Pregnancy and Getting Pregnant

Services: Pregnancy

Pregnancy & Getting Pregnant

Pregnancy is a life-changing experience, and you must have the best information. Celebration Obstetrics and Gynecology want to ensure that you can trust the facts, advice from experts, and stories from women like you.

Our experienced team of Providers can answer your many questions about Pregnancy

Getting Pregnant

The years leading up to menopause are called perimenopaus

Having a Baby After Age 35: How Aging Affects Fertility and Pregnancy?

A woman’s peak reproductive years are between the late teens and late 20s. By age 30, fertility (the ability to get pregnant) starts to decline. This decline becomes more rapid once you reach your mid-30s. By 45, fertility has declined so much that getting pregnant naturally is unlikely for most women.

Women begin life with a fixed number of eggs in their ovaries. The number of eggs decreases as women get older. Also, the remaining eggs in older women are more likely to have abnormal chromosomes. And as women age, they are at higher risk of disorders that can affect fertility, such as uterine fibroids and endometriosis.

Women who get pregnant later in life have a higher risk of complications. For example, pregnant women over 40 have an increased risk of preeclampsia. Pregnancy later in life also can affect the health of the fetus.

e. Beginning in your 30s and 40s, the amount of estrogen produced by the ovaries fluctuates. A common sign of perimenopause is a change in your menstrual cycle. Cycles may become longer than usual for you or become shorter. You may begin to skip periods. The amount of flow may become lighter or heavier. Although changes in menstrual bleeding are regular during perimenopause, you still should report them to your health care professional. Abnormal bleeding may be a sign of a problem.

Infertility is defined as not getting pregnant after one year of having regular sexual intercourse without using birth control (see FAQ136 Evaluating Infertility). If you are older than 35, an evaluation is recommended after six months of trying. If you are older than 40, talk with your obstetrician-gynecologist (ob-gyn) about an assessment.

The most common cause of female infertility is a problem with ovulation. The most common cause of male infertility is a problem with sperm cells and how they function. Other factors that may affect fertility include:

Age
Lifestyle
Health conditions

Sometimes no cause is found. This is called unexplained infertility.

Your treatment options will depend on the type of problem found. Recommendations may include:

Lifestyle changes
Surgery, or
Medication

Some treatments may be combined. In some cases, infertility can be successfully treated even if no cause is found.

Staying at a healthy weight and eating a healthy diet can be helpful for both men and women with infertility. If you and your male partner smoke, use drugs or drink alcohol, you should stop.

The months before you get pregnant are the best time to take steps to be healthier. These steps may include:

Eating a healthy diet and taking a prenatal vitamin
Getting regular exercise
Reaching and maintaining a healthy weight
Stopping unhealthy substances (tobacco, alcohol, marijuana, illegal drugs, and prescription drugs taken for a nonmedical reasons)
Keeping your environment safe

A prepregnancy care checkup is the first step in planning a healthy pregnancy. This checkup aims to find things that could affect your pregnancy. Identifying these things is essential because the first eight weeks of pregnancy are when major organs develop in a fetus.

During this visit, you and your obstetrician-gynecologist (ob-gyn) or another obstetric care provider will talk about:

Your diet and lifestyle
Your medical and family history
Medications you take
Past pregnancies

Your ob-gyn or another obstetric care provider will also review your vaccination history to ensure that you have had all the recommended vaccines for your age group. You’ll also go over the risks of sexually transmitted infections (STIs) and discuss how to protect yourself.

The estrogen produced by women’s ovaries before menopause protects against h

Obesity during pregnancy puts you at risk of several serious health problems:

Gestational hypertension—High blood pressure that starts during the second half of pregnancy. It can lead to severe complications.
Preeclampsia—Preeclampsia is a severe form of gestational hypertension that usually happens in the second half of pregnancy or soon after childbirth. This condition can cause the woman’s kidneys and liver to fail. In rare cases, seizures, heart attacks, and strokes can happen. Other risks include problems with the placenta and growth problems for the fetus.
Gestational diabetes—High glucose levels (blood sugar) during pregnancy increase the risk of having a giant baby. This also increases the chance of cesarean birth. Women who have had gestational diabetes have a higher risk of diabetes mellitus. So do their children.
Obstructive sleep apnea—Sleep apnea is when a person stops breathing for short periods. Sleep apnea can cause fatigue during pregnancy and increase the risk of high blood pressure, preeclampsia, and heart and lung problems.

Obesity increases the risk of the following problems during pregnancy:

congenital disabilities—Babies born to women who are obese have an increased risk of having congenital disabilities, such as heart defects and neural tube defects (NTDs)
Problems with diagnostic tests—Having too much body fat can make it difficult to see specific problems with the fetus’s anatomy on an ultrasound exam. Checking the fetus’s heart rate during labor may be more difficult if obese.
Macrosomia—The fetus is more significant than usual in this condition. This can increase the risk of injury during birth. For example, the fetus’s shoulder can get stuck after the head is delivered. Macrosomia also increases the risk of cesarean delivery. Infants born with too much body fat have a greater chance of being obese later.
Preterm birth—Problems associated with a woman’s obesity, such as preeclampsia, may lead to a medically indicated preterm birth. This means that the baby is delivered early for medical reasons. Preterm babies are not as fully developed as babies born after 39 weeks. As a result, preterm babies have an increased risk of short-term and long-term health problems.
Stillbirth—The higher the woman’s BMI, the greater the risk of stillbirth.

eart attacks and stroke. Women lose much of this protection when less estrogen is made after menopause. Midlife is also when risk factors for heart disease, such as high cholesterol levels, high blood pressure, and being physically inactive, are more common. These combined factors increase the risk of heart attack and stroke in menopausal women.

Menopause is the time in your life when you naturally sto

Most birth defects cannot be prevented because their cause is not known. For a few birth defects, you may be able to decrease your risk by taking specific steps:

See your doctor before getting pregnant.
Know your risk factors.
Take a daily multivitamin before and during pregnancy.
Maintain a healthy weight.
Use medications wisely.
Take care of medical conditions before pregnancy.
Do not use alcohol, marijuana, illegal drugs, or prescription drugs for a nonmedical reason.
Prevent infections.
Avoid known harmful agents.

Scheduling a health care visit before getting pregnant is a good idea. You can get advice about diet and exercise from your obstetrician-gynecologist (ob-gyn) or other healthcare professionals. You can discuss whether you have any factors that increase the risk of having a child with a birth defect. If you have a medical condition, you can talk about any special care you may need before or during pregnancy.

What factors increase the risk of having a baby with a birth defect?

You may be at an increased risk of having a baby with a birth defect if you:

Are older
Have a family or personal history of birth defects
Have had a child with a birth defect
Use certain medicines around the time you become pregnant
Have a medical condition such as diabetes mellitus or obesity
Use recreational drugs or drink alcohol during pregnancy

If you have any risk factors, your ob-gyn or other health care professional may recommend special tests or other steps that may help reduce your risk. For example, genetic counseling and testing may be recommended if you have a personal or family history of birth defects.

p having menstrual periods. Menopause happens when the ovaries stop making estrogen. Estrogen is a hormone that helps control the menstrual cycle. Menopause marks the end of the reproductive years. The average age that women go through menopause is 51 years.

During Pregnancy

Bioidentical hormones come from plant sources. They include commer

Back Pain:
Backache is one of the most common pregnancy problems, especially in the later months. Your expanding uterus shifts your center of gravity, stretches out, and weakens your abdominal muscles. This changes your posture and puts a strain on your back. Plus, the extra weight you’re carrying means more work for your muscles and increased stress. This is why your back may feel worse at the end. The pain usually goes away after the baby is born. But for many women, back pain lingers for months after giving birth.

Bleeding:

Vaginal bleeding during pregnancy has many causes. Bleeding in the first trimester happens in 15 to 25 in 100 pregnancies. Light bleeding or spotting can occur 1 to 2 weeks after fertilization when the fertilized egg implants in the uterus lining. The cervix may bleed more easily during pregnancy because more blood vessels develop. It is not uncommon to have spotting or light bleeding after sexual intercourse or after a Pap test or pelvic exam. Contact your obstetrician-gynecologist (ob-gyn) if you have any bleeding during pregnancy.

Skin Conditions:

Many women notice changes to their skin, nails, and hair during pregnancy. Some of the most common changes include the following:

Dark spots on the breasts, nipples, or inner thighs
Melasma—brown patches on the face around the cheeks, nose, and forehead
Linea nigra—a dark line that runs from the navel to the pubic hair
Stretch marks
Acne
Spider veins
Varicose veins
Changes in nail and hair growth

cially available products and compounded preparations. A compounding pharmacist makes compounded bioidentical hormones from a health care professional’s prescription. Compounded drugs are not regulated by the U.S. Food and Drug Administration (FDA). Compounding pharmacies must be licensed, but they do not have to show the safety, effectiveness, and quality control that the FDA requires of drug makers. The American College of Obstetricians and Gynecologists recommends FDA-approved hormone therapy over compounded hormone therapy.

An ectopic pregnancy occurs when a fertilized egg grows outside of the uterus. Almost all ectopic pregnancies—more than 90%—occur in a fallopian tube. As the pregnancy develops, it can cause the pipe to burst (rupture). A break can cause major internal bleeding. This can be a life-threatening emergency that needs immediate surgery.

What are the risk factors for ectopic pregnancy?

The risk factors for ectopic pregnancy include the following:

Previous ectopic pregnancy
Prior fallopian tube surgery
Previous pelvic or abdominal surgery
Certain sexually transmitted infections (STIs)
Pelvic inflammatory disease
Endometriosis
Other factors that may increase a woman’s risk of ectopic pregnancy include:
Cigarette smoking
Age older than 35 years
History of infertility

Use of assisted reproductive technology, such as in vitro fertilization (IVF)

About one-half of all women with ectopic pregnancies do not have known risk factors. Sexually active women should be alert to changes in their bodies, especially if they experience symptoms of an ectopic pregnancy.

How is ectopic pregnancy treated?

An ectopic pregnancy cannot move to the uterus, so it always requires treatment. There are two methods used to treat ectopic pregnancy: 1) medication and 2) surgery. Several weeks of follow-up are required with each treatment.

When is surgery used to treat ectopic pregnancy?

If the ectopic pregnancy has ruptured a tube, emergency surgery is needed. Sometimes surgery is required even if the fallopian tube has not ruptured. In these cases, the ectopic pregnancy can be removed from the tube, or the entire tube with the pregnancy can be removed.

Surgery typically is done with laparoscopy. This procedure uses a slender, lighted camera inserted through small cuts in the abdomen. It is done in a hospital with general anesthesia.

What are some causes of multiple pregnancies?

The use of fertility drugs to induce ovulation often causes more than one egg to be released from the ovaries, resulting in twins, triplets, or more.

In vitro fertilization (IVF) can lead to multiple pregnancies if more than one embryo is transferred to the uterus. Identical multiples also may result if the fertilized egg splits after transfer.

Women older than age 35 are more likely to release two or more eggs during a single menstrual cycle than younger women. So older women are more likely than younger women to become pregnant with multiples.

Hormone therapy can help relieve the symptoms of perimenopau

What is early pregnancy loss (miscarriage)?

The loss of a pregnancy before 13 completed weeks is called early pregnancy loss. It also may be called a miscarriage or spontaneous abortion. Early pregnancy loss is common. It happens in about 10 of 100 known pregnancies.

What causes early pregnancy loss?

About half of early miscarriages happen when the embryo does not develop properly. This often is due to an abnormal number of chromosomes. Chromosomes are in each cell of the body and carry the blueprints (genes) for developing and functioning.

When the egg and sperm join, two sets of chromosomes come together during fertilization. If an egg or sperm has more or fewer chromosomes than usual, the embryo also will have an odd number. This can lead to miscarriage.

What can I expect during recovery from early pregnancy loss?

To help prevent infection, you should not put anything in your vagina for 1 to 2 weeks. This includes not using tampons, not having sexual intercourse, and not having sex with penetration (using fingers or sex toys). You should see your ob-gyn for a follow-up visit shortly after your miscarriage. Call your ob-gyn right away if you have

heavy bleeding (soaking through more than two maxi pads per hour for more than 2 hours in a row)

fever
chills
severe pain

Is there anything to help me and my partner cope with early pregnancy loss?

Losing a pregnancy can cause sadness and grief. For many women, emotional healing takes longer than physical healing. And your feelings of grief may differ from those of your partner. If you have trouble handling the emotions that accompany a pregnancy loss, talk with your ob-gyn or a counselor.

You also can reach out to support groups. Share: Pregnancy and Infant Loss Support is one group that provides support for those who have experienced miscarriage.

se and menopause. Hormone therapy means taking estrogen and, if you have never had a hysterectomy and still have a uterus, a hormone called progestin. Estrogen plus progestin sometimes is called “combined hormone therapy” or simply “hormone therapy.” Taking progestin helps reduce the risk of uterus cancer that occurs when estrogen is used alone. If you do not have a uterus, estrogen is given without progestin. Estrogen-only therapy sometimes is called “estrogen therapy.”

How is hormone therapy given?

Estrogen can be given in several forms. Systemic forms include pills, skin patches, gels, and sprays applied to the skin. If progestin is prescribed, it can be given separately or combined with estrogen in the same pill or a patch. With systemic therapy, estrogen is released into the bloodstream and travels to the organs and tissues where it is needed. Women who only have vaginal dryness may be prescribed “local” estrogen therapy in the form of a vaginal ring, tablet, or cream. These forms release small doses of estrogen into the vaginal tissue.

What are the benefits of hormone therapy?

Systemic estrogen therapy (with or without progestin) is the best treatment for relieving hot flashes and night sweats. Both systemic and local types of estrogen therapy relieve vaginal dryness. Systemic estrogen protects against bone loss early in menopause and helps prevent hip and spine fractures. Combined estrogen and progestin therapy may reduce the risk of colon cancer.

What are the risks of hormone therapy?

Hormone therapy may increase the risk of certain types of cancer and other conditions:

Estrogen-only therapy causes the uterus lining to grow and can increase the risk of uterine cancer.
Combined hormone therapy is associated with a small increased risk of a heart attack. This risk may be related to age, existing medical conditions, and when a woman starts taking hormone therapy.
Combined hormone therapy and estrogen-only therapy are associated with a small increased risk of stroke and deep vein thrombosis (DVT). Forms of therapy not taken by mouth (patches, sprays, rings, and others) may have less risk of causing deep vein thrombosis than those taken by mouth. Combined hormone therapy is associated with a small increased risk of breast cancer.
There is a small increased risk of gallbladder disease associated with estrogen therapy with or without progestin. The risk is most significant with oral forms of therapy.

Routine Tests:

Several routine lab tests are done early in pregnancy, including

complete blood count (CBC)
blood type and Rh factor
urinalysis
urine culture

Also, pregnant women typically are tested for specific diseases and infections early in pregnancy, including

rubella
hepatitis B and hepatitis C
sexually transmitted infections (STIs)
human immunodeficiency virus (HIV)
tuberculosis (TB)

Genetic Tests:

There are two types of prenatal tests for genetic disorders:

Prenatal screening tests: These tests can tell you the chances that your fetus has an aneuploidy and a few other disorders. This FAQ focuses on these tests.
Prenatal diagnostic tests: These tests can tell you whether your fetus has certain disorders. These tests are done on cells from the fetus or placenta obtained through amniocentesis or chorionic villis sampling (CVS). FAQ164 Prenatal Genetic Diagnostic Tests focuses on these tests.

Both screening and diagnostic testing are offered to all pregnant women.

Special Tests:

Special testing during pregnancy most often is done when there is an increased risk of pregnancy complications or stillbirth. This can occur in the following situations:

High-risk pregnancy (a woman has had complications in a previous pregnancy or has a pre-existing health condition such as diabetes mellitus or heart disease)
Problems during pregnancy, such as fetal growth problems, Rh sensitization, or high blood pressure
Decreased movement of the fetus
Pregnancy that goes past 42 weeks (posterm pregnancy)
Multiple pregnancies with certain complications

Labor and Delivery

A fetus usually moves in the last weeks of pregnancy, so its head is positioned to come out of the vagina first during birth. This is called a vertex presentation. A breech presentation occurs when the fetus’s buttocks, feet, or both are in place to come out first during birth. This happens in 3–4% of full-term births.

What factors are related to the breech presentation?

It is not always known why a fetus is breech. Some factors that may contribute to a fetus being in a breech presentation include the following:

You have been pregnant before.
There is more than one fetus in the uterus (twins or more).
There is too much or too little amniotic fluid.
The uterus is not customary in shape or has abnormal growths such as fibroids.
The placenta covers all or part of the opening of the uterus (placenta previa)
The fetus is preterm.

Occasionally fetuses with specific congenital disabilities will not turn into the head-down position before birth. However, most fetuses in a breech presentation are otherwise normal.

What are the options for birth if my fetus is breech?

Most fetuses that are breech are born by planned cesarean delivery. A planned vaginal birth of a single breach fetus may be considered in some situations. Both vaginal birth and cesarean birth carry certain risks when a fetus is breech. However, complications are higher with a planned vaginal delivery than scheduled cesarean delivery.

Cesarean birth is the delivery of a baby through incisions (surgical cuts) made in the belly and uterus. In the United States, about 1 in 3 babies is delivered by cesarean birth.

What are the reasons for cesarean birth?

These are some of the reasons why a cesarean birth may be done:

Failure of labor to progress—Contractions may not open the cervix enough for the baby to move into the vagina.

Concern for the baby—For example, the umbilical cord may become pinched or compressed, or fetal monitoring may detect an abnormal heart rate.

Multiple pregnancies—Many women having twins can have a vaginal delivery. But if the babies are born too early, are not in good positions in the uterus, or have other problems, a cesarean birth may be needed. The chance of having a cesarean delivery increases with the number of babies.

Problems with the placenta
a giant baby
Breech presentation
You have a medical condition that makes vaginal birth risky—For example, cesarean delivery may be done if you have an active genital herpes infection during labor. It may also be done if you have certain heart conditions or brain problems, such as an aneurysm.

What are the risks of cesarean birth?

Like any major surgery, cesarean delivery has risks. Problems happen in a small number of surgeries and can usually be treated. But in sporadic cases, complications can be severe or even fatal:

The uterus, nearby pelvic organs, or skin incision can get infected.
You may lose blood, sometimes enough to require a blood transfusion. A hysterectomy may need to be done in rare cases if bleeding cannot be controlled.
You may develop blood clots in the legs, pelvic organs, or lungs.
Your bowel or bladder may be injured.
You may have an allergic reaction to medications or the types of anesthesia used.

Cesarean birth also increases risks for future pregnancies. These risks include placenta problems, rupture of the uterus, and hysterectomy. Some placenta problems can cause serious complications.

Because of these risks, cesarean delivery is usually done only when the benefits of the surgery outweigh the risks. In some situations, cesarean delivery is the best option. In other cases, vaginal birth is best. Talk with your ob-gyn about the risks and benefits of your problem.

Patients prefer non-invasive an

The average length of pregnancy is 280 days or 40 weeks. But there is no way to know precisely when you will labor. Most women give birth between 38 and 41 weeks of pregnancy. The more you know about what to expect during labor, the better prepared you will be once it begins.

No one knows precisely what causes labor to start, although changes in hormones may play a role. Most women can tell when they are in labor, but sometimes it’s hard to tell when labor begins.

As labor begins, the cervix opens (dilates). The muscles of the uterus contract at regular intervals. When the uterus contracts, the abdomen becomes hard. Between the contractions, the uterus relaxes and becomes soft.

What changes should I watch for?

Specific changes may signal that labor is beginning. These changes include:

Lightening
Loss of the mucus plug
Rupture of membranes
Contractions

You might or might not notice some of these changes before labor begins.

How will I know whether to call my provider or go to the hospital?

If you think you are in labor (or are not sure), call your ob-gyn or another obstetric care provider. You should go to the hospital if you have any of these signs:

Your water has broken, and you are not having contractions.
You are bleeding heavily from the vagina.
You have constant, severe pain with no relief between contractions.
You notice the fetus is moving less often.

d minimally invasive treatments for tightening or rejuvenating skin and women’s wellness due to the reduced recovery time. Treatment using the InMode suite of devices is typically pain-free in most cases. For aesthetics that genuinely please the eye, InMode can provide a cutting-edge solution for our Celebration Health & Wellness patients.

Patients prefer non-invasive and minimally invasive treatments for tightening or

What is preterm labor?

A typical pregnancy lasts about 40 weeks. Preterm labor is labor that starts before 37 weeks of pregnancy. Going into preterm labor does not automatically mean that a woman will have a preterm birth. But preterm labor needs medical attention right away.

What is preterm birth?

Preterm birth is the birth of a baby before 37 weeks. Preterm babies may be born with severe health problems. Some health problems, like cerebral palsy, can be lifelong. Other issues, such as learning disabilities, may appear later in childhood or adulthood.

What are the signs and symptoms of preterm labor?

Preterm labor contractions lead to changes in the cervix. The changes include effacement (thinning of the cervix) and dilation (opening of the cervix). Signs and symptoms include the following:

Mild abdominal cramps, with or without diarrhea
A change in the type of vaginal discharge—watery, bloody, or with mucus
An increase in the amount of discharge
Pelvic or lower abdominal pressure
Constant, low, dull backache
Regular or frequent contractions or uterine tightening, often painless
Ruptured membranes (your water breaks with a gush or a trickle of fluid)

If you have any signs or symptoms of preterm labor, do not wait. Call the office of your obstetrician-gynecologist (ob-gyn) right away or go to the hospital.

rejuvenating skin and women’s wellness due to the reduced recovery time. Treatment using the InMode suite of devices is typically pain-free in most cases. For aesthetics that genuinely please the eye, InMode can provide a cutting-edge solution for our Celebration Health & Wellness patients.

After Pregnancy

These over-the-counter poducts can help with vaginal dryness and painful sexual intercourse d

How long should I breastfeed my baby?

Exclusive breastfeeding is recommended for the first six months of a baby’s life. Breastfeeding should continue until the baby’s first birthday as new foods are introduced. You can keep breastfeeding after the baby’s first birthday for as long as you and your baby would like.

Breast milk has the right amount of fat, sugar, water, protein, and minerals needed for a baby’s growth and development. As your baby grows, your breast milk changes to adapt to the baby’s changing nutritional needs.
Breast milk is easier to digest than formula.
Breast milk contains antibodies that protect infants from certain illnesses, such as ear infections, diarrhea, respiratory illnesses, and allergies. The longer your baby breastfeeds, the greater the health benefits.
Breastfed infants have a lower risk of sudden infant death syndrome (SIDS).
Breast milk can help reduce the risk of many short-term and long-term health problems affecting preterm babies.

How does breastfeeding benefit me?

Breastfeeding triggers the release of a hormone called oxytocin that causes the uterus to contract. This helps the uterus return to its standard size more quickly and may decrease the amount of bleeding you have after giving birth.
Breastfeeding may make it easier to lose the weight you gained during pregnancy.
Breastfeeding may reduce the risk of breast cancer and ovarian cancer.

What should I do if I am having trouble breastfeeding?

Breastfeeding is a natural process, but it can take some time for you and your baby to learn. Most women can breastfeed. A few women cannot breastfeed because of medical conditions or other problems.

Lots of breastfeeding help is available. Peer counselors, nurses, doctors, and certified lactation consultants can teach you what to know to get started. They also can advise if you run into challenges. And remember, if you can’t breastfeed or decide not to, it’s OK. There are other feeding options, and you will find the best one for you, your baby, and your family.

uring menopause. They do not contain hormones, so they do not affect the vagina’s thickness or elasticity. Vaginal moisturizers can be used every 2–3 days as needed. Lubricants can be used each time you have sexual intercourse.

Celebration Pediatrics offers a wide variety of comprehensive medical care for infants, children, and adolescents. Our courteous and knowledgeable staff work hard to make every visit to our office a positive experience for your child and you!

With over 20 years of experience, our board-certified pediatricians believe exceptional care is obtained when there is an ongoing relationship between the doctor and patient.
We want to be lifelong partners in your child’s health and know we can achieve this goal by listening to your questions and concerns as we educate you on how to promote a healthy lifestyle for the entire family.

These over-th

Pregnancy takes a toll on a woman’s body. This is especially true for women who’ve had multiple children or twins. Often after pregnancy, the abdomen muscles cannot return to a youthful, taut position, a problem diet and exercise cannot fix.

Furthermore, the skin has been stretched, cellulite and stretchmarks have developed, and hyperpigmentation may have developed due to changes in hormone levels. The result is a body that has radically changed in appearance.

Celebration Obstetrics & Gynecology now offers patients minimally invasive anti-aging treatments and a chance to experience rejuvenation for the face, body, skin, and women’s wellness through the innovation of the InMode technology to get you feeling back to your normal self.

e-counter products can help with vaginal dryness and painful sexual intercourse during menopause. They do not contain hormones, so they do not affect the vagina’s thickness or elasticity. Vaginal moisturizers can be used every 2–3 days as needed. Lubricants can be used each time you have sexual intercourse.

The pelvic organs include the vagina, uterus, bladder, urethra, and rectum. These organs are held in place by muscles of the pelvic floor. Layers of connective tissue also give support. Pelvic organ prolapse (POP) occurs when tissue and muscles can no longer support the pelvic organs, dropping down.

The leading cause of POP is pregnancy and vaginal childbirth, weakening the pelvic floor muscles. Other causes of pelvic support problems include menopause, aging, and repeated heavy lifting. Conditions that create pressure on the abdomen can cause POP, including being overweight or obese; being constipated and straining to have bowel movements; and chronic coughing caused by smoking, asthma, or other medical conditions. POP can occur at any age, but most women who develop symptoms do so after menopause.

What are the symptoms of pelvic organ prolapse?

Symptoms can come on gradually and may not be noticed at first. Many women have no symptoms and do not know they have a prolapse. An obstetrician-gynecologist (ob-gyn) or other health care professional may discover a prolapse during a physical exam.

Sometimes, a bulge can feel inside the vagina when POP is mild. For severe cases of POP, organs may push out of the vaginal opening. Women with symptoms may experience the following:

Feeling of pelvic pressure or fullness
Organs bulging out of the vagina
Leakage of urine (urinary incontinence)
Difficulty completely emptying the bladder
Problems having a bowel movement
Lower back pain
Problems with inserting tampons or applicators

Is treatment needed for pelvic organ prolapse?

Many women do not need treatment. At regular checkups, your ob-gyn or other health care professional will keep track of the problem. If symptoms become bothersome, treatment may be required. Treatment decisions are based on the following factors:

Age
Desire for future children
Sexual activity
Severity of symptoms
Degree of prolapse
Other health problems

No form of treatment is guaranteed to solve the problem, but getting some degree of relief is good. If treatment is recommended, you may be referred to a physician who treats pelvic support and urinary problems.

Before your baby is born, take time to build a postpartum care team. These are the people who will support you and your baby in your first months together. Talk with your obstetrician-gynecologist (ob-gyn) or another obstetric care provider about who you need on your team.

Your Family and Friends

The people closest to you can help by:

Caring for your newborn and other children
Offering breastfeeding support
Making meals
Doing chores
Helping you get to your health care visits
Providing emotional support

Your Maternal Care Provider

This is the ob-gyn or other obstetric care provider in charge of your care during the postpartum period. Call this person first if you have questions about your health after delivery.

Your Baby’s Primary Care Provider

This is the pediatrician or other healthcare provider in charge of your baby’s care. Call this person if you have questions about your baby’s health.

Other Professionals

These people may include:

Other doctors to help with medical conditions
Counselors to help with breastfeeding
Nurses, social workers, and other trained professionals

Remember

This is your team. It should include the people you and your baby need to get the best start.

Make a list of everyone on your team’s names and phone numbers before the baby is born.
Review the list after giving birth and make changes if needed.
Keep your list nearby after you get home.

Women with postpartum depression have intense feelings of sadness, anxiety, or despair that prevent them from doing their daily tasks. Postpartum depression can occur up to 1 year after having a baby, but it most commonly starts about 1–3 weeks after childbirth.

Postpartum depression probably is caused by a combination of factors. These factors include the following:

Changes in hormone levels—Levels of estrogen and progesterone decrease sharply in the hours after childbirth. These changes may trigger depression in that more minor changes in hormone levels trigger mood swings and tension before menstrual periods.
History of depression—Women who have had depression at any time—before, during, or after pregnancy—or who currently are being treated for depression have an increased risk of developing postpartum depression.
Emotional factors—Feelings of doubt about pregnancy are common. If the pregnancy is not planned or wanted, this can affect how a woman feels about her pregnancy and fetus. Even when a pregnancy is designed, it can take a long to adjust to having a new baby. Parents of sick babies or who need to stay in the hospital may feel sad, angry, or guilty. These emotions can affect a woman’s self-esteem and deal with stress.
Fatigue—Many women feel exhausted after giving birth. It can take weeks for a woman to regain her normal strength and energy. It may take even longer for women who have had their babies by cesarean birth.
Lifestyle factors—Lack of support from others and stressful life events, such as a recent death of a loved one, a family illness, or moving to a new city, can significantly increase the risk of postpartum depression.

How is postpartum depression treated?

Postpartum depression can be treated with medications called antidepressants. Talk therapy is also used to treat depression, often combined with medications.

Support groups can be found at local hospitals, family planning clinics, or community centers. The hospital where you gave birth or your health care professional may assist you in finding a support group. Helpful information about postpartum depression can be found on the following websites:

National Women’s Health Information Center https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

Medline Plus http://www.nlm.nih.gov/medlineplus/postpartumdepression.html

What substances should I avoid during pregnancy?

Women should not use tobacco, alcohol, marijuana, illegal drugs, or prescription medications for nonmedical reasons during pregnancy. Avoiding these substances and getting regular prenatal care is essential to having a healthy pregnancy and a healthy baby. Counseling and treatment are available if you have a hard time quitting unhealthy substances on your own.

How do nicotine and smoking affect pregnancy?

When a woman smokes cigarettes during pregnancy, her fetus is exposed to many harmful chemicals. Nicotine is one of 4,000 chemicals that can pass from a pregnant woman to her fetus.

Nicotine damages a fetus’s brain and lungs. This damage is permanent. Nicotine also causes blood vessels to narrow, so less oxygen and fewer nutrients reach the fetus.

Smoking during pregnancy increases the risk of preterm birth. Babies that are born too early may not be fully developed. They may be born with severe health problems. Some health problems, like cerebral palsy, can last a lifetime. Other issues, such as learning disabilities, may appear later in childhood or adulthood

Can I drink any alcohol during pregnancy?

Alcohol can interfere with normal growth and cause birth defects. When a woman drinks during pregnancy, her fetus can develop lifelong problems. It is safest not to drink at all while you are pregnant.

What is fetal alcohol syndrome?

Fetal alcohol syndrome (FAS) is the most severe disorder caused by drinking during pregnancy. FAS can cause:

Growth problems
Mental disability
Behavioral problems
Abnormal facial features

FAS is most likely in infants whose mothers drink heavily throughout pregnancy. But alcohol-related problems also can occur with lesser amounts of alcohol use.

What effects does marijuana have during pregnancy?

Marijuana use during pregnancy is associated with attention and behavioral problems in children. Some studies suggest that marijuana use may increase the risk of stillbirth and the risk that babies will be smaller than babies who are not exposed to marijuana before birth. For these reasons, you should not use marijuana during pregnancy.

What should I know about drug use during pregnancy?

Drug use can mean using illegal drugs, such as heroin, cocaine, and methamphetamines (“meth”). It also can mean using prescription medication in a way your doctor did not order, such as taking pain medication for the “high” even when you no longer have pain. Your ob-gyn or another obstetric care provider may ask about your use of drugs throughout your pregnancy.

How do drugs affect the fetus in pregnancy?

The early stage of pregnancy is the time when the main body parts of the fetus form. Using illegal drugs or misusing prescription medication early in pregnancy can cause birth defects and miscarriage.

During the later weeks of pregnancy, illegal drug use can interfere with the growth of the fetus and cause preterm birth and fetal death. Babies born to women who use illegal drugs during pregnancy may need specialized care after birth. These babies have an increased risk of long-term medical and behavioral problems.

Is it safe to take prescription opioids during pregnancy?

When taken under a doctor’s care, opioids are safe for you and your fetus. If you are prescribed an opioid before or during pregnancy, you and your ob-gyn or another obstetric care provider should discuss the risks and benefits of this treatment. It is essential to take the medication only as prescribed.

What is opioid use disorder?

Most people who use a prescription opioid have no trouble stopping their use, but some develop an addiction. This is called opioid use disorder. People with this disorder may look for other ways to get the drug when their prescription runs out. They may go from doctor to doctor to have new prescriptions written for them, or they may use illegal opioids.

What problems can opioid use disorder cause during pregnancy?

Misusing opioids during pregnancy can increase the risk of serious complications, including:

Placenta problems
Fetal growth problems
Preterm birth
Stillbirth

Pregnancy takes a toll on a woman’s body.

This is especially true for women who’ve had multiple children or twins. Often after pregnancy, the abdomen muscles cannot return to a youthful, taut position, a problem diet and exercise cannot fix.

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