During pregnancy

For a completely accurate due date, visit your OB/GYN provider. Or, you can use our pregnancy due date tool to calculate you estimated due date.

During the early stages of pregnancy, 90 percent of women suffer from morning sickness²: nausea and/or vomiting. It is most likely caused by hormones, such as human chorionic gonadotropin (hCG), the pregnancy hormone.¹ Luckily, women have found many helpful at-home remedies, including:

• Trying small, frequent meals to keep your stomach from getting too empty.
• Changing your routine to help you learn which foods and smells your body can and cannot handle.
• Taking ginger or vitamin B6.
• Trying acupressure.

A birth plan is a document that tells the health care provider what's important to you during labor and delivery. Your number-one goal is the safe delivery of your baby, so it's important to keep your plan flexible. You may have to adjust it if circumstances change during delivery. Here are a few birth plan examples/resources:

• WebMD: How to Create a Birth Plan
• American Pregnancy Association: Creating Your Birth Plan

A Lamaze class is one of the many childbirth classes you can take throughout your pregnancy. Lamaze classes focus on coping strategies, breathing techniques, and other ways to keep yourself comfortable while giving birth.³

It’s all about preference. There are classes around care for your baby, yoga classes to keep your mind and body at peace throughout pregnancy, classes to prepare you for childbirth, and so much more. Your health care provider, ob-gyn, or midwife should be able to give you information about classes that fit your needs.

Keep in mind that for some health plans you may pay for these classes, though classes are reimbursable. Our maternity health coaches can discuss which classes are available for reimbursement and help you submit the proper form.

• View a list of available classes.
• Download a reimbursement form.

Your baby needs a lot from you during pregnancy, so it’s possible to develop issues. However, do not fret, because most common pregnancy problems are manageable by your health care provider. Here are a few you should know about:

• Preterm Labor
  • Labor that comes too early-between 20 and 37 weeks of pregnancy
• Gestational hypertension (pregnancy-induced hypertension or PIH)
  • This affects 6-8 percent of pregnant women.⁵
• Gestational diabetes mellitus (GDM)
  • This can cause early delivery, having a baby with low blood sugar or other health issues, or cause the need for a Cesarean birth.⁶
• Infections
  • Some infections do not affect your baby’s health, but some can. Wash your hands and avoid specified foods to prevent infection.⁶

Whatever has caused you to lose your baby or your pregnancy—miscarriage, ectopic pregnancy, molar pregnancy, stillbirth, or early newborn death—can be extremely difficult and upsetting for you and those close to you. It may be helpful for you to speak with your health care provider, a support group, or with a therapist to help during this emotional time. UPMC Health Plan maternity health coaches are also here to offer support and additional resources.

1. Stage one includes three phases: early, active and transition. This is when you:
   • May have contractions every 5 to 20 minutes that last 30 to 60 seconds. - Begin effacing and dilating. The cervix opens (dilates) and thins out (effaces) to allow the baby to move into the birth canal.
   • Have bloody discharge from your vagina.
   • May feel pressure in your lower back.
   • Need to go to the hospital or birthing center.
   • Will be ready to give birth.
2. Your baby is almost here! This is when you:
   • Start feeling an urge to push.
   • Can receive an episiotomy (a small cut made to help the baby come out and will prevent tearing) if your health care provider suggests this.
   • Start to have your baby crown.
   • Finish giving birth and the umbilical cord is cut.
3. Delivery of the placenta—the final stage of birth.

An important part of the birth plan is being prepared for different birthing outcomes. A Cesarean section (C-section) is the delivery of a baby through a cut (incision) in the mother's abdomen and uterus.

If you are pregnant, chances are good that you will be able to deliver your baby through the birth canal (vaginal birth). But in some cases, a C-section is needed for the safety of the mother or baby. So even if you plan on a vaginal birth, it's a good idea to learn about C-sections in case the unexpected happens. Here are a few reasons you might need a C-section:

• Labor is too slow and stops completely.
• The baby shows signs of distress, such as a very fast or slow heart rate.
• The baby is too big to be delivered vaginally.
• The baby is not in a head-down position (breach presentation) close to your due date.
• You are carrying more than one baby (multiple pregnancies).

So many things to keep track of during those last few weeks of pregnancy! Not sure what to bring to the hospital? Use this checklist as a starting point. Your personal list may include more (or fewer) items.

Still have questions or want to go over more details? Our UPMC Health Plan maternity health coaches are here for you. They can talk through your questions or send information that may help you feel more confident in your decisions. Call 1-866-778-6073 now.

Appropriate pregnancy weight gain is based on an individual’s pre- pregnancy BMI. You should discuss this with your provider.

In the meantime, there are ways to stay on track with your weight, like eating right and exercising moderately in order for you and your baby to be as healthy as possible.⁴

If you have had a C-section before, you may be able to deliver your next baby vaginally. This is called vaginal birth after cesarean, or VBAC. Women can talk to their health care providers to find out if they are a good candidate to try for a VBAC. Some of the reasons women consider VBAC over a repeat C-section are:

• Avoiding another scar on your uterus. This is important if you are planning on a future pregnancy. The more scars you have on your uterus, the greater the chance of problems with a later pregnancy.
• Fewer days in the hospital and a shorter recovery at home.
• A more active role for you and your birthing partner in the birth of your child.