Your health care team is hired by you and your insurance company. Essentially, they work for you. Do not ever be afraid to ask for more tests or to simply ask more questions. Some women focus on respecting their health care provider’s time which is proper etiquette. However, asking questions or requesting additional sources of monitoring for your expected baby based on your concerns is not a poor use of their time or your judgment.

Their number one goal is to have your baby arrive safely alive and kicking, with few problems along the way. Again, don’t ever hesitate to call and ask your health care team about your questions or concerns, or anything you don’t understand. And always trust your instincts. Your team is there to educate and inform you, that’s their job.

The presence of Group B Strep (GBS) is tested for at your first health care visit with a urine culture. If you are positive, you will be given antibiotics. A test of cure (TOC) urinalysis will be done at your next health care visit to make sure the infection is cleared. Please refer to My Pregnancy, 1st Trimester and Week 8 for more information.

A rectovaginal swab will be taken at some point between 35-37 weeks and if positive, you will be given intravenous antibiotics once your waters break or you go into labor. If you are positive for GBS, you should discuss its effects and how it will impact your pregnancy with your health care team. Please refer to My Pregnancy, 3rd Trimester and Week 35 for more details.

Begin your Pregnancy PUR$E at your first health care visit. It’s simple and easy to do. Just put $10 a week aside to cover the cost of an ultrasound sometime around Week 28 and also at Week 36 to check the position of your baby’s umbilical cord and check for the normal development and position of the placenta. Insurance companies usually cover the cost of an ultrasound if warranted and ordered by your health care team. However, this ultrasound may not be covered as most health care teams do not request it.

An ultrasound around 28 weeks and again at 36 weeks is a safety measure to ensure that the position of your baby’s umbilical cord and that the development and position of the placenta are normal. Similar to the 20 week ultrasound, your baby’s organs and skeletal system will be visualized on the screen. If there is a problem with either the umbilical cord or placenta at this 28 week ultrasound, your health care team will then monitor you more closely with ultrasounds (this is the only way your baby can be seen), Fetal Non Stress Tests (NST), Biophysical Profiles (BPP), very diligent movement counting, and even daily home fetal rate heart home monitoring.

Just about all babies experience “hiccups”, which will first be noticed as soft, regular, rhythmic movements usually in the same uterine location. As your pregnancy progresses, they will feel stronger and will eventually seem like hiccups except in your abdomen! Your baby’s hiccups should decrease as your pregnancy advances. Although many babies do have hiccups without a problem, once you pass week 30, your baby should not have hiccups every day. If after week 30 your baby has daily hiccups, hiccups lasting longer than 15 minutes, or hiccups occurring more than 3–4 times in 24 hours, you should alert your health care team and have your baby evaluated for umbilical cord issues.

Be prepared as your health care team may not seem troubled by you reporting your baby’s hiccups. Most likely, they will not advise further testing nor will they be worried. Unfortunately, not all health care teams are aware of the possible correlation between hiccups and fetal distress.

If you encounter this scenario, remember, you are the mom. It is OK for you to suggest and request an ultrasound to check for cord and placental issues (an ultrasound is the ONLY way your baby, the umbilical cord and placenta can be seen), NST, BPP, or a Cord Doppler Test. You are the best guardian and person to protect your baby. Trust your instincts.

Begin keeping track of your baby’s movements at 20 weeks. Start a journal to blueprint when your baby is awake and asleep. Beginning around Week 28, Movement Counting is one efficient way to begin monitoring your expected baby. Since prenatal appointments are not every day, it is up to you, the Mom, to pay close attention to your expected baby’s movements each and every day. By simply counting your baby’s movements on a daily basis, this easy and noninvasive method allows you to get to know your baby’s movement patterns and that your baby is well. A change in your baby’s moments could mean that your baby is not well. If you are unable to obtain the usual 10 movements in your normal amount of time, or you detect an unusual level of activity for your baby (an increase or decrease in fetal movement), or you notice any sudden changes in movement, call your health care team to make sure your baby is well. If you are unable to contact or visit your health care team, go to Labor and Delivery (L&D) as most L&D units will see you immediately for Decreased Fetal Movements (DFM), or go to the nearest Emergency Room (ER).

Don’t ever hesitate to call your health care team about any questions or concerns that you may have or comments that you don’t understand. They are there to educate and inform you. That’s their job! You know your baby best. Always trust your gut.

You can print our Mom & Baby Tracking Chart from Week 13 to keep track of both you and your baby’s milestones. If you are at Week 28 or beyond, then our Mom & Baby Tracking Chart from Week 28 is ideal to monitor you and your baby.

You can count your movements at any point during the day. Ideally, we recommend first thing in the morning, once in the afternoon, and once in the evening before bed. Movement counting usually takes about 8 minutes!

Whenever you want to count your baby’s movements, lie on your left side if possible and count every kick, punch, roll, swish, jab and swoosh, but not hiccups. You should be able to get 10 movements in one hour or less. Jot down the number in your Operation Due Date Mom & Baby Tracking Chart, which may also become part of your medical record.

You may wonder, “How will I know if something isn’t right?” You are looking for anything different or out of the ordinary. For example: Let’s say you always do your movement counts at 7am, immediately following breakfast, and it usually takes about 5 minutes to count your 10 movements. If one morning, at the same time, it suddenly took you 45 minutes to get 10 movements, that would be considered out of the ordinary. You might want to wait a few minutes and do another movement counting session just to be sure. But if you are truly concerned, call your health care team.

Another example: You may count 4 or 5 movements in an hour instead of the usual 10 movements. Count your movements again. If, for any reason, you are still not able to obtain the usual 10 movements in your normal amount of time, or you detect an unusual level of activity for your baby (an increase or decrease in fetal movement), or you notice any sudden changes in movement, call your health care team to make sure your baby is well. If you are unable to contact or visit your health care team, go to Labor and Delivery (L&D) as most L&D units will see you immediately for Decreased Fetal Movements (DFM), or go to the nearest Emergency Room (ER).

Don’t ever hesitate to call your health care team about any questions or concerns that you may have or comments that you don’t understand. They are there to educate and inform you. That’s their job! You know your baby best. Always trust your gut.

No. Babies’ movements and heart rates remain the same during the last trimester of your pregnancy. A change in your baby’s movements such as speeding up or slowing down or changes in sleep-wake cycles could be the sign that your baby is not well. When you mention to your health care team that you have noticed a change in your baby’s movements, action needs to be taken! Why not ask your health care team to perform an ultrasound (an ultrasound is the only way your baby, the umbilical cord and the placenta can be seen) to ensure that your baby is well? There are many tests available to reassure you that your baby is well. And always, trust your instincts.

Well, it is a fact of pregnancy and life, stillbirth does happen. It is surely one of the most devastating situations a family can endure. Begin by mentioning and discussing your concerns openly with your health care team.

Please don’t make yourself miserable during your pregnancy dwelling on the possibility of your baby being born still. There are a few things you need to know to enjoy your pregnancy and stop worrying about your baby who is living very happily inside you! First, don’t ever hesitate to call your doctor, midwife or health care team with any questions and concerns, or comments you don’t understand. They are there to educate and inform you. That’s their job! And, always trust your gut.

The most recent research now encourages all pregnant women to begin sleeping on their left side. At 10 and 18 weeks, and at every ultrasound, have your baby’s Estimated Placental Volume (EPV) measured. This will let your health care team know how the placenta is functioning in relation to the growth of your baby (there is an EPV measuring app for your IPhone). At 20 weeks during the anatomy ultrasound, make sure your baby’s heart, umbilical cord and placenta are checked on screen for normal development and placement, along with your baby’s organs and systems; count your baby’s 10 fingers and 10 toes. Begin a daily journal of your baby’s moments at this time.

Insist on additional ultrasounds around 28 weeks and again at 36 weeks to check the umbilical cord and placenta as mentioned above. If a problem is seen on your ultrasound, work with your health care team for close monitoring solutions such as ultrasounds (an ultrasound is the only way your baby can be seen), daily fetal  heart rate home monitoring, NSTs, BPPs and very diligent movement counting to name a few. Begin movement counting now ideally three times a day and remember a change in your baby’s movements such as speeding up or slowing down or changes in sleep-wake cycles could be a sign that your baby is not well. Don’t ever hesitate to voice your questions and concerns to your healthcare team, and request additional testing and ultrasounds during your pregnancy.

Your baby may experience hiccups which will first be noticed as soft, regular, rhythmic movements usually in the same uterine location. As your pregnancy progresses, they will feel stronger and will eventually seem like hiccups except in your abdomen! Your baby’s hiccups should decrease as your pregnancy advances. Many babies have hiccups and there is no problem, but after you reach 30 weeks, your baby should not have hiccups every day. If your baby has daily hiccups, hiccups lasting longer than 15 minutes, or hiccups occurring more than 3–4 times in 24 hours, your baby should be evaluated for umbilical cord issues.

Also, check out the following websites for both viral and bacterial infections that can impact your pregnancy. Group B Strep (GBS), CMV, and Toxoplasmosis can be found on the CDC and March of Dimes websites. Most health care professionals don’t mention these infections to moms who may be asymptomatic. Awareness, a proactive attitude and vigilance empowers.

Getting to know your baby’s movements is imperative. In asking simple yet essential questions to your health care team enables you to become your baby’s guardian to ensure a happy and healthy delivery day.

There is great concern regarding nuchal cords among many expectant moms due to our advanced technology enabling us to see our baby’s surroundings in utero. Nuchal cords are extremely common and most babies can wriggle their way out of them, and they do! But, that being said, all nuchal cords have the potential to be extremely problematic. The most important aspect of any umbilical cord issue is to be aware of its presence. So if your baby starts having changes in his or her patterns of movement, or heart decelerations are present on an NST, you may know the probable cause.

Nuchal cords come under the category of the umbilical cord. There are 2 types of nuchal cords: A & B. Type A encircles the neck in an unlocked pattern. Type B encircles the neck in a locked pattern and this second type is responsible for 1 in 50 stillbirths according to Dr. Jason Collins, MD of The Pregnancy Institute.

Umbilical Cord Accidents (UCA), including nuchal cords, true knots, twists, torsion, kinks and long or short cords are responsible for approximately 16 per cent of the 26,000 stillbirths yearly in the United States (3 million globally). That is 71 each and every day in our country alone. They are not a rare condition or event, and should be watched for in the last trimester of pregnancy.

Speak openly with your health care team about your fears. If a nuchal cord is seen in your baby’s ultrasound, a close monitoring solution such as movement counting, NSTs, BPPs, home monitoring or ultrasounds will be needed. If the nuchal cord remains, a plan of action needs to be decided upon with your health care team. We can’t stress enough how moms can become their baby’s guardian through awareness, a proactive attitude and vigilance.

As we’ve said before, a change in your baby’s movements such as speeding up or slowing down or changes in sleep-wake cycles may be the sign that your baby is not well. Make sure you are  counting movements ideally three times a day for the duration of your pregnancy and pay attention to any unusual hiccups after your 30th week (refer to our Q & A on hiccupping as there may be a link between hiccupping and umbilical cord issues). Don’t ever hesitate to voice your questions and concerns to your healthcare team, and request additional ultrasounds throughout the duration of your pregnancy.