Pregnancy Week by Week

Get a window on what’s happening in your pregnancy, week by week. From week four to week 42, your baby is experiencing a miraculous transformation from a clump of cells to a fully formed (and totally cute) newborn. Just imagine, as early as five weeks, your baby is already starting to form major organs (heart, stomach, liver, and kidneys) and systems (digestive, circulatory, nervous). By eight weeks, your raspberry-sized womb-mate is moving her arms and legs. At the beginning of your second trimester (week 14), your wee one is sucking his thumb. By week 28, the first week of the third trimester, baby (now as big as an eggplant) is prepping for breathing, developing his eyesight and packing on pounds in anticipation of life outside the womb. Each week is a new miracle. Less miraculous is how a mom-to-be may feel. Pregnancy Week-by-Week charts your baby’s development but also lets mom know what she might be feeling during each week of her pregnancy. Pregnancy week by Week includes everything mom needs to know to feel a sense of control over her pregnancy. Each week offers a complete guide to what you might feel, your must-do’s, your nice-to do’s, and answers and advice on everything pregnancy-related. Plus each week’s guide offers tips on maintaining a healthy and comfortable pregnancy from strategies on coping with pregnancy symptoms (morning sickness anyone?) to ideas for healthy eating, and pointers on talking to your OB. Let us guide you along your pregnancy, week by week.

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Q&A: Contraction stress test?

I've heard about the contraction stress test, though my doctor hasn't mentioned it yet -- what is this, and should I expect to have one?

Re: I've heard about the contraction stress test, though my doctor hasn't mentioned it yet -- what is this, and should I expect to have one?

The Bump Expert

We're guessing this topic came up in conversation with a friend who gave birth many years ago -- nonreactive nonstress tests used to be routinely followed by a contraction stress test, but today the biophysical profile (less expensive, less cumbersome and fewer potential risks) is more often used to measure fetal well-being. The contraction stress test (also called an oxytocin challenge test, or simply a stress test) involves tracking fetal heart rate while minor contractions are stimulated in your uterus, and is useful in evaluating whether baby is in strong enough condition to go through vaginal birth.

You'll start the test by lying down on your left side while two instruments are strapped on your belly with a belt. One of the devices measures baby's heart rate, and the other records your contractions. First, baseline measures of fetal heart rate and your contractions (if any) are taken for about ten minutes. Then, you'll be given a low dose of the hormone oxytocin (a labor stimulant) through an IV. The dosage will be increased until you have three contractions of more than 45 seconds each within ten minutes. You also may be asked to massage one or both of your nipples -- this triggers your body's production of oxytocin, further stimulating contractions. Fetal heart rate and your contractions will be measured throughout the process. The entire test can take around two hours, and you'll continue to be monitored until the contractions stop entirely or return to their baseline rate.

What's your doctor looking for? If the fetal heart rate remains constant during contractions, or slows briefly but then returns to the normal rate, baby's doing just fine. But, if the fetal heart rate slows during contractions and remains low, the placenta may be having trouble. During a contraction, blood and oxygen flow to the placenta temporarily slow, but a healthy placenta has enough blood stored to keep up baby's oxygen supply. A slowed heart rate indicates that the placenta is not capable of providing baby with sufficient oxygen during a contraction, and that the contractions occurring during vaginal delivery may put baby in danger.

If the test indicates a possible problem, your doc may recommend a c-section or immediate labor induction. (Keep in mind, though, the chances of getting a false positive are as great as 30%.) If everything looks fine, you'll just wait to deliver naturally, though the test may be repeated in a week to be sure baby is still healthy.

The test shouldn't be painful, but it may be a little uncomfortable. You might not even notice the contractions, but if you do, they'll probably feel similar to menstrual cramps. In other words... nothing like what you should expect during labor. No scare intended.

American College of Obstetrics and Gynecologists. Your pregnancy and birth. 4th ed. Washington, DC: ACOG; 2005.

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