The main reason that makes a woman think about a possible pregnancy is a delay in menstruation.

You can confirm your assumptions using a pregnancy test.

If a woman has regular periods, then the test results can be considered true from the first day. It is better to carry out the test in the morning, since morning urine contains the largest amount of the pregnancy hormone - hCG (human chorionic gonadotropin). Two lines on the test, even faint ones, are a positive result.

If a woman has irregular periods, then a possible pregnancy can be assumed in the following cases:

1. Unprotected sexual intercourse took place. In this case, it is advisable to carry out the test after 3 weeks.
2. If menstruation is not the same as usual - it started earlier, was short-lived, the intensity and color of the discharge have changed (brown, brown, light pink).
3. Unusual sensations in the body - breasts are swollen and painful to the touch (the pain is more pronounced than usual before menstruation), fatigue and severe weakness after usual physical activity or training, changes in appetite and taste perceptions, frequent sensations full bladder.

In most cases, a woman herself can detect the fact of pregnancy with the help. However, you should be aware that the test results may be distorted by the following factors:

• Use large quantity liquids
• Taking diuretics
• Kidney and heart diseases
• Treatment with drugs containing hCG
• Presence of tumors in the body

Medical confirmation of pregnancy

The most accurate way to find out about your pregnancy from the first days of delay

menstruation - donate blood for hCG.

The pregnancy hormone begins to be produced within 7 days after conception. In fact, a blood test cannot confirm pregnancy even before the expected period begins, so this test is the most accurate for early diagnosis.

The question: “I’m pregnant, what should I do first?” is especially relevant among women who are pregnant for the first time.

A woman needs to go to an antenatal clinic, where a gynecologist will confirm pregnancy upon examination and give a referral for an ultrasound. An ultrasound examination is necessary to identify the fertilized egg in the uterus, its location, and determine the approximate duration of pregnancy. They also do an ultrasound to rule out ectopic pregnancy (ovum located in the fallopian tube, ovary or abdominal cavity). detects pregnancy from 5 weeks.

If a woman has firmly decided to continue her pregnancy, she must register with the antenatal clinic at her place of residence. Why is it important? First of all, a woman will be protected by the state, and at the expense of budgetary allocations will have the right:

• Providing social protection
• Resolution of the issue of obtaining certain quotas
• Guarantees of insurance payments
• Providing free examinations and analyzes

After revealing the fact of pregnancy, the woman will have regular visits to the gynecologist, various examinations and tests to monitor normal pregnancy.

Setting the gestational age

Many women believe that the start date of pregnancy is determined from the moment of conception, this is the middle menstrual cycle. In practice, it is impossible to calculate the exact period in this way, since it is impossible to say when exactly ovulation occurred, especially if the menstrual cycle is irregular.

Therefore, in medical practice, in order to avoid confusion, pregnancy is usually considered according to the obstetric period, where the countdown is from the beginning of the last

A visit to the doctor is the first action

menses.

Pregnancy lasts 40 weeks. In some cases, the period is from 37 to 42 weeks, which is the norm. This discrepancy in timing is due to many factors that influence the intrauterine development of life.

To set the most accurate timing, doctors comprehensively use all examination methods. This results in an average.

Should I change my lifestyle?

The state of pregnancy should not significantly change your normal daily routine. A pregnant woman, as before, can and should eat whatever she wants, go to work, go to the gym, sleep on her stomach in her favorite position. The child’s development will itself gradually make adjustments to the usual way of life.

Appearance on early stages- a common occurrence. It appears from the second month of pregnancy and usually goes away by the fourth month. Nausea, especially in the morning, causes great discomfort. Here it would be advisable to choose proper nutrition, making a woman feel better.

A visit to the gym is mandatory for a pregnant woman unless there are strict contraindications associated with the risk. However, it is better to replace intense workouts with measured ones. The best option would be yoga classes or visiting the pool.

Swimming strengthens all muscle groups, this is important in the last stages, when there is a lot of stress on the back and spine. Water has a tonic effect on the skin; it is a kind of alternative to massage (indications for massage during pregnancy are limited). After visiting the pool, in order for the skin to remain elastic, it needs to be moisturized. You don't have to use expensive creams for this. Olive oil- An excellent remedy for the prevention of stretch marks on the skin.

If your work involves physical activity, then according to the Labor Code, the employer is obliged to transfer you to light work.

Many women are interested in the question: can pregnant women fly on an airplane? At normal course There are no restrictions on flying during pregnancy. It is not recommended to use air transport several weeks before

The main symptom is nausea in the morning

- an important aspect of the relationship between a man and a woman. To date, all bans on intimate life subject to a favorable pregnancy. It is necessary to limit or abstain from sexual contacts only if there is a threat of miscarriage.

Do not deny yourself communication with your pets, it is absolutely safe. The only caveat is that cleaning after animals must be done with rubber gloves.

Psychological support

Pregnancy is a natural, physiological state of a woman. When a pregnant woman learns about her situation, she develops various kinds of fears. This is due to a psychological shift when a woman, on a subconscious level, begins to preserve and provide for her unborn child.

Some women begin to panic if, before the fact of their interesting situation was established, they smoked, drank, were sick and took medications. You need to talk to your doctor about this. Nature reliably protects the unborn child; for example, a pregnant woman creates a so-called placental barrier in her body, which protects the fetus from exposure to chemicals.

It is important during pregnancy to feel the support of loved ones and close people - husband, relatives, friends. Do not refuse the help they can offer you, do not hesitate to ask them for it yourself.

Cancel all fears, calm down in your soul and remember that pregnancy is a wonderful state that will definitely end with the happy moment of the birth of a new life!

The answer to your question is in the video:

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• When can a woman become pregnant and is it possible to count the days in...
• Positive pregnancy test, but no pregnancy?...
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A pregnancy test, which reacts to an increase in the concentration of hCG in the body, is one of the most accurate and accessible methods of self-diagnosis. But due to various circumstances, a woman may be interested in how to find out whether she is pregnant or not without a test. This need is associated with various factors - the inability to check hCG in the coming days or simply the desire to verify the test results. We will talk about how to find out about pregnancy and on what principles popular “folk” methods are based.

Am I pregnant or not: what happens in the early stages?

Preparation for conception begins from the first days of the cycle. While menstruation occurs and the uterus “sheds” the old endometrium, a dominant follicle matures in the ovaries. On the days of ovulation, which normally occurs in the middle of the cycle, an egg is released - mature, healthy and ready for fertilization within 12-36 hours. If at this time she meets a sperm, an embryo is formed when the male and female reproductive cells merge. A day after the union of the oocyte and sperm, it will begin to divide and at the same time move into the uterine cavity. After 3-5 days, implantation begins when the chorionic villi slowly grow into the endometrium. This process gives rise to many biochemical and physiological changes in a woman’s body. They are regulated by different hormones - estrogen, estradiol, progesterone, androgens. Each of them has its own function, and their action affects the well-being of the expectant mother. This is precisely what methods are associated with that tell you how to understand whether you are pregnant without a test.

What happens in the body at the beginning of pregnancy?

Main symptom

The main and most obvious sign of pregnancy is a delay in menstruation. If there was sexual intercourse 2 weeks before, then even in the absence of any indirect symptoms, we can say that there is a possibility of conception. The delay is also caused by many other factors - stress, increased physical activity, sudden loss or, conversely, increase in body weight, illness, anemia. Deviations within 7 days from the usual cycle length are considered normal. If after 7 days from the expected date of the onset of menstruation, menstruation does not begin and it is not possible to conduct a test, you should consult a gynecologist to check your pregnancy and rule out diseases of the reproductive system.

How to find out if I'm pregnant by basal temperature

For those who want to know how to determine that a girl is pregnant without a test, a simple and scientific method may be useful - measuring basal temperature (BT). It is measured rectally, using a thermometer with a flexible rubber tip, always in the morning - immediately after waking up, at the same time. The principle of this method is associated with proven patterns of changes in BT in different phases of the menstrual cycle. So, from the beginning of menstruation, the temperature slowly decreases, reaching a minimum on the eve of ovulation, when the dominant follicle matures in the ovary. In the luteal phase, during which a mature and ready-for-fertilization egg is released, BT rises sharply to 37-37.2 degrees Celsius. If the oocyte and sperm do not unite, then 36-48 hours after ovulation the BT will gradually return to normal level. If conception has taken place, the basal temperature will remain above 37.1-37.2 degrees - this is how the body creates optimal conditions for preserving the embryo, its advancement into the uterine cavity and implantation.

High basal temperature in the second half of the cycle is one of the symptoms of pregnancy

This method will give the most accurate results if the woman has kept a basal temperature chart for at least 2-3 months, knows the approximate days of ovulation and indications for each phase of the menstrual cycle. But even if such studies have not been carried out, high BT in the second half of the cycle, and even more so on the days of a missed period, should be a reason to conduct a test, donate blood for hCG and visit a gynecologist.

Pregnant or not: subjective feelings

How can you find out if you are pregnant or not? First of all, you need to pay attention to changes in your well-being. They are associated with strong changes in hormonal levels and the body’s adaptation to new operating conditions. Simply put, part of the body's protective functions perceives the embryo implanting in the uterus as a foreign body, a kind of threat that needs to be gotten rid of as quickly as possible. At the same time, the reproductive system works in the diametrically opposite direction - it tries to stop protective reactions so that the embryo becomes established in the endometrium and begins to receive nutrients for normal development. Such a “conflict of interest” one way or another affects the condition of the expectant mother, and some of its changes may make a woman ask the question: “Am I pregnant or not?”

Morning sickness is a typical early sign of pregnancy.

The most obvious early and common symptoms are:

• nausea - toxicosis can manifest itself in the form of vomiting already in the first days of the delay, and in some women - even before it; in the absence of direct causes such as food poisoning, nausea can be a sign of conception;
• morning sickness - this symptom usually accompanies nausea and manifests itself in weakness, the inability to quickly get up and get ready, unusual slowness; it can also be caused by chronic fatigue or a lack of iron in the body;
• drowsiness - due to restructuring, the body begins to intensively save resources and energy, which is why a pregnant woman in the early stages may face an irresistible desire to sleep and rest in a lying position, even if her daily routine and lifestyle did not change;
• spontaneous dizziness is another companion early toxicosis, it can be caused by the formation of a new uteroplacental circulation and the associated increase in fluid volume in the body;
• decreased performance - this symptom manifests itself in absent-mindedness, difficulty concentrating during mental work, forgetfulness, which have not been encountered before;
• feeling of chills - due to the body’s adaptation to pregnancy, a woman may notice that she begins to feel cold all the time, regardless of the season, room temperature and clothing;
• breast enlargement and tenderness - even on the eve of menstruation, the breasts become engorged, but after fertilization, their sensitivity and volume change faster and over a wider range.

An “interesting situation” is often indicated by subjective sensations. Many of them are associated with the appearance of the so-called pregnancy dominant - a special focus of excitation in the cerebral cortex, which regulates various physiological and psychosomatic changes. How can you find out if you are pregnant without a test? The sense of smell changes most often and most quickly - familiar smells become unpleasant, and some aromas can cause nausea and loss of appetite for a long time. Sources of odors that cause negative reactions include meat and dishes made from it, household chemicals, hygiene products, men's clothing, fats, some legumes and spices.

After conception, the perception of familiar odors may change

At the same time or following the sense of smell, food preferences may also change - a woman begins to want to eat specific foods, even those that were rarely found in her diet. Thus, the body tries to find a source of the nutrients it needs. It is worth listening to such unusual “requests” both during pregnancy and in everyday life. For example, a desire to eat sweets indicates a lack of magnesium and chromium, and a craving for inedible things (ice, chalk, etc.) signals an iron deficiency.

The third sign by which you can tell whether you are pregnant or not is sudden changes in appetite. Thus, some women, due to early toxicosis, literally stop eating and lose up to 5-6 kg in the first trimester, while others, on the contrary, feel the need to eat for two.

How can you tell if you're pregnant or not by looking at your belly?

Those who have ever registered at a antenatal clinic know that during examinations from the first days, the doctor, using careful palpation, determines the enlargement of the uterus, assesses the location and height of its fundus. How can you tell by your belly that you are pregnant? It is unlikely that you will be able to do this on your own - a specialist has a special skill and experience that allows you to notice changes in the pelvic organs upon the onset of conception from the first weeks. Another thing is unusual sensations in the lower abdomen - distension, pressure, some heaviness appear, radiating to the sacrum and lower back, but there is no pain. Such symptoms are associated with the action of progesterone, which softens the ligaments and relaxes the muscle muscles, so that as the uterus grows, the organs can gradually shift.

Can you tell if you're pregnant by looking at your belly?

Another way to find out whether a girl is pregnant or not is to feel the pulse on her stomach - about 8 cm above the navel. If the pulse is felt, pregnancy has most likely occurred. The results of this “research” are explained by the fact that with the beginning of implantation, blood flow to the pelvis increases and a “beat” appears above the navel. In any case, none of folk ways cannot replace an hCG test and an examination by a gynecologist.

How to determine that a girl is pregnant using folk methods?

Is it possible to use traditional methods to check whether you are pregnant or not? Such “tests” can be an auxiliary, but not the main way to diagnose conception. However, they are safe, do not require expensive materials, and therefore can be performed at home without any restrictions.

Drop of iodine

Urine should be collected in a small transparent container. Next, you need to drop iodine into it - just one drop. If it blurs immediately, gradually dissolving and losing intensity, it means that conception has not taken place. In a pregnant woman, already in the early stages, according to this method, the urine is denser and has a special composition, so a drop of iodine will remain on the surface for some time.

Home test strip

This method is in many ways identical to the previous one. To perform it, you need to take a strip of clean white paper, moisten it in urine and apply 1-2 drops of iodine. The strip will become colored upon contact with it; if it changes color to purple-pink, the test result is positive, pregnancy has occurred. A blue tint indicates a lack of conception.

Soda

The folk method, with which you can find out whether you are pregnant or not, is based on the fact that the urine of a woman in an interesting position changes its composition. To carry out the analysis, you need to collect the biomaterial in a clean transparent container and put 1 spoon in it baking soda- just put it in, carefully, without stirring. If the soda just sinks to the bottom of the container, there is no pregnancy; if it gives any reaction, we can say that conception has occurred.

Am I pregnant or not?

Finally

Subjective sensations and changes in well-being can be caused not only by pregnancy, but also by many other factors - fatigue and stress, the results of a strict diet or, conversely, excess body weight, diseases and hidden pathologies. That is why it is impossible to take only them into account when trying to find out whether a girl is pregnant or not. Check only hCG level using a pharmacy test or a blood test, supplemented by a visit to the gynecologist, will give an accurate and unambiguous answer about whether conception has occurred, whether the embryo has implanted in the uterus and not in the fallopian tube, and whether it is developing normally.

The same applies to traditional methods - in some cases, their result may coincide with the real one, but, again, the composition and density of urine may change due to problems with kidney metabolism, hormonal levels and other prerequisites. Therefore, it is important to seek professional medical help as soon as possible at the slightest suspicion of pregnancy.

"I'm pregnant, what should I do?" As a rule, this is the first reaction to good news. Except in cases where the pregnancy was long-awaited and suffered, usually such news is a complete surprise for future parents. Almost always people panic. It seems good, but at the same time there is fear of what awaits you now.

Girls who are acutely interested in the answer to the question: “I’m pregnant, what should I do?” should first of all calm down and not get excited. Now it seems to you that the world is collapsing along with all your plans for life and the near future. Believe me, very little time will pass and you will calm down, think about everything and slowly begin to realize the beauty of your situation. Some women who exclaim: “I’m pregnant, what should I do next?” think about abortion. Throw them away without regret. Killing one's own born child- this is not just a crime against him, yourself and society, it is an immoral, immoral act, the consequences of which can torment you for the rest of your life. Therefore, when a girl finds out that she is pregnant, she does not understand what to do next, it is important to provide her with the maximum possible support at this moment. This can be done by her husband, parents or friends, it all depends on whether she will raise this child alone.

So, you have already begun to slowly realize that something has arisen inside you. new life, now it’s important to put an end to it once and for all bad habits, If there are any. Smoking, drinking alcohol and other factors that can have a negative impact on the baby must be stopped. And you don’t need to convince yourself that nothing will happen from one cigarette, or that the neighbor from the third entrance gave birth to two and smoked like a locomotive. Any woman can pull herself together and deny herself anything for the sake of the health of her own child. If you are not capable of such actions, then this is nothing more than licentiousness, selfishness, ignorance and simply meanness.

Among other things, if you have already said: “I’m pregnant, what should I do?”, you need to register with the antenatal clinic. Every woman does this different periods pregnancy. But, of course, it is best to be under medical supervision from the very beginning.

Read less different literature for pregnant women. No, of course, to know some important and necessary things about the symptoms of this condition, the process of childbirth itself and other interesting and the right things necessary. But if you are particularly impressionable, limit your reading to articles that tell in detail about unsuccessful births, genetic diseases and other facts that can deprive you of sleep.

The most important thing you should do now is sleep well, walk a lot in the fresh air and try to be less nervous. Some household chores can be delegated to loved ones, but you need to save your energy. This does not mean that you should spend your entire pregnancy in bed with a compress on your forehead. If your health allows, that is, there is no toxicosis or other ailments, lead active image life. You are not sick, but just expecting a baby. He will only thank you if you go on a trip, meet friends, go for walks, go out into nature, and generally receive

Towards the end of the term, you can go to courses for pregnant women. This will help you mentally and physically prepare yourself for the birth process. You must talk to the baby, watch good films and children's cartoons, and also look at the world with optimism no matter what happens.

"I'm pregnant, what should I do?" How to answer this question? Calm down, be patient, try to follow the recommendations of doctors and those who have already gone through this and, of course, give birth. Nine months will fly by like one day, and you will finally be able to see your baby.

The test showed two stripes - clear, bright, convincing. They confirm that a miracle happened and now you will have a child. This news causes a state of euphoria, which, however, is quickly replaced by anxiety: what to do next? How to behave correctly in your new status, should you go to the doctor, when and where to register for pregnancy, what tests and examinations should you undergo? Do I need to collect any documents for maternity leave, until what period do I need to work, what is a birth certificate, when and how to choose a maternity hospital, should I conclude a contract? In general, we need clear guidance on further actions, so to speak. step-by-step instruction on pregnancy. This is exactly the instruction we decided to bring to your attention.

Visit to the gynecologist and first ultrasound.

You should go to see a doctor without delay as soon as you find out you are pregnant. The first appointment with a gynecologist will include an external examination, examination in a gynecological chair, ultrasound and a blood test for hCG.

Based on the results of this express examination, the doctor will be able to accurately confirm the fact of pregnancy (or refute it, because tests are sometimes “wrong”), determine the due date and exclude the ectopic location of the embryo. In addition, at the first appointment you will receive information about further medical measures: visits to other doctors - this may be necessary if you have chronic diseases, – additional tests, the date of the next visit to the gynecologist and ultrasound.

Adjusting your lifestyle

Now you need to reconsider your daily routine, work schedule and physical activity. The first weeks of pregnancy are a critical period in the development of the fetus: any overload, stress and illness of the expectant mother during this period can negatively affect the health of the baby and the course of pregnancy. Night walks, clubs and noisy parties will have to be postponed until better times. In the first weeks of pregnancy, you should try to be in crowded places as little as possible to avoid the risk of infection and injury. Try to rest more, get enough sleep and walk in the fresh air.

You must refuse immediately overtime work, business trips; if possible, move the start and end times of the working day to avoid crowding in transport during rush hour. For all these pleasant changes in your work schedule, you have every right in accordance with labor legislation.

In the first weeks, you should temporarily stop playing sports; subsequently, with a normal course of pregnancy, it will be possible to return to sports - of course, adjusted for the “interesting situation”.

It is useful for a new expectant mother to walk and swim; but cycling, running, skating and skiing should be abandoned immediately as soon as pregnancy becomes known. Try not to make sudden movements or lift heavy objects: the maximum recommended weight is 3 kg, evenly distributed in both hands.

You should also adjust your diet: it is important for a pregnant woman to eat right. It is necessary to give up canned food, synthetic drinks and products with artificial food additives, and do not abuse spicy, fatty and fried foods.

Taking vitamins

From the first days of pregnancy, expectant mothers are recommended to take folic acid - vitamin B9. This vitamin ensures the necessary speed of growth and development of the baby in the early stages, and is the main means of preventing undeveloped pregnancy and the formation of malformations of the nervous system and heart of the fetus. In addition, folic acid ensures better absorption of iron, necessary for the formation of hemoglobin. The recommended daily dose of vitamin B9 in tablets is 800 mcg.

Another “vitamin of the first days of pregnancy” is E; it is necessary for the body of the expectant mother to synthesize the main hormone of pregnancy - progesterone, which ensures normal tone and blood supply to the uterus.

Second ultrasound

The second ultrasound is performed at 8–12 weeks. The purpose of the study: to confirm the prolongation - the successful course and development of pregnancy, to determine the correspondence of the size and development of the fetus to the expected period of pregnancy, to exclude the formation of malformations. Based on the results of the second ultrasound, the expectant mother is recommended to begin regular visits to the gynecologist to monitor the progress of the pregnancy.

Pregnancy registration

It is advisable to begin systematic medical monitoring of the development of pregnancy no later than 12 weeks; It’s better to register early – simultaneously with the second ultrasound examination.
Early pregnancy registration and the beginning of regular medical monitoring can significantly reduce the risk of exacerbations of chronic diseases and pregnancy complications. Women who register no later than 12 weeks are paid a one-time benefit in the amount of half the minimum wage when going on maternity leave. When registering at the antenatal clinic, the expectant mother should present a passport, compulsory health insurance policy and the results of medical examinations for the last year, including the conclusion of the first ultrasound and test data. In the future, the expectant mother is recommended to visit the doctor at least 12 times during pregnancy. For periods up to 28 weeks, you should go to the doctor at least once a month, from 28 to 37 weeks - at least 2 times a month, and starting from 38 weeks - every 7-10 days. If there are special indications, for example, if there is a need for further examination based on test results or health conditions, the doctor may recommend unscheduled visits at any of the listed dates.

We take tests

A referral for the necessary laboratory tests is issued by the doctor at the first visit, i.e. when registering for pregnancy. The standard set of studies carried out at week 12 includes:

• clinical (general) blood test;
• general urine analysis;
• blood chemistry;
• coagulogram - blood test for clotting;
• determination of blood group and Rhesus affiliation;
• blood test for HIV, hepatitis B and C, syphilis;
• testing for the presence of torch infections: rubella, toxoplasmosis, coxsackie, herpes, cytomegalovirus, papillomavirus, chlamydia, urea and mycoplasmosis, gardnerellosis. These diseases occur latently and can pathologically affect the development of the fetus;
• vaginal flora smear;
• At the discretion of the doctor, a screening examination for congenital diseases may be recommended - a blood test for alpha-fetoprotein and hCG.

Despite the frightening size of the list, all tests can be taken at one time - to do this, you need to find out the days of blood sampling and the necessary preparation measures. For example, a biochemical blood test should be taken on an empty stomach, and on the eve of the test for RW (syphilis), you should not eat a lot of sweets: failure to follow these rules can lead to incorrect test results. If you have chronic diseases or as prescribed by other doctors, such as a therapist or endocrinologist, the list may expand. In the future, many tests will have to be taken again: for example, a urine test - at each visit to the gynecologist; general blood test - at least twice per trimester; test for HIV, syphilis and hepatitis - once each in the second and third trimester; flora smear - at least once per trimester. Repeated tests for the same infections are necessary because theoretically future mom can also get sick during pregnancy.

Related specialists

Allied in obstetrics are doctors of other specialties, whose examination helps the gynecologist choose the right tactics for managing pregnancy. To monitor the course of pregnancy, examinations by a general practitioner, endocrinologist, ophthalmologist, dentist and ENT specialist are most relevant, however, if you have health problems, you may need to consult other doctors, for example, a nephrologist - a specialist in kidney diseases, a neurologist, a phlebologist - a specialist in vein diseases - or a cardiologist . Visits to related specialists should begin no later than 12 weeks and be completed by 16 weeks of pregnancy. As part of the examination, the therapist needs to do an electrocardiogram. If necessary, doctors can invite the expectant mother for a second appointment in the second and third trimester of pregnancy or prescribe additional diagnostic tests.

Screening study

At 16–18 weeks of pregnancy, the expectant mother is recommended to undergo the so-called “ triple test", which makes it possible to identify a risk group for the formation of fetal malformations. To do this, a pregnant woman's venous blood is examined for the amount of alpha-fetoprotein, human chorionic gonadotropin and estriol. Changes in the amount of these substances produced by the tissues of the fetus and placenta may indicate the presence of a serious fetal abnormality, such as Down syndrome. At positive results After testing, the expectant mother is referred for genetic counseling.

Third ultrasound

Next ultrasonography It is recommended to do it at 18–20 weeks; by this moment, the formation of the placenta is completed, as well as the formation of the main organs and systems of the fetus. Echography at this stage allows you to assess the degree of development of the cardiovascular, nervous and urinary systems of the fetus, the correspondence of the development and size of the baby to the gestational age, determine the placenta insertion and the level of blood flow in its vessels, evaluate the structure of the placenta and umbilical cord. The third ultrasound is included in the recommended scope of screening studies to identify genetic anomalies and fetal malformations.

Physical exercise

After the 20th week of pregnancy, when the main “critical” periods have already passed, it is worth discussing with your doctor the possibility of sports activities that are acceptable during this period. Let us remind you that active expectant mothers who were involved in sports before pregnancy need to discuss the correction of their usual physical activity at their first visit to the gynecologist. If pregnancy proceeds without complications, dosed physical activity is not only permitted, but also strongly recommended: good muscle tone and elasticity of the ligamentous apparatus makes it easier to tolerate weight gain during pregnancy and the discomfort of labor pains. It is better to give preference to stretching exercises, such as yoga for pregnant women, Pilates and body flex. Pregnant women can practice swimming, special water aerobics for expectant mothers, and even belly dancing. A necessary condition is the complete exclusion of sudden movements, stress on the abs and lifting heavy objects; All of the listed exercises are best performed under the supervision of a trainer who is competent in selecting loads for pregnant women. In the absence of special recommendations from a doctor, you can engage in “allowed” sports for 40–60 minutes 2–3 times a week until birth.

Exchange card

This document can be considered a “pregnancy passport”: it contains all the necessary medical information about the health of the expectant mother, the characteristics of this and previous pregnancies, the results of tests and examinations, medications received and expert opinions.

"The Exchange" consists of three parts; the first is filled out by the doctor in consultation, the second by the obstetrician-gynecologist who delivered the child, the third by the neonatologist who monitored the baby in the maternity hospital after birth. With the help of this important document, continuity is ensured in the transfer of information about the health of mother and baby between the antenatal clinic, maternity hospital and children's clinic. According to Order No. 30 of February 10, 2003, the exchange card is issued to the expectant mother by the supervising doctor at the antenatal clinic no later than the 23rd week of pregnancy. From the moment of receipt, the “pregnancy passport” must always be in the expectant mother’s purse along with her general passport and compulsory medical insurance policy: they may be needed in the event of an unexpected emergency hospitalization.

Courses for future parents

The choice of courses should be decided by the 25th week of pregnancy: the most complete and interesting series of lectures are designed for an average of two months of visits with 1-2 classes per week. You can start attending courses earlier: most topics will be informative and relevant even in the first weeks of pregnancy, and many classes include useful information in addition to lectures physical exercise. Courses are needed for correct psychological mood for childbirth, acquiring skills for self-anesthesia of contractions, which include postures, massage, relaxation and breathing techniques, and caring for the newborn.

A standard set of lectures usually includes topics about the characteristics of pregnancy, childbirth and the postpartum period, fetal development, the main aspects of medical supervision of a pregnant woman, a woman in labor, a postpartum woman and a newborn in the maternity hospital, breastfeeding, introduction of complementary feeding, development of a child in the first year of life, review of maternity hospitals in your city. At most courses, in addition to lectures, practical classes are conducted - obstetric gymnastics and childbirth training, where pain relief techniques are practiced. It is better to attend classes for future parents together with a partner. Such courses can be found at the antenatal clinic or maternity hospital; There are also independent commercial clubs for future parents. When choosing courses, pay attention to the qualifications of teachers (usually lectures are given by medical specialists and psychologists), gymnastics coaches, the convenience of the location of courses and class times, the ability to attend lectures with your husband and choose individual topics that interest you.

Maternity leave

A certificate of incapacity for work for pregnancy and childbirth is issued by an obstetrician-gynecologist who monitors the course of pregnancy for the following periods:

in case of a normal pregnancy - from the 30th week for 140 calendar days (70 days before birth and 70 after birth);
in case of multiple pregnancy - from 28 weeks to 180 calendar days;
in case of complicated childbirth, postpartum leave is increased by 16 calendar days and the total duration of maternity leave is 156 (70+16+70) calendar days.

Birth certificate

Making out maternity leave At 30 weeks of pregnancy, the expectant mother can receive another important document. This is a birth certificate intended for additional payment for the services of doctors at the antenatal clinic, maternity hospital and children's clinic from the federal budget. The project to issue birth certificates started on January 1, 2006; its goal is to improve the quality of medical care for expectant mothers and babies in public medical institutions.

The certificate consists of three coupons: the first goes to pay for the services of a antenatal clinic, the second for a maternity hospital, and the third for medical services in a children's clinic. At the consultation, a certificate is issued in hand at 30 weeks, subject to registration no later than 12 weeks and visiting one antenatal clinic doctor at least 12 times during pregnancy; By agreeing to take the certificate, the expectant mother shows that she is satisfied with the medical care she received. In case of irregular monitoring, late registration, medical care on a commercial basis, or if the pregnant woman is dissatisfied with the level of medical services provided, a birth certificate will not be issued at the consultation. In this case, the expectant mother will receive a birth certificate already in the maternity hospital. It should be emphasized that the birth certificate is not mandatory document for planned or emergency hospitalization in a maternity hospital, regardless of which maternity hospital is chosen and on what insurance conditions - under a compulsory medical insurance policy or on a paid basis - the expectant mother will be served.

Fourth ultrasound

The last ultrasound examination recommended for normal pregnancy is performed after 32 weeks. By this time, the fetus has already formed, occupies a stable position in the uterus, and the doctor can evaluate it based on the results of the study physical development, location, presentation, expected size by the end of pregnancy, amount of water, condition of the placenta, blood flow in the vessels of the placenta, umbilical cord and uterine arteries. This data allows you to draw up a proposed birth plan, determine the degree of risks and the need for additional medical preparation.

Cardiotocography

It is advisable to conduct this study after the 32–34th week of pregnancy. The method allows you to assess the well-being of the fetus by frequency and variability, i.e. changes in his heart rate. To do this, within 20–40 minutes, the baby’s heartbeat is taken using an ultrasonic sensor and recorded on a paper tape in the form of a graph. In addition, the CTG graph shows moments of the baby’s movements and increased uterine tone. By changes in pulse, frequency of fetal movements and increases in myometrial tone, one can assess the risk of developing fetal hypoxia and premature onset of labor.

Choosing a maternity hospital

This important process should begin no later than the 34th–36th week of pregnancy. When choosing, you should take into account such criteria as the remoteness of the maternity hospital, the dates of preventive treatments (“washes”), the technical equipment of the maternity hospital, the level of comfort of the delivery rooms, if necessary, the presence of a special medical specialization, the ability to choose a doctor and individual management of labor, the presence of a partner at the birth, mother and baby staying together in the postpartum ward.

Getting to know the maternity hospital

Having previously decided on the choice of maternity hospital, after the 36th week it is worth going to it in person and “look around the place.” It is better to study in advance the options for the route to the maternity hospital, see where the entrance to the emergency department is located, familiarize yourself with the admission rules for admission to prenatal hospitalization and childbirth, find out the times of visits, conversations with doctors and receiving packages. When planning individual management of childbirth at 36 weeks, you can meet with the doctor and enter into a contract for childbirth.

Things and documents for the maternity hospital

This must be done no later than the 38th week of pregnancy in order to take everything into account, double-check and not fuss at the very last moment. You can ask for a list of things allowed for hospitalization in the antenatal, delivery and postnatal departments at the maternity hospital help desk or from an insurance agent when concluding a contract for childbirth. Requirements for clothing and personal items that you can take with you may vary greatly from one maternity hospital to another, so do not be lazy to find out the rules in the chosen maternity hospital in advance. It is better to collect things separately for each compartment, packing them in plastic bags. Documents for hospitalization will require a passport, compulsory medical insurance policy, exchange card, birth certificate and birth contract - if there is one; It is better to make photocopies of these documents in advance for the admissions department of the maternity hospital. You can immediately take a bag with things and documents for childbirth with you, but bags with things for the postpartum ward can be transferred to the maternity hospital only after the birth of the baby, so it is better to label them in advance and provide instructions for relatives.