caused by pregnancy hormones may include brownish or yellowish patches on the face called chloasma and a dark line on the midline of the lower abdomen, known as the linea nigra.

Also, moles or freckles that you had prior to pregnancy may become bigger and darker. Even the areola,
the area around the nipples, becomes darker. Stretch marks are thin
pink or purplish lines that can appear on your abdomen, breasts, or
thighs.

Except for the darkening of the areola, which can last, these skin changes will usually disappear after you give birth.

Mood Swings



It's very common to have mood swings during pregnancy. Some girls may
also experience depression during pregnancy or after delivery. If you
have symptoms of depression such as sadness, changes in sleep patterns,
thoughts of hurting yourself, or bad feelings about yourself or your
life, tell your doctor so he or she can help you to get treatment.

Pregnancy Discomforts



Pregnancy can cause some uncomfortable side effects. These include:

• nausea and vomiting (especially early in the pregnancy)
  
• leg swelling
  
• varicose veins in the legs and the area around the vaginal opening
  
• hemorrhoids
  
• heartburn and constipation
  
• backache
  
• fatigue
  
• sleep loss
  

If you have one or more of these side effects, keep in mind that
you're not alone! Ask your doctor for advice on how to deal with these
common problems.

If you are pregnant and have bleeding or pain, call the doctor
immediately, even if you are not planning to continue the pregnancy.Things to Avoid



Smoking, drinking alcohol, and taking drugs when you are pregnant put
you and your baby at risk for a number of serious problems.

Alcohol



Doctors now believe that it's not safe to drink any amount of alcohol
when you are pregnant. Drinking can harm a developing fetus, putting a
baby at risk for birth defects and mental problems.

Smoking



The risks of smoking during pregnancy include stillbirths (when a
baby dies while inside the mother), low birth weight (which increases a
baby's risk for health problems), prematurity (when babies are born
earlier than 37 weeks), and sudden infant death syndrome (SIDS). SIDS is
the sudden, unexplained death of an infant who is younger than 1 year
old.

Drugs



Using illegal drugs such as cocaine or marijuana during pregnancy can
cause miscarriage, prematurity, and other medical problems. Babies can
also be born addicted to certain drugs.

Ask your doctor for help if you are having trouble quitting smoking,
drinking, or drugs. Check with your doctor before taking any medication
while you are pregnant, including over-the-counter medications, herbal
remedies and supplements, and vitamins.

Unsafe Sex



Talk to your doctor about sex during pregnancy. If your doctor says
it's OK to have sex while you're pregnant, you must use a condom to help
prevent getting an STD. Some STDs can cause blindness, pneumonia, or
meningitis in newborns, so it's important to protect yourself and your
baby.Taking Care of Yourself During Pregnancy



Eating



Many girls worry about how their bodies look and are afraid to gain
weight during pregnancy. But now that you are eating for two, this is
not a good time to cut calories or go on a diet. Both you and your baby
need certain nutrients so the baby can grow properly. Eating a variety
of healthy foods, drinking plenty of water, and cutting back on high-fat
junk foods will help you and your developing baby to be healthy.

Doctors generally recommend adding about 300 calories a day to your
diet to provide adequate nourishment for the developing fetus. You
should gain about 25 to 35 pounds during pregnancy, most of this during
the last 6 months — although how much a girl should gain depends on how
much she weighed before the pregnancy. Your doctor will advise you based
on your individual situation.

Eating additional fiber — 25 to 30 grams a day — and drinking plenty
of water can help to prevent common problems such as constipation. Good
sources of fiber are fresh fruits and vegetables and breads, cereals, or
muffins that have lots of whole grain in them.

You'll need to avoid eating or drinking certain things during pregnancy, such as:

• certain types of fish, such as swordfish, canned tuna, and other
  fish that may be high in mercury (your doctor can help you decide which
  fish you can eat)
  
• foods that contain raw eggs, such as mousse or Caesar salad
  
• raw or undercooked meat and fish
  
• processed meats, such as hot dogs and deli meats
  
• soft, unpasteurized cheeses, such as feta, brie, blue, and goat cheese
  
• unpasteurized milk, juice, or cider
  

It's also a good idea to limit artificial sweeteners, and drinks that contain caffeine and artificial sweeteners.

Exercise



Exercising during pregnancy is good for you as long as you are having
an uncomplicated pregnancy and choose appropriate activities. Doctors
generally recommend low-impact activities such as walking, swimming, and
yoga. Contact sports and high-impact aerobic activities that pose a
greater risk of injury should generally be avoided. Also, working at a
job that involves heavy lifting is not recommended for women during
pregnancy. Talk to your doctor if you have questions about whether
particular types of exercise are safe for you and your baby.

Sleep



It's important to get plenty of rest while you are pregnant. Early in
your pregnancy, try to get into the habit of sleeping on your side.
Lying on your side with your knees bent is likely to be the most
comfortable position as your pregnancy progresses. Also, it makes your
heart's job easier because it keeps the baby's weight from applying
pressure to the large vein that carries blood back to the heart from
your feet and legs.

Some doctors recommend that girls who are pregnant sleep on the left
side. Because of where some of your major blood vessels are, lying on
your left side helps keep the uterus from pressing on them. Ask what
your doctor recommends — in most cases, lying on either side should do
the trick and help take some pressure off your back.

Throughout your pregnancy, but especially toward the end, you may
wake up often at night to go to the bathroom. While it's important to
drink enough water while you're pregnant, try to drink most of it during
the day rather than at night. Use the bathroom right before going to
bed. As you get further along in your pregnancy, you might have a
difficult time getting comfortable in bed. Try positioning pillows
around and under your belly, back, or legs to get more comfortable.

Stress can also interfere with sleep. Maybe you're worried about your
baby's health, about delivery, or about what your new role as a parent
will be like. All of these feelings are normal, but they may keep you up
at night. Talk to your doctor if you are having problems sleeping
during your pregnancy.Emotional Health



It's common for pregnant teens to feel a range of emotions, such as
fear, anger, guilt, confusion, and sadness. It may take a while to
adjust to the fact that you're going to have a baby. It's a huge change,
and it's natural for pregnant teens to wonder whether they're ready to
handle the responsibilities that come with being a parent.

How a girl feels often depends on how much support she has from the
baby's father, from her family (and the baby's father's family), and
from friends. Each girl's situation is different. Depending on your
situation, you may need to seek more support from people outside your
family. It's important to talk to the people who can support and guide
you and help you share and sort through your feelings. Your school
counselor or nurse can refer you to resources in your community that can
help.

Sometimes girls who are pregnant have miscarriages and lose the
pregnancy. This can be very upsetting and difficult to go through for
some girls, although it may bring feelings of relief for others. It is
important to talk about these feelings and to get support from friends
and family — or if that's not possible, from people such as counselors
or teachers.School and the Future



Some girls plan to raise their babies themselves. Sometimes
grandparents or other family members help. Some girls decide to give
their babies up for adoption. It takes a great deal of courage and
concern for the baby to make these difficult decisions.

Girls who complete high school are more likely to have good jobs and
enjoy more success in their lives. If possible, finish high school now
rather than trying to return later. Ask your school counselor or an
adult you trust for information about programs and classes in your
community for pregnant teens.

Some communities have support groups especially for teen parents.
Some high schools have child-care centers on campus. Perhaps a family
member or friend can care for your baby while you're in school.

You can learn more about what to expect in becoming a parent by
reading books, attending classes, or checking out reputable websites on
child raising. Your baby's doctor, your parents, family members, or
other adults can all help guide you while you are pregnant and after the
baby is born.