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Whether one considers the preteen young girl or the mature woman in her fifties, a pregnancy with the goal of delivery of a healthy infant is a physiologic state. It means that, as a normal process, pregnancy should be welcomed as a life's event, similar to the daily cardiovascular, respiratory, gastrointestinal, or urinary normal functions, just to name these few.
It is true that pregnancy is not as vital as these already-named functions, as a woman may live a healthy and fulfilled life without this experience. However, when it occurs, it challenges the woman to look beyond herself in caring for her unborn progeny. There are basic facts about pregnancy that everyone should know.
The average length of a normal term pregnancy is established as two hundreds eighty days (280) from the first day of the last menses. It is divided into three periods or trimesters.
The first trimester: If a woman has a reliably regular menstrual cycle of 28 days, by the time she misses her menstrual flow a biochemical diagnosis of pregnancy can be made (urine pregnancy test). In the absence of symptoms of complications such as pelvic pain or vaginal bleeding, a visit to an obstetrician gynecologist (or her family physician) should help confirm the pregnancy with a pelvic sonogram within two weeks. This is a crucial time in the life of the embryo/fetus, the foundation of life. It is the time when malformations may occur and that's why the newly pregnant woman must live a healthy life away from drugs, alcohol, cigarettes and extreme living habits that may interfere with this process we call organogenesis. The early physiologic changes may be experienced as morning symptoms of lightheadedness, breasts tenderness, nausea or vomiting, change in appetite, a bloated feeling or pelvic fullness. This is the time to begin your prenatal care preferably with the medical team that will assist you through this process until your recovery from delivery. Laboratory tests are requested to establish your basic health, rule out sexually transmitted illness (STD), inherited or genetic illnesses. Nutritional supplements of vitamins and minerals are commonly prescribed to ensure adequate supply for the developing fetus. Many women will receive low dose of Aspirin, especially those at risk for preeclampsia. The average woman would have at least two sonograms confirming the location, the apparent normalcy and measurement of the baby's nuchal area (back of the neck), the identification of the nasal bones, to rule out certain malformations (Down syndrome, cardiac anomalies...)
The second and third trimesters: The fetus continues to grow and his/her different organs progressively mature. The second trimester is that period from the 14 to the 26 weeks of the pregnancy. For a first pregnancy the woman is expected to feel the baby move by the 20th week, but a previously pregnant women who went through this process before will likely feel fetal movements (quickening) by the 14th week. This is the time when at least one sonogram to check on the baby's anatomy to rule out fetal anomalies will be requested by the obstetrician. An important landmark, often overlooked, is the appearance of the cervix which may give a clue regarding the risk of preterm labor and delivery. The screening for gestational diabetes, significant anemia and prevention of Rh sensitization( for Rh negative women with Rh positive baby's fathers) will be offered by the prenatal care team.
During the 3rd timester, that period from the 27th to the 40th week, the discomfort of pregnancy may intensify in some women, but generally vary from one person to another. The breasts have become more enlarged and are prepared for lactation which has many health advantages for both the mother and the baby, when initiated and maintained in the first few months of life. The workload of the woman's heart has increased to over 50% of the pre-pregnancy level, the respiratory space (chest cavity) has changed in its configuration and some women may experience difficulty breathing that must be differentiated from respiratory illnesses by the prenatal care team. The fetus grows at an average rate of half a pound a week and the fetal pole closest to the maternal birth canal is establishing itself in preparation for delivery. Most of the time that pole ends up being the fetal head (about 94-95%). Irregular contractions (1-minute tightning of the uterus) may become part of the daily experience of the woman after the 36th week of pregnancy and may cause occasional back pain and pelvic pressure, which will become more regular as the days go by, until the onset of true labor.
These basic facts should guide any couple considering a pregnancy in the near future or currently facing an ongoing pregnancy. Discuss any concern with your obstetrical team and be proactive.