What to expect when you're expecting (96 page)

These days, it’s pretty much routine for women in their second trimester to be scheduled for a level 2 ultrasound, no matter how normally their pregnancies seem to be proceeding. That’s because practitioners have found that it’s a great way to see how a baby is developing and to offer reassurance that everything is going exactly the way it should be. On the plus side for parents, it’s fun to get a sneak peek at your baby—and to take home a souvenir photo to start the album with and to start bonding with. It can also give you the 4-1-1 on baby’s sex (on a want-to-know basis, of course; see next question).

Even if you had a first-trimester (level 1) sonogram to confirm or date your pregnancy, or as part of a first- trimester screening test, the more detailed level 2 sonogram (also called an anatomy scan), typically performed between 18 and 22 weeks, gives your practitioner additional valuable information about what’s going on in that belly of yours. For example, it can measure the size of your baby and check out all the major organs. It can determine the amount of amniotic fluid to make sure there’s just the right amount, and evaluate the location of your placenta. In short, this second-trimester ultrasound—besides being fun to watch—will give you and your practitioner a clear picture (literally) of the overall health of your baby and your pregnancy.

If you’re concerned about the upcoming picture show (and what those grainy images reveal), talk to your practitioner about what he or she is looking for. Chances are you’ll come away enlightened (and relieved).

A Picture That Lasts a Lifetime

Now that you’ve got your baby’s first portrait, courtesy of your second-trimester ultrasound exam, you’ll want to preserve it forever—right? To make sure that precious picture doesn’t get damaged (or fade), scan it into your computer and save it on your hard drive or onto a CD. Or scan it into a photo website and have it printed out on acid-free paper with real photo ink. That way your memories won’t fade with, well, your memory.

Baby’s First Mall Portrait

Want a womb with a view? Ultrasound is a window into the wonderful world of your womb, and to get a sneak peek into that world, you often don’t have to go farther than your local mall. But is it safe to take that peek inside your tummy on the way to Sears?

The FDA hasn’t yet established rules for these storefront prenatal photography studios, but it does warn against having ultrasounds for fun (instead of for medical reasons), since the three-dimensional imaging machines they use are much higher powered than the typical ultrasound machines at your doctor’s office. What’s more, many medical professionals fear that nervous moms-to-be will come away wrongly convinced there’s something wrong with their babies, or, worse, that the less-trained wand wavers will miss real problems that a pro would detect.

If you’re still intrigued by the idea, check with your practitioner before you leap (or in this case heave yourself) onto the exam table at the mall. If you decide to go ahead with this kind of elective sonography, do so wisely: Limit your visits to one or two, with each ultrasound no more than 15 minutes in length. And bring your wallet. The image may be priceless, but some studios charge a hefty price for that suitable-for-framing photo, CD, and DVD of your baby-to-be.

“I’m going for my 20-week ultrasound, and we’re not sure whether to find out the baby’s sex or not.”

This is one pregnancy decision only a mom and dad can make—and there’s no right or wrong when it comes to making it. Some parents opt to know for practical reasons: It makes layette shopping, nursery painting, and name selection (only one to pick!) a lot simpler. Others opt to know because they simply can’t stand the suspense. But many parents still prefer the guessing game, and they decide to find out the old-fashioned way—when baby’s lower half finally makes its way out into the world. The choice is yours.

If you do decide to find out now, keep in mind that determining the sex of a baby through ultrasound is not an exact science (unlike amniocentesis, which determines the sex of the baby through chromosomal analysis). Very occasionally, parents are told by the sonographer that they’re expecting a girl only to hear at delivery, “It’s a boy!” (or vice versa). So if you do choose to find out your baby’s gender when you go for your ultrasound, remember that it’s only a guess, however educated it may be.

“The doctor said my ultrasound showed that the placenta was down near the cervix. She said that it was too early to worry about it, but of course I started worrying.”

Think your baby is the only thing moving around in your uterus? Think again. Like a fetus, a placenta can move around during pregnancy. It doesn’t actually pick up and relocate, but it does appear to migrate upward as the lower segment of the uterus stretches and grows. Though an estimated 10 percent of placentas are in the lower segment in the second trimester (and an even larger percentage before 14 weeks), the vast majority move into the upper segment by the time delivery nears. If this doesn’t happen and the placenta remains low in the uterus, partially or completely covering the cervix (the mouth of the uterus), a diagnosis of “placenta previa” is made. This complication occurs in very few full-term pregnancies (about 1 in 200). In other words, your doctor is right. It’s too early to worry—and statistically speaking, the chances are slim that you’ll ever have to worry.

“During my ultrasound, the technician told me I have an anterior placenta. What does that mean?”

It means your baby is taking a backseat to the placenta. Usually, a fertilized egg situates itself in the posterior uterus—the part closest to your spine, which is where the placenta eventually develops. Sometimes, though, the egg implants on the opposite side of the uterus, closest to your belly button. When the placenta develops, it grows on the front (or anterior) side of your uterus, with the baby behind it. And that, apparently, is what happened in your case.

Happily, your baby doesn’t care which side of the uterus he or she is lying on, and where the placenta is located certainly makes no difference to his or her development. The downside for you is that you might be less able to feel (and later see. your baby’s early kicks and punches because the placenta will serve as a cushion between your baby and your tummy (which could lead to unnecessary worrying). For the same reason, your doctor or midwife may find it a bit harder to hear fetal heart sounds (and it could make amniocentesis a little more challenging). But despite those slight inconveniencies—which are nothing to be concerned about—an anterior placenta is inconsequential. What’s more, it’s very likely that the placenta will move into a more posterior position later on (as anterior placentas commonly do).

“I’ve always slept on my stomach. Now I’m afraid to. And I just can’t seem to get comfortable any other way.”

Unfortunately, two common favorite sleeping positions—on the belly and on the back—are not the best (and certainly not the most comfortable) choices during pregnancy. The belly position, for obvious reasons: As your stomach grows, it’s like sleeping on a watermelon. The back position, though more comfortable, rests the entire weight of your pregnant uterus on your back, your intestines, and major blood vessels. This pressure can aggravate backaches and hemorrhoids, make digestion less efficient, interfere with optimum circulation, and possibly cause hypotension, or low blood pressure, which can make you dizzy.

Sleeping on your side

Carrying Baby, Fifth Month

Here are just three of the very different ways that a woman may carry near the end of her fifth month. The variations on these are endless. Depending on your size, your shape, the amount of weight you’ve gained, and the position of your uterus, you may be carrying higher, lower, bigger, smaller, wider, or more compactly.

This doesn’t mean you have to sleep standing up. Curling up or stretching out on your side—preferably the left side, though either side is fine—with one leg crossed over the other and with a pillow between them (see illustration, facing page), is ideal for both you and your fetus. It not only allows maximum flow of blood and nutrients to the placenta but also enhances efficient kidney function, which means better elimination of waste products and fluids and less swelling (edema) of ankles, feet, and hands.

Very few people, however, manage to stay in one position through the night. Don’t worry (repeat: do not worry) if you wake up and find yourself on your back or abdomen. No harm done (repeat: no harm done); just turn back to your side. You may feel uncomfortable for a few nights, but your body will soon adjust to the new position. A body pillow that’s at least 5 feet long or a wedge-shaped pillow can offer support, making side sleeping much more comfortable and staying on your side much easier.
If you don’t have either of these, you can improvise with any extra pillows, placing them against your body in different positions until you find that perfect combination for catching z’s.

“I have a friend who insists that taking her unborn baby to concerts will make him a music lover, and another one whose husband reads to her tummy every night to give their baby a love of literature. Should I be trying to stimulate my baby, too?”

All parents want only the best for their children—or in this case, for their children-to-be. But it’s important to keep some perspective before switching on the Beethoven and reciting the Shakespeare.

While it’s true the fetus’s ability to hear is well developed by the end of
the second trimester, there is no proof that an in utero concerto or a lesson in the great classics gives the baby a head start in education (or on a musical or literary career). Promoting an educational or cultural agenda this early can also come with a potential downside—especially if it signals the start of extremely premature parental pushiness, and begins placing too much emphasis on achievement at a too-tender age (and before birth is definitely too tender an age). Fetuses (like the babies and children they’ll become before you know it. develop—and later, learn—best at their own pace, no prodding necessary. There’s also the theoretical risk that when parents attempt to turn the womb into a classroom, they may unwittingly disrupt the natural sleep patterns of their baby-to-be, actually hampering development instead of nurturing it (just as waking up a newborn for a game of name-this-letter might).

That said, there’s nothing wrong—and a lot right—with providing a uterine environment that’s rich in language and music, and much more important, about finding ways to get close to your little one long before you even have that first cuddle. Talking, reading, or singing to your baby while in the womb (no amplification necessary) won’t guarantee a scholarship to Yale, but it will guarantee that your baby will know your voice at birth—and will give you both a head start on bonding.

Playing classical music now may increase the likelihood that your newborn will appreciate, and even be soothed by, these sounds later on (though it’s been shown that exposure to music and literature has a much more significant effect once your baby is actually born than it does prenatally—so keep the sonatas handy once baby’s arrived). And don’t underestimate the power of touch. Since this sense also begins to develop in utero, stroking your belly now may also help strengthen the bond between you and your baby later.

So turn on the Mozart, bring on the Bach, pull out those dusty Shakespeare sonnets and read away to your belly if you like (and if you can do it without cracking up). Just make sure you’re doing it all to get closer to your baby—not to get your baby closer to an Ivy League degree.

Of course, if you feel silly performing for your bloated belly, there’s no reason to worry that your baby will miss out on getting to know you. He or she is getting used to the sound of your voice—and Dad’s, too—every time you speak to each other or someone else. So enjoy making baby contact now, but definitely don’t worry about early learning this early. As you’ll discover, kids grow up all too soon anyway. There’s no need to rush the process, particularly before birth.