Monthly Pregnancy guide

Learning you are pregnant is a joyous occasion. For the next nine months, you will go through many changes. Although each woman's pregnancy is different, this month-by-month guide can help you plan for some of the changes that may occur.

Your Body


By the end of the third month, you may have gained several pounds. You may feel very tired due to hormonal changes. Plan to get extra rest, sneaking in naps when you can and slow down. You should feel more energetic by the end of the third month.

You may need to urinate more frequently now. This is common during the first trimester of pregnancy, and again right before your baby is born.

For greater comfort, start wearing loosely fitting clothes.

See your health care provider by the second month to confirm your pregnancy. Regular check-ups will be scheduled for your prenatal care.

"Morning Sickness"


Nausea sometimes occurs early in pregnancy and usually goes away after the third month. Although it is called "morning sickness," it can happen any time of the day or night or you may never experience nausea.


Your Diet
Calcium, Fruits and Vegetables and Water


Calcium is very important for both you and your baby's bones and teeth. An easy way to include calcium in your diet is to eat and drink pasturized dairy products such as milk, cheese, yogurt and ice cream.

Eat plenty of raw fruits and vegetables, whole grain breads and bran cereal to make sure your bowel movements are regular. Be sure to drink plenty of water.

Your Feelings


Talk to your partner about how you are feeling. Ask for help, especially if you are tired. During this time you may be feel overweight and clumsy. Remember the extra weight is preparing your body for pregnancy and breastfeeding.

During pregnancy, it is common to have mood swings in your feelings about sex. It is not harmful to have sexual relations during pregnancy, but check with your healthcare provider about sexual activity during this time.



Month Four

Your Body


You may notice that you have more energy. Nausea and fatigue may stop. You may also notice that your belly looks larger because the baby has grown.

Your Diet


During pregnancy, your need for iron increases. To be sure you get enough iron, eat meats, leafy green vegetables, whole grain breads, dried fruits and beans.

Childbirth Preparation Classes


Childbirth classes should begin in month seven. Register now since classes fill up early.

Month Five

Your Body


Changes in your circulation require that you to stand and move often. Continue to do this throughout the remainder of your pregnancy. Your breasts may begin to leak a yellowish fluid called colostrum in preparation for breastfeeding and you may begin to feel the baby move during this month.

Your Diet


Be sure to eat food rich in Vitamin C. Your body does not store Vitamin C, so it is important to get a fresh supply every day. Good sources of Vitamin C are oranges, broccoli, and tomatoes.

Choosing a Health Care Provider for your Baby


Before you are admitted to the hospital to the hospital, you need to decide who will care for your baby after the delivery. This is a good time in your pregnancy to start looking for a health care provider for your baby if you have not already chosen one. Talk to your friends and ask them if they are happy with the health care provider who cares for their children. Many pediatricians and family care physicians will meet with you before your baby is born and let you interview them. It is a good idea to select someone that close to where you live! Month Six


Your Body


You may gain 3-4 pounds this month. Your feet may swell during the latter stages of pregnancy. Putting your feet up may help reduce any ankle swelling. Shop for wide, comfortable shoes, preferably with a flat heel.

Your Diet


You may crave certain foods or find that other foods smell or taste bad, even if you like them before you were pregnant. If this happens, try to find substitutes that provide the right nutrients.

Hospital Pre-Registration


If you have not already pre-registered at the hospital you will be delivering at, this is a good time to do so. Check with your health care provider or call the hospital directly for pre-registration information.

Month Seven

Your Body


You may gain 3-4 pounds this month. You may tire more easily. Again, ask for help. If you work, try to work shorter hours or a more flexible schedule if possible. Rest when you can.

Your Feelings


Mood swings and increased irritability are common during the last three months of pregnancy. Be sure to discuss your feelings with your partner.

Childbirth Preparation Classes


Begin childbirth preparation classes with your partner. These classes provide useful information on labor and birth, and what to expect.


Month Eight

Your Body


You may gain 3-4 pounds this month. Increases in frequency of urination, backaches, anxiety, heartburn, and shortness of breath occur at this time. Shop for larger maternity clothes, if necessary. You will be growing quite a bit these last few weeks.

Your Diet


What you eat is still important. If you have trouble sleeping, try drinking something warm and lying on your side with pillows to support your body. Taking a warm shower before bed also helps to relax you and make you sleepy.

Month Nine

Your Body


You may gain 3-4 pounds this month. Your stomach may change shape as the baby begins to position itself for birth. It may be easier to breathe now, but you may have to urinate more often. Get plenty of rest!

Hospital Stay


Make arrangements for your hospital stay. Keep important phone numbers and papers close by. Pack your bag for the hospital, and plan how you will get there at different times of the day or night. Make sure you have everything you will need when you come home from the hospital, such as food and diapers.

PRECAUTIONS for PREGNANCY

Special PRECAUTIONS

The first three months of pregnancy is the most crucial stage in your baby's development as all organs are forming. Throughout your pregnancy, but especially during the first three months, be very careful about using alcohol, drugs and medication. The following information outlines substances that require special precautions during pregnancy. Instructions are also given on how to keep track of fetal movements, an important sign of your baby's health.




Fish and Seafood



Fish and seafood are excellent low-fat sources of many nutrients and an important part of a healthy diet. However, there is a concern about eating fish and seafood during preganancy, since many types of fish may contain high levels of mercury. To be safe, choose wisely among types of fish.

Precautions

• Eat no more than 12 ounces of cooked fish a week.
  
• Do not eat shark, swordfish, king mackerel or tilefish.
  
• Limit albacore (white) tuna (even canned) to once a week.
  
• If you eat fish caught by family and friends from local waters, check local advisories about the safety of fish.
  
• Fish sticks and fast food sandwiches are commonly made from fish low in mercury

Alcohol



No one knows how much alcohol is safe to drink during pregnancy

The danger of alcohol use during pregnancy is that it may cause fetal alcohol syndrome (FAS). Babies born with FAS may:

• grow more slowly
  
• have learning problems
  
• have abnormal facial features

There is no cure for these problems caused by fetal alcohol syndrome.

Alcohol is an ingredient in many over-the-counter medicines. For example, some cough medicines are 25 percent alcohol. Ask your health care provider if you should use such products during pregnancy. Always read the label before taking any medicine.

Precautions

Because there is no known safe level of alcohol taken during pregnancy, the National Institute of Alcohol Abuse and Alcoholism and the March of Dimes caution pregnant women to follow the safest course:

• Completely avoiding alcoholic beverages while pregnant.
  
• Discuss your concerns about alcohol and pregnancy with your healthcare provider.

Caffeine



Caffeine is a stimulant that affects people differently. Caffeine can cause nervousness, irritability, anxiety, irregular heartbeats and problems sleeping. How caffeine affects an unborn baby is still under investigation. Some scientists believe caffeine can cause premature or smaller than normal babies or possible birth defects.

Precautions

• Cut down or eliminate food and drinks that contain caffeine such as coffee, tea, colas and other soft drinks, cocoa and chocolate.
  
• Caffeine is an ingredient in many non-prescription medicines such as headache, cold, allergy, and pills made to combat drowsiness.
  
• If you have been consuming caffeine in large quantities, gradually decrease your intake. Stopping all at once can cause severe headaches, nausea, fatigue and other symptoms. Check with your health care provider for more information.

Cigarettes



Cigarette smoking may lead to serious health problems. Women who smoke during pregnancy usually give birth to babies that weigh less than those of women who don't smoke. Low birth
weight babies are more likely to have health problems such as:

• Infections
  
• Trouble keeping warm
  
• Feeding problems
  
• Breathing problems.
  
• Sudden Infant Death Syndrome (SIDS)

New research shows that exposure to second hand smoke is also linked to SIDS and can cause major health problems to your baby.

Precautions

• Stop smoking or cut down your smoking when pregnant. There are many community programs available to assist you. Call the American Cancer Society for information on Smoke-Stopper Programs in your area. Call 1-800-NOBUTTS( 800-662-8887) .
  
• Avoid smokers and smoking areas whenever possible.

Food Additives



Precautions

Whenever possible, try to minimize your use of

• Processed food items (such as hot dogs)
  
• Foods containing sodium nitrate, such as cured meats (hams, bacon, etc.); these substances may be carcinogenic (cancer-causing) .
  
• Be sure to wash fruit and and peel carrots to avoid eating pesticides used on farms to kill insects.

Food Handling Concerns



Eating raw fish, meats or poultry may increase your risk of infection or parasitic disease. Cooking food destroys bacteria and parasites. Milk that is not pasteurized may also cause illness.

Precautions

• Avoid eating raw fish (sushi, ceviche), meats or eggs.
  
• Only drink pasturized milk.
  
• Cook your fish, meat, poultry and eggs thoroughly.
  
• Always wash cutting boards after slicing any raw fish, meats, or poultry.

Recommendations

• Run plastic cutting boards through the dishwasher.
  
• Microwave wooden boards for five minutes.

Medications and Herbs



Some medications and herbs may harm your baby. Before taking any medication or medicinal herbs during your pregnancy, ask your health care provider these questions:

• What is this medicine/herb?
  
• What does it treat?
  
• What are the side effects my baby or I may experience?
  
• What is the smallest effective dose?
  
• How long will I need to take this medication?

Precautions

Be cautious about using medicines that contain multiple ingredients. They are more likely to contain extra substances, that may harm your baby.

Saunas and Hot Tubs



Avoid saunas and hot tubs that maintain a temperature greater than body temperature. They can potentially cause overheating and possible affect the development of your baby.

Precautions

Avoid possible overheating. Check with your health care provider for recommendations.

Toxoplasmosis



Toxoplasmosis is a condition caused by a parasite found in cat feces, plant soil, and raw or undercooked meat. The parasite can cause brain damage in a developing baby if the mother becomes infected during pregnancy.

Precautions

• Avoid contact with cat feces. Have someone else change the litter box.
  
• Wash dirt from fresh produce before eating.
  
• Use gloves when you garden.
  
• A blood test is available to determine if you have been exposed to toxoplasmosis. Ask your health care provider for more information.
  
• Cook all meat to at least medium, preferably well done.

Video Display Terminals (VDTs)



At this time, there are no solid research findings regarding the effects of computer monitors or Video Display Terminals (VDT) on a developing baby.

Precautions

• Reduce your exposure to VDT's whenever possible.
  
• Be sure to take frequent stretch breaks and look away from the computer screen whenever possible.

Other Precautions and Concerns

Fetal Solvent Syndrome - Risk for Major Birth Defectors

Exposure to chemicals may cause birth defects. Talk with your health care provider if you are concerned about exposure to chemicals in your environment.

Rh Negative Mothers and Rhogam

If you (mother) are Rh negative and your baby's blood is Rh positive there is an Rh incompatibility. Because some of the baby's red blood cells leak into your system, your body will produce antibodies to fight the Rh factor as if it were a harmful substance. These antibodies will remain in your body and may affect your next baby. If you are Rh negative, you will be given an injection of Rhogam at about 28 weeks of pregnancy, and within 72 hours after a birth, miscarriage, abortion or amniocentesis. The Rhogam will prevent your body from making these harmful antibodies. If your baby is Rh negative, you will not need Rhogam after delivery. Talk with your health care provider for more information.

Preeclampsia

Preeclampsia is also called Pregnancy Induced Hypertension (PIH) or toxemia. The cause of preeclampsia is unknown. It occurs in 5% of pregnancies and is most common in:

• First pregnancies
  
• Twin or other multiple pregnancies
  
• Women with high blood pressure before 20 weeks of pregnancy
  
• Teenage pregnancies
  
• Women with diabetes
  
• Women who have had preeclampsia during a previous pregnancy

Symptoms of preeclampsia include a rise in blood pressure, protein in your urine and rapid weight gain due to fluid retention. If left untreated, preeclampsia can cause many problems that could be life threatening to you and your baby. Early preeclampsia can be diagnosed during a routine visit with your health care provider. Call your health care provider immediately if you experience blurred vision, headache, upper abdominal pain, rapid weight gain or increased swelling.

Gestational Diabetes

Gestational diabetes only occurs during pregnancy. The changes in your body during pregnancy can cause your blood sugar (glucose) levels to be high, which can cause problems for you and your baby. You will receive specific education on how to care for yourself if you develop gestational diabetes. It is very important to follow the diet, exercise, and blood sugar monitoring plans given to you.

Gestational diabetes is most likely to develop if you:

• Are overweight
  
• Have a family history of diabetes
  
• Gave birth to a baby weighing 9 pounds or more
  
• Had a baby who died before birth
  
• Had gestational diabetes in the past
  
• Are of Latin, American Indian, African, Asian or Pacific Islander descent

You and your baby may have the following problems if you don't keep your blood sugar under control:

• Baby
  
  
  
  • Big baby
    
  • Premature birth
    
  • Jaundice
    
  • Low blood sugar
    
  • Stillborn (although this is rare)
  
  
• Mother




• High blood pressure
  
• Bladder or kidney infection
  
• Shortness of breath
  
• Harder birth and longer recovery time
  

PRENATAL NUTRITION

Nutrition Before Delivery

The following guidelines were develped to help you get the best possible nutrition for you and your baby. However, the guidelines are only recommendations and may need to be adjusted if you are under or overweight, unable to eat, have special dietary needs or allergies; or if you are carrying more than one baby. If you are concerned about weight gain or need help using a food guide, talk to your health care provider about seeing a prenatal nutritionist with your health care provider.  Food Guidelines 
 
Health weight gain: 28-40 pounds (depending on pre-pregnant weight)

• Key nutritients
• Protein
• Folic acid and other vitamins
• Calcium
• Micronutrients, including iron
• Food servings recommended per day
• 6-11 breads and cereals
• 3-5 vegetables
• 2-4 fruits
• 2-3 protein/protein alternates (6-9 oz per day)
• 2-3 dairy
• Drink 8 or more large glasses of water
   
   
  Recommended Weight Gain during Pregnancy 
  
   
  Weight gain usually occurs at a smooth, gradual rate during pregnancy. For the first three months, expect to gain a total of 2 to 5 pounds. During the remaining six months, the normal rate of weight gain is about 2 to 6 pounds per month, or one pound per week. The average expected weight gain is 25 to 35 pounds if you begin a pregnancy at a desirable weight and are carrying only one baby. A variety of weight gain levels can result in healthy babies. What is important is to gain enough weight to keep you and your baby healthy. The amount of weight gain needed depends on your height and weight before becoming pregnant.
  
  Range of Weight Gain* 
• 
  If you start pregnancy underweight, the recommended total weight gain is: 28-40 pounds.
•  
  If you start pregnancy at desirable weight, the recommended total weight gain is: 25-35 pounds.
•  
  If you start pregnancy overweight, the recommended total weight gain is: 15-25 pounds. 
• 
  If you start pregnancy very overweight, the recommended total weight gain is: at least 15 pounds.
•  
  If you are pregnant with twins, the recommended total weight gain is: 35-45 pounds.
• 
  * Women who are shorter than 5'2" should gain weight within the lower ranges. Teenagers and women who smoke should gain weight within the upper ranges. You never want to lose weight while pregnant.  
   
  A Note on the Pyschological Aspects of Pregnancy Weight Changes 
  
   
  The topic of weight and weight gain can be a source of concern and anxiety for some women. However, pregnancy is the ideal time to embrace your body as it gradually changes in shape and size. Remember, pregnancy is a temporary state. With good nutrition and exercise, there is every reason to expect that you will return to your pre-pregnancy weight after your baby is born and your body has recovered from the birth.
   
  
  
  

Discomforts during Pregnancy

Simple Solutions 

The following are the most common pregnancy concerns and the strategies to deal with them while you are on the job:

 

Backache

Backaches are common during pregnancy because of the increased weight you're carrying, especially if your baby is resting on your spine. Neck and shoulder aches can be due to tension and/or the increased weight of your growing breasts. Lower back pain that extends or shoots down one buttock and into one leg is probably sciatica, caused when the baby's head compresses the sciatic nerve. The tips that follow will help to relieve the discomfort of backaches or avoid them altogether:

• Drive comfortably—Move your car seat forward to keep your knees bent and higher than your hips. Use a small pillow to support your lower back area.
  
  
• Lift correctly—Stabilize your body first by assuming a wide stance and tucking in your buttocks. Bend at the knees, not at the waist, and lift with your arms and legs, which will take the stress off your back. Lift objects only chest high. If your job demands frequent heavy lifting, ask to be assigned to less taxing duties.
  
  
• Limit your standing—Try not to stand in one place or one position for too long. If your job requires long periods of standing, keep one foot on a raised surface, such as a step or a box, to prevent your lower back from curving inward; or stand on a small, skid-proof rug. When standing at a table, lean forward with your knees slightly bent, and support your weight with your hands or elbows.
  
  
• Use ice or a cold pack—Place a bag with ice, wrapped in a towel, against the small of your back when you're sitting down.
  
  
• Relieve strain—When seated at your desk, prop up one leg on a footstool, stack of files, trash can, or anything else available. When walking, sitting, or lying down, avoid putting stress on your back muscles by tucking in your buttocks. Keep your back from arching forward when you stand or lie on your side. At work or at home, you can also lean forward in a chair and lower your head to your knees for thirty seconds. Rise and repeat six times, up to six times a day.
  
  
• Stretch daily—Try setting the clock on your computer to beep at you every thirty minutes to remind you to stretch.
  
  
• Avoid wearing high heels to work—Wear sturdy shoes, with a heel no higher than one inch. Save higher heels for special meetings and appointments with clients, and place thin, foam-rubber inserts in the toes to reduce pressure.
  
  
• Wear a maternity belt—A wide, soft, supportive elastic band that wraps around your lower back and under your belly can take over part of the job of tired, stretched abdominal and back muscles as it cradles the weight of your growing belly.
  
  
• Poor posture can also cause your back to ache—Try to keep your shoulders and hips in line as you walk, and keep your back straight by tucking a pillow behind you when you're seated.
  

Edema (Swelling)

More than 70 percent of pregnant women experience some fluid accumulation in their feet, legs, face, and hands. This condition is related to hormone buildup in your system, which results in the kidneys collecting more water and salt than normal. If your job keeps you on your feet, you are also more likely to experience edema.

If you experience sudden, extreme swelling, you should immediately alert your physician. This could be a warning sign of preclampsia or toxemia. Mild swelling, which is considered normal and beneficial, can be relieved by these methods.

• Raise your legs—Prop up your legs at work on anything available: a stack of papers, books, or a box. Also, elevate your feet and hands above your heart to reduce swelling by gravity. If possible, lie down during the day on your left(heart) side, not on your back. This position prevents your uterus from compressing major arteries and lets your system reabsorb the fluid. Also try walking around the block on your lunch hour.
  
  
• Soak your feet—Tired, burning feet should be soaked at the end of a workday. Rotate your ankles to reduce swelling.
  
  
• Keep water at your desk—Consuming extra water will help to draw fluid from puffy tissues back into your bloodstream to be excreted by your kidneys later. Have a glass or a squeeze bottle of water nearby throughout the day.
  
  
• Wear loose clothing—Although you always want to look well dressed at work, choose looser clothes for maternity wear. Wear elastic support hose, too, and remove tight-fitting rings and other jewelry. Keep an extra, larger pair of shoes in your office to wear when your feet swell.
  
  
• Watch your diet—Stay away from fatty foods, eat plenty of protein, and cut down on salt, which causes fluid retention.
  
  
• Avoid chemicals—Chemical diuretics have been found to be harmful to a pregnant woman. Try taking a couple of spoonfuls of apple-cider vinegar, a natural diuretic, before each meal. Herbal and homeopathic remedies can help.

 

Fatigue

During your first trimester, you may experience extreme fatigue. By the second trimester, your body will probably have adjusted, and you may feel full of energy. By the third trimester, however, you may feel exhausted again and need more rest. There's no cure for this; your body is just reflecting the strains being put on it. These are things you can do to help combat work fatigue:

• Retire early—Never mind the undone chores you see all around you.
  
  
• Try to reduce worrying—Making an effort not to worry about work and home concerns can relieve the tension that builds up during the day.
  
  
• Delegate responsibilities—If you're in a position to delegate responsibility when the pressure becomes too great, do so. Most coworkers will understand and be cooperative, so don't feel guilty about doing it.
  
  
• Learn your daily rhythms of alertness and fatigue—Do your strenuous or creative work during alert times; rest during tired periods. Take a short nap every day during your lunch hour. If you don't have a room to retire to, rest your head on your desk or find an empty conference room or lounge you can use. If possible, ask your employer to reduce your hours temporarily if you just can't keep up near the end of your term.
  
  
• Combat anemia—Anemia can result in tiredness, weakness, and fainting. Add more iron-rich foods to your diet, such as lentils and green leafy vegetables. Doctor-recommended iron tablets can help as well.
  

Headaches

Headaches are extremely common during pregnancy. They may be caused by hormonal changes over which you have little control. But you may alleviate the problem by doing the following:

• Rest—Sit in a dark, quiet room with your eyes closed. Try meditation, yoga, or other relaxation techniques until it passes
  
  
• Breathe fresh air—Avoid stuffy, overheated, smoke-filled rooms. Step outside, if possible, for a breath of clear air.
  
  
• Eat regularly—Little or no food over a long period causes your blood sugar level to drop. Excessive caffeine can cause headaches as well.
  
  
• Try to reduce stress—Whenever possible, avoid unnecessary stressful situations and find ways to control the stress you cannot avoid.
  
  
• Take calcium—Calcium tends to quiet your nerves and ease a headache. If the headaches are regular, take up to four 450-milligram calcium tablets a day. If you suddenly develop a severe headache, call your doctor. It could indicate the onset of toxemia.
  
  
• Cut down on your salt intake—Especially during pregnancy, too much salt can cause headaches and high blood pressure.
  
  
• Use cold compresses—Place a cold, moist cloth on your forehead or on the back of your neck. Add a few drops of essential oil of lavender on your washcloth.
  
  
• Use liniments—Rub peppermint oil, Tiger Balm, or white flower oil into your temples, or drink peppermint tea.
  
  
• Take nonaspirin pain relievers—Get your doctor's approval first.

 

Heartburn and Indigestion

The heart has nothing to do with this problem, which was named long before it was understood. Heartburn involves regurgitation of stomach acid back into the throat or esophagus. It's a mild form of indigestion that, once again, is caused by your hormonal changes. You may experience a burning sensation in your upper abdomen or lower chest, a bitter taste in your mouth, and belching. Here are ways to relieve this problem:

• Eliminate certain foods—Stop drinking citrus fruit juices or beverages made from them. Eliminate rich, greasy, and spicy foods from your diet. Instead, take snacks to work, such as yogurt and honey, papaya, apples, or toast. Also stay away from caffeine-filled drinks.
  
  
• Eat small amounts regularly rather than a few big meals—Avoid eating too much, too quickly.
  
  
• Drink water—A glass of water will wash away the acid. Then drink a little milk, buttermilk, or cream to coat your stomach. Or try some peppermint tea.
  
  
• Chew gum—Chew a stick of gum after meals or sip a carbonated drink.
  
  
• Try a tablespoon of honey in a glass of warm milk.
  
  
• Use antacids—Ask your physician about using Maalox or Gelusil to relieve the discomfort. These are products you can keep in your desk drawer and use whenever necessary without disrupting your work. Liquid antacids are more effective than tablets.
  
  
• Change your position—Try sitting or standing. Avoid lying down; it may only worsen the condition. Sleep propped up with extra pillows an elevated head may help.
  
  
• Remain upright after eating.
  
  
• Try some herbal and homeopathic remedies.

Hemorrhoids

Constipation and straining to move your bowels may cause hemorrhoids (varicose veins of the rectum caused by pressure). While hemorrhoids are common in pregnancy, they shrink right after delivery. If they cause you pain at work, try the following aids:

• If you sit for long hours, use a pillow or a rubber doughnut-shaped cushion to relieve the discomfort. Apply ice packs or pads soaked in witch hazel or Annusol. Drugstores sell Tucks, which work well too.
  
  
• If you stand for long hours at work, take sitting breaks whenever your supervisor gives you the okay.

Muscle Cramps

Muscle cramps in the back, groin, and legs caused by slow blood circulation and pressure on certain nerves are common occurrences. If you cramp up at work, give these ideas a try:

• Change your position by sitting in another position for a few minutes.
  
  
• If you're standing when the cramp occurs, keep your weight evenly distributed and flex your knees. Avoid pointing your toes. Instead, bring your toes upward, pushing out with your heel.
  
  
• Place a hot-water bag or heating pad directly on the cramped muscle.
  
  
• Drink lots of fluids. Place two tablespoons of honey in a glass of warm water to help your muscles relax.
  
  
• Wear support hose to help relive leg cramps. A well-fitting maternity girdle and low-heeled shoes will relieve the strain on your muscles as well.

Nausea, Vomiting, and Morning Sickness

Many women suffer from occasional nausea because of the pressure on organs and the high levels of estrogen in the body, especially in early pregnancy. If you are prone to vomiting, keep towels, a trash can, and mouthwash or breath mints at your desk, and figure out the quickest way to the bathroom. If you are driving, have a big bottle of ice water handy and drive with the window down or with cool air on your face. Keep plastic grocery bags ready. There are steps you can take to fend off nausea, among them:

• Eat little but frequently—Get plenty of protein. Keep high carb foods like dry crackers, pretzels, popcorn, and toast at your desk. Bananas are nutritious and kind to queasy stomachs.
  
  
• Stay away from coffee and spicy, sweet, or greasy foods—Add a drop of peppermint oil directly on the tongue or mix with honey. Papaya enzyme and ginger capsules (found in health foods stores) are also helpful.
  
  
• Drink carefully—Drink fruit juices or carbonated drinks at the end of, rather than during, meals. Find out whether very hot or very cold drinks (like ice water) are best for you. Sip on some clove, Raspberry, or ginger tea.
  
  
• Try acupuncture—Wear an acupuncture bracelet found at most stores (e.g., Sea Bands) or apply pressure on your wrist yourself. Gently press on a spot at the center of the underside of your wrist, about three finger-widths below your balm.
  
  
• Use ice—Bring an ice pack to work. If nausea strikes, fill it with ice and hold it against your forehead or stomach. When an ice bag is not handy, use a cold, moist towel instead.
  
  
• Breathe deeply.

Nosebleeds

The tiny blood vessels of the nose become more congested during pregnancy and break open easily. That's why nosebleeds are so common. Dry air tends to worsen the problem. You might try these techniques:

• Apply pressure—Lean your head forward (not backwards, because you could swallow and choke on your blood), and apply pressure to the bridge of your nose with your fingers for at least four minutes. Keep tissues handy on your desk to protect your clothing.
  
  
• Try Vaseline—Apply Vaseline with a cotton-tip swab to each nostril to stop the bleeding.
  
  
• Use a spray—If your nose feels uncomfortably full after a nosebleed, mix ½ teaspoon of salt with ½ cup of warm water, and spray each nostril with the mixture.

Overheating

Your basal metabolic rate (the rate at which you spend energy) increases by 20 percent during pregnancy. This causes sweat glands to work overtime and the blood flow to your skin to increase. You're likely to feel uncomfortable in both warm weather and cold. It will take a little extra effort to keep yourself cool, so try to do the following:

• Bathe daily—A daily bath is a must during pregnancy. Also use a good antiperspirant.
  
  
• Dress in layers—As the office gets warmer, you can remove a layer at a time until you're down to a thin blouse.
  
  
• Keep tissues nearby—Sometimes sweaty palms make it difficult to work. A box of tissues, a handkerchief, or even a towel are handy things to keep conveniently nearby.
  
  
• Wear foot pads—If your feet become less tolerant to heat, use foot pads to keep perspiration under control.
  
  
• Keep a fan in your office or at your workstation.
  
  
• Schedule your time—Make sure you're not outside between 11:00 and 3:00 when the sun is at its strongest.
  
  
• Try not to accept work assignments that could take too much of a physical toll—An all-day business conference is draining enough under any circumstances, but for mothers-to-be, such an event can be downright exhausting.

Frequent Urination

Your uterus is placing pressure on your bladder, that's true, but also you're drinking more water to relieve constipation, dehydration, and possibly to treat a urinary-tract infection. To be on the safe side, do the following:

• Empty your bladder frequently throughout the day—You may have to explain to your boss that you need more frequent toilet breaks.
  
  
• Wear a sanitary napkin—Be prepared in case you can't make it to the restroom in time.
  
  
• Tell your doctor—Frequent urination may also be the result of an infection. If the problem increases, talk to your doctor.

Varicose Veins

When veins become weakened and enlarged because they've had to work harder to circulate the blood, they are called varicose veins. Heredity also plays a part in their development. Pregnant women will often develop them in their legs, and less often, in their genital area. You can expect them to fade dramatically after birth. While you're still pregnant, however, there are efforts you can make to reduce the threat, such as:

• Move around often—Walking and exercising provide the best protection against varicose veins. Elevate your legs when you're sitting to hurry the return of blood from your legs.
  
  
• Wear support hose—Especially if you stand for long periods, wear elastic support stockings or maternity pantyhose, which you should put on while lying on your back. Avoid tight clothing.
  
  
• Don't cross your legs for long periods of time.

Vision Changes

Increased water retention and elevated hormone levels may cause vision disturbances. The difficulty is only temporary; just take these precautions while waiting for it to pass:

• Cleanse contact lenses often—Cloudy contact lenses interfere with your work. Keep a lens-cleaning kit at work and use it whenever necessary. If contacts don't fit as well as usual, wear eyeglasses instead.
  
  
• Use eye drops—Ask your doctor to recommend a good brand of eye drops and use them several times during the workday.
  
  
• Avoid eye strain—You may not be able to cut down on reading if your work responsibilities require it. But be sure to rest your eyes in the evening if they've been bothering you. Avoid watching TV.