The second trimester is often considered the most pleasant stage of pregnancy, but changes that occur in this trimester affect your entire body. Heartburn, frequent urination, and round ligament pain are all common symptoms found in the second trimester. Here are some ways to reduce the common discomforts of the second trimester.

Round ligament pain (belly, hips, and pelvis)

As your baby grows, your uterus expands and extends out of your pelvis. Women have two round ligaments—one each on either side of the uterus—that act as suspenders to elevate and support the uterus in the body.

The increasing size and weight of the uterus as the baby grows causes these ligaments to stretch. This stretching can cause sharp, shooting, or jabbing pain. Round ligament pain commonly occurs while walking or exercising, or at night after a day spent standing or walking.

Here’s how to help reduce pain:

• Resting will often relieve the pain.
• Using a belly band or pregnancy support belt can reduce stress on these ligaments by supporting the back and the uterus.
• Using a pregnancy pillow or placing a pillow under your belly when sleeping on your side can also provide support while you rest.

Heartburn during pregnancy

Pregnancy hormones relax the valve between your stomach and esophagus. This can cause acid reflux or heartburn.

Here are some ways to prevent heartburn:

• Eat small, frequent meals.
• Avoid citrus fruit, chocolate, and spicy or fried food.
• Wait at least 90 minutes before lying down after eating.
• Use an extra pillow for your head when sleeping.
• Drink fluids low in acid, such as water.
• Drink between meals, not at meals.
• When dealing with heartburn, rinse your mouth with 1 cup of water mixed with 1 teaspoon of baking soda.

Frequent urination

If you’re tired of getting up every couple hours with the incessant need to urinate, try these steps:

• Drink less fluid two hours before bedtime.
• Avoid caffeine in coffee, tea, sodas, sport drinks, and energy drinks.

If you have a burning feeling when you urinate, call your health care provider.

Dizziness during pregnancy

Feeling dizzy is fairly common in the second trimester of pregnancy. This can happen because of low blood pressure, and your growing uterus can reduce proper blood flow. To help with light-headedness:

• Eat a small meal every two to three hours to keep yourself energized throughout the day.
• Drink 10 eight-ounce cups of fluid each day.
• Lie down on your left side.
• Change positions slowly, such as from lying to sitting or sitting to standing.
• Sit down to do tasks instead of standing.
• Avoid being in temperature extremes, such as too much sun, cold, or heat.

Contact your healthcare provider if your light-headed symptoms don’t improve.

Nosebleeds during pregnancy

Nosebleeds are more common during pregnancy due to hormonal changes. To stop a nosebleed:

• Squeeze the bridge of your nose gently between your thumb and forefinger for a few minutes.
• Tilt your head forward to avoid swallowing the blood and breathe through your mouth until the bleeding stops.

Contact your healthcare provider if your bleeding is severe or doesn’t improve.

Congratulations, momma! The signs of labor might be intimidating, but it means you’ll shortly meet your baby!

Labor starts with a series of continuous, progressive contractions of the uterus that help the cervix dilate (open) and efface (thin out) so the baby can move through the birth canal. Labor ends with the delivery of the placenta.

When does labor start?

Labor is unique for each woman and each pregnancy. Less than 5% of women go into labor on their due date, and over 90% of women will go into labor within two weeks (before or after) their due date.

What do contractions feel like?

During a contraction, you’ll feel your uterine muscles tighten, which causes pain. If you put your hand on your abdomen, you’ll feel it getting harder, which causes dull pain in your lower abdomen and back and pressure in the pelvis. When the muscles relax, the pain fades. Some women describe contractions as strong menstrual cramps.

You may have contractions during your pregnancy—particularly towards the end—that start and stop. Your provider may describe these contractions as Braxton Hicks contractions or false labor. What do Braxton Hicks feel like, and what’s the difference between Braxton Hicks vs contractions? These contractions can be uncomfortable, but they don’t typically get stronger or closer together and don’t open or thin your cervix. Unlike labor contractions, Braxton Hicks contractions often stop or slow down when you change your position or relax.

Timing contractions

Pay attention to the characteristics of your contractions. How often are they happening? How long do they last? How uncomfortable are the contractions?

If you like, you can time and track your contractions on paper or within a mobile app. Timing contractions can help you tell the difference between true and false labor contractions and help you figure out when it’s time for you to head to the hospital or birthing center.

Signs of approaching labor

In addition to having contractions, your body will go through other changes as you get closer to delivering your baby. Remember, every pregnancy is different, so you may experience only some of the following signs.

Nesting

You may experience a sudden surge of energy in the days or weeks before labor. You might also have the urge to “nest” and prepare your home for the baby. Although nesting can begin any time during your pregnancy, many women experience it just before labor begins.

Lightening

Your baby drops lower into your pelvis in the weeks, days, or hours before labor. This is called lightening because you may feel lighter. Breathing may feel a little easier since the baby isn’t pressing on your diaphragm as much as before.

Anyone who’s experienced fatigue can attest to how debilitating it can be. Pregnancy fatigue is no exception. It’s hard to work up the willpower to accomplish the things you need to, like budgeting, preparing your house, and preparing your heart for your coming baby.

If you can relate to this, you’re not alone—pregnancy fatigue is normal. But just because it’s normal doesn’t mean it’s welcome.

When does pregnancy fatigue start?

Sudden, extreme fatigue is one of the earliest indicators of pregnancy. When does fatigue start in pregnancy? Unfortunately, it can start as early as the first week after conception. Extreme tiredness in early pregnancy is most common, but pregnancy fatigue can extend to both the second trimester and third trimester as well.

What does pregnancy fatigue feel like?

Pregnancy fatigue may feel like lack of motivation, trouble getting up in the morning, difficulty completing tasks, going to bed earlier than usual, and trouble staying asleep. You’ll typically need to sleep for longer periods of time—between 8-10 hours.

Causes of pregnancy fatigue

Your exhaustion will differ depending on what stage of your pregnancy you’re in. Early pregnancy exhaustion has different causes than late pregnancy exhaustion.

Early pregnancy exhaustion

In early pregnancy, your body goes through a myriad of changes, and these changes naturally lead to fatigue.

• Hormonal changes. Pregnancy causes increased estrogen and progesterone levels, which leads to drowsiness. Fortunately, the increased drowsiness progesterone provides can lead to deeper and more restful sleep.
• Low blood pressure. Your growing baby needs extra blood, which means your blood sugar and blood pressure lower as your body supplies this additional blood.
• Placenta. Early in pregnancy, your body is working hard to grow a placenta for your baby. This organ supplies nutrients and oxygen to your baby as they grow throughout your pregnancy.

Third trimester fatigue

You might experience a short period of relief after your body adjusts to the major changes that occur in early pregnancy, but fatigue often hits hard in later pregnancy for a couple reasons.

• Extra weight. As your baby grows bigger, so do you. The extra weight you carry around easily leads to exhaustion as you go about your day.
• Pregnancy insomnia. Sleep eludes many women due to lack of comfortable pregnancy sleeping positions. Many of the third trimester pregnancy symptoms contribute to poor sleep.

How to fight fatigue

While you may not be able to prevent fatigue in its entirety, here are some tips to improve it.

Ask for help

This is a great time to call on your support network for help. When someone says, “If you need anything, let me know,” take them up on it! People often want to help but don’t know how to assist you. It’s ok to ask family members and friends to fix a meal, help with housework, run errands, or sit with other children while you rest.

“New baby” and “rest” aren’t the most synonymous words for a new mother, but the first few days of postpartum recovery after having your baby should be a time for rest and recuperation. While you have an infant who needs constant care, you also need to care for yourself.

Your body will experience a number of changes following birth. Here’s an overview of the physical changes occurring after birth and guidance on how to manage postpartum recovery.

Vaginal discharge

Vaginal discharge—or lochia—is the tissue and blood that lined your uterus during pregnancy. It’s heavy with blood clots for the first few days but will gradually become lighter in flow and color until it goes away after a few weeks. You may notice increased lochia when you get up in the morning when you’re physically active, or while breastfeeding. A mom who has a cesarean section will also have lochia but less than a mom who has a vaginal delivery.

Episiotomies and perineal tears

Your vagina and your perineum (the area between your vagina and rectum) will feel very tender and sore from the strain of childbirth. If you gave birth vaginally, it’ll probably take you a few weeks to heal, especially if you had an episiotomy or a perineal tear. If you gave birth by cesarean section after attempting to push, you’re also very likely to be sore.

To keep your perineum clean, fill a peri bottle (given to you in the hospital or purchasable online) with warm water and squirt the water over the area between your vagina and rectum in a front-to-back motion each time you use the bathroom or change your sanitary pad. Pat the area dry with toilet tissue—don’t rub. To maintain good hygiene and cleanliness, change your pad frequently. Continue to practice this perineal care for at least one week after delivery.

Uterine contraction

Mild contractions after birth help reduce bleeding and shrink your uterus back to its pre-baby size. You may notice these contractions more if you breastfeed. This is because breastfeeding causes your body to release oxytocin, a hormone that causes uterine contractions.

To relieve discomfort, you can try a heating pad or take anti-inflammatory pain medication (ibuprofen) as recommended by your healthcare provider.

Breast engorgement

Around the third or fourth day after giving birth, your breasts may become engorged and feel firm, swollen, and sore as they start filling with milk. The initial tightness and soreness will eventually wear off whether you choose to breastfeed or not.

• When breastfeeding, you can prevent engorgement by frequently feeding your baby. You may experience a tender, heavy feeling if a feeding is a little overdue.
• If you are bottle-feeding your baby, you can relieve the discomfort of engorgement by applying ice packs to your breasts, wearing a supportive bra, and by taking an anti-inflammatory pain medication (ibuprofen) to reduce swelling.

Sore nipples

Blood flow to your nipples increases the first few days after giving birth, making them particularly sensitive. If you choose to breastfeed, it’s common to experience some pain as your baby learns how to properly latch on to your breast. A little discomfort as baby gets into a rhythm is normal but feeling constant pain throughout the feeding is not. If you experience constant pain, ask for help from a nurse or lactation consultant.

Your newborn baby is a blessing, a joy, and a gift from God. They’re also a huge undertaking, and it can be difficult to know whether you’re giving the best possible care to your newborn. With sleepless nights, struggles with self-care, and the need to stay steadfast in your relationship with God, it’s important to get a handle on feeding a newborn as well as their sleep schedules.

How often to feed your newborn

Feed your baby when they show signs of hunger rather than putting them on a newborn feeding schedule. Your baby may cue you by turning their head in search of the breast, sucking on their fingers or hands, making sucking noises, or opening and closing their mouth. Try to recognize these feeding cues and feed your baby before they start crying, which is a late sign of hunger.

Babies often feed irregularly. Sometimes they go an hour or less between feedings and other times they might go as long as three or four hours between feedings. The length of each feed also varies. You should continue feeding as long as your baby is actively sucking and swallowing. Most babies signal that they’re finished by relaxing their face and hands, and no longer showing any feeding cues.

Generally, a newborn baby should be fed every two to three hours, so if you don’t see feeding cues by hour three, try to feed the baby—even if it requires waking them up. If your baby seems satisfied, produces about six wet diapers and several stools a day, sleeps well, and is gaining weight regularly, then you’ll know they’re eating enough.

Breastfeeding tips

Breast milk is the optimal source of baby nutrition. It meets their nutritional needs for their first six months—the age when solid foods are usually added to the diet. Your baby doesn’t require any additional water or food before then.

While breastfeeding is natural, it’s still a learning process for you and your baby, and it may take weeks before you both get the hang of it. If you’re feeling lost or confused along the way, many people can help:

• A nurse at your delivery location
• A lactation consultant
• Your midwife or doctor
• Your baby’s pediatrician

Getting started

It’s important to start breastfeeding within the first few hours after birth, if possible. Early and frequent breastfeeding after birth is important because this signals the breasts to produce more milk.

It’s also important for the baby to get the colostrum that’s produced in the first few days after birth. Colostrum is a concentrated yellow liquid that’s rich in nutrition and healthy antibodies that help protect your baby from infections. If you need to be separated from your baby for medical reasons, you can still release the colostrum, either by hand or with a pump.

How to breastfeed

While breastfeeding is a natural process, it’s normal to feel awkward at first. It’s helpful to keep some basic principles in mind and be prepared to handle common problems.

• Positioning: A good position is one where you and your baby are comfortable. It’s helpful to try different positions, especially if you are experiencing any discomfort or your baby is having problems feeding.
• Helping your baby latch on: The key step in breastfeeding is making sure your baby properly “latches on,” so that their mouth forms a seal around the areola (dark area of skin around your nipple). A comfortable latch protects you from sore nipples and pain during breastfeeding and allows for good milk flow. Signs that your baby has a good latch-on include:
  • You’re comfortable during breastfeeding. You may feel some tugging, pressure, or tingling, but you shouldn’t feel pain or nipple soreness.
  • The nipple is high and deep in the baby’s mouth.
  • The baby’s top and bottom lips are wide open (like a big yawn), with the lower lip turned outward against the breast.
  • The baby’s tongue comes out over the lower lip during latch-on and stays below the areola during nursing.
• Adjusting the latch: Any time you feel pain, it’s important to adjust the baby’s latch to protect your nipple and allow good milk flow. To adjust the latch, gently insert your finger in the side of your baby’s mouth to break the suction.
• Sucking and swallowing: When your baby is feeding well, you can usually hear them swallow. At the beginning, they’ll suck rapidly without swallowing to get the milk flow started.

How to increase milk supply

Throughout breastfeeding, the amount of milk you produce depends on how often your breasts are emptied. Your body adapts to meet your baby’s needs. You can help increase milk supply by doing the following:

• Feed your baby frequently.
• If you need to be separated from your baby, pump at your baby’s usual feeding times.
• Don’t give your baby formula unless your healthcare provider advises that it’s medically necessary—this may cause you to produce less milk.

You’re finally ready to begin life with your baby!

Caring for a newborn can feel overwhelming at first. Ask experts, nurses, and trusted friends or relatives for help and advice in the first days or weeks after you get home. In the meantime, these tips can also help you feel more confident about caring for a newborn.

Holding a baby

If you’re a new mother and haven’t spent a lot of time around newborns, it may feel intimidating. Here are a few basics to remember:

• Wash your hands before handling your baby. Make sure that everyone who handles your baby has clean hands. Newborns don’t have a strong immune system yet, so they can get sick easily.
• Support your baby’s head and neck.
• Make sure your baby is securely fastened into the carrier, stroller, or car seat.
• Limit any activity that could be too rough or bouncy, such as rough play, being thrown in the air, or shaking.

Bonding and soothing

Bonding happens when parents make a deep connection with their infant within the first hours and days after birth. Physical closeness can promote an emotional connection and contribute to the baby’s emotional growth, which also affects their development in other areas.

Begin bonding by cradling and gently stroking your baby. Both you and your partner can hold your newborn against your skin while feeding or cradling. If your little one is fussy, try singing, reciting nursery rhymes, or reading aloud as you gently sway or rock your baby.

Newborn sleep

Newborns can sleep 16 hours or more a day but usually only a couple of hours at a time. The digestive system of a newborn is so small that they need nourishment every few hours and should be awakened if they haven’t been fed for 2-4 hours.

Many babies will begin sleeping through the night (between 6–8 hours) at around three months of age; however, if it takes longer for them to sleep through the night, it’s not a cause for concern.

Babies should always be placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). It’s also important to remove blankets, loose bedding, pillows, crib bumpers, toys, and stuffed animals from the sleeping area.

Swaddling a baby

Swaddling is a soothing technique that works well for babies for the first few weeks. Not only does swaddling keep a baby warm, but it gives newborns a sense of security and comfort.

To swaddle a baby:

• Spread out a blanket in a diamond shape and fold it over the top corner.
• Lay the baby on the blanket with their head above the folded corner.
• Wrap the left corner over the body and tuck it snuggly beneath their back, going under the right arm.
• Bring the bottom corner up over their feet and pull it toward their head, folding the fabric down if it gets close to their face.
• Wrap the right corner around the baby and tuck it under their back on the left side, leaving only the neck and head exposed.
• To make sure your baby isn’t wrapped too tightly, check to see if you can slip a hand between the blanket and their chest. This allows comfortable breathing.

Babies shouldn’t be swaddled after they’re two months old. At this age, some babies can roll over while swaddled, which increases their risk of SIDS.

The first trimester of pregnancy is your first step in motherhood. You may not look pregnant yet, but your body is going through an amazing transformation and massive hormonal changes. The rapid influx of human chorionic gonadotropin (hCG), estrogen, and progesterone can lead to various early pregnancy symptoms, including nausea, breast tenderness, and fatigue. 

Here are some ways to reduce first-trimester discomforts, aches, and pains.

Morning sickness

Nausea might be the most well-known pregnancy symptom, and it hits hardest in the first trimester. Despite being commonly referred to as “morning sickness,” nausea can hit at any time of the day or night. It’s commonly caused by a hormone produced by the placenta.

Here are some ways to counteract nausea:

• Keep something in your stomach. Eat crackers, toast, or dry cereal before getting out of bed in the morning or whenever you feel sick.
• Avoid smells that make nausea worse.
• Eat small meals throughout the day.
• Avoid eating greasy, spicy, or fried foods.
• Try ginger tea, chews, or drops.
• If you are vomiting, it’s important that you stay hydrated. Sip clear liquids.
• Try the over-the-counter vitamin B6 or a combination therapy of vitamin B6 and doxylamine (Unisom SleepTabs or generic). Take 10 to 25 mg of vitamin B6 three times a day, every 6 to 8 hours. Add doxylamine 25 mg once before bed if the B6 alone doesn’t alleviate symptoms (Note: over-the-counter medications aren’t eligible for CHM sharing).
• Consider talking to your doctor about medications to treat the symptoms of pregnancy-related nausea.

Back and sciatic pain during pregnancy

Back and sciatic pain during pregnancy is, unfortunately, fairly common. Here are some ways to fight back pain, sciatic pain, and cramping during early pregnancy:

• Use a side-lying position with pillows between the knees, behind the back, and under the abdomen to give you support.
• Rest on a supportive mattress.
• Wear low-heeled or athletic shoes.
• Sit up straight and avoid slouching.
• Change positions often, whether sitting, standing, or lying down.
• Engage in physical activity to build muscle strength.
• Use your legs and squat to pick up objects. Do not bend over.
• Use massage, take a warm shower, or apply ice for 15 minutes at a time (then remove) to help with low back pain.

Avoid over-the-counter medicines until you speak with your provider. If your pain is constant and hasn’t gone away after trying these suggestions, call your provider.

Sore nipples and breast tenderness

Sore nipples and breast tenderness are often early signs of pregnancy, and symptoms can include tingly, sore, and swollen breasts as well as sensitive nipples. These discomforts are caused by hormonal changes. To help with the discomfort, you should:

• Go up a bra size (or more).
• Wear a bra to bed.
• Wear a support bra that is not too tight.

Pregnancy fatigue

Early pregnancy comes with a lot of hormonal changes accompanied by many physical issues. One of these issues is fatigue, which is caused when progesterone levels spike. To help with fatigue, you should:

• Take more rest periods or naps, if possible.
• Make adequate sleep a top priority.
• Try to get eight hours of sleep each night.
• Try winding down with relaxing activities before bed.

If you’re expecting, you might be knee deep in decisions already—baby names, budgeting, nursery ideas. But one of the most important decisions you need to make in your pregnancy is where to go for your prenatal care.

It’s important to surround yourself with a team of people you trust to guide you through the incredible changes your body undergoes, answer all the questions you’ll have at each visit, and help create the childbirth experience you and your husband want. This guide is designed to help you make this important decision. 

What matters most?

Finding the right care will depend on what you need and what matters most to you. If where you give birth is important to you, you’ll need to find a doctor or midwife who can deliver your baby in your selected birthing location. If you work during the week, it may be especially important to you to have an office with convenient hours or options for weekend appointments. For some couples, having a healthcare provider who shares your cultural background or beliefs is essential.
Once you zero in on the factors that are most important, you can narrow your options and find the right care for you and your baby.

What do you need?

Women have a wide range of needs for a healthy pregnancy and birth. These needs range from basic education and prenatal visits to high-risk specialty care and management of complications.

Choose a doctor or midwife that will not only provide great care for you and your baby but also can connect you to a team that includes the people and services that fit your needs.  You’ll likely have a team of people who are experts in different areas, including providers, nurses, nurse practitioners, physician assistants, and medical assistants. 

Different communities have various types of providers available: You may have a midwife, a family physician, an obstetrician (OB/GYNs), and/or a maternal fetal medicine specialist involved in your care.  

To learn more about these different types of providers and their training and focus, visit:

• American College of Nurse-Midwives
• National Association of Certified Professional Midwives
• American Academy of Family Physicians
• American College of Obstetricians and Gynecologists
• Society for Maternal Fetal Medicine

Ask for help

Once you know the types of providers available, it’s time to make a choice.

This is your decision, but you may have people you want to be part of that decision. It’s also important to involve your husband in exploring the options and finding a practice in which he feels involved, respected, and able to get answers to his questions. 

Ask your primary care doctor, friends, and family members for provider recommendations. If you have a medical condition that will need to be managed along with your pregnancy, you should consult a trusted medical care professional for recommendations.

You’re almost there—baby and mother are about to meet! Your baby’s movements are more obvious in your third trimester. These exciting sensations are often accompanied by increasing discomfort and other signs and symptoms, including constipation, swelling, and backaches. Here are some ways to reduce the common discomforts of the third trimester.

Constipation and hemorrhoids during pregnancy

While pregnancy constipation is more common in the third trimester due to pressure on your bowel, it can happen at any point. To help with constipation and hemorrhoids, you should:

• Drink six to eight cups of liquid each day. Choose water, juices, and milk.
• Eat plenty of fiber-rich foods, such as raw fruits and vegetables, whole grains, high-fiber cereal, popcorn, and beans.
• Walk or do light exercise each day as you are able.
• Avoid using laxatives or enemas.
• Avoid straining or pushing when having a bowel movement.
• Drink less fluid two hours before bedtime.
• Use the bathroom often.
• Do Kegel exercises. Kegels are performed by squeezing the muscles around the vagina, urethra, and rectum, and holding them for three to five seconds. Slowly increase holding to 10 seconds. Repeat 10 times. Do Kegels at least three times each day.
• Avoid caffeine in coffee, tea, sodas, sport drinks, and energy drinks.

Leg cramps during pregnancy

Leg cramps are most common in late pregnancy, and they often occur at night. The cause of this cramping isn’t entirely clear, but it’s suspected to be linked to low calcium levels or high phosphorus levels. Regardless of the cause, here’s how you can relieve your cramps:

• Drink plenty of water.
• Stretch your legs before bed.
• If you have a leg cramp, work to straighten your leg. Alternate flexing and relaxing your foot.
• Stretch your calf muscles during the day.
• Do low to moderate exercise as directed by your provider.
• Add calcium to your diet, such as dairy, leafy greens, and calcium-fortified juice.
• Avoid crossing your legs or sitting in a position that reduces blood flow.

What to do when you can’t sleep

Sleeping trouble during pregnancy is most common in the third trimester, and it often stems from heartburn, congestion, hormone changes, and the need to make multiple bathroom trips throughout the night. To help combat insomnia:

• Turn off your smart phone, TV, and tablet one or more hours before bedtime. The light from these devices can make it harder to fall asleep.
• Exercise earlier in the day. Late day exercise can wake up your body.
• Use relaxation, meditation, and other strategies to get ready for sleep.
• Use pillows to cradle your body.
• Avoid caffeine in coffee, tea, sodas, sport drinks, and energy drinks, especially after 2:00 p.m.

Braxton Hicks contractions

Braxton Hicks contractions (or false labor) are characterized by mild, irregular contractions or tightness in your abdomen. This is more likely to occur in the afternoon or evening after physical activity. These contractions also tend to occur more often and become stronger as you approach your due date. 

Contact your healthcare provider if the contractions become regular and steadily increase in strength.

Swelling in hands and feet

Pregnancy causes your body to hold more water than usual, and this can result in swollen hands, fingers, and feet. Here’s how to reduce swelling:

• Wear supportive shoes.
• Prop your feet up when sitting or lying down.
• Add protein to your diet, such as eggs, beans, tofu, meat, and yogurt.
• Avoid standing for long periods of time.

Varicose veins

Varicose veins (or spider veins) look swollen, raised, or bulging. In addition to their distinctive appearances, they can also cause pain or discomfort. To help avoid varicose veins:

• Keep feet slightly raised when sitting and avoid standing for long periods of time.
• Avoid tight-fitting clothing.
• Avoid crossing your legs.