What to expect when you're expecting (136 page)

Your urine, for sugar and protein

Your feet and hands for swelling, and legs for varicose veins

Your cervix (the neck of your uterus), by internal examination, to see if effacement (thinning) and dilation (opening) have begun

The height of the fundus

The fetal heartbeat

Fetal size (you may get a rough weight estimate), presentation (head or buttocks first), position (front or rear facing), and descent (is presenting part engaged?) by palpation (feeling with the hands)

Questions and concerns you want to discuss, particularly those related to labor and delivery—have a list ready. Include frequency and duration of Braxton Hicks contractions, if you’ve noticed any, and other symptoms you have been experiencing, especially unusual ones.

You can also expect to receive a labor and delivery protocol (when to call if you think you are in labor, when to plan on heading to the hospital or birthing center) from your practitioner; if you don’t, be sure to ask for these instructions.

“During the last few days, it seems like I’m in the bathroom constantly. Is it normal to be urinating this frequently now?”

Having a little first-trimester déjà vu? That’s because your uterus is right back where it started: down low in your pelvis, pressing squarely on your bladder. And this time, the weight of your uterus is significantly greater, which means the pressure on your bladder is greater, too—as is that need to pee. So you go, girl—again, and again, and again. As long as frequency isn’t accompanied by signs of infection (see
page 498
), it’s completely normal. Don’t
be tempted to cut back on fluids in an attempt to cut back on your trips to the bathroom—your body needs those fluids more than ever. And, as always, go as soon as you feel the urge (and can find a bathroom).

“A friend of mine says she had milk leaking from her breasts in the ninth month; I don’t. Does this mean I won’t have any milk?”

Milk isn’t made until baby’s ready to drink it—and that’s not until three to four days after delivery. What your friend was leaking was colostrum, a thin, yellowish fluid that is the precursor to mature breast milk. Colostrum is chock-full of antibodies to protect a newborn baby and has more protein and less fat and milk sugar (the better to digest it) than the breast milk that arrives later.

Some, but far from all, women leak this phenomenal fluid toward the end of their pregnancies. But even women who don’t experience leakage of colostrum are still producing it. Not leaking, but still curious? Squeezing your areola may allow you to express a few drops (but don’t squeeze with a vengeance—that’ll only result in sore nipples). Still can’t get any? Don’t worry. Your baby will be able to net what he or she needs when the time comes (if you plan to breastfeed). Not leaking isn’t a sign that your supply won’t ultimately keep up with demand.

If you are leaking colostrum, it’s probably just a few drops. But if you’re leaking more than that, you may want to consider wearing nursing pads in your bra to protect your clothes (and to prevent potentially embarrassing moments). And you might as well get used to the wet T-shirt look, since this is just a glimpse of leaky breasts—and wet bras, nightgowns, and shirts—to come.

“Right after my husband and I made love this morning, I began to spot a little. Does this mean that labor is beginning?”

Don’t order the birth announcements yet. Pinkish-stained or red-streaked mucus appearing soon after intercourse or a vaginal examination, or brownish-tinged mucus or brownish spotting appearing within 48 hours after the same, is usually just a normal result of the sensitive cervix being bruised or manipulated, not a sign that labor’s about to start up. But pinkish- or brownish-tinged or bloody mucus accompanied by contractions or other signs of oncoming labor, whether it follows intercourse or not, could be signaling the start of labor (see
page 359
).

If you notice bright red bleeding or persistent red spotting after intercourse—or any time, for that matter—check in with your practitioner.

“I’m really worried that my water will break in public.”

Most women worry about springing an amniotic leak—especially a public one—late in pregnancy, but few ever do. Contrary to popular pregnancy belief, your “water” (more accurately, your membranes) isn’t likely to “break” (more accurately, rupture) before labor begins. In fact, more than 85 percent of women enter the birthing room with their membranes fully intact. And even if you end up being among the 15 percent who do spring a prelabor leak, you won’t have to fear a public puddle at your feet. Unless you’re lying down (something you probably don’t do much in public anyway), amniotic
fluid is less likely to go with the flow, and more likely to come out as a slow trickle—or at most a small gush. That’s because when you’re upright (standing, walking, even sitting), your baby’s head acts like a cork in a bottle, blocking the opening of the uterus and keeping most of the amniotic fluid in. In other words, it’s probable that the forecast for the rest of your pregnant future will remain “mainly dry.”

Baby’s Crying Already?

The most joyous sound a new parent hears is that first cry the baby makes after he or she is born. But would you believe that your little one is already crying inside you? It’s true, according to researchers, who found that third-trimester fetuses show crying behaviors—quivering chin, open mouth, deep inhalations and exhalations, and startle responses—when a loud noise and vibration were sounded near the mom’s belly. It’s known that the crying reflex is well developed even in premature infants, so it’s not surprising that babies are perfecting this skill long before they’re ready to emerge (and it explains why they’re so good at crying once they come out!).

Something else to keep in mind: If you do actually experience a noticeable public gush of fluid, you can be sure that no one around you will stare, point, or chuckle. Instead, they will either offer you help or discreetly ignore you. After all, no one is likely to overlook the fact that you’re pregnant, so it’s just as unlikely they’ll mistake amniotic fluid for anything else.

The bright side of a water break (in public or at home) is that it’s usually followed by labor, typically within 24 hours. If labor doesn’t start spontaneously within that time, your practitioner will probably start it for you. Which means your baby’s arrival will be just a day away, either way.

Though it really isn’t necessary, wearing a panty liner or maxipad in the last weeks may give you a sense of security, as well as keep you fresh as your vaginal discharge increases. You also might want to place heavy towels, a plastic sheet, or hospital bed pads under your sheets in the last few weeks, just in case your water breaks in the middle of the night.