Terms of Pregnancy

Operculum Mucus plug in the cervical os Quickening Mother feels the fetus move (usually starts between 16-20 weeks gestation) Braxton Hicks Intermittent contractions of the uterus (usually start between 16-20 weeks) Lightening Fetus descends into the pelvis; engages (usually 39-40 weeks) Gravidity The state of a woman being pregnant Refers to the number of times she has been pregnant (any duration) o Gravida: pregnant o Primigravida: pregnant for the first time o Multigravida: pregnant again, or has had 2 or more pregnancies Parity The state of a woman haven given birth to a viable fetus (i.e. capable of surviving even if they did not survive) *Does not reflect the number of babies delivered o Primipara: delivered one viable pregnancy o Multipara: has delivered 2 or more viable pregnancies Examples: Gravida 1, Para 0 currently pregnant for the first time was pregnant once and lost the pregnancy Gravida 1, Para 1 delivered a viable fetus from her first pregnancy delivered viable twins (or more) from her first pregnancy Gravida 2, Para 0 currently pregnant for the second time, lost the first pregnancy pregnant twice and lost both Gravida 2, Para 1 pregnant for the second time, first pregnancy was a viable delivery Gravida 2, Para 2

pregnant twice and both were viable deliveries

Doulas woman who serves Provide continuous support that includes physical comfort measures, emotional reassurance, and information and suggestions to improve progress or ease discomfort o Knowledge: knowing what to expect can reduce fear which can in turn reduce pain o Skin stimulation: massage, warm bath or shower, and/or cold compresses on neck and face o Relaxation: progressive relaxation of all your muscles will allow the uterus to do its work and may decrease pain o Change of position: walk, sit, squat, rock on all fours o Nourishment: food and liquid reduce stress hormones; gives needed energy o Brain activity: puzzles, word games, cards, music, & focused breathing Midwives Specialize in caring for healthy women anticipating a normal pregnancy and birth Focus on health and wellness; encourage women and families to join in decision-making Trained to identify possible problems in pregnancies; work with physicians for complicated pregnancies Certified nurse-midwife (CNM) Registered nurse who has additional education and certification in midwifery Trained to provide prenatal care, education, and support; attend a birth in a birth center, hospital or home; provide follow-up care to mother and newborn after birth Most are licensed to write prescriptions and provide well-woman care such as gynecological checkups, pelvic and breast exams, pap smears, & family planning Certified midwives (CM) Like CNMs they are certified by the American College of Nurse Midwives Come from backgrounds other than nursing (i.e. physicians assistant, physical therapists, or other health professionals) Comparable to CNMs Certified professional midwives (CPM) Have passed the certification exam of the North American Registry of Midwives (NARM) Provide prenatal care, care during labor and birth, and postpartum care of the mother and her baby in the early weeks after birth Most attend births in birth centers or at home Family Physicians Focus on healthcare needs of the entire family (not all include maternity care in their practice) May work hand-in-hand with an OB if a complication arises during pregnancy, labor or birth

Primarily attend births in hospitals

Obstetricians Either MD or DO and has completed a 4 year residency program in OB/Gyn Care for women before, during, and after their pregnancies Trained to identify and treat medical problems in pregnancy; trained in surgery and are able to perform cesarean sections May manage high-risk pregnancies with a perinatologist Perinatologist OBs with additional training in managing high-risk pregnancy and birth Consult with and accept referrals from other maternity care providers Practice mostly in major medical centers in large cities

Special Diagnostic Tests Depending on age and risk factors Ultrasound Uses sound waves to create an image of the fetus Can be used anytime after 5 weeks gestation Should have a medical reason for being performed Determining twins, more accurately estimating the due date, suspected complication, etc. Although no side effects have been identified, we do not know what the long-range effects are

Alpha-fetoprotein (AFP) Blood test usually offered between 15-18 weeks Screen for birth defects (spina bifida, Down Syndrome) *Only indicates increased risk, it does not establish that a birth defect exists Amniocentesis Usually performed between 14-18 weeks Insert a long, thin needle through the abdomen into the uterus (using ultrasound as a guide) to withdraw a sample of amniotic fluid Used to determine whether the fetus has a genetic defect Risk of infection, hemorrhage, leaking of amniotic fluid, and/or miscarriage Glucose tolerance testing May be conducted between 24 and 28 weeks Mother drinks a highly concentrated glucose solution and blood samples are taken one hour later (sometimes more)

Adapted from Journey to Parenthood. Your guide through pregnancy, birth and beyond. Childbirth Connection 2007. More information available at www.childbirthconnection.org