If you're still intrigued by the idea, check with your practitioner before you leap (or in this case heave yourself) onto the exam table at the mall. If you decide to go ahead with this kind of elective sonography, do so wisely: Limit your visits to one or two, with each ultrasound no more than 15 minutes in length. And bring your wallet. The image may be priceless, but some studios charge a hefty price for that suitable-for-framing photo, CD, and DVD of your baby-to-be.

"I'm going for my 20-week ultrasound, and we're not sure whether to find out the baby's sex or not."

This is one pregnancy decision only a mom and dad can make-and there's no right or wrong when it comes to making it. Some parents opt to know for practical reasons: It makes layette shopping, nursery painting, and name selection (only one to pick!) a lot simpler. Others opt to know because they simply can't stand the suspense. But many parents still prefer the guessing game, and they decide to find out the old-fashioned way-when baby's lower half finally makes its way out into the world. The choice is yours.

If you do decide to find out now, keep in mind that determining the sex of a baby through ultrasound is not an exact science (unlike amniocentesis, which determines the sex of the baby through chromosomal analysis). Very occasionally, parents are told by the sonographer that they're expecting a girl only to hear at delivery, "It's a boy!" (or vice versa). So if you do choose to find out your baby's gender when you go for your ultrasound, remember that it's only a guess, however educated it may be.

Placenta Position "The doctor said my ultrasound showed that the placenta was down near the cervix. She said that it was too early to worry about it, but of course I started worrying."

Think your baby is the only thing moving around in your uterus? Think again. Like a fetus, a placenta can move around during pregnancy. It doesn't actually pick up and relocate, but it does appear to migrate upward as the lower segment of the uterus stretches and grows. Though an estimated 10 percent of placentas are in the lower segment in the second trimester (and an even larger percentage before 14 weeks), the vast majority move into the upper segment by the time delivery nears. If this doesn't happen and the placenta remains low in the uterus, partially or completely covering the cervix (the mouth of the uterus), a diagnosis of "placenta previa" is made. This complication occurs in very few full-term pregnancies (about 1 in 200). In other words, your doctor is right. It's too early to worry-and statistically speaking, the chances are slim that you'll ever have to worry.

"During my ultrasound, the technician told me I have an anterior placenta. What does that mean?"

It means your baby is taking a backseat to the placenta. Usually, a fertilized egg situates itself in the posterior uterus-the part closest to your spine, which is where the placenta eventually develops. Sometimes, though, the egg implants on the opposite side of the uterus, closest to your belly button. When the placenta develops, it grows on the front (or anterior) side of your uterus, with the baby behind it. And that, apparently, is what happened in your case.

Happily, your baby doesn't care which side of the uterus he or she is lying on, and where the placenta is located certainly makes no difference to his or her development. The downside for you is that you might be less able to feel (and later see. your baby's early kicks and punches because the placenta will serve as a cushion between your baby and your tummy (which could lead to unnecessary worrying). For the same reason, your doctor or midwife may find it a bit harder to hear fetal heart sounds (and it could make amniocentesis a little more challenging). But despite those slight inconveniencies-which are nothing to be concerned about-an anterior placenta is inconsequential. What's more, it's very likely that the placenta will move into a more posterior position later on (as anterior placentas commonly do).

Sleeping Position "I've always slept on my stomach. Now I'm afraid to. And I just can't seem to get comfortable any other way."

Unfortunately, two common favorite sleeping positions-on the belly and on the back-are not the best (and certainly not the most comfortable) choices during pregnancy. The belly position, for obvious reasons: As your stomach grows, it's like sleeping on a watermelon. The back position, though more comfortable, rests the entire weight of your pregnant uterus on your back, your intestines, and major blood vessels. This pressure can aggravate backaches and hemorrhoids, make digestion less efficient, interfere with optimum circulation, and possibly cause hypotension, or low blood pressure, which can make you dizzy.

Sleeping on your side

Carrying Baby, Fifth Month Here are just three of the very different ways that a woman may carry near the end of her fifth month. The variations on these are endless. Depending on your size, your shape, the amount of weight you've gained, and the position of your uterus, you may be carrying higher, lower, bigger, smaller, wider, or more compactly.

This doesn't mean you have to sleep standing up. Curling up or stretching out on your side-preferably the left side, though either side is fine-with one leg crossed over the other and with a pillow between them (see illustration, facing page), is ideal for both you and your fetus. It not only allows maximum flow of blood and nutrients to the placenta but also enhances efficient kidney function, which means better elimination of waste products and fluids and less swelling (edema) of ankles, feet, and hands.

Very few people, however, manage to stay in one position through the night. Don't worry (repeat: do not worry) if you wake up and find yourself on your back or abdomen. No harm done (repeat: no harm done); just turn back to your side. You may feel uncomfortable for a few nights, but your body will soon adjust to the new position. A body pillow that's at least 5 feet long or a wedge-shaped pillow can offer support, making side sleeping much more comfortable and staying on your side much easier. If you don't have either of these, you can improvise with any extra pillows, placing them against your body in different positions until you find that perfect combination for catching z's.

Class Womb?

"I have a friend who insists that taking her unborn baby to concerts will make him a music lover, and another one whose husband reads to her tummy every night to give their baby a love of literature. Should I be trying to stimulate my baby, too?"

All parents want only the best for their children-or in this case, for their children-to-be. But it's important to keep some perspective before switching on the Beethoven and reciting the Shakespeare.

While it's true the fetus's ability to hear is well developed by the end of the second trimester, there is no proof that an in utero concerto or a lesson in the great classics gives the baby a head start in education (or on a musical or literary career). Promoting an educational or cultural agenda this early can also come with a potential downside-especially if it signals the start of extremely premature parental pushiness, and begins placing too much emphasis on achievement at a too-tender age (and before birth is definitely too tender an age). Fetuses (like the babies and children they'll become before you know it. develop-and later, learn-best at their own pace, no prodding necessary. There's also the theoretical risk that when parents attempt to turn the womb into a classroom, they may unwittingly disrupt the natural sleep patterns of their baby-to-be, actually hampering development instead of nurturing it (just as waking up a newborn for a game of name-this-letter might).

That said, there's nothing wrong-and a lot right-with providing a uterine environment that's rich in language and music, and much more important, about finding ways to get close to your little one long before you even have that first cuddle. Talking, reading, or singing to your baby while in the womb (no amplification necessary) won't guarantee a scholarship to Yale, but it will guarantee that your baby will know your voice at birth-and will give you both a head start on bonding.

Playing classical music now may increase the likelihood that your newborn will appreciate, and even be soothed by, these sounds later on (though it's been shown that exposure to music and literature has a much more significant effect once your baby is actually born than it does prenatally-so keep the sonatas handy once baby's arrived). And don't underestimate the power of touch. Since this sense also begins to develop in utero, stroking your belly now may also help strengthen the bond between you and your baby later.

So turn on the Mozart, bring on the Bach, pull out those dusty Shakespeare sonnets and read away to your belly if you like (and if you can do it without cracking up). Just make sure you're doing it all to get closer to your baby-not to get your baby closer to an Ivy League degree.

Of course, if you feel silly performing for your bloated belly, there's no reason to worry that your baby will miss out on getting to know you. He or she is getting used to the sound of your voice-and Dad's, too-every time you speak to each other or someone else. So enjoy making baby contact now, but definitely don't worry about early learning this early. As you'll discover, kids grow up all too soon anyway. There's no need to rush the process, particularly before birth.

Carrying Older Children "I have a three-year-old who always wants to be carried. Is it okay to keep doing it at this point in pregnancy? It's definitely killing my back."

Carrying moderately heavy loads (even some 35 or 40 pounds of preschooler) is safe throughout pregnancy unless your practitioner has told you otherwise. What giving in to those choruses of "carry me" can end up doing to your back is another story-a probably painful one. Breaking her of the being-carried habit would definitely be a better strategy than continuing to break your back-so try making walking fun for her. Challenge her to mini races, or climb the stairs to a song. Don't forget to applaud her efforts when she does agree to walk on her own two feet instead of hailing the mommy taxi-and try to blame your back (not her sibling-to-be. for the slowdown in pick ups. Compensate, too, with plenty of holding and hugging from a sitting position. And because there will be times when she definitely won't take "walk" for an answer, save your back some strain by learning the proper way to lift her (see page 237 page 237).

Approaching Parenthood "I keep wondering if I will be happy with this whole parenthood thing. I have no clue what it'll really be like."

Most people approach any major change in their lives-and there's no more major change than an upcoming birth-wondering whether it will be a change they'll be happy with. And it's always much more likely to be a happy change if you keep your expectations realistic.

So, if you have images of bringing a cooing, smiling, picture-perfect baby home from the hospital, you may want to read up on what newborns are really like. Not only won't your newborn be smiling or cooing for many weeks, he or she may hardly communicate with you at all, except to cry-and this will almost invariably be when you're sitting down to dinner or starting to get busy in bed, have to go to the bathroom, or are so tired you can't move.

And if your visions of parenthood consist of nothing but leisurely morning walks through the park, sunny days at the zoo, and hours coordinating a wardrobe of miniature, picture-perfect clothes, another reality check is probably in order. You'll have your share of walks in the park, but there will also be many mornings that turn into evenings before you and your baby have the chance to see the light of day; many sunny days that will be spent largely in the laundry room; very few tiny outfits that will escape unstained by spit-up, pureed bananas, and baby vitamins.

What you can expect realistically, however, are some of the most wondrous, miraculous experiences of your life. The fulfillment you will feel when cuddling a warm, sleeping bundle of baby (even if that cherub was howling moments before) is incomparable. That-along with that first toothless smile meant just for you-will be well worth all the sleepless nights, delayed dinners, mountains of laundry, and frustrated romance.

Happy? Just you wait, Mom.

Wearing a Seat Belt "Is it safe to buckle my seat belt in the car? And is the air bag an issue when you're pregnant?"

There's no safer way for an expectant mother-and her unborn baby-to travel than buckled up. Plus, it's the law in most places. For maximum safety and minimum discomfort, fasten the belt below your belly, across your pelvis and upper thighs. Wear the shoulder harness over your shoulder (not under your arm), diagonally between your breasts and to the side of your belly. And don't worry that the pressure of an abrupt stop will hurt your baby; he or she is well cushioned by amniotic fluid and uterine muscle, among the world's best shock-absorbing materials.

As for air bags, it's safest to keep your distance. So if you're sitting in the passenger seat, set the seat as far back as you can (your legs will appreciate the stretching room, too). If you're driving, tilt the wheel up toward your chest, away from your tummy, and sit at least 10 inches from the steering wheel, if possible.

Travel "Is it safe for me to go ahead and take the vacation we had planned for this month?"

Never again will it be so easy to vacation with your baby. Fast-forward to next year when you'll be lugging a car seat, diapers, toys, and child-proofing kits wherever you go, and you'll see why. And there's no better time for pregnant travel than the second trimester. After all, the fatigue, queasiness, and emotional extremes of the first trimester are behind you-but you're not yet at the point where your belly has a life of its own, making it hard enough to drag yourself around, never mind the luggage.

So don't have reservations about those reservations you've made. But before you pack your suitcase, do get the go-ahead from your practitioner. Chances are your vacation plans will be green-lighted, since travel is rarely restricted during pregnancy unless there's an obstetrical or medical complication.

Once you've been cleared for takeoff, you'll only need to do a little planning to ensure a safe and pleasant expectant voyage, whether it's a quick business trip or a leisurely babymoon: Time it right. When you're planning a pregnancy vacation, timing is everything. For long-distance travel, the second trimester is the clear winner. Far-flung travel during the first trimester, even in a low-risk pregnancy, can be pretty uncomfortable, especially if morning sickness, fatigue, and other early symptoms have hit hard. Likewise, roaming far from home isn't recommended in the last part of the last trimester for obvious reasons: Should you go into labor early, you'd be stranded far from your practitioner. When you're planning a pregnancy vacation, timing is everything. For long-distance travel, the second trimester is the clear winner. Far-flung travel during the first trimester, even in a low-risk pregnancy, can be pretty uncomfortable, especially if morning sickness, fatigue, and other early symptoms have hit hard. Likewise, roaming far from home isn't recommended in the last part of the last trimester for obvious reasons: Should you go into labor early, you'd be stranded far from your practitioner.

Choose a suitable destination. A hot, humid climate may be hard for you to handle because of your hopped- up metabolism; if you do choose such a locale, make sure that your hotel and transportation are air-conditioned and that you stay hydrated and out of the sun. Travel to areas at high altitude (more than 7,000 feet above sea level) may be unsafe, because adjusting to the decrease in oxygen may be too taxing for both you and your baby. Other inappropriate destinations are developing regions of the world for which vaccinations would be necessary, since some vaccines may be hazardous during pregnancy (check with your practitioner). Not insignificantly, these same locales may be hotbeds of certain potentially dangerous infections for which there are no vaccines-another reason to avoid them when you're expecting. Not to mention the risk of food- and water-borne illnesses common in those parts. A hot, humid climate may be hard for you to handle because of your hopped- up metabolism; if you do choose such a locale, make sure that your hotel and transportation are air-conditioned and that you stay hydrated and out of the sun. Travel to areas at high altitude (more than 7,000 feet above sea level) may be unsafe, because adjusting to the decrease in oxygen may be too taxing for both you and your baby. Other inappropriate destinations are developing regions of the world for which vaccinations would be necessary, since some vaccines may be hazardous during pregnancy (check with your practitioner). Not insignificantly, these same locales may be hotbeds of certain potentially dangerous infections for which there are no vaccines-another reason to avoid them when you're expecting. Not to mention the risk of food- and water-borne illnesses common in those parts.

Buckling up for two

Jettisoning Jet Lag Add jet lag to the normal fatigue of pregnancy and you're likely to want to end your trip before it begins. So it makes sense to try to minimize-if you can't completely eliminate-the physically draining effects of travel across time zones. Here's how: Start switching time zones before you leave. Ease yourself into the time zone you're headed for by setting your watch-and your schedule-gradually back or forward. If you're heading east, start getting up a little earlier and going to bed a little earlier a few days before your departure. If you're heading west, go to bed a little later and get up a little later (if you can). On your plane ride, try to sleep if it's an appropriate sleeping time at your destination, or stay awake if it's not. Ease yourself into the time zone you're headed for by setting your watch-and your schedule-gradually back or forward. If you're heading east, start getting up a little earlier and going to bed a little earlier a few days before your departure. If you're heading west, go to bed a little later and get up a little later (if you can). On your plane ride, try to sleep if it's an appropriate sleeping time at your destination, or stay awake if it's not.

Live on local time. Once you arrive at your destination, start living on local time full-time. If you arrive at your Paris hotel room at 7 Once you arrive at your destination, start living on local time full-time. If you arrive at your Paris hotel room at 7 A.M A.M., exhausted from an overnight flight, resist the urge to nap until noon. Instead, try to get a second wind going with a shower and a hearty breakfast, and then step out for a slow-paced day. Don't push yourself-take frequent breaks to sit down with your feet up-but do try hard to stay vertical. Lie down and you're sure to surrender to sleep. Dine, too, according to the local clock and not your internal one (snack if you're hungry, but hold off on a full meal until the clock strikes "eat"), and strive to stay awake until as close to your usual bedtime (local time) as possible. This should help you sleep through the local night. Avoid sleeping in, too, which could make going to bed at a normal time the next night more difficult. Ask for a wake-up call, even if you think you won't need it.

Seek out sun. Getting some sunlight will help you reset your biological clock, so be sure to spend some time outdoors on your first day at your new destination. If there's no sun to be found, at least spend some time outdoors. If you've gone west to east, the best sun to seek is morning sun; if you've gone east to west, get your daylight in the late afternoon. Getting some sunlight will help you reset your biological clock, so be sure to spend some time outdoors on your first day at your new destination. If there's no sun to be found, at least spend some time outdoors. If you've gone west to east, the best sun to seek is morning sun; if you've gone east to west, get your daylight in the late afternoon.

Eat, drink, and be less jet-lagged. Anyone who travels frequently knows how dehydrating air travel can be. And dehydration can make jet lag symptoms more severe (not to mention put you at risk for pregnancy complications). So drink plenty of water on the plane, and continue drinking once you have arrived. Take time to eat regularly, too. Concentrate on foods that are high in long-term energy boosters, such as protein and complex carbohydrates, preferably eaten in combo. Getting some exercise (nothing strenuous; a walk in a park or a few laps in the hotel pool are just right) will also help you feel less fatigued. Anyone who travels frequently knows how dehydrating air travel can be. And dehydration can make jet lag symptoms more severe (not to mention put you at risk for pregnancy complications). So drink plenty of water on the plane, and continue drinking once you have arrived. Take time to eat regularly, too. Concentrate on foods that are high in long-term energy boosters, such as protein and complex carbohydrates, preferably eaten in combo. Getting some exercise (nothing strenuous; a walk in a park or a few laps in the hotel pool are just right) will also help you feel less fatigued.

Don't look for a miracle. Don't use any over-the-counter, prescription, or herbal preparation for jet lag (or any purpose) without your practitioner's approval. Don't use any over-the-counter, prescription, or herbal preparation for jet lag (or any purpose) without your practitioner's approval.

Give it time. You should start to feel less tired and more in sync with the local schedule within a couple of days. You should start to feel less tired and more in sync with the local schedule within a couple of days.

You may find sleep problems-and the fatigue that inevitably accompanies them-continue to plague you during the entire trip. But let's face it, that may have less to do with jet lag and more to do with the fact that you're carrying around a lot of extra baggage-the kind you can't ask a skycap or bellman to help you with.

Pregnant at a High Altitude Women who are accustomed to breathing thinner air because they live at a high altitude are far less likely to encounter an altitude-induced problem in their pregnancies (hypertension, water retention, a somewhat smaller-than-average baby) than those who just moved there after a lifetime at sea level. For that reason, many practitioners suggest postponing a contemplated move or visit from low altitude to high until after delivery. And scaling Mount Rainier is definitely out for now.

If you must make a trip to a destination at a high altitude, try to ascend gradually, if possible (if you're driving, for example, try to go up 2,000 feet a day, rather than going up 8,000 feet all at once). To minimize the risk of developing acute mountain sickness (AMS), also plan on limiting exertion for a few days after your arrival, drink lots of fluids, eat frequent small meals instead of three large ones, avoid rich and heavy food, and seek sleeping accommodations, if feasible, at a somewhat lower altitude.

Plan a trip that's relaxing. A single destination trumps a whirlwind tour that takes you to six cities in six days. A vacation for which you set the pace is a lot better than one where a group tour guide sets it for you. A few hours of sightseeing or shopping (or meetings) should be alternated with time spent with your feet up. You'll need to listen to your pregnant body, which may have to set the agenda. A single destination trumps a whirlwind tour that takes you to six cities in six days. A vacation for which you set the pace is a lot better than one where a group tour guide sets it for you. A few hours of sightseeing or shopping (or meetings) should be alternated with time spent with your feet up. You'll need to listen to your pregnant body, which may have to set the agenda.

Insure yourself. Sign up for reliable travel insurance, in case a pregnancy complication should require you to change your plans and stick close to home. Consider medical evacuation insurance as well if you're traveling overseas, in case you need to return home quickly and under medical supervision. Medical travel insurance may also be useful if your regular insurance plan does not include foreign medical care. Check your policy ahead of time. Sign up for reliable travel insurance, in case a pregnancy complication should require you to change your plans and stick close to home. Consider medical evacuation insurance as well if you're traveling overseas, in case you need to return home quickly and under medical supervision. Medical travel insurance may also be useful if your regular insurance plan does not include foreign medical care. Check your policy ahead of time.

Pack a pregnancy survival kit. Make sure you take enough prenatal vitamins to last the trip; some healthy snacks; Sea-Bands if you're susceptible to motion sickness and a medication for traveler's stomach that's been recommended by your practitioner; comfortable shoes roomy enough to accommodate feet swelled by long hours of sightseeing or work; and sunscreen. Make sure you take enough prenatal vitamins to last the trip; some healthy snacks; Sea-Bands if you're susceptible to motion sickness and a medication for traveler's stomach that's been recommended by your practitioner; comfortable shoes roomy enough to accommodate feet swelled by long hours of sightseeing or work; and sunscreen.

If you're traveling overseas, have the name of a local obstetrician handy, just in case. Contact the International Association for Medical Assistance to Travelers (IAMAT) at (716) 754-4883 or at iamat.org, which can provide you with a directory of English-speaking physicians throughout the world. Some major hotel chains can also provide you with this kind of information. When you're overseas, if for any reason you find yourself in need of a doctor in a hurry and your hotel can't provide you with one, you can call the American embassy, an American military base, or the nearest teaching hospital. Or you can head for the hospital's emergency room. If you have medical travel insurance, you should have a number to call for help.

Take healthy eating habits with you. You may be on vacation, but your baby is working as hard as ever at growing and developing and has the same nutritional requirements as always. Order thoughtfully and you will be able to savor the local cuisine while also fulfilling your baby's requirements. Most important: Eat regularly and snack as needed. Don't skip breakfast or lunch to save up for a six-course dinner. You may be on vacation, but your baby is working as hard as ever at growing and developing and has the same nutritional requirements as always. Order thoughtfully and you will be able to savor the local cuisine while also fulfilling your baby's requirements. Most important: Eat regularly and snack as needed. Don't skip breakfast or lunch to save up for a six-course dinner.

Eat selectively. In some regions, it may not be safe to eat raw unpeeled fruits or vegetables or salads. (Peel fruit yourself, washing the fruit first and your hands after peeling to avoid transferring germs to the fruit; bananas and oranges tend to be safer than other fruits because of their thick skins.) No matter where you roam, avoid cooked foods that are lukewarm or at room temperature, raw or undercooked meat, fish, and poultry, as well as unpasteurized or unrefrigerated dairy products and juice and food sold by street vendors, even if it's hot. For complete information on such restrictions, on other foreign health hazards, and on immunizations for travel, contact the Centers for Disease Control and Prevention's Traveler's Hotline at (877) FYI-TRIP (394-8747. or at In some regions, it may not be safe to eat raw unpeeled fruits or vegetables or salads. (Peel fruit yourself, washing the fruit first and your hands after peeling to avoid transferring germs to the fruit; bananas and oranges tend to be safer than other fruits because of their thick skins.) No matter where you roam, avoid cooked foods that are lukewarm or at room temperature, raw or undercooked meat, fish, and poultry, as well as unpasteurized or unrefrigerated dairy products and juice and food sold by street vendors, even if it's hot. For complete information on such restrictions, on other foreign health hazards, and on immunizations for travel, contact the Centers for Disease Control and Prevention's Traveler's Hotline at (877) FYI-TRIP (394-8747. or at www.cdc.gov/travel. Travel warnings are also available from the State Department at (202) 647-5225 or at travel.state.gov.

Don't drink the water (or even brush your teeth with it) unless you're certain it's safe. If the purity of the water is questionable at your destination, plan to use bottled water for drinking and brushing (and always make sure the seal on the bottle cap is intact when you open it). Avoid ice, too, unless you are certain it wasmade from bottled or boiled water. If the purity of the water is questionable at your destination, plan to use bottled water for drinking and brushing (and always make sure the seal on the bottle cap is intact when you open it). Avoid ice, too, unless you are certain it wasmade from bottled or boiled water.

Don't swim in the water, either. In some areas, lakes and oceans may be polluted. Check with the CDC about the waters at your destination to be sure of safety before taking a dip. Any pool you swim in should be properly chlorinated (a whiff will usually clue you in). In some areas, lakes and oceans may be polluted. Check with the CDC about the waters at your destination to be sure of safety before taking a dip. Any pool you swim in should be properly chlorinated (a whiff will usually clue you in).

Pregnant Women Are Delicious If mosquitoes seem to love snacking on you more than ever now that you're pregnant, it's not just your imagination. Scientists have found that pregnant women attract twice as many mosquitoes as nonpregnant women do, possibly because those pesky bugs are fond of carbon dioxide and pregnant women tend to take more frequent breaths, thereby releasing more of this mosquito-friendly gas. Another reason why mosquitoes make a beeline for expectant mothers: They're heat-seeking, and expectant mothers generally have higher body temperatures, what with all that baby making going on. So if you live in or travel to an area where mosquitoes are a problem (especially if they pose a health risk), take proper precautions. You can avoid their bites by staying indoors in heavily mosquito-infested areas, by using tight-fitting screens on windows, and by using a non-DEET-based insect repellent.

Head off traveler's irregularity. Changes in schedule and diet can compound constipation problems. So make sure you get plenty of the three most effective constipation combaters: fiber, fluids, and exercise. It may also help to eat breakfast (or at least a morning snack) a little early so you'll have time to use the bathroom before you set out for the day. Changes in schedule and diet can compound constipation problems. So make sure you get plenty of the three most effective constipation combaters: fiber, fluids, and exercise. It may also help to eat breakfast (or at least a morning snack) a little early so you'll have time to use the bathroom before you set out for the day.

When you've gotta go, go. Don't encourage a UTI or constipation by postponing trips to the bathroom. Go as soon as you feel the urge (and can find a rest room). Don't encourage a UTI or constipation by postponing trips to the bathroom. Go as soon as you feel the urge (and can find a rest room).

Get the support you need. Support hose, that is, particularly if you already suffer from varicose veins. But even if you only suspect you may be predisposed to them, consider wearing support hose when you'll be doing a lot of sitting (in cars, planes, or trains, for example) and when you'll be doing a lot of standing (in museums, in airport lines). They'll also help minimize swelling in your feet and ankles. Support hose, that is, particularly if you already suffer from varicose veins. But even if you only suspect you may be predisposed to them, consider wearing support hose when you'll be doing a lot of sitting (in cars, planes, or trains, for example) and when you'll be doing a lot of standing (in museums, in airport lines). They'll also help minimize swelling in your feet and ankles.

Don't be stationary while on the move. Sitting for long periods can restrict the circulation in your legs, so be sure to shift in your seat frequently, and stretch, flex, wiggle, and massage your legs often-and avoid crossing your legs. If possible, take your shoes off and elevate your feet a bit. Get up at least every hour or two to walk the aisles when you are on a plane or train. When traveling by car, don't go for more than two hours without stopping for a stretch and a stroll. Sitting for long periods can restrict the circulation in your legs, so be sure to shift in your seat frequently, and stretch, flex, wiggle, and massage your legs often-and avoid crossing your legs. If possible, take your shoes off and elevate your feet a bit. Get up at least every hour or two to walk the aisles when you are on a plane or train. When traveling by car, don't go for more than two hours without stopping for a stretch and a stroll.

If you're traveling by plane. Check with the airline in advance to see if it has special regulations concerning pregnant women (many airlines do). Arrange ahead of time for a seat in the bulkhead (preferably on the aisle, so you can get up and stretch or use the rest room as needed), or if seating is not reserved, ask for preboarding. Check with the airline in advance to see if it has special regulations concerning pregnant women (many airlines do). Arrange ahead of time for a seat in the bulkhead (preferably on the aisle, so you can get up and stretch or use the rest room as needed), or if seating is not reserved, ask for preboarding.

When booking your flight, ask whether any meal will be served or available for purchase. More and more often, the so-called friendly skies are also the go-hungry skies. If the pickings will be slim (half an ounce of snack mix) at best, bring along a meal of your own (a sandwich or salad, for instance). Even if you will be scoring a meal, keep in mind that it may be (a. tiny (b) inedible (c) a long time in coming due to flight delays, or (d) all of the above. Pack snacks accordingly: cheese sticks or wedges, raw vegetables, fresh fruit, trail mix, dry cereal, some healthy chips. And don't forget to drink plenty of bottled water (don't drink airplane tap water or water that you suspect might have originated in the airplane tap), milk, and juice to counter the dehydration caused by air travel. This tactic will also encourage trips to the bathroom, which will ensure your legs get stretched periodically.

Wear your seat belt comfortably fastened below your belly. If you're traveling to a different time zone, take jet lag (see box, page 251 page 251) into account. Rest up in advance, and plan on taking it easy for a few days once you arrive.

If you're traveling by car. Keep a bagful of nutritious snacks and a thermos of juice or milk handy for when hunger strikes. For long trips, be sure the seat you will occupy is comfortable; if it isn't, consider buying or borrowing a special cushion for back support, available in auto supply or speciality stores or online. A pillow for neck support may also add to your comfort. For car safety tips, see Keep a bagful of nutritious snacks and a thermos of juice or milk handy for when hunger strikes. For long trips, be sure the seat you will occupy is comfortable; if it isn't, consider buying or borrowing a special cushion for back support, available in auto supply or speciality stores or online. A pillow for neck support may also add to your comfort. For car safety tips, see page 250 page 250.

If you're traveling by train. Check to be sure there's a dining car with a full menu. If not, bring adequate meals and snacks along. If you're traveling overnight, book a sleeper car, if you can. You don't want to start your trip exhausted. Check to be sure there's a dining car with a full menu. If not, bring adequate meals and snacks along. If you're traveling overnight, book a sleeper car, if you can. You don't want to start your trip exhausted.

Sex and the Pregnant Woman Religious and medical miracles aside, every pregnancy starts with sex. So why does what probably got you here in the first place become so complicated now that you're here?

Whether you're having it more often or you're having it less often, whether you're enjoying it more or enjoying it less-or whether you're not doing it or enjoying it at all-chances are that making a baby has changed the way you make love. From sorting out what is and isn't safe in bed (or on the living room rug or on the kitchen counter) to figuring out which positions best accommodate your ever-bigger belly; from mismatched moods (you're turned on, he's turned off; he's turned on, you're turned off) to hormones gone wild (leaving your breasts more enticing than ever, yet too tender to touch), pregnancy sex is full of challenges on both sides of the bed. But not to worry. A little creativity, a good sense of humor, plenty of patience (and practice), and lots of love will conquer all when it comes to pregnancy lovemaking.

Sex Through the Trimesters Down-up-down. While that might sound like a new sex position, it's actually a good description of the roller-coaster pattern most couples can expect their sex lives to follow during their nine months of pregnancy. In the first trimester, many women find that their libidos take a nosedive, plummeting promptly as soon as pregnancy hormones kick in. And that slowdown in sexual interest should come as no shocker. After all, fatigue, nausea, vomiting, and painfully tender nipples don't make great sex partners. But as with all things pregnancy, no two women are alike, which means no two libidos are alike, either. If you're lucky, you might actually find that the first trimester makes you hotter than ever, thanks to the happy side of hormonal changes. genitals that are ultrasensitive and ever-tingly, and breasts that are extra big and extra fun to touch (or have touched).

Interest often-though not always-picks up during the second trimester, when early pregnancy symptoms have subsided and there's more energy to put into lovemaking (and when less time in the bathroom leaves more time in the bedroom). Never had multiple orgasms before (or any orgasms)? This may be your lucky break-and your chance to get lucky again and again. That's because extra blood flow to the labia, clitoris, and vagina can make it easier to climax than ever before-and to have orgasms that are stronger and longer lasting, too. But again, nothing's a given during pregnancy. Some women actually lose that loving feeling in the second trimester-or never end up finding it at all during their nine months, and that's normal, too.

As delivery nears, libido usually wanes again, sometimes even more drastically than in the first trimester, for obvious reasons. First, your watermelon-size abdomen makes the target more difficult for your partner to reach, even with creative positioning. second, the aches and discomforts of advancing pregnancy can cool even the hottest passion; and third, late in the trimester it's hard to concentrate on anything but that eagerly and anxiously awaited event. Still, some couples manage to overcome those late-pregnancy obstacles and keep up the action until that first contraction.

What's Turning You On (or Off)?

With all the many physical changes you're undergoing during your nine months of pregnancy, it's no wonder desire and sexual pleasure are being affected, both positively and negatively. You'll have to learn to accommodate some of the negative effects so their interference in your sex life is minimal.

Nausea and vomiting. Morning sickness can certainly come between you and a good time. After all, it's hard to purr with pleasure when you're busy gagging up dinner. So use your time wisely. If your morning sickness rises with the sun, put after-dark hours to good use. If your evenings are queasy, hop on the morning love train. If morning sickness stays with you day and night, you and your spouse may just have to wait out its symptoms, which typically taper off by the end of the first trimester. Whatever you do, don't pressure yourself to feel sexy when you're feeling lousy; the result won't be satisfying for anyone. Morning sickness can certainly come between you and a good time. After all, it's hard to purr with pleasure when you're busy gagging up dinner. So use your time wisely. If your morning sickness rises with the sun, put after-dark hours to good use. If your evenings are queasy, hop on the morning love train. If morning sickness stays with you day and night, you and your spouse may just have to wait out its symptoms, which typically taper off by the end of the first trimester. Whatever you do, don't pressure yourself to feel sexy when you're feeling lousy; the result won't be satisfying for anyone.

Fatigue. It's hard to get busy when you barely have the energy to get undressed. Happily, the worst of pregnancy fatigue should pass by the fourth month (though exhaustion will probably return in the last trimester). Until then, make love while the sun shines (when the opportunity presents itself) instead of trying to force yourself to stay up for after-dinner romance. Cap off a weekend afternoon of lovemaking with a nap or the other way around. Have the kind of breakfast in bed that doesn't leave crumbs. It's hard to get busy when you barely have the energy to get undressed. Happily, the worst of pregnancy fatigue should pass by the fourth month (though exhaustion will probably return in the last trimester). Until then, make love while the sun shines (when the opportunity presents itself) instead of trying to force yourself to stay up for after-dinner romance. Cap off a weekend afternoon of lovemaking with a nap or the other way around. Have the kind of breakfast in bed that doesn't leave crumbs.

Your changing shape. Making love can be both awkward and uncomfortable when your bulging belly seems to loom as large and forbidding as a Himalayan mountain. As pregnancy progresses, the gymnastics required to scale that growing abdomen may not seem, to some couples, worth the effort. (But there are ways to manage that mountain; read on for more.) What's more, your fuller-than-ever figure may make you feel less sexy (though some women-and most partners-find that pregnant shape the most sensual of all female forms). If your body is a turnoff to you, try dressing it up in lacy lingerie or lighting your love nest with the flattering glow of candles. Also try to shed those negative body images by thinking: Big (in pregnancy) is beautiful. Making love can be both awkward and uncomfortable when your bulging belly seems to loom as large and forbidding as a Himalayan mountain. As pregnancy progresses, the gymnastics required to scale that growing abdomen may not seem, to some couples, worth the effort. (But there are ways to manage that mountain; read on for more.) What's more, your fuller-than-ever figure may make you feel less sexy (though some women-and most partners-find that pregnant shape the most sensual of all female forms). If your body is a turnoff to you, try dressing it up in lacy lingerie or lighting your love nest with the flattering glow of candles. Also try to shed those negative body images by thinking: Big (in pregnancy) is beautiful.

Your engorged genitals. Increased blood flow to the pelvic area, caused by hormonal changes of pregnancy, can make some women more sexually responsive than ever. But it can also make sex less satisfying (especially later in pregnancy) if a residual fullness persists after orgasm, leaving you feeling as though you didn't quite make it. For your partner, too, the engorgement of your genitalia may increase pleasure (if he feels pleasantly and snugly caressed) or decrease it (if the fit is so tight he loses his erection). Increased blood flow to the pelvic area, caused by hormonal changes of pregnancy, can make some women more sexually responsive than ever. But it can also make sex less satisfying (especially later in pregnancy) if a residual fullness persists after orgasm, leaving you feeling as though you didn't quite make it. For your partner, too, the engorgement of your genitalia may increase pleasure (if he feels pleasantly and snugly caressed) or decrease it (if the fit is so tight he loses his erection).

Leakage of colostrum. Late in pregnancy, some women begin producing the premilk called colostrum, which can leak from the breasts during sexual stimulation and can be a little disconcerting (and messy) in the middle of foreplay. It's nothing to worry about, of course, but if it bothers you or your partner, concentrate on other parts of the body (like that possibly trigger-happy clitoris of yours!). Late in pregnancy, some women begin producing the premilk called colostrum, which can leak from the breasts during sexual stimulation and can be a little disconcerting (and messy) in the middle of foreplay. It's nothing to worry about, of course, but if it bothers you or your partner, concentrate on other parts of the body (like that possibly trigger-happy clitoris of yours!).

The Ins and Outs of Sex During Pregnancy Wondering what's safe and what's not when it comes to making love during pregnancy? Here's the lowdown: Oral sex. Cunnilingus (oral stimulation of the female genitals) is as safe as it is potentially pleasurable throughout pregnancy, so don't hesitate to go for it (just make sure your partner doesn't forcefully blow air into your vagina). Fellatio (oral stimulation of the penis) is always safe during pregnancy (as is swallowing semen), and for some couples is a very satisfactory substitute when intercourse isn't permitted. It's wise to avoid oral sex if your partner has an STD. Cunnilingus (oral stimulation of the female genitals) is as safe as it is potentially pleasurable throughout pregnancy, so don't hesitate to go for it (just make sure your partner doesn't forcefully blow air into your vagina). Fellatio (oral stimulation of the penis) is always safe during pregnancy (as is swallowing semen), and for some couples is a very satisfactory substitute when intercourse isn't permitted. It's wise to avoid oral sex if your partner has an STD.

Anal sex. Anal sex is probably safe during pregnancy, but proceed to the back door with caution. First, it probably won't be comfortable if you have hemorrhoids, an occupational hazard of pregnancy-and it can make them bleed (which can really spoil the moment). Second, you'll need to remember the same safety rule of anal sex whether you're pregnant or not, but be especially fastidious about following it now: Never go from anal to vaginal sex without cleaning up first. Doing so may introduce harmful bacteria into your vaginal canal, setting you up for infection and risk to the baby. Anal sex is probably safe during pregnancy, but proceed to the back door with caution. First, it probably won't be comfortable if you have hemorrhoids, an occupational hazard of pregnancy-and it can make them bleed (which can really spoil the moment). Second, you'll need to remember the same safety rule of anal sex whether you're pregnant or not, but be especially fastidious about following it now: Never go from anal to vaginal sex without cleaning up first. Doing so may introduce harmful bacteria into your vaginal canal, setting you up for infection and risk to the baby.

Masturbation. Unless orgasm is off-limits because of a high-risk pregnancy or premature labor, masturbating during pregnancy is perfectly safe-and a great way to release all that tension you're feeling. Unless orgasm is off-limits because of a high-risk pregnancy or premature labor, masturbating during pregnancy is perfectly safe-and a great way to release all that tension you're feeling.

Vibrators or dildos. As long as your practitioner has okayed vaginal penetration, dildos and vibrators are safe to use during pregnancy; after all, they're just mechanical versions of the real thing. But be sure anything you introduce into the vagina is clean before you use it, and be careful not to penetrate the vagina too deeply with it. As long as your practitioner has okayed vaginal penetration, dildos and vibrators are safe to use during pregnancy; after all, they're just mechanical versions of the real thing. But be sure anything you introduce into the vagina is clean before you use it, and be careful not to penetrate the vagina too deeply with it.

Breast tenderness. For some couples, pregnant breasts (full, firm, and possibly larger than life) are favorite toys that can't get enough play time. But for many, that early pregnancy swelling comes with a high price-painful tenderness-and along with it, a look-but-don't-touch policy. If your breasts are bringing you more pain than pleasure, make sure your partner gets the memo-and remind him that the tenderness will ease up by the end of the first trimester, at which point he'll be able to enjoy a hands-on approach. For some couples, pregnant breasts (full, firm, and possibly larger than life) are favorite toys that can't get enough play time. But for many, that early pregnancy swelling comes with a high price-painful tenderness-and along with it, a look-but-don't-touch policy. If your breasts are bringing you more pain than pleasure, make sure your partner gets the memo-and remind him that the tenderness will ease up by the end of the first trimester, at which point he'll be able to enjoy a hands-on approach.

Changes in vaginal secretions. Wet isn't always wild when you're expecting. Normal vaginal secretions increase during pregnancy and also change in consistency, odor, and taste. If you've always been on the dry or narrow side, that extra lubrication may make sex more enjoyable. But sometimes, too much of a good thing can make the vaginal canal so wet and slippery that it actually decreases sensation for both of you-and even makes it more difficult for your partner to keep his erection or reach orgasm. (A little extra foreplay for him may help him out in that department.) The heavier scent and taste of the secretions may also make oral sex off-putting. Massaging scented oils into the pubic area or the inner thighs (but not the vagina) may help. Wet isn't always wild when you're expecting. Normal vaginal secretions increase during pregnancy and also change in consistency, odor, and taste. If you've always been on the dry or narrow side, that extra lubrication may make sex more enjoyable. But sometimes, too much of a good thing can make the vaginal canal so wet and slippery that it actually decreases sensation for both of you-and even makes it more difficult for your partner to keep his erection or reach orgasm. (A little extra foreplay for him may help him out in that department.) The heavier scent and taste of the secretions may also make oral sex off-putting. Massaging scented oils into the pubic area or the inner thighs (but not the vagina) may help.

Some expectant moms experience vaginal dryness during sex, even with all those extra secretions. Unscented water-based lubricants, such as K-Y or Astroglide, are safe to use as needed when you're having a dry spell.

Bleeding caused by the sensitivity of the cervix. The mouth of the uterus also becomes engorged during pregnancy-crisscrossed with many additional blood vessels to accommodate increased blood flow-and is much softer than before pregnancy. This means that deep penetration can occasionally cause spotting, particularly late in pregnancy when the cervix begins to ripen for delivery (but also at any time during pregnancy). This type of bleeding is usually nothing to be concerned about, though do mention it to your practitioner for extra reassurance. The mouth of the uterus also becomes engorged during pregnancy-crisscrossed with many additional blood vessels to accommodate increased blood flow-and is much softer than before pregnancy. This means that deep penetration can occasionally cause spotting, particularly late in pregnancy when the cervix begins to ripen for delivery (but also at any time during pregnancy). This type of bleeding is usually nothing to be concerned about, though do mention it to your practitioner for extra reassurance.

There are also plenty of psychological hang-ups that can get between you, your partner, and full sexual enjoyment during pregnancy. These, too, can often be minimized.

Fear of hurting the fetus or causing a miscarriage. Stop worrying and start enjoying. In normal pregnancies, sex isn't harmful. Your baby is well cushioned and protected inside the amniotic sac and uterus, and your uterus is securely sealed off from the outside world by a mucous plug in the mouth of your cervix. Your practitioner will let you know if there's a reason why you shouldn't have sex during your pregnancy. Otherwise, go for it. Stop worrying and start enjoying. In normal pregnancies, sex isn't harmful. Your baby is well cushioned and protected inside the amniotic sac and uterus, and your uterus is securely sealed off from the outside world by a mucous plug in the mouth of your cervix. Your practitioner will let you know if there's a reason why you shouldn't have sex during your pregnancy. Otherwise, go for it.