Your Pregnancy Week by Week: Weeks 1-4

If you are newly pregnant, or trying to conceive, you have many questions about what to expect. How will your body change? What's happening inside you? WebMD has teamed up with experts from The Cleveland Clinic to guide you, week by week, through the nine months of pregnancy. Each week offers information about your body and baby's, as well as invaluable tips. Let's start with a peek inside the womb.

Weeks 1 and 2

Baby:Your baby is still just a glimmer in your eye. Although it's confusing to think about a pregnancy starting before your child is even conceived, doctors calculate your due date from the beginning of your last cycle since it's hard to know exactly when conception occurred.

Mom-to-be: At the beginning of a cycle, about 20 eggs called ova begin to ripen and occupy fluid-filled sacs called follicles. One of these follicles matures and ruptures, releasing an egg that will travel down the fallopian tube, where it awaits fertilization. This all takes place about 14 days before the end of your cycle. This is the time you're most fertile, so light some candles, take the phone off the hook, and set aside some intimate time. An egg can be fertilized for only about 12 to 24 hours once the ovum is released. Don't be disappointed if it doesn't work the first time. You have only about a 20% chance of getting pregnant each month.

Tip for the Week: Make sure you've scheduled a preconception visit with your OB-Gyn to determine risks of genetic diseases, environmental hazards and lifestyle changes necessary to ensure a healthy pregnancy and baby. Most important, make sure you've started taking 0.4 milligrams, or 400 micrograms, of folic acid a day. Folic acid taken a few months before conception has been shown to dramatically reduce the likelihood of neural tube defects, such as spina bifida.

Week 3

Baby:Congratulations! If your egg and your partner's sperm have joined successfully, your embryo is really there, although it's very small -- about the size of the head of a pin. It doesn't look like a fetus or baby; it's just a group of about 100 cells multiplying and growing rapidly. The outer layer of cells will become the placenta, and the inner layer will become the embryo.

Mom-to-be: You won't notice any changes. It's too soon. Remember, you haven't even missed your period yet.

Tip for the Week: Home pregnancy tests are about as reliable as a urine test or blood test done in the doctor's office and can give you more immediate results than waiting for a doctor's visit. To ensure accuracy, make sure you've read the directions carefully and that all equipment being used is clean

Week 4

Baby:Your baby is still very small, only about 0.014 inches to 0.04 inches in length. The embryo, probably in about its second week of development, has multiplied to about 150 cells. Your baby is being nourished by secretions from the uterine lining. Layers of cells already are specialized according to functions. The outer layer will become the nervous system, skin and hair; the inner layer will be the breathing and digestive organs; and the middle layer will become the skeleton, bones, cartilage, muscles, circulatory system, kidneys and sex organs.

Mom-to-be:You're probably expecting your period this week, and if it doesn't occur it might be one of the first signs that you're pregnant. You may also notice light spotting as the embryo implants itself in your uterus. You might not feel any different yet, but the amniotic cavity, which will be filled with fluid, and the placenta, which will bring oxygen and nutrients to nourish your baby, are forming in your uterus.

Tip for the Week:Try to eat healthfully, which means choosing a variety of foods from the recommended food groups and drinking at least six to eight 8-ounce glasses of water a day. But you don't really need to "eat for two." You need only an extra 300 calories per day during pregnancy. And don't worry if your food intake drops a little in the beginning because of morning sickness. If you've been eating right already, your baby will get what it needs.

What’s Happening Inside You?

As the fertilized egg grows, a water-tight sac forms around it, gradually filling with fluid. This is called the amniotic sac, and it helps cushion the growing embryo.

The placenta also develops. The placenta is a round, flat organ that transfers nutrients from the mother to the baby, and transfers wastes from the baby.

A primitive face takes form with large dark circles for eyes. The mouth, lower jaw, and throat are developing. Blood cells are taking shape, and circulation will begin.

By the end of the first month, your baby is about 1/4 inch long - smaller than a grain of rice!

Reviewed by The Cleveland Clinic Birthing Services and the Department of Obstetrics and Gynecology

What Are the Treatments for Pregnancy Discomforts?

Understanding Pregnancy Discomforts - Treatment
What Are the Treatments for Pregnancy Discomforts?

Here are some tips on what you can do for some of the common health problems you may face during your pregnancy, along with alternative therapies that may help. Remember, though: Never hesitate to call your doctor about any discomfort or illness you experience while you're pregnant.

Abdominal Pain

To relieve sharp pains or cramps from stretched abdominal muscles and ligaments, particularly when sitting or lying down, use a warm heating pad. Regular exercise will strengthen and tone your abdominal muscles. Take care to avoid exercises while supine (lying on your back) after the first trimester, since this may decrease blood flow to your developing baby.

Backache

Keep your weight gain under control with proper diet and exercise. Avoid taking analgesics; instead, use a heating pad to relieve pain. Special exercises to strengthen abdominal muscles can also help reduce backache. Try a pregnancy girdle or elastic sling to support your abdomen. Wear shoes or shoe inserts designed for pregnant women, and avoid high heels.

Don't stand for long periods and don't stretch to reach high places. Sit straight without slouching, and whenever possible, sit with your legs elevated. Sleep on a firm mattress. Lying on your side with a pillow between your legs may provide some relief.

Be careful when lifting heavy loads -- especially children. Bend at the knees, keep your back as straight as possible, hold the object or child close to your body, and raise yourself slowly.
See a licensed chiropractor for treatment of possible spinal misalignment brought about by the stress of the pregnancy. Or try a chair massage: Sit on a straight chair, facing the back. Lean forward, over the back of the chair, with your head resting on your crossed arms. Have the massager use long strokes, working upward and outward from the lower back, avoiding pressure on the spine.

Breast Discomfort

Wear a bra that gives your enlarged breasts proper support. If your breasts leak small amounts of fluid, use nursing pads in your bra.

Breathlessness

Some breathlessness is common and normal. Keep your weight gain within the recommended limits and maintain good posture, especially when you are sitting. Sleep on your side -- preferably your left side -- not on your back.

Constipation

To keep stools soft and bowel movements regular, get plenty of dietary fiber from fresh fruit, vegetables, whole-grain cereals and breads, and dried fruit. Avoid using over-the-counter laxatives. Fiber or stool softener agents may be helpful. Try psyllium (Plantago psyllium), an herbal bulk-forming agent. Drink lots of fluids and exercise regularly.

Contractions

Mild, painless uterine contractions usually start sometime after the 20th week of pregnancy. If they cause discomfort, try changing positions. If contractions start coming at regular intervals, call your doctor.

Cystitis (Bladder Infection)

If you develop a bladder infection or any type of urinary tract infection, ask your doctor about appropriate treatment. Many bladder infections are triggered by sexual intercourse. Remember to empty your bladder immediately after sex and watch for symptoms. Several glasses of cranberry juice a day are said to be helpful in preventing urinary tract infections.

Dizziness and Faintness

Slow down when you stand up or get out of bed. Dizziness when you stand up too quickly from sitting or lying down is called postural hypotension. If you're in a crowd and start feeling dizzy, step away and get some fresh air; if possible, lie down with your feet elevated or sit with your head between your knees.

Fatigue

Get a full night's sleep, and rest with your feet up for at least 15 minutes several times a day.

Headaches

Make sure you get enough rest, eat regularly, and drink 6 or more glasses of water daily. Avoid aspirin or other over-the-counter painkillers except for acetaminophen. Instead, try stress-reduction techniques like yoga or meditation. Or try taking a hot bath with a cold pack on your forehead.

Heartburn

Avoid heavy meals and spicy, greasy, sugary, and acidic foods. Stick to a bland, high-fiber diet, drink lots of fluids, and exercise daily. Small, frequent meals may relieve some of the symptoms. Don't lie down right after a meal. Raise the head of your bed 2 to 4 inches with a stable support such as wooden blocks. Antacids can be helpful.

Hemorrhoids

Hemorrhoids may develop due to the increased blood in your body during pregnancy, along with the increased pressure to the blood vessels in your pelvis. Hemorrhoids usually disappear after delivery. Eat a high-fiber diet to keep your stool soft, drink lots of fluids, and don't strain during bowel movements. To relieve itching or pain, try a warm sitz bath, or apply an ice pack or a cloth soaked in witch hazel. Kegel exercises, designed to strengthen the pelvic muscles, can improve circulation in the area. Getting off your feet may also help.

Leg Pains and Cramps

Wear support hose during the day, and elevate your feet when resting, if possible. Use a heating pad or gentle massage on the back of your thigh to ease sciatica.
When a leg cramp hits, straighten your leg and slowly flex your ankle and toes while massaging your calf; or soak your leg in hot water. You may be able to prevent night cramps by wearing socks to bed or by pressing your foot against the bed board. If painful cramps persist, ask your doctor about calcium or magnesium supplements.

Morning Sickness

You may feel nauseated at any time of the day, typically in the first trimester. Try eating frequent, small meals rather than three full meals. Keep your diet high in protein and complex carbohydrates, and low in sweets and fatty foods. Drink plenty of fluids, and eat fresh fruits and vegetables, which are high in water content.
Talk to your doctor about trying 25 mg of vitamin B-6 taken 3 times a day. Antacids sometimes help, especially if heartburn is part of the problem. In general, try to minimize stress in your everyday activities.

Mouth and Gum Discomfort

Pregnancy can be demanding on your teeth, so see your dentist early in your pregnancy for a checkup and cleaning. Brush your teeth and tongue at least twice a day, and floss regularly. Sugarless gum can be substituted for an after-meal cleaning if it isn't feasible to brush your teeth.
Make sure you're getting plenty of calcium in your diet -- 1,200 mg daily. You might try a folic acid rinse, but don't swallow it -- and check with your doctor first.

Nasal Congestion or Nosebleeds

Use a vaporizer to humidify your bedroom at night. Lubricate each nostril with a dab of petroleum jelly during the day to prevent nosebleeds. Avoid decongestant nasal sprays, which can constrict blood vessels.

Numbness

Avoid lying on your hands while sleeping. If your hands feel numb when you wake up, shake them over the side of the bed. Soaking the hand in warm water or using a heating pad twice daily may help ease numbness; or try wearing a wrist splint. If numbness persists, try vitamin B6 supplements

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Skin Changes and Stretch Marks

Rashes from hormone changes during pregnancy generally go away after the baby is born. To prevent freckles or darkened skin on your face, called a "pregnancy mask" or chloasma, wear a wide-brimmed hat and use sunblock on sunny days.
Lubricate dry skin around your abdomen with a moisturizing cream; stretch marks usually fade and decrease after the birth. For heat rash, try to stay as cool as possible and use cornstarch powder under your breasts, on your thighs, or wherever your skin tends to chafe.

Sleep Problems and Insomnia

Women who are pregnant often experience sleepless nights and daytime fatigue in their first and third trimesters. During the first trimester, frequent trips to the bathroom and morning sickness may disrupt sleep. Later in pregnancy, vivid dreams and physical discomfort may prevent deep sleep. After delivery, the new baby's care or a mother's postpartum depression may interrupt sleep.
Fatigue during the first trimester of a pregnancy is likely due to changing levels of hormones, such as progesterone. Toward the end of pregnancy, some women find it difficult to sleep because they're uncomfortable due to the size of a growing abdomen. Some women are too excited, anxious, or worried about becoming mothers to sleep well. Sleep apnea, especially if it's severe and causes your blood oxygen level to drop during sleep, is a risk to the fetus.
Pregnant women who experience insomnia during pregnancy may find relief by taking afternoon naps, drinking warm milk, or taking a warm (not hot) bath before bedtime. Exercise during the day may help, too. Expectant mothers may find it more comfortable to sleep on one side, with pillows supporting the head, abdomen, and topside knee. Don't take sleeping pills or herbal sleeping remedies without talking with your doctor first.

Leg Swelling

Monitor your weight gain throughout your pregnancy. To control swelling in your legs and ankles, wear support hose and avoid standing for long periods. Wear shoes that fit well and give good support, or buy shoe inserts designed especially for pregnant women. Getting off your feet helps the most. Lying down is often more comfortable than sitting.

Taste Changes

You may find some foods unappealing and develop a craving for others, especially sweets. Iron supplements may leave a bad taste in your mouth; talk to your practitioner if this is a problem. Use mouthwash often. Chewing gum, mints, or hard candies can also chase away unpleasant tastes.
Urination Problems
Kegel exercises can help you control stress incontinence -- losing a small amount of urine when you sneeze, cough, or laugh. You can also use a sanitary pad. Leaning forward while urinating helps to empty your bladder completely.

Vaginal Discharge or Itching

A thin, mild-smelling discharge is normal in pregnancy. Use sanitary pads, but don't douche without your doctor's approval. Any red or brown discharge is a signal to call your doctor immediately.
Vaginal itching and soreness may indicate an infection, which requires treatment by your doctor. Vaginal yeast infections can be common in pregnancy and may disappear without treatment after the baby is born.

Varicose Veins

Pregnancy puts extra strain on the blood vessels in your legs. Support stockings or pantyhose can help relieve the discomfort. Exercise regularly, but don't stand for long periods. Raise your legs above hip level when sitting, if possible. Lie on your side in bed, or put a pillow under your feet. Ask your doctor or a nutritionist about taking vitamin C supplements to strengthen blood vessels.

Vision Change

If your eyes swell from fluid retention and hard contact lenses become uncomfortable, switch to soft lenses or glasses

Special Warnings: Caring For Two

* The most dangerous time to take any medication is during the first trimester,
when the fetus is developing rapidly and is more vulnerable to injury. Always
check with your doctor before taking any over-the-counter or prescription drugs,
including drugs that were prescribed before you became pregnant.

* Several diseases pose special hazards to pregnant women and an unborn child,
such as rubella, chickenpox, "fifth disease" (erythema infectiosum), mumps,
cytomegalovirus, chlamydia, gonorrhea, genital herpes, genital warts, syphilis,
and AIDS/HIV. Call your doctor immediately if you think you have been exposed
to any of these. If possible, get vaccinated against rubella, chickenpox, and
mumps before pregnancy, unless you've had those diseases or their vaccines
already. Ask your doctor about performing a blood test for chickenpox and rubella
if you can't remember if you've had these conditions as a child, and try to get the
vaccines at least 4 weeks before pregnancy (or afterward) if you need them.

* Don’t smoke. Smoking during pregnancy increases the risks of vaginal bleeding,
miscarriage, stillbirth, premature birth, low birth weight, and many other potential
problems that you and your baby don't need. Second-hand smoke, smoke-filled
rooms, car exhaust, and industrial fumes can also be hazardous to pregnant
women. Avoid prolonged exposure to environmental pollutants as best you can.

* Avoid breathing in or touching chemical household cleaners, paints, and insecticides.

* Be careful walking and getting out of the shower or tub since a growing baby can
throw you off balance.

* Check with your doctor before you start exercising. Some otherwise normal activities
should not be undertaken during pregnancy, and others need to be modified.

* Most couples are able to have sexual intercourse until near the time of birth.
Check with your doctor about the advisability of intercourse if you have a history
of miscarriage or preterm birth, any infection or bleeding, if the placenta is in an
abnormal position (known as placenta previa), or during the last trimester if you're
carrying multiple fetuses. Avoid sex after the amniotic sac has broken or fluids leak.
If you develop pain or abdominal cramps that continue or worsen for more than an hour
after having intercourse, call your doctor, since your cervix could be dilating.

* Avoid having unnecessary X-rays. If you must get an X-ray, be sure to tell the doctor
or the technician that you are pregnant.

* Don't get overheated, avoid exercising in hot and humid weather, and stay out of hot tubs,
saunas, and whirlpool baths. If you have a fever, cool down with a shower or cool bath and
take acetaminophen