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Soon after you suspect that you're pregnant, your body will confirm your suspicions. While the symptoms differ in each woman, here are nine early signs of pregnancy:

1. Fatigue – you no longer have stamina for usual activities, such as walking up a hill or staying awake until midnight. This is because your body is demanding huge amounts of energy to make the changes for pregnancy.

2. Nausea and vomiting – morning sickness may be confused with the flu or feeling like you're "coming down with something." You may feel queasy, have nausea all day long, or vomit and have dry heaves. (See Morning Sickness)

3. Missed menstrual period. While nonpregnancy-related issues, such as stress, can cause you to miss a period, this is a first sign of pregnancy, too.

4. Slight staining or spotting. Bleeding at the time of implantation can be mistaken for menstruation. Some women have bleeding in the early months of pregnancy at the time when they would have menstruated.

5. Aversions to odors, alcohol, and smoke. Once you are pregnant, baby-protective mechanisms click in. You will notice how coffee, alcohol, and cigarette smoke make you ill.

6. Food cravings. Once you become pregnant, you may mysteriously crave foods that you seldom ate before. Your tastes may change from sweet to salty or vice versa.

7. Breast changes. The changes are similar to premenstrual feelings in your breasts only more dramatic: nipples tingle, breasts feel tender and fuller, the areola begins to darken, and tiny glands on the areola enlarge.

8. Crampy pelvic discomfort. This discomfort may be felt throughout the lower abdomen and pelvis. (A sharp one-sided pain is not normal and your doctor should be notified.)

9. Frequent urination. From the beginning, you will urinate more often due to pregnancy hormones. (Later on, you will have frequent urination because of pressure on the bladder from the enlarging uterus.)

1. Hypersensitivity to odors. Certain strong smells—garlic, fish, or coffee—may "go right to your stomach," and trigger instant nausea. Some pregnant women complain that usual household odors that didn't bother them pre-pregnancy become intensely unpleasant.

2. Aversion to certain foods. Sometimes you will be unable to eat certain foods (meat, greens, milk) without gagging. At other times, only a few foods are palatable. Chances are your "cravings" will actually be for the few things you can stand to eat.

3. Afternoon, evening, or midnight sickness. The intestinal upsets of pregnancy can occur at anytime of the day or night and in any month of your pregnancy. The most common feelings include slight seasickness, feelings of breathlessness, dizziness, a sense of being suffocated, the dry heaves, and the full-blown whoopsies.

4. Constipation. Pregnancy hormones slow the action of your intestines. The slowing of your intestines plus their competition with the expanding uterus for room to work may leave you feeling constipated.

Finding Dr. Right is not always easy. Ideally, you want a doctor who views you as a participant during the birthing process—not as a patient. Before you choose this healthcare profession, consider the following:

1. What hospitals are you affiliated with? Some hospitals are high-tech, others are high-touch, still others are both.

2. What is your call schedule? Who covers for you, how often, and what are these doctors' birthing philosophies?

5. Can I use a professional labor support person at the birth? Does your office provide referrals?

7. Do you believe in walking or changing positions during labor or will I be stuck in the horizontal position?

8. What are routine procedures during labor? Are ultrasound, intravenous fluids, and electronic fetal monitoring used?

10. What type of payment plan do you have? How does the insurance company participate?

If your pregnancy begins low-risk and stays that way, you may prefer a high touch, low-tech birth with a midwife. If you are in good health, had no complications with previous births, and the medical system in your community is set up for midwife-attended births, then this alternative may be a consideration. When interviewing a midwife, ask the following questions:

American College of Home Obstetrics
P.O. Box 508
Oak Park, IL 60303(708) 388-1461

Association for Childbirth at Home International
P.O. Box 430
Glendale, CA 91209(213) 667-0839

California Association of Midwives (CAM)
P.O. Box 417854
Sacramento, CA 95814
(800) 829-5791
(Request their publication Midwife Means "With Woman," An informative 56-page booklet about choosing and using a midwife.)

American College of Nurse-Midwives (ACNM)
1522 K Street NW, Suite 1120
Washington, D.C. 20005
(202) 347-5445

Informed Home birth and Parenting
P.O. Box 3675
Ann Arbor, MI 48106
(313) 662-6857

Are You Really Pregnant? Take a Test and Find Out!Most hopeful moms-to-be want to know if they are pregnant. In most cases, you can know for sure as soon as one week after conception. When implantation occurs, the developing placenta begins to produce the hormone HCGChuman chorionic gonadotropin. This hormone is detectable as early as one week after conception in your blood and 7 to 10 days after conception in your urine.

The urine test is performed in your doctor's office or at home (if you follow the directions on a home pregnancy kit). A very early test may register negative if your body has not yet produced enough HCG to be detected. A repeat test a few days or week later may come out positive. By the way, a home pregnancy test is nearly 100 percent positive within 7 to 10 days after conception. Whether your test registers positive or negative, if you think you are pregnant, take care of yourself and your baby as if you were pregnant.

A few drops of blood can let you know if you are pregnant as early as one week after conception. This blood test is performed in your doctor's office or a laboratory. Within a day or two, you will have the final results. The test is nearly 100 percent accurate, depending on no laboratory error.

At some time during your pregnancy your doctor will mention a certain test, such as a blood test, an ultrasound, or an amniocentesis. You may wonder if this test is really safe or even necessary. You deserve answers to these questions! After all, you are a key partner in making these decisions. Here are some basic facts about three common tests.

The AFP screen is the most commonly available prenatal screening test for birth defects. AFP, a natural substance produced by baby's liver, normally enters the mother's bloodstream during pregnancy. Maternal levels of AFP are elevated if the mother is carrying a baby with a neural tube defect, NTD, (the vertebrae that normally enclose the spinal cord fail to develop), because AFP leaks out of an open spinal column. These defects include spina bifida (in which the spinal cord is not enclosed in the spinal column, often cause paralysis from the waist down) and anencephaly (in which baby's brain is either severely underdeveloped or doesn't develop at all). AFP levels are lower than normal if the baby has Down syndrome or another chromosomal defect.

The AFP screen is performed on a small amount of blood taken from the mother's arm. This common test is safe and is done between the sixteenth and eighteenth week of pregnancy. You will know the score within one week.

While the AFP screen is safe, it can be traumatic and lead to unnecessary worries. A confirmed positive test will be followed by other tests, which carry greater risks and anxiety, and in most cases, you find out there was nothing to worry about in the first place (or nothing you want to do about it anyway).

To decide whether or not to have a prenatal screening test for birth defects, consider these questions:Would the results matter to you?Would you change the course of your pregnancy? Are the results of the test going to create or alleviate anxiety?Would having the test or not having the test worry you more or less?Would knowing about a birth defect before hand dampen the joy of your pregnancy?If so, would it be better for you to have the time to prepare to handle a special needs baby?

Keep in mind that this screening is not very accurate. Ninety-five to ninety- eight percent of "positive high" or "positive low" AFPs turn out to be false (i.e., the baby has neither a chromosomal abnormality nor a neural tube defect). If your AFP test is abnormally high or abnormally low, your healthcare provider may recommend that you have further tests, such as an ultrasound and/or amniocentesis.

A new test, called the "triple screen" (also known as the "prenatal risk profile" or "expanded AFP"), is used to screen for birth defects. The triple screen measures the following:Maternal levels of AFPHCG, human chorionic gonadotropin, which is elevated if mother is carrying a baby with some chromosomal abnormalitiesStroll, a byproduct of the hormone estrogen, which is lower if mother is carrying a baby with some chromosomal abnormalities

The triple screen raises the accuracy from twenty-five percent with the AFP alone to 60 percent. The triple screen may detect 70 percent of Down syndrome babies in women over age thirty-five, and sixty percent in women under age thirty-five.

Amniocentesis provides a lot of valuable genetic information, but it is not without risk to mother and baby. Therefore, parents and practitioners must exercise a high level of responsibility in deciding whether or not to have this prenatal test.

This test tells a lot about the genetic makeup of your baby and reveals more common genetic defects. Amniocentesis is usually performed between the 12th and the 16th week, after the last menstrual period when there is enough fluid surrounding the baby that a sample is possible. Amniocentesis may also be performed in the last eight weeks of pregnancy. It takes a week or two to get the results on chromosomal abnormalities (and the baby's sex). Results on conditions such as spinal defects, Hunter's Syndrome, and Tay-sachs Disease are available the next day.

Using ultrasound to locate an area where baby and placenta are not in the way, the doctor inserts a long needle through the skin on the abdomen into the uterus and withdraws some amniotic fluid. These materials are then sent to genetic and biochemical laboratories for analysis. The whole procedure takes around thirty minutes.

The material obtained in amniocentesis reveals the gender of the baby, his or her chromosomal make-up, the maturity of the baby (especially the lungs) and whether or not he or she may have certain inherited diseases. There are various reasons your doctor may recommend amniocentesis such as if you already have a previous child with a genetic abnormality, inherited genetic disorder or other disease; if your AFP levels are high; or if you are over 35. While it is safe, it is not without a slight risk of damage to the organs of the baby, placenta, and umbilical cord, though ultrasound guidance reduces this risk considerably. There also is a 1 in 200 chance of inducing a miscarriage with amniocentesis.

CVS provides more genetic and biochemical information than amniocentesis and can be performed earlier in pregnancy and with quicker results. Yet CVS carries a slightly higher risk of damage to the baby than amniocentesis does. So, this higher-yield-higher-risk procedure demands even greater responsibility in making the decision to have the test.

CVS is usually performed between the eighth and twelfth week after the last menstrual period. It is most beneficial when your doctor needs a faster decision than could be obtained by amniocentesis.

There are two methods of performing CVS—transabdominal and transcervical, depending on the safest in your pregnancy. Both approaches depend on ultrasound and results are usually available within 48 hours to one week.

Even though CVS provides information earlier in pregnancy than amniocentesis, it carries a risk of miscarriage that is 2 to 4 times higher, depending on the expertise of the physician. Vaginal bleeding frequently occurs following CVS. Studies also suggest a possible increased risk of limb deformities, and CVS may cause a decrease in the amniotic fluid production.

Gestational glucose intolerance is detected during pregnancy with the glucose tolerance test (GTT). This test is usually recommended around 24-28 weeks, and may be repeated around 32-34 weeks in mothers with high-risk pregnancies.

By identifying gestational glucose intolerance during pregnancy, the mother can alter her diet to keep her blood sugar from getting too high. Gestational glucose intolerance is more common in overweight women, older women, those with a family history of diabetes, or women who have previously delivered a baby weighing more than nine pounds.

The GTT is done at your doctor's office. You drink a glass of sweet liquid called glucola (it tastes like sweetened Coke or Pepsi) on an empty stomach, and then your blood sugar is checked one hour later. (An alternative to drinking the sugar-loaded liquid is to measure the blood sugar 1-2 hours after a big meal.) The result of the GTT should be available within a few hours. After ingesting the test "meal," it's important to stay active (e.g. walking) so your body has a better chance of metabolizing the sugar load than if you just sit there waiting to have your blood drawn.

If this one-hour screening test turns out to show high blood sugar, the doctor may recommend a more accurate three-hour test. Only around 15 percent of women with abnormal one-hour GTT will have an abnormal three-hour GTT test. If the three-hour test is abnormal, the doctor may recommend a diabetic diet throughout the rest of pregnancy. New research questions the value of routine screening for gestational glucose intolerance. A 1990 study of 1,307 women (533 of whom were not screened and 774 who were screened) showed that screening resulted in more tests and worry during pregnancy and a significantly higher cesarean rate in the screened mothers, but it did not decrease the number of large infants. These researchers concluded that the routine use of GTT caused more worry than the benefits derived. Discuss with your practitioner whether or not the GTT is necessary in your particular pregnancy.