Here are 7 changes that may need immediate action.

Discovering that you are expecting is emotional and exciting. Especially if it's your first baby, you may have a lot of questions about what's normal, what's not, and when you should call your doctor.

Most women will have healthy pregnancies. Taking care of yourself and heeding any changes in your health will probably go a long way towards easing your mind. Many of the changes your body will go through while pregnant are perfectly normal. Still, some deserve swift attention.

Here are seven symptoms, what they may mean, and what you should do about them. Of course, you should feel free to raise questions with your doctor at any point during your pregnancy, even if it's not on this list.

1. Vaginal Bleeding

What it may mean: "Some spotting is normal, but heavy bleeding could be a sign of miscarriage or ectopic pregnancy," says Natali Aziz, MD, a maternal-fetal medicine specialist at Lucile Packard Children's Hospital in Palo Alto, Calif.  "The brighter red the bleeding, the more significant it is," she says. 

"If you have bleeding and bad cramping similar to period cramps, this can be a sign of threatened miscarriage," says maternal-fetal medicine specialist Manju Monga, MD, of the University of Texas Health Science Center at Houston. "If this is coupled with sharp lower abdominal pain, it may be a sign of ectopic pregnancy," a serious complication that occurs when the fertilized egg implants outside the uterus, usually in the fallopian tubes.

What to do: "Call your doctor," Monga says. "Your doctor will likely do anultrasound, an exam, and some blood work based on your symptoms." Though most spotting or light bleeding may not be a serious problem, "you don’t want to ignore it if it is associated with cramping, heavy bleeding, or abdominal pain."

2. Excessive Nausea and Vomiting.

It's normal to have some nausea and vomiting during your first trimester. Most pregnant women go through that.

But if it's severe or makes you dehydrated, that's something to heed.

What it may mean: “Vomiting that interferes with your day-to-day activities can lead to weight loss, dizziness, dehydration, and an imbalance of electrolytes,” Aziz says.

What to do:  Tell your doctor. “You may need hospitalization to treat the dehydration, and many medications are available to control nausea," Aziz says.

Bottom line: "Nausea and vomiting are normal occurrences during pregnancy, but the extremes can cause problems," says ob-gyn Stanley M. Berry, MD, of William Beaumont Hospital in  Royal Oak, Mich. "The majority of women who have nausea and vomiting in their first trimester will go on to have normal, healthy pregnancies."

3. High Fever

A fever greater than 101 degrees Fahrenheit or 38 Celsius during pregnancy may be serious.

What it may mean: It could be a sign of infection, which could affect the baby.\

Fevers during pregnancy that are accompanied with rash and joint pain may be a sign of infection such as cytomegalovirus (CMV), toxoplasma, and parvovirus. "CMV is the most common cause of congenital deafness, and it is not as uncommon as we think," Aziz says. 

What to do:  "Report any fever plus upper respiratory symptoms, body ache, andflu-like symptoms or rashes and joint pain to your doctor," Aziz says. And get your yearly flu vaccine.

4. Vaginal Discharge and Itching

Some vaginal discharge is normal. But in some cases, "These may be be signs of treatable infections or sexually transmitted diseases that can have important consequences in pregnancy," Aziz says.

What this may mean: If it's an infection, it could harm the baby.

What to do: Don't be shy. Let your ob-gyn know what is going on down there because if there's a problem, treating it could make a difference to your baby.

5. Pain or Burning During Urination

What this may mean: "These can be signs of bladder or urinary tract infections, and if left untreated, they can lead to more serious illness, infection, pre-term labor, and pre-term birth," Aziz says.

What to do: If it's an infection, treating it can relieve your pain, and help assure a healthy pregnancy.

6. Leg or Calf Pain or Swelling on One Side/ Severe Headache

This won't happen in most pregnancies. But pregnancy does mean a greater chance of developing a blood clot.  

A blood clot in the calf may result in pain or swelling and can result in a blood clot that travels to the lung, which could be fatal.

A blood clot in the brain may be heralded by a severe headache. There are other possible causes of bad headaches during pregnancy.

What to do: If you have a history of blood clots, or if you get a severe headache, consult your doctor.

7. Flare-Ups of Chronic Diseases.

Women who have certain preexisting medical conditions -- such as thyroid disease,diabetes, high blood pressure, asthma, and/or lupus -- should note any changes in their condition during pregnancy.

What it may mean: If your underlying disease is flaring up or not well-controlled, it can have serious consequences for your health -- and your baby's.  

For example, "if your thyroid hormone is too high or low, you can be at an increased risk of miscarriage," says Gayle Olson, MD, a maternal-fetal specialist at the University of Texas Medical Brach in Galveston. Or, "if your blood sugar levels are not tightly controlled, you may be at increased risk of miscarriage or fetal abnormalities," she says.

The bottom line: "Any flare in an underlying condition is a red flag and should be followed up," Olson says.

Still, most women will have healthy pregnancies, Berry says, so try to enjoy your pregnancy.

"Stress is no good and the more positive the attitude, the better things are for mom and baby," he says. So make sure you have good prenatal care and a healthy diet, and get proper rest and take your prenatal vitamins.

First Trimester of Pregnancy

Wow, there's a lot going on in there as your baby begins to develop and your pregnant body starts to go through some (big!) changes. Here's more about what to expect in the first trimester of pregnancy.

You may not look pregnant yet, but chances are you're feeling it. That's because a flood of pregnancy hormones is prepping your body to play baby hostess for the next nine months. And that means you could be in line for a bunch of wackypregnancy symptoms from breast changes to bloating to fatigue to flatulence. Sure, you might be less than thrilled with some of the stuff you'll be coping with (did we mention heartburn and constipation?), but remember that these temporary discomforts are part of the incredible process that's happening inside: You're growing a child! 

During the first trimester alone your baby changes from a single fertilized cell (a zygote) to the embryo that implants itself in your uterine wall to a peach-sized bundle of growing limbs and body systems. So much happens in so little time: Organs take shape, baby starts to move (aroundweek eight of pregnancy), and hair follicles and nail beds form. More major first-trimester milestones include the formation of muscles, the production of white blood cells to fight off germs, and the development of vocal cords (I want Mommy!). 

For Mom, a lot happens quickly in the first trimester as well. At some point, you'll likely have a routine ultrasound to make sure things are progressing as they should, and ascreening (done through a blood test between 11 and 14 weeks of pregnancy) to look for chromosomal abnormalities such as Down syndrome and congenital heart defects. 

In terms of day-to-day stuff, by week five of pregnancy you may be well into morning-sickness malaise (which, unfortunately, doesn't just strike in the morning!). By week six, you might be wondering who replaced your boobs with those alien orbs (so tender, so tingly, and sooo big!). Pregnancy mood swings may hit by week seven, leaving you feeling up, then down, then up again — and that was just in the past five minutes! Weeks eight through 12 bring a laundry list of other possible pregnancy symptoms, including metallic taste, food aversions, and headaches. 

The thing to keep in mind when it comes to pregnancy woes during the first trimester is that every woman is different, so while your neighbor may have moaned about endlessly peeing, that may not happen to you at all. And just because your mom or sister reported cramping or spotting doesn't mean you'll do the same. No matter what symptoms you do have, take heart in knowing that most lessen or disappear as your pregnancy evolves. 

Your first ob-gyn visit may well be the longest as the doctor goes over your medical history and performs a thorough physical exam. You'll likely undergo a battery of tests including a Pap smear, urinalysis, and blood work to determine your blood type and Rh status, hCG levels, and the presence of any infections. You might also be screened for genetic illnesses or diabetes, depending on your family history. And while your practitioner is asking you lots of questions, be prepared to ask plenty of your own. Now's the time to inquire about prenatal vitamins, GERD, weight gain, sexual desire (or lack thereof), or anything (really…anything!) you might be concerned about. 

Weight gain during pregnancy

Being pregnant inevitably means you will gain weight. However, how much weight you gain varies from woman to woman. Whilst it often becomes a source of concern for many pregnant women many caregivers have become less inclined to regularly weigh expectant mums as part of their routine care. Frequent weighing can often only create anxiety for women about 'not putting on enough' or 'putting on too much' weight.

It is fairly common for caregivers to ask you to weigh yourself as part of yourfirst pregnancy visit. This is aimed at having a 'baseline' weight in case the doctor needs to prescribe drug dosages calculated on your average weight at some stage. However, beyond this weighing during pregnancy becomes a little irrelevant. Even so, some caregivers still continue to weigh women as part of their routine antenatal visits.

About weight gain:

Whatever your weight was before your pregnancy, and regardless of how much weight you are (or are not) putting on, it is important to have a well-balanced diet with plenty of carbohydrates, protein and fresh fruits and vegetables, with not too many fatty and sugary foods. Pregnancy is not an appropriate time to diet, nor is it an excuse to 'eat for two'! If you have a special diet, or any health conditions that require diet modification (such asdiabetes), you should consult with a dietician about planning your weekly meals.

Many information sources and pregnancy books will try to provide guides about the 'recommended weight gain' during pregnancy. These are usually along the lines of 'putting on 2- 3 kg in the first 20 weeks, then ½ a kilo per week until the baby is due, averaging 12-14 kg in total. While this may be true for some in women, in practise this is rarely the case.

Many women will put on most of their pregnancy weight gain during the first 20 weeks, or only gain a few kilograms up until 12 to 16 weeks of the pregnancy, then experience a large 'growth spurt' during the middle of their pregnancy up until about 32 weeks, slowing down their weight gain over the next 4 to 6 weeks and then losing 1 to 2 kg just prior to going into labour. A woman's overall weight gain when carrying a single baby may be as little as 8 kg, or as much as 20 kg.

NOTE: For conversion, 1 kg = approx. 2.2 lbs. To convert pounds into kilograms you divide the number of pounds by 2.2 (for example, 22 lbs ÷ 2.2 = 10 kg).

The 'average' weight gain of around 12 to14 kg can be physically attributed to:

baby = 3 to 4 kg

placenta = 0.5 kg

amniotic fluid = 1 kg

uterus = 1 kg

blood volume = 1.5 kg

breasts = 0.5 kg

Fat stores for breastfeeding = 3.5 kg

Fluid retention = 1.5 kg

Individual differences:

Each woman's body responds differently to their pregnancy and there are many reasons why individual women will put on more or less weight, at various stages of their pregnancy and yet still be classified as being 'normal' for pregnancy. This is particularly the case for women who were not within their 'ideal weight range' before they conceived. You can read about the concept of ideal weight ranges here.

While it can be difficult to generalise for each woman, the following are a few suggestions that may explain why you are gaining weight the way you are:

• Women who were relatively 'underweight' for their height before they conceived often find that their body naturally 'adjusts' by putting on more weight during pregnancy. This is because necessary fat stores are being laid down by the body to maintain the pregnancy and support breastfeeding after the birth. If this is the case, the woman's weight will increase by a certain amount (to be more in line with her 'ideal weight range' for her height), as well as her expected pregnancy weight gain. Even though the woman does not really look overweight, she has put on quite a few more kilograms than expected.

• Women who were relatively 'overweight' for their height before they conceived often find that they put on very little weight during pregnancy (or perhaps even naturally lose some weight at different stages). This is because the existing fat stores become depleted by the increased physical needs of the pregnancy and an increased metabolism. This is normal and regarded as being safe if you continue to eat a well-balanced diet.

• If you are excessively sick during the earlier months of pregnancy, you may find you do not put on any weight for a while (or possibly even lose weight). Usually when the nausea and/or vomiting settles, your appetite returns and you have a 'growth spurt' for a few weeks, as your body 'catches up'. Of course if your vomiting gets to the point where you are becoming dehydrated, it may be necessary to see your caregiver and be admitted to the hospital for a drip in the vein, and/or medications to help stop the vomiting. You can read more in morning sickness.

• Some women retain more fluid than others. Fluid retention and swelling (or oedema) affects about 65% of healthy pregnant women with a normal blood pressure, usually after about 20 weeks of the pregnancy.
• Most women carrying twins, triplets or more will put on more weight, however it is not 'double' or 'triple' the expected amount. Many women carrying multiples find that their weight gain is not that much different from women having a single baby. As a guide for twins you may put on up to 15 to 20 kgs (or more) and for triplets it may be up to 20 to 25 kgs (or more). Be aware that with triplets or quads, your babies will probably be born premature (less than 37 weeks) and therefore your weight gain will generally be put on early and more quickly.

Our thoughts...

Unfortunately, many pregnant women spend a lot of time and energy worrying about their weight gain. This is no doubt a reflection of our society's obsession with weight and how we look. An obstetrician we know once said, "The worst thing you can give a pregnant woman is a set of scales!" and we tend to agree with him.

Tips How to Sleep in Pregnency ?

It’s a cruel reality that the time of your life when you need a decent night’s sleep the most – when you’re pregnancy and doing all the hard work of growing a baby – is also the time when sleeping well becomes harder and harder.

Recent research has found more reasons why mums-to-be need their sleep, linking higher blood pressure in the third trimester with poor sleeping habits in the first three months of pregnancy.

But it’s not just women not getting enough sleep who are at risk – mums-to-be who oversleep (i.e. more than 10 hours a night) are also risk.

High blood pressure in the last trimester carries certain risks with it including decreasing blood flow to the placenta and increasing the chance of a premature delivery. Pregnant women who develop high blood pressure may also require extra monitoring.

What’s the perfect amount of sleep?

For a healthy blood pressure, pregnant women need 9 hours a night, say researchers. Try these 7 tips to help you get a good night’s sleep.

Establish a routine

It’s not only little babies who thrive on a sleep routine. By following a similar nightly ritual, you are preparing your body and mind for sleep.

Cushion up

Even early in the pregnancy when the bump is teeny, it can be hard getting comfortable. Legs cramp up or are jumpy, and your pelvic area can feel unsupported. Extra cushions and pillows strategically placed between or under your legs can do wonders – and you’ll need them by the third trimester.

Power naps

Having a quick shut-eye of no more than 20-30 minutes during the day can lessen the pregnancy fatigue and make sure you’re not overtired. Just like with a baby, sleep promotes sleep, and being overtired can have a negative impact on the quality of sleep you get.

Late-night fasting

Avoid drinking a lot of fluids or eating a full meal within a few hours of going to bed at night. All those pregnancy hormones increase blood flow to the pelvic region from your first trimester on, putting pressure on your bladder and leading to the need to wee more frequently. Hormones are also to blame for a higher chance of getting heartburn, as they relax the sphincter valve at the entrance to your stomach.

Learn relaxation techniques

Practicing relaxation techniques before bed is a great way to wind down, calm the mind, and prepare for sleep. Some simple relaxation techniques include deep breathing, visualisation of a calm place and progressive muscle relaxation.

Get regular exercise…

…but not just before bed. Studies have found that we sleep more deeply if we build in some moderate daily exercise – just 20-30 minutes of walking should do it.

Keep your bedroom dark and cool

Especially at sleep time. Even dim lights—especially the flickering kind from a TV—can confuse the body clock. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool and ventilated room (around 18°C).

8 Early Signs of Pregnancy

Wondering if you're pregnant? A pregnancy test is the way to know for sure. But what if it's too soon for accurate results? You may notice some subtle signs of pregnancy -- fatigue, nausea, frequent urination, and breast tenderness. Here's some expert advice on how to respond to these symptoms if you're trying to get pregnant.

1. Fatigue

"Extreme, unexplainable fatigue is probably the most common sign of early pregnancy," says Gil Gross, MD, an associate professor of obstetrics and gynecology at the Washington University School of Medicine in St. Louis.

"Don't treat fatigue with excessive caffeine if there is a chance you may be pregnant." Instead, "listen to your body, take it easy, and try to keep well-rested," says Donnica Moore, MD, a women's health expert in Far Hills, N.J.

2. Food Aversions

If opening the refrigerator makes you wince and you can't even walk past the local Chinese restaurant without gagging, you could be pregnant. Many women report that such intense food aversions are one of the first signs of early pregnancy. These can be caused by rising levels of beta-hCG hormone, Moore says. The best thing you can do to help yourself through this is to steer clear of triggers.

3. Sensitivity to Smells

Scents that were never pleasant (like cigarette smoke) and even ones that were pleasing (like your partner's cologne) can make you queasy during pregnancy's early stages. "For some women, this can be a tip-off that they are expecting," Moore says. This is likely a result of rising hormone levels. Unfortunately, "there is really nothing you can do except avoid them when you can," she says, "especially cigarette smoke, which is not good for you or the baby."

4. Nausea and Vomiting

Nausea and vomiting can be some of the first indications that you're pregnant. Blame it on rising hormones levels in early pregnancy.

One of the things that can help expectant moms get through their first trimester is the reassurance that the nausea and vomiting will likely pass by 19 weeks. "It also helps to know that morning sickness can be a good thing," Moore says, because rising levels of the beta-HCG hormone, which may cause morning sickness, indicate a growing pregnancy.

When you eat may make a difference, too. "The key is not to let your stomach get too empty," Moore says. "Keep crackers by your bedside and have them before you get out of bed in the morning."  It is also a good idea to eat small, more frequent meals throughout the day and a snack just before bed.  Lemon and peppermint flavored candies can also ease queasiness.

Prenatal vitamins can also trigger nausea for some expectant moms. "Don't take your vitamins on an empty stomach," Moore says. "A lot of women feel better if they take them at nighttime or with dinner."

If you are vomiting often, speak with your doctor about medication options.

5. Breast Swelling and Tenderness

Breast changes may be another early sign of pregnancy. "The best thing to do about breast tenderness is to get a better bra," Gross says.  A sports bra, for instance, can give you more support.

6. Frequent Urination

"In early pregnancy, the uterus grows and pushes on the bladder, triggering the urge to urinate more often," says Xavier Pombar, DO, an obstetrician at Rush University Medical Center in Chicago

There is no way to avoid this, but going to the bathroom right before bed may allow you to get a little more sleep. "You will probably still have to get up at least once in the night to use the bathroom," Pombar says.

7. Shortness of Breath

Some women feel mildly short of breath when they first become pregnant and sometimes throughout pregnancy. "This is because you need extra oxygen due to the growing embryo," Pombar says. "The further along you are, the worse this gets. Still, don't just brush this off as a 'normal' sign of pregnancy." Talk to your doctor if you are concerned or if any of the following are true for you:

These can be signs of something more serious.

-->You have a sudden onset of shortness of breath that is not associated with exercise.

-->Breathing is at all painful.

-->The breathless feeling is worse when you are lying down.

8. Physical Changes

If you think that you may be pregnant because you've been sexually active without contraception, make an appointment with your doctor. There are changes in the vagina's color and the softness of the cervix that an experienced clinician can identify during a pelvic exam, Pombar says.

"Remember that while these are early signs of pregnancy, these are also the symptoms of other things, including premenstrual syndrome (PMS)," Moore says. "The most reliable early sign of pregnancy is your first missed period if you have regular periods."

Check your baby breathing

How often should I check my baby's breathing?

As often as you feel you need to. If your baby is premature, has a chronic lung disease, or another condition such as central sleep apnea, it may help to monitor your baby's breathing. But even if your baby doesn't have a medical problem, you may worry that he could develop one, such as sudden infant death syndrome (SIDS).If you feel compelled to check your baby's breathing all the time, you're not alone.

It may help to keep in mind that babies have various stages of slumber – sometimes deep and still, sometimes active, sometimes noisy and snuffly. Your comfort level should grow with your experience as a parent, but it's okay if you continue to make nightly forays into your child's bedroom, just to check on his breathing, for years to come.

Danielle Buckley-Werner remembers feeling panic-stricken every time she put her son to bed during his first months of life.

"I was sure that if I wasn't there to hear him breathe, then he couldn't take a breath," she says. "I was so tired all the time because when he slept, I would watch him. I finally collapsed on the floor of the nursery one afternoon and realized that something had to give if I was going to have the energy to be a good mom."

Buckley-Werner started using a baby monitor when she couldn't be with her son. For the first three months, she and her husband, Daniel, kept the crib in their room so they could easily respond to any coughs, cries, or breathing emergencies – which, thankfully, never arose.

"I can't tell new parents that they shouldn't worry and that constantly checking breathing is insane," says Buckley-Werner. "But depriving yourself of rest and waking your baby up all the time will exhaust everyone. For me, keeping my baby close helped me overcome my fears that he'd stop breathing."

SIDS Consideration 

Newborns and young babies normally have 'periodic breathing' patterns. They also breathe differently when in various stages of sleep. For example, sometimes being still when in a deep sleep, sometimes active and noticeable breathing and sometimes noisy and snuffly. The various stages of sleep are explained in class 11.

A normal breathing pattern for a young baby is to:

-->Breathe for a short period that is fast and deep, then

-->Breathe slower and shallower for a while, then

-->Pause for up to 5 seconds or so, before starting again with progressively fast, deep breaths.

This breathing cycle is normal and changes into more adult like breathing patterns (with occasional sighs), as they mature in the first few months.

Many new parents have concerns about SIDS, often checking their baby's breathing regularly in the early weeks and months. How often you check your baby's breathing is very personal and often comes down to whatever makes you feel comfortable. Try and remember that SIDS is rare and that 1,999 out 2,000 babies will not die from SIDS, with the risks dramatically decreasing after 6 months of age. If you are feeling anxious, take the recommended steps to reduce the risks and perhaps consider learning infant CPR.

If you do feel compelled to check your baby's breathing all the time, this is normal and your comfort level should increase as your child grows. If you suspect your baby has stopped breathing, or simply want to reassure yourself that they are still breathing, you can:

-->Listen, by putting your ear next to your baby's mouth and nose to hear breath sounds.

-->Look at your baby's chest and watch for up and down movements.

-->Feel your baby's chest, by gently placing the palm of your hand on their chest to feel the up and down movements.

-->Feel your baby's breath on your cheek by placing your face close to your baby's mouth and nose (this may be difficult to detect).

If after 5 seconds or so you can't detect any signs of breathing and your baby is limp and unable to be roused or woken (their skin and lips may also look a dusky grey or purple-blue colour, especially if they are fair-skinned), you will need to call an ambulance (dial 000 in Australia) and commence CPR (if you know how to perform CPR).

NOTE: Reading about how to perform infant CPR is not enough to teach you how to do it correctly. The following information is guide only. You should attend an approved course to learn CPR. For example, through St. John's Ambulance, their website is:

This article contains general information only and is not intended to replace advice from a qualified health professional.

When will my baby be ready to shower instead of bath?

When your child can stand in a shower stall and tolerate the feeling of water hitting his body from above, he can start taking showers. But most young children would rather sit and play in a tub than stand and scrub in the shower. Wait until he shows an interest. When he does, I would encourage you to get him used to the process first.

To get your child used to showering, start by holding him in your arms. The security you offer will help make the transition smoother. You can also get him used to the feeling in steps. Start by having him stand in the shower without the water running. For extra security, your child can sit on a plastic chair or a mat. When he feels comfortable there, have him stand outside the shower with the water on to get used to the sound. Then, allow him to watch a parent or older sibling taking a shower. This will help him put it together and understand the process. Also, it can be hard — even for adults — to stand in a wet bathtub without slipping. A non-slip mat will make it easier for your little one to stay upright.

It may take a while for your child to enjoy taking a shower; don't be surprised if the noise and spray are too much for him at first. If he doesn't like it, go back to the bath. In time he will desire showers, but until then, let him be a kid. Around age 6, your child can shower alone, as long as you are nearby in case he needs help. Until then, make sure you keep an eye on him when he is in the shower.