In this section, we’ll talk about pregnancy, including things to know before getting pregnant, getting care while pregnant, changes that occur during pregnancy, and the process of giving birth. We’ll also discuss some things to know after giving birth. It is a good idea to talk to your doctor before you become pregnant to learn how you can prepare your body. If you have a medical condition that can affect the unborn baby, your doctor will want to make sure it is under control. It is important to take a multivitamin with enough folic acid before getting pregnant; folic acid is a type of vitamin B that can reduce the risk of birth defects of the brain and spine. A missed period is often the first clue that a woman might be pregnant. If using a home pregnancy test, it is important to follow the instructions exactly as written. If the woman is unsure about the result, her doctor can use a more sensitive test to see if the woman is pregnant. Prenatal care is the health care a woman gets while pregnant to keep her and the baby healthy. If you are pregnant, you should get early and regular prenatal care, whether this is your first pregnancy or your seventh. Doctors can spot health problems early when they see mothers regularly. Early treatment can cure many problems and prevent others. Babies of mothers who do not get prenatal care are more likely to have low birth weight, be born too soon, or die than those born to mothers who do get care. During the first prenatal visit, the doctor will ask about the woman’s health history, do a physical exam, calculate the due date, check blood pressure and weight, take blood and urine for testing, and answer any questions. Later prenatal visits will probably be shorter. The doctor will check on the mother’s health and make sure the baby is growing as expected; other tests and an ultrasound may be ordered. If the woman has had the Pharaonic form of FGC, the doctor should talk to her about the appropriate time to open her scar to prepare for childbirth. The doctor will advise a woman on healthy habits throughout her pregnancy. A pregnant woman should continue taking multivitamins with enough folic acid. Everything a pregnant woman puts in her body may also go to the baby. Chewing khat, smoking, including exposure to second hand smoke, and drinking alcohol can all harm the baby. She should eat nutritious foods to nourish her baby, while avoiding excessive calories, fat, sugar, and sodium. A pregnant woman should not limit her food intake to purposely keep the baby small for fear of a difficult delivery. This can endanger the health of the mother and baby. Programs in your State can offer information about health insurance and other services, such as WIC, which provides nutritious food to low-income pregnant women. To find out more, call 1-800-311-BABY or 1-800-311-2229, which will connect you to the health department in your State. Pregnancy lasts about 40 weeks, counting from the first day of your last normal period. Pregnancy is divided into 3 stages, called trimesters, which are about 13 weeks each. In a woman’s first trimester (weeks 1 to 12), her body undergoes many changes, which can include: tiredness; tender, swollen breasts; nausea and vomiting; mood swings; constipation; and needing to urinate often. Even if a woman has been pregnant before, she might have different symptoms with each pregnancy. In the first trimester, the baby has gone from being a cluster of cells to forming organs and even having a heartbeat. In a woman’s second trimester (weeks 13 to 28), some of the symptoms of the first trimester, like the nausea, may start to go away. Other changes continue to happen. Her abdomen will expand as the baby grows. In addition, some women may have body aches, such as back pain; stretch marks; patches of darker skin on the face; and swelling of the extremities and face. If a woman has had the Pharaonic form of FGC, the second trimester may be a good time to consider opening her scar. This reduces complications during childbirth. In the second trimester, the baby has formed skin, hair, and even fingerprints. The mother may feel some fluttering movements. In a woman’s third trimester (weeks 29 to 40), some women may have shortness of breath, heartburn, hemorrhoids, and trouble sleeping. She may start to have contractions, which can be a sign of real labor or false labor. False labor, called Braxton Hicks in English, is not regular and goes away after a period of time. With true labor, contractions become regular, stronger, and more frequent. In the third trimester, the baby continues to grow. By 37 weeks, the baby’s organs can function on their own. A woman should call her doctor if she has any signs that indicate a problem with the pregnancy. If she has sudden or severe swelling, headache, abdominal pain, changes in vision, or gains a lot of weight quickly, she could have preeclampsia. If she has vomiting and yellowing of the eyes combined with itching, she could have a pregnancy-related liver disease. A woman may want to take childbirth classes to prepare for labor and birth. She’ll learn that she should go to the hospital immediately if she has any of the following symptoms: her water breaks, the baby stops moving, vaginal bleeding, or strong and regular contractions. Now, let’s talk some more about labor, called labor in English. There are 3 stages. The first stage begins with regular contractions and ends when the little opening of the cervix fully stretches out to 10 centimeters. This is the longest stage of labor, and can last for many hours. When the contractions get closer together, her doctor will tell her to go to the hospital. The doctor may want to monitor the baby’s heartbeat by putting straps around the mother’s abdomen. The second stage involves pushing and the delivery of the baby. It can last from minutes to a few hours. A woman can give birth in many positions, such as squatting or lying back. The mother should choose the birth position that feels best to her. The third stage involves delivery of the placenta and usually takes less than 30 minutes. Contractions will begin after birth to deliver the placenta. Labor is now over. The doctor will repair any tears from the delivery. For labor pain, some women prefer natural methods of pain relief, such as breathing techniques, using cold washcloths on the forehead, or listening to music. There are also medical pain relief options, such as an epidural. This is a small tube that is placed in the mother’s lower back through which numbing medicine is given. The doctor can help the mother decide what pain control method is best for her. Sometimes, a Cesarean delivery, called Cesarean delivery or c-section in English, might be necessary for the health of the mother or baby. A c-section is a surgery that delivers a baby through the mother’s abdomen. The doctor will recommend a c-section if she thinks it is safer than a vaginal birth. Most c-sections are done when unexpected problems happen during delivery. For example, the baby’s heart rate could be too low, perhaps from the umbilical cord wrapped around the baby’s neck. There are many other reasons for a c-section. If your doctor advises a c-section, talk to her to understand the risks and benefits. A Cesarean delivery usually takes less than an hour in an operating room. Remember, it is generally a safe surgery and worth the risk to save your life or your baby’s. A c-section does not affect a woman’s ability to get pregnant again. A vaginal birth after c-section is also possible. My experience with the C-section was to deliver the baby safely and to protect both of us, and to deliver safely and totally healthy. I was scared at first, but when the doctor explained it to me, I accepted, and everything went the way it was supposed to go. I would say to them, consult with your doctor and the c-section will not cause you any problems. Your and your babies’ lives will be saved Sometimes, a doctor might need to bring about labor if it hasn’t happened naturally. Using medicine to start labor is induction, called induction in English. This often happens when a woman is past her due date (over 42 weeks in her pregnancy), but labor has not yet begun. There is a higher risk of health problems and death if a baby is born after 42 weeks. A baby past its due date is more likely to have its first bowel movement while still inside the mother; the baby can suffocate from breathing in this bowel movement. A baby not born by its due date may also grow too large, causing injury to both the mother and baby during delivery; or the amniotic fluid surrounding the baby may become too low. If the baby’s or mother’s life is at risk, induction may be started even if the baby is not past 42 weeks. If your doctor suggests inducing labor, talk to her to understand the risks and benefits of induction. I had some worries about it [my induction], and many people in my family and friends were making me worried, too. However, the doctor told me that my child and I would be saved, and in fact, we would not experience any difficulties. Medicine was given to me, and then after the medicine, I went into labor and had the baby without any difficulties After the birth. This time is called postpartum in English. After the birth of the baby, the doctor will tell the woman about what she may experience as her body starts to recover. A woman should have a postpartum visit about 4 – 6 weeks after birth. After childbirth, many mothers may feel sad and overwhelmed for a few days. These feelings are normal and usually go away quickly. But if you are feeling sad for more than two weeks, call your doctor. You might have postpartum depression. Postpartum depression can happen any time within the first year after birth. Signs include crying a lot, having no energy, not having any interest in the baby, feeling worthless or guilty, and thoughts of harming yourself or your baby. Postpartum depression can make it hard for a new mother to take care of her baby. If this happens to you, you are not crazy! Confide in someone you trust and tell your doctor. Therapy and/or medicine can treat postpartum depression. New mothers must take special care of themselves after giving birth to regain their energy and strength. When a woman takes care of herself, she is able to best care for her family.