Pregnancy Archive

Pregnancy: 2nd Trimester

Questions to Discuss with Your Doctor:

• How do you feel? Have you had any problems since your last visit?
• Have you had any vaginal bleeding or spotting?
• Have you had persistent vomiting?
• Have you had any pain or uterine cramping?
• Have you noticed swelling of your face or fingers?
• Have you had any problems with your vision?
• Are you getting frequent headaches?
• Have you had any vaginal discharge?
• Have you noticed fetal movement?
• Are you planning to breast-feed or bottle-feed?

Your Doctor Might Examine the Following Body Structures or Functions:

• Blood pressure, weight
• Abdominal exam including measurement of the height of your fundus (top of the uterus) and using a portable Doppler instrument or stethoscope to measure fetal heart sounds

Your Doctor Might Order the Following Lab Tests or Studies:

• Consider repeat complete blood count
• Fetal ultrasound
• Glucose tolerance test

Your Doctor Might Order the Following Treatment:

• Rhogam (Rh-Immunoglobulin), if your blood type is Rh negative (see p. 920)

Research from Denmark found an association between the use of hormonal birth control and an increased likelihood of depression. While the risk of depression among women using hormonal forms of birth control was clearly increased, the overall number of women affected was small and was found to be highest in women under 20.

Many women may plan to start using birth control at their six-week postpartum checkup, but as many as 40% of women do not go to a follow-up appointment. The American Congress of Obstetricians and Gynecologists advocates for offering women the option of long-acting, implantable contraceptives in the period immediately following giving birth, before leaving the hospital. It’s safe, effective, and eliminates the need for an outpatient visit during a hectic time. Making postpartum contraception easily available and a covered benefit is essential to reduce unintended pregnancy and rapid, repeat pregnancy rates.

A major controlled clinical trial indicates that taking progesterone doesn’t prevent miscarriage in women at elevated risk.

Miscarriages can be devastating — especially for women who experience recurrent miscarriage, defined as three or more in a row. Doctors used to give these women supplements of progesterone, a hormone that helps maintain a healthy pregnancy. However, a recent study has confirmed that these supplements don’t improve pregnancy outcomes. For those who experience recurrent miscarriage, the best solution may be to simply keep trying.

Ask the doctors

Image: Thinglass/Thinkstock

Q. My daughter is 38 years old and pregnant with her first child. Her due date is in two weeks, and her doctor has recommended that she have labor induced a week early. Why can't she just allow nature to take its course?

A. Having a baby when you're "older" can have some advantages—women may feel more secure with them-selves, their relationships, or their careers. However, expectant moms 35 or older—and their babies—have some increased pregnancy-related risks.