The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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1} d Many doctors and midwives like to see women early in pregnancy so they can gather information to be used at the end: namely, the baby’s due date. Why is an accurate due date so important? “About a week past the due date, the placenta may start to break down, so we want to make sure the baby’s heart rate is OK and there’s enough fluid around him. If not, we may need to induce labor,” says Pamela Berens, M.D., an OB-GYN at the University of Texas Medical School at Houston. “If a woman has a perfect 28-day cycle, getting an accurate due date isn’t much of an issue,” Berens adds.
“Otherwise, we can do an ultrasound to date the pregnancy, and that’s the most accurate way to do it in the first 12 weeks.” Having an accurate due date is also important when it comes to prenatal screening. For example, “The AFP [alpha-fetoprotein] test needs to be done between 15 and 20 weeks,” says Mayri Sagady Leslie, R.N., C.N.M., a faculty member at Georgetown University’s nurse-midwifery graduate program in Washington, D.C. “This window is the only time it can be done.” Similarly, the nuchal translucency, a newer test that can assess your baby’s risk of having Down syndrome and some other chromosomal abnormalities as well as major heart problems, must be done when you’re between 11 and 14 weeks pregnant.
Screening for existing health problems is another chief reason to get prenatal care early, says Gideon Koren, M.D., founding director of the Motherisk Program at Toronto’s Hospital for Sick Children and author of 2004’s The Complete Guide to Everyday Risks in Pregnancy and Breastfeeding. For instance, if you have high blood pressure, diabetes, epilepsy or other health problems, your doctor will want to make sure the condition is under control and that any medications you’re taking are pregnancy-safe. (This also is why experts recommend seeing a doctor before becoming pregnant, if possible.) So why is looking or listening for a heartbeat not at the top of the list? Simply, it may be too hard to detect very early in pregnancy. “Not seeing a heartbeat before six weeks doesn’t mean much,” Berens says. “But no heartbeat after six weeks could indicate a problem.”
2} b “Don’t go cold turkey or change any medications you’re taking without consulting your doctor,” Koren says. “There are many conditions, including depression and asthma, that require ongoing treatment, and if you alter your medications suddenly because you’re pregnant, you could harm yourself, as well as your baby.”
3} c Eeeww, but true. Toxoplasmosis is an infection caused by the Toxoplasma gondii parasite. Most adults who contract the infection have mild flulike symptoms or no symptoms at all. But the parasite can cross the placenta and cause significant risk to the developing fetus, including lifelong problems with the brain, eyes, heart and other organs.
The parasite can be transmitted a number of ways, the most common of which is by eating infected meat that hasn’t been cooked sufficiently to kill the parasite, according to geneticist and OB-GYN Karen Filkins, M.D., a clinical professor at the University of California, Irvine. Other risky food sources include unpasteurized milk and raw eggs, as well as fruit and vegetables that have not been washed thoroughly. Cats also can carry the disease if they eat raw meat or rodents; since the parasite can be passed on through feline feces, pregnant women should wear gloves when gardening and designate the litter box duties to someone else. Interestingly, while dogs can become infected with toxoplasmosis, they can’t transmit it.