First Trimester

The first stage of your pregnancy includes week 1 to week 12, or the first three months. The week after fertilization, a microscopic ball of cells implants on the wall of the uterus, which signifies the beginning of hormonal and physical changes.

The third through eighth week of your first trimester are referred to as the embryonic stage.  During this stage, your baby will begin to develop major body organs, and is especially vulnerable to damaging substances.

During the ninth week of your first trimester your baby will develop 1 inch in growth, and will transform from an embryo to a fetus.

 Pregnancy side effects may include:

• Fatigue
• Tenderness of the breasts
• Increased urination
• Nausea or morning sickness
• Constipation
• Mood swings
• Vaginal discharge
• Vaginal bleeding

Second Trimester

The second stage of your pregnancy includes week 13 to week 27, and this is when women begin to “look pregnant.” For most women, this stage is described as the easiest part of pregnancy because early side effects of pregnancy begin to fade away and the discomfort of the final weeks of pregnancy have not yet arrived.

 It is between 18 and 22 weeks that you will begin to feel your fetus move.

Side effects may include:

• Breast changes
• Leg cramps
• Back pain
• Stretch marks
• Nose bleeds
• Constipation
• Carpel Tunnel Syndrome

Third Trimester

The third and final stage of your pregnancy includes week 28 until birth.  A typical due date is 40 weeks after fertilization, but some women deliver between the 37th and 42nd weeks.  It is during this stage of pregnancy that your fetus gets larger and its body organs mature.

 Side effects may include:

• Braxton Hicks Contractions
• Fatigue
• Back pain
• Pelvic/hip pain
• Constipation
• Heartburn
• Difficulty sleeping
• Trouble breathing
• Frequent urination

There are three main types of abnormal pregnancies. These include an early pregnancy failure, an ectopic pregnancy, and a molar pregnancy. It is important to know the signs and symptoms of abnormal pregnancies, so that you can seek our medical attention, if you believe you are at risk.

Early Pregnancy Failure

This abnormal pregnancy occurs when there is a failure in the embryonic growth. This can be detected through an ultrasound. The image would appear as a large gestational sac, and this would signify that the growth of the embryo had failed. There are usually no symptoms of this condition, except some bleeding or cramps.

Ectopic Pregnancy

This condition occurs when the fertilized egg implants outside of the uterus. Ninety-five percent of the time, the egg would settle in the fallopian tubes; however, it is also possible for the egg to settle in the ovary, abdomen, or the cervix. Unfortunately, none of these organs have enough space or nurturing tissue for the pregnancy to develop. This can be very dangerous, because if the embryo does happen to grow, it could endanger surrounding organs of the mother.

If the ectopic pregnancy is discovered early enough, an injection can stop the growth of the embryo. However, if the abnormal pregnancy is not detected until later, one would need surgery to remove it.

 Warning Side Effects include:

• Sharp or stabbing pain
• Vaginal bleeding
• Vaginal spotting
• Dizziness
• Low blood pressure
• Low back pain

The most common signs of an ectopic pregnancy include sharp or stabbing pain and/or vaginal bleeding. Other symptoms include vaginal spotting, dizziness, low blood pressure, or low back pain.

Molar Pregnancy

Often, a molar pregnancy will mimic a healthy pregnancy. This occurs when a genetic error takes place during the fertilization process, which leads to the growth of abnormal tissue within the uterus.

 A compete molar pregnancy will result in only a placenta and no baby being formed, while a partial molar pregnancy will result in several defects to the embryo, and eventually the fetus will be overcome by the growing abnormal mass. A very rare version of the partial mole will happen when twins are conceived, with one developing normally and the other mole. In this case, the healthy embryo will quickly be consumed by the abnormal growth.

This abnormal pregnancy is very rare, but also very frightening. Only 1 in every 1,000 women in the United States suffer from this condition, with women over the age of 40 being at a higher risk.  Women who have had a previous molar pregnancy are also at a higher risk to have another one.

A molar pregnancy can be detected through a pelvic exam, or by a sonogram.

Warning side effects include:

• Vaginal bleeding
• Nausea
• High blood pressure levels
• Increased hCG levels
• No fetal movement or heart tone

The labor and delivery of a baby can be very nerve-racking, but also very exciting for parents. This is considered a very personal event, so Sarah Miller will be there to help evaluate your progress and to provide physical and emotional support.

There are three stages of delivery, and the process can take anywhere between 12 to 24 hours or more for the first birth.

Stage 1

This is the longest stage of labor and delivery, and usually lasts up to 20 hours. This stage begins when the cervix begins to dilate and finishes when it is completely open, which is 10 centimeters apart. The first phase of this stage is called the latent phase. During this phase, the mother will experience mild contractions, which are 15 to 20 minutes apart and usually last 60-90 seconds.  Once the cervix becomes 4 to 8 centimeters dilated, the mother will enter the active phase.  During this phase, contractions will become more regular lasting 45 seconds and usually are about 3 minutes apart. This phase also comes with increased bleeding and more severe backaches. Towards the end of this phase the mother’s water could “break,” resulting in stronger contractions. These are 2 to 3 minutes apart and last about one minute.

Stage 2 

This stage occurs when the mother becomes fully dilated and can last for two hours or more.  This stage continues as the baby passes through the birth canal, on through the vagina, until the baby is born. At the beginning of stage two, the contractions will begin to feel different. At this point, the contractions will slow to 2 to 5 minutes apart, lasting 60-90 seconds. While the urge to push will be very strong, the mother should only do so when instructed to do so by the OB/GYN or mid-wife.

Stage 3 

This stage begins after the baby is born and ends when the placenta separates from the wall of the uterus and passes through the vagina. This stage can last anywhere from 3 to 20 minutes.  During this time the mother may experience contractions, but they will be less painful. If a tear or episiotomy occurred during the birthing, this will be sutured after delivery.

One in 10 American couples are infertile. Despite common beliefs, male infertility is just as common as female infertility. There can be many reasons as to why infertility occurs, but it does not mean a couple is never capable of having a child. Because of drugs and other high-tech procedures, over 50% of couples that are infertile eventually are able to have a successful pregnancy.

It is important to know that you are 10 times more likely to conceive if you get medical help. So if you are having trouble conceiving, you should consult Dr. Ferguson for a full medical work-up and evaluation.

 Causes and symptoms of infertility may include:

• Uterine fibroids
• Pelvic inflammatory disease
• Women over the age of 35
• Tobacco, marijuana, and other drugs
• Chemotherapy
• Painful menstrual periods
• Pelvic infection
• Abdominal surgery
• Irregular menstrual cycles

Postpartum depression affects 1 in 8 women in the first few months following pregnancy and giving birth. This condition can bring about feelings of sadness, hopelessness, anxiety, trouble sleeping, mood swings, irritability, and the feeling of being numb to emotions. Postpartum depression can become serious, so if you believe you are at risk, you should consult your doctor.  This condition can be treated with antidepressant drugs and/or counseling.

The two types of depression include early onset and late onset. Of the women diagnosed with this condition, 80% are diagnosed with early onset and 10-16% are diagnosed with late onset.  The late onset form of postpartum depression is more severe and will require a higher level of care. If you experience more than two weeks of “baby blues,” you should tell one of the Carolina Women’s Physicians medical staff immediately.

To prevent suffering from postpartum depression you should:

• Ask others for help, so that you can sleep, eat healthy, and exercise.
• Stay away from alcohol, caffeine, and other drugs in the first few weeks following pregnancy and delivery.
• Monitor your condition closely, and don’t go more than six weeks before seeing your doctor for a postnatal check-up.

Carolina Women’s Physicians is dedicated to treating patients that are affected by the medical challenges in obstetrics. Our knowledgeable staff is trained to help you through every stage of your recovery. We will educate you about your condition, develop an individualized treatment plan, and help you and your family to cope with your condition. If you have any health concerns or want more information about medical challenges in obstetrics, please talk to your doctor.

Carolina Women’s Physicians has cutting edge technology available for you and your baby.  The ability to capture a 3-D picture of your child with real time movement is called a 4-D ultrasound.

The procedure does not use radiation or any other agents that may be harmful to you or your baby.

This ultrasound is not prescribed for medical purposes and does not take the place of a physician’s diagnostic ultrasound. The best time to perform the procedure is between 28 and 32 weeks.