Pregnancy is a very exciting time in a woman's life. But it can also be a time filled with questions and concerns. Sometimes pregnancy symptoms can be confusing, making you wonder whether you really are pregnant or not. Only a pregnancy test will be able to help answer that question.

Now that you know that you are pregnant, it's time to see a prenatal health care provider. But which one is right for you? Take a look at Choosing a Prenatal Practitioner to understand how OB/GYNs, family doctors and midwives differ. No matter which of these practitioners you choose, though, all will offer you a multitude of prenatal tests over the course of your pregnancy to help make sure you and your baby are healthy. A cordocentesis may be performed if your baby is in distress; this fetal blood sampling test has also been used to administer in utero treatment to fetuses with heart problems and other dire health conditions.

During early pregnancy, you may have some concerns about already existing health conditions and how you and your baby will be affected. For women with asthma, Asthma and Pregnancy will likely answer many of your questions, while Prozac and Pregnancy will be useful for those women using this common antidepressant. If you are HIV positive, or are infected with this virus during your pregnancy, be sure to learn how HIV can affect your pregnancy. And if your pregnancy symtpoms seem really bad, then you may want to check to see if you're having twins or multiples.

There are a number of infections that a woman may contract during her pregnancy. Common Infections details a variety of illnesses and how they may affect you during pregnancy. One infection that woman are often cautioned of is toxoplasmosis. Though the risk of catching the virus is low, there are a number of steps you can take to prevent having to deal with it at all. Other infections that pregnant women shold guard against include chickenpox, group B strep, and the parvovirus, also know as Fifth Disease.

One concern for all women is the risk of ectopic pregnancy. If you suspect that your pregnancy may be ectopic, it is important to seek treatment quickly. While generally effective, occasionally some women may require to have a repeat treatment. False pregnancy is a condition in which a woman believes she is pregnant when she is really not.

If you have been having troubles getting pregnant, you may want to be investigated for antiphospholipid syndrome. This syndrome can contribute to repeat miscarriages as well as increase a woman's risk of developing pre-eclampsia during pregnancy, a condition associated with hypertension.

Other complications that can develop during late pregnancy include a low-lying placenta and cervical incompetence. Having an incompetent cervix increases your risk of premature labour. Also increasing the risk for premature labour is PROM, or premature rupture of the membranes. At the other end of the spectrum, prolonged pregnancy can also be problematic making it necessary for health care professionals to induce labour.

Many women are worried about giving birth. Will it be painful? Is it safe to use pain medications? What if something goes wrong? Will you need a caesarean section? Give yourself one less thing to worry over by using our labour checklist to make sure you have everything in order for the big day. And don't forget to check out Birthing Options, which explains all the choices you have when it comes to how and where to give birth. Of course, creating a birth plan is one of the best ways to let your health care professionals know what you want on that special day.

Breech Babies will give you an idea of what to expect if your baby isn't in the head first position, while Pain Relief for Labour will help you better understand your choices of labour medications. If you prefer not to use medications to deal with pain during labor, then you'll want to read Alternative Pain Management. One decision you may have to make once your baby is born is whether or not to administer vitamin K. Vitamin K for Newborns outlines the pros and cons of this treatment.

In addition to the complications a mother may experience during pregnancy, complications with your baby can also arise. This includes amniotic bands and sheets, single umbilical artery, and choroids plexus cysts. One complication that can be tested for during pregnancy is Downs syndrome. The chances of your baby developing this disorder increases with maternal age. However, there are a number of birth defects that can be diagnosed during your pregnancy. Though scary, knowing early on what to expect can help you prepare for that very special bundle that is arriving.

Early Pregnancy

Discovering that you are pregnant can be one of the most exciting and joyful things that you and your partner may ever find out. Now that you are pregnant, you are probably looking forward to the next three trimesters with much excitement and curiosity. But you and your partner may also be a little bit concerned about exactly what to expect during pregnancy. Early pregnancy is often the most difficult to deal with, especially as your body begins to adjust to your new baby. Here are some of the basics about what to expect during your first 20 weeks of pregnancy.

Signs of Pregnancy

Most women experience a number of different health symptoms after they become pregnant. You may notice some of these pregnancy symptoms, including:

  • Food Cravings: It is not unusual to feel more hungry during the initial days of pregnancy, and you may find yourself craving some very strange items, ranging from pickles and ice cream, to hot dogs and chocolate syrup! These food cravings are actually caused by the hormonal changes that are going on in your body. This early sign of pregnancy is your body’s way of making sure that you get the proper nutrition needed to support your baby’s initial growth.

  • Sore Breasts: Breast tenderness is often one of the very first signs of pregnancy that women experience. You may notice that the area around your nipples (the areola) begins to darken, and that your breasts become a little more tender and sore than usual. This is a sign that your breasts are beginning to prepare for breastfeeding.

  • Morning Sickness: Morning sickness is one of the classic signs of pregnancy. In fact, more than 50% of all pregnant women experience some kind of morning sickness. You might find that you feel particularly dizzy or you may experience nausea and vomiting. This symptom is particularly common during the first trimester, but usually disappears by the 15th week of pregnancy.

  • Fatigue: As your body begins to prepare for your baby’s future growth and development, you will likely notice that you are significantly more fatigued than usual. Even if you are getting a full night’s sleep, you will probably experience some type of fatigue throughout the first twelve weeks of pregnancy. This fatigue will pass in time, and by the second trimester you will begin to feel a sense of renewed energy and spirit.

Physical Changes During Early Pregnancy

Throughout the first 20 weeks of pregnancy, you will notice a number of changes in your body. As your baby begins to develop, your body will start to change in order to support his growth and development. These changes will be slow at first, but will pick up as your pregnancy continues. Changes can include:

  • Growing Belly: Throughout the first trimester and first few weeks of the second trimester, you will begin to notice a small bulge in your stomach. This bulge will slowly grow as your baby begins to develop. Most women begin to show their pregnancy by the 12th week of pregnancy.

  • Swollen Breasts: You will also notice changes in your breasts as your pregnancy progresses. Your breasts will become larger and more sensitive as your body prepares for breastfeeding. In particular, you may notice that your nipples become more prominent and that you areolas darken.

  • Stretch Marks By the beginning of the second trimester, you might start to see faint stretch marks surrounding your abdomen or breasts. This is a sign that your body is growing just as it should during pregnancy. These stretch marks will fade after labor and delivery, or you can use special creams to help them heal.

Other systems a woman may experience while pregnant is lack of sleep, varicose veins, forgetfulness, gas, or snoring.  Find out about these common pregnancy symptoms and side effects and discover more about the many other pregnancy surprises you can expect from your body.

Baby’s Development During Early Pregnancy

During the first 20 weeks of pregnancy, your baby is growing at an extremely rapid pace. Specifically, by 20 weeks your baby will have developed:

  • all of his organs and bodily systems

  • his sex organs (which will determine baby’s gender)

  • his brain

  • his heart beat

Your baby will also be growing quickly in length. By six weeks, she will already be 20 millimeters long, and by 12 weeks she will by over 100 millimeters long! By the beginning of the second trimester your baby will be able to hear sounds in the womb and will start to make movements inside of you (known as quickening).

Also check out our article on fetal development during late pregnancy.

Diet and Exercise

It is particularly important that you follow a healthy pregnancy diet during the early days of pregnancy. Your baby depends on you for all her nutrients and calories, which are vital for her growth and development. In particular, it is important for you to take a prenatal vitamin throughout the 20 weeks of early pregnancy. It is especially important that this prenatal vitamin contain folic acid. Folic acid has been clinically proven to help reduce the risks of neural tube defects in babies by up to 70%.

Pregnancy weight gain is also significant during the first 20 weeks of pregnancy. In the first trimester, weight gain should be slow: aim for approximately four to six pounds. During the second trimester, you can begin to speed up the weight gain process to about a pound a week. This will help to ensure your baby gets all the nutrients and calories she needs and help to keep you on target for a healthy pregnancy weight gain. If you are expecting twins, you may want to begin gaining up to a pound and a half per week, beginning in the 13th week of pregnancy.

Exercise should also form a part of your early pregnancy experiences. Exercise will help to minimize your pregnancy discomforts and help to keep weight gain in check. Be sure to consult with your health care provider before beginning any exercise routine, though. In some cases, exercise is not appropriate for mom and baby.

Also read up on why smoking can be dangerous for both you and your baby during pregnancy and discover some fun ways to enjoy being pregnant.

Complications During Early Pregnancy

Sometimes, early pregnancy can be marred by serious health complications. Now that you are pregnant, it is important to be aware of these problems, so that you can seek immediate attention should you need it. Complications include:

  • Miscarriage: Miscarriages are very common in early pregnancy, particularly in the first 12 weeks. In fact, miscarriages are thought to occur in almost 50% of pregnancies, however, many women who experience them do so before they know that they are pregnant. Signs of miscarriage include vaginal spotting or bleeding, abdominal cramping, and pressure in the lower back. Should you experience any of these symptoms, visit with your health care provider as soon as possible.

  • Ectopic Pregnancy: Though a much rarer complication than miscarriage, ectopic pregnancy can be extremely dangerous for a pregnant women. An ectopic pregnancy occurs when the fetus attaches outside of the uterus, commonly along the fallopian tube. This type of pregnancy can causes serious health complications, including tubal rupture and even death. Ectopic pregnancies are most commonly found between the eight and tenth weeks of pregnancy, and symptoms include dizziness, sharp abdominal or shoulder pain, and vaginal spotting.

Also check out are articles on cordocentesis (find out why you may need this prenatal test) and find out what to do if you are experiencing a prolonged pregnancy.  Also get information on teen pregnancy for parents and teen pregnancy for teenagers, and find out how perfume can adversely affect fetal development.  Also relive your concerns about flying while pregnant and learn more about whether it is safe to fly when pregnant. 

Hear from experienced moms about the must have for new moms, and also discover why it may be worthwhile to keep a pregnancy journal. 

Infections During Pregnancy

Infections are a part of normal life. We all suffer from the odd coughs and colds, and many women have experienced troublesome thrush (yeast infections) or cystitis. Pregnancy is a time when some infections are more common than usual, and a time when other infections can present a particular risk either to the woman or her unborn baby. This article will review the more common and problematic infections that might affect pregnancy.

Coughs, Colds & Flus

Women are just as likely to get these during pregnancy as outwith this time. They are little threat to the pregnancy itself and all that is needed is symptom relief: lots of fluids, rest and TLC. Inhaled decongestants are safe, but cough linctus should be avoided. It is quite safe to take paracetamol up to normal maximum doses (1g, four times per day). If a cough becomes productive with green phlegm, this may mean a bacterial infection needing antibiotics. There are antibiotics that are safe during pregnancy, so be sure to tell any doctor you see that you are pregnant.

Vaginal Infections

Thrush
Pregnancy makes a woman more likely to get a thrush infection, most commonly caused by the yeast Candida albicans. This yeast is commonly found in the vagina in up to 16% of non-pregnant women and 32% during pregnancy. It does not always cause symptoms and only requires treatment if it causes troublesome itching, soreness or the typical thick, white discharge. It is more common in second and subsequent pregnancies, in the third trimester, during summer months, following a course of antibiotics and in diabetic women. Treatment with Clotrimazole (Canesten) vaginal suppositories is usually effective. The tablet treatment Fluconazole (Diflucan) is not advised during pregnancy.

Men can be affected by thrush, it causing a redness and soreness of the glans of the penis, with a pin-point spotty appearance. Thrush affecting men is a lot less common than for women and it is even less frequent for a man to act as a 'reservior' of infection where the woman keeps getting it back from him. It is not necessary for your partner to get treatment unless they have symptoms.

Group B Streptococcus (GBS)
Group B streptococcus is a bacterium that around 15-20% of pregnant women carry in the vagina, usually causing no problems at all. In a small number of cases, the bug is passed to the baby during delivery and it can lead to a blood-borne infection or even meningitis. This condition affects only 3 per 10,000 babies in the UK. The incidence is much higher in the US, so they have developed a comprehensive screening programme for GBS.

In the UK treatment is usually only advised in one of a number of 'high risk' scenarios. These include: early labour (before 37 weeks), prolonged or early rupture of the membranes (PROM), if there is a temperature during labour or if a previous baby has been affected with the condition. The treatment involves antibiotics through a drip during labour - tablet treatment cannot reliably eradicate the infection.

Sexually Transmitted Infections

Both chlamydia and gonorrhoea infections can pass to the baby during delivery causing eye infections. Gonorrhoea is quite rare in the UK, occurring in less than 1 per 1000 women. Chlamydia is more common, affecting around 5% of pregnancies. It can also lead to chest infections in the baby or infections of the lining of the womb for the mother after delivery. Both 

of these infections are treatable during pregnancy but a second swab should be taken afterwards to confirm that they are cleared. It is most important to screen and treat sexual partners, otherwise they will pass the infection back again.

Genitourinary medicine clinics (previously known as STD or VD clinics) have come a long way since the 1970's. They are really sexual health clinics and many young women use them for smear tests, contraceptive advice or any unusual vaginal itch or discharge - not necessarily sexually transmitted. They have facilities not available to GP's, obstetricians or gynaecologists and are the best place to go for any vaginal discharge that proves troublesome to clear.

Testing for HIV infection is routine in some hospitals, but is not usual outside of high-risk areas. If you feel that you may have been at risk, any GUM or hospital clinic will be able to arrange one, often the same day if necessary. HIV infection passes to the baby in about 15% of cases, but this can be reduced to 8% with drug treatment and perhaps even lower with an elective caesarean section, so there is definitely a benefit to knowing for sure if you are concerned.

Urinary Tract (Water) Infections

Urinary tract infections (UTI's) are more common during pregnancy than at other times, mostly because of a slowing down of the urine flow on its way from the kidney to the bladder. Around 1 in 25 women get a UTI during pregnancy, the common symptoms being a discomfort or burning sensation on passing urine, an aching pain over the bladder or needing to pass water very frequently. This last symptom is unfortunately very common in pregnancy anyway and is not very reliable in making the diagnosis. If the infection passes up to the kidneys and into the blood stream (pyelonephritis or septicaemia) it causes loin pain, vomiting, a fever and can even start premature labour.

By treating early UTI's, kidney infections and their complications can be prevented. The infection is diagnosed by looking at the urine under a microscope and seeing if a bug can be grown from the sample. This can also confirm which antibiotic is the best to use. A mild infection is treated with a course of antibiotic tablets for at least a week, but a more severe one would need admission to hospital, intravenous antibiotics and rest. After one UTI, further infections are more common and monthly checks on the urine are suggested to see if one is developing even before symptoms appear.

Genital herpes

Herpes infections affect about 10% of the UK population, though only in one third of cases is an actual diagnosis as such made. It usually presents initially with a flu-like illness, followed by an outbreak of vulval sores, which are very painful and swollen glands in the groin. By a week to 10 days later these have usually healed over. Sometimes the initial attack is mistaken for a thrush infection, just causing an itch or soreness, seemingly responding to cream or pessaries. Occasionally it is completely without symptoms at all. The first (primary) attack is usually the most painful. The herpes virus stays in the nerve in the spine and can reactivate causing a secondary attack. This occurs on average at 3-4 months after the first one, and recurrences return on average 2-3 times per year, but this is extremely variable.

The risk of herpes to pregnancy is greatest if the primary attack occurs after 28 weeks. The mother's initial antibody response can take up to 12 weeks to fully develop. Secondary attacks are much less of a risk. The risk of herpes is passing the infection to the baby at the time of delivery. Primary attacks also can lead to early labour or poor growth. Because of these risks, a caesarean section is usually advised at term if a primary attack occurs during pregnancy after 28 weeks, or if there is an active secondary attack at the time of labour. SHould a woman experience signs od herpes during pregnancy, it is critical that she consult a doctor to find the appropriate herpes cure.

Toxoplasmosis

Toxoplasmosis is caused by a parasite called toxoplasma gondii. This is found in different forms in raw meat, within cats that eat raw meat and their faeces. Toxoplasmosis infection is common in both men and women outside of pregnancy, however it is infection during pregnancy that is of most concern as it can lead to infection in the unborn infant: congenital toxoplasmosis. Once you have had toxoplasma infection, the bodies immunity will prevent you catching it again. Around 30% of women will have already had a toxoplasma infection before pregnancy. It typically causes a flu-like illness with swollen glands in the neck. Most people are unaware that it was in fact toxoplasmosis. It is not known for sure how many women catch toxoplasmosis during pregnancy, but some research suggests it is of the order 2 in every 1000, which means about 1400 each year in the UK.

In only about 30-40% of women who catch toxoplasmosis during pregnancy, does the infection pass to the unborn baby. The actual risk appears to be related to the gestation at which it is acquired. It is greatest in the third trimester at 70%, whereas in early pregnancy only 15% of infants will become infected. Toxoplasmosis infection may lead to miscarriage, stillbirth, or survival with growth problems, blindness, water on the brain (hydrocephalus), brain damage, epilepsy, or deafness. If a woman is found to have acquired toxoplasmosis during pregnancy, she will be offered an ultrasound scan to look for signs of fetal infection. After 20 weeks gestation, she may be offered a definitive test - cordocentesis. This involves a scan and blood sample being taken from the umbilical cord.

Although toxoplasmosis is quite serious when it occurs, as you will see from the figures above, it is relatively rare. Women with cats do not need to get rid of them when they become pregnant; it is just necessary to take a few precautions. Be sure to only eat meat that has been cooked right through. Wash your hands, cooking utensils and food surfaces after preparing raw meat and wash all the soil from fruit and vegetables before eating. Keep raw meat and cooked foods on separate plates. If possible get someone else to clean out the dirty cat litter or use gloves and wash your hands afterwards. Always use gloves when gardening and wash your hands afterwards. Lastly if you have a cat, make sure you take it to the vet and check out all its cat health problems.

Chicken Pox

It's not uncommon for women who are pregnant to come into contact with someone who has chicken pox. This can cause great worry, but it is uncommon for there to be a problem.

Firstly, if you have definitely had chicken pox before, there is no risk to the baby. In any case, even if you don't recall having had chicken pox, it is likely you have antibodies (80% do) from a silent infection. So if there's any doubt about it, you should see a doctor for a blood test to check for immunity. Sometimes the laboratory can use the stored blood taken at booking to speed this up.

Risks to the baby are important at the following two times, only if mum gets chicken pox:

1. Before 20 weeks - risk of chicken-pox syndrome. This is actually quite rare. Up until 14 weeks the risk is about 0.4%, whereas between 14-20 weeks it is 2%. If a woman has VZ-Ig treatment (see below) after being exposed, the risk is even lower.

2. Mum's rash developing within a week before delivery to a month afterwards. It takes about a week for mum to pass the protective antibodies to the baby, so if born before that time, the baby is at risk of overwhelming infection after birth.

Between 20 weeks and term there is no risk to the baby.

VZ-Ig is a form of antibody treatment that can reduce the risk of chicken-pox syndrome and should be given by 10 days after the initial attack.

Pregnancy Symptoms

Pregnancy symptoms can vary widely from woman to woman. If you suspect that you're pregnant the most obvious sign is, of course, a missed period, but not everyone will skip their period during the very early stages of pregnancy. To make matters more complicated, the signs that you are pregnant can easily be misinterpreted as symptoms of other things.  The best way to know for sure is to take a pregnancy test.

Also if you are trying to become pregnant find out more about how to prepare your body for this special time like learning more about prenatal tests you should take, how to develop healthy habits for pregnancy, and get information on the best diet and exercise to do when trying to conceive.  Find out more about what you should be doing for preconception care.

Signs that You are Pregnant

Delay/Difference in Menstruation
This is the most obvious and common pregnancy symptom. If you are pregnant you will probably miss your period, or you may have a period that is shorter and lighter than your periods usually are. It may also start earlier or later than usual. However, this is not always a sign of pregnancy; any excessive weight gain or loss, hormonal problems, stress, or stopping the birth control pill can bring on a delay or difference in menstruation.

Implantation Bleeding
Approximately six to 12 days after concept, an embryo will implant itself in the uterine wall.

This can cause cramping and spotting in some women. This can also be mistaken for menstruation, or can result from infections or changes in oral contraception usage.

    Quick Tip:A heating pad can help with the cramping if you are avoid taking painkillers in case you are pregnant.

Nausea/Morning Sickness
This is probably the most well known of all the signs that you might be pregnant. Usually morning sickness will start within two to 8 weeks after conception. Despite being called "morning" sickness, nausea can occur at any time during the day. Some women may never experience this, or only feel sick during part of their pregnancy, others continue to feel nauseous for the entire time they are pregnant. This symptom can be mistaken for food poisoning and other stomach ailments. However, severe nausea or morning sickness can be signs of hyperemesis gravidarum, which can have very serious side effects.  For morning sickness relief, check out our article on cures for morning sickness.

    Quick Tip: Some women suffering from morning sickness find it helpful to eat small meals throughout the day, or munch on soda crackers when they begin to feel nauseous.

Tender, Swollen Breasts
One to 2 weeks into their pregnancy, some women may start to notice changes in the appearance and sensitivity of their breasts. They may become sore, swollen, or tender to the touch and there may be colour or size changes to the areola or nipple. This symptom can also occur as a result of PMS, hormonal imbalances or from taking birth control pills.

    Quick Tip: Try cutting back on caffeine as this can sometimes contribute to breast tenderness.

Fatigue
This symptom might be noticed as early as one week after conception, but can also be caused by a host of other ailments and stresses, so it's not a very reliable indicator.

Increased Sensitivity to Tastes or Odours
No one is completely certain as to why this happens, one theory is that increased levels of estrogen are to blame. What is known is that in the early stages of pregnancy certain smells that never bothered you before may cause you to gag. Sometimes even your favourite foods will begin to disgust you.

Frequent Urination
Can begin six weeks after conception. During pregnancy, the amount of blood and other fluids in your body will increase. Once the extra fluid is processed, it ends up in your bladder and the next thing you know, you're running for the bathroom every 10 minutes. The bad news is, as the baby continues to grow, it will start to push on your bladder and that will mean more frequent trips to the washroom for the rest of your pregnancy.

Abdominal Bloating
In early pregnancy your hormones will being to run amok, which could make you feel bloated, similar to what you may experience around the time your period starts.

    Quick Tip: If you're feeling bloated, try cutting back on salt and drink some extra water, this should help to ease bloat.

Food Cravings
No, it's not an old wives tale, pregnant women do find themselves craving certain foods. This may happen only one time, or it might continue to happen for the entire time that you're pregnant.

Elevated Basal Body Temperature
If you've been charting your basal body temperature and you notice that your temperature has been elevated for 18 days in a row, you're likely pregnant.

Testing

Whether you're experiencing these symptoms or not, if you think you might be pregnant the best way to find out as soon as possible is to take a home pregnancy test or get the doctor to test you. Keep in mind that most home pregnancy tests are not sensitive enough to detect pregnancy until at least one week after a missed period.

Even if you take a home pregnancy test and get a negative result, if your symptoms persist or your period does not return to normal, you should see your doctor.

Labour

Giving birth to a child is a unique experience. Something that can never be the same even if you have delivered before. And though you may have thought of labour simply as the time when the baby finally comes into the world, it is in fact divided into various stages, each with its own special contribution to childbirth.

Signs of Labour

Labour and birth can happen in a matter of seconds or take hours to occur. The signs of labour are unique to everyone and if you are a little doubtful, it is best to contact your gynaecologist.

During labour, what may be happening inside your body is this:

  • There is a mucous plug that seals the opening of the cervix during pregnancy. When your body starts getting ready for delivery, this plug comes out. In some women, it comes out as a single pinkish blob while in others it may be in small pieces. The time gap between the plug coming out and proper labour beginning may vary from a few weeks to days and hours.

  • The amniotic sac, the fluid surrounding the baby, breaks and the water gushes or trickles out. This is a sure sign that you are in labour and should call your doctor immediately

The physical signs that you may experience during labor are:

  • Period like cramps

  • Backaches

  • Diarrhoea

  • A blood like stain, which is due to the thinning of the cervix and the mucous plug, may drop out

  • Water coming out as the membrane breaks

  • Contractions (these can begin early but you'll know the time for delivery is near if the interval between each contraction is short and the contractions are strong)

Stages of Labour

The complete process of labour and delivery is divided into three stages.

First Stage

This stage is usually the longest and can last days or weeks without being noticed though it often takes place a bit quicker. The first stage refers to when your cervix begins to dilate and you begin to have contractions that gradually get closer and stronger.

This stage is again divided into three phases:

Latent phase - The very early period when your contractions just begin and you feel slight discomfort. You may also not feel anything at all when the phase lasts for a week or more. When these early contractions happen, it is best to distract yourself by taking a walk, reading, sitting, talking and relaxing at home, as there is not much that you or your doctor can do at this time. The cervix dilates to around 3cm to 4cm.

Active phase - This is the time when labour contractions are much more regular and come in intervals of 3 or 4 minutes. The cervix may dilate to about 6cm or 7cm and you may find it a little more difficult to talk or relax. You may call your doctor or midwife at this point.

If you are given a Pitocin, the artificial oxytocin, your phase may last for a shorter duration unlike if you are using an epidural. If you have already had a vaginal birth before, this phase may also be shorter for you.

Transition phase - The contractions become more intense and painful. You may feel that the interval between two contractions has shortened and you may not even feel the gap between them. The cervix dilates to around 10cm. You may get an urge to go to the toilet, as this is the time when the baby's head touches the rectum.

Many mothers get an urge to push at this time even though complete dilation may not have taken place. If you are taking an epidural and want to actively participate during the delivery and the pushing, it is best to lower your dosage of epidural at the end of this phase.

The exact time when you know that you are in actual labour can be a tricky one if your contractions start very soon and the gap between them are almost 4-5 minutes. Early labour contractions may also be confused with Braxton Hicks contractions, which sometimes start half way during pregnancy and may tend to lift and tighten your abdomen a bit.

Second Stage

This is the more active phase of labour when you will be actually delivering your baby. The cervix has dilated completely and it may be at this time when your water breaks. If it doesn't happen naturally, your gynaecologist may artificially rupture it. This stage can last for as little as 10 minutes for someone who has previously had a vaginal birth to two to three hours for a first time mom. There may be a burning or stretching sensation as the baby moves through the vagina.

The actual action of pushing should usually be started when you get a natural urge and the uterus has done its work of moving the baby. But some doctors may suggest pushing with each contraction so as to hasten the process. Listen to your doctor's instruction carefully and follow it to utilise your complete energy and deliver the baby without any problem. Most women find the semi-sitting or squatting position most comfortable as gravity helps to deliver the baby.

The stage is over when the baby has been born and the doctor has cut the umbilical chord. You can relish in the sight of your newborn for the very first time.

Third Stage

Once the baby is delivered, the uterus shrinks in size and the placenta, which provided your baby's nourishment for the last nine months, separates from the uterine wall. Though you may be too exhausted at this point, it is necessary to deliver the placenta, which is also known as the afterbirth. This stage can last anywhere from five minutes to a half hour.

To deliver the placenta, just one mild push may be all that's needed. Once this is done, your uterus will contract more and become very firm. It is important to cut off the open blood vessels at the places where the placenta was attached; if this is not done it can lead to profuse bleeding.

What to Expect After

After birth, the doctor usually checks the pulse, blood pressure, and uterus contraction of the mother to ensure everything is fine. The baby may be given a dose of Vitamin K and will have an APGAR test done. Keep in contact with your doctor on a regular basis to understand what all you can or cannot do just after the delivery.

Following delivery, you may feel pain, like menstrual cramps, for a few hours or days. If you are breastfeeding, your uterus will tighten even more thanks to the oxytocin that is released during breastfeeding in the first few days. If you've had an episiotomy, where your doctor makes a small cut on the vagina to help widen the opening and make delivering your baby easier, it will be necessary to stitch the cut.

Every mother has an inborn strength to deliver and nurture a child. Use it and enjoy this novel experience.