So what exactly is your body up to? For one thing, it's manufacturing your baby's life-support system, the placenta, which won't be completed until the end of the first trimester. For another, your body's hormone levels have increased significantly, you're producing more blood, your heart rate is up, your blood sugar is down, your metabolism is burning energy overtime (even when you're lying down), and you're using up more nutrients and water. And if that's not enough to wear you out, just toss into the enervating equation all the other physical and emotional demands of pregnancy that your body is adjusting to. Add it all up, and it's no wonder you feel as if you're competing in a triathlon each day-and coming in dead last (or at least, dead tired).

Happily, there is some relief headed your way-eventually. Once the herculean task of manufacturing the placenta is complete (around the fourth month) and your body has adjusted to the hormonal and emotional changes pregnancy brings, you'll feel a little peppier.

In the meantime, keep in mind that fatigue is a sensible signal from your body that you need to take it easier these days. So listen up, and get the rest your body needs. You may also be able to recapture some of that get-up-and-go with some of the following tips: Baby yourself. If you're a first-time expectant mother, enjoy what will probably be your last chance for a long while to focus on taking care of yourself without feeling guilty. If you already have one or more children at home, you will have to divide your focus (see next page). But either way, this is not a time to strive for supermom-to-be status. Getting adequate rest is more important than keeping your house spotless or serving four-star dinners. Let the dishes wait until later, and turn the other way as the dust bunnies breed under your dining table. Order your groceries (and anything else you can think of) online instead of dragging yourself to the stores. Be a regular on the take-out circuit. Don't book activities-or take care of chores-that aren't essential. Never been a slacker? There's never been a better time to try it on for size. If you're a first-time expectant mother, enjoy what will probably be your last chance for a long while to focus on taking care of yourself without feeling guilty. If you already have one or more children at home, you will have to divide your focus (see next page). But either way, this is not a time to strive for supermom-to-be status. Getting adequate rest is more important than keeping your house spotless or serving four-star dinners. Let the dishes wait until later, and turn the other way as the dust bunnies breed under your dining table. Order your groceries (and anything else you can think of) online instead of dragging yourself to the stores. Be a regular on the take-out circuit. Don't book activities-or take care of chores-that aren't essential. Never been a slacker? There's never been a better time to try it on for size.

Let others baby you. You're doing enough heavy lifting these days, so make sure your spouse is doing his fair share (right now, that should be more than half) of household chores, including laundry and grocery shopping. Accept your mother-in-law's offer to vacuum and dust the house when she's visiting. Have a pal pick up some essentials for you while she's going on a shopping run anyway. That way, you might actually have enough energy left to drag yourself out for a walk (before you drag yourself into bed). You're doing enough heavy lifting these days, so make sure your spouse is doing his fair share (right now, that should be more than half) of household chores, including laundry and grocery shopping. Accept your mother-in-law's offer to vacuum and dust the house when she's visiting. Have a pal pick up some essentials for you while she's going on a shopping run anyway. That way, you might actually have enough energy left to drag yourself out for a walk (before you drag yourself into bed).

Chill out more. Exhausted once the day's over? Spend evenings chilling out (preferably with your feet up) instead of stepping out. And don't wait until nightfall to take it easy. If you can squeeze in an afternoon nap, by all means go for it. If you can't sleep, lie down with a good book. If you're a working mom-to-be, a nap at the office may not be an option, of course, unless you have a flexible schedule and access to a comfortable sofa, but putting your feet up at your desk or on the sofa in the ladies' room during breaks and lunch hours may be possible. (If you choose to rest at lunch hour, make sure you make time to eat, too.) Exhausted once the day's over? Spend evenings chilling out (preferably with your feet up) instead of stepping out. And don't wait until nightfall to take it easy. If you can squeeze in an afternoon nap, by all means go for it. If you can't sleep, lie down with a good book. If you're a working mom-to-be, a nap at the office may not be an option, of course, unless you have a flexible schedule and access to a comfortable sofa, but putting your feet up at your desk or on the sofa in the ladies' room during breaks and lunch hours may be possible. (If you choose to rest at lunch hour, make sure you make time to eat, too.) Be a slacker mom. Have other kids? Fatigue may be more pronounced, for obvious reasons (you have less time to rest, more demands on your body). Or it may be less noticeable, since you're already accustomed to exhaustion-or too busy to pay attention to it. Either way, it's not easy babying yourself when you have other babies (and older children) clamoring for your attention. But try. Explain to them that growing a baby is hard work and it's leaving you beat. Ask for their help around the house, and their help in letting you get more rest. Instead of running around playgrounds during the day and chasing children at night, spend more time at quiet pursuits-reading, doing puzzles, being the patient in a game of "hospital" (you'll get to lie down), watching DVDs. Napping when you're mothering full-time may also be difficult, but if you can time your rest with the children's naptime (if they still nap), you may be able to swing it. Have other kids? Fatigue may be more pronounced, for obvious reasons (you have less time to rest, more demands on your body). Or it may be less noticeable, since you're already accustomed to exhaustion-or too busy to pay attention to it. Either way, it's not easy babying yourself when you have other babies (and older children) clamoring for your attention. But try. Explain to them that growing a baby is hard work and it's leaving you beat. Ask for their help around the house, and their help in letting you get more rest. Instead of running around playgrounds during the day and chasing children at night, spend more time at quiet pursuits-reading, doing puzzles, being the patient in a game of "hospital" (you'll get to lie down), watching DVDs. Napping when you're mothering full-time may also be difficult, but if you can time your rest with the children's naptime (if they still nap), you may be able to swing it.

Get some more sleep. It may be stating the obvious, but just in case: Getting even an hour more sleep at night can pick you up come morning. Skip the It may be stating the obvious, but just in case: Getting even an hour more sleep at night can pick you up come morning. Skip the Late Show Late Show and turn in earlier; ask your spouse to fix breakfast so you can turn out later. But don't overdo. Too many z's can actually leave you feeling even more exhausted. and turn in earlier; ask your spouse to fix breakfast so you can turn out later. But don't overdo. Too many z's can actually leave you feeling even more exhausted.

Eat well. To keep your energy up, you need a steady supply of premium fuel. Make sure you're getting enough calories each day (which may be easier said than done if morning sickness has you down-but is definitely worth the effort), and focus on long-lasting energy boosters, such as protein, complex carbohydrates, and iron-rich foods. Caffeine or sugar (or both) may seem like the perfect quick fix for an energy slump, but they're not. Though that candy bar or those jolt-in-a-can energy drinks might pick you up briefly, that blood sugar high will be followed by a free-falling crash, leaving you more beat than ever. (Plus, some canned energy drinks may contain dietary supplements that aren't safe for pregnancy use.) To keep your energy up, you need a steady supply of premium fuel. Make sure you're getting enough calories each day (which may be easier said than done if morning sickness has you down-but is definitely worth the effort), and focus on long-lasting energy boosters, such as protein, complex carbohydrates, and iron-rich foods. Caffeine or sugar (or both) may seem like the perfect quick fix for an energy slump, but they're not. Though that candy bar or those jolt-in-a-can energy drinks might pick you up briefly, that blood sugar high will be followed by a free-falling crash, leaving you more beat than ever. (Plus, some canned energy drinks may contain dietary supplements that aren't safe for pregnancy use.) Eat often. Like so many other pregnancy symptoms, fatigue responds well to the Six-Meal Solution (see Like so many other pregnancy symptoms, fatigue responds well to the Six-Meal Solution (see page 91 page 91). Keeping your blood sugar on an even keel will help keep your energy steady, too-so resist meal skipping, and opt for frequent mini meals and snacks (the sustaining kind, comprised of protein and complex carbs).

Take a hike. Or a slow jog. Or a stroll to the grocery store. Or do a pregnancy exercise or yoga routine. Sure, the couch has never looked more inviting-but paradoxically, too much rest and not enough activity can heighten fatigue. Even a little exercise can be more rejuvenating than a sofa break. Just don't overdo it-you want to finish up your workout feeling energized, not enervated-and be sure to follow the guidelines starting on Or a slow jog. Or a stroll to the grocery store. Or do a pregnancy exercise or yoga routine. Sure, the couch has never looked more inviting-but paradoxically, too much rest and not enough activity can heighten fatigue. Even a little exercise can be more rejuvenating than a sofa break. Just don't overdo it-you want to finish up your workout feeling energized, not enervated-and be sure to follow the guidelines starting on page 218 page 218.

Though fatigue will probably ease up by month 4, you can expect it to return in the last trimester (could it be nature's way of preparing you for the long sleepless nights you'll encounter once the baby has arrived?).

Morning Sickness "I haven't had any morning sickness. Can I still be pregnant?"

Morning sickness, like a craving for pickles and ice cream, is one of those truisms about pregnancy that isn't necessarily true. Studies show that nearly three quarters of all expectant women experience the nausea and vomiting associated with morning sickness, which means that a little more than 25 percent of moms-to-be don't. If you're among those who never have a nauseous moment, or who feel only occasionally or mildly queasy, you can consider yourself not only pregnant but also lucky.

Your Nose Knows Have you noticed, now that you're expecting, that you can smell what's on the menu before you even set foot in the restaurant. That heightened sense of smell you're experiencing is actually a very real side effect of pregnancy, caused by hormones (in this case estrogen) that magnify every little scent that wafts your way. What's worse, this bloodhound syndrome can also ramp up morning sickness symptoms. Smell trouble? Here are some strategies you can try to give your poor nose a break: [image] If you can't stand the smell, get out of the kitchen. Or the restaurant. Or the perfume aisle of the department store. Or anywhere odors that sicken you hang out. If you can't stand the smell, get out of the kitchen. Or the restaurant. Or the perfume aisle of the department store. Or anywhere odors that sicken you hang out.[image] Open your windows whenever possible to banish cooking or musty odors. Or run the exhaust fan on the stove. Open your windows whenever possible to banish cooking or musty odors. Or run the exhaust fan on the stove.[image] Wash your clothes more often than usual, since fibers tend to hold on to odors. Use unscented detergent and softener, though, if the scented ones bother you (same goes for all your cleaning supplies). Wash your clothes more often than usual, since fibers tend to hold on to odors. Use unscented detergent and softener, though, if the scented ones bother you (same goes for all your cleaning supplies).[image] Switch to unscented or lightly scented toiletries. Switch to unscented or lightly scented toiletries.[image] Ask those who are regularly within sniffing distance of you (and who you know well enough to ask) to be extra considerate of your sensitive smell status. Get your spouse to wash up, change his clothes, and brush his teeth after stopping for a chili cheeseburger. Request that friends and coworkers go easy on the perfume when they're with you. And, of course, avoid people who are smoking. Ask those who are regularly within sniffing distance of you (and who you know well enough to ask) to be extra considerate of your sensitive smell status. Get your spouse to wash up, change his clothes, and brush his teeth after stopping for a chili cheeseburger. Request that friends and coworkers go easy on the perfume when they're with you. And, of course, avoid people who are smoking.[image] Try to surround yourself with those scents (if there are any) that actually make you feel better. Mint, lemon, ginger, and cinnamon are more likely to be soothing, especially if you're queasy, though some expectant moms suddenly embrace smells that invoke infants, such as baby powder. Try to surround yourself with those scents (if there are any) that actually make you feel better. Mint, lemon, ginger, and cinnamon are more likely to be soothing, especially if you're queasy, though some expectant moms suddenly embrace smells that invoke infants, such as baby powder.

"My morning sickness lasts all day. I'm afraid that I'm not keeping down enough food to nourish my baby."

Welcome to the queasy club-a club that up to 75 percent of pregnant women belong to. Happily, though you and all the other miserable members are definitely feeling the effects of morning sickness-a misnamed malady, as you've already noticed, since it can strike morning, noon, night, or all three-your baby almost definitely isn't. That's because your baby's nutritional needs are minuscule right now, just like your baby (who's not even the size of a pea yet). Even women who have such a hard time keeping food down that they actually lose weight during the first trimester aren't hurting their babies, as long as they make up for the lost weight in later months. Which is usually pretty easy to do because the nausea and vomiting of morning sickness don't generally linger much beyond the 12th to 14th week. (An occasional expectant mom continues to experience symptoms into the second trimester, and a very few, particularly those expecting multiples, may suffer some well into the third.) What causes morning sickness? No one knows for sure, but there's no shortage of theories, among them the high level of the pregnancy hormone hCG in the blood in the first trimester, elevated estrogen levels, gastroesophageal reflux (GER), the relative relaxation of muscle tissue in the digestive tract (which makes digestion less efficient), and the enhanced sense of smell that pregnant women develop.

Not all pregnant women experience morning sickness the same way. Some have only occasional queasy moments, others feel queasy round the clock but never vomit, others vomit once in a while, and still others vomit frequently. There are probably several reasons for these variations: Hormone levels. Higher-than-average levels (as when a woman is carrying multiple fetuses) can increase morning sickness; lower levels may minimize or eliminate it (though women with normal hormone levels may also experience little or no morning sickness). Higher-than-average levels (as when a woman is carrying multiple fetuses) can increase morning sickness; lower levels may minimize or eliminate it (though women with normal hormone levels may also experience little or no morning sickness).

Sensitivity. Some brains have a nausea command post that's more sensitive than others, which means they're more likely to respond to hormones and other triggers of pregnancy queasiness. If you have a sensitive command center (you always get carsick or seasick, for instance), you're more likely to have more severe nausea and vomiting in pregnancy. Never have a queasy day ordinarily? You're less likely to have lots of them when you're expecting. Some brains have a nausea command post that's more sensitive than others, which means they're more likely to respond to hormones and other triggers of pregnancy queasiness. If you have a sensitive command center (you always get carsick or seasick, for instance), you're more likely to have more severe nausea and vomiting in pregnancy. Never have a queasy day ordinarily? You're less likely to have lots of them when you're expecting.

Stress. It's well known that emotional stress can trigger gastrointestinal upset, so it's not surprising that symptoms of morning sickness tend to worsen when stress strikes. It's well known that emotional stress can trigger gastrointestinal upset, so it's not surprising that symptoms of morning sickness tend to worsen when stress strikes.

Fatigue. Physical or mental fatigue can also exacerbate the symptoms of morning sickness (conversely, severe morning sickness can increase fatigue). Physical or mental fatigue can also exacerbate the symptoms of morning sickness (conversely, severe morning sickness can increase fatigue).

First-time pregnancy status. Morning sickness is more common and tends to be more severe in first pregnancies, which supports the idea that both physical and emotional factors may be involved. Physically, the novice pregnant body is less prepared for the onslaught of hormones and other changes it's experiencing than one that's been there, done that. Emotionally, first timers are more likely to be subject to the kinds of anxieties and fears that can turn a stomach-while women in subsequent pregnancies may be distracted from their nausea by the demands of caring for older children. (Generalities never hold true for every expectant mom, though, and some women are queasier in subsequent pregnancies than they were in their first.) Morning sickness is more common and tends to be more severe in first pregnancies, which supports the idea that both physical and emotional factors may be involved. Physically, the novice pregnant body is less prepared for the onslaught of hormones and other changes it's experiencing than one that's been there, done that. Emotionally, first timers are more likely to be subject to the kinds of anxieties and fears that can turn a stomach-while women in subsequent pregnancies may be distracted from their nausea by the demands of caring for older children. (Generalities never hold true for every expectant mom, though, and some women are queasier in subsequent pregnancies than they were in their first.) No matter the cause (and does it really matter when you're upchucking for the third time today?), the effect of morning sickness is the same: pure misery. Though there is no sure cure for the queasies but the passing of time, there are ways of minimizing the misery while you're waiting for a less nauseous day to dawn: [image] Eat early. Morning sickness doesn't wait for you to get up in the morning. In fact, nausea's most likely to strike when you're running on empty, as you are after a long night's sleep. That's because when you haven't eaten in a while, the acids churning around inside your empty tummy have nothing to digest but your stomach lining-which, not surprisingly, increases queasiness. To head off heaving, don't even consider getting out of bed in the morning without reaching for a nibble (crackers or rice cakes, dry cereal, a handful of trail mix) that you stashed on your nightstand the night before. Keeping nibbles next to the bed also means you don't have to get up for them if you wake up hungry in the middle of the night. It's a good idea to have a bite when you rise for those midnight bathroom runs, too, just so your stomach stays a little bit full all night long. Eat early. Morning sickness doesn't wait for you to get up in the morning. In fact, nausea's most likely to strike when you're running on empty, as you are after a long night's sleep. That's because when you haven't eaten in a while, the acids churning around inside your empty tummy have nothing to digest but your stomach lining-which, not surprisingly, increases queasiness. To head off heaving, don't even consider getting out of bed in the morning without reaching for a nibble (crackers or rice cakes, dry cereal, a handful of trail mix) that you stashed on your nightstand the night before. Keeping nibbles next to the bed also means you don't have to get up for them if you wake up hungry in the middle of the night. It's a good idea to have a bite when you rise for those midnight bathroom runs, too, just so your stomach stays a little bit full all night long.[image] Eat late. Eating a light snack high in protein and complex carbs (a muffin and a glass of milk, string cheese and a few dried apricots) just before you go to sleep will help ensure a happier tummy when you wake up. Eat late. Eating a light snack high in protein and complex carbs (a muffin and a glass of milk, string cheese and a few dried apricots) just before you go to sleep will help ensure a happier tummy when you wake up.[image] Eat light. A stuffed tummy is just as susceptible to queasiness as an empty one. Overloading-even when you feel hungry-can lead to upchucking. Eat light. A stuffed tummy is just as susceptible to queasiness as an empty one. Overloading-even when you feel hungry-can lead to upchucking.[image] Eat often. One of the best ways to keep nausea at bay is to keep your blood sugar at an even keel-and your stomach a little filled-all the time. To head off an attack of the queasies, join the graze craze. Eat small, frequent meals-six mini meals a day is ideal-instead of three large ones. Don't leave home without a stash of snacks that your tummy can handle (dried fruit and nuts, granola bars, dry cereal, crackers, soy chips, or pretzels). Eat often. One of the best ways to keep nausea at bay is to keep your blood sugar at an even keel-and your stomach a little filled-all the time. To head off an attack of the queasies, join the graze craze. Eat small, frequent meals-six mini meals a day is ideal-instead of three large ones. Don't leave home without a stash of snacks that your tummy can handle (dried fruit and nuts, granola bars, dry cereal, crackers, soy chips, or pretzels).[image] Eat well. A diet high in protein and complex carbohydrates can help combat queasiness. General good nutrition may help, too, so eat as well as you can (given the circumstances, that might not always be so easy). Eat well. A diet high in protein and complex carbohydrates can help combat queasiness. General good nutrition may help, too, so eat as well as you can (given the circumstances, that might not always be so easy).[image] Eat what you can. So the eating well thing isn't working out so well for you? Right now, getting anything in your tummy-and keeping it there-should be your priority. There will be plenty of time later on in your pregnancy for eating a balanced diet. For the queasy moment, eat whatever gets you through the day (and night), even if it's nothing but ice pops and gingersnaps. If you can manage to make them real fruit ice pops and whole-grain gingersnaps, great. If you can't, that's fine, too. Eat what you can. So the eating well thing isn't working out so well for you? Right now, getting anything in your tummy-and keeping it there-should be your priority. There will be plenty of time later on in your pregnancy for eating a balanced diet. For the queasy moment, eat whatever gets you through the day (and night), even if it's nothing but ice pops and gingersnaps. If you can manage to make them real fruit ice pops and whole-grain gingersnaps, great. If you can't, that's fine, too.[image] Drink up. In the short term, getting enough fluids is more important than getting enough solids-particularly if you're losing lots of liquids through vomiting. If you're finding liquids are easier to get down when you're feeling green, use them to get your nutrients. Drink your vitamins and minerals in soothing smoothies, soups, and juices. If you find fluids make you queasier, eat solids with a high water content, such as fresh fruits and vegetables-particularly lettuce, melons, and citrus fruits. Some women find that drinking and eating at the same sitting puts too much strain on their digestive tract; if this is true for you, try taking your fluids between meals. Drink up. In the short term, getting enough fluids is more important than getting enough solids-particularly if you're losing lots of liquids through vomiting. If you're finding liquids are easier to get down when you're feeling green, use them to get your nutrients. Drink your vitamins and minerals in soothing smoothies, soups, and juices. If you find fluids make you queasier, eat solids with a high water content, such as fresh fruits and vegetables-particularly lettuce, melons, and citrus fruits. Some women find that drinking and eating at the same sitting puts too much strain on their digestive tract; if this is true for you, try taking your fluids between meals.[image] Get chilly. Experiment with temperature, too. Many women find icy cold fluids and foods are easier to get down. Others favor warm ones (melted cheese sandwiches instead of cold ones). Get chilly. Experiment with temperature, too. Many women find icy cold fluids and foods are easier to get down. Others favor warm ones (melted cheese sandwiches instead of cold ones).[image] Switch off. Often, what starts out as a comfort food (it's the only thing you can keep down, so you eat it 24/7) becomes associated with nausea-and actually starts to trigger it. If you're so sick of crackers that they're actually beginning to make you sick, switch off to another comforting carb (maybe it'll be Cheerios or watermelon next). Switch off. Often, what starts out as a comfort food (it's the only thing you can keep down, so you eat it 24/7) becomes associated with nausea-and actually starts to trigger it. If you're so sick of crackers that they're actually beginning to make you sick, switch off to another comforting carb (maybe it'll be Cheerios or watermelon next).[image] If it makes you queasy, don't go there. Period. Don't force yourself to eat foods that don't appeal or, worse, make you sick. Instead, let your taste buds (and your cravings, and your aversions) be your guide. Choose only sweet foods if they're all you can tolerate (get your vitamin A and protein from peaches and yogurt at dinner instead of from broccoli and chicken). Or select only savories if they're your ticket to a less tumultuous tummy (have reheated pizza for breakfast instead of cereal). If it makes you queasy, don't go there. Period. Don't force yourself to eat foods that don't appeal or, worse, make you sick. Instead, let your taste buds (and your cravings, and your aversions) be your guide. Choose only sweet foods if they're all you can tolerate (get your vitamin A and protein from peaches and yogurt at dinner instead of from broccoli and chicken). Or select only savories if they're your ticket to a less tumultuous tummy (have reheated pizza for breakfast instead of cereal).[image] Smell (and see) no evil. Thanks to a much more sensitive sense of smell, pregnant women often find once appetizing aromas suddenly offensive-and offensive ones downright sickening. So stay away from smells that trigger nausea-whether it's the sausage and eggs your spouse likes to make on the weekends or the aftershave of his that used to make you head over heels (but now makes you head for the toilet). Steer clear, too, of foods that you can't stand the sight of (raw chicken is a common culprit). Smell (and see) no evil. Thanks to a much more sensitive sense of smell, pregnant women often find once appetizing aromas suddenly offensive-and offensive ones downright sickening. So stay away from smells that trigger nausea-whether it's the sausage and eggs your spouse likes to make on the weekends or the aftershave of his that used to make you head over heels (but now makes you head for the toilet). Steer clear, too, of foods that you can't stand the sight of (raw chicken is a common culprit).[image] Supplement. Take a prenatal vitamin supplement to compensate for nutrients you may not be getting. Afraid you'll have trouble choking the pill down-or keeping it down? Actually, that one-a-day can decrease nausea symptoms (especially if you take a slow-releasing vitamin that's higher in quease-combating vitamin B Supplement. Take a prenatal vitamin supplement to compensate for nutrients you may not be getting. Afraid you'll have trouble choking the pill down-or keeping it down? Actually, that one-a-day can decrease nausea symptoms (especially if you take a slow-releasing vitamin that's higher in quease-combating vitamin B6). But take it at a time of day when you are least likely to chuck it back up, possibly with a substantial bedtime snack. If your symptoms are particularly rough, ask your practitioner about taking extra vitamin B6, which can help relieve nausea in some women.[image] Tread gingerly. It's true what the old wives (and midwives) have been saying for centuries: Ginger can be good for what ails a queasy pregnant woman. Use ginger in cooking (ginger- carrot soup, ginger muffins), steep it into tea, nibble on some ginger biscuits, nosh on some crystallized ginger, or suck on some ginger candy or lollipops. A drink made from real ginger (regular ginger ale isn't) may also be soothing. Even the smell of fresh ginger (cut open a knob and take a whiff) may quell the queasies. Or try another trick of the queasy trade: lemons. Many women find the smell-and taste-of lemons comforting (when life gives you morning sickness, make lemonade?). Sour sucking candies are the ticket to relief for others. Tread gingerly. It's true what the old wives (and midwives) have been saying for centuries: Ginger can be good for what ails a queasy pregnant woman. Use ginger in cooking (ginger- carrot soup, ginger muffins), steep it into tea, nibble on some ginger biscuits, nosh on some crystallized ginger, or suck on some ginger candy or lollipops. A drink made from real ginger (regular ginger ale isn't) may also be soothing. Even the smell of fresh ginger (cut open a knob and take a whiff) may quell the queasies. Or try another trick of the queasy trade: lemons. Many women find the smell-and taste-of lemons comforting (when life gives you morning sickness, make lemonade?). Sour sucking candies are the ticket to relief for others.[image] Rest up. Get some extra sleep and relaxation. Both emotional and physical fatigue can exacerbate nausea. Rest up. Get some extra sleep and relaxation. Both emotional and physical fatigue can exacerbate nausea.[image] Go slow-mo. Don't jump out of bed and dash out the door-rushing tends to aggravate nausea. Instead, linger in bed for a few minutes, nibbling on that bedside snack, then rise slowly to a leisurely breakfast. This may seem impossible if you have other children, but try to wake up before they do so you can sneak in some quiet time, or let your spouse take the dawn shift. Go slow-mo. Don't jump out of bed and dash out the door-rushing tends to aggravate nausea. Instead, linger in bed for a few minutes, nibbling on that bedside snack, then rise slowly to a leisurely breakfast. This may seem impossible if you have other children, but try to wake up before they do so you can sneak in some quiet time, or let your spouse take the dawn shift.[image] Minimize stress. Easing the stress can ease the quease. See Minimize stress. Easing the stress can ease the quease. See page 141 page 141 for tips on dealing with stress during pregnancy. for tips on dealing with stress during pregnancy.[image] Treat your mouth well. Brush your teeth (with a toothpaste that doesn't increase queasiness) or rinse your mouth after each bout of vomiting, as well as after each meal. (Ask your dentist to recommend a good rinse.) Not only will this help keep your mouth fresh and reduce nausea, it will decrease the risk of damage to teeth or gums that can occur when bacteria feast on regurgitated residue in your mouth. Treat your mouth well. Brush your teeth (with a toothpaste that doesn't increase queasiness) or rinse your mouth after each bout of vomiting, as well as after each meal. (Ask your dentist to recommend a good rinse.) Not only will this help keep your mouth fresh and reduce nausea, it will decrease the risk of damage to teeth or gums that can occur when bacteria feast on regurgitated residue in your mouth.[image] Try Sea-Bands. These 1-inch-wide elastic bands, worn on both wrists, put pressure on acupressure points on the inner wrists and often relieve nausea. They cause no side effects and are widely available at drug and health food stores. Or your practitioner may recommend a more sophisticated form of acupressure: a battery-operated wristband that uses electronic stimulation. Try Sea-Bands. These 1-inch-wide elastic bands, worn on both wrists, put pressure on acupressure points on the inner wrists and often relieve nausea. They cause no side effects and are widely available at drug and health food stores. Or your practitioner may recommend a more sophisticated form of acupressure: a battery-operated wristband that uses electronic stimulation.[image] Go CAM crazy. There are a wide variety of complementary medical approaches, such as acupuncture, acupressure, biofeedback, or hypnosis, that can help minimize the symptoms of morning sickness-and they're all worth a try (see Go CAM crazy. There are a wide variety of complementary medical approaches, such as acupuncture, acupressure, biofeedback, or hypnosis, that can help minimize the symptoms of morning sickness-and they're all worth a try (see page 85 page 85). Meditation and visualization can also help.

Though there are medications that may help ease morning sickness (often a combo of doxylamine-an antihistamine found in Unisom Sleep Tabs-and vitamin B6), they'll usually only be recommended or prescribed when morning sickness is severe. Keep in mind, too, that the antihistamine part of the combo will make you drowsy-a good thing if you're going to sleep, but not such a good thing if you're driving to work. Don't take any medication (traditional or herbal) for morning sickness unless it is prescribed by your practitioner.

In fewer than 5 percent of pregnancies, nausea and vomiting become so severe that medical intervention may be needed. If this seems to be the case with you, see page 545 page 545.

Excess Saliva "My mouth seems to fill up with saliva all the time-and swallowing it makes me queasy. What's going on?"

It may not be cool to drool (especially in public), but for many women in the first trimester, it's an icky fact of life. Overproduction of saliva is a common-and unpleasant-symptom of pregnancy, especially among morning sickness sufferers. And though all that extra saliva pooling in your mouth may add to your queasiness-and lead to a gaggy feeling when you eat-it's completely harmless, and thankfully short-lived, usually disappearing after the first few months.

Spitting mad about all that spit? Brushing your teeth frequently with a minty toothpaste, rinsing with a minty mouthwash, or chewing sugarless gum can help dry things up a bit.

Metallic Taste "I have a metallic taste in my mouth all the time. Is this pregnancy related-or is it caused by something I ate?"

So your mouth tastes like loose change? Believe it or not, that metal mouth taste is a fairly common-though not often talked about-side effect of pregnancy, and one more you can chalk up to hormones. Your hormones always play a role in controlling your sense of taste. When they go wild (as they do when you have your period-and as they do with a vengeance when you're pregnant), so do your taste buds. Like morning sickness, that icky taste should ease up-or, if you're lucky, disappear altogether-in your second trimester when those hormones begin to settle down.

Until then, you can try fighting metal with acid. Focus on citrus juices, lemonade, sour sucking candy, and-assuming your tummy can handle them-foods marinated in vinegar (some pickles with that ice cream?). Not only will such assertive acidics have the power to break through that metallic taste, they'll also increase saliva production, which will help wash it away (though that could be a bad thing, if your mouth's already flooded with the stuff). Other tricks to try: Brush your tongue each time you brush your teeth, or rinse your mouth with a salt solution (a teaspoon of salt in 8 ounces of water) or a baking soda solution (1/4 teaspoon baking soda in 8 ounces of water) a few times a day to neutralize pH levels in your mouth and keep away that flinty flavor. You might also ask your practitioner about changing your prenatal vitamin; some seem to lead to metal mouth more than others. teaspoon baking soda in 8 ounces of water) a few times a day to neutralize pH levels in your mouth and keep away that flinty flavor. You might also ask your practitioner about changing your prenatal vitamin; some seem to lead to metal mouth more than others.

Frequent Urination "I'm in the bathroom every half hour. Is it normal to be peeing this often?"

It may not be the best seat in the house, but for most pregnant women, it's the most frequented one. Let's face it, when you gotta go, you gotta go-and these days (and nights) you gotta go all the time. And while nonstop peeing might not always be convenient, it's absolutely normal.

What causes this frequent urination? First, hormones trigger not only an increase in blood flow but in urine flow, too. Second, during pregnancy the efficiency of the kidneys improves, helping your body rid itself of waste products more quickly (including baby's, which means you'll be peeing for two). Finally, your growing uterus is pressing on your bladder now, leaving less storage space in the holding tank for urine and triggering that "gotta go" feeling. This pressure is often relieved once the uterus rises into the abdominal cavity during the second trimester and doesn't usually return until the third trimester or when the baby's head "drops" back down into the pelvis in the ninth month. But because the arrangement of internal organs varies slightly from woman to woman, the degree of urinary frequency in pregnancy may also vary. Some women barely notice it; others are bothered by it for most of the nine months.

Leaning forward when you urinate will help ensure that you empty your bladder completely, as can making it good to the last drop by double voiding (pee, then when you're done, squeeze out some more). Both tactics may reduce trips to the bathroom, though realistically, not by much.

Don't cut back on liquids thinking it'll keep you out of the bathroom. Your body and your baby need a steady supply of fluids-plus dehydration can lead to urinary tract infection (UTI). But do cut back on caffeine, which increases the need to pee. If you find that you go frequently during the night, try limiting fluids right before bedtime.

If you're always feeling the urge to urinate (even after you've just urinated), talk to your practitioner. He or she might want to run a test to see if you've got a UTI.

"How come I'm not urinating frequently?"

No noticeable increase in the frequency of urination may be perfectly normal for you, especially if you ordinarily pee often. But be sure you're getting enough fluids (at least eight 8-ounce glasses a day-more if you're losing some through vomiting). Not only can too little fluid intake cause infrequent urination, it can lead to dehydration and urinary tract infection.

Breast Changes "I hardly recognize my breasts anymore-they're so huge. And they're tender, too. Will they stay that way, and will they sag after I give birth?"

Looks like you've discovered the first big thing in pregnancy: your breasts. While bellies don't usually do much growing until the second trimester, breasts often begin their expansion within weeks of conception, gradually working their way through the bra cup alphabet (you may ultimately end up three cups bigger than you started out). Fueling this growth are those surging hormones-the same ones that boost your bust premenstrually but at much greater levels. Fat is building up in your breasts, too, and blood flow to the area is increasing. And there's a swell reason for all this swelling-your breasts are gearing up to feed your baby when he or she arrives.

In addition to their expanding size, you will probably notice other changes to your breasts. The areola (the pigmented area around the nipple) will darken, spread, and may be spotted with even darker areas. This darkening may fade but not disappear entirely after birth. The little bumps you may notice on the areola are lubrication glands, which become more prominent during pregnancy and return to normal afterward. The complex road map of blue veins that traverses the breasts-often vivid on a fair-skinned woman and sometimes not even noticeable on darker women-represents a mother-to-baby delivery system for nutrients and fluids. After delivery-or, if you're breastfeeding, sometime after baby's weaned-the skin's appearance will return to normal.

Fortunately, that cup size gain won't continue to come with pain (or uncomfortable sensitivity). Though your breasts will probably keep growing throughout your nine months, they're not likely to stay tender to the touch past the third or fourth month. Some women find that the tenderness eases well before that. In the achy meantime, find relief in cool or warm compresses (whichever is more soothing).

As for whether or not your breasts will end up sagging, a lot of that's up to genetics (if your mom drooped, you may, too), but some of it's up to you. Sagging results not just from pregnancy itself but from a lack of support during pregnancy. No matter how firm your breasts are now, protect them for the future by wearing a supportive bra (though in that tender first trimester, you may want to avoid restrictive underwires). If your breasts are particularly large or have a tendency to sag, it's a good idea to wear a bra even at night. You'll probably find a cotton sports bra most comfortable for sleeping.

Not all women notice pronounced breast changes early in pregnancy, and some find the expansion takes place so gradually that it's not perceptible. As with all things pregnancy, what's normal is what's normal for your breasts. And don't worry: Though slower growth-or less substantial growth-means you won't have to replace bras so often, it won't have any impact on your ability to breastfeed.

"My breasts became very large in my first pregnancy, but they haven't seemed to change at all in my second. Is that normal?"

Last time your breasts were newbies-this time, they entered pregnancy with previous experience. As a result, they may not need as much preparation-or react as dramatically to those surging hormones-as they did in your first round of baby making. You may find that your breasts will enlarge gradually as your pregnancy progresses-or you may find that their expansion holds off until after delivery, when milk production begins. Either way, this slow growing is completely normal-and an early indication of how very different two pregnancies can be.

Lower Abdominal Pressure "I've been having a nagging feeling of pressure in my lower abdomen. Should I be worried?"

It sounds like you're very tuned in to your body-which can be a good thing (as when it helps you recognize ovulation) or a not-so-good thing (when it makes you worry about the many innocuous aches and pains of pregnancy).

Don't worry. A feeling of pressure or even mild crampiness without bleeding is very common, especially in first pregnancies-and is usually a sign that everything's going right, not that something's going wrong. Chances are, that sensitive body radar of yours is just picking up some of the many dramatic changes that are taking place in your lower abdomen, where your uterus is currently located. What you're feeling may be the sensation of implantation, increased blood flow, the buildup of the uterine lining, or simply your uterus beginning to grow-in other words, your first growing pains (there will be many more to come). It could also be gas pains or bowel spasms that come with constipation (another common pregnancy side effect).

For further reassurance, ask your practitioner about the feeling (if you're still having it) at your next office visit.

Spotting "I was using the toilet and noticed a small amount of blood when I wiped. Am I having a miscarriage?"

It's definitely scary to see blood down below when you're pregnant. But what's not definite is that bleeding is a sign that something's wrong with your pregnancy. Many women-about 1 in 5, in fact-experience some bleeding during pregnancy, and a very large majority go on to have a perfectly healthy pregnancy and baby. So if you're only noticing light spotting-similar to what you see at the beginning or end of your period-you can take a deep breath and read on for a probable (and probably reassuring. explanation. Such light spotting is usually caused by one of the following: Implantation of the embryo into your uterine wall. Affecting 20 to 30 percent of women, such spotting (called "implantation bleeding" in the obstetrical business) will usually occur before (or in some cases around the time) you expected your period, around five to ten days after conception. Scantier than your monthly flow (and lasting anywhere from a few hours to a few days), implantation bleeding is usually light to medium pink or light brown in color and is spotty. It occurs when the little ball of cells you'll one day call your baby burrows its way into the uterine wall. Implantation bleeding is not a sign that something is wrong. Affecting 20 to 30 percent of women, such spotting (called "implantation bleeding" in the obstetrical business) will usually occur before (or in some cases around the time) you expected your period, around five to ten days after conception. Scantier than your monthly flow (and lasting anywhere from a few hours to a few days), implantation bleeding is usually light to medium pink or light brown in color and is spotty. It occurs when the little ball of cells you'll one day call your baby burrows its way into the uterine wall. Implantation bleeding is not a sign that something is wrong.

Intercourse or an internal pelvic exam or Pap smear. During pregnancy, your cervix becomes tender and engorged with blood vessels and can occasionally become irritated during intercourse or an internal exam, resulting in some light bleeding. This type of bleeding is common, can occur at any time during your pregnancy, and usually doesn't indicate a problem, but do tell your practitioner about any post-intercourse or-exam spotting for extra reassurance. During pregnancy, your cervix becomes tender and engorged with blood vessels and can occasionally become irritated during intercourse or an internal exam, resulting in some light bleeding. This type of bleeding is common, can occur at any time during your pregnancy, and usually doesn't indicate a problem, but do tell your practitioner about any post-intercourse or-exam spotting for extra reassurance.

When to Call Your Practitioner It's best to set up a protocol for emergencies with your practitioner before an emergency strikes. If you haven't, and you are experiencing a symptom that requires immediate medical attention, try the following: First call the practitioner's office. If he or she isn't available, leave a message detailing your symptoms. If you don't get a call back within a few minutes, call again or call the nearest emergency room and tell the triage nurse what's going on. If he or she tells you to come in, head to the ER and leave word with your practitioner. Call 911 if no one can take you to the ER.

When you report any of the following to your practitioner or to the triage nurse, be sure to mention any other symptoms you may be experiencing, no matter how unrelated they may seem to the immediate problem. Also be specific, mentioning when you first noticed each symptom, how frequently it recurs, what seems to relieve or exacerbate it, and how severe it is.

Call immediately if you experience: [image] Heavy bleeding or bleeding with cramps or severe pain in the lower abdomen. Heavy bleeding or bleeding with cramps or severe pain in the lower abdomen.[image] Severe lower abdominal pain, in the center or on one or both sides, that doesn't subside, even if it isn't accompanied by bleeding. Severe lower abdominal pain, in the center or on one or both sides, that doesn't subside, even if it isn't accompanied by bleeding.[image] A sudden increase in thirst, accompanied by reduced urination, or no urination at all for an entire day. A sudden increase in thirst, accompanied by reduced urination, or no urination at all for an entire day.[image] Painful or burning urination accompanied by chills and fever over 101.5F and/or backache. Painful or burning urination accompanied by chills and fever over 101.5F and/or backache.[image] Fever over 101.5F. Fever over 101.5F.[image] Very sudden and severe swelling or puffiness of hands, face, and eyes, accompanied by headache, vision difficulties, or sudden significant weight gain not related to overeating. Very sudden and severe swelling or puffiness of hands, face, and eyes, accompanied by headache, vision difficulties, or sudden significant weight gain not related to overeating.[image] Vision disturbances (blurring, dimming, double vision) that persist for more than a few minutes. Vision disturbances (blurring, dimming, double vision) that persist for more than a few minutes.[image] A severe headache or a headache that persists for more than two or three hours. A severe headache or a headache that persists for more than two or three hours.[image] Bloody diarrhea. Bloody diarrhea.

Call the same day (or the next morning, if it's the middle of the night) if you experience: [image] Blood in your urine. Blood in your urine.[image] Swelling or puffiness of your hands, face, eyes. Swelling or puffiness of your hands, face, eyes.[image] Sudden excessive weight gain not related to overeating. Sudden excessive weight gain not related to overeating.[image] Painful or burning urination. Painful or burning urination.[image] Fainting or dizziness. Fainting or dizziness.[image] Chills and fever over 100F in the absence of cold or flu symptoms (start bringing down any fever over 100F promptly by taking acetaminophen, or Tylenol). Chills and fever over 100F in the absence of cold or flu symptoms (start bringing down any fever over 100F promptly by taking acetaminophen, or Tylenol).[image] Severe nausea and vomiting; vomiting more often than two or three times a day in the first trimester; vomiting later in pregnancy when you didn't earlier. Severe nausea and vomiting; vomiting more often than two or three times a day in the first trimester; vomiting later in pregnancy when you didn't earlier.[image] Itching all over, with or without dark urine, pale stools, or jaundice (yellowing of skin and whites of the eye). Itching all over, with or without dark urine, pale stools, or jaundice (yellowing of skin and whites of the eye).[image] Frequent (more than three times a day) diarrhea, especially if it's mucousy (if it's bloody, call right away). Frequent (more than three times a day) diarrhea, especially if it's mucousy (if it's bloody, call right away).

Your practitioner may want you to call for different reasons or within different parameters, so be sure to ask him or her what protocol you should follow if you experience any of these symptoms.

Keep in mind, too, that there might be some times when you have none of the symptoms listed here, but you feel unusually exhausted, achy, not quite right. If a good night's sleep and some extra relaxation don't team up to make you feel better in a day or two, check with your practitioner. Chances are what you're feeling is normal-par for the pregnancy course. But it is also possible that you've become anemic or you're fighting an infection of some kind. Certain conditions-UTI, for example-can do their dirty work without causing any clear-cut symptoms. So when in doubt, check it out.

Infection of the vagina or cervix. An inflamed or irritated cervix or vagina might cause some spotting (though the spotting should disappear once you're treated for the infection). An inflamed or irritated cervix or vagina might cause some spotting (though the spotting should disappear once you're treated for the infection).

Subchorionic bleed. Subchorionic bleeding occurs when there is an accumulation of blood under the chorion (the outer fetal membrane, next to the placenta) or between the uterus and the placenta itself. It can cause light to heavy spotting but doesn't always (sometimes it is only detected during a routine ultrasound). Most subchorionic bleeds resolve on their own and do not end up being a problem for the pregnancy (see Subchorionic bleeding occurs when there is an accumulation of blood under the chorion (the outer fetal membrane, next to the placenta) or between the uterus and the placenta itself. It can cause light to heavy spotting but doesn't always (sometimes it is only detected during a routine ultrasound). Most subchorionic bleeds resolve on their own and do not end up being a problem for the pregnancy (see page 545 page 545 for more). for more).

Spotting is as variable in a normal pregnancy as it is common. Some women spot on and off for their entire pregnancies. Other women spot for just a day or two-and others for several weeks. Some women notice mucousy brown or pink spotting; others see small amounts of bright red blood. But happily, most women who experience any kind of spotting continue to have completely normal and healthy pregnancies and end up delivering perfectly healthy babies. Which means that there's probably nothing for you to worry about (though, realistically, that doesn't mean you'll stop worrying).

For extra reassurance, put in a call to your practitioner (no need to call immediately or during nonoffice hours unless you're noticing spotting accompanied by cramping or bright red, soak-through-a-pad bleeding), who will likely order an ultrasound. If you're past the sixth week, you'll probably be able to see your baby's heartbeat during the ultrasound, which will reassure you that your pregnancy is progressing along just fine, even with the spotting.

What if the spotting progresses to heavier bleeding similar to a period? Though such a scenario is more cause for concern (especially if it's accompanied by cramps or pain in your lower abdomen) and does warrant an immediate call to your practitioner, it's not a sign that you're inevitably miscarrying. Some women bleed-even heavily-for unknown reasons throughout their pregnancies and still deliver healthy babies at term.

If it does end up that you're having a miscarriage, see page 536 page 536.

No Worries Some expectant moms (and you know who you are) will always find something to worry about-especially in the first trimester and particularly in first pregnancies. Topping the list of most common concerns, understandably, is a fear of miscarriage.

Fortunately, most expectant worriers end up worrying unnecessarily. Most pregnancies continue uneventfully, and happily, to term. Just about every normal pregnancy includes some cramps, some abdominal aches, or some spotting-and many include all three. While any of these symptoms can be understandably unnerving (and when it comes to a stain on your underwear, downright scary), more often than not, they're completely innocuous-and not a sign that your pregnancy is in trouble. Though you should report them to your practitioner at your next visit (or sooner if you need some professional reassurance), the following are no cause for concern. So don't worry if you have: [image] Mild cramps, achiness, or a pulling sensation in the lower abdomen or on one or both sides of the abdomen. This is probably caused by the stretching of ligaments that support the uterus. Unless cramping is severe, constant, or accompanied by significant bleeding, there's no need to worry. Mild cramps, achiness, or a pulling sensation in the lower abdomen or on one or both sides of the abdomen. This is probably caused by the stretching of ligaments that support the uterus. Unless cramping is severe, constant, or accompanied by significant bleeding, there's no need to worry.[image] Slight spotting that isn't accompanied by cramps or lower abdominal pain. There are plenty of reasons why pregnant women spot, and it often has nothing to do with a miscarriage. See Slight spotting that isn't accompanied by cramps or lower abdominal pain. There are plenty of reasons why pregnant women spot, and it often has nothing to do with a miscarriage. See page 137 page 137 for more on spotting. for more on spotting.

Of course, it's not just symptoms that pregnant women worry about in early pregnancy-it's a lack of symptoms, too. In fact, not "feeling pregnant" is one of the most commonly reported first-trimester concerns. And that's not surprising. It's hard to feel pregnant this early on even if you're experiencing every early pregnancy symptom in the book-and it's far harder still to feel pregnant if you're relatively symptom-free. Without tangible proof yet of that baby-to-be growing inside you (a swelling belly, those first flutters of movement), it's pretty easy to start wondering whether the pregnancy is going well-or whether you're even still pregnant at all.

Once again, not to worry. A lack of symptoms-such as morning sickness or breast tenderness-is not a sign that something's wrong. Consider yourself lucky if you're spared these and other unpleasant early pregnancy symptoms-and also consider that you might be a late bloomer. After all, since every pregnant woman experiences pregnancy symptoms differently and at different times, these and other symptoms may be just around the corner for you.

HCG Levels "My doctor gave me the results of my blood test and it says that my hCG level is at 412 mIU/L. What does that number mean?"

It means you're definitely pregnant! Human chorionic gonadotropin (hCG) is manufactured by the cells of the newly developing placenta within days after the fertilized egg implants in your uterine lining. HCG is found in your urine (you came face-to-stick with hCG the day that positive readout showed up on your home pregnancy test) and in your blood, which explains why your practitioner ran a blood test to find out your expectant status for sure. When you're very early in the pregnancy game (as you are), the level of hCG in your blood will be quite low (it's just starting to show up in your system, after all). But within days, it'll begin to soar, doubling every 48 hours (give or take). The rapid increase peaks somewhere between 7 and 12 weeks of pregnancy and then starts to decline.

But don't start swapping your numbers with those of your pregnant best friend. Just as no two women's pregnancies are alike, no two pregnant women's hCG levels are alike either. They vary enormously from day to day, person to person, even as early as the first missed day of a period and continuing throughout pregnancy.

HCG Levels Really want to play the hCG numbers game? The following are ranges of "normal" hCG levels based on date. Keep in mind that anywhere in that wide range is normal-your baby doesn't have to be scoring off the charts for your pregnancy to be progressing perfectly-and that a slight miscalculation in your dates can throw the numbers off completely.

Weeks of Pregnancy Amount of hCG in mIU/L 3 weeks 5 to 50 4 weeks 5 to 426 5 weeks 19 to 7,340 6 weeks 1,080 to 56,500 7 to 8 weeks 7,650 to 229,000 9 to 12 weeks 25,700 to 288,000

What's more important and relevant to you is that your hCG level falls within the very wide normal range (see box, this page. and continues to increase over the coming weeks (in other words, look for a pattern of increasing levels instead of focusing on specific numbers). Even if your readings fall outside these ranges, don't worry. It's still quite likely that everything's fine (your due date might just be off-a very common cause of hCG number confusion-or you might be carrying more than one baby). As long as your pregnancy is progressing normally and your hCG levels are increasing during the first trimester, you don't have to obsess about these numbers or even try to find them out (plus, if your practitioner is happy with your numbers, then you can be, too). Ultrasound findings after five or six weeks of pregnancy are much more predictive of pregnancy outcome than are hCG levels. Of course, as always, if you are concerned, talk with your practitioner about your results.

Stress "My job is a high-stress one. I wasn't planning to have a baby now, but I got pregnant. Should I quit work?"

Depending on how you handle and respond to it, stress can be good for you (by sparking you to perform better, to function more effectively) or it can be bad for you (when it gets out of control, overwhelming and debilitating you). Research shows that pregnancy isn't affected by typical stress levels-and if you're able to cope well with your on-the-job stress (even if it's more than most people could take on), then your baby will be able to cope just fine, too. But if the stress makes you anxious, sleepless, or depressed, if it's causing you to experience physical symptoms (such as headache, backache, or loss of appetite), if it's causing you to turn to unhealthy behaviors (smoking, for instance), or if it is exhausting you, then it could eventually pose a problem.

Relaxation Made Easy Is your growing bundle of joy making you a quivering bundle of nerves? Now's a great time to learn some soothing relaxation techniques-not just because they can help you cope with pregnancy concerns, but because they'll come in handy in your hectic life as a new mom. Yoga's a fabulous destresser, if you have time to take a prenatal class or practice with a DVD. If you don't, you can try this simple relaxation technique, which is easy to learn and to do anywhere, anytime. If you find it helpful, you can do it when anxiety strikes and/or regularly several times a day to try to ward it off.

Sit with your eyes closed and imagine a beautiful, peaceful scene (a sunset over your favorite beach, waves gently lapping the shore; a serene mountain vista, complete with babbling brook), or even your fantasized baby-to-be, wrapped in your arms on a sunny day in the park. Then, working your way up from your toes to your face, concentrate on relaxing every muscle. Breathe slowly, deeply, through your nose (unless it's stuffed up) and choose a simple word (such as "yes" or "one") to repeat aloud every time you exhale. Ten to 20 minutes should do the trick, though even a minute or two is better than nothing.

Since negative reactions to stress can take a toll, especially if they continue into the second and third trimesters-learning to handle the stress constructively, or cutting back on it, as needed, should become a priority now. The following should help: Unload it. Allowing your anxieties to surface is the best way of ensuring that they don't get you down. Make sure you have somewhere to vent-and someone to vent to. Maintain open lines of communication with your spouse, spending some time at the end of each day (preferably not too close to bedtime, which should be as stress free as possible) sharing concerns and frustrations. Together you may be able to find some relief, some solutions-and ideally a good laugh or two. Is he too stressed to absorb enough of your stress? Find others who can lend an ear-a friend, another family member, coworkers (who will understand your workplace stress better?), or your practitioner (especially if you're concerned about the physical effects of your stress). Empathy helps, too, so try to find other expectant moms who can relate, either in a pregnancy group or online. If you need more than a friendly ear, consider counseling to help you develop strategies to better deal with your stress. Allowing your anxieties to surface is the best way of ensuring that they don't get you down. Make sure you have somewhere to vent-and someone to vent to. Maintain open lines of communication with your spouse, spending some time at the end of each day (preferably not too close to bedtime, which should be as stress free as possible) sharing concerns and frustrations. Together you may be able to find some relief, some solutions-and ideally a good laugh or two. Is he too stressed to absorb enough of your stress? Find others who can lend an ear-a friend, another family member, coworkers (who will understand your workplace stress better?), or your practitioner (especially if you're concerned about the physical effects of your stress). Empathy helps, too, so try to find other expectant moms who can relate, either in a pregnancy group or online. If you need more than a friendly ear, consider counseling to help you develop strategies to better deal with your stress.

Do something about it. Identify sources of stress in your life and determine how they can be modified. If you're clearly trying to do too much, cut back in areas that are not high priority (this is something you're going to have to do big time anyway, once you have a bigger priority-a new baby-on the agenda). If you've taken on too many responsibilities at home or at work, decide which can be postponed or delegated. Learn to say no to new projects or activities before you're overloaded (another skill you're wise to cultivate pre-baby). Identify sources of stress in your life and determine how they can be modified. If you're clearly trying to do too much, cut back in areas that are not high priority (this is something you're going to have to do big time anyway, once you have a bigger priority-a new baby-on the agenda). If you've taken on too many responsibilities at home or at work, decide which can be postponed or delegated. Learn to say no to new projects or activities before you're overloaded (another skill you're wise to cultivate pre-baby).

Sometimes, sitting down with a pad or PDA and making lists of the hundreds of things you need to get done (at home or at work), and the order in which you're planning to do them, can help you feel more in control of the chaos in your life. Cross items off your list as they're taken care of for a satisfying sense of accomplishment.

Sleep it off. Sleep is the ticket to regeneration-for mind and body. Often, feelings of tension and anxiety are prompted by not getting enough shut-eye-and, of course, having too much tension and anxiety can also prevent you from getting enough shut-eye. If you're having trouble sleeping, see the tips on Sleep is the ticket to regeneration-for mind and body. Often, feelings of tension and anxiety are prompted by not getting enough shut-eye-and, of course, having too much tension and anxiety can also prevent you from getting enough shut-eye. If you're having trouble sleeping, see the tips on page 265 page 265.

Nourish it. Hectic lifestyles can lead to hectic eating styles. Inadequate nutrition during pregnancy can be a double whammy: It can hamper your ability to handle stress, and it can eventually affect your baby's well-being. So be sure to eat well and regularly (six mini meals will best keep you going when the going gets tough). Focus on complex carbs and protein, and steer clear of excesses of caffeine and sugar, two staples of the stressed life that can actually leave you less able to cope. Hectic lifestyles can lead to hectic eating styles. Inadequate nutrition during pregnancy can be a double whammy: It can hamper your ability to handle stress, and it can eventually affect your baby's well-being. So be sure to eat well and regularly (six mini meals will best keep you going when the going gets tough). Focus on complex carbs and protein, and steer clear of excesses of caffeine and sugar, two staples of the stressed life that can actually leave you less able to cope.

Wash it away. A warm bath is an excellent way to relieve tension. Try it after a hectic day; it will also help you to sleep better. A warm bath is an excellent way to relieve tension. Try it after a hectic day; it will also help you to sleep better.

Run it off. Or swim it off. Or prenatal yoga it off. You might think that the last thing you need in your life is more activity, but exercise is one of the best stress relievers-and mood boosters. Build some into your busy day. Or swim it off. Or prenatal yoga it off. You might think that the last thing you need in your life is more activity, but exercise is one of the best stress relievers-and mood boosters. Build some into your busy day.

CAM it. Explore the many complementary and alternative therapies that can promise inner calm from CAM, among them biofeedback, acupuncture, hypnotherapy, massage (ask your spouse for a back or shoulder rub, or splurge on a professional pregnancy massage). Meditation and visualization can also melt the stress away (just close your eyes and picture a bucolic scene, or keep them open and gaze at a soothing picture or photo placed strategically in your office). Practice relaxation techniques (see box, Explore the many complementary and alternative therapies that can promise inner calm from CAM, among them biofeedback, acupuncture, hypnotherapy, massage (ask your spouse for a back or shoulder rub, or splurge on a professional pregnancy massage). Meditation and visualization can also melt the stress away (just close your eyes and picture a bucolic scene, or keep them open and gaze at a soothing picture or photo placed strategically in your office). Practice relaxation techniques (see box, page 142 page 142), not just because they'll come in handy during childbirth, but because they can help drain the strain anytime. See page 85 page 85 for more on CAM techniques. for more on CAM techniques.

Expect the Best It's long been speculated that optimistic people live longer, healthier lives. Now it's been suggested that an expectant mother's optimistic outlook can actually improve the outlook for her unborn baby, too. Researchers have found that seeing the bright side reduces the chance of a high-risk woman delivering a preterm or low-birthweight baby.

A lower level of stress in optimistic women definitely plays a part in the lowered risk; high levels of stress, after all, have been implicated in a variety of health problems both in and out of pregnancy. But stress itself apparently doesn't tell the whole story. Women who are optimistic, not surprisingly, are more likely to take better care of themselves-eating well, exercising right, getting regular prenatal care, not smoking, drinking, or using drugs. And these positive behaviors-fueled by the power of positive thinking-can, of course, have a very positive effect on pregnancy and fetal well-being.

Researchers point out that it's never too late to start reaping the benefits of optimism, even if you're already pregnant. Learning how to expect the best-instead of the worst-can actually help make those expectations come true: a good reason to start seeing that glass of milk as half full instead of half empty.