Most people think that pregnancy signs are unmistakable and many women ‘just know’ when they are pregnant. But other times, pregnancy can come as quite a shock and those who have ‘symptoms’ were not even aware. There are a few common symptoms you could have to show you are pregnant.

The most obvious sign is if you miss your menstrual period. Although this is a common sign something is not as normal, it is not the only sign to say that you may be pregnant. Women can skip their cycle for a number of reasons and it may not be that you are pregnant.

Nausea is another common symptom women get whilst pregnant. Morning sickness is common among half of pregnant women and can occur at any time of the day. The sickness is usually brought on suddenly and can last for the first few weeks.

Another early sign of pregnancy is tender nipples and breasts. This tender felling usually disappears once your hormone levels have become accustomed to your body and the baby begins to grow.

If you have frequent urination and a high body temperature, it could also mean you are pregnant. Women often experience more urination as the changes in hormone levels produce the need to go. Body temperature may be high due to an increase at ovulation and may stay high for the first few weeks of pregnancy.

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Do you know what to expect from each of the three trimesters? Here is an overview of each with the common signs of pregnancy trimesters one, two and three.

Weeks one to 12: Pregnancy Trimester One

The first and most prominent pregnancy symptom is a missed menstrual cycle. You may see pinkish or brownish discharge that varies in colour and lightness. Other pregnancy symptoms include nausea, frequent urination, darker areolas, fatigue, heartburn, headache, mood swings and constipation.

Weeks 13 to 26: Pregnancy Trimester Two

As you progress through the second trimester, you will experience frequent kicking movements from the growing foetus. You will also gain weight, your breasts will grow and there may be discharge from your nipples. You may also sweat more than usual and notice dark lines develop on your skin between the navel and pubic area. The skin on your stomach will begin to stretch at this time.

Weeks 27 to 40: Pregnancy Trimester Three

The last 13 weeks of pregnancy involve having the body change to prepare for labour. The child will also grow large enough to be seen more clearly during the CAT scan. You will see your navel pushing out and will experience backaches. There will be some changes in how you walk to accommodate the weight of your child.

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Exercise is highly recommended for pregnant women as it helps prepare the body for the demands of a changing body and labour. The most popular exercise routines for women include swimming and brisk walking as well as special yoga classes, tai chi and pilates.

One of the lesser-known exercises that can work wonders for pregnant women is abdominal exercise. Although it may sound drastic, abdominal exercise during pregnancy yields good results. The abdominal muscles play a major role during childbirth and thus abdominal exercise during pregnancy reduce the ‘diastasis recti’ effect whereby the abdominal muscles get separated during pregnancy. Abdominal exercise during pregnancy will also reduce the likelihood of back pain by strengthening back muscles.

Before beginning abdominal exercise during pregnancy, it is worth discussing it with a doctor. Most doctors tell pregnant women to never engage in ‘lying face up’ exercises during the first trimester of the pregnancy period. The ideal routine is one that comes recommended by a doctor, as they will have a number of appropriate abdominal exercise routines to share.

Abdominal exercise during pregnancy has a number of benefits, including improved resistance to fatigue, improved posture, less ability to gain body fat, better sleeping habits, stronger back muscles, physical preparation for labour as well as faster recovery after labour.

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You’re nesting and would love to make some clothes for your baby. But you don’t even own a sewing machine. You drool over the delightful hand-made baby clothes at specialty shops but can’t afford them – especially when you know they will be grown out of in a month.

You can do it! You don’t have to have any skill, just a bit of creativity. Here are some ideas to very easily create your own style for your baby without needing a sewing machine. Buy a basic baby outfit in a plain colour and add:

1. Ribbons or rikrak: For your baby girl, buy small quantities of ribbons in pretty colours. For your baby boy, buy some pieces of rikrak in fun colours. Lay them on the front of your baby outfit in pleasing arrangements and hand stitch into place.
2. Cloth badges and buttons: Have a look in op shops or at souvenir stores for cloth badges that say something about you. For example, if you’re a Queenslander maybe a cloth badge from the Big Pineapple? Stitch it on the front by hand. Find some little buttons that match the colour tone and sew them on along the shoulders.
3. Potato stamp and non-toxic paint: Do you remember doing these in school? Cut a potato in half, cut a stamp shape into the wet side and blot it on a paper towel. Place a piece of cardboard inside your baby outfit, squirt some non-toxic fabric paint onto a paper plate and start stamping! Add more stamps in different colours and thoroughly dry the fabric when done (in the sun or the dryer).
4. Iron-on transfers: You can find Australian providers online who will print your own words, or some clipart, onto transfer paper for you to iron onto your baby outfit at home in minutes. Or, you can buy coloured iron-on paper to cut out your own shapes. It is cheap, easy and original. Check out www.wearablewords.com.au.
5. No sewing appliqué: Head to the patchwork section of your local fabric shop, or find a speciality patchworking store online, and buy a small piece of gorgeous patterned fabric. Also buy a small piece of no-sew bond (an iron-on adhesive that bonds two layers of fabric together without needing to sew the edges). Cut out your fabric into a shape and follow the instructions to iron it on.

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As a first time parent you are probably daunted by the prices of all the baby paraphernalia you’ll need and the huge sum it will add up to. The good news is there is ways to obtain it all without spending a cent.

1. Ask for hand-me-downs from your friends who have had babies

Ask all your friends who have kids if they want to hand down to you their baby stuff they have finished with. You will find many people are keen to get rid of all the gear that takes up so much storage space. Or, ask them if they mind lending you items for you to return before they need them again for their next baby.

2. Find free stuff within your community

The Freecycle Network™ is a grassroots and nonprofit movement of people who are giving and getting stuff for free in their own towns. It is popular with parents getting rid of their baby stuff. There are 175 groups in Australia and membership is free.

3. Take advantage of gifts for those things you must have new

Often friends and family members ask what you would like as a gift. This is a good opportunity to ask for those items that it is not recommended you obtain second-hand. These are:

1. 1. Baby car seats: It may not meet current Australia standards, you will miss out on recent improvements in safety design, and/or it may have been in a car crash resulting in compromised safety.
   2. Cots: Australia has mandatory safety standards that an old cot may not meet. Furthermore, it may be coated with toxic lead paint that you do not want baby chewing on or breathing in.
   3. Mattresses: These could have dust mites in them that may trigger an allergic reaction.

These items can be expensive so you could arrange eager friends and family to pool their gift money together for you.

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Advanced technology now allows even clearer and more magnified images. Some of these pictures were taken with conventional cameras with macro lenses, while others were taken with the use of an endoscope. Scanning electron microscope technology enabled Nilsson to take pictures at a magnification of hundreds of thousands

His remarkable pictures have been collected in a large hardcover book: A Child Is Born, published by Jonathan Cape

[Show as slideshow]

[View with PicLens]

Pictures by: LENNART NILSSON

- Five weeks. The embryo is approximately 9mm long. A face develops, with openings for the mouth, the nostrils and eyes.

- Eight weeks. The rapidly-growing embryo is well protected in the foetal sac.

- Ten weeks. The eyelids are semi-shut. They will close completely in a few days.

- Sixteen weeks. The foetus uses its hands to explore its own body and its surroundings.

- Eighteen week. Approximately 14cm. The foetus can now perceive sounds from the outside world

- The foetus can now grab and pull the long umbilical cord. The skeleton consists mainly of flexible cartridge. A network of blood vessels is visible through the thin skin.

- Twenty weeks. Approximately 20cm. Woolly hair, known as lanugo, covers the entire head.

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The bills resulted from a review earlier in the year by Rosemary Bryant, Commonwealth Chief Nurse (a position established by Roxon), which concluded what Australian women by and large have been saying for years, that unless you’re privately-insured there’s not enough choice when it comes to giving birth, especially in a regional community. Roxon’s bills also added to the growing push for collaborative care, making midwives more central in maternity care as part of a team-based approach. It needs to be said, however, that doctors are not over-keen about the reforms.

If Roxon thought this major reform would get support from those who support choice in "birthing", she was wrong. The bills upset many homebirth advocates who wanted Medicare funding for midwives outside clinical settings like planned home births, and 'homebirth midwives to have professional indemnity cover.

Roxon’s bills established a publicly-funded professional indemnity scheme for midwives, but didn’t extend to services provided outside clinical settings where risks are much higher. Private insurers won’t provide indemnity cover for homebirth midwives because there’s too few of them to provide a premium pool, and homebirths are too high risk.
This hasn’t stopped some women suing after bad outcomes.

As Ms Bryant’s report notes, if one practitioner can’t be sued [and many homebirth midwives strip themselves of assets and require tight contracts against litigation, then some clients will try to sue other practitioners who were involved, e.g. obstetricians called in at the last minute when a homebirth has gone badly wrong. Other medical professionals are reluctant to become involved now for fear of becoming 'the litigee of choice'.

The reaction from many homebirth advocates has been extreme and Nicola Roxon has been vilified across the blogosphere and deluged with letters and emails.

Many claim that the Government is seeking to ban homebirths, when it is doing no such thing, and claim - against considerable contrary evidence - that homebirths are as safe    or safer than deliveries in clinical settings, including birthing centres.

The missing fact in the virulent attacks on Roxon and her reforms -- which the Coalition have eagerly taken up in Parliament -- is that only a tiny fraction of Australian women choose homebirths - 0.22% of all births in Australia, according to Bryant’s report. Even in New Zealand, where taxpayers fund homebirths, the rate is only 2.7%. Moreover the rate was declining rapidly in Australia even in the 1990s, when homebirth-midwife insurance was available.

No one is stopping Australian women who want homebirths from choosing them. Nicola Roxon’s bills merely continue the current approach of not providing Medicare funding for homebirths and require that midwives are either part of a professional, accredited, indemnified, collaborative care model.

What should have been hailed as a major midwifery step forward in the Australian health system - long characterised by a maternity care approach dominated by obstetricians (usually male) has been drowned out by ideological attacks from a tiny unrepresentative minority.

AGAINST THE ABOVE [midwife author]

The issue of homebirth divides the community into those who think it is OK and those  who don’t. Often, no amount of evidence, opinion, or research will convince either side.
The above view is based on two incorrect pieces of information. The first is that "no one is stopping Australian women who want homebirths from choosing them". The second is that there exists 'considerable evidence' that home births are dangerous.

To start with the first. As of July next year it will no longer be legal to have a homebirth attended by a registered private midwife in Australia. This is a fact, the reason being that the state and Commonwealth governments are implementing a National Registration and Accreditation Scheme for health professionals.

As part of this scheme a health professional must hold professional indemnity insurance in order to register to practise. Private midwives are presently unable to obtain such insurance because there is no insurance product available for them to purchase: they form too small a collective to make it worthwhile for an insurer to provide that product.

The legislation currently before Parliament proposes indemnity insurance to some midwives. It is not at all clear who these midwives will be only that they are "eligible" and that they will work "collaboratively" and that they won’t attend homebirths. Extending this legislation to cover homebirth midwives is the only realistic way that homebirth with a registered private midwife will remain an option for Australian women after July 2010.
This is why so many have written to Nicola Roxon, visited their local MPs and made submissions to the recent Senate inquiry concerning this legislation.

The second piece of incorrect information is that home birth is an inherently dangerous and high-risk option. There is a body of evidence regarding the safety of homebirthing. The most recent published study (only a few months ago), of over half a million low risk births showed that women and their babies were as safe at home as they were in hospital. Even the Australian homebirth study published over a decade ago found that low-risk women were no less safe at home giving birth.

That study did point out that the practices of unregistered midwives versus registered practitioners was the issue of concern. The fact is that flawed research from the 1970s which falsely concluded homebirths were not safe has misinformed government policy for decades.

The UK Department of Health website states that "for a healthy woman experiencing a normal pregnancy with no major complications anticipated during the birth, studies have shown that it is equally safe to be attended by midwives in the comfort of your own home as to have your baby in hospital." The Department of Health in the UK has made one of its priority targets for 2009/10 to give more mothers-to-be the opportunity to choose to give birth at home.

One could write many pages setting out the breadth of evidence that supports homebirth as an option for women but would distract from the fact that at its heart this debate is not about safety or risk or insurance. It is not a turf war about whether obstetricians or midwives should be the most important care provider for pregnant women. It is about whether all Australian women have the autonomy to make their own choices about how they will give birth -- a fundamental choice about a fundamental life experience.

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Massage:

• Encourages muscle co-ordination
• Promotes sleep
• Relieves pain
• Soothes irritations and inflammations
• Stimulates you baby’s immune system
• Helps circulation
• Aids digestion
• Encourages bowel function
• Nourishes the skin
• Cleanses the skin
• Increases flexibility
• Enhances emotional security

Do not carry out massage if your baby:

• Is ill
• Is asleep
  Is obviously in pain
• Has just eaten
• Has just been immunised (wait two days for any reaction, then avoid massaging the injection site for a week)
• Has a reactive skin disorder
• Some homeopathic medications should not be used with aromatherapy essential oils. Check with your naturopath. A natural base oil can be used on its own.

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"Elderly Prima Gravidas" is the medical term given to a woman over 30 or 35 (depending on the doctor) giving birth for the first time. It literally translates to "old first-time mum". However, it is a term that is quickly dating as more women are choosing to delay motherhood until later in life.

In the last quarter of a century, the median age of first time mothers has increased from 24 years in 1975 to 29 in 2000. Australia Bureau of
Statistics (ABS) projections assume the median age of mothers will reach 31.2 years by 2008.

So why are so many women choosing to have children later in life? There are thought to be many influencing factors. Many women may be:

• Choosing to spend more time developing relationships before settling down with a partner in their mid 30s
• Choosing to achieve financial independence and security before having their first child
• Enjoying the freedom that a family life may potentially compromise choosing instead to travel, study or establish a successful career.

It’s a universal conundrum that for mothers in their 20s, the best years for having children from a medical perspective coincides with the best years for establishing a career.

There is also the thought that the widespread availability and long-term use of contraception has led to both less unplanned pregnancies and obligatory marriages. Also to be considered is the increasing number of pregnancies that are voluntarily terminated.

Many women may choose to delay parenthood in the belief that emotional and psychological maturity better equips them for dealing with the roles that parenthood presents. Some women find it necessary to live a varied and fulfilling life in both a personal and professional sense before embarking on motherhood. Establishing a sense of self is as important to many in today’s progressive society.

The April edition of Time magazine this year ran a cover photograph of a baby on top of an overflowing "pending" filing tray titled: "Babies vs Career - Which should come first for women who want both? The harsh facts about fertility". The article sought to highlight the potential medical obstacles women may face as older women wishing to start a family.

Medical Fraternity

In the medical fraternity it is broadly acknowledged that female fecundity (the ability to conceive) decreases with age. Delaying pregnancy and parenthood raises the likelihood of complications such as:

Difficulty Conceiving

Approximately one in seven couples experience infertility problems if the female is aged between 30-34 years, one in five when she is aged between 35-40 years and one in four for women aged between 40-44 years.

Chromosomal Anomalies

Chromosomal anomalies, including Down’s Syndrome. For a woman aged 20, the risk of Down’s Syndrome is one in 1000; by the age of 30 this increases to one in 600; at the age of 35, it is one in 225 and by 40 years, it is one in 62.

Aging Oocytes

Research indicates that age influences the quality of a woman’s oocytes (eggs) raising the risk of chromosomal anomalies and consequently the incidence of miscarriage and stillbirth.

Pregnancy Complications

The incidence of high blood pressure and gestational diabetes increases with age.

Foetal Deformities

The increasing incidence of foetal problems caused by nutritional deficiencies, such as folic acid, may lead to foetal deformities including neural tube defects and spina bifida.

Fertility Treatment

The effectiveness of fertility treatment, including IVF, is reduced. In 1997 about 9% of mothers assisted by artificial conception were aged 40 years and over, comprising 2% of all mothers.

Pelvic Inflammatory Disease

The incidence of pelvic inflammatory disease is increased.

Most health professionals, however, agree that with careful preconception and pregnancy planning, monitoring these problems can be managed, and to some extent, reduced.

Youth is certainly no guarantee of a clean bill of health. There’s genetics to consider, dietary choices, stress levels, along with the fact that many young women today consume far greater quantities of alcohol, recreational drugs and alcohol than women 20 year’s their senior. All these factors will have a bearing on fertility, pregnancy and labour.

Celebrated author and medical professional Christiane Northrup believes that whether or not a woman in her 30s is more at risk of fertility problems or a difficult pregnancy must be completely individualised.
A certified obstetrician and gynaecologist with vast experience in women’s health, Northrup writes in her book Women’s Bodies, Women’s Wisdom:
"I’d much rather take care of a 40-year-old in excellent health who had planned her pregnancy than a 25 year old who smokes two packs and quaffs a gallon of Diet Coke per day. Too often the medical profession "hexes" women who become pregnant in their 30s and 40s by lumping them into a statistically high-risk categories that are not necessarily applicable."
She also says that age is not an absolute measure of the intensity or duration of labour.
"Chronological age (age in years) and biological age (age of one’s tissues) aren’t necessarily related," writes Northrup.

Emotional Ramifications

Having a child later in life will always stir the emotional balance for a couple. When two people have spent a long time establishing themselves as individuals and as a couple living a full life, it can be an unexpectedly difficult transition to life as a family. The sudden responsibility of being parents can threaten a relationship and in some cases, it may not survive.
But one can always argue that a baby will alter any relationship, whatever age the couples and however long they have been together. As Nora Ephron once said:
"A baby is a hand grenade thrown into a marriage".

Bypassing Parenthood

If current rates of birth continue in Australia, 24% of all Australian women will remain childless at the end of their reproductive lives.
In the United States, recent census data indicates that childlessness has doubled in the past 20 years so that one in five women between 40 and 44 are childless.

Increasing median age of fathers

Meanwhile, the median age of fathers in Australia has increased from 29.4 years in 1980 to 32.3 years in 2000, according to the ABS. The growing proportion of fathers aged 40 years and over has contributed to this rise.
In 1980, 5% of fathers were aged 40 years and over - this figure has increased to 11% in 2000.
While it is thought that some fathers may have deliberately delayed fatherhood, it is also a possibility that many of these fathers could be starting a second family with a different partner.

Motherhood on Ice

In the United Kingdom, a 36-year-old woman has achieved pregnancy using her own previously frozen eggs and her husbands sperm, and gone on to give birth to a baby girl. Realistically this means women can choose to freeze their eggs and delay motherhood.

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Many couples today are confronted with “unexplained” fertility problems or have experienced a previous pregnancy that resulted in miscarriage, stillbirth, malformation or impaired development.

It's been estimated that 60 per cent of couples will conceive after three menstrual cycles and that 85 per cent will conceive within a year.

Timing, health, hormonal state and age of both the male and female can all affect conception. A woman under 25 may conceive within two or three months, whereas a woman over 35 may take six months or longer. The reason for this is that as a woman gets older, the vitality and number of her eggs being released which are capable of being fertilised, is in gradual decline.

The quality of sperm is also an important factor, but deterioration only becomes significant beyond the age of 60.

Fertility Times

Women remain fertile for only 24 hours a month. During ovulation the ovum or egg is released by the ovary into the fallopian tube. Whereas ovum remain ripe for 24 hours, male sperm have a longer life span, surviving for four to five days in a woman’s body. This means that there are about five or six days during which time conception could possibly occur each month. To maximise the chances of conception, sexual intercourse ideally should occur in the six days leading up to and on the day of ovulation as the quality of sperm deteriorates the longer it is inside the woman’s body.

Most women ovulate in the middle of their menstrual cycle. In a 28-day cycle, ovulation will occur around day 14.
Your partner may recognise the most reliable signs of ovulation as follows:

• a distinct rise in temperature
• the cervix becomes softer and slightly more open
• the mucus plug, or discharge, comes away from the cervix to allow the entry of sperm
• the discharge has a similar consistency to egg white and is elastic in texture
• an increased libido
• a tugging sensation in her lower abdomen

The nature of this fertile mucus helps your sperm to swim up through the vagina and cervix, through the uterus and into the fallopian tubes.

Genetic and Medical History

It is important for both of you to assess your family medical and genetic history. Is there a history of diabetes, high blood pressure, heart disease (especially valve replacement), epilepsy, kidney disease, tuberculosis, syphilis, active herpes, cerebral palsy or AIDS/HIV? It may be wise to seek genetic counselling and discuss prescribed medication with your doctor to see if there are implications for a healthy pregnancy. You may need to adjust your medication.

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