Ankle swelling during pregnancy: Is it a concern?

What causes ankle swelling during pregnancy? Should I be concerned about severe swelling?

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Mayo Clinic obstetrician and gynecologist Roger Harms, M.D., and colleagues answer select questions from readers.

Answer

Foot and ankle swelling during pregnancy is common and almost always goes away after delivery. You may notice that it's worse at the end of the day or during hot weather.

So what causes foot and ankle swelling during pregnancy? Your body produces and retains more fluid during pregnancy. Also, your growing uterus puts pressure on the veins to your legs — especially in the later months of pregnancy. This impairs return of blood to the heart and causes more fluid to build up in your legs, ankles and feet. Standing for long periods can increase this pressure.

To manage or relieve leg swelling during pregnancy:

• Take breaks during the day when you can sit with your feet up. When possible, go a step further and lie down with your legs elevated for an hour in the middle of the afternoon.
• While sleeping, lie on your side or elevate your legs slightly with pillows.
• Don't cross your legs when you sit.
• Use a footrest when sitting.
• Avoid standing or sitting with your feet on the floor for long periods.
• Stay cool because heat can make the swelling worse.
• Swim, walk or even stand in a pool at least 4 feet deep. The buoyancy of the water helps lift the baby off your pelvis.
• Avoid tight clothing.
• Wear supportive, elastic hose; regular nylons won't help.
• Exercise regularly.
• Apply cold-water compresses on swollen areas.

Although mild foot and ankle swelling during pregnancy is normal, call or see your doctor promptly if you have:

• Severe or sudden swelling. This could be a sign of a serious condition called preeclampsia. Other signs and symptoms of preeclampsia include severe headaches, blurred vision and dizziness.
• Swelling in only one leg, especially if you have pain or tenderness in your calf or thigh. This could be a sign of a blood clot.

Source:
www.mayoclinic.com

Pregnancy and prenatal care go hand in hand, even as your due date approaches. During the third trimester, prenatal care includes vaginal exams to check the baby's position.

Prenatal care continues until delivery. Your health care provider will continue to monitor your blood pressure and weight, as well as your baby's heartbeat and movements. During the last month of pregnancy, expect weekly checkups.

Testing for group B strep

Most pregnant women are screened for group B streptococcus (GBS) during the third trimester. GBS is a common bacterium that's usually harmless in adults — but babies who become infected with GBS can become critically ill. If a swab from your vagina and rectal area tests positive for GBS, you'll probably be given intravenous antibiotics during labor to protect your baby from the bacterium.

Prenatal care: What to expect during the third trimester

Pregnancy and prenatal care go hand in hand, even as your due date approaches. During the third trimester, prenatal care includes vaginal exams to check the baby's position.

Prenatal care continues until delivery. Your health care provider will continue to monitor your blood pressure and weight, as well as your baby's heartbeat and movements. During the last month of pregnancy, expect weekly checkups.

Testing for group B strep

Most pregnant women are screened for group B streptococcus (GBS) during the third trimester. GBS is a common bacterium that's usually harmless in adults — but babies who become infected with GBS can become critically ill. If a swab from your vagina and rectal area tests positive for GBS, you'll probably be given intravenous antibiotics during labor to protect your baby from the bacterium.

MORE ON THIS TOPIC

• Group B strep: How to protect your baby

Resuming vaginal exams

As your due date approaches, your checkups may include vaginal exams. Your health care provider may:

• Check the baby's position. During a vaginal exam, your health care provider can feel your baby's head in your lower abdomen or at the top of the birth canal. If your baby is positioned headfirst, you're good to go. If your baby is positioned rump-first or feet-first (breech), your health care provider may recommend trying to turn the baby by applying pressure to your abdomen. This procedure is called an external version. If your baby remains in a breech position, you may need a C-section delivery.

• Detect cervical changes. As your body prepares for birth, your cervix will begin to soften, open (dilate) and thin (efface). Progress is expressed in centimeters (cm) and percentages. For example, your cervix may be 3 cm dilated and 30 percent effaced. When you're ready to push your baby out, your cervix will be 10 cm dilated and 100 percent effaced.

  Resist the temptation to put much stock in these numbers. Cervical changes can help your health care provider determine how difficult it would be to induce your labor, but these numbers can't predict spontaneous labor. You may be dilated to 3 cm for weeks — or you may go into labor without any dilation or effacement at all.

Keep asking questions

You may have plenty of questions as your due date approaches. Is it OK to have sex? How will I know when I'm in labor? What's the best way to manage the pain? Ask away! Also discuss a birthing plan with your health care provider. Feeling prepared can help calm your nerves before delivery.

Source:

www.mayoclinic.com

Pregnancy symptoms: What to expect during the third trimester

You're in the home stretch! The last stage of pregnancy may bring new pregnancy symptoms — but relieve earlier ones.

The last few months of pregnancy can be physically and emotionally challenging. Your baby's size and position may make it hard for you to get comfortable. You may be tired of pregnancy and anxious to get it over with. If you've been gearing up for your due date, you may be disappointed if it comes and goes uneventfully.

Try to remain positive as you look forward to the end of your pregnancy. Soon you'll hold your baby in your arms! Here's what to expect in the meantime.

Your body

As your baby grows, his or her movements will become more obvious. These exciting sensations are often accompanied by increasing discomfort and other late pregnancy symptoms.

• Backaches. As your baby continues to gain weight, pregnancy hormones relax the joints between the bones in your pelvic area. These changes can be tough on your back. Hip pain is common, too.

  If you must stand, place one foot on a box or stool. Sit in chairs with good back support. Apply a heating pad or ice pack to the painful area. Ask your partner for a massage. If the back pain doesn't go away or is accompanied by other signs and symptoms, contact your health care provider.

• Swelling. Swollen feet and ankles may become an issue at this stage of pregnancy. Your growing uterus puts pressure on the veins that return blood from your feet and legs. Fluid retention and dilated blood vessels may leave your face and eyelids puffy, especially in the morning. If you have persistent face or eyelid swelling, contact your health care provider.

  To reduce swelling, use cold compresses on the affected areas. Lying down or using a footrest may relieve ankle swelling. You might even elevate your feet and legs while you sleep. It may also help to swim or simply stand in a pool.

• Shortness of breath. You may get winded easily as your uterus expands beneath your diaphragm, the muscle just below your lungs. This may improve when the baby settles deeper into your pelvis before delivery. In the meantime, practice good posture and sleep on your side. As long as your health care provider says it's OK, aerobic exercise can help relieve this pregnancy symptom, too.
• Heartburn. Your growing uterus may push your stomach out of its normal position, which can contribute to heartburn. To keep stomach acid where it belongs, eat small meals and drink plenty of fluids. If this doesn't help, ask your health care provider about antacids.

• Spider veins, varicose veins and hemorrhoids. Increased blood circulation may cause small reddish spots that sprout tiny blood vessels on your face, neck, upper chest or arms, especially if you have fair skin. Varicose veins — blue or reddish lines beneath the surface of the skin — also may appear, particularly in the legs. Hemorrhoids — varicose veins in your rectum — are another possibility.

  If you have painful varicose veins, elevate your legs and wear support stockings. To prevent hemorrhoids, avoid constipation. Include plenty of fiber in your diet and drink lots of fluids.

• Stretch marks. You may notice pink, red or purple streaks along your abdomen, breasts, upper arms, buttocks or thighs. Your stretching skin may also be itchy. Moisturizers can help. Although stretch marks can't be prevented, eventually they fade in intensity.
• Continued breast growth. By now, you may have an additional 1 to 3 pounds of breast tissue. As delivery approaches, your nipples may start leaking colostrum — the yellowish fluid that will nourish your baby during the first few days of life.

• Frequent urination. As your baby moves deeper into your pelvis, you'll feel more pressure on your bladder. You may find yourself urinating more often, even during the night. This extra pressure may also cause you to leak urine — especially when you laugh, cough or sneeze.

  Continue to watch for signs of a urinary tract infection, such as urinating even more than usual, burning during urination, fever, abdominal pain or backache. Left untreated, a urinary tract infection may damage your kidneys and trigger preterm labor.

• Braxton Hicks contractions. These contractions are warm-ups for the real thing. They're painless and come and go unpredictably. True labor contractions get longer, stronger and closer together. If you're having contractions that concern you, contact your health care provider.
• Weight gain. By your due date, you may weigh 25 to 35 pounds more than you did before pregnancy. Your baby accounts for some of the weight gain, but you also need to count the placenta, amniotic fluid, larger breasts and uterus, extra fat stores, and increased blood and fluid volume.
• Vaginal discharge. Potentially heavy vaginal discharge is common at the end of pregnancy. If you saturate a panty liner within a few hours or wonder if the discharge is leaking amniotic fluid, contact your health care provider.

Your emotions

As anticipation grows, fears about childbirth may become more persistent. How much will it hurt? How long will it last? How will I cope?

If you haven't done so already, you may want to take childbirth classes. You'll learn what to expect — and meet other moms-to-be who share your excitement and concerns. Talk with women who've had positive birth experiences, and ask your health care provider what options you may have for pain relief. Tell yourself that you'll simply do the best you can. There's no right or wrong way to have a baby.

The reality of parenthood may start to sink in as well. You may feel anxious and overwhelmed, especially if this is your first baby. To stay calm, revel in the emotions and sensations of being pregnant.

• Write your thoughts in a journal.
• Listen to soft music.
• Talk to your baby.
• Take photos of your pregnant belly to share with your child one day.

It also may help to review your decisions about issues such as circumcision and breast-feeding. Knowing how you'll proceed once the baby arrives can give you a greater sense of control.

Appointments with your health care provider

During the third trimester, your health care provider may ask you to come in for more frequent checkups — perhaps every other week beginning at week 32 and every week beginning at week 36.

Like previous visits, your health care provider will check your weight and blood pressure and ask about any signs or symptoms you may be experiencing. You may need screening tests for various conditions, including:

• Gestational diabetes. This is a temporary type of diabetes that sometimes develops during pregnancy. Prompt treatment and healthy lifestyle choices can help you manage your blood sugar level and deliver a healthy baby.
• Anemia. Anemia is an abnormally low level of red blood cells or hemoglobin, a protein in red blood cells that contains iron. Severe anemia may slow your baby's growth or trigger preterm labor. To treat anemia, you may need to take iron supplements.
• Group B strep. Group B strep is a type of bacteria that may live in your vagina or rectum. It won't make you sick, but it may cause a serious infection for your baby after birth. If you test positive for group B strep, your health care provider may recommend antibiotics while you're in labor.

Your health care provider will also check your baby's size and heart rate. Near the end of your pregnancy, vaginal exams may help your health care provider determine your baby's position inside your uterus. He or she may also check your cervix to see whether it's begun to soften or dilate in preparation for birth.

If you have specific desires or preferences for labor and birth — such as laboring in water or avoiding medication — you might want to define your wishes in a birth plan. Review the plan with your health care provider ahead of time to prevent any misunderstandings.

As your due date approaches, keep asking questions. How can I tell the difference between false labor and the real thing? When do I need to go to the hospital? Could I be too late for an epidural? Remember, there's no silly question. Understanding what's happening can help you have the most positive birth experience.

Source:

www.mayoclinic.com

Overdue pregnancy: What to do when baby's overdue

You probably didn't bargain for an overdue pregnancy — but it happens. Here's help hanging in there.

Your due date has come and gone — and you're still pregnant. What's going on?

Probably nothing unusual. Although your due date may seem to have magical qualities, it's simply an educated guess about when your baby is most likely to arrive. It's perfectly normal to give birth one to two weeks before — or after — your due date. In fact, your pregnancy must continue two weeks past your due date to earn the official label of overdue pregnancy.

Enough already!

By this point, you're probably tired of being pregnant. Your back may ache, and your ankles may be swollen. You may be struggling with heartburn and varicose veins. You may have trouble sleeping because you simply can't get comfortable — or anxiety about childbirth may keep you awake.

Rest assured, an overdue pregnancy won't last forever. Labor may begin anytime.

Keeping an eye on your pregnancy

As your pregnancy continues, your health care provider will closely monitor you and your baby. He or she may check your cervix to see if it's begun to thin and dilate in preparation for labor. If you're more than one week past your due date, your health care provider may track your baby's heartbeat with an electronic fetal monitor or use ultrasound to observe your baby's movements and measure the amount of amniotic fluid.

Giving baby a nudge

Sometimes, it's better to deliver sooner rather than later — particularly if your health care provider is concerned about your health or your baby's health or your pregnancy continues more than two weeks past your due date.

Why the concern about two weeks? The longer your pregnancy continues, the larger your baby is likely to be — which may complicate a vaginal delivery. In a few cases, aging of the placenta may compromise your baby's ability to thrive in the womb. An overdue baby is also more likely to inhale fecal waste (meconium) during childbirth, which can cause a lung disease.

If you and your health care provider decide to induce your labor, you may be given medication to help your cervix soften and open. If your amniotic sac is still intact, an opening may be created with a thin plastic hook. It doesn't hurt, but you may feel a warm gush of fluid when the sac breaks open.

Often, these steps are accompanied by medication to kick-start your contractions. The most common choice is Pitocin, a synthetic version of oxytocin — a hormone your body produces at low levels throughout pregnancy and in higher levels during active labor. The dosage may be adjusted to regulate the strength and frequency of your contractions.

Hang in there

You're in the homestretch! Whether your health care provider suggests a wait-and-see approach or schedules an induction, do your best to enjoy the rest of your pregnancy.

• Accept your emotions. It's OK to feel frustrated or disappointed. You probably didn't bargain for more than 40 weeks of pregnancy.
• Take advantage of the extra time. Sleep in while you can. Put the finishing touches on the nursery. Stock your freezer with extra meals. Address birth announcements and thank you cards.
• Make plans. Your health care provider may want you to stay close to home, but that's no reason to miss a new movie, go out to dinner or take a walk in the park. Don't be afraid to make plans just because you may need to cancel at the last minute.
• Put your answering machine or voice mail to work. To keep well-meaning friends and loved ones up-to-date, consider recording a greeting with the latest on the pregnancy front. "We're patiently waiting for the big day!" may be enough to handle the inquiries that are sure to test your patience.
• Treat home remedies with a dose of caution. A simple Internet search will yield countless results for "natural" ways to trigger labor, such as eating spicy food or having sex. Some tactics are relaxing, others silly — and a few may do more harm than good. Get your health care provider's OK before trying any home remedies, herbal supplements or alternative treatments.
• Stay in touch with your health care provider. You'll need frequent checkups until your baby is born. If you think you're in labor, call your health care provider right away.

Soon you'll hold your baby in your arms — and the long wait will no longer matter.

Source:

www.mayoclinic.com

Group B strep: How to protect your baby

wamoGroup B strep can be dangerous for newborns. Here's what you need to know about group B strep — and why you need to be tested.

Group B streptococcus (group B strep) is a common bacterium often carried in the intestines or lower genital tract. Although group B strep is usually harmless in adults, it can be serious — even life-threatening — for newborns.

Having group B strep in your body is normal. There's nothing you can — or need — to do about it. But if you're pregnant, a group B strep screening test in the third trimester and antibiotic treatment during labor can help protect your baby.

Harmless in adults

Many adults have group B strep in their bodies, usually in the bowel, vagina, rectum or throat. In adults with serious medical conditions, such as liver failure or cancer, group B strep can cause dangerous infections. But most adults simply carry the bacterium, which means they have no symptoms and don't feel sick. In fact, group B strep in otherwise healthy adults isn't treated.

Pregnant women with group B strep are the exception. The bacteria can spread to a baby during a vaginal delivery if the baby is exposed to — or swallows — fluids containing group B strep.

Dangerous for babies

Most babies born to women carrying group B strep are born healthy. But the few who become infected can become critically ill. The risk is highest for premature babies.

In infants, group B strep disease can take two forms:

• Early-onset. This is the more common and serious form of group B strep infection in infants. A baby with early-onset group B strep disease typically becomes sick within hours after birth. The infection usually starts with fever, difficulty feeding and lethargy. But it can lead to life-threatening complications, such as inflammation of the lungs (pneumonia), inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis), or infection in the bloodstream (sepsis).
• Late-onset. Late-onset group B strep disease develops within a week to a few months after birth. Problems associated with late-onset group B strep disease can be similar to early-onset group B strep disease, but the impact is usually less severe.

Long-term effects of either type of group B strep disease may include seizures, hearing loss or other neurological damage — particularly following meningitis.

How to know if you have group B strep

Most cases of group B strep disease in infants can be prevented by screening and antibiotic treatment during labor. The Centers for Disease Control and Prevention (CDC) recommends group B strep screening for all pregnant women between weeks 35 and 37.

Your health care provider will send a swab from your vagina and rectum to a lab for testing. A positive test indicates that you carry group B strep. It doesn't mean that you're ill or that your baby will be affected. It simply means the potential for newborn infection exists.

How group B strep affects labor

You can have a vaginal delivery if you test positive for group B strep. To protect your baby, you'll be given an intravenous (IV) antibiotic — such as penicillin or ampicillin — when labor begins. If you're allergic to penicillin and related drugs, you may receive clindamycin or a similar alternative. Taking oral antibiotics ahead of time isn't likely to help because the bacterium can return before labor begins.

Antibiotic treatment during labor is also recommended for women who:

• Have a urinary tract infection caused by group B strep
• Delivered a previous baby with group B strep disease
• Develop a fever during labor
• Haven't delivered the baby within 18 hours of the membranes rupturing
• Go into labor before 37 weeks and haven't been tested for group B strep

Antibiotic therapy isn't usually needed for women who have C-sections.

How group B strep affects baby's first days

Group B strep typically doesn't affect the length of time you and your baby spend in the hospital — and it doesn't affect your ability to breast-feed safely.

Your baby will be carefully monitored after delivery. If your baby's doctor suspects a group B strep infection, a sample of your baby's blood or spinal fluid will be tested for group B strep. If the test is positive, your baby will be given IV antibiotics. In some cases, IV fluids, oxygen or other medications may be needed as well.

Ease your anxiety

The possibility of group B strep disease is scary — but remember that the condition is rare. A woman who has group B strep but doesn't receive antibiotics during labor has a one in 200 chance of delivering a baby with group B strep disease, according to the CDC. But with antibiotic treatment during labor, a full-term baby born to a mother who carries group B strep has only a one in 4,000 chance of developing group B strep disease.

If you test positive for group B strep, remind your health care team during labor. Don't worry about repeating yourself or seeming overly anxious. Your reminders will help your health care team provide the best possible care during labor and delivery.

Source:

www.mayoclinic.com

Fetal development: What happens during the third trimester?

The countdown is on! See how fetal development continues as your due date approaches.

The end is in sight! By now, you may be tired of being pregnant — and eager to meet your baby face to face. But your uterus is still a busy place. See how fetal development continues as your due date approaches.

Week 28: Baby's eyes open

Your baby is about 15 inches long and weighs about 2 to 3 pounds.

Your baby's eyes are beginning to open and close. The color has been established, but the story's not over yet. Eye color may change within the first six months after birth — especially if your baby's eyes are blue or gray-blue at birth.

Your baby is now sleeping for about 20 to 30 minutes at a time. Fetal movement will be most obvious when you're sitting or lying down.

Week 29: Movement is more forceful

Your baby's bones are fully developed, but they're still soft and pliable. This week, your baby begins storing iron, calcium and phosphorus.

As your baby continues to grow, his or her movements will become more frequent and vigorous. Some of your baby's jabs and punches may even take your breath away.

Week 30: Baby packs on pounds

Your baby weighs about 3 pounds — but not for long. He or she will gain about 1/2 pound a week until week 37.

Your baby may practice breathing by moving his or her diaphragm in a repeating rhythm. If your baby gets the hiccups, you may feel slight twitches or spasms in your uterus.

Week 31: Reproductive development continues

If your baby is a boy, his testicles are moving from their location near the kidneys through the groin on their way into the scrotum. If your baby is a girl, her clitoris is now relatively prominent.

Your baby's lungs are more developed, but they're not fully mature. If your baby is born this week, he or she will probably need a ventilator to assist breathing. Complications such as bleeding in the brain are less likely than they were even a few weeks ago.

Week 32: Downy hair falls off

Your baby is between 15 and 17 inches long and weighs about 4 to 4 1/2 pounds. Nearly all babies born at this age survive the challenges of premature birth.

The layer of soft, downy hair that has covered your baby's skin for the past few months — known as lanugo — starts to fall off this week.

As space in your uterus becomes more cramped, your baby's kicks and other movements may seem less forceful. You may want to check on your baby's movements from time to time — especially if you think you've noticed decreased activity. If you count fewer than 10 movements in two hours, contact your health care provider.

Week 33: Baby detects light

Your baby's pupils now constrict, dilate and detect light. Your baby continues to gain about 1/2 pound a week, and his or her lungs are more completely developed. Babies born this week need extra attention, but almost all will be healthy.

Week 34: Protective coating gets thicker

The pasty white coating that protects your baby's skin — called vernix — gets thicker this week. When your baby is born, you may see traces of vernix firsthand, especially under the arms, behind the ears and in the groin area. The soft, downy hair that covered your baby under the vernix for the past few months is now almost completely gone.

Week 35: Rapid growth continues

Your baby continues to pack on the pounds and store fat all over his or her body. The crowded conditions inside your uterus may make it harder for your baby to give you a punch, but you'll probably feel lots of stretches, rolls and wiggles.

Week 36: Baby can suck

Your baby is between 16 and 19 inches long and weighs about 6 to 6 1/2 pounds. Recent fat deposits have rounded out your baby's face, and your baby's powerful sucking muscles are ready for action. To prepare for birth, your baby may descend into the head-down position.

Week 37: Baby is full-term

By the end of this week, your baby will be considered full-term. As fat continues to accumulate, your baby's body will slowly become rounder.

Week 38: Organ function continues to improve

Your baby weighs nearly 7 pounds. His or her brain and nervous system are working better every day. This developmental process will continue through childhood and adolescence.

Week 39: Placenta provides antibodies

Your baby has enough fat under the skin to maintain body temperature as long as there's a little help from you. The placenta continues to supply your baby with antibodies that will help fight infection the first six months after birth. If you breast-feed your baby, your milk will provide additional antibodies.

Week 40: Your due date arrives

Your baby may be 19 to 21 inches long and weigh 7 to 8 pounds.

Don't be alarmed if your due date comes and goes without incident. It's just as normal to deliver a baby a week or two late — or early — than it is to deliver right on time.

Taking care of your baby

Although your pregnancy is nearly over, healthy lifestyle choices remain important. Remember these simple do's and don'ts:

Do:

• Take a prenatal vitamin
• Maintain a healthy weight
• Exercise regularly, with your health care provider's OK
• Eat healthy foods
• Manage stress and any chronic health conditions
• See your health care provider for regular prenatal checkups — probably once a week for the last month of pregnancy

Don't:

• Smoke
• Drink alcohol
• Use illicit drugs
• Take medication without your health care provider's OK

Enjoy the final days of your pregnancy. This is it! The next chapter in your life is about to begin.

Source:

www.mayoclinic.com

Childbirth education: Get ready for labor and delivery

Do you know what to expect during labor and delivery? Whether you're a first-time mom or a delivery room veteran, here's why you should take a childbirth education class.

By now, you've probably surrounded yourself with articles on childbirth and heard countless labor stories from friends and loved ones. But do you really know what to expect during labor and delivery? A childbirth education class can make all the difference.

Why should I take a childbirth education class?

Whether you're a first-time mom or a delivery room veteran, a childbirth education class can help you prepare to meet the challenges of labor and delivery. Consider the opportunities:

• Learn things you never knew about labor, delivery and postpartum care. You'll find out what happens to your body as your baby makes his or her way into the world — from just how messy delivery can be to why you may need to leave your contact lenses at home.
• Address your fears. What if I don't make it to the hospital in time? What if I lose control during labor? During class, you'll have the chance to talk about your fears with other couples who probably share the same concerns. The instructor can dispel myths and help put your mind at ease.
• Connect with your partner or labor coach. A childbirth education class offers your partner or labor coach the chance to learn about childbirth, too — as well as how to support you during labor.
• Discuss options for handling pain. You'll practice various methods for coping with contractions, such as breathing, relaxation and visualization. Most classes also cover the pros and cons of common medications, such as narcotic analgesics and epidural blocks.
• Get the basics on Caesarean delivery. You'll learn why a C-section may be needed — and what to expect if you deliver your baby surgically.
• Check out the facility. You may tour the facility and see various devices that may be used during labor or delivery, such as a fetal monitor.
• Brush up on newborn care. In addition to labor and delivery, you'll likely get a primer on newborns. Common topics include breast-feeding, diapering, bathing and comforting.
• Gain a sense of control. Knowledge is power. You'll feel less vulnerable during labor and delivery if you understand what's happening.

Are there different types of childbirth education classes?

Yes. Some classes cover specific types of births, such as C-section, vaginal birth after C-section (VBAC) and multiple births. Refresher courses are available for parents who simply want to review the basics. Other classes focus on specific methods of childbirth. For example:

• Lamaze. The goal of Lamaze is to increase confidence in your ability to give birth. Lamaze classes help you learn how to respond to pain in ways that both facilitate labor and promote comfort — including focused breathing, movement and massage.
• Bradley. The Bradley Method considers birth a natural process. You're encouraged to trust your body, focusing on diet and exercise throughout pregnancy. You're taught to manage labor through relaxation, deep breathing and the support of your husband or partner.

You may also find classes on other approaches to childbirth, including hypnotherapy and water birth.

What's the best way to find a class?

Childbirth education classes are offered at most hospitals and birthing centers. Some classes are available online or in video format. Ask your health care provider about available classes.You might also check with other parents who've recently had babies.

When should I take the class?

Childbirth education classes are often recommended near the sixth or seventh month of pregnancy — but anytime before you go into labor would be helpful. Typically, classes are offered as one- or two-hour sessions over the course of several months or as full-day weekend sessions. The earlier you register, the more options and flexibility you'll have regarding class dates and times.

How much will it cost?

That depends. Short courses may be offered for a nominal fee. More intense courses may cost $100 or more. Some insurance plans offer reduced registration fees or reimbursement plans for childbirth education classes. Fees at some facilities may be based on your ability to pay.

What is my health care provider's role?

Your health care provider is there to help you have a positive birth experience. With his or her input, use what you learn in your childbirth education class to create a birth plan. No one can guarantee how labor and delivery will unfold, but together you can design a birth plan that meets your expectations for labor, delivery and postpartum care — and that promotes the best care for you and your baby.

Source:

www.mayoclinic.com