Having a Healthy Pregnancy

If you're a pregnant teen, you're not alone. About half a million adolescents give birth each year. Most teens who have babies didn't plan on becoming pregnant. You may have been surprised when you found out or even hoped it wasn't true. You may have been terrified to tell your parents. You may have worried how this might affect your relationships with your family, friends, and the baby's father. Sharing the news of your pregnancy can be one of the most difficult conversations to have.

Whether you feel confused, worried, scared, or excited, you'll want to know how your life will change, what you can do to have a healthy baby, and what it takes to become a good parent.

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
If you are pregnant, you need to see a doctor as soon as possible 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, there are social service organizations that can help you. Ask your parent, school counselor, or another trusted adult to help you locate resources in your community.

During your first visit, your doctor will ask you lots of questions including the date of your last period. This is so he or she can estimate how long you have been pregnant and your due date. Doctors measure pregnancies in weeks. It's important to remember that your due date is only an estimate: Most babies are born between 38 and 42 weeks after the first day of a woman's last menstrual period, or 36 to 38 weeks after conception (when the sperm fertilizes the egg). Only a small percentage of women actually deliver exactly on their due dates.

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 will also perform blood tests, a urine test, and tests for sexually transmitted diseases (STDs), 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, miscarriage, and delivering a baby earlier than usual (called premature delivery).

Your doctor will want you to start taking prenatal vitamins that contain the minerals folic acid, calcium, and iron as soon as possible. The vitamins may be prescribed by the doctor, or he or she may 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 to 30 weeks of your pregnancy, then every 2 to 3 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. Think of your doctor both as a resource and a friend who you can confide in about what's happening to you. And always be honest when your doctor asks questions about issues that could affect your baby's health.

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 is usually permanent, 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, or bad feelings about yourself or your life for more than 2 weeks, 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; and sleep loss. If you experience 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.

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

Alcohol
Doctors now feel 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 you are sexually active while you are 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. Don't try to hide your pregnancy by dieting - both you and your baby need certain nutrients to 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 250 calories a day to your diet to provide adequate nourishment for the developing fetus. Depending on your prepregnancy weight, you should gain about 25 to 35 pounds during pregnancy, most of this during the last 6 months. Your doctor will advise you about this based on your individual situation.

Eating additional fiber - 20 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 whole-grain breads, cereals, or muffins.

Exercise
Exercising during pregnancy is good for you as long as you 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 the last trimester of 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 specifically recommend that girls who are pregnant sleep on the left side. Because your liver is on the right side of your abdomen, lying on your left side helps keep the uterus off that large organ. Ask what your doctor recommends - in most cases, lying on either side should do the trick and help take some pressure off your back.

Stress can 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, 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.

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.

Life takes unexpected turns. These changes often bring opportunities to learn and grow and develop new strengths. You can stay informed by reading books, attending classes, or checking out reputable websites on child raising. Keep communications open in your own family and talk to your parents about this new phase in your life. Your baby's doctor, your parents, family members, or other adults can all help guide you while you are pregnant and when you become a parent.