Yay! You’re pregnant! So what’s next?
Planned or unplanned, whether it’s your first or your fifth, pregnancy is exciting and nerve-wracking at the same time. When you’re pregnant, everyone has an opinion about what you should and shouldn’t do. The good news is, most of those opinions are wrong!
Let’s separate fact from fiction. Here you’ll find only scientific and evidence-based answers to your pregnancy questions and concerns. Some of the answers may surprise you, but much of what you have heard and read about pregnancy is just not true.
Click here to read about what happens at your prenatal visits.
If you don’t have a doctor yet (or even if you do), you might wonder what you should look for in an OB/GYN. The world is full of advice about this question, but here’s ours:
- A good OB will have a low Cesarean delivery rate (don’t be afraid to ask – if they don’t know their rate, it’s probably too high).
- A good OB will never cut episiotomies.
- A good OB will be okay with letting you do almost anything during your pregnancy or delivery.
- A good OB will be supportive of a trial of labor for a vaginal birth after Cesarean delivery (VBAC).
- A good OB will not push you towards elective induction of labor.
Sometimes the best place to start is by picking the hospital where you would like to deliver. Don’t be afraid to call the birth units of your local hospitals and ask these same questions. A lot of hospitals have Cesarean rates well above 30% – even above 50%. Those are probably places to avoid.
If you have specific concerns, ask for specific examples. For example, let’s say you have had a previous Cesarean and want to attempt to have a vaginal birth after Cesarean (VBAC); don’t just ask whether a doctor or hospital will allow women to try to have a vaginal birth. Instead, ask them what percentage of their eligible patients attempt a VBAC and are successful.
Many providers have learned to say the right things to get patients in the door, but they actually don’t support things like VBAC or external cephalic version (turning a breech baby so that its head down to avoid a Cesarean) or vaginal delivery of twin pregnancies. So, ask them how often they do it – not just whether they will “let” you try.
Hopefully, you already have a doctor or midwife that you know and trust, or will find one soon. If you are stuck seeing someone who you think isn’t quite what you want, don’t be afraid to switch. Remember, it’s your pregnancy – not theirs.
Click here for full explanation of what should happen at your prenatal visits.
How your due date is calculated is often confusing and different from what you might expect. Pregnancy is 40 weeks, or 280 days, long when measuring from the first day of the last menstrual period. But conception occurs usually two weeks after the first day of the last menstrual period. This means that at the time of conception, a woman is already two weeks pregnant when measured this way. This assumes that her menstrual cycles are 28 days apart.
There are plenty of pregnancy due date apps and calculators that will tell you your estimated due date (EDD) based upon the first day of your last menstrual period (LMP). There’s even one on the front page of wonderfulpregnancy-com.preview-domain.com. Calculating your EDD from your LMP assumes a few things:
- That you remember the first day of your last menstrual period correctly;
- That you weren’t on birth control or something that would alter your cycles at the time of conception;
- That you have regular, 28-day cycles.
If your cycles are shorter or longer, your due date must be adjusted. If you don’t remember when your period was or you were on birth control at the time, you will probably have to be dated by an ultrasound. The earlier the ultrasound is performed, the more accurate it is for estimating your due date. Your doctor or midwife will help you figure out an exact due date at your first or second visit.
Many times, women don’t remember the exact day of their last menstrual period, or they may not have menstrual cycles that are exactly 28 days long, or they might have been on birth control at the time of conception. Sometimes women ovulate a little bit later than usual, or the bleeding they thought was their last menstrual period was actually related to the pregnancy (e.g., implantation bleeding). All of these factors mean that dating based on the last menstrual period is wrong about 40% of the time. Your doctor or midwife will determine your due date based on your last menstrual period and compare that to a due date determined by the earliest ultrasound, and in some cases, your due date will need to change based on the ultrasound.
As we said, the earliest ultrasound that you have is the best one to determine your due date. Sometimes, patients are confused because subsequent ultrasounds will show measurements that have a slightly different due date and they will wonder if their due date should be changed again based on these later ultrasounds. The answer is no. The later ultrasounds reflect a pregnancy that is just a little bigger or smaller than the average for that gestational age or vary just because of the margin of error of the scan.
Make sure you clarify at one of your first prenatal visits what your final estimated due date is; then, don’t get too fixed on that day. Only 2% of women deliver on their due date. Maybe we should’ve called it a due month!
Good question. The truth is, you can eat just about anything you want. Click here for a full explanation. The short answer is to not eat:
- Big fish with high levels of mercury (shark, swordfish, king mackerel, and tilefish)
- Unpasteurized milk and soft cheeses
- Raw or undercooked meats
- Cold cuts (lunch meat, salami, etc.)
Finally, make sure you wash your fruits and vegetables well before eating them. The absolute risk of the anything that happening from eating any of these foods is incredibly low. So you shouldn't worry too much; but pregnancy isn't the time to explore strange and new foods from uncertain sources.
Normal weight women (BMI of 18.5-24.9) should gain about 25-35 pounds during their pregnancies. Underweight women (BMI < 18.5) may need to gain more and overweight women less. For obese women (BMI > 30), dieting is safe and beneficial during pregnancy. Most weight gain comes in the second half of pregnancy and often women have gained no weight or even lost weight by their 20th week; this is healthy and okay.
We check your weight at every visit, but please don’t focus on how much you gain. We are usually not worried about you gaining too little weight but instead gaining too much weight. Excess weight gain increases the risks of several pregnancy complications, including the risks of preeclampsia, diabetes, fetal macrosomia (a big baby), and Cesarean delivery.
Many overweight women can gain no weight for the entire pregnancy or even lose some weight if they’re actively dieting. This is not a bad thing. Maternal weight gain, if it is excessive, is associated with a larger fetal size; but that doesn’t mean that gaining too little weight during pregnancy will not make your baby too small if you are overweight at the start of the pregnancy. The goal is to have a healthy baby and a healthy mom. Talk with your doctor or midwife about what your weight journey should look like throughout pregnancy based on your pre-pregnancy weight.
Yes, you can.
As with most things in life, moderation is the key. Scientific studies have not demonstrated any problems with caffeine consumption during pregnancy until a woman consumes over 700 mg per day. That’s a lot of caffeine! To be safe, and to make sure that a woman never approaches that amount of caffeine consumption, we recommend that women limit themselves to 350 mg of caffeine per day.
Click here to find out how much caffeine is in your favorite beverage.
Pregnant women are often excessively tired in the first and third trimesters, but probably for different reasons. In the first trimester, your body undergoes rapid physiological changes accompanied by high levels of hormones that conspire to exhaust you. Couple this with food aversion or nausea and vomiting, and the result for many women is complete exhaustion.
This tends to get better by the second trimester and then in the third trimester, particularly the last few weeks of pregnancy, exhaustion returns as you sleep less at night and carry around 30+ extra pounds during the day. If you have another small baby or two at home already, then the effect is even worse.
To help with symptoms in the first trimester, you can work on minimizing the effects of nausea and vomiting of pregnancy by eating several small meals or snacks throughout the day and adding vitamin B6 twice a day if you haven’t already. Naps sometimes feel like a good idea, but they often have the opposite effect than what you desire. Napping can interfere with your ability to get good rest at night and this can create a vicious cycle. Going for a walk or getting some exercise is probably a better idea and will improve your nighttime sleep.
Some women in the first trimester are excessively tired because they have cut caffeine completely out of their diets. Remember, you are still allowed to have up to 350 mg of caffeine per day; so don’t feel too bad about having that cup of coffee in the morning or maybe after lunch.
Many pregnant women need to work on maximizing their sleep hygiene. Make sure you have a dark room, maybe with a noisemaker, like a fan or something else that makes background noise, to minimize interruptions. Try to use your bedroom for sleep only; don’t make a habit of watching TV from your bed or staring at your phone. Women in the third trimester often find every little uncomfortable spring in their mattresses with their rounder bellies and hips. Try adding an extra layer of egg crate or a foam topper to your mattress and make sure you have a long pillow that you can hug with your legs. A hot shower about an hour before you go to sleep can also make a huge difference.
Also, be sure to empty your bladder right before you go to sleep and if you find that you are waking up to pee several times a night, you might need to restrict water intake for two to three hours before going to sleep.
In rare cases, excess fatigue might indicate another problem like a thyroid abnormality or anemia; if you feel like you are more tired than the average pregnant woman, be sure to talk to your doctor.
If you are occasionally tired or having a difficult time getting to sleep, tossing and turning, etc. an antihistamine like Unisom SleepTabs or Benadryl can be a safe option for moms to help with sleep. We recommend trying healthy sleeping habits before resorting to medications. Finally, if you are snoring a lot, you might have sleep apnea. A sleep study and treatment for this can be life-changing! Don’t hesitate to talk to your doctor about a sleep study while you’re pregnant.
Nausea and vomiting during pregnancy is no one’s idea of a good time. Unfortunately, it affects about two-thirds of pregnant women. The good news is, nausea and vomiting are not associated with risks to the pregnancy; the bad news is, you are nauseated and throwing up.
What can you do?
- Eat several small meals per day and avoid high-fat foods.
- Eat more bland foods and avoid smells that are noxious.
- Increase the protein and liquid content of your food.
- Ginger ale, ginger teas, or ginger capsules can help (three 250 mg capsules a day and one before bed).
- Taking a vitamin B6 supplement (25mg) 2-3 times per day alone or in combination with Unisom SleepTabs (doxylamine) at night may be beneficial.
Your doctor may need to prescribe an anti-nausea medicine for you if these remedies don’t resolve the issue. There are several drugs that are safe in pregnancy to choose from, including ondansetron (Zofran), metoclopramide (Reglan), promethazine, haloperidol, and a few others.
Make sure that your acid reflux and constipation are treated since both of those can contribute to nausea and vomiting as well.
In bad cases, you may need to be hospitalized for IV fluids and other treatments if you are unable to keep anything down and experiencing signs of severe dehydration/malnutrition. Hopefully, you should feel better by the end of the first trimester. If you don’t, or if the above remedies are not working, your doctor may need to investigate other causes of your nausea and vomiting apart from pregnancy. Typically, you shouldn’t be concerned as long as you can maintain your body weight and stay hydrated during the first trimester. If you lose a few pounds from the nausea and vomiting, it isn’t too concerning; but, more significant losses should be investigated further.
Almost all women have some cramping or other pains during pregnancy, particularly in the first trimester. This cramping is almost never anything to be worried about, particularly if you’re not bleeding. In the first trimester, the uterus grows rapidly and most of the cramping that a woman experiences is simply growing pains. As the uterus gets bigger, it becomes top-heavy and has a tendency to pull and tug from one side to the other. This will stretch ligaments, particularly the round ligaments of the uterus, and cause either cramping or sharp pains in the groin. None of these symptoms put the baby at risk.
Sometimes cramping is not related to your uterus at all. Many women become constipated during pregnancy and the cramping they experience is actually related to their bowels slowing down. Sometimes cramping is related to the bladder and might be a sign of bladder infection, but almost always there will be other symptoms like burning when you pee.
In the second and third trimesters, cramping is often what is called Braxton-Hicks contractions. We will talk about these contractions and compare them to real labor contractions later when we answer the question, “How can I tell if I’m in labor?”.
In most cases, the answer is no.
There is a whole industry that markets supplements and other products to pregnant women. Even among prenatal vitamins, for most women the only ingredient that is actually required is folate, and folate is only necessary until the baby’s neural tube is closed, which happens early in the first trimester. The truth is, prenatal vitamins are best taken beginning at least two to three months before pregnancy and provide little to no benefit past the first half of the first trimester. In fact, if you are beyond six weeks and prenatal vitamins are making you nauseous or constipated, there’s no reason for you to keep taking them.
Aside from the folate in a prenatal vitamin, the other ingredients often found in these vitamins are not science-based. Don’t get caught up in buying the most expensive prenatal vitamin because the company says it will make your child smarter or reduce the risks of pregnancy; this simply is not true.
In some cases, due to restrictive diets or preexisting anemia or other risk factors, your doctor might ask you to take an additional supplement or medication, most commonly iron.
The most important vaccine that you should get prior to pregnancy is the MMR (measles, mumps, rubella) vaccine. Many people received this vaccine during their childhood; however, immunity can wane over time. Your doctor can order a blood test called a titer that looks at your immunity to those diseases and will decide based on your antibody levels whether you should get the vaccine again. Historically, congenital rubella syndrome was a devastating disease that affected newborns whose mothers developed rubella in the first trimester. Thankfully, because of the vaccine, this condition is now rare with fewer than 1,000 cases a year but even those are preventable.
If you are pregnant during flu season, you should have a flu shot as soon as it’s available. We also recommend that you stay up-to-date with any needed COVID booster shots and you can receive this vaccine during pregnancy if needed. Seasonal flu and COVID infections are a leading cause of maternal death and pregnancy complications and these vaccines are highly effective and safe. If you are between 32-36 weeks’ gestation during the months of September to January, you should also receive the RSV vaccine to protect your newborn against RSV infection in those peak months after birth. We also recommend the Tdap vaccine during pregnancy to protect you and your newborn against whooping cough (pertussis). We recommend this between 27-36 weeks’ gestation to optimize the production and transmission of antibodies across the placenta to protect your newborn. If you happen to receive this shot earlier in pregnancy for some reason (maybe you stepped on a nail), you don’t need to repeat it later.
Most women have traditionally learned the sex of their baby at the time of the anatomy ultrasound, at around 18 to 20 weeks. Today, most women find out earlier. If you happen to have an ultrasound any time after 14 weeks, usually the sex is visible. Ultrasounds at around 12 weeks can sometimes lead to a guess about the fetal sex (the angle of the dangle), but these guesses are only about 85% accurate.
If you choose to have NIPS performed, this includes the fetal sex so you may be able to find out as soon as 11 weeks’ gestation if you do the test at 10 weeks’ gestation.
Many women choose to not find out the sex of their baby until after it is born, but most women want to know. If you’re planning a gender reveal party, make sure you tell your doctor and your sonographer ahead of time so they don’t give away something accidentally. They can always put the answer in a sealed envelope. If you don’t want to find out until after the baby is born, make sure you tell whoever might do an ultrasound at any time that you don’t want to know; if it’s a later ultrasound, they will assume that you already know and they may say or show something that you don’t want to see.
The scientific ways of determining the fetal sex are:
- Ultrasound
- Noninvasive prenatal testing
- Amniocentesis
- Chorionic villus sampling
There are also some not so scientific ways that you’ll read about on the Internet. None of these work:
- Chinese gender charts
- Fetal heart rate (under 140=boy, over 140=girl)
- Wedding ring test (pendulum=boy, circle=girl)
- Peeing on Drano (brown=boy, no color change=girl)
- Carrying high vs low (low=boy, high=girl)
- Morning sickness (absent or mild=boy, present or severe=girl)
- Location of weight (belly=boy, hips and butt=girl)
- Placental location (right=boy, left=girl)
Most of these are harmless fun, but there are some products on the market that take advantage of these myths. Don’t waste your money.
If you are pregnant during flu season, you should have a flu shot as soon as it’s available. We also recommend that you stay up-to-date with any needed COVID booster shots and you can receive this vaccine during pregnancy if needed. Seasonal flu and COVID infections are a leading cause of maternal death and pregnancy complications and these vaccines are highly effective and safe. If you are between 32-36 weeks’ gestation during the months of September to January, you should also receive the RSV vaccine to protect your newborn against RSV infection in those peak months after birth. We also recommend the Tdap vaccine during pregnancy to protect you and your newborn against whooping cough (pertussis). We recommend this between 27-36 weeks’ gestation to optimize the production and transmission of antibodies across the placenta to protect your newborn. If you happen to receive this shot earlier in pregnancy for some reason (maybe you stepped on a nail), you don’t need to repeat it later.
Pregnant women are often excessively tired in the first and third trimesters, but probably for different reasons. In the first trimester, your body undergoes rapid physiological changes accompanied by high levels of hormones that conspire to exhaust you. Couple this with food aversion or nausea and vomiting, and the result for many women is complete exhaustion.
This tends to get better by the second trimester and then in the third trimester, particularly the last few weeks of pregnancy, exhaustion returns as you sleep less at night and carry around 30+ extra pounds during the day. If you have another small baby or two at home already, then the effect is even worse.
To help with symptoms in the first trimester, you can work on minimizing the effects of nausea and vomiting of pregnancy by eating several small meals or snacks throughout the day and adding vitamin B6 twice a day if you haven’t already. Naps sometimes feel like a good idea, but they often have the opposite effect than what you desire. Napping can interfere with your ability to get good rest at night and this can create a vicious cycle. Going for a walk or getting some exercise is probably a better idea and will improve your nighttime sleep.
Some women in the first trimester are excessively tired because they have cut caffeine completely out of their diets. Remember, you are still allowed to have up to 350 mg of caffeine per day; so don’t feel too bad about having that cup of coffee in the morning or maybe after lunch.
Many pregnant women need to work on maximizing their sleep hygiene. Make sure you have a dark room, maybe with a noisemaker, like a fan or something else that makes background noise, to minimize interruptions. Try to use your bedroom for sleep only; don’t make a habit of watching TV from your bed or staring at your phone. Women in the third trimester often find every little uncomfortable spring in their mattresses with their rounder bellies and hips. Try adding an extra layer of egg crate or a foam topper to your mattress and make sure you have a long pillow that you can hug with your legs. A hot shower about an hour before you go to sleep can also make a huge difference.
Also, be sure to empty your bladder right before you go to sleep and if you find that you are waking up to pee several times a night, you might need to restrict water intake for two to three hours before going to sleep.
In rare cases, excess fatigue might indicate another problem like a thyroid abnormality or anemia; if you feel like you are more tired than the average pregnant woman, be sure to talk to your doctor.
If you are occasionally tired or having a difficult time getting to sleep, tossing and turning, etc. an antihistamine like Unisom SleepTabs or Benadryl can be a safe option for moms to help with sleep. We recommend trying healthy sleeping habits before resorting to medications. Finally, if you are snoring a lot, you might have sleep apnea. A sleep study and treatment for this can be life-changing! Don’t hesitate to talk to your doctor about a sleep study while you’re pregnant.
Every pregnant woman at some point in her pregnancy will begin to wonder if she is in labor. Most women have a few false starts. Braxton-Hicks contractions can be confusing and can become frequent and regular – at least for a short time – before going back to their irregular pattern. Women frequently have physiologic discharge or will urinate and wonder if their water is broken. So how can you tell real labor from false labor?
The answer is time. Real labor is progressive in every way, but you won’t be able to see this until some time has passed. If you’re having some regular contractions, the best thing to do is to see what happens over the next two to three hours. If you are really in labor, your contractions will become more frequent (maybe going from every six to seven minutes apart to every three to four minutes apart), last longer (going from, say, 30 seconds in length to 45 or 50 seconds in length), become more painful, regular, predictable, and persist. False labor, on the other hand, may start strong but will lose steam and wane over two to three hours.
If it’s your first baby, you have plenty of time. Labor will likely last many hours and you will have plenty of time to arrive at the hospital. If it’s your fourth baby, then you already know what to expect. If you are reading this anyway, your labor probably won’t last that long and you should head to the hospital a little sooner.
In some cases, your doctor may ask you to come to the hospital a bit earlier; for example, if you’re positive for group B Strepococcus, then you will need four hours of IV antibiotic therapy in addition to however long it takes to get to the hospital, get admitted, and get an IV started before the baby is born.
If your water breaks, you should probably head to the hospital. This may be a sign that your labor is already very advanced, since water tends to break on its own at an average of about 8 cm. If your water is broken and you’re not already in labor, then you should still go to the hospital because your labor likely needs to be augmented or induced. If you have had a previous Cesarean delivery, then you should come to the hospital much sooner because you do not want to risk laboring at home. A trial of labor after Cesarean is a good idea for most women, but because of the risk of uterine rupture, that trial of labor should happen at the hospital to maximize the safety for mom and baby.
You can’t always tell; but, in general, once your water breaks, it keeps coming. Ruptured membranes are not just a small gush or a little bit of spotting; if you think your water has broken, clean up and see if the leakage persists. If it does or you are unsure, you probably need to be examined.
Discharge is common in pregnancy but usually never results in more leakage than would fill a small pad or panty liner. If you are getting cervical checks at your later appointments, the gel we use can sometimes appear later as a leakage of fluid but it is usually only a small amount and you would not see continued leakage.
Probably the most common reason why women believe that their water has broken is because they have peed on themselves. Most women cannot believe that they have peed on themselves, especially if they never felt the urge to pee, but in the third trimester with the baby’s head smashed right against your bladder, this is a common occurrence. If it happens on your bed sheets or in your underwear, you won’t always be able to tell that it is urine by smell or color alone. Amniotic fluid has a unique odor that is like a combination of ejaculate and bleach; that may not be helpful if you’ve never smelled amniotic fluid before, but when you do maybe you’ll recognize it.
All of this being said, large gushes with continual leakage after the fact should be assessed at the hospital or your doctor’s office. You may be ready to rock and roll!
There’s no reason to check your cervix unless you’re having signs of labor, like regular contractions, or bleeding or leakage of fluid. If you’re considering an induction, checking your cervix might help determine how good the idea might be. If your cervix isn’t ready for labor (not dilated at all), then an induction might unnecessarily increase your chances of a Cesarean delivery.
Inductions happen for lots of good reasons – but also some not so good ones. Unless there’s a medical reason to do so, you shouldn’t be induced before 39 weeks’ gestation. Even at 39 weeks, induction might not be the best idea unless your body is ready for labor. Checking your cervix can help determine this. Otherwise, it might be better to wait until 41 weeks. After 41 weeks’ gestation, it’s unusual that going any further makes much sense due to increasing risks for the baby and no benefit to the mother in terms of decreased Cesarean rate (in fact, the risk of Cesarean actually goes up for most women after 41 weeks).
Sometimes you might need to be induced much earlier, but it should be because you have a medical problem like high blood pressure or some other complication.
No! Except in some very rare emergency cases, episiotomies should never be performed. If your doctor performs routine or frequent episiotomies, then he may not be practicing up-to-date medicine. We have known since the mid-1980s that episiotomies are harmful and unnecessary except in a handful of rare emergencies, such as severe shoulder dystocia.
This doesn’t mean that you might not tear, but however badly you might tear, an episiotomy likely would have made things much worse.
We hope not! But some women do, of course.
Cesarean delivery is definitely over-used in the United States. There are some good reasons why a woman might need one:
- If she has had a prior “classical” Cesarean delivery (where the incision on the uterus is made higher than normal)
- If she has had more than two prior regular (“low transverse” incision) Cesareans
- If she has placenta previa, where the placenta covers (or is very close to) the cervix or vasa previa (where placental blood vessels cover the cervix)
- If her baby is breech or sideways (and the doctor is unable to turn the baby to be head down)
- If her baby does not tolerate labor (this should be relatively rare and there are some specific criteria that can indicate this)
- If her baby is too big, which is more than 5,000 grams (or about 11 lbs) for a nondiabetic mother or more than 4,500 grams (or just under 9 lbs 15 oz) for a diabetic mother
- If her labor doesn’t progress or she is unable to push the baby out after sufficient time (many doctors don’t give women enough time for these things; however, we have criteria that we follow to determine if this is happening)
- If she has triplets or quadruplets, or monochorionic-monoamniotic twins
- If she has active genital herpes or uncontrolled HIV
Those are just about all of the reasons, aside from the more emergent ones we won’t go into here. We don’t know for sure, but as many as half of all Cesareans performed are unnecessary. Most of the unnecessary Cesareans are related to impatience. Guidelines from the American College of Obstetricians and Gynecologists (ACOG) will, if followed, result in significantly fewer Cesareans if doctors follow them.
Probably not. This is a trick question, though. You have to separate out laboring in the water and actually giving birth in water. Most of the known advantages of water birth are actually related to the process of laboring in water while the known disadvantages of water birth are associated with giving birth in the water.
For example, the benefits of reduced pain during the first stage of labor (that is, the part leading up to pushing), a shorter first stage of labor, and less need for anesthesia all occur before the birth itself takes place. At the same time, the reported disadvantages of a water birth all take place during the actual process of delivery, including newborn aspiration, drowning, infections, hyponatremia, depressed Apgar scores, and umbilical cord rupture. So, it probably makes the most sense to labor in the water and then get out when it’s time to push and have the baby on dry land.
If you think about it, nature designed the birth process to happen on dry land. One of the benefits of a vaginal delivery compared to a Cesarean delivery is that the baby gets most of the amniotic fluid squeezed out of her lungs while traveling through the birth canal so that her first breath, once delivered, is full of nice, clean air. This doesn’t always happen with a Cesarean delivery and, consequently, babies have higher rates of respiratory problems with Cesarean birth as compared to vaginal birth. In any event, when a baby is born vaginally underwater, the first inspiration by the baby may be underwater and therefore lead to aspiration of water with subsequent increased risk of infections, drowning, and other respiratory problems. Keep these things in mind when you read about water births being more natural than land births. There’s nothing natural about it at all. In fact, water births are a rather modern invention. Currently, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend against deliveries occurring underwater.
If you’ve had a previous Cesarean delivery (or two), you may be a candidate for a trial of labor after Cesarean (TOLAC). This is a complicated issue. The short answer is that most women with only one prior cesarean delivery should try VBAC (vaginal birth after Cesarean), but you should read more about it here.
If you are pregnant during flu season, you should have a flu shot as soon as it’s available. We also recommend that you stay up-to-date with any needed COVID booster shots and you can receive this vaccine during pregnancy if needed. Seasonal flu and COVID infections are a leading cause of maternal death and pregnancy complications and these vaccines are highly effective and safe. If you are between 32-36 weeks’ gestation during the months of September to January, you should also receive the RSV vaccine to protect your newborn against RSV infection in those peak months after birth. We also recommend the Tdap vaccine during pregnancy to protect you and your newborn against whooping cough (pertussis). We recommend this between 27-36 weeks’ gestation to optimize the production and transmission of antibodies across the placenta to protect your newborn. If you happen to receive this shot earlier in pregnancy for some reason (maybe you stepped on a nail), you don’t need to repeat it later.