Health Topics

Pregnancy and reproduction

Miscarriage
National Library of Medicine
Pregnancy Loss
Spontaneous Abortion

A miscarriage is an unexpected loss of pregnancy before the 20th week of pregnancy. Most miscarriages happen very early in the pregnancy, often before a woman even knows she is pregnant.

Factors that may contribute to miscarriage include:

  • A genetic problem with the fetus
  • Problems with the uterus or cervix
  • Chronic diseases, such as polycystic ovary syndrome

Signs of a miscarriage include vaginal spotting, abdominal pain or cramping, and fluid or tissue passing from the vagina. Bleeding can be a symptom of miscarriage, but many women also have it in early pregnancy and don't miscarry. To be sure, contact your health care provider right away if you have bleeding.

Women who miscarry early in their pregnancy usually do not need any treatment. In some cases, there is tissue left in the uterus. Doctors use a procedure called a dilatation and curettage (D&C) or medicines to remove the tissue.

Counseling may help you cope with your grief. Later, if you do decide to try again, work closely with your health care provider to lower the risks. Many women who have a miscarriage go on to have healthy babies.

NIH: National Institute of Child Health and Human Development


Abortion, Spontaneous
Women
Pregnancy and Reproduction
Female Reproductive System
A miscarriage is an unexpected loss of pregnancy before the 20th week of pregnancy. Most miscarriages happen very early in the pregnancy, often before ...
Ectopic Pregnancy
National Library of Medicine
Abdominal Pregnancy
Cervical Pregnancy
Tubal Pregnancy

The uterus, or womb, is the place where a baby grows when a woman is pregnant. If you have an ectopic pregnancy, the fertilized egg grows in the wrong place, outside the uterus, usually in the fallopian tubes. The result is usually a miscarriage.

Ectopic pregnancy can be a medical emergency if it ruptures. Signs of ectopic pregnancy include:

  • Abdominal pain
  • Shoulder pain
  • Vaginal bleeding
  • Feeling dizzy or faint

Get medical care right away if you have these signs. Doctors use drugs or surgery to remove the ectopic tissue so it doesn't damage your organs. Many women who have had ectopic pregnancies go on to have healthy pregnancies later.

Dept. of Health and Human Services Office on Women's Health


Pregnancy, Ectopic
Women
Pregnancy and Reproduction
Female Reproductive System
The uterus, or womb, is the place where a baby grows when a woman is pregnant. If you have an ectopic pregnancy, the fertilized egg grows in the wrong place, ...
Postpartum Depression
National Library of Medicine
Baby Blues
Post-pregnancy depression

Many women have the baby blues after childbirth. If you have the baby blues, you may have mood swings, feel sad, anxious or overwhelmed, have crying spells, lose your appetite, or have trouble sleeping. The baby blues most often go away within a few days or a week. The symptoms are not severe and do not need treatment.

The symptoms of postpartum depression last longer and are more severe. You may also feel hopeless and worthless and lose interest in the baby. You may have thoughts of hurting yourself or the baby. Very rarely, new mothers develop something even more serious. They may have hallucinations or try to hurt themselves or the baby. They need to get treatment right away, often in the hospital.

Postpartum depression can begin anytime within the first year after childbirth. The cause is unknown. Hormonal and physical changes after birth and the stress of caring for a new baby may play a role. Women who have had depression are at higher risk.

If you think you have postpartum depression, tell your health care provider. Medicines, including antidepressants, and talk therapy can help you get well.

Dept. of Health and Human Services Office on Women's Health


Depression, Postpartum
Women
Mental Health and Behavior
Pregnancy and Reproduction
Many women have the baby blues after childbirth. If you have the baby blues, you may have mood swings, feel sad, anxious or overwhelmed, have crying spells, ...
Teenage Pregnancy
National Library of Medicine
Adolescent Pregnancy
Pregnancy, Teen

Most teenage girls don't plan to get pregnant, but many do. Teen pregnancies carry extra health risks to both the mother and the baby. Often, teens don't get prenatal care soon enough, which can lead to problems later on. They have a higher risk for pregnancy-related high blood pressure and its complications. Risks for the baby include premature birth and a low birth weight.

If you're a pregnant teen, you can help yourself and your baby by:

  • Getting regular prenatal care
  • Taking your prenatal vitamins for your health and to prevent some birth defects
  • Avoiding smoking, alcohol, and drugs
  • Using a condom, if you are having sex, to prevent sexually transmitted diseases that could hurt your baby. If your or your partner is allergic to latex, you can use polyurethane condoms.

Pregnancy in Adolescence
Children and Teenagers
Women
Pregnancy and Reproduction
Female Reproductive System
Most teenage girls don't plan to get pregnant, but many do. Teen pregnancies carry extra health risks to both the mother and the baby. Often, teens don't ...
Health Problems in Pregnancy
National Library of Medicine
High Risk Pregnancy
Pregnancy and Health Problems
Pregnancy, High-Risk

Every pregnancy has some risk of problems. You may have problems because of a health condition you had before you got pregnant. You could also develop a condition during pregnancy. Other causes of problems during pregnancy can include being pregnant with more than one baby, a health problem in a previous pregnancy, drug use during pregnancy, or being over age 35. Any of these can affect your health, the health of your baby, or both.

If you have a chronic condition, you should talk to your health care provider about how to minimize your risk before you get pregnant. Once you are pregnant, you may need a health care team to monitor your pregnancy. Some common health problems that can complicate a pregnancy include:

  • High blood pressure
  • Polycystic ovary syndrome
  • Kidney problems
  • Autoimmune disorders
  • Obesity
  • HIV/AIDS
  • Cancer
  • Infections

Other conditions that can make pregnancy risky can happen while you are pregnant - for example, gestational diabetes and Rh incompatibility. Good prenatal care can help detect and treat them.

Some discomforts, like nausea, back pain, and fatigue, are common during pregnancy. Sometimes it is hard to know what is normal. Call your health care provider if something is bothering or worrying you.


Pregnancy, High-Risk
Pregnancy Complications
Pregnancy and Reproduction
Female Reproductive System
Every pregnancy has some risk of problems. You may have problems because of a health condition you had before you got pregnant. You could also develop a condition ...
Pregnancy and Medicines
National Library of Medicine
Medicines and Pregnancy

Not all medicines are safe to take when you are pregnant. Some medicines can harm your baby. That includes over-the-counter or prescription drugs, herbs, and supplements.

Always speak with your health care provider before you start or stop any medicine. Not using medicine that you need may be more harmful to you and your baby than using the medicine. For example, many pregnant women take prescription medicines for health problems like diabetes, asthma, seizures, and heartburn. The decision about whether or not to take a medicine depends on the risks and benefits. You and your health care provider should make this choice together.

Pregnant women should not take regular vitamins. They may have too much or too little of the vitamins that you need. There are special vitamins for pregnant women. It is important to take 0.4 mg of folic acid every day before you become pregnant through the first part of your pregnancy. Folic acid helps to prevent birth defects of the baby's brain or spine.

Food and Drug Administration


Abnormalities, Drug-Induced
Pregnancy and Reproduction
Genetics/Birth Defects
Not all medicines are safe to take when you are pregnant. Some medicines can harm your baby. That includes over-the-counter or prescription drugs, herbs, ...
Tumors and Pregnancy
National Library of Medicine
Cancer and Pregnancy
Gestational Trophoblastic Disease
Molar Pregnancy

Tumors during pregnancy are rare, but they can happen. Tumors can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. The most common cancers in pregnancy are breast cancer, cervical cancer, lymphoma, and melanoma. Cancer itself rarely harms the baby, and some cancer treatments are safe during pregnancy. You and your health care provider will work together to find the best treatment. Your options will depend on how far along the pregnancy is, as well as the type, size, and stage of your cancer.

Another type of tumor that women can get is called a gestational trophoblastic disease (GTD). It happens when a fertilized egg doesn't become a fetus. GTD is not always easy to find. It is usually benign, but some types can be malignant. The most common type of GTD is a molar pregnancy. In its early stages, it may look like a normal pregnancy. You should see your health care provider if you have vaginal bleeding (not menstrual bleeding).

Treatment depends on the type of tumor, whether it has spread to other places, and your overall health.


Pregnancy Complications, Neoplastic
Pregnancy Complications
Neoplasms
Pregnancy
Cancers
Pregnancy and Reproduction
Tumors during pregnancy are rare, but they can happen. Tumors can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. The most common ...
Pregnancy
National Library of Medicine

You're going to have a baby! It's an exciting time, but it can also feel a bit overwhelming. You may have a lot of questions, including what you can do to give your baby a healthy start. To keep you and your baby healthy during pregnancy, it is important to:

  • Have regular visits with your health care provider. These prenatal care visits help make sure that you and your baby are healthy. And if there are any health problems, your provider can find them early. Getting treatment right away can cure many problems and prevent others.
  • Eat healthy and drink plenty of water. Good nutrition during pregnancy includes eating a variety of
    • Fruits
    • Vegetables
    • Whole grains
    • Lean meats or other protein sources
    • Low-fat dairy products
  • Take prenatal vitamins. Pregnant women need higher amounts of certain vitamins and minerals, such as folic acid and iron.
  • Be careful with medicines. Always check with your health care provider before you start or stop any medicine. This includes over-the-counter medicines and dietary or herbal supplements.
  • Stay active. Physical activity can help you stay strong, feel and sleep better, and prepare your body for birth. Check with your provider about which types of activities are right for you.
  • Avoid substances that could hurt your baby, such as alcohol, drugs, and tobacco.

Your body will keep changing as your baby grows. It can be hard to know whether a new symptom is normal or could be a sign of a problem. Check with your health care provider if something is bothering or worrying you.


Pregnancy
Women
Pregnancy and Reproduction
Female Reproductive System
You're going to have a baby! It's an exciting time, but it can also feel a bit overwhelming. You may have a lot of questions, including what you can do to ...
Pregnancy and Opioids
National Library of Medicine

Many women need to take medicines while they are pregnant. But not all medicines are safe during pregnancy. Many medicines carry risks for you, your baby, or both. Opioids, especially when misused, can cause problems for you and your baby while you are pregnant.

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers, such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some health care providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your health care provider. However, opioid dependence, addiction, and overdose are still potential risks. These risks increase when these medicines are misused. Misuse means you are not taking the medicines according to your provider's instructions, you are using them to get high, or you are taking someone else's opioids.

What are the risks of taking opioids during pregnancy?

Taking opioids during pregnancy can cause problems for you and your baby. The possible risks include:

  • Neonatal abstinence syndrome (NAS) - withdrawal symptoms (irritability, seizures, vomiting, diarrhea, fever, and poor feeding) in newborns
  • Neural tube defects - birth defects of the brain, spine, or spinal cord
  • Congenital heart defects - problems with the structure of the baby's heart
  • Gastroschisis - a birth defect of the baby's abdomen, where the intestines stick outside of the body through a hole beside the belly button
  • Loss of the baby, either miscarriage (before 20 weeks of pregnancy) or stillbirth (after 20 or more weeks)
  • Preterm delivery - a birth before 37 weeks
  • Stunted growth, leading to low birthweight

Some women need to take opioid pain medicine while they are pregnant. If your health care provider suggests that you take opioids during pregnancy, you should first discuss the risks and benefits. Then if you both decide that you need to take the opioids, you should work together to try to minimize the risks. Some of the ways to do this include:

  • Taking them for the shortest time possible
  • Taking the lowest dose that will help you
  • Carefully following your provider's instructions for taking the medicines
  • Contacting your provider if you have side effects
  • Going to all your follow-up appointments
If I am already taking opioids and I become pregnant, what should I do?

If you have been taking opioids and you become pregnant, contact your health care provider. You should not stop taking the opioids on your own. If you suddenly stop taking opioids, it could cause severe health problems for you or your baby. In some cases, stopping suddenly during pregnancy may be more harmful than taking the medicines.

Can I breastfeed while taking opioids?

Many women who regularly take opioid medicines can breastfeed. It depends on which medicine you are taking. Check with your health care provider before breastfeeding.

There are some women who should not breastfeed, such as those who have HIV or take illegal drugs.

What are the treatments for opioid use disorders in pregnancy?

If you are pregnant and have an opioid use disorder, do not stop taking opioids suddenly. Instead, see your health care provider so you can get help. The treatment for opioid use disorder is medication-assisted therapy (MAT). MAT includes medicine and counseling:

  • Medicine can reduce your cravings and withdrawal symptoms. For pregnant women, health care providers use either buprenorphine or methadone.
  • Counseling, including behavioral therapies, which can help you
    • Change your attitudes and behaviors related to drug use
    • Build healthy life skills
    • Continue taking your medicine and getting prenatal care

Opioid-Related Disorders
Pregnancy
Substance Abuse Problems
Pregnancy and Reproduction
Female Reproductive System
Many women need to take medicines while they are pregnant. But not all medicines are safe during pregnancy. Many medicines carry risks for you, your baby, ...
Pregnancy and Nutrition
National Library of Medicine
Nutrition and Pregnancy
What is nutrition, and why is it important during pregnancy?

Nutrition is about eating a healthy and balanced diet so your body gets the nutrients that it needs. Nutrients are substances in foods that our bodies need so they can function and grow. They include carbohydrates, fats, proteins, vitamins, minerals, and water.

When you're pregnant, nutrition is more important than ever. You need more of many important nutrients than you did before pregnancy. Making healthy food choices every day will help you give your baby what he or she needs to develop. It will also help make sure that you and your baby gain the proper amount of weight.

Do I have any special nutrition needs now that I am pregnant?

You need more folic acid, iron, calcium, and vitamin D than you did before pregnancy:

  • Folic acid is a B vitamin that may help prevent certain birth defects. Before pregnancy, you need 400 mcg (micrograms) per day. During pregnancy and when breastfeeding, you need 600 mcg per day from foods or vitamins. It is hard to get this amount from foods alone, so you need to take a supplement that contains folic acid.
  • Iron is important for your baby's growth and brain development. During pregnancy, the amount of blood in your body increases, so you need more iron for yourself and your growing baby. You should get 27 mg (milligrams) of iron a day.
  • Calcium during pregnancy can reduce your risk of preeclampsia, a serious medical condition that causes a sudden increase in blood pressure. Calcium also builds up your baby's bones and teeth.
    • Pregnant adults should get 1,000 mg (milligrams) of calcium a day
    • Pregnant teenagers (ages 14-18) need 1,300 mg of calcium a day
  • Vitamin D helps the calcium to build up the baby's bones and teeth. All women, pregnant or not, should be getting 600 IU (international units) of vitamin D per day.

Keep in mind that taking too much of a supplement can be harmful. For example, very high levels of vitamin A can cause birth defects. Only take vitamins and mineral supplements that your health care provider recommends.

You also need more protein when you are pregnant. Healthy sources of protein include beans, peas, eggs, lean meats, seafood, and unsalted nuts and seeds.

Hydration is another special nutritional concern during pregnancy. When you are pregnant, your body needs even more water to stay hydrated and support the life inside you. So it's important to drink enough fluids every day.

How much weight should I gain during my pregnancy?

How much weight you should gain depends on your health and how much you weighed before pregnancy:

  • If you were at a normal weight before pregnancy, you should gain about 25 to 35 pounds
  • If you were underweight before pregnancy, you should gain more
  • If you were overweight or had obesity before you become pregnant, you should gain less

Check with your health care provider to find out how much weight gain during pregnancy is healthy for you. You should gain the weight gradually during your pregnancy, with most of the weight gained in the last trimester.

Do I need to eat more calories when I am pregnant?

How many calories you need depends on your weight gain goals. Your health care provider can tell you what your goal should be, based on things like your weight before pregnancy, your age, and how fast you gain weight. The general recommendations are:

  • In the first trimester of pregnancy, you probably do not need extra calories
  • In the second trimester, you usually need about 340 extra calories
  • In the last trimester, you may need around 450 extra calories per day
  • During the final weeks of pregnancy, you may not need extra calories

Keep in mind that not all calories are equal. You should eat healthy foods that are packed with nutrients - not "empty calories" such as those found in soft drinks, candies, and desserts.

What foods should I avoid during pregnancy?

During pregnancy, you should avoid:

  • Alcohol. There is no known amount of alcohol that is safe for a woman to drink during pregnancy.
  • Fish that may have high levels of mercury. Limit white (albacore) tuna to 6 ounces per week. Do not eat tilefish, shark, swordfish, or king mackerel.
  • Foods that are more likely to contain germs that could cause foodborne illness, including
    • Refrigerated smoked seafood like whitefish, salmon, and mackerel
    • Hot dogs or deli meats unless steaming hot
    • Refrigerated meat spreads
    • Unpasteurized milk or juices
    • Store-made salads, such as chicken, egg, or tuna salad
    • Unpasteurized soft cheeses, such as unpasteurized feta, Brie, queso blanco, queso fresco, and blue cheeses
    • Raw sprouts of any kind (including alfalfa, clover, radish, and mung bean)
  • Too much caffeine. Drinking high amounts of caffeine may be harmful for your baby. Small or moderate amounts of caffeine (less than 200 mg (milligrams) per day) appear to be safe during pregnancy. This is the amount in about 12 ounces of coffee. But more research is needed. Check with your health care provider about whether drinking a limited amount of caffeine is okay for you.

Maternal Nutritional Physiological Phenomena
Pregnancy and Reproduction
Food and Nutrition
What is nutrition, and why is it important during pregnancy? Nutrition is about eating a healthy and balanced diet so your body gets the nutrients that ...