OB 2 Pregnancy

🤰 Common Complaints During Pregnancy

• 🤢 Nausea — feeling sick to your stomach, especially in the morning (that’s why it’s called “morning sickness”)

• 😖 Back and shoulder pain — the baby’s weight makes the back work extra hard!

• 🤮 Hyperemesis — when nausea is so bad they throw up all the time

• 🦵 Leg cramps — muscles tighten up, especially at night (ouch!)

• 🔥 Heartburn — feels like fire in your chest because the baby pushes on the stomach

• 😮‍💨 Shortness of breath — the baby takes up space, so there’s less room for lungs to expand

• 🩸 Varicose veins — blue, squiggly veins on legs because of extra pressure and blood flow

• 🍑 Hemorrhoids — swollen veins in the bottom area from pressure and pushing

👶 Gravidity (G)

👉 The total number of times someone has been pregnant — even if the pregnancy didn’t last or is still going on.

• Nulligravida 🤰🚫 = never been pregnant

• Primigravida 🤰1⃣ = pregnant for the first time

• Multigravida 🤰➕ = been pregnant 2 or more time

👶 Parity (P)

👉 The number of pregnancies that made it to 20 weeks or more, or where the baby weighed more than 500 grams (about 1.1 lbs) — no matter if the baby was born alive or not.

• Nullipara 🚫👶 = never given birth after 20 weeks

• Primipara 👶1⃣ = given birth once after 20 weeks

• Multipara 👶👶 = given birth 2 or more times after 20 weeks

• Grand Multipara 👶👶👶👶👶 = given birth 5 or more times

💦 “Breaking the Water”

• Shrawn 🌊 = when the water breaks naturally by itself

• Ashrawn 💧💉 = when the doctor or nurse breaks the water on purpose

 ⚖ Fun Fact:

• 500 grams = 1.1 pounds 🧠⚖

🧩 The 5-Digit Code = GTPAL

🧩 The 5-Digit Code = GTPAL

Let’s break it down like this:

Letter	Meaning	Emoji	Example
G	Gravida — total number of pregnancies 🤰	🤰	G3 = 3 pregnancies
T	Term births (37+ weeks, full-term babies)	🍼	T1 = 1 full-term birth
P	Preterm births (20–37 weeks)	👶	P1 = 1 preterm baby
A	Abortions — pregnancy losses before 20 weeks (spontaneous “SAB” or therapeutic “TAB”)	💔	A1 = 1 miscarriage or abortion
L	Living children — how many are alive today	❤	L2 = 2 children living

 

 

🌟 Easy way to remember:

G → Got Pregnant 🤰

T → Took to Term 🍼

P → Premature 👶

A → Angel baby 💔

L → Living ❤

🩷 Presumptive Signs (What she feels)

These are the signs that make a woman suspect she’s pregnant — but they aren’t 100% proof yet!

👩‍🍼 “I feel pregnant…”

• 💞 Breast tenderness or changes

• 🚫 No period (Amenorrhea)

• 🤢 Nausea or vomiting

• 🚽 Peeing more often (Urinary frequency)

• 💤 Feeling tired (Fatigue)

• 🦋 Feeling tiny flutters (Quickening)

• 🌈 Darker skin or nipples (Hyperpigmentation)

• 📈 Bigger breasts or belly (Uterine/Breast enlargement)

💜 Probable Signs (What the nurse or provider sees)

These are stronger clues that point to pregnancy, but they still aren’t 100% proof!

👩‍⚕ “I see signs of pregnancy…”

• 🍑 Goodell’s Sign → soft cervix

• 💜 Chadwick’s Sign → bluish-purple cervix

• 🤰 Hegar’s Sign → soft lower uterus

• 🧪 Positive pregnancy test

• 💫 Braxton Hicks contractions (practice contractions)

💚 Positive Signs (What proves pregnancy)

These are for sure — only a baby can cause them 👶✅

🩻 Ultrasound — you can see the baby

💓 Fetal heart tones (FHT) — you can hear the heartbeat

✋ Fetal movement felt by examiner — the nurse feels the baby move

💜 Chadwick’s Sign

• 💡 What it is: Bluish-purple color of the cervix and vaginal walls

• 👀 Who sees it: The OB nurse or provider during an exam

• 🧠 Memory tip: “Chadwick → Chapstick 💄” — think of purple/blue lips 💋

🍑 Goodell’s Sign

• 💡 What it is: Softening of the cervix

• 🧠 Memory tip: “Goodell → Gooey cervix” (soft and squishy like goo!)

🩷 Hegar’s Sign

• 💡 What it is: Softening of the lower uterine segment

• 🧠 Memory tip: “Hegar → Heavy baby causes soft lower segment”

🧪 Verifying Pregnancy — The hCG Test

💡 What’s hCG?

hCG = Human Chorionic Gonadotropin

It’s a pregnancy hormone that shows up after the egg and sperm meet! 🥚💞💫

Biologic marker for pregnancy

 

🌱 When does it show up?

• Starts being made right after implantation (when the baby sticks to the uterus wall)

• Can be found in:

  • 💉 Blood → about 6 days after conception

  • 🚽 Urine → about 1–2 days after a missed period

• Best to test using your first morning pee ☀💧 (it’s the strongest sample!)

 

📈 When is hCG the highest?

• It rises fast and peaks around 60–70 days (about 2 months) into pregnancy ⏰

• Then it slowly goes down after that

The hCG Test ⚠ Important Reminder

Just because the test is positive ➕ doesn’t always mean pregnancy!

Other things can make hCG go up too ⬆

• 💊 Some fertility medications

• 🎗 Certain tumors

• 💔 Therapeutic abortions (recent pregnancy loss or procedures)

🩷 EDC = EDB

Both mean the same thing!

• EDC = Estimated Date of Confinement (old term 👵)

• EDB = Estimated Date of Birth (modern term 👶)

🧮 Naegele’s Rule (how doctors & nurses calculate due dates)

It assumes a 28-day menstrual cycle with ovulation on day 14.

Here’s the magic formula 💫👇

1⃣ Write down the first day of the last menstrual period (LMP) 🩸

2⃣ ➕ Add 7 days

3⃣ ➖ Subtract 3 months

4⃣ ➕ Add 1 year

🎉 That’s the Estimated Due Date (EDD)!

How the Uterus Grows During Pregnancy (by size!)

During the first trimester, hormones like estrogen and progesterone help it grow fast 📈

Weeks	Size Comparison	Emoji
7 weeks	🥚 Hen’s egg	🐣
9 weeks	🎾 Tennis ball	🎾
10 weeks	🍊 Orange	🍊
12 weeks	🍈 Grapefruit	🍈

By this time, you can feel it above the pubic bone! 🩺

 

💧 Blood Flow Increases

As the uterus grows, more blood flows to it — to bring oxygen and food for the baby! ❤🩸

Uteroplacental blood flow = ↑ blood flow = ↑ baby nutrients! 🍎🥦

 

📏 Predictable Growth Pattern

Nurses measure fundal height (the top of the uterus) to track how the baby is growing 👩‍⚕📐

• By 20 weeks, the uterus reaches the belly button (umbilicus) 🎯

• Growth helps us see if baby is growing on track 💕

 

🌸 Reproductive System Adaptations 💞 Quickening

👶 = when the mom first feels the baby move!

• Feels like little flutters or gas bubbles 🫧

• Usually happens:

  • 🩷 Around 17–18 weeks if she’s had babies before (multipara)

  • 💛 Around 20 weeks or later if it’s her first baby (nullipara)

💡 Think: “Quickening = Quick kicks!” 🦶✨

🌸 Reproductive System Adaptations 💫 Braxton Hicks Contractions

🌀 These are practice contractions — your uterus is getting ready for the big day!

• Irregular and painless 💆‍♀

• Start after 16+ weeks

• Help increase blood flow to the uterus ❤

• Usually stop when the mom moves or walks 🚶‍♀

• Sometimes feel like real labor, but they aren’t!

💬 Tip: Keep calm — it’s just Braxton Hicks!

🌸 Reproductive System Adaptations 👶 Fetal Drop (“Lightening”)

This happens in the third trimester, when the baby moves down into the pelvis getting ready for birth! ⬇

• Nulliparous (first baby) — happens about 2 weeks before labor ⏳

• Multiparous (had babies before) — happens at the start of labor ⏰

• It’s very normal and means the baby is getting into position! 🤰✅

Nullipara

No births beyond 20 weeks

Multipara

Two or more births beyond 20 weeks

💗 Vagina & Vulva Changes

As the body prepares for birth, blood flow 💉 and hormones 💊 make a lot of changes:

• 💜 Chadwick’s Sign → cervix turns bluish-purple from extra blood flow (usually seen 6–8 weeks)

• 🧴 Lactic acid increases → keeps pH low to fight bacteria 🦠

• 🩸 More blood vessels = more color & swelling

• 💧 Leukorrhea → white or gray discharge that’s normal in pregnancy (because of ↑ estrogen)

  • Has a mild musty odor

  • Helps clean and protect the vagina

  • But too much = yeast infection risk 🍞⚠

💬 Think: “Leuko = Light-colored, clean, normal!”

💜 Cervical Changes

• 🍑 Goodell’s Sign → cervix becomes soft around 6 weeks

• 🧱 Mucus Plug forms → fills the cervix like a jelly cap!

  • 🛡 Blocks bacteria from entering the uterus

  • Can come out before labor (“bloody show”)

🥚 Ovarian Changes

• 🚫 No ovulation! (the body stops releasing eggs)

• 💕 hCG (the pregnancy hormone) keeps the corpus luteum alive — it makes hormones until the placenta takes over 🌿

 

🩷 Extra Notes

• 🩸 More blood flow = swollen veins (varicosities) in the vulva

• 💧 May feel puffy or tender (sometimes called “blue twinkies” jokingly 😅)

• ⚠ Because of hormone changes, pregnant women are more likely to get yeast infections

• 🧠 Always check for STIs too — similar symptoms can overlap

 

🩷 Breast Changes During Pregnancy

🧁 1⃣️Bigger and Fuller

• Breasts get larger, heavier, and more sensitive 🥺

• Feels tingly or sore because milk glands and ducts are growing

• You might notice your bra getting tighter — that’s normal! 🩷

 

🎨 2⃣️Color and Texture Changes

• Areola (the dark circle) gets darker so baby can find it easier 🍼

• Nipples stick out more 👀

• You might see veins on the breasts — that’s from more blood flow 💉

• Stretch marks (striae) may appear as the skin stretches 🩹

💡 Hormones like estrogen and progesterone are responsible for all these changes!

 

💧 3⃣️“Liquid Gold” (Colostrum)m)

• Around 16 weeks, the breasts can make a thick yellow fluid called colostrum 🌟

• It’s full of antibodies that protect the baby from germs 💪🦠

• After birth, colostrum changes into regular breast milk 🍼

💬 Think: Colostrum = Baby’s first superfood! 🌟

 

🧬 4⃣️Inside the Breasts

• Glands and ducts grow bigger (glandular hyperplasia and hypertrophy) 🧠

• By mid-pregnancy, the milk-making system is fully developed 🧩

• But real milk doesn’t come in until after the hormone estrogen drops post-birth 🕓

🩵 Venacaval Compression (Supine Hypotensive Syndrome)

💡 What Happens

When a pregnant woman lies flat on her back, the big uterus (and the baby!) 🍼 presses on a large vein called the vena cava — that’s the vein that carries blood 🩸 from the lower body back up to the heart ❤

 

⚠ Why It’s a Problem

When the vein gets squished:

• 🚫 Blood can’t flow properly back to the heart

• 💔 Less blood pumped out (↓ cardiac output)

• ⬇ Blood pressure drops (supine hypotension)

• 🧠 Mom might feel dizzy, lightheaded, or faint 😵

• ❤ Slower heart rate (bradycardia) can happen too

🩵 Venacaval Compression Interventions

🚫 Never Let a Laboring Woman Lie Flat!

If she’s flat on her back, the vein is compressed 😩

That means less blood for mom and baby!

 

✅ Best Position

👉 Have her lie on her LEFT SIDE

• This moves the uterus off the vena cava

• Blood flows easily again 💉

• Keeps both mom and baby happy and safe 🤰💓

💬 Left side = Life side! 🩷

💓 Pregnancy-Related Cardiovascular (CV) Changes

🩸 1⃣️Blood Volume Increases

• Blood volume ↑ by 40–50% 😮

• Helps protect against blood loss during birth

• Plasma ↑ more than red blood cells → blood becomes diluted 🩹

  • This causes “Physiologic Anemia of Pregnancy” (low Hgb/Hct = normal)

• More blood = stronger pulse 💪

💡 Think: “More blood for baby, less oxygen per drop.”

 

❤ 2⃣ Heart & Circulation Changes

• 💓 Cardiac output ↑ (heart pumps more blood per minute)

• 💓 Heart rate ↑ by 10–20% (faster to handle extra volume)

• 🫀 Heart muscle enlarges a bit (temporary)

• 🩵 Veins in the legs may swell (more pressure = varicose veins)

💬 Your heart works overtime like a super pump!

 

💨 3⃣️Blood Pressure Changes

• BP may decrease slightly 🩸

  • Systolic ↓ 5–10 mmHg

  • Diastolic ↓ 10–15 mmHg

• Caused by progesterone relaxing blood vessels

• Normal BP = Slightly lower than usual! ✅

⚠ But if mom lies flat → vena cava compression → blood pressure drops too low!

 

🧠 4⃣️“Hypercoagulable” State

• Blood clots easier (protective 🛡 to prevent bleeding during birth)

• But increases DVT (clot) risk 🦵

💬 Think: “Thicker blood = safer for baby, but careful for clots!”

 

💥 5⃣️Vascular Resistance Decreases

• Arteries relax → less resistance = easier flow 💧

• Good for baby’s oxygen but can cause:

  • Leg swelling 🦵

  • Varicose veins

  • Slight dizziness when standing up too fast 😵‍💫

🌬 Respiratory System Changes in Pregnancy

💨 1⃣️Breathing for Two

• Mom’s oxygen needs go up ⬆ because the baby needs O₂ too!

• Baby also gives off carbon dioxide (CO₂) that mom’s lungs must get rid of 😮‍💨

💬 Think: “Mom breathes for two — one breath for her, one for baby!”

 

🫁 2⃣️Bigger, Deeper Breaths

• Tidal volume (amount of air per breath) ↑

• Oxygen use ↑

• Breathing changes from abdominal (belly) to thoracic (chest) because the uterus pushes up the diaphragm ⬆

💡 So even though she might feel “out of breath,” she’s actually breathing more efficiently!

 

🧠 3⃣️What Estrogen Does

Estrogen causes lots of changes up top!

• 💧 Makes the nose, throat, and airway more swollen and full of blood (more vascular)

• 🤧 Can cause nasal stuffiness, runny nose, or even nosebleeds (epistaxis)

• 🫨 Rib cage expands and relaxes to make room for baby

💬 Think: “Estrogen = Puffy airways & runny nose!”

 

🌟 4⃣️Common Respiratory Symptoms

Change	Effect	Emoji
↑ Oxygen needs	Breathes faster or deeper	💨
Diaphragm pushed up	Feels short of breath	😮‍💨
↑ Estrogen	Stuffy nose or nosebleeds	🤧
Rib cage expands	Chest breathing instead of belly	🫁

💧 Renal (Urinary) System Changes in Pregnancy

🚽 1⃣️Peeing More Often

• The growing uterus pushes on the bladder — so mom has to pee a lot! 💦

• This happens mostly in the 1st and 3rd trimesters

• The bladder can’t hold as much, and there’s more blood to filter, too!

💬 Think: “Baby takes space → mom pees in place!” 😂

 

💉 2⃣️Kidneys Work Harder

• Kidneys filter more blood because of all the baby waste and extra fluids 🩸

• GFR (glomerular filtration rate) ↑ = kidneys clean faster

• Renal plasma flow ↑ = more fluid moving through the kidneys

• More urine output (up to 25% more!) 💧

 

🧫 3⃣️Hormones Change How Urine Flows

• Progesterone relaxes everything — even the ureters (the tubes from kidneys to bladder) 🌀

• This can cause urinary stasis (urine sits still) 🧍‍♀💦

• Stagnant urine = higher risk for UTIs 🚨

💡 Think: “Slow flow = more germs can grow!” 🦠

 

🍬 4⃣️What Nurses Watch For

• Glucose in urine (glycosuria) — can be normal but also a sign of diabetes 🍭

• Protein in urine (proteinuria) — may mean preeclampsia ⚠

• Always check urine for infection, sugar, or protein during prenatal visits 🩺

🧴 Skin & Body Changes During Pregnancy

🎨 1⃣️Hyperpigmentation (Darker Skin Areas)

• Caused by hormones (estrogen + progesterone)

• Common spots: face, belly, nipples, and inner thighs 🌈

• 💛 Facial chloasma (melasma gravidarum) → “Mask of pregnancy” 😷

  • Brown patches on cheeks, nose, and forehead

• 🖤 Linea nigra → dark “black line” down the middle of the belly

💬 Think: “Pregnancy paint!” 🎨

 

🩷 2⃣️Stretch Marks (Striae Gravidarum)

• Stretching skin causes pink or purple lines — later fade to silver 🌈

• Common on belly, thighs, hips, and breasts

💬 Think: “Baby stripes of honor!” 🦓✨

 

💅 3⃣️Hair & Nails

• 💨 Nails grow faster (thanks, hormones!)

• 🧔‍♀ Hirsutism: Extra hair growth in new places (face, chest, belly)

• 💇‍♀ Some women lose more hair after delivery

• 💦 Sweat glands and oil glands get more active → more sweating + acne

 

🤚 4⃣️Hands & Gums

• ❤ Palmar erythema: Red, warm palms

• 🪥 Gum hypertrophy: Puffy, bleeding gums — 60–70% get pregnancy gingivitis!

💬 Brush gently and floss often! 🦷✨

 

😣 5⃣️ Itching & Rashes

• Pruritus: Itchy skin (especially belly and breasts) from stretching

• Moisturizing helps a lot 🧴

 

👁 6⃣️Eyes

• 👀 Cornea thickens and eye pressure decreases

• Contact lenses might feel weird or not fit right! 👁

 

🧠 7⃣️Brain & Sleep (CNS)

• 💤 Harder to sleep comfortably

• 🧠 “Pregnancy brain” = forgetfulness, less focus, and daydreaming 😅

💬 Think: “More baby thoughts, less brain space!” 🧸

🌿 Endocrine System Adaptations in Pregnancy

🦋 1⃣️Thyroid Gland

• Gets a little bigger 🧠

• Works harder = increased metabolism 🔥 (you burn more energy)

• Keeps your body temperature steady and gives you energy ⚡

• This increase is called ↑ BMR (Basal Metabolic Rate)

💬 Think: “Thyroid = Tiny furnace for baby heat!” 🔥👶

 

🧠 2⃣️Pituitary Gland

• Decreases FSH and LH (you don’t need to ovulate or make eggs 🥚)

• Increases oxytocin near the end of pregnancy — helps with uterine contractions and milk letdown 🤱

• Controls other hormones throughout pregnancy

💬 Think: “Pituitary = hormone boss!” 👩‍💼🧠

 

🍬 3⃣️Pancreas

• Has to make more insulin, but mom’s body becomes a little resistant to it

• This helps baby get more glucose (sugar) for growth 🍭
  ⚠ Sometimes this causes gestational diabetes

💬 Think: “Pancreas = sugar manager for two!” 🍬🤰

 

😤 4⃣️Adrenal Glands

• ↑ Cortisol → helps body manage stress 🧠

• ↑ Aldosterone → holds onto water and salt to keep blood pressure stable 💧

• Keeps everything balanced even with all the baby demands! ⚖

💬 Think: “Adrenal = stress + salt control!” 🧂💪

 

🌸 5⃣️Placenta (The Hormone Factory!)

The placenta acts like a temporary endocrine organ 🌿

It makes:

• hCG → maintains early pregnancy (supports corpus luteum) 🩷

• Relaxin → loosens joints for delivery 🦴

• Progesterone → relaxes uterus (keeps baby safe and calm) 😌

• Estrogen → helps uterus grow and increases blood flow ❤

💬 Think: “Placenta = the pregnancy hormone factory!” 🏭✨

🦴 Musculoskeletal System Changes in Pregnancy

🧍‍♀ 1⃣️Pelvic Tilt & Center of Gravity

• The pelvis tilts forward because of the baby bump 🤰

• The center of gravity shifts — so balance feels off (like walking on a boat!) ⛵

• Causes that famous “pregnancy waddle” 🦆💕

💬 Think: “Baby bump = balance bump!”

 

💪 2⃣️Back and Spine Changes

• The spine curves more in the lower back — called lordosis 🌀

• This keeps you from falling forward but can cause back pain 😣

• Progressive lordosis → extra strain on back muscles

💡 Lordosis = Leaning for the baby!

 

🦵 3⃣️Relaxed Joints & Waddling

• Hormone relaxin loosens joints, especially in the pelvis

• Makes it easier for the baby to pass through during delivery 👶

• But also makes joints feel wobbly and achy 😖

💬 Relaxin = “relaxes” everything!

 

🩻 4⃣️Abdominal Muscle Stretching

• Rectus abdominis muscles (belly muscles) may separate → called diastasis recti

• Causes ↓ abdominal tone and a little belly “doming” when sitting up

💬 Think: “Abs on a break!” 😅

 

💨 5⃣️Other Musculoskeletal Effects

• 🦶 Legs may ache from posture changes

• 💆‍♀ Muscle cramps or hip pain are common

• 🦴 Pelvic joints become more mobile

• 🧍‍♀ Walking feels different — slow, side-to-side “waddle gait

🍽 Gastrointestinal (GI) System Changes in Pregnancy

🤢 1⃣️Morning Sickness

• Common in the first trimester

• Caused by hormones (especially hCG + estrogen)

• Includes nausea, vomiting, and loss of appetite
  💬 Think: “Baby’s first prank — morning sickness!” 😂

 

🍽 2⃣️Changes in Appetite & Taste

• Cravings or aversions (you might want pickles one minute 🥒 and hate them the next 😖)

• Metallic taste or weird smell sensitivity 👃

💡 Totally normal!

 

🪥 3⃣️Mouth & Gums

• Swollen, bleeding gums (from ↑ blood flow and estrogen) 🩸

• Gums are more sensitive → brush gently 🦷✨
  💬 Think: “Pregnancy gums = extra puffy!”

 

🧘‍♀ 4⃣️Slower Digestion

• Hormone progesterone relaxes smooth muscles

• Makes the stomach and intestines move slower 🐢

• Can cause:

  • Constipation 💩

  • Heartburn (acid reflux) 🔥

  • Gas and bloating 💨

💡 Tip: Eat small meals, drink water, and move around! 🚶‍♀💧

 

💛 5⃣️Gallbladder & Liver

• Gallbladder slows down → bile sits longer

  • This can cause itching or gallstones 🪨

• Mild liver changes due to hormones

💬 Think: “Gallbladder = slow and sleepy during pregnancy.” 💤

 

🩹 6⃣️Other Abdominal Changes

• Round ligament pain from stretching uterus 🤰

• Abdominal discomfort and distension (full, tight feeling

❤ Heartburn (Acid Reflux) in Pregnancy

Why it happens:

The hormone progesterone relaxes smooth muscles — including the valve between the stomach and esophagus — letting acid sneak up 🔥

Prevention/Treatment:

• 🍽 Eat small, frequent meals (don’t overload the tummy!)

• 🧍‍♀ Stay upright after eating (no lying down right away)

• 🚫 Avoid spicy, greasy, or fried foods

• 🛌 Sleep with your head slightly elevated (gravity helps!)

💬 Memory tip:

“Sit, Split, and Skip the Spice!”

🍽 Sit up, Split meals, Skip spicy stuff! 🌶

 

💩 Constipation in Pregnancy

Why it happens:

• Progesterone slows bowel movement 🐢

• Iron supplements and uterine pressure make it worse

Prevention/Treatment:

• 🍎 Eat fruits (natural fiber!)

• 🥦 Add fiber-rich foods like whole grains & veggies

• 💧 Drink plenty of fluids (8–10 glasses/day)

• 🚶‍♀ Stay active — walking helps your bowels move!

💬 Memory tip:

“3 F’s for Constipation: Fruits, Fiber, and Fluids!” 🍓🥦

🤰 Prenatal Care — Caring for Mom & Baby

💡 What Is It?

Prenatal care = regular checkups during pregnancy to keep both mom and baby healthy 🩺👶

 

🎯 Main Goals

• 💕 Help mom learn how to take care of herself during pregnancy

• 🩺 Prevent or treat pregnancy discomforts (like nausea, swelling, or heartburn)

• 👩‍👩‍👧 Support positive feelings for the mom and family

• 🫶 Make sure pregnancy has a safe and healthy outcome

• 🚼 Lower the risk of problems or baby death (reduces morbidity and mortality)

💬 Think: “Healthy Mom = Healthy Baby!” 🌸

📅 Prenatal Visit Schedule

✅ When to Start:

👉 As soon as possible! Ideally within the first 12 weeks of pregnancy (1st trimester).

 

🗓 How Often to Visit

For a normal, healthy (“uneventful”) pregnancy:

• Every month (every 4 weeks) ➜ Weeks 16–28

• Every 2 weeks ➜ Weeks 29–36

• Every week ➜ From week 36 until delivery

💬 Tip: As the belly grows, visits grow closer together! 🤰➡📆➡👶

 

⚠ High-Risk Pregnancies

Moms with complications (like diabetes, hypertension, or twins 👯‍♀) will need more frequent checkups 💉🩸

 

🧠 Memory Trick

"1-2-4 Rule for Prenatal Visits!"

1⃣ Every month until 28 weeks

2⃣ Every 2 weeks until 36 weeks

4⃣ Every week until baby comes! 👶

🍼 PNC Visits

🗓 Why PNC Visits Matter

Each visit helps doctors and nurses check on you and your baby’s health — kind of like a team check-up to make sure everything’s growing strong and safe 💕👶

 

💡 At Your Visit, Nurses/Providers Will:

• 🧮 Find Your Due Date (EDD) — to know when baby is expected!

• 🩺 Check Medical & Surgical History — to see if mom has any health risks

• ⚖ Do a Physical Exam — weight, vital signs, and pelvic check

📏 Ongoing PNC Checks

At every visit:

• 👂 FHR (Fetal Heart Rate) — listen to baby’s heartbeat 💓

• 📏 Fundal Height — measure belly growth (should match weeks of pregnancy)

🍼 PNC Visits 🧪 Lab Tests You’ll Have

All these help keep mom & baby safe:

• 🩸 HGB & HCT: Check for anemia (low iron)

• 🧫 WBC: Check immune system

• 💉 Blood type & Rh factor: Important for Rhogam decision

• 🧠 Rubella titer: Check if mom is immune to German measles

• 🚻 Urinalysis: Check for protein, sugar, or infection

• 🧪 HIV, Hep B, Syphilis (RPR), and glucose test (done 24–28 weeks to screen for gestational diabetes)

💬 If results show mom is Rh-negative (–), she’ll get Rhogam at 28 weeks and again within 72 hours after birth if baby is Rh-positive! 💉

💉 Vaccines should be?

• ✅ Keep vaccines updated

• 🚫 NO live vaccines during pregnancy (like MMR or varicella)

⚠ Things to Avoid During Pregnancy

🚫 Avoid	🧠 Why
🥤 Energy drinks	Too much caffeine
🌡 Overheating	Can harm baby’s development
🎨 Paint	Fumes are toxic
🍵 Herbal teas (some)	May cause contractions
🍷 Alcohol	Causes birth defects
🐱 Cats/animals	Risk of toxoplasmosis
🐟 Raw/high-mercury fish	Can harm baby’s brain
🍖 Uncooked processed meats	Can cause listeria infection
💊 Excedrin	Contains aspirin—unsafe for pregnancy

💬 Tip: Think “No weird drinks, no raw stuff, no toxins!” ☕❌🐟❌🎨❌

🧫 TORCH Infections

These are infections that can pass from mom to baby during pregnancy and cause serious birth problems ⚠

💬 Think of TORCH as a group of infections that “burn” the baby’s health — just like the torch emoji 🔥

 

🔠 What TORCH Stands For:

Letter	Infection	How It Harms Baby	Emoji
T	Toxoplasmosis gondii	From 🐱 cat poop or raw meat 🍖 → can cause brain & eye damage	🐱🧠👁
O	Other viruses (Listeria, Syphilis, Chickenpox, HIV, Parvovirus B19)	Cause rash, birth defects, or miscarriage	🦠
R	Rubella (German measles)	Causes deafness, heart defects, blindness	👂❤👁
C	Cytomegalovirus (CMV)	Can cause hearing loss & developmental delays	👶🎧🧩
H	Herpes simplex virus (HSV-1 or HSV-2)	Passed during birth if mom has sores → brain damage or death	🚫👶💥

 

🧫 TORCH Infections 🩺 How Nurses Help

• Teach moms to avoid cat litter 🚫🐱

• Avoid raw or undercooked meats 🥩

• Make sure vaccines (like Rubella) are up to date before pregnancy 💉

• Avoid contact with people who have cold sores, chickenpox, or rubella 🤒

• If mom has herpes, C-section may be needed to protect the baby 🏥

📏 What Is Fundal Height (McDonald’s Rule)?

It’s a way for doctors and nurses to measure how the baby is growing inside the uterus! 🍼✨

 

🩺 How It’s Measured

• A measuring tape is used to check the distance 📏

• From the top of mom’s pubic bone ➡ to the top of the uterus (fundus)

• This tells how big the uterus (and baby) are growing 🤰💗

 

📅 When It’s Done

• Usually starts around 20 weeks of pregnancy

• After that, the fundal height (in cm) ≈ the weeks of pregnancy

🧠 Example:

If mom is 28 weeks pregnant, her fundal height should be about 28 cm! 🎯

 

💬 Why It’s Important

It helps check:

• 👶 Baby’s growth (too small or too big could mean a problem)

• 💧 Amount of amniotic fluid

• 🩸 Position of the baby and uterus health

🗣 Prenatal Topics to Discuss Before Baby Arrives

🧑‍🏫 1⃣Childbirth Classes

• Teach what to expect during labor and delivery 🤱

• Practice breathing & relaxation techniques 🧘‍♀

• Learn about pain relief options (like epidural, breathing, movement) 💉

• Helps both mom and partner feel ready and confident 💪

💬 Think: “Less fear, more cheer!” 🎉

 

📋 2⃣️Birth Plan

A birth plan is like a wish list 📝 for labor and delivery — moms can write down what they want for:

• 🌊 Delivery style: hospital, birth center, or water birth

• 💉 Pain management: epidural, natural, etc.

• 👶 Baby care: skin-to-skin contact, delayed cord clamping, breastfeeding

• 👨‍👩‍👧 Support people: who’s allowed in the room

• 💗 Emergency preferences: what to do if complications arise

💡 Birth plans help nurses and providers know the mom’s choices — but flexibility is key!

 

🏡 3⃣️Home Births

• Only for moms who are low-risk and healthy 🩺

• Must have trained professionals (midwife/nurse) present

• Emergency plan should always be in place 🚑

💬 Think: “Safe at home only if low-risk!” 🏠✅

🍼 Promoting Breastfeeding During Pregnancy

💭 When Decisions Are Made

• Many moms decide before pregnancy or during the 1st trimester 🩷

• Studies show over 50% of women decide early (Aberman & Kirchhoff, 1985)

• The earlier a mom plans to breastfeed → the more likely she will exclusively breastfeed for 3+ months 👶

 

🤝 Why Early Support Matters

• Support from nurses, OBs, and pediatric staff builds confidence 🫶

• Education and encouragement help initiate and continue breastfeeding successfully

• Moms who feel supported are less likely to switch to formula early

 

🩺 Health Care Provider (HCP) Role

• Provide education before birth on benefits, techniques, and challenges 💬

• Collaborate as a team — OB, neonatal, and pediatric providers should reinforce consistent messages 🤰👩‍⚕👶

• Avoid misinformation — many providers lack lactation training, so interprofessional collaboration is key

🚨 Danger Signs During Pregnancy 🌿 First Trimester (Weeks 1–13)

👉 Call provider if the mom has:

• 🚫 Burning or pain with urination → UTI 🔥

• 🤮 Severe vomiting → risk for dehydration (Hyperemesis Gravidarum)

• 💩 Persistent diarrhea → dehydration or infection risk

• 🌡 Fever or chills → infection

• 🤕 Severe abdominal pain → possible ectopic pregnancy or miscarriage

💡 Nursing Note

If any danger sign occurs:

• Instruct patient to stop activity and call HCP immediately 📞

• Document findings

• Monitor vitals & fetal movement if in clinical setting

🚨 Danger Signs During Pregnancy 🌼 Second & Third Trimester (Weeks 14–40)

⚠ Report right away:

• 💧 Gush or leakage of fluid → possible rupture of membranes

• ❤ Vaginal bleeding (VB) → placenta previa or abruption

• 👶 Change or decrease in fetal movement → fetal distress or hypoxia

• 🤯 Severe headache (H/A) → preeclampsia warning

• 🌡 Fever or infection symptoms

• 👁 Blurred vision or seeing spots → preeclampsia

• 🖐 Swelling (edema) in face, hands → preeclampsia

• 💔 Epigastric pain (E/P) → liver involvement from preeclampsia

• 🔥 Burning urination → UTI

 

🧠 Memory Trick

“HEAD, HANDS, HEART, HURTS!”

• Head: headache, vision changes

• Hands: swelling/edema

• Heart: decreased fetal movement

• Hurts: pain, burning, or bleeding

💡 Nursing Note

If any danger sign occurs:

• Instruct patient to stop activity and call HCP immediately 📞

• Document findings

• Monitor vitals & fetal movement if in clinical setting

🍓 Nutritional Needs During Pregnancy

🧠 Why It Matters

• Nutrition directly affects fetal growth and brain development 🧬

• Poor intake → ↑ risk for low birth weight, neural tube defects, and developmental delays

 

🥦 Key Dietary Goals

✅ Increase in:

• Protein → builds fetal tissue & placenta

• Iron → prevents maternal anemia, supports oxygenation 🩸

• Folate (Folic Acid) → prevents neural tube defects (spina bifida, anencephaly)

• Calories → +340 kcal/day (2nd trimester), +450 kcal/day (3rd trimester)

✅ Daily prenatal vitamins

• Folic acid = 400–800 mcg/day

• Iron = 27 mg/day

• Calcium = 1000 mg/day

✅ Follow the USDA “My Plate” guide — balance between:

🥕 Vegetables | 🍎 Fruits | 🍗 Protein | 🥖 Grains | 🥛 Dairy

🌍 Cultural & Lifestyle Considerations

• Respect vegetarian, vegan, lactose-free, or gluten-free diets 🌾

• Help patients find equivalent nutrient sources (e.g., plant protein, calcium-fortified milk alternatives)

• Teach about PICA — craving non-food items (clay, dirt, ice, starch) 🧊

  • Risk: anemia, lead poisoning, GI blockage

🍓 Nutritional Needs During Pregnancy ⚠ Avoid / Limit

• 🐟 Fish high in mercury: shark, swordfish, king mackerel, tilefish, bigeye tuna

• 🍣 Raw or undercooked fish/meat: ↑ risk for Listeria or Toxoplasmosis

• 🥚 Raw eggs (e.g., Caesar dressing)

• 🧀 Unpasteurized dairy 🧫

• ☕ Caffeine: ≤ 200 mg/day (≈ 1 cup coffee)

• 🍷 Alcohol: none — causes Fetal Alcohol Syndrome

🦠 Listeriosis (Listeria Infection)

• Cause: Listeria monocytogenes – bacteria found in soil, water, and some foods

• Risks:

  • Miscarriage

  • Stillbirth

  • Preterm labor (PTL)

  • Serious newborn illness or death 🚨

 

🍖 High-Risk Foods to AVOID

❌ Deli meats, hot dogs, processed meats (unless reheated until steaming)

❌ Unpasteurized cheeses (Brie, feta, queso fresco, blue cheese)

❌ Unpasteurized milk or juice

❌ Smoked seafood or pâté

✅ Substitute with roasted fresh meats and pasteurized dairy

 

🥬 Safety Tips

• Wash all fresh fruits & vegetables thoroughly 🍎🥕

• Keep raw & cooked foods separate to avoid cross-contamination

• Refrigerate leftovers promptly (<2 hours)

🧠 Note: Pregnant Hispanic women have higher rates of listeriosis → teach culturally sensitive food safety practices ❤

 

🌿 Vegetarian & Vegan Diet Considerations

🥚 Lactovovegetarians (eat eggs + dairy + plants)

• Need extra iron & vitamin B12
  (because plant sources alone are often insufficient)

🥛 Lacto-vegetarians (dairy + plants only)

• Need iron, zinc, B12, iodine supplements

🌱 Strict Vegans (no animal products)

• Need increased:

  • Protein 🍚 (beans, lentils, tofu, quinoa)

  • Calcium 🥦 (fortified milks, kale, almonds)

  • Vitamin B12 (fortified cereals, supplements)

  • Iron & Zinc 🫘

  • Riboflavin & Iodine

 

💡 Nursing Tip

Always assess for PICA or malnutrition signs in clients following restrictive diets.

Collaborate with a dietitian for tailored supplementation 💊

🌸 Importance of Folic Acid in Pregnancy

🧠 What It Does

• Essential for fetal brain and spinal cord development

• Prevents Neural Tube Defects (NTDs) such as:

  • 🧠 Anencephaly → brain does not develop properly

  • 🦴 Spina bifida → spinal column doesn’t close completely

 

⏱ Critical Time Frame

• Most helpful during the first 28 days after conception

• Neural tube closes by week 4, often before a woman even knows she’s pregnant

• → That’s why folic acid should be taken before conception! 💊

 

🥦 Folic Acid Sources

• Green leafy vegetables (spinach, kale, broccoli)

• Dried peas & beans

• Citrus fruits / orange juice 🍊

• Seeds and nuts 🌰

• Fortified grains & cereals

 

💊 Recommended Dosage

• Before pregnancy (preconception): 400 mcg/day

• During pregnancy: 600 mcg/day

• If history of NTD or taking anti-seizure meds: up to 4 mg/day (as prescribed)

🩺 March of Dimes Recommendation:

Women planning pregnancy should start folic acid at least 1 month before conception and continue through the first trimester.

 

⚠ Special Considerations

• Women taking anti-epileptic medications (like valproic acid or carbamazepine) need higher doses of folic acid because these drugs interfere with folate metabolism.

• Encourage use of prenatal vitamins that meet total daily folate needs.

Pregnancy Weight Gain Guidelines

🧍‍♀ Healthy Weight (BMI 18.5–24.9)

• Total gain: 🟩 25–35 lbs

• First trimester: 3.5–5 lbs

• Second & third trimesters: ~1 lb/week

 

⚪ Underweight (BMI < 18.5)

• Total gain: 🟦 28–40 lbs

• First trimester: 5 lbs

• Second & third trimesters: ~1 lb/week
  🧠 Encourage small, frequent, high-calorie meals.

 

🟠 Overweight (BMI 25–29.9)

• Total gain: 🟧 15–25 lbs

• First trimester: 2 lbs

• Second & third trimesters: ~⅔ lb/week

 

🔴 Obese (BMI ≥ 30)

• Total gain: 🔴 11–20 lbs

• Monitor closely for complications like gestational diabetes, preeclampsia, and macrosomia.