Fetal Development

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Fetal Development
Please keep in mind that this information is
approximate. Each pregnancy is different and
growth rates vary. If you have any questions,
please check with your care provider.
Week by Week
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Week One

• Fetal Development Because we are counting with
  the gestational age method, week one begins with
  the first day of your menstrual period.
  Conception hasn't yet occurred, but you already
  get to start counting. Such a deal - see how time
  flies when you're having fun!

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Maternal Changes

• Your period has just started and you may be
  thinking about conception. For women with a 28
  day cycle, ovulation occurs around 14 days after
  the start of your menstrual cycle. Now is a good
  time to begin healthy habits (if you haven't
  yet!). Start your pregnancy diet with plenty of
  fresh fruits and vegetables exercise start
  taking additional folic acid if you haven't
  already and stop smoking, drinking alcohol, and
  using over-the-counter medications. Stay away
  from toxic materials and rest well. Start
  "thinking pregnant" before you conceive so you
  can give your baby the best start possible.

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Ideas for Dad

• Rest this week Dad. At the end of next week, you
  have an important job to do!

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Inspirational Thoughts

• Once you bring life into this world, you must
  protect it. We must protect it by changing the
  world. Elie Weisel

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Week Two

• Fetal Development Nothing yet!

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Maternal Changes

• Your uterus has shed its lining through your
  period and is now preparing a lush new bed of
  blood-rich tissue designed to house a growing
  fetus. Your eggs are ripening in one of the
  ovaries and preparing to release one.
• MultiplesSame as for singletons except that in
  the case of fraternal twins, your ovaries will
  release two eggs (or 3 in the case of fraternal
  triplets, etc.)

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Ideas for Dad

• Okay Dad, on day 14, if Mom has a regular 28-day
  cycle, (counting from the first day of Mom's last
  period) which should be the end of this week, you
  know what to do! Enjoy, but remember, your
  involvement is needed throughout the pregnancy,
  not just for conception.

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Inspirational Thoughts

• A baby is Mom and Pop art. Patricia Warner

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Week Three

• Fetal Development Sperm meets egg within the
  fallopian tube and the miracle of life begins.
  Although several sperm may penetrate the egg's
  outer layer, only one sperm will enter the ovum
  and fertilize it. In the middle of the ovum, the
  chromosomes of mother and father splash about and
  bits of information from both begin to form the
  chromosomes of your baby. At the moment of
  conception, your baby's gender is determined
  thanks to the sex chromosomes in the father's
  sperm. If you don't like the gender of your baby,
  blame dad.

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• Multiples If two eggs are released from the
  ovary (or one egg from each ovary) and are
  fertilized by two separate sperm, fraternal twins
  (dizygotic) have been conceived. Fraternal twins
  can be the same sex or boy/girl, and will look as
  much alike or as different as any siblings. If
  one egg is fertilized and later divides in two,
  identical twins will develop (or divides into
  three, identical triplets will develop, etc).
• Identical multiples have the same chromosomal
  makeup so will be the same gender, and have the
  same hair and eye color, blood type, etc. Only
  one-third of all twins are identical
  (monozygotic).
• In the case of triplets or quadruplets, etc., any
  combination is possible. Three (or four or more)
  eggs can be fertilized creating fraternal
  triplets, etc. One fertilized egg can split into
  identical twins with another fertilized egg
  making it a triplet pregnancy (two identical
  babies and one fraternal). Or one egg can split
  into three creating identical triplets, etc.

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Maternal Changes

• Around the 14th day from the start of your last
  menstrual cycle, one of the ripened eggs is
  released from your ovary and is drawn into your
  fallopian tube where conception occurs. You may
  experience some spotting or bleeding at the time
  the blastocyst implants into your uterus. Don't
  be alarmed it's normal, but not all women will
  experience this. Most women are unaware of the
  exact moment of conception.
• Multiples Same as for singletons except times
  two (or three or four . . .)

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Ideas for Dad

• You may still be making regular deposits in the
  conception effort. Enjoy because your life is
  about to change dramatically!

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Inspirational Thoughts

• That most sensitive, most delicate of
  instruments the mind of a little child. Henry
  Handel Richardson

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Week Four

• Fetal Development Taking root! Implantation
  occurs. Once the blastocyst gets to the uterus,
  it searches for a spot to settle down. Blastocyst
  means "sprout pouch," and these cells begin to
  divide into two groups - those that form the
  placenta and those that form the baby. The
  blastocyst will burrow itself into the lining of
  the uterus which is called implantation.
• Multiples Same as above times two, or three,
  etc. See week three for more information on
  twinning.

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Maternal Changes

• At the end of this week, you'll be expecting your
  period (or hoping it won't come if you've planned
  your pregnancy). Some of the first pregnancy
  symptoms are very similar to those experienced at
  the time your period is due such as fatigue,
  breast soreness and mood swings. You may be
  feeling these things and thinking "I guess it
  didn't happen this month." Just wait a few days .
  . . Multiples You probably aren't even thinking
  twins yet unless you've had infertility
  treatments. Your symptoms will be similar to
  singleton moms but intensified.

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Ideas for Dad

• Is Mom ignoring you while she's waiting and
  hoping her period will (won't?) start at the end
  of the week? Or is she a clinging vine? Whichever
  (and nearly everything in between) she is, she's
  normal. It can be an emotional time for her.

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Inspirational Thoughts

• Let us make pregnancy an occasion when we
  appreciate our female bodies. Merete
  Leonhardt-Lupa

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Week Five

• Fetal Development The developing embryo has
  three layers. In the top layer (ectoderm), the
  neural tube will form which will further develop
  into the nervous system (brain, spinal cord, skin
  and hair). In the middle layer (mesoderm), the
  heart and circulatory system, bones, muscles,
  kidneys and reproductive organs will develop -
  eventually. At this stage, however, the heart and
  primitive circulatory system will rapidly form.
  In fact, the circulatory system is the first
  organ system to function. In the inner layer
  (endoderm), a simple tube will develop into the
  intestines, liver, pancreas and bladder.

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Maternal Changes

• Your period is late and you may be wondering if
  you're pregnant. There are many home pregnancy
  test kits available that are fairly reliable a
  few days after a missed period. The hormonal
  changes that come with pregnancy may cause your
  breasts to be swollen and tender as the milk
  glands multiply. You may feel hungry often or
  nauseated as morning sickness kicks in. Your
  growing uterus will begin to press on your
  bladder causing frequent trips to the bathroom.
  Not only do these symptoms vary in intensity from
  woman to woman but also from pregnancy to
  pregnancy in the same woman.
• Multiples Your appetite will probably shift into
  high gear as you need about 1 1/2 times the
  calories as a singleton mom. Fatigue may also be
  taking its toll. Rest and eat!

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• It's time to think about what type of caregiver
  will follow you through your pregnancy. It's
  important to find someone you trust and who will
  strive to make this a positive experience for
  you. Many parents have insurance constraints
  making the freedom of "choice" in selecting a
  caregiver difficult. Be sure to look into your
  insurance policy and then start working on
  finding the best caregiver for you and your baby.

What type of care provider?
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Ideas for Dad

• Mom may be feeling crummy and taking it out on
  you (or anyone else around). Try not to take it
  personally. Plan a special date to celebrate your
  positive pregnancy test.

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Inspirational Thoughts

• Happy is he that is happy in his children.
  Thomas Fuller

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Week Six

• Fetal Development My Heart Belongs to You!The
  first heartbeats have begun! The baby is now an
  embryo and is about 1/17 of an inch long. Growth
  is very rapid this week. The umbilical cord
  develops. The eyes and ears begin to form as well
  as an opening for the mouth. The heart has begun
  to pump blood and most of the other organs are
  well under construction. Buds form on the body
  that will become the arms and legs.
• Exciting week!
• Multiples Same as for singletons.

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Maternal Changes

• This week tends to bring on the nausea. Morning
  Sickness is a constant companion any time of the
  day. You may be craving certain foods while the
  very thought of other foods will send you to the
  porcelain goddess. Because this is a critical
  time in your baby's organ development, avoid
  alcohol, substances, drugs, and treatments
  (perms, hair coloring, manicures, etc.) that you
  don't really need. If you haven't yet, make your
  first prenatal appointment with your care
  provider.
• Multiples Morning Sickness can be very severe
  with multiples' pregnancies. Since your fluid
  requirements have increased, be sure to drink
  lots of water to keep hydrated when the vomiting
  is severe. Contact your care provider if you have
  any concerns at all.

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When and How to tell the world?

• You may be so excited that you want to tell the
  world immediately. Or, you may want to wait and
  cherish the secret. Some parents worry about
  miscarriage and prefer not to tell "just in case"
  and wait until the threat of miscarriage is past.
  (However, friends and family can be an enormous
  source of support in the event of a miscarriage,
  and you may be missing out on this support by not
  sharing the news.) The bottom line . . . do what
  feels the most comfortable. Make it a special
  event whenever you do spill the beans.

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• Every mom worries about the possibility of
  miscarrying. If you have any of these signs,
  contact your caregiver immediately
• Bleeding
• Cramping and/or abdominal pains
• Passing of grayish or pinkish tissue or blood
  clots
• Not every cramp or every drop of blood is a sign
  of a miscarriage. Many women bleed during
  pregnancy and go on to have healthy babies. It is
  an important warning sign, however, and you
  should notify your caregiver. In the case of
  multiples, it's very possible to miscarry one
  twin and carry the remaining twin safely to term.
  

Signs of Miscarriage
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Ideas for Dad

• If morning sickness has hit home, there are a few
  things you can do to help 1) Certain smells can
  make Mom queasy - even things like coffee can set
  off a wave of nausea. Try to keep these things
  away until the morning sickness abates 2)
  encourage Mom to maintain a healthy diet high in
  protein and carbohydrates and to drink lots of
  fluids, especially water 3) set some saltine
  crackers or pretzels by the bed and encourage her
  to eat some BEFORE she gets out of bed 4)
  understand that she may not feel up to cooking,
  cleaning and other household chores right now.
  You can be a big help to her (and baby) by
  suggesting she rest while you do some of her
  chores you don't normally do.

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Inspirational Thoughts

• It is the child in man that is the source of his
  uniqueness and creativeness. Eric Hoffer

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Week Seven

• Fetal Development I'm Tiny But Gaining
  Fast!The baby is about 1/3 of an inch, the size
  of a grain of rice. Development of the arms and
  legs continue although the fingers and toes
  haven't yet formed. The brain is growing as well
  as the lenses of the eyes, nostrils, intestines,
  pancreas and bronchi.

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Maternal Changes

• This week tends to be like last week with the
  usual symptoms of early pregnancy continuing.
  You're not showing yet and may have lost a few
  pounds or gained a few pounds. Both are normal at
  this stage.
• Multiples Early Signs and Symptoms of a Multiple
  Pregnancy
• Faster rate of weight gainSize of abdomen and
  increased itching on its surfaceA feeling of
  heaviness in the pelvis or vaginaGreater
  tendency to retain waterVaricose veinsIncreased
  fatigue

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• Having your head in a toilet bowl or bucket most
  of the day is NO FUN, and you may have discovered
  that "morning" may mean all day and not just the
  morning. One important thing to remember is to
  never let your stomach get completely empty or
  overly full. Ginger (the real thing, not
  artificial) helps. Drink ginger ale or ginger
  tea, try ginger snaps or ginger root capsules.
  Lemons also help - lemonade or sucking on raw
  lemons. Many people swear by Seabands which are a
  form of acupressure.

Morning Sickness Tips
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Ideas for Dad

• Do you have a cat? If so, Dad, PLEASE take over
  the job of cleaning the litter box. Cat feces can
  contain a parasite that causes toxoplasmosis - an
  infection that can cross the placenta and harm
  your baby.

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Inspirational Thoughts

• When morning sickness hits, remember this The
  way I see it, if you want the rainbow, you gotta
  put up with the rain. Dolly Parton

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Week Eight

• Fetal Development An ultrasound done at this
  stage should show a fluttering heartbeat. Elbows
  begin to form in the arms and fingers start to
  develop. The leg buds begin to show feet with
  tiny notches for the toes. The face continues to
  change as the ears, eyes and the tip of the nose
  appear. The intestines start to form in the
  umbilical cord. Teeth develop under the gums.
• Multiples Your babies are developing at the same
  rate as singletons and each are about the length
  of two grains of rice.

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Maternal Changes

• Your uterus is the size of an orange now, and you
  may find your waistline expanding. If this is
  your first pregnancy, you're probably not
  showing. If it's not your first, you may have a
  "pooch" already. You will tend to show earlier in
  subsequent pregnancies since your muscles and
  ligaments aren't so tight. You may be feeling
  like a teenager if you find yourself with pimples
  and other skin problems. Don't fret pregnancy
  causes an increase in oil secretions not to
  mention those rampant hormones! Your break-outs
  will go away either after the first trimester as
  your hormones level off or after delivery.
• Multiples Your breasts are probably very tender
  and swollen, and your tummy is probably starting
  to "pooch out," particularly if you've been
  pregnant before.

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Ideas for Dad

• When mom goes to her first prenatal appointment,
  you'll be doing yourself a huge favor by making
  every effort to go with her. Be an involved
  parent NOW! Ask the doctor/midwife questions and
  share in this adventure. Take mom out for a nice
  meal afterwards to celebrate and talk about the
  appointment.

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Inspirational Thoughts

• We don't see things as they are, we see them as
  we are. Anais Nin

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Week Nine

• Fetal Development Cartilage and bones begin to
  form. The basic structure of the eye is well
  underway and the tongue begins to develop. The
  intestines start to move out of the umbilical
  cord and into the abdomen as the body grows and
  makes room. The fingers and thumb have appeared
  but are short and webbed.
• Multiples The babies are developing just like
  singleton babies. Each baby is about one gram in
  weight and about the same size as singleton
  babies.

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Maternal Changes

• You're missing your second period this week. Your
  breasts may be fuller now than ever before and
  may feel very sensitive. Wearing a supportive bra
  can ease some of the tenderness. Your waistline
  may be growing and you may experience some
  heartburn and indigestion as your body adjusts to
  pregnancy hormones.

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Ideas for Dad

• Sex got you to this point so let's talk about it.
  Many women go through a change in their desires
  during the first trimester. Mom may feel so
  crummy with morning sickness that she won't even
  let you in the bedroom. (Don't take it personally
  - there's that line again). On the other hand,
  without the hassles and worries of birth control
  and with the surge of hormones, she may be a
  sexual maniac. In either case, she's normal. What
  about you? Dads can also experience a change. At
  this point, mom isn't showing (or isn't showing
  very much) but her breasts are expanding in a
  glorious way. The figure changes may be quite
  attractive to you, and you may feel like a
  16-year old boy again. But, you may be worried
  about hurting the baby or doing something to
  disrupt the pregnancy. If you're worried about
  this Dad, talk to the doctor/midwife so you can
  alleviate your fears.
• If mom isn't on the same wavelength you are, this
  can be tough. Be understanding and remember that
  her hormones can make her moods look like a yo-yo
  in perpetual motion. If you're both in the mood,
  enjoy it. If you're not, you can still be
  close/intimate without having intercourse. TALK
  ABOUT IT with her so you aren't playing guessing
  games.

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Inspirational Thoughts

• And do respect the women of the world remember
  you all had mothers. Allen Toussaint

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Week Ten

• Fetal Development I'm Swimming! The baby has
  begun moving inside the womb although it's too
  small for mom to notice. Most of the joints are
  formed now - elbow, wrist, knee, shoulder, and
  ankle as well as the hands, fingers, feet and
  toes.

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Maternal Changes

• The morning sickness may start to ease a bit.
  This week, we'll blame moodiness and a blotchy
  complexion on those wild hormones. Have heart
  this is only temporary. Your blood volume will
  increase 40-50 during pregnancy. As a result,
  you may start to notice your veins more,
  particularly in your tummy, breasts, and legs.

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• The amount of weight pregnant women gain varies
  from woman to woman and even pregnancy to
  pregnancy in each woman. Your pre-pregnancy
  weight affects how much you should gain during
  pregnancy. Here are some guidelines but keep in
  mind, the numbers don't count as much as the food
  you eat. If you consume nutritious food in
  adequate quantities, you'll be eating good enough
  for your baby. If you gain more than these
  recommended amounts but have eaten healthy foods,
  chances are the weight will come off easily and
  quickly after delivery. Remember - do NOT diet
  during pregnancy! Eat wisely!

Weight Gain
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• Weight Gain for Singleton Moms
• pre-pregnancy weight acceptable gain in
  pounds
• underweight 30 to 40
• normal weight 25 to 35
• overweight 15 to 25
• Weight Gain for Twin Moms
• Higher Order Multiples Moms, Contact the Triplet
  Connection pre-pregnancy weight acceptable
  gain in pounds
• underweight 40 to 50
• normal weight 35 to 45
• overweight 25 to 35
• Where Does the Weight Go? (Singletons)
• baby 7.5 lbs
• uterus 2.0 lbs
• placenta 1.5 lbs

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Ideas for Dad

• Mom is probably singing the moody blues right
  now, and you may be humming right along with her.
  One minute you may want to shout from the
  rooftops that you're going to be a father. The
  next minute, you want to forget about it or
  you're terrified of the very idea of fatherhood.
  Share these thoughts - the excitement and fears -
  with mom. She's probably feeling as you are too.

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Inspirational Thoughts

• The sweetest flowers in all the world - A baby's
  hands. Swinburne

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Week Eleven

• Fetal Development I'm a Fetus!Starting with
  this week, the baby is now called a fetus. The
  most critical part of the baby's development is
  over. This is a period of rapid growth, and the
  baby is about an inch or so in length at the
  beginning of the week and will be about 2 inches
  by the end of the week. The baby's head is about
  half its length. The eyelids will fuse shut, and
  the irises will begin to develop. Sometime during
  this week or the next week, blood will begin to
  circulate between the baby and uterus and the
  placenta starts to function.

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Maternal Changes

• Your uterus is the size of a small grapefruit
  already! You may find that your appetite is
  better as your nausea subsides even though
  certain smells may bother you. Multiples Morning
  Sickness is probably still bothersome with nausea
  alternating between having a ravenous appetite.

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• You may have already discussed prenatal testing
  with your caregiver, and you've probably had a
  few of the tests done. Learn as much as you can
  about these tests many can alleviate your fears
  about the health and well-being of your baby
  some may cause more stress than they're worth. Do
  your homework on prenatal diagnostic testing and
  remember that you do NOT have to have any test
  you don't want.

Prenatal Testing
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Ideas for Dad

• Is this whole pregnancy business getting to you?
  The highs and lows, the endless worries about
  finances and responsibilities, seeing mom puking
  her guts out day after day? Dad, you need a
  break. Be good to yourself and take a few hours
  off to play a round of golf, workout at the gym
  or do something with your buddies. When you come
  home, surprise mom with a single long stem red
  rose and a little note that says, "Thanks Honey.
  I love you."

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Inspirational Thoughts

• God could not be everywhere, and therefore He
  created mothers. Jewish Proverb

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Week Twelve

• Fetal Development By this point, nearly all of
  the organs and structures of the fetus are
  formed. They will continue to grow and develop
  until delivery. Fingers and toes have separated
  and hair and nails begin to grow. The genitals
  begin to take on their gender characteristics.
  Amniotic fluid begins to accumulate as the babys
  kidneys begin to produce and excrete urine. The
  muscles in the intestinal walls begin to practice
  peristalsis - contractions within the intestines
  that digest food.

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Maternal Changes

• Around this week, your uterus will shift up and
  forward as it grows. The good news is it won't be
  pressing on your bladder so much and those
  bathroom visits will get less frequent. Enjoy
  this while you can because by the third
  trimester, the uterus will grow large enough to
  sit on your bladder once again. Morning Sickness
  is usually getting better by this time, and you
  may be less tired. Headaches and light-headedness
  are common now thanks to the increased blood
  volume but be sure to discuss these symptoms with
  your care provider.

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Ideas for Dad

• Mom is probably feeling better. Now's a good time
  to exercise with her regularly. Go out for a nice
  walk in your neighborhood and be sure to hold
  hands.

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Inspirational Thoughts

• Pregnancy is getting company inside one's skin.
  Maggie Scarf

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Week Thirteen

• Fetal Development As our baby continues to
  develop, the vocal cords begin to form. The face
  is looking more and more human each day as the
  eyes begin to move closer together instead of
  being on the sides of the head and the ears move
  to a normal position. It would be possible now to
  determine the baby's sex by looking at the
  genitals if we could only get close enough. (We
  usually can't "guess" via ultrasound until around
  the 16th week.) The intestines move farther into
  the baby's body the liver begins to secrete bile
  and the pancreas begins to produce insulin. A
  very busy week indeed!

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Maternal Changes

• Welcome to the second trimester! This is the most
  comfortable and enjoyable stage of pregnancy.
  Most of the difficult early symptoms are over (or
  soon will be), and your tummy isn't getting in
  the way yet. If you're still feeling tired,
  listen to your body and REST. It's working hard
  right now! As your uterus stretches, you may feel
  some abdominal achiness. The ligaments that hold
  up your uterus stretch to accommodate your
  growing uterus. This is called "round ligament
  pain".

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Ideas for Dad

• Welcome to the second trimester Dad! The next few
  months are the easiest of the pregnancy. Mom is
  feeling better, the hormones have settled in, and
  she's not huge and uncomfortable yet. Celebrate
  the completion of your first trimester with a
  special date.

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Inspirational Thoughts

• If there is a measure of good parenthood, it
  could be when your children exceed your own
  achievements. Tom Haggai

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Week Fourteen

• Fetal Development Our baby is a whopping 3 1/2
  inches long and is 1 to 2 ounces. S/he begins to
  practice inhaling and exhaling movements. The
  eyes and ears continue to move and develop, the
  neck is still getting longer, and the baby's chin
  no longer rests on his/her chest. The hands are
  becoming functional, and the baby is beginning to
  learn to move/use them (probably more reflex than
  anything). At this point, our little one is
  receiving all of his/her nourishment from the
  placenta.
• If you haven't already, you should be able to
  hear the baby's heartbeat with a doppler. Don't
  panic if you can't (I know, easier said than
  done.) an ultrasound can confirm a beating
  heart if it isn't heard through a doppler.

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Maternal Changes

• By now, pregnancy hormones are leveling off. This
  means less nausea, less frequent urination and
  less exhaustion. What a relief! However, you may
  be experiencing some constipation since those
  darned hormones have relaxed your bowel muscles
  causing them to work slower and less efficiently.
  Your uterus is also pressing on your bowel. Be
  sure to increase the fiber in your diet if
  constipation becomes a problem. You may notice
  the veins on your chest and breasts are dilated
  and more noticeable. The areolas of your breasts
  may be darkening and growing in diameter. Your
  body has been preparing for breastfeeding since
  you became pregnant!

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Ideas for Dad

• How are you dad? Are you totally stressed out
  worrying about finances, working overtime and
  fretting about expenses? If so, stop and take a
  deep breath and then try to rationally assess
  your situation. Are your worries out of
  proportion to your familys real needs? Many
  times, men are expected to handle family finances
  which becomes dad's focus while he's actually
  hiding his true worries - fear of fatherhood and
  the pregnancy. Think about what your REAL worries
  are. Often putting your finger on them is enough
  to make them smaller.

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Inspirational Thoughts

• Each child is an adventure into a better life, an
  opportunity to change the old pattern and make it
  new. Hubert H. Humphrey

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Week fifteen

• Fetal Development If you have an ultrasound
  now, you may notice your baby sucking his/her
  thumb. The bones are getting harder each day. The
  baby's skin is very thin and transparent you can
  see blood vessels through the skin. Lanugo, a
  very fine hair, covers the body and will continue
  growing on the baby until around the 26th
  gestational week of pregnancy.

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Maternal Changes

• Your uterus will begin rising past your hipbones
  any time now. You can feel it about three to four
  inches below your navel. During your
  appointments, your care provider will be
  measuring "fundal height" to make sure your baby
  is growing consistently and adequately. Fundal
  height is the distance from the top of the uterus
  (fundus) to the pubic bone.

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• If you have an ultrasound in the next few weeks,
  the technician may be able to make an "educated
  guess" at the gender of your baby. (Keep in mind,
  gender determination via ultrasound is not 100
  reliable and is only as good as the person doing
  the scan.) If you have an amniocentesis, gender
  can be reliably determined via the chromosomes.
  Neither of these tests are performed (or should
  be performed) just to find out the baby's sex. If
  your care provider recommends these tests for
  various reasons, ask yourself if you really want
  to know your baby's gender. The majority of
  parents nowadays do want to know, but if you love
  a special surprise, it's perfectly okay to tell
  the tech/care provider that you do NOT want to
  know the gender.

Boy or Girl?
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Ideas for Dad

• Make sure you hug mom often. Research tells us
  that the more hugs mom gets, the more she'll hug
  the baby (and you too)!

83
Inspirational Thoughts

• A baby is someone just the size of a hug.
  Anonymous

84
Week Sixteen

• Fetal Development If you haven't already, you
  may begin to feel movement as the babys bones
  harden. If you are somewhat overweight, have a
  thick uterus, and/or if this is your first
  pregnancy, you may not be feeling baby yet or
  feeling baby regularly. Don't panic! You will
  soon. The legs are now longer than the arms, and
  s/he is moving those arms and legs frequently,
  especially since there's still lots of room to
  move within the uterus.
• Fingernails and toenails are growing too. In
  fact, some babies need their nails clipped right
  after birth!
• Multiples Each twin is about 4 inches and 120
  grams!

85
Maternal Changes

• Do you have a stuffy nose or nosebleeds? As
  mentioned before, your blood volume increases 40
  - 50. This affects your estrogen levels which in
  turn swells your nasal membranes. This increased
  blood volume also causes your heart to work
  harder to support your pregnancy. This isn't a
  problem for a healthy heart. Your ligaments
  continue to stretch, and you may be feeling
  achiness and pain in your abdomen. If you're
  planning to have an amniocentesis, it may be
  scheduled between 16 and 18 weeks.
• Multiples Breast tenderness has probably
  subsided along with the nausea. Your waistline is
  definitely a thing of the past, and your feet may
  be swelling by the end of the day.

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87
Ideas for Dad

• Dad, do you have a life insurance policy and a
  will? It may sound morbid to think about now but
  this is a perfect time to get both. If something
  should happen to either of your baby's parents,
  the other shouldn't have to worry about mortgage
  payments, college tuition, etc.

88
Inspirational Thoughts

• I imagine the moment of quickening as a sudden
  awakening of my own being, which never before had
  life. Evelyn Scott

89
Week Seventeen

• Fetal Development This is a period of rapid
  growth as the fat begins to form underneath the
  baby's skin. Baby and placenta are about equal in
  size now. The tiny heart is pumping as much as 25
  quarts of blood a day! The reflexes are probably
  in place now as the baby sucks, swallows and
  blinks.

90
Maternal Changes

• Your uterus is about 1 1/2 to 2 inches below your
  belly button. The baby is going through a growth
  spurt and chances are, you may be gaining too!
  Average weight gain is between five and ten
  pounds at this point. Have you felt any
  fluttering in your uterus? You may be feeling
  your baby move any time now if you haven't
  already!

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92
Ideas for Dad

• Mom may be feeling the baby moving within her but
  you may not be able to yet. She may yell for you
  to quickly put your hand on her tummy, but you
  feel nothing. Don't worry - the baby has nothing
  against you. They play games very early! Humor
  mom, place your hand on her tummy and one of
  these days, you'll feel your little one - and
  your heart will be stolen forever.

93
Inspirational Thoughts

• What's done to children, they will do to society.
  Karl Menninger

94
Week Eighteen

• Fetal Development Our little one is nearly
  half a pound now and very human looking. Pads are
  forming on the fingertips and toes, and the eyes
  are looking forward rather than out the sides of
  the head. Meconium, the baby's first bowel
  movement, is accumulating within the bowel. If
  your baby is a boy, his prostate gland is
  beginning to develop.
• If you notice your belly making jerky movements
  in sync, don't panic your baby may have the
  hiccups!

95
Maternal Changes

• Feeling dizzy, lightheaded or faint are normal
  during pregnancy. These symptoms aren't harmful
  unless they occur frequently or severely.
  "Postural hypotension" is low blood pressure due
  to a change in position and happens frequently in
  pregnancy because your cardiovascular system
  doesn't react as fast. Your uterus is just below
  your belly button now.
• If you're having an ultrasound to verify fetal
  age or for other reasons, your careprovider will
  probably schedule it between now and 20 weeks.
  It's often possible to determine your baby's sex
  at this stage, and you'll be able to tell arms
  from legs and all sorts of delightful details!

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97
Ideas for Dad

• Are you a "Mr. Fix-It" kind of guy? It's common
  for dads to feel very protective of moms. Often,
  Mom will need a big shoulder to cry on and get
  out all of those crazy pregnancy emotions. Dad
  can feel rather helpless listening to Mom carry
  on, and in his frustration, try to do what he can
  to "fix" whatever she's grumbling about. Dad,
  relax. Nine times out of ten, Mom just needs to
  vent and really doesn't expect you to act upon
  her complaints. As hard as it may be for you,
  just LISTEN! Give her your undivided attention.
  This is the best gift you can give to Mom.

98
Inspirational Thoughts

• If you bungle raising your children, I don't
  think whatever else you do well matters very
  much. Jacqueline Kennedy Onassis

99
Week Nineteen

• Fetal Development Along with the lanugo,
  vernix caseosa forms on your baby's skin. Vernix
  is a white cheesy substance that protects your
  baby's skin from its aquatic environment
  imagine how your skin would look if you sat in
  water for nine months! The placenta continues to
  grow and nourish the baby.
• Multiples If you're expecting twins, you're
  probably half-way there already!

100
Maternal Changes

• You may be noticing several skin changes. These
  are hormone-related and will disappear after
  delivery. You may have the "mask of pregnancy" -
  blotchy patches on your forehead, cheeks, nose
  and chin. Itchy skin is also very common. Your
  skin may be dry and flaky in certain areas and
  many pregnant women develop rashes, particularly
  on the stretched skin. You can't prevent stretch
  marks but lotions or oil can ease the dryness and
  itching. Drinking lots of water and eating a
  healthy diet will go a long way in reducing
  dryness.

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102
Ideas for Dad

• You've felt your baby move within Mom's womb, and
  BLAM! It hits you like a ton of bricks - YOU'RE
  GOING TO BE A FATHER! You're excited and then
  terrified. You may be questioning yourself as to
  whether you're ready to be a father or whether
  you'll be a good dad. If you didn't have a good
  role model as a child, you may be even more
  concerned. You may be wondering if you can take
  care of a family or if you can provide for one.
  This one little kick can open a Pandora's Box
  that you weren't prepared to handle. If you find
  yourself preoccupied with such thoughts, don't
  worry. You're experiencing a normal reaction to
  impending fatherhood. Mom is probably having
  similar thoughts about herself in her role as
  mother. Go ahead and discuss these feelings with
  Mom. Read up on pregnancy, childbirth and
  parenting. And - give yourself a break when you
  need one. The fact that you're here reading this
  already says a lot about the kind of parent
  you'll be!

103
Inspirational Thoughts

• Babies are such a nice way to start people. Don
  Herold

104
Week Twenty

• Fetal Development We're halfway through the
  pregnancy, and the baby has as much sleep and
  awake time as a newborn. The scalp hair begins to
  grow. If your baby is a girl, her uterus is
  starting to develop.
• Multiples Your twins are each 7 1/2 inches long
  and weigh close to one pound each!

105
Maternal Changes

• Your uterus is at your navel now. You may
  experience some tenderness as your belly button
  becomes an "outtie" from the uterus pressing on
  it. The line between your navel (linea nigra) and
  pubic hair has darkened it will fade after
  delivery. You're probably feeling the baby
  frequently now as the movements become stronger.
  If you're having an ultrasound to verify fetal
  age, it will probably be scheduled around this
  time. It's a good time to look into childbirth
  classes.
• Hey! You're halfway there already!
• Multiples Your uterus is two or three inches
  higher than your singleton counterpart. Now is a
  good time to look into childbirth classes just in
  case you end up on bedrest. If you start now,
  you'll have you time to finish the class.

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107
Ideas for Dad

• Mom may be checking into the various childbirth
  classes available in your area and reporting to
  you with dates, times, styles of childbirth and
  all kinds of things you may have never heard of
  before. This is important to Mom (and to you too)
  so jump in there and be ready to head off to
  class! Some dads feel reluctant to go while
  others are very excited. If you're feeling a
  little reluctant, remember that you'll get to ask
  the instructor lots of questions and meet other
  dads who probably feel just like you do all of
  which can go a long way to squelch your fears.

108
Inspirational Thoughts

• Don't be discouraged if your children reject your
  advice. Years later they will offer it to their
  own offspring. Oscar Wilde

109
Week Twenty-One

• Fetal Development The rapid growth phase
  begins to slow down this week. The heart grows
  stronger this week, and the legs are reaching
  their relative proportions.
• Multiples The babies are kicking each other
  frequently as they move around. The membrane
  separating them is very very elastic so don't
  worry about them kicking each other. They are
  well protected and the membrane won't rupture
  from their activity.

110
Maternal Changes

• Over halfway there, and you're probably showing
  now. Your uterus is about 1/2 inch above your
  belly button. The average weight gain is between
  10 and 15 pounds at this point. If you're eating
  a healthy diet, don't count pounds and calories
  too strictly. Emotionally, you're probably
  feeling more stable and comfortable. Your ankles
  and feet may be swelling, particularly at the end
  of the day. Drink lots of water and rest with
  your feet elevated.
• Multiples Fluid retention can be exacerbated in
  a multiple pregnancy. Rest, drink lots of fluids,
  and put those poor feet up.

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112
Ideas for Dad

• With the second trimester being the easiest, this
  is a good time for planning and preparing
  together. The "pukiness" of the first trimester
  is (hopefully) a memory, and the heaviness of the
  third trimester is yet to come. Now is a good
  time to do something special together like taking
  a vacation or a weekend away (check with your
  caregiver first about travel). If you can't get
  away, use the time to grow closer and spend
  quality time together.

113
Inspirational Thoughts

• Let a joy keep you. Reach out your hands and take
  it when it runs by. Carl Sandburg

114
Week Twenty-Two

• Fetal Development The baby is probably close to
  a pound and very thin but very developed. The
  eyelids and eyebrows are now formed, and the
  brain begins rapid growth. If your baby is a boy,
  his testes have begun their descent from the
  pelvis to the scrotum.

115
Maternal Changes

• Your uterus is nearly an inch above your navel.
  You'll probably be gaining weight more steadily
  now as your baby continues to fill out. The extra
  weight may begin to take its toll on your back.
  Wear low heeled shoes (flat shoes can strain your
  back as much as high heeled shoes) and avoid
  sitting or standing for long periods of time.
  When you sit, use a footstool to raise your knees
  higher than your hips.   Multiples Having leg
  cramps? You could be suffering from a shortage of
  calcium thanks to your babies. When the cramps
  hit, straighten your leg and flex your ankle.
  Have your partner massage the muscle.

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117
Ideas for Dad

• Some parents have no problem agreeing on a name
  for their baby. Other parents go through World
  War III. Here are a few ideas . . . make a list
  of ten of your favorite names (if you don't know
  your baby's gender, make a list of boys' names
  and a list of girls' names). Have mom do the same
  thing and then exchange lists. Cross off the
  names on her list that you absolutely hate while
  mom crosses off her least favorite names on your
  list. If any names survive the process, start
  playing with those in various configurations.
  This may be one of those areas where compromise
  is a gift.

118
Inspirational Thoughts

• Happiness is something that comes into our lives
  through doors we don't even remember leaving
  open. Rose Lane

119
Week Twenty-Three

• Fetal Development Your baby weighs about a
  pound now! The body is becoming better
  proportioned each day, and the bones of the
  middle ear begin to harden.
• If born now, your baby has a chance for survival.
  Let's hope, however, that the baby stays put for
  several more weeks!
• Multiples Your babies will have periods of
  activity and sleep periods which may not coincide
  with each other.

120
Maternal Changes

• Your baby still has room to move around so you're
  probably feeling kicks, jabs, flips and flops.
  You may even see your abdomen move. Your uterus
  is about 1 1/2 inches above your belly button. If
  you're having some wild mood swings, don't fret.
  They're normal even if they don't feel normal.
  Try to be good to yourself when you're feeling
  blue.
• Multiples Familiarize yourself with the symptoms
  of preterm labor. Carrying multiples puts you at
  a higher risk for premature birth. Call your
  Doctor immediately if you experience any of these
  symptoms
• sense of pelvic fullness
• recurrent contractions (4 or more an hour)
• vaginal discharge
• ruptured membranes
• cramping

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122
Ideas for Dad

• Do something nice and totally unexpected like
  doing the laundry without being asked or bringing
  home dinner after work. Let mom know how special
  she is and show her how special you are.

123
Inspirational Thoughts

• Pregnancy is a process that invites you to
  surrender to the unseen force behind all life.
  Judy Ford

124
Week Twenty-Four

• Fetal Development The baby gains about 6
  ounces this week as the body begins to fill out.
  This weight is in muscle, bone mass and the
  growing organs and tissues. The weight could top
  1 1/3 pounds by the end of the week.
• Multiples Week 24 is usually considered the
  point of viability, meaning that if your babies
  are born now, they have a chance for survival.
  They would, however, be in intensive care for
  many months.

125
Maternal Changes

• Between weeks 24 and 28, your care provider may
  order a glucose tolerance test to determine if
  you have gestational diabetes. Your uterus is 1
  1/2 to 2 inches above the navel. Multiples Watch
  your vaginal discharge and report any changes to
  your caregiver. Preterm labor may start by
  infection that ascends from the vagina. Your
  doctor may want to do a check of your cervix
  sometime soon so that if you develop preterm
  labor symptoms, s/he will have a baseline for
  comparison.

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127
Ideas for Dad

• Take lots of pictures of Mom. Even though she may
  not like it at the time, she will treasure the
  photos later. They will make a wonderful keepsake.

128
Inspirational Thoughts

• Now my belly is as noble as my heart. Gabriela
  Mistral

129
Week Twenty-Five

• Fetal Development The structures of the spine -
  33 rings, 150 joints and 1000 ligaments - begin
  to form. The blood vessels of the lungs are
  developing and the nostrils begin to open. Busy
  week!

130
Maternal Changes

• You may be feeling like a "Soccer Mom" now that
  your uterus is the size of a soccer ball. Your
  growing uterus places pressure on your back and
  pelvis and may cause periodic shooting pains in
  your lower back and legs. When you experience
  this, rest, change your position, take a warm
  bath or apply ice to the sore area.

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132

• Do you know the warning signs of preterm labor?
  The March of Dimes advises that you never ignore
  any of these symptoms
• Menstrual-like cramps (constant or occasional)
• Low, dull backache (constant or occasional)
• Pelvic pressure (feels like the baby is pushing
  down)
• Abdominal cramping (with or without diarrhea)
• Increase or change in mucous vaginal discharge
• Uterine contractions every 10 minutes or more
  often (may be painless)
• Be sure to discuss with your caregiver what you
  should do in the event you experience these
  warning signs before the 37th week of pregnancy.

Pre-term Labor Signs
133
Ideas for Dad

• Now is a good time to start thinking about your
  work schedule when your baby arrives. If you want
  to take a leave, check with your employer about
  your options. Your company may qualify for the
  Family and Medical Leave Act of 1993. Most
  companies still do not pay for maternity/paternity
  leave, some do but do not announce that
  information unless you ask, while other companies
  have a whole range of benefits. You may have
  other options available such as telecommuting
  (working from home), job sharing and/or flexible
  work schedules. Start your research now and do
  some soul-searching about how much time off you
  wish to have.

134
Inspirational Thoughts

• When I approach a child, he inspires in me two
  sentiments tenderness for what he is, and
  respect for what he may become. Louis Pasteur

135
Week Twenty-Six

• Fetal Development Your baby could weigh about
  two pounds now and be around 9 inches long (crown
  of the head to the rump). As the blood vessels in
  the lungs began last week, the air sacs in the
  lungs begin this week. The lungs begin to secrete
  surfactant which covers the inner lining of the
  air sacs which then allows the lungs to expand
  normally during breathing.
• Besides the active lung growth, the brain kicks
  in with brain wave activity for the visual and
  auditory systems.

136
Maternal Changes

• Your uterus is about 2 1/2 inches above your
  belly button. If you feel your uterus suddenly
  tighten and then relax, don't panic. You're
  experiencing "Braxton Hicks" Contractions. These
  are normal, usually painless or feel similar to
  menstrual cramps and happen at irregular
  intervals. They are your body's way of practicing
  for the real thing and help to tone up your
  uterus for the tough job of labor. Are you eating
  well? You need about 300 extra calories now. Make
  them count!
• Multiples Women carrying multiples will have
  more Braxton Hicks contractions than singleton
  moms. If you have more than four in an hour, you
  should call your doctor.

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138
Ideas for Dad

• How is the nursery coming? Not everyone prepares
  a nursery before the baby arrives. However, if
  you are planning to have everything ready, now is
  a good time to start. Paint the nursery (and keep
  Mom away from the fumes), put the crib together
  and have fun preparing for this new little family
  member with Mom. These are a few of the things
  you can do for your baby while Mom is gestating.

139
Inspirational Thoughts

• The best inheritance a parent can give his
  children is a few minutes of his time each day.
  O. A. Battista

140
Week Twenty-Seven

• Fetal Development During this week, the brain
  continues its rapid growth, and the lungs
  continue to grow. Eyelids begin to open, and the
  retinas begin to form. The baby will grow over
  1/2 inch this week and will be about 1 1/3 feet
  long (from crown of head to the toes or 9.6
  inches from crown to rump)!

141
Maternal Changes

• Congratulations! At the end of this week, you
  will have finished the second trimester already!
  You may be experiencing some shortness of breath.
  Your uterus is close to your rib cage now, and
  your lungs may not be able to fully expand. Don't
  worry though. Your baby isn't lacking oxygen and
  your circulatory system is actually working more
  efficiently thanks to those pregnancy hormones
  that have caused you so much discomfort.

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143

• In week 25, we discussed paternity leave in the
  dads section. If you're a working mom, you're
  probably thinking about maternity leave and
  whether or not you'll go back to work after your
  baby arrives. This can be a very difficult
  decision for some families while easy for others.

To work or not to work?
144
Ideas for Dad

• It's 2 am, and you're blissfully dreaming about
  winning the Indy 500 in record-breaking time.
  Suddenly, you're awakened by a pregnant woman who
  is shaking the buttons off your pajamas. You come
  to your senses (or at least you think you do),
  sit straight up in bed and ask her if she's sure
  it's time. "No, of course it's not time. But I
  HAVE to have some cold mooshy McDonald's french
  fries NOW or I'll just DIE. Hurry, PALEEEEEEZE."
  Nope, it's not labor . . . it's cravings! She's
  craving weird things, and you just want to sleep.
  She's insistent and you know there'll be no sleep
  until you go. What's a dad to do? Sound remotely
  familiar? Think of this as preparation for being
  awakened in the middle of the night by the baby -
  and you won't have to go to McDonald's for him.
  Try your best to suggest healthy snacks for Mom
  but realize at this point, your suggestions may
  not carry a lot of weight.
• If all else fails, keep your slippers by the
  front door and your car keys handy!

145
Inspirational Thoughts

• A flower has to go through a lot of dirt before
  it can bloom. Unknown

146
Week Twenty-Eight

• Fetal Development Our little miracle is
  growing and developing at an astonishing rate!
  Eyebrows and eyelashes are now present, and the
  hair on the head is growing. The eyelids open,
  and the eyes are completely formed. The body is
  getting plumper and rounder (weighs about 2
  pounds) and is composed of around 2 to 3 body
  fat. Muscle tone is gradually improving. The
  lungs are capable of breathing air but if the
  baby is born now, it would struggle to properly
  breathe. Be sure to talk to your baby a lot
  because s/he can recognize your voice now!
• Multiples If born now, your babies have a 90
  chance for survival. Let's hope they stay put for
  awhile though!

147
Maternal Changes

• Welcome to the third trimester the period of
  leg cramps, hemorrhoids, varicose veins, itchy
  skin, aches and pains, swelling, heartburn,
  indigestion and . . . your baby's arrival! Your
  uterus is around 3 inches above your navel
  average weight gain is between 17 and 24 pounds
  at this point. If you haven't had a glucose
  tolerance test yet to test for gestational
  diabetes, your care provider may order one this
  week.
• Multiples You're probably feeling really heavy
  now with lots of pelvic pressure and backaches.
  It probably feels like the babies are sitting on
  your rectum and bladder - and they are! Warm
  baths can help. Be good to yourself and gets lots
  of help.

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149

• In routine pregnancies, your health-care provider
  appointments may be every two weeks from week 28
  to 36, with weekly appointments from week 36
  until delivery. During these appointments, your
  doctor/midwife will check the size and height of
  your uterus to be certain your baby is growing
  appropriately. Your weight and blood pressure
  will be checked as well as your urine for signs
  of infection, sugar, and protein. As the due date
  approaches, the baby's position is checked and
  vaginal exams are performed to check for cervical
  dilatation.
• If any high-risk situations are noted
  (pre-clampsia, PIH - Pregnancy-Induced
  Hypertension, gestational diabetes, placenta
  previa), care provider visits will be more
  frequent and more tests may be advised.
• Be sure to take a list of questions and concerns
  to your appointments. It's normal to have
  questions and worries about labor this trimester
  so don't be shy! Ask! Ask! Ask!

Third Trimester Appointments
150
Ideas for Dad

• It's the last trimester! Go out and celebrate
  with a special date to shop for something for the
  baby or a few maternity outfits for Mom. Treat
  Mom to an olive oil tummy massage or foot
  massage. This isn't an easy trimester for Mom.
  Dads support can go a long way to make it
  easier. Stay involved Dad! You're needed more
  than ever now.

151
Inspirational Thoughts

• Children . . . they string our joys, like jewels
  bright, upon the thread of years. Edward A.
  Guest

152
Week Twenty-Nine

• Fetal Development The baby's head is in
  proportion to the rest of the body. Fat continues
  to accumulate under the skin. The brain can
  control primitive breathing and body temperature
  control, and the eyes can move in the sockets.
  The baby is becoming sensitive to light, sound,
  taste and smell. Now, I wonder how experts know a
  baby can smell in utero?
• Multiples Your babies are on the same growth
  track as singletons at this point.

153
Maternal Changes

• Do you feel like you've been pregnant forever?
  Are those discomforts of pregnancy getting to
  you? This is the time when itchy skin, shortness
  of breath, hemorrhoids, leg cramps, heartburn and
  indigestion and achy muscles takes a toll. What
  do you do? Remember that these annoyances are
  temporary. Focus on the positive aspects of
  pregnancy and check out our suggested reading
  below by Sherry L. M. Jimenez. Multiples Fatigue
  is probably a constant companion. Try to rest
  when possible take a nap or put your feet up to
  keep the edema at bay.

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155

• You've probably heard a lot about birth plans. No
  matter what kind of birth you're planning, a
  written birth plan can be a good idea. A birth
  plan is defined as "a list of the options you and
  your partner prefer for your birth experience."
  Preparing a birth plan makes you take some time
  to research and think about your options in some
  detail which makes you ultimately better
  prepared.

Birth Plans
156
Ideas for Dad

• Read our birth plan information and help Mom work
  on a plan. This will help educate you (and Mom)
  about labor and delivery and give you a
  pro-active role. Your input and support to Mom is
  invaluable and a special way to parent your
  unborn baby.

157
Inspirational Thoughts

• Children are the purpose of life. We were once
  children and someone took care of us. Now it is
  our turn to care. Cree elder

158
Week Thirty

• Fetal Development Our little one is nearly
  three pounds already and growing like a weed.
• The early lanugo is disappearing, the eyelids
  open and close, and the toenails are growing. The
  bone marrow is now responsible for red blood cell
  production.

159
Maternal Changes

• The best sleeping position for a pregnant woman
  is on her left side. Your aorta and vena cava are
  slightly to the right of the center of your back,
  so laying/sleeping on your left side as much as
  possible ensures an unobstructed blood flow to
  your organs and extremities. You may be having
  some trouble sleeping now. Try one of the many
  maternity pillows or full-body pillows on the
  market. Sleeping in a recliner chair might also
  help, especially when the heartburn gets nasty.
  Multiples Familiarize yourself with the symptoms
  of pre-eclampsia which is more common in multiple
  pregnancies than in singleton pregnancies. If you
  experience severe headache seeing "spots" or
  "flashing lights" while at rest sudden increase
  in swelling especially of the face abdominal
  pain and nausea, vomiting and feeling sick,
  contact your doctor immediately.

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161

• About half of the babies born today in the United
  States are breastfed which means half are bottle
  fed. What wi