Pregnancy

Pregnancy is the time during which one or more offspring gestates inside a woman's uterus.[1][2] A multiple pregnancy involves more than one offspring, such as with twins.[3]

Conception usually occurs following vaginal intercourse, but can also occur through assisted reproductive technology procedures.[4] A pregnancy may end in a live birth, a miscarriage, an induced abortion, or a stillbirth. Childbirth typically occurs around 40 weeks from the start of the last menstrual period (LMP), a span known as the gestational age;[1][5] this is just over nine months. Counting by fertilization age, the length is about 38 weeks.[5][2] Implantation occurs on average 8-9 days after fertilization.[6] An embryo is the term for the developing offspring during the first seven weeks following implantation (i.e. ten weeks' gestational age), after which the term fetus is used until the birth of a baby.[5]

Signs and symptoms of early pregnancy may include missed periods, tender breasts, morning sickness (nausea and vomiting), hunger, implantation bleeding, and frequent urination.[7] Pregnancy may be confirmed with a pregnancy test.[8] Methods of contraception are used to avoid pregnancy.

Pregnancy is divided into three trimesters of approximately three months each. The first trimester includes conception, which is when the sperm fertilizes the egg. The fertilized egg then travels down the fallopian tube and attaches to the inside of the uterus, where it begins to form the embryo and placenta. During the first trimester, the possibility of miscarriage (natural death of embryo or fetus) is at its highest. Around the middle of the second trimester, movement of the fetus may be felt. At 28 weeks, more than 90% of babies can survive outside of the uterus if provided with high-quality medical care, though babies born at this time will likely experience serious health complications such as heart and respiratory problems and long-term intellectual and developmental disabilities.

Prenatal care improves pregnancy outcomes.[9] Nutrition during pregnancy is important to ensure healthy growth of the fetus.[10] Prenatal care also include avoiding recreational drugs (including tobacco and alcohol), taking regular exercise, having blood tests, and regular physical examinations.[9] Complications of pregnancy may include disorders of high blood pressure, gestational diabetes, iron-deficiency anemia, and severe nausea and vomiting.[11] In the ideal childbirth, labour begins on its own "at term".[12] Babies born before 37 weeks are preterm and at higher risk of health problems such as cerebral palsy.[1] Babies born between weeks 37 and 39 are considered "early term" while those born between weeks 39 and 41 are considered "full term".[1] Babies born between weeks 41 and 42 weeks are considered "late-term" while after 42 weeks they are considered "post-term".[1] Delivery before 39 weeks by labour induction or caesarean section is not recommended unless required for other medical reasons.[13]

## Contents

* 1 Terminology
* 2 Demographics
* 2.1 Teenage pregnancy
* 3 Diagnosis
* 3.1 Symptoms and signs
* 3.2 Biomarkers
* 3.3 Ultrasound
* 3.4 Medical imaging
* 4 Timeline
* 4.1 Start of gestational age
* 4.2 Trimesters
* 4.3 Estimation of due date
* 5 Physiology
* 5.1 Capacity
* 5.2 Initiation
* 5.3 Development of embryo and fetus
* 5.4 Maternal changes
* 5.5 Childbirth
* 5.5.1 Childbirth maturity stages
* 5.6 Postnatal period
* 6 Management
* 6.1 Prenatal care
* 6.2 Nutrition
* 6.3 Weight gain
* 6.4 Medication
* 6.5 Recreational drugs
* 6.6 Exposure to toxins
* 6.7 Death by violence
* 6.8 Sexual activity
* 6.9 Exercise
* 6.9.1 High intensity exercise
* 6.10 Sleep
* 6.11 Stress
* 6.12 Dental care
* 6.13 Flying
* 6.14 Pregnancy classes and birth plan
* 7 Complications and diseases
* 7.1 Miscarriage and stillbirth
* 7.2 Diseases in pregnancy
* 8 Birth control and abortion
* 8.1 Birth control and education
* 8.2 Abortion
* 8.3 Assisted reproductive technology
* 9 Society and culture
* 9.1 Legal protections
* 9.2 Racial disparities
* 9.3 Transgender people
* 9.4 Culture
* 9.4.1 Arts
* 10 See also
* 11 References
* 12 Further reading
* 13 External links

## Terminology

File:Anatomia uteri humani gravidi V00001 00000002.tif

Associated terms for pregnancy are gravid and parous. Gravidus and gravid come from the Latin word meaning "heavy" and a pregnant female is sometimes referred to as a gravida.[14] Gravidity refers to the number of times that a female has been pregnant. Similarly, the term parity is used for the number of times that a female carries a pregnancy to a viable stage.[15] Twins and other multiple births are counted as one pregnancy and birth.

A woman who has never been pregnant is referred to as a nulligravida. A woman who is (or has been only) pregnant for the first time is referred to as a primigravida,[16] and a woman in subsequent pregnancies as a multigravida or as multiparous.[14][17] Therefore, during a second pregnancy a woman would be described as gravida 2, para 1 and upon live delivery as gravida 2, para 2. In-progress pregnancies, abortions, miscarriages and/or stillbirths account for parity values being less than the gravida number. Women who have never carried a pregnancy more than 20 weeks are referred to as nulliparous.[18]

A pregnancy is considered term at 37 weeks of gestation. It is preterm if less than 37 weeks and post-term at or beyond 42 weeks of gestation. The American College of Obstetricians and Gynecologists have recommended further division to early term from 37 weeks up to 39 weeks, full term 39 weeks up to 41 weeks, and late term 41 weeks up to 42 weeks.[19] The terms preterm and post-term have largely replaced the earlier terms premature and postmature, which related historically to the infant's size and state of development rather than to the stage of pregnancy.[20][21]

## Demographics

About 213 million pregnancies occurred in 2012, of which, 190 million (89%) were in the developing world and 23 million (11%) were in the developed world.[22] The number of pregnancies in women aged between 15 and 44 is 133 per 1,000 women.[22] Pregnancy rates are 140 per 1000 women of childbearing age in the developing world and 94 per 1000 in the developed world.[22] The rate of pregnancy, as well as the ages at which it occurs, differ by country and region. It is influenced by a number of factors, such as cultural, social and religious norms; access to contraception; and rates of education. The total fertility rate (TFR) in 2024 was estimated to be highest in Niger (6.64 children/woman) and lowest in South Korea (1.12 children/woman).[23]

About 10% to 15% of recognized pregnancies end in miscarriage.[24] In 2016, complications of pregnancy resulted in 230,600 maternal deaths, down from 377,000 deaths in 1990.[25] Common causes include bleeding, infections, hypertensive diseases of pregnancy, obstructed labour, miscarriage, abortion, or ectopic pregnancy.[25] Globally, 44% of pregnancies are unplanned.[26] Over half (56%) of unplanned pregnancies are aborted.[26] In countries where abortion is prohibited, or only carried out in circumstances where the mother's life is at risk, 48% of unplanned pregnancies are aborted illegally. Compared to the rate in countries where abortion is legal, at 69%.[26] Among unintended pregnancies in the United States, 60% of the women used birth control to some extent during the month pregnancy began.[27][needs update]

In the United States, a woman's educational attainment and her marital status are historically correlated with childbearing: the percentage of women unmarried at the time of first birth drops with increasing educational level. Three studies conducted between 2015 and 2018 indicate a large fraction (~80%) of women without a high school diploma or local equivalent in the US are unmarried at the time of their first birth. By contrast, the same studies indicated fewer women with a bachelor's degree or higher (~24%) have their first child while unmarried. However, this phenomenon also has a strong generational component: a 1996 study found 48.2% of US women without a bachelor's degree had their first child whilst unmarried, and only 4% of women with a bachelor's degree had their first child whilst unmarried. These studies indicate a rising trend for US women of all educational levels to be unmarried at the time of their first birth.[28]

### Teenage pregnancy

Teenage pregnancy is also known as adolescent pregnancy.[29] The WHO defines adolescence as the period between the ages of 10 and 19 years.[30] Adolescents face higher health risks than women who give birth at age 20 to 24 and their infants are at a higher risk for preterm birth, low birth weight, and other severe neonatal conditions. Their children continue to face greater challenges, both behavioral and physical, throughout their lives. Teenage pregnancies are also related to social issues, including social stigma, lower educational levels, and poverty.[31][29] Female adolescents are often in abusive relationships at the time of their conceiving.[32]

## Diagnosis

Penile-vaginal sex is typically the cause of pregnancy, although myths regarding other sexual acts persist, particularly in populations that received poor sex education such as abstinence-only.[33][34] Pregnancy can also be the result of assisted reproductive technology.[35]

The beginning of pregnancy may be detected based on the woman's symptoms or by using pregnancy tests. Denial of pregnancy by the woman is a common condition with serious health implications. About 1 in 475 denials will last until around the 20th week of pregnancy. Denial persisting until delivery occurs in about 1 in 2,500 cases.[36] Conversely, some non-pregnant women have a strong belief that they are pregnant along with some physical changes. This condition is known as a false pregnancy.[37]

### Symptoms and signs

Linea nigra in darker and lighter skinned women

Most pregnant women experience a number of symptoms which can signify pregnancy[38] such as breast tenderness[3] or morning sickness. A number of early medical signs are associated with pregnancy.[39][40] Physical signs of pregnancy include:

* the presence of human chorionic gonadotropin (hCG) in the blood and urine
* missed menstrual period
* implantation bleeding that occurs at implantation of the embryo in the uterus during the third or fourth week after last menstrual period[41]
* increased basal body temperature sustained for over two weeks after ovulation
* Chadwick's sign (bluish discolouration of the cervix, vagina, and vulva)
* Goodell's sign (softening of the vaginal portion of the cervix)
* Hegar's sign (softening of the uterine isthmus)
* Pigmentation of the linea alba, called linea nigra (darkening of the skin in a midline of the abdomen, resulting from hormonal changes, usually appearing around the middle of pregnancy).[39][40]
* Darkening of the nipples and areolas due to an increase in hormones[42]
* Stretch marks
* Varicose veins
* Peripheral edema (swelling of legs, feet, and ankles)[43]
* Gum bleeding[44]
* Melasma

Other common symptoms include constipation, back pain, pelvic girdle pain, headaches,[44] and food cravings or food aversions.[41] Pregnant women may also experience urinary tract infections,[45] increased urinary frequency,[46] worsened sleep quality, increased dream recall, and nightmares.[47] In later pregnancy, hemorrhoids are more common.[48] Each person's pregnancy can be different and many women do not experience all of the common signs and symptoms.[49] The usual signs and symptoms of pregnancy do not significantly interfere with activities of daily living or pose a health-threat to the mother or fetus.[49] Complications during pregnancy can cause other more severe symptoms, such as those associated with anemia.[50]

### Biomarkers

Pregnancy detection can be accomplished using one or more various pregnancy tests,[51] which detect hormones generated by the newly formed placenta, serving as biomarkers of pregnancy.[52] Blood and urine tests can detect pregnancy by 11 and 14 days, respectively, after fertilization.[53][54] Blood pregnancy tests are more sensitive than urine tests (giving fewer false negatives).[55] Home pregnancy tests are urine tests, and normally detect a pregnancy 12 to 15 days after fertilization.[56] A quantitative blood test can determine approximately the date the embryo was fertilized because hCG levels double every 36 to 72 hours before 8 weeks' gestation.[57][54] A single test of progesterone levels can also help determine how likely a fetus will survive in those with a threatened miscarriage (bleeding in early pregnancy), but only if the ultrasound result was inconclusive.[58]

### Ultrasound

Main article: Medicine:Obstetric ultrasonography

Obstetric ultrasonography can detect fetal abnormalities, detect multiple pregnancies, and improve gestational dating at 24 weeks.[59] The resultant estimated gestational age and due date of the fetus are slightly more accurate than methods based on last menstrual period.[60] Ultrasound is used to measure the nuchal fold in order to screen for Down syndrome.[61]

### Medical imaging

CT scanning (volume rendered in this case) confers a radiation dose to the developing fetus. A pregnant woman undergoing an ultrasound. Ultrasound is used to check on the growth and development of the fetus.

Main article: Medicine:Medical imaging in pregnancy

Medical imaging may be indicated in pregnancy because of pregnancy complications, disease, or routine prenatal care. Medical ultrasonography including obstetric ultrasonography, and magnetic resonance imaging (MRI) without contrast agents are not associated with any risk for the mother or the fetus, and are the imaging techniques of choice for pregnant women.[62] Projectional radiography, CT scan and nuclear medicine imaging result in some degree of ionizing radiation exposure, but in most cases the absorbed doses are not associated with harm to the baby.[62] At higher dosages or frequency, effects can include miscarriage, birth defects and intellectual disability.[62]

## Timeline

Comparison of dating systems for a typical pregnancy  Event  | Gestational age

(from the start of the last menstrual period)

| Fertilization age  | Implantation age

|
|
|

Menstrual period begins  | Day 1 of pregnancy  | Not pregnant | Not pregnant
Has sex and ovulates  | 2 weeks pregnant  | Not pregnant | Not pregnant
Fertilization; cleavage stage begins[63] | Day 15[63] | Day 1[63][64] | Not pregnant
Implantation of blastocyst begins  | Day 20  | Day 6[63][64] | Day 0
Implantation finished  | Day 26  | Day 12[63][64] | Day 6 (or Day 0)
Embryo stage begins; also, first missed period  | 4 weeks  | Day 15[63] | Day 9
Primitive heart function can be detected  | 5 weeks, 5 days[63] | Day 26[63] | Day 20
Fetal stage begins  | 10 weeks, 1 day[63] | 8 weeks, 1 day[63] | 7 weeks, 2 days
First trimester ends  | 13 weeks  | 11 weeks  | 10 weeks
Second trimester ends  | 26 weeks  | 24 weeks  | 23 weeks
Childbirth | 39–40 weeks  | 37–38 weeks[64]: 108 | 36–37 weeks

The chronology of pregnancy is, unless otherwise specified, generally given as gestational age, where the starting point is the beginning of the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available. This model means that the woman is counted as being "pregnant" two weeks before conception and three weeks before implantation. Sometimes, timing may also use the fertilization age, which is the age of the embryo since conception.

### Start of gestational age

Main article: Social:Gestational age

The American Congress of Obstetricians and Gynecologists recommends the following methods to calculate gestational age:[65]

* Directly calculating the days since the beginning of the last menstrual period.
* Early obstetric ultrasound, comparing the size of an embryo or fetus to that of a reference group of pregnancies of known gestational age (such as calculated from last menstrual periods), and using the mean gestational age of other embryos or fetuses of the same size. If the gestational age as calculated from an early ultrasound is contradictory to the one calculated directly from the last menstrual period, it is still the one from the early ultrasound that is used for the rest of the pregnancy.[65]
* In case of in vitro fertilization, calculating days since oocyte retrieval or co-incubation and adding 14 days.[66]

### Trimesters

Pregnancy is divided into three trimesters, each lasting for approximately three months.[1] The exact length of each trimester can vary between sources.

* The first trimester begins with the start of gestational age as described above, that is, the beginning of week 1, or 0 weeks + 0 days of gestational age (GA). It ends at week 12 (11 weeks + 6 days of GA)[1] or end of week 14 (13 weeks + 6 days of GA).[67]
* The second trimester is defined as starting, between the beginning of week 13 (12 weeks +0 days of GA)[1] and beginning of week 15 (14 weeks + 0 days of GA).[67] It ends at the end of week 27 (26 weeks + 6 days of GA)[67] or end of week 28 (27 weeks + 6 days of GA).[1]
* The third trimester is defined as starting, between the beginning of week 28 (27 weeks + 0 days of GA)[67] or beginning of week 29 (28 weeks + 0 days of GA).[1] It lasts until childbirth.

Timeline of pregnancy, including (from top to bottom): Trimesters, embryo/fetus development, gestational age in weeks and months, viability and maturity stages

### Estimation of due date

Distribution of gestational age at childbirth among singleton live births, given both when gestational age is estimated by first trimester ultrasound and directly by last menstrual period.[68] Roughly 80% of births occur between 37 and 41 weeks of gestational age.

Main article: Estimated date of delivery

Due date estimation basically follows two steps:

* Determination of which time point is to be used as origin for gestational age, as described in the section above.
* Adding the estimated gestational age at childbirth to the above time point. Childbirth on average occurs at a gestational age of 280 days (40 weeks), which is therefore often used as a standard estimation for individual pregnancies.[69] However, alternative durations as well as more individualized methods have also been suggested.

The American College of Obstetricians and Gynecologists divides full term into three divisions:[70]

* Early-term: 37 weeks and 0 days through 38 weeks and 6 days
* Full-term: 39 weeks and 0 days through 40 weeks and 6 days
* Late-term: 41 weeks and 0 days through 41 weeks and 6 days
* Post-term: greater than or equal to 42 weeks and 0 days

Naegele's rule is a standard way of calculating the due date for a pregnancy when assuming a gestational age of 280 days at childbirth. The rule estimates the expected date of delivery (EDD) by adding a year, subtracting three months, and adding seven days to the origin of gestational age. Alternatively there are mobile apps, which essentially always give consistent estimations compared to each other and correct for leap year, while pregnancy wheels made of paper can differ from each other by 7 days and generally do not correct for leap year.[71]

Furthermore, actual childbirth has only a certain probability of occurring within the limits of the estimated due date. A study of singleton live births came to the result that childbirth has a standard deviation of 14 days when gestational age is estimated by first trimester ultrasound, and 16 days when estimated directly by last menstrual period.[68]

## Physiology

### Capacity

Fertility and fecundity are the respective capacities to fertilize and establish a clinical pregnancy and have a live birth. Infertility is an impaired ability to establish a clinical pregnancy and sterility is the permanent inability to establish a clinical pregnancy.[72]

The capacity for pregnancy depends on the reproductive system, its development and its variation, as well as on the condition of a person. Anyone who has a functioning female reproductive system, regardless of intersex or transgender identity, is capable of becoming pregnant.

Some people are not capable of becoming pregnant, even with advanced assisted reproductive technology. In some cases, someone might produce viable eggs, but might not have a womb or none that can sufficiently gestate, in which case they will not be able to become pregnant or sustain the pregnancy. Surrogacy is their only option for having genetic children.[73]

### Initiation

Fertilization and implantation in humans

Through an interplay of hormones that includes follicle stimulating hormone that stimulates folliculogenesis and oogenesis creates a mature egg cell, the female gamete. Fertilization is the event where the egg cell fuses with the male gamete, spermatozoon. After the point of fertilization, the fused product of the female and male gamete is referred to as a zygote or fertilized egg. The fusion of female and male gametes usually occurs following the act of sexual intercourse. Pregnancy rates for sexual intercourse are highest during the menstrual cycle time from some 5 days before until 1 to 2 days after ovulation.[74] Fertilization can also occur by assisted reproductive technology such as artificial insemination and in vitro fertilisation.

Fertilization (conception) is sometimes used as the initiation of pregnancy, with the derived age being termed fertilization age. Fertilization usually occurs about two weeks before the next expected menstrual period.

A third point in time is also considered by some people to be the true beginning of a pregnancy: This is time of implantation, when the future fetus attaches to the lining of the uterus. This is about a week to ten days after fertilization.[75]

### Development of embryo and fetus

Main articles: Biology:Human embryonic development, Prenatal development, and Fetus

The initial stages of human embryogenesis

The sperm and the egg cell, which has been released from one of the female's two ovaries, unite in one of the two fallopian tubes. The fertilized egg, known as a zygote, then moves toward the uterus, a journey that can take up to a week to complete. Cell division begins approximately 24 to 36 hours after the female and male cells unite. Cell division continues at a rapid rate and the cells then develop into what is known as a blastocyst. The blastocyst arrives at the uterus and attaches to the uterine wall, a process known as implantation.

The development of the mass of cells that will become the infant is called embryogenesis during the first approximately ten weeks of gestation. During this time, cells begin to differentiate into the various body systems. The basic outlines of the organ, body, and nervous systems are established. By the end of the embryonic stage, the beginnings of features such as fingers, eyes, mouth, and ears become visible. Also during this time, there is development of structures important to the support of the embryo, including the placenta and umbilical cord. The placenta connects the developing embryo to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. The umbilical cord is the connecting cord from the embryo or fetus to the placenta.

After about ten weeks of gestational age—which is the same as eight weeks after conception—the embryo becomes known as a fetus.[76] At the beginning of the fetal stage, the risk of miscarriage decreases sharply.[77] At this stage, a fetus is about 30 mm (1.2 inches) in length, the heartbeat is seen via ultrasound, and the fetus makes involuntary motions.[78] During continued fetal development, the early body systems, and structures that were established in the embryonic stage continue to develop. Sex organs begin to appear during the third month of gestation. The fetus continues to grow in both weight and length, although the majority of the physical growth occurs in the last weeks of pregnancy.

Electrical brain activity is first detected at the end of week 5 of gestation, but as in brain-dead patients, it is primitive neural activity rather than the beginning of conscious brain activity. Synapses do not begin to form until week 17.[79] Neural connections between the sensory cortex and thalamus develop as early as 24 weeks' gestational age, but the first evidence of their function does not occur until around 30 weeks, when minimal consciousness, dreaming, and the ability to feel pain emerges.[80]

Although the fetus begins to move during the first trimester, it is not until the second trimester that movement, known as quickening, can be felt. This typically happens in the fourth month, more specifically in the 20th to 21st week, or by the 19th week if the woman has been pregnant before. It is common for some women not to feel the fetus move until much later. During the second trimester, when the body size changes, maternity clothes may be worn.

* Embryo at 4 weeks after fertilization (gestational age of 6 weeks)

* Fetus at 8 weeks after fertilization (gestational age of 10 weeks)

* Fetus at 18 weeks after fertilization (gestational age of 20 weeks)

* Fetus at 38 weeks after fertilization (gestational age of 40 weeks)

* Relative size in 1st month (simplified illustration)

* Relative size in 3rd month (simplified illustration)

* Relative size in 5th month (simplified illustration)

* Relative size in 9th month (simplified illustration)

### Maternal changes

The uterus expands making up a larger and larger portion of the abdomen. During the final stages of gestation the uterus may drop to a lower position.

Breast changes as seen during pregnancy. The areolae are larger and darker.

During pregnancy, a woman undergoes many normal physiological changes, including behavioral, cardiovascular, hematologic, metabolic, renal, and respiratory changes. Increases in blood sugar, breathing, and cardiac output are all required. Levels of progesterone and estrogens rise continually throughout pregnancy, suppressing the hypothalamic axis and therefore the menstrual cycle. A full-term pregnancy at an early age (less than 25 years) reduces the risk of breast, ovarian, and endometrial cancer, and the risk declines further with each additional full-term pregnancy.[81][82]

End of second trimester + 2 weeks (26 weeks of pregnancy)

The fetus is genetically different from its mother and can therefore be viewed as an unusually successful allograft.[83] The main reason for this success is increased immune tolerance during pregnancy,[84] which prevents the mother's body from mounting an immune system response against certain triggers.[83] A Rho(D) immune globulin shot is recommended for women with RhD negative blood carrying a RhD positive fetus as a preventative measure against Rhesus disease.[85]

During the first trimester, minute ventilation increases by 40 percent.[86] The womb will grow to the size of a lemon by eight weeks. Many symptoms and discomforts of pregnancy, such as nausea and tender breasts, appear in the first trimester.[87] Braxton Hicks contractions are sporadic uterine contractions that may start around six weeks into a pregnancy but are usually not felt until the second or third trimester.[88]

Pregnant women have higher total blood volume that increases throughout the duration of the pregnancy.[89] It is during the third trimester that maternal activity and sleep positions may affect fetal development due to restricted blood flow. For instance, the enlarged uterus may impede blood flow by compressing the vena cava when lying flat, a condition that can be relieved by lying on the left side.[90]

Most weight gain takes place during the third trimester. A pregnant woman's navel may become convex ("popping" out) during this time. Her abdomen will expand and change in shape as the fetus turns in a downward position nearing childbirth.[91] Head engagement, also called "lightening" or "dropping", occurs as the fetal head descends into a cephalic presentation. While it relieves pressure on the upper abdomen and gives a renewed ease in breathing, it also severely reduces bladder capacity, resulting in a need to void more frequently, and increases pressure on the pelvic floor and the rectum. It is not possible to predict when lightening will occur. In a first pregnancy it may happen a few weeks before the due date, though it may happen later or even not until labour begins, as is typical with subsequent pregnancies.[92]

### Childbirth

Main article: Medicine:Childbirth

Childbirth, referred to as labour and delivery in the medical field, is the process whereby an infant is born.[57]

A woman is considered to be in labour when she begins experiencing regular uterine contractions, accompanied by changes of her cervix—primarily effacement and dilation. While childbirth is widely experienced as painful, some women do report painless labours, while others find that concentrating on the birth helps to quicken labour and lessen the sensations. Most births are successful vaginal births, but sometimes complications arise and a woman may undergo a cesarean section.

During the time immediately after birth, both the mother and the baby are hormonally cued to bond, the mother through the release of oxytocin, a hormone also released during breastfeeding. Studies show that skin-to-skin contact between a mother and her newborn immediately after birth is beneficial for both the mother and baby. A review done by the World Health Organization found that skin-to-skin contact between mothers and babies after birth reduces crying, improves mother–infant interaction, and helps mothers to breastfeed successfully. They recommend that neonates be allowed to bond with the mother during their first two hours after birth, the period that they tend to be more alert than in the following hours of early life.[93]

#### Childbirth maturity stages

Stages of pregnancy term  stage | starts | ends

|
|

Preterm[94] | - | at 37 weeks
Full term[95] | 39 weeks | 41 weeks
Late term[95] | 41 weeks | 42 weeks
Postterm[95] | 42 weeks | \-

In the ideal childbirth, labour begins on its own when a woman is "at term".[12] Events before completion of 37 weeks are considered preterm.[94] Preterm birth is associated with a range of complications and should be avoided if possible.[96]

Sometimes if a woman's water breaks or she has contractions before 39 weeks, birth is unavoidable.[95] However, spontaneous birth after 37 weeks is considered term and is not associated with the same risks of a preterm birth.[57] Planned birth before 39 weeks by caesarean section or labour induction, although "at term", results in an increased risk of complications.[97] This is from factors including underdeveloped lungs of newborns, infection due to underdeveloped immune system, feeding problems due to underdeveloped brain, and jaundice from underdeveloped liver.[98]

Babies born between 39 and 41 weeks' gestation have better outcomes than babies born either before or after this range.[95] This special time period is called "full term".[95] Whenever possible, waiting for labour to begin on its own in this time period is best for the health of the mother and baby.[12] The decision to perform an induction must be made after weighing the risks and benefits, but is safer after 39 weeks.[12]

Events after 42 weeks are considered postterm.[95] When a pregnancy exceeds 42 weeks, the risk of complications for both the woman and the fetus increases significantly.[99][100] Therefore, in an otherwise uncomplicated pregnancy, obstetricians usually prefer to induce labour at some stage between 41 and 42 weeks.[101]

### Postnatal period

Main article: Medicine:Postpartum period

The postpartum period also referred to as the puerperium, is the postnatal period that begins immediately after delivery and extends for about six weeks.[57] During this period, the mother's body begins the return to pre-pregnancy conditions that includes changes in hormone levels and uterus size.[57]

## Management

Flowchart showing the recommended weight limits for lifting at work during pregnancy as a function of lifting frequency, weeks of gestation, and the position of the lifted object relative to the lifter's body.[102][103]

### Prenatal care

Pre-conception counseling is care that is provided to a woman or couple to discuss conception, pregnancy, current health issues and recommendations for the period before pregnancy.[104]

Prenatal medical care is the medical and nursing care recommended for women during pregnancy, time intervals and exact goals of each visit differ by country.[105] Women who are high risk have better outcomes if they are seen regularly and frequently by a medical professional than women who are low risk.[106] A woman can be labeled as high risk for different reasons including previous complications in pregnancy, complications in the current pregnancy, current medical diseases, or social issues.[107][108]

The aim of good prenatal care is prevention, early identification, and treatment of any medical complications.[109] A basic prenatal visit consists of measurement of blood pressure, fundal height, weight and fetal heart rate, checking for symptoms of labour, and guidance for what to expect next.[104] Healthcare providers may screen for domestic violence during pregnancy, particularly in regards to reproductive coercion.[110]

### Nutrition

Nutrition during pregnancy is important to ensure healthy growth of the fetus.[10] Nutrition during pregnancy is different from the non-pregnant state.[10] There are increased energy requirements and specific micronutrient requirements.[10] Women benefit from education to encourage a balanced energy and protein intake during pregnancy.[111] Some women may need professional medical advice if their diet is affected by medical conditions, food allergies, or specific religious or ethical beliefs.[112] Further studies are needed to access the effect of dietary advice to prevent gestational diabetes, although low quality evidence suggests some benefit.[113] Adequate periconceptional (time before and right after conception) folic acid (also called folate or Vitamin B9) intake has been shown to decrease the risk of fetal neural tube defects, such as spina bifida.[114] L-methylfolate, the bioavailable form of folate is also considered acceptable to take. L-methylfolate is best used by the 40% to 60% of the population with genetic polymorphisms that reduce or impair conversion of folic acid into its active form.[115] The neural tube develops during the first 28 days of pregnancy, a urine pregnancy test is not usually positive until 14 days post-conception, explaining the necessity to guarantee adequate folate intake before conception.[56][116] Folate is abundant in green leafy vegetables, legumes, and citrus.[117] In the United States and Canada, most wheat products (flour, noodles) are fortified with folic acid.[118]

### Weight gain

Measurement of the belly being performed by a pregnant woman during her pregnancy

The amount of healthy weight gain during a pregnancy varies.[119] Weight gain is related to the weight of the baby, the placenta, extra circulatory fluid, larger tissues, and fat and protein stores.[10] Most needed weight gain occurs later in pregnancy.[120]

The Institute of Medicine recommends an overall pregnancy weight gain for those of normal weight (body mass index of 18.5–24.9), of 11.3–15.9 kg (25–35 pounds) having a singleton pregnancy.[121] Women who are underweight (BMI of less than 18.5), should gain between 12.7 and 18 kg (28–40 lb), while those who are overweight (BMI of 25–29.9) are advised to gain between 6.8 and 11.3 kg (15–25 lb) and those who are obese (BMI ≥ 30) should gain between 5–9 kg (11–20 lb).[122] These values reference the expectations for a term pregnancy.

During pregnancy, insufficient or excessive weight gain can compromise the health of the mother and fetus.[120] The most effective intervention for weight gain in underweight women is not clear.[120] Being or becoming overweight in pregnancy increases the risk of complications for mother and fetus, including cesarean section, gestational hypertension, pre-eclampsia, macrosomia and shoulder dystocia.[119] Excessive weight gain can make losing weight after the pregnancy difficult.[119][123] Some of these complications are risk factors for stroke.[124]

Around 50% of women of childbearing age in developed countries like the United Kingdom are overweight or obese before pregnancy.[123] Diet modification is the most effective way to reduce weight gain and associated risks in pregnancy.[123]

### Medication

Drugs used during pregnancy can have temporary or permanent effects on the fetus.[125] Anything (including drugs) that can cause permanent deformities in the fetus are labeled as teratogens.[126] In the U.S., drugs were classified into categories A, B, C, D and X based on the Food and Drug Administration (FDA) rating system to provide therapeutic guidance based on potential benefits and fetal risks.[127] Drugs, including some multivitamins, that have demonstrated no fetal risks after controlled studies in humans are classified as Category A.[125] On the other hand, drugs like thalidomide with proven fetal risks that outweigh all benefits are classified as Category X.[125]

### Recreational drugs

The use of recreational drugs in pregnancy can cause various pregnancy complications.[57]

* Alcoholic drinks consumed during pregnancy can cause one or more fetal alcohol spectrum disorders.[57] According to the CDC, there is no known safe amount of alcohol during pregnancy and no safe time to drink during pregnancy, including before a woman knows that she is pregnant.[128]
* Tobacco smoking during pregnancy can cause a wide range of behavioral, neurological, and physical difficulties.[129] Smoking during pregnancy causes twice the risk of premature rupture of membranes, placental abruption and placenta previa.[130] Smoking is associated with 30% higher odds of preterm birth.[131]
* Prenatal cocaine exposure is associated with premature birth, birth defects and attention deficit disorder.[57]
* Prenatal methamphetamine exposure can cause premature birth and congenital abnormalities.[132] Short-term neonatal outcomes in methamphetamine babies show small deficits in infant neurobehavioral function and growth restriction.[133] Long-term effects in terms of impaired brain development may also be caused by methamphetamine use.[132]
* Cannabis in pregnancy has been shown to be teratogenic in large doses in animals, but has not shown any teratogenic effects in humans.[57]

### Exposure to toxins

File:N95 Respirator Use During Advanced Pregnancy.webm

Intrauterine exposure to environmental toxins in pregnancy has the potential to cause adverse effects on prenatal development, and to cause pregnancy complications.[57] Air pollution has been associated with low birth weight infants.[134] Conditions of particular severity in pregnancy include mercury poisoning and lead poisoning.[57] To minimize exposure to environmental toxins, the American College of Nurse-Midwives recommends: checking whether the home has lead paint, washing all fresh fruits and vegetables thoroughly and buying organic produce, and avoiding cleaning products labeled "toxic" or any product with a warning on the label.[135]

Pregnant women can also be exposed to toxins in the workplace, including airborne particles. The effects of wearing an N95 filtering facepiece respirator are similar for pregnant women as for non-pregnant women, and wearing a respirator for one hour does not affect the fetal heart rate.[136]

### Death by violence

Pregnant women or those who have recently given birth in the U.S. are more likely to be murdered than to die from obstetric causes. These homicides are a combination of intimate partner violence and firearms. Health authorities have called the violence "a health emergency for pregnant women", but say that pregnancy-related homicides are preventable if healthcare providers identify those women at risk and offer assistance to them.[137][138][139]

### Sexual activity

Most women can continue to engage in sexual activity, including sexual intercourse, throughout pregnancy.[140] Research suggests that during pregnancy both sexual desire and frequency of sexual relations decrease during the first and third trimester, with a rise during the second trimester.[141][142][143][144] Sex during pregnancy is low-risk except when the healthcare provider advises that sexual intercourse be avoided for particular medical reasons.[140] For a healthy pregnant woman, there is no single safe or right way to have sex during pregnancy.[140]

### Exercise

A pregnant woman and her colleague returning from fishing, Gurara River bridge, Kachia, Nigeria

Regular aerobic exercise during pregnancy appears to improve (or maintain) physical fitness.[145] Physical exercise during pregnancy appears to decrease the need for C-section[146] and reduce time in labour,[147] and even vigorous exercise carries no significant risks to babies[148] while providing significant health benefits to the mother. Studies show that performing light moderate intensity and strength exercises while pregnant does not harm the mother's cardiovascular system and may limit excessive weight gain.[149][additional citation(s) needed]

The American College of Sports and Medicine recommends pregnant women should participate in at least 150 minutes/week of moderate exercise.[150] These forms of exercise should avoid heavy lifting, hot temperatures, and high impact sports. The Clinical Practice Obstetrics Committee of Canada recommends that "All women without contraindications should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy".[151] Although an upper level of safe exercise intensity has not been established, women who were regular exercisers before pregnancy and who have uncomplicated pregnancies should be able to engage in high intensity exercise programs without a higher risk of prematurity, lower birth weight, or gestational weight gain.[148] In general, participation in a wide range of recreational activities appears to be safe, with the avoidance of those with a high risk of falling such as horseback riding or skiing or those that carry a risk of abdominal trauma, such as soccer or hockey.[152]

Bed rest, outside of research studies, is not recommended as there is potential harm and no evidence of benefit.[153]

#### High intensity exercise

During pregnancy, women can experience a loss of postural stability, pelvic incontinence, back pain, and fatigue, among other symptoms. Resistance training has been found to reduce pregnancy symptoms and reduce postpartum complications.{{citation needed|date=November 2024} articipate in low-impact training, strength training can improve pelvic girdle pain severity postpartum.[154] When incorporating exercises that focus on pelvic muscle strength, they can help reduce pain and stress urinary incontinence.[154]

Engaging in regular exercise and physical activity has been shown to be beneficial during pregnancy. Acute bouts of high intensity interval training can help decrease the risks of health complications associated with pregnancy, maintain a healthy body fat percentage during pregnancy, as well as improve overall well-being.[155] Pregnant women who participated in high intensity interval training have been shown to undergo physical improvements in body composition after intervention as well as show general improvement in cardiorespiratory fitness and exercise tolerance.[156] Taking part in this style of exercise, similarly to moderate intensity continuous training, has also been shown to improve glycemic response and insulin sensitivity.[157] There are specific concerns to be avoided with exercise during pregnancy such as overheating, fall-risk, and remaining in a supine position for an extended period of time. Inexperienced individuals new to high-intensity interval training could potentially increase their risk for negative conditions associated with hypertension, such as pre-eclampsia.[158]

### Sleep

Main article: Biology:Pregnancy and sleep

It has been suggested that shift work and exposure to bright light at night should be avoided at least during the last trimester of pregnancy to decrease the risk of psychological and behavioral problems in the newborn.[159]

### Stress

Heightened maternal stress during pregnancy has been consistently associated with alterations in fetal and infant brain development and an increased risk for later mental health problems ("psychopathology"). Prenatal adversity (for example elevated maternal stress and depressive and anxiety symptoms during pregnancy) has been consistently associated with an increased risk for psychopathology in children. Maternal stress during pregnancy is therefore thought to influence fetal brain development and thereby contribute to increased vulnerability to later psychopathology.[160]

Research demonstrates that prenatal stress can fundamentally alter the brain’s physical architecture (smaller overall volume, altered cortical thinning, functional connectivity, ...), leading to reduced volume and weakened connectivity in areas critical for emotion processing and regulation, as well as learning and memory. In contrast, also caregiving-focused interventions and higher natural caregiving quality have been associated with a positive impact on the brain structure. Animal studies further show that enhanced maternal care or enriched environments can reverse the effects of prenatal adversity at the cellular level, supporting the biological plausibility of similar processes in humans.[160] Children of women who experienced high stress levels during pregnancy are slightly more likely to show externalizing behavioral problems, such as impulsivity. These behavioral effects appear to be most pronounced during early childhood.[156]

Importantly, prenatal stress does not inevitable cause mental health problems. Not all children who are exposed to prenatal adversity develop psychiatric disorders. Evidence from both human and animal studies suggests that high-quality caregiving, cognitive and language stimulation, social support, and higher socioeconomic status can act as protective or supportive factors. Improving outcomes for children exposed to prenatal stress mainly involves strengthening the early postnatal environment rather than attempting to eliminate all stress during pregnancy. Supportive environments in early postnatal life may promote brain development and help normalize developmental trajectories that were altered by prenatal stress, highlighting caregiving quality, cognitive and language input, social support, and socioeconomic stability as key factors. High-quality caregiving is consistently identified as especially important, with studies showing that associations between prenatal stress and adverse outcomes are not observed when maternal sensitivity is high, and that sensitive caregiving can reduce the impact of prenatal stress on neurocognitive and neuroendocrine pathways linked to later psychopathology. Beyond the parent–child relationship, broader support systems also matter: higher levels of social support and socioeconomic resources are associated with more adaptive development and can, in some contexts, reduce the negative effects of preterm birth or low birth weight on neurocognitive outcomes. Overall, promoting warm, responsive caregiving and ensuring families have adequate social and material support during the early years can meaningfully improve children’s developmental trajectories, even when prenatal stress has occurred.[160]

Extreme stress caused by events such as natural disasters, genocide, slavery, forced family separation, or long-term exposure to war is thought to create widespread trauma that changes how people function physically, psychologically, and socially, and these changes may be passed on across generations. Research suggests that recognizing severe maternal stress early, during or after such events, and providing structured psychological support such as psychological first aid or cognitive behavioural therapy can lower long-term risks for child development. When stress exposure is particularly high, ongoing monitoring, early developmental support, and sensitive, responsive caregiving are especially important to prevent lasting negative effects.[161][162]

### Dental care

See also: Medicine:Prenatal dental care

The increased levels of progesterone and estrogen during pregnancy make gingivitis more likely; the gums become edematous, red in colour, and tend to bleed.[163] Also a pyogenic granuloma or "pregnancy tumor", is commonly seen on the labial surface of the papilla. Lesions can be treated by local debridement or deep incision depending on their size, and by following adequate oral hygiene measures.[164] There have been suggestions that severe periodontitis may increase the risk of having preterm birth and low birth weight; however, a Cochrane review found insufficient evidence to determine if periodontitis can develop adverse birth outcomes.[165]

### Flying

In low risk pregnancies, most health care providers approve flying until about 36 weeks of gestational age.[166] Most airlines allow pregnant women to fly short distances at less than 36 weeks, and long distances at less than 32 weeks.[167] Many airlines require a doctor's note that approves flying, especially at over 28 weeks.[167] During flights, the risk of deep vein thrombosis is decreased by getting up and walking occasionally, as well as by avoiding dehydration. The exposure to cosmic radiation is negligible for most travelers. For pregnant women, even the longest intercontinental flight would expose them less than 15% of both the NCRPM and ICRP limit.[168][167] Full body scanners use non-ionizing radiation that does not penetrate the body for more than 1 mm, and are believed not to pose a risk in pregnancy.

### Pregnancy classes and birth plan

Main article: Medicine:Birthing classes and birth plans

It is also suggested that a birth plan be written at this time. A birth plan is a written statement that outlines the desires of the mother during labour and delivery of the baby. Discussing the birth plan with the midwife or other care provider gives parents a chance to ask questions and learn more about the process of labour.[169]

In 1991 the WHO launched the Baby-Friendly Hospital Initiative, a global program that recognizes birthing centers and hospitals that offer optimal levels of care for giving birth. Facilities that have been certified as "Baby Friendly" accept visits from expecting parents to familiarize them with the facility and the staff.[170]

## Complications and diseases

See also: Medicine:High-risk pregnancy

The following are some examples of pregnancy complications:

* Pregnancy induced hypertension
* Anemia[171]
* Perinatal depression[172]
* Postpartum depression, a common but solvable complication following childbirth that may result from decreased hormonal levels.[173]
* Postpartum psychosis
* Thromboembolic disorders, with an increased risk due to hypercoagulability in pregnancy. These are the leading cause of death in pregnant women in the US.[174][175]
* Pruritic urticarial papules and plaques of pregnancy (PUPPP), a skin disease that develops around the 32nd week. Signs are red plaques, papules, and itchiness around the belly button that then spreads all over the body except for the inside of hands and face.
* Ectopic pregnancy, including abdominal pregnancy, implantation of the embryo outside the uterus
* Hyperemesis gravidarum, excessive nausea and vomiting that is more severe than normal morning sickness.
* Pulmonary embolism, a blood clot that forms in the legs and migrates to the lungs.[175]
* Acute fatty liver of pregnancy is a rare complication thought to be brought about by a disruption in the metabolism of fatty acids by mitochondria.

There is also an increased susceptibility and severity of certain infections in pregnancy.

### Miscarriage and stillbirth

Main articles: Medicine:Miscarriage and Stillbirth

See also: Medicine:Miscarriage and grief

Miscarriage is the most common complication of early pregnancy. It is defined as the loss of an embryo or fetus before it is able to survive independently. The most common symptom of miscarriage is vaginal bleeding with or without pain. The miscarriage may be evidenced by a clot-like material passing through and out of the vagina.[176] About 80% of miscarriages occur in the first 12 weeks of pregnancy. The underlying cause in about half of cases involves chromosomal abnormalities.[177]

Stillbirth is defined as fetal death after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. Each year about 21,000 babies are stillborn in the U.S.[178] Sadness, anxiety, and guilt may occur after a miscarriage or a stillbirth. Emotional support may help with processing the loss.[179] Fathers may experience grief over the loss as well. A large study found that there is a need to increase the accessibility of support services available for fathers.[180]

### Diseases in pregnancy

A pregnant woman may have a pre-existing disease, which is not directly caused by the pregnancy, but may cause complications to develop that include a potential risk to the pregnancy; or a disease may develop during pregnancy.

* Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus (not restricted to gestational diabetes) and pregnancy. Risks for the child include miscarriage, growth restriction, growth acceleration, large for gestational age (macrosomia), polyhydramnios (too much amniotic fluid), and birth defects.
* Thyroid disease in pregnancy can, if uncorrected, cause adverse effects on fetal and maternal well-being. The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child. Demand for thyroid hormones is increased during pregnancy, which may cause a previously unnoticed thyroid disorder to worsen.
* Untreated celiac disease can cause a miscarriage, intrauterine growth restriction, small for gestational age, low birthweight and preterm birth. Often reproductive disorders are the only manifestation of undiagnosed celiac disease and most cases are not recognized. Complications or failures of pregnancy cannot be explained simply by malabsorption, but by the autoimmune response elicited by the exposure to gluten, which causes damage to the placenta. A gluten-free diet avoids or reduces the risk of developing reproductive disorders in pregnant women with celiac disease.[181][182] Also, pregnancy can be a trigger for the development of celiac disease in genetically susceptible women who are consuming gluten.[183]
* Lupus in pregnancy confers an increased rate of fetal death in utero, miscarriage, and of neonatal lupus.
* Hypercoagulability in pregnancy is the propensity of pregnant women to develop thrombosis (blood clots). Pregnancy itself is a factor of hypercoagulability (pregnancy-induced hypercoagulability), as a physiologically adaptive mechanism to prevent postpartum bleeding.[184] However, in combination with an underlying hypercoagulable state, the risk of thrombosis or embolism may become substantial.[184]

## Birth control and abortion

### Birth control and education

Family planning, as well as the availability and use of contraception, along with increased comprehensive sex education, has enabled many to prevent pregnancies when they are not desired. Schemes and funding to support education and the means to prevent pregnancies when they are not intended have been instrumental and are part of the third of the Sustainable Development Goals (SDGs) advanced by the United Nations.[185]

### Abortion

Main article: Medicine:Abortion

An abortion is the termination of an embryo or fetus via medical method. It is usually done within the first trimester, sometimes in the second, and rarely in the third. Reasons for pregnancies being undesired are broad.[186] Many jurisdictions restrict or prohibit abortion, with rape being the most legally permissible exception.[187]

### Assisted reproductive technology

Main article: Engineering:Assisted reproductive technology

Modern reproductive medicine offers many forms of assisted reproductive technology for couples who stay childless against their will, such as fertility medication, artificial insemination, in vitro fertilization and surrogacy.

## Society and culture

### Legal protections

Many countries have various legal regulations in place to protect pregnant women and their children. Many countries have laws against pregnancy discrimination.[188]

The Maternity Protection Convention ensures that pregnant women are exempt from activities such as night shifts or carrying heavy stocks. Maternity leave typically provides paid leave from work during roughly the last trimester of pregnancy and for some time after birth. Notable extreme cases include Norway (8 months with full pay) and the United States (no paid leave at all except in some states).

In the United States, some actions that result in miscarriage or stillbirth, such as beating a pregnant woman, are considered crimes. One law that does so is the federal Unborn Victims of Violence Act. In 2014, the American state of Tennessee passed a law which allows prosecutors to charge a woman with criminal assault if she uses illegal drugs during her pregnancy and her fetus or newborn is harmed as a result.[189]

However, protections are not universal. In Singapore, the Employment of Foreign Manpower Act forbids current and former work permit holders from becoming pregnant or giving birth in Singapore without prior permission.[190][191] Violation of the Act is punishable by a fine of up to S$10,000 (US$7246.38) and deportation,[190][192] and until 2010, their employers would lose their $5,000 security bond.[193]

### Racial disparities

There are significant racial imbalances in pregnancy and neonatal care systems.[194] Midwifery guidance, treatment, and care have been related to better birth outcomes. Diminishing racial inequities in health is an increasingly large public health challenge in the United States. Despite the fact that average rates have decreased, data on neonatal mortality demonstrates that racial disparities have persisted and grown. The death rate for African American babies is nearly double that of white neonates. According to studies, congenital defects, SIDS, preterm birth, and low birth weight are all more common among African American babies.[195]

### Transgender people

Transgender people have experienced significant advances in societal acceptance in recent years[when?] leaving many health professionals unprepared to provide quality care. A 2015 report suggests that "numbers of transgender individuals who are seeking family planning, fertility, and pregnancy services could certainly be quite large". Regardless of prior hormone replacement therapy treatments, the progression of pregnancy and birthing procedures for transgender people who carry pregnancies are typically the same as those of cisgender women.[196] However, transgender people may be subjected to discrimination, which can include a variety of negative social, emotional, and medical experiences, as pregnancy is regarded as an exclusively female activity. According to a study by the American College of Obstetricians and Gynecologists, there is a lack of awareness, services, and medical assistance available to pregnant trans men.[197]

### Culture

The Visitation: Mary, pregnant with Jesus, visiting pregnant Elizabeth, depicted as a statue at the Church of the Visitation in Ein Karem, Israel

In most cultures, pregnant women have a special status in society and receive particularly gentle care.[198] At the same time, they are subject to expectations that may exert great psychological pressure, such as having to produce a son and heir. In many traditional societies, pregnancy must be preceded by marriage, on pain of ostracism of mother and (illegitimate) child.

Overall, pregnancy is accompanied by numerous customs that are often subject to ethnological research, often rooted in traditional medicine or religion. The baby shower is an example of a modern custom. Contrary to common misconception, women historically in the United States were not expected to seclude themselves during pregnancy, as was popularized by Gone With the Wind.[199][200]

Pregnancy is an important topic in sociology of the family. The prospective child may preliminarily be placed into numerous social roles. The parents' relationship and the relation between parents and their surroundings are also affected.

A belly cast may be made during pregnancy as a keepsake.

#### Arts

Images of pregnant women, especially small figurines, were made in traditional cultures in many places and periods, though it is rarely one of the most common types of image. These include ceramic figures from some Pre-Columbian cultures, and a few figures from most of the ancient Mediterranean cultures. Many of these seem to be connected with fertility. Identifying whether such figures are actually meant to show pregnancy is often a problem, as well as understanding their role in the culture concerned.

Among the oldest surviving examples of the depiction of pregnancy are prehistoric figurines found across much of Eurasia and collectively known as Venus figurines. Some of these appear to be pregnant.

Due to the important role of the Mother of God in Christianity, the Western visual arts have a long tradition of depictions of pregnancy, especially in the biblical scene of the Visitation, and devotional images called a Madonna del Parto.[201]

The unhappy scene usually called Diana and Callisto, showing the moment of discovery of Callisto's forbidden pregnancy, is sometimes painted from the Renaissance onwards. Gradually, portraits of pregnant women began to appear, with a particular fashion for "pregnancy portraits" in elite portraiture of the years around 1600.

Pregnancy, and especially pregnancy of unmarried women, is also an important motif in literature. Notable examples include Thomas Hardy's 1891 novel Tess of the d'Urbervilles and Goethe's 1808 play Faust.

## See also

* Couvade syndrome
* Cryptic pregnancy
* False pregnancy
* Simulated pregnancy
* Pregnancy-related anxiety
* Superfecundation

## References

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6. ↑ "Mass. General Laws c.112 § 12K" (in en). https://www.mass.gov/info-details/mass-general-laws-c112-ss-12k.
7. ↑ "What are some common signs of pregnancy?". 12 July 2013. https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/signs.
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25. ↑ 25.0 25.1 Cite error: Invalid `<ref>` tag; no text was provided for refs named `GBD2016`
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30. ↑ "Adolescent health". https://www.who.int/health-topics/adolescent-health#tab=tab_1.
31. ↑ "The Adverse Effects of Teen Pregnancy". https://youth.gov/youth-topics/pregnancy-prevention/adverse-effects-teen-pregnancy.
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55. ↑ "BestBets: Serum or Urine beta-hCG?". http://www.bestbets.org/bets/bet.php?id=936.
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60. ↑ "Evaluation of ultrasound-estimated date of delivery in 17,450 spontaneous singleton births: do we need to modify Naegele's rule?". Ultrasound in Obstetrics & Gynecology 14 (1): 23–28. July 1999. doi:10.1046/j.1469-0705.1999.14010023.x. PMID 10461334.
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62. ↑ 62.0 62.1 62.2 "Guidelines for Diagnostic Imaging During Pregnancy and Lactation". https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Guidelines-for-Diagnostic-Imaging-During-Pregnancy-and-Lactation. February 2016
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74. ↑ Taking Charge of Your Fertility (Revised ed.). New York: HarperCollins. 2002. pp. 242, 374. ISBN 978-0-06-093764-5. https://archive.org/details/takingchargeofyo00toni.
75. ↑ The Developing Person Through the Life Span. Macmillan. 2011. p. 90. ISBN 978-1-4292-3205-0. https://books.google.com/books?id=mC_LNMy2rbkC.
76. ↑ "Stages of Development of the Fetus – Women's Health Issues". https://www.msdmanuals.com/en-gb/home/women-s-health-issues/normal-pregnancy/stages-of-development-of-the-fetus.
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78. ↑ Handbook of Brain and Behaviour in Human Development. Springer. 1 January 2001. p. 1. ISBN 978-0-7923-6943-1. https://books.google.com/books?id=FzyPozUyKPkC&pg=RA1-PA416.
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80. ↑
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81. ↑ "Abortion & Pregnancy Risks". Louisiana Department of Health. http://ldh.la.gov/index.cfm/page/915.
82. ↑ "Reproductive History and Cancer Risk". 30 November 2016. https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/reproductive-history-fact-sheet#are-any-pregnancy-related-factors-associated-with-a-lower-risk-of-breast-cancer.
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84. ↑ "Inducing tolerance to pregnancy". The New England Journal of Medicine 367 (12): 1159–1161. September 2012. doi:10.1056/NEJMcibr1207279. PMID 22992082.
85. ↑ "Rhesus disease". November 16, 2021. https://www.nhs.uk/conditions/rhesus-disease/prevention/.
86. ↑ "Implications for the pregnant patient". American Journal of Respiratory and Critical Care Medicine 163 (5): 1051–1054. April 2001. doi:10.1164/ajrccm.163.5.16353. PMID 11316633.
87. ↑ "Your baby at 0–8 weeks pregnancy – Pregnancy and baby guide – NHS Choices". 2017-12-20. http://www.nhs.uk/conditions/pregnancy-and-baby/pages/pregnancy-weeks-4-5-6-7-8.aspx#close.
88. ↑ The BabyCenter Essential Guide to Pregnancy and Birth: Expert Advice and Real-World Wisdom from THE tip Top Pregnancy and Parenting Resource. Emmaus, Penn.: Rodale Books. 2005. ISBN 1-59486-211-7. https://books.google.com/books?id=AK60Xmnrm_AC&q="Braxton+Hicks+contractions"&pg=PA294.
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91. ↑ Human Anatomy, Physiology and Health Education. S. Chand Publishing. 2010. p. 239. ISBN 978-81-219-3357-5.
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100. ↑ The American College of Obstetricians and Gynecologists (April 2006). "What To Expect After Your Due Date". Medem, Inc.. http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZRDLPH97C&sub_cat=2005.
101. ↑ "Induction of labour – Evidence-based Clinical Guideline Number 9". Royal College of Obstetricians and Gynaecologists. 2001. http://www.rcog.org.uk/resources/public/pdf/rcog_induction_of_labour.pdf.
102. ↑ "Provisional recommended weight limits for manual lifting during pregnancy". Human Factors 56 (1): 203–214. February 2014. doi:10.1177/0018720813502223. PMID 24669554. PMC 4606868. https://www.cdc.gov/niosh/nioshtic-2/20043108.html.
103. ↑ "Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations". American Journal of Obstetrics and Gynecology 209 (2): 80–88. August 2013. doi:10.1016/j.ajog.2013.02.047. PMID 23467051.
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105. ↑ "WHO | Antenatal care". https://www.who.int/gho/maternal_health/reproductive_health/antenatal_care_text/en/.
106. ↑ "Alternative versus standard packages of antenatal care for low-risk pregnancy". The Cochrane Database of Systematic Reviews 2015 (7). July 2015. doi:10.1002/14651858.cd000934.pub3. PMID 26184394.
107. ↑ American College of Obstetricians Gynecologists Committee on Health Care for Undeserved Women (August 2006). "ACOG Committee Opinion No. 343: psychosocial risk factors: perinatal screening and intervention". Obstetrics and Gynecology 108 (2): 469–477. doi:10.1097/00006250-200608000-00046. PMID 16880322.
108. ↑ The Johns Hopkins manual of gynecology and obstetrics (4th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. 2011. ISBN 978-1-4511-0913-9. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=booktext&D=books&AN=01437579$&XPATH=/PG(0).
109. ↑ Prenatal care: effectiveness and implementation. Cambridge, UK; New York: Cambridge University Press. 1999. ISBN 978-0-521-66196-6. http://ucsfcat.library.ucsf.edu/record=b1285675~S0. Retrieved 10 November 2015.
110. ↑ Deshpande, Neha; Lewis-O'Connor, Annie (2013). "Screening for Intimate Partner Violence During Pregnancy". Rev Obstet Gynecol 6 (3–4): 141–148. PMID 24920977.
111. ↑ "Antenatal dietary education and supplementation to increase energy and protein intake". The Cochrane Database of Systematic Reviews 2015 (6). June 2015. doi:10.1002/14651858.CD000032.pub3. PMID 26031211.
112. ↑ "| Choose MyPlate". 2015-04-29. http://www.choosemyplate.gov/moms-medical-conditions.
113. ↑ "Dietary advice interventions in pregnancy for preventing gestational diabetes mellitus". The Cochrane Database of Systematic Reviews 1 (1). January 2017. doi:10.1002/14651858.CD006674.pub3. PMID 28046205.
114. ↑ "A decreasing rate of neural tube defects following the recommendations for periconceptional folic acid supplementation". Acta Paediatrica 94 (11): 1538–1542. November 2005. doi:10.1080/08035250500340396. PMID 16303691.
115. ↑ Greenberg, James A (2011). "Multivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate". Reviews in Obstetrics and Gynecology 4 (3–4): 126–127. PMID 22229066.
116. ↑ "Decline in prevalence of neural tube defects in a high-risk region of the United States". Pediatrics 106 (4): 677–683. October 2000. doi:10.1542/peds.106.4.677. PMID 11015508.
117. ↑ "Folic acid in diet: MedlinePlus Medical Encyclopedia". https://www.medlineplus.gov/ency/article/002408.htm.
118. ↑ Centers for Disease Control Prevention (CDC) (January 2008). "Use of supplements containing folic acid among women of childbearing age--United States, 2007". MMWR. Morbidity and Mortality Weekly Report 57 (1): 5–8. PMID 18185493.
119. ↑ 119.0 119.1 119.2 "Outcomes of Maternal Weight Gain". Evidence Report/Technology Assessment. Evidence Reports/Technology Assessments, No. 168 (Agency for Healthcare Research and Quality) (168): 1–223. May 2008. PMID 18620471. PMC 4781425. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0007502/. Retrieved 23 June 2013.
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122. ↑ American College of Obstetricians Gynecologists (January 2013). "ACOG Committee opinion no. 548: weight gain during pregnancy". Obstetrics and Gynecology 121 (1): 210–212. doi:10.1097/01.AOG.0000425668.87506.4c. PMID 23262962.
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124. ↑ "Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association". Stroke 45 (5): 1545–1588. May 2014. doi:10.1161/01.str.0000442009.06663.48. PMID 24503673.
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126. ↑ Genetic Alliance; The New England Public Health Genetics Education Collaborative (2010-02-17). "Appendix A: Teratogens/Prenatal Substance Abuse". Understanding Genetics: A New England Guide for Patients and Health Professionals. Genetic Alliance. https://www.ncbi.nlm.nih.gov/books/NBK132176/.
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128. ↑ "Basics about FASDs". https://www.cdc.gov/ncbddd/fasd/facts.html.
129. ↑ "Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls". Human Reproduction Update 17 (5): 589–604. Sep–Oct 2011. doi:10.1093/humupd/dmr022. PMID 21747128.
130. ↑ Centers for Disease Control and Prevention. 2007. Preventing Smoking and Exposure to Secondhand Smoke Before, During, and After Pregnancy .
131. ↑ "Tobacco Use and Pregnancy – Reproductive Health". 2019-01-16. https://www.cdc.gov/reproductivehealth/tobaccousepregnancy/index.htm.
132. ↑ 132.0 132.1 "New Mother Fact Sheet: Methamphetamine Use During Pregnancy". North Dakota Department of Health. http://www.ndmch.com.
133. ↑ "Patterns of methamphetamine use during pregnancy: results from the Infant Development, Environment, and Lifestyle (IDEAL) Study". Maternal and Child Health Journal 14 (4): 519–527. July 2010. doi:10.1007/s10995-009-0491-0. PMID 19565330.
134. ↑ "12. Air and Water Pollution". Prenatal exposures: psychological and educational consequences for children. New York: Springer. 2008. doi:10.1007/978-0-387-74398-1. ISBN 978-0-387-74398-1.
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136. ↑ "N95 Respirator Use During Pregnancy – Findings from Recent NIOSH Research | NIOSH Science Blog | Blogs | CDC". 18 June 2015. https://blogs.cdc.gov/niosh-science-blog/2015/06/18/respirators-pregnancy/.
137. ↑ "Homicide leading cause of death for pregnant women in U.S.". Harvard T.H. Chan School of Public Health. 2022-10-21. https://www.hsph.harvard.edu/news/hsph-in-the-news/homicide-leading-cause-of-death-for-pregnant-women-in-u-s/.
138. ↑ "With homicide a leading cause of maternal death, doctors urged to screen pregnant women for domestic violence". 20 October 2022. https://www.cnn.com/2022/10/20/health/homicide-maternal-mortality-us-editorial/index.html.
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147. ↑ Barakat, Ruben; Franco, Evelia; Perales, María; López, Carmina; Mottola, Michelle F. (May 2018). "Exercise during pregnancy is associated with a shorter duration of labor. A randomized clinical trial" (in en). European Journal of Obstetrics & Gynecology and Reproductive Biology 224: 33–40. doi:10.1016/j.ejogrb.2018.03.009. PMID 29529475. https://linkinghub.elsevier.com/retrieve/pii/S0301211518300964.
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151. ↑ "Exercise in pregnancy and the postpartum period". Journal of Obstetrics and Gynaecology Canada 25 (6): 516–529. June 2003. doi:10.1016/s1701-2163(16)30313-9. PMID 12806453.
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157. ↑ Wowdzia, Jenna B.; Hazell, Tom J.; Davenport, Margie H. (September 2022). "Glycemic response to acute high-intensity interval versus moderate-intensity continuous exercise during pregnancy". Physiological Reports 10 (18). doi:10.14814/phy2.15454. ISSN 2051-817X. PMID 36117457.
158. ↑ Nagpal, Ts; Everest, C; Goudreau, Ad; Manicks, M; Adamo, Kb (March 2021). "To HIIT or not to HIIT? The question pregnant women may be searching for online: a descriptive observational study" (in en). Perspectives in Public Health 141 (2): 81–88. doi:10.1177/1757913920985898. ISSN 1757-9139. PMID 33579178. https://journals.sagepub.com/doi/10.1177/1757913920985898.
159. ↑ "Melatonin and stable circadian rhythms optimize maternal, placental and fetal physiology". Human Reproduction Update 20 (2): 293–307. 2014. doi:10.1093/humupd/dmt054. PMID 24132226.
160. ↑ 160.0 160.1 160.2 Nolvi, Saara; Merz, Emily C.; Kataja, Eeva-Leena; Parsons, Christine E. (May 2023). "Prenatal Stress and the Developing Brain: Postnatal Environments Promoting Resilience" (in en). Biological Psychiatry 93 (10): 942–952. doi:10.1016/j.biopsych.2022.11.023. https://linkinghub.elsevier.com/retrieve/pii/S0006322322018534.
161. ↑ Bustnes, Kaia A.; Schäfer, Sarah; Held, Linus; Wessels, Hannah; Friehs, Maximilian A. (October 2025). "Risks to the Unborn: An Umbrella Review on the Effects of Prenatal Maternal Stress Caused by Natural Disasters" (in en). Stress and Health 41 (5). doi:10.1002/smi.70108. ISSN 1532-3005. PMID 41017161. PMC 12477415. https://onlinelibrary.wiley.com/doi/10.1002/smi.70108.
162. ↑ Thomason, Moriah E.; Hendrix, Cassandra L. (2024-12-09). "Prenatal Stress and Maternal Role in Neurodevelopment" (in en). Annual Review of Developmental Psychology 6 (1): 87–107. doi:10.1146/annurev-devpsych-120321-011905. ISSN 2640-7922. PMID 39759868. PMC 11694802. https://www.annualreviews.org/content/journals/10.1146/annurev-devpsych-120321-011905.
163. ↑ "Oral health care during pregnancy: A strategies and considerations". http://jprsolutions.info/files/final-file-5af1b556a7b4b5.85475067.pdf.
164. ↑ "Oral pyogenic granuloma: a review". Journal of Oral Science 48 (4): 167–175. December 2006. doi:10.2334/josnusd.48.167. PMID 17220613.
165. ↑ "Treating periodontal disease for preventing adverse birth outcomes in pregnant women". The Cochrane Database of Systematic Reviews 2017 (6). June 2017. doi:10.1002/14651858.CD005297.pub3. PMID 28605006.
166. ↑ The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth. Simon and Schuster. 2017. p. 173. ISBN 978-1-5011-4668-8. https://books.google.com/books?id=7TCzCwAAQBAJ&pg=PA173.
167. ↑ 167.0 167.1 167.2 Pregnancy For Dummies. John Wiley & Sons. 2011. p. 157. ISBN 978-1-119-99706-1. https://books.google.com/books?id=YaVwrjpeRZsC&pg=PT57.
168. ↑ "Air Travel During Pregnancy". https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/08/air-travel-during-pregnancy.
169. ↑ "Antenatal classes". December 2020. https://www.nhs.uk/pregnancy/labour-and-birth/preparing-for-the-birth/antenatal-classes/.
170. ↑ "Promoting baby-friendly hospitals". https://www.who.int/activities/promoting-baby-friendly-hospitals.
171. ↑ "Pregnancy complicated by disease". Merck Manual, Home Health Handbook. Merck Sharp & Dohme. https://www.merckmanuals.com/home/women-s-health-issues/pregnancy-complicated-by-disease/anemia-during-pregnancy.
172. ↑ Dagher, Rada; Bruckheim, Hannah; Colpe, Lisa; Edwards, Emmaline; White, Della (2021). "Perinatal Depression: Challenges and Opportunities". J Womens Health (Larchmt 30 (2): 154–159. doi:10.1089/jwh.2020.8862. PMID 33156730.
173. ↑ "Postpartum Depression". The New England Journal of Medicine 375 (22): 2177–2186. December 2016. doi:10.1056/nejmcp1607649. PMID 27959754.
174. ↑ Lara A Friel. "Thromboembolic Disorders During Pregnancy". Merck Manuals Consumer Version. Merck Sharp & Dohme Corp. https://www.merckmanuals.com/home/women-s-health-issues/pregnancy-complicated-by-disease/thromboembolic-disorders-during-pregnancy.
175. ↑ 175.0 175.1 "52". Williams Manual of Pregnancy Complications. New York: McGraw-Hill Medical. 2013. pp. 323–334. ISBN 978-0-07-176562-6.
176. ↑ "What are the symptoms of pregnancy loss (before 20 weeks of pregnancy)?". September 2017. https://www.nichd.nih.gov/health/topics/pregnancyloss/conditioninfo/symptoms.
177. ↑ "Miscarriage Causes". https://www.webmd.com/baby/4-common-causes-miscarriage#1.
178. ↑ "What Is Stillborn". 29 September 2022. https://www.cdc.gov/ncbddd/stillbirth/facts.html.
179. ↑ "Miscarriage". 9 March 2022. https://www.nhs.uk/conditions/miscarriage/.
180. ↑ "Men's grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model". BMC Pregnancy and Childbirth 20 (1). January 2020. doi:10.1186/s12884-019-2677-9. PMID 31918681.
181. ↑ "Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms". Human Reproduction Update 20 (4): 582–593. 2014. doi:10.1093/humupd/dmu007. PMID 24619876.
182. ↑ "Celiac disease and obstetric complications: a systematic review and metaanalysis". American Journal of Obstetrics and Gynecology 214 (2): 225–234. February 2016. doi:10.1016/j.ajog.2015.09.080. PMID 26432464.
183. ↑ "The Gluten Connection". Health Canada. May 2009. https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/food-safety/celiac-disease-gluten-connection-1.html.
184. ↑ 184.0 184.1 Page 264 in: Gresele, Paolo (2008). Platelets in hematologic and cardiovascular disorders: a clinical handbook. Cambridge, UK: Cambridge University Press. ISBN 978-0-521-88115-9.
185. ↑ "SDG Indicator 3.7.1 on Contraceptive Use". https://www.un.org/development/desa/pd/data/sdg-indicator-371-contraceptive-use.
186. ↑ "Women have abortions for many reasons aside from rape and incest. Here are some of them". 2019-05-21. https://www.cnn.com/2019/05/21/health/women-reasons-abortion-trnd/index.html.
187. ↑ "Law and Policy Guide: Rape and Incest Exceptions". 2022-01-18. https://reproductiverights.org/maps/worlds-abortion-laws/law-and-policy-guide-rape-and-incest-exceptions/.
188. ↑ "Maternity and paternity at work: Law and practice across the world". https://www.ilo.org/global/topics/equality-and-discrimination/maternity-protection/publications/maternity-paternity-at-work-2014/lang--en/index.htm.
189. ↑ Katie Mcdonough (30 April 2014). "Tennessee just became the first state that will jail women for their pregnancy outcomes". Salon. http://www.salon.com/2014/04/30/tennessee_just_became_the_first_state_that_will_jail_women_for_their_pregnancy_outcomes/.
190. ↑ 190.0 190.1 "NONFICTION: When Pregnancy is a Crime". 17 June 2021. https://yaledailynews.com/blog/2021/06/16/when-pregnancy-is-a-crime/.
191. ↑ "Employment of Foreign Manpower (Work Passes) Regulations 2012 - Singapore Statutes Online". https://sso.agc.gov.sg/SL/EFMA1990-S569-2012?DocDate=20210902#Sc4-.
192. ↑ "Employment of Foreign Manpower Act - Singapore Statutes Online". https://sso.agc.gov.sg/Act/EFMA1990?ProvIds=pr25A-#pr25A-.
193. ↑ "Employers will not lose security bond if FDW gets pregnant – MOM". 1 July 2011. https://twc2.org.sg/2011/07/01/employers-will-not-lose-security-bond-if-fdw-gets-pregnant-mom/.
194. ↑ "Perceived racism or racial discrimination and the risk of adverse obstetric outcomes: a systematic review". Sao Paulo Med J 140 (5): 705–718. 2022. doi:10.1590/1516-3180.2021.0505.R1.07042022. PMID 36043663.
195. ↑ "Racial disparities in birth care: Exploring the perceived role of African-American women providing midwifery care and birth support in the United States". Women and Birth 30 (1): e9–e16. February 2017. doi:10.1016/j.wombi.2016.06.004. PMID 27364419.
196. ↑ "Transgender men and pregnancy". Obstetric Medicine 9 (1): 4–8. March 2016. doi:10.1177/1753495X15612658. PMID 27030799.
197. ↑ "Transgender men who experienced pregnancy after female-to-male gender transitioning". Obstetrics and Gynecology 124 (6): 1120–1127. December 2014. doi:10.1097/AOG.0000000000000540. PMID 25415163. https://escholarship.org/uc/item/3dz427qw.
198. ↑ The anthropology of health and healing.. Plymouth: AltaMira Press. 2010. p. 133. ISBN 978-0-7591-1044-1. https://books.google.com/books?id=DvR53MCGx1YC&q=In+most+cultures,+pregnant+women+have+a+special+status+in+society&pg=PA133.
199. ↑ Baumgarten, Linda (2002). What Clothes Reveal: The Language of Clothing in Colonial and Federal America. Williamsburg, Virginia: Colonial Williamsburg. pp. 148. ISBN 0-87935-216-7. https://archive.org/details/whatclothesrevea0000baum/.
200. ↑ Chrisman-Campbell, Kimberly (July 12, 2013). "Dressing for Two". Slate. https://slate.com/human-interest/2013/07/kay-goldmans-history-of-maternity-clothes-dressing-modern-maternity-reviewed.html.
201. ↑ Mary in western art. New York: In Association with Hudson Hills Press. 2005. p. 106. ISBN 978-0-9712981-9-4. https://books.google.com/books?id=qd7EZAFouDgC&q=097129819X+pregnancy&pg=PA106.

## Further reading

* "Nutrition for the First Trimester of Pregnancy". IDEA Health & Fitness Association. https://www.ideafit.com/personal-training/nutrition-for-the-first-trimester-of-pregnancy/.
* "Iron requirements in pregnancy and strategies to meet them". The American Journal of Clinical Nutrition 72 (1 Suppl): 257S–264S. July 2000. doi:10.1093/ajcn/72.1.257S. PMID 10871591.
* "Pregnancy envy and the politics of compensatory masculinities". Politics & Gender 1 (2): 265–296. June 2005. doi:10.1017/S1743923X05050087.

## External links

* Merck Manual Home Health Handbook – further details on the diseases, disorders, etc., which may complicate pregnancy.
* Pregnancy care – NHS guide to having a baby including preconception, pregnancy, labor, and birth.

Classification|

* ICD-10: O00-O99, Z33, Z34, Z35
* ICD-9-CM: 650
* MeSH: D011247
* DiseasesDB: 10545

|

External resources|

* MedlinePlus: 002398
* eMedicine: article/259724

* v
* t
* e

Pregnancy and childbirth

Planning|

* Birth control
* Natural family planning
* Pre-conception counseling

Conception|

* Assisted reproductive technology
* Artificial insemination
* Fertility medication
* In vitro fertilisation
* Fertility awareness
* Unintended pregnancy

Testing|

* 3D ultrasound
* Obstetric ultrasonography
* Pregnancy test
* Home testing
* Prenatal diagnosis

Prenatal|

| Anatomy|

* Amniotic fluid
* Amniotic sac
* Endometrium
* Placenta

|

Development|

* Fundal height
* Gestational age
* Human embryogenesis
* Maternal physiological changes
* Postpartum physiological changes

Care|

* Nutrition
* Environmental toxicants
* In pregnancy
* Prenatal
* Concomitant conditions
* Drinking
* Diabetes mellitus
* Smoking
* Vaping
* SLE
* Sexual activity during pregnancy

Procedures|

* Amniocentesis
* Cardiotocography
* Chorionic villus sampling
* Nonstress test
* Abortion

Childbirth|

| Preparation|

* Bradley method
* Hypnobirthing
* Lamaze
* Nesting instinct

|

Roles|

* Doula
* Birth attendant
* Men's roles
* Midwife
* Obstetrician
* Perinatal nurse
* Traditional birth attendant

Delivery|

* Bloody show
* Childbirth positions
* Home birth
* Multiple birth
* Natural childbirth
* Pelvimetry / Bishop score
* Cervical dilation
* Cervical effacement
* Position
* Presentation
* Breech
* Cephalic
* Shoulder
* Rupture of membranes
* Unassisted childbirth
* Uterine contraction
* Water birth

Postpartum|

| Maternal|

* Postpartum confinement
* Sex after pregnancy
* Psychiatric disorders of childbirth
* Postpartum physiological changes

|

Roles|

* Doula
* Health visitor
* Lactation consultant
* Monthly nurse
* Confinement nanny

Infant|

* Adaptation to extrauterine life
* Child care
* Congenital disorders

Obstetric history|

* Gravidity and parity

* v
* t
* e

Women's health

Reproductive
&Sexual health

| Reproductive health|

| Reproductive tract|

* External female genitalia (vulva)
* Clitoris
* Clitoral hood
* Labia minora
* Labia majora
* Vagina
* Cervix
* Uterus
* Fallopian tube
* Ovary
* Reproductive system disease

|

Maternal health|

* Pregnancy
* Unintended pregnancy
* Gravidity and parity
* Obstetrics
* Antenatal care
* Adolescent pregnancy
* Complications of pregnancy
* Hyperemesis gravidarum
* Ectopic pregnancy
* Miscarriage
* Obstetrical bleeding
* Gestational diabetes
* Hypertension
* Preeclampsia
* Eclampsia
* Childbirth
* Midwifery
* Preterm birth
* Multiple births
* Oxytocin
* Obstructed labor
* Cesarian section
* Retained placenta
* Obstetrical fistulae
* Vesicovaginal fistula
* Rectovaginal fistula
* Episiotomy
* husband stitch
* Postpartum care
* Postpartum confinement
* Maternal deaths
* Perinatal mortality
* Stillbirths
* Abortion
* Mother-to-child transmission
* Sterilization
* Compulsory sterilization
* Breastfeeding and mental health

Reproductive life plan|

* Infertility
* Childlessness
* Assisted reproductive technology
* In vitro fertilization
* Parenting
* Adoption
* Fostering

Contraception &
Family planning|

* Unsafe sex
* Intrauterine devices
* Oral contraceptives
* Condoms
* Contraceptive prevalence
* Contraceptive security
* Planned parenthood
* Fertility awareness

Menstruation|

* Culture and menstruation
* Feminine hygiene
* Menarche
* Menstrual cycle
* Menstrual aids
* Cloth menstrual pad
* Menstrual cup
* Tampon
* Sanitary pad
* Dysmenorrhea
* Menorrhagia
* Amenorrhoea
* Menopause
* Hormone replacement therapy

Sexual health|

| Sexually transmitted
infections|

* HIV
* Human papilloma virus
* HPV vaccine
* Pelvic inflammatory disease

|

* Female genital mutilation
* Clitoridectomy
* Infibulation
* Breast ironing
* Child marriage
* Forced marriage
* Leblouh
* Polygamy
* Sexual intercourse
* Orgasm
* Dyspareunia

Other|

* Sex differences
* Sex education
* Puberty
* Breast health
* Gynaecological disorders

* Vaginitis

Non-reproductive health|

| Violence against women|

* Abuse during childbirth
* Domestic violence
* Intimate partner violence
* Misogyny
* Sexual harassment
* Sexual assault
* Rape
* Femicide
* Gender discrimination

|

Non-communicable diseases|

| Cancer|

* Lung cancer
* Breast cancer
* Uterine cancer
* Endometrial cancer
* Cervical cancer
* Papanicolaou test
* Ovarian cancer

|

* Cardiovascular disease
* Dementia
* Alzheimer's disease
* Bone health
* Osteoporosis
* Hip fracture
* Anaemia

* Mental health
* Anxiety
* Depression
* Major depressive disorder
* Urinary tract
* Urethra
* Urinary tract infection
* Urinary incontinence

Sociocultural factors|

* Poverty
* Disadvantaged
* Gender equality
* Healthcare inequality
* Gender disparities in health
* Social determinants of health
* Reproductive justice
* Women's empowerment

Politics, Research
& Advocacy|

| United Nations|

* The Convention on the Elimination of All Forms of Discrimination against Women
* Declaration on the elimination of violence against women
* International Day of the Girl Child
* Commission on the Status of Women
* UN Women

|

United States|

* Office of Research on Women's Health
* Women's Health Initiative

* International Center for Research on Women
* Nurses' Health Study
* Black Women's Health Study
* Cartwright Inquiry
* Society for Women's Health Research

Women's health
by country|

* Women's health in China
* Women's health in Ethiopia
* Women's health in India

* Family planning

* Birth control in the United States

* Category
* Commons
* WikiProject

* v
* t
* e

Pathology of pregnancy, childbirth and the puerperium (O, 630–679)

Pregnancy|

| Pregnancy with
abortive outcome|

* Abortion
* Ectopic pregnancy
* Abdominal
* Cervical
* Interstitial
* Ovarian
* Heterotopic
* Fetal resorption
* Molar pregnancy
* Miscarriage
* Stillbirth

|

Oedema, proteinuria and
hypertensive disorders|

* Gestational hypertension
* Pre-eclampsia
* HELLP syndrome
* Eclampsia

Other, predominantly
related to pregnancy|

| Digestive system|

* Acute fatty liver of pregnancy
* Gestational diabetes
* Hepatitis E
* Hyperemesis gravidarum
* Intrahepatic cholestasis of pregnancy

|

Integumentary system /
dermatoses of pregnancy|

* Gestational pemphigoid
* Impetigo herpetiformis
* Intrahepatic cholestasis of pregnancy
* Linea nigra
* Prurigo gestationis
* Pruritic folliculitis of pregnancy
* Pruritic urticarial papules and plaques of pregnancy (PUPPP)
* Striae gravidarum

Nervous system|

* Chorea gravidarum

Blood|

* Gestational thrombocytopenia
* Pregnancy-induced hypercoagulability

Maternal care related to the
fetus and amniotic cavity|

* amniotic fluid
* Oligohydramnios
* Polyhydramnios
* Braxton Hicks contractions
* [[Biology:Chorchorion]] / amnion
* Amniotic band syndrome
* Chorioamnionitis
* Chorionic hematoma
* Monoamniotic twins
* Premature rupture of membranes
* Obstetrical bleeding
* Antepartum
* placenta
* Circumvallate placenta
* Monochorionic twins
* Placenta accreta
* Placenta praevia
* Placental abruption
* Twin-to-twin transfusion syndrome

Labor|

* Amniotic fluid embolism
* Cephalopelvic disproportion
* Dystocia
* Shoulder dystocia
* Fetal distress
* Locked twins
* Obstetrical bleeding
* Postpartum
* Pain management during childbirth
* placenta
* Placenta accreta
* Preterm birth
* Postmature birth
* Umbilical cord prolapse
* Uterine inversion
* Uterine rupture
* Vasa praevia

Puerperal|

* Breastfeeding difficulties
* Low milk supply
* Cracked nipples
* Breast engorgement
* Childbirth-related posttraumatic stress disorder
* Diastasis symphysis pubis
* Postpartum bleeding
* Peripartum cardiomyopathy
* Postpartum depression
* Postpartum psychosis
* Postpartum thyroiditis
* Puerperal fever
* Puerperal mastitis

Other|

* Concomitant conditions
* Diabetes mellitus
* Systemic lupus erythematosus
* Thyroid disorders
* Maternal death
* Sexual activity during pregnancy

* Category

* v
* t
* e

Certain conditions originating in the perinatal period / fetal disease (P, 760–779)

Maternal factors and
complications of pregnancy,
labour and delivery|

| placenta:|

* Placenta praevia
* Placental insufficiency
* Twin-to-twin transfusion syndrome

|

chorion/amnion:|

* Chorioamnionitis

umbilical cord:|

* Umbilical cord prolapse
* Nuchal cord
* Single umbilical artery

presentation:|

* Breech birth
* Asynclitism
* Shoulder presentation

Length of gestation
and fetal growth|

* Small for gestational age/Large for gestational age
* Preterm birth/Postmature birth
* Intrauterine growth restriction

Birth trauma|

* scalp
* Cephalhematoma
* Chignon
* Caput succedaneum
* Subgaleal hemorrhage
* Brachial plexus lesion
* Erb's palsy
* Klumpke paralysis

By system|

| Respiratory|

* Intrauterine hypoxia
* Infant respiratory distress syndrome
* Transient tachypnea of the newborn
* Meconium aspiration syndrome
* pleural disease
* Pneumothorax
* Pneumomediastinum
* Wilson–Mikity syndrome
* Bronchopulmonary dysplasia

|

Cardiovascular|

* Pneumopericardium
* Persistent fetal circulation

Haemorrhagic and
hematologic disease|

* Vitamin K deficiency bleeding

* HDN
* ABO
* Anti-Kell
* Rh c
* Rh D
* Rh E
* Hydrops fetalis
* Hyperbilirubinemia
* Kernicterus
* Neonatal jaundice

* Velamentous cord insertion
* Intraventricular hemorrhage
* Germinal matrix hemorrhage
* Anemia of prematurity

Digestive|

* Ileus
* Necrotizing enterocolitis
* Meconium peritonitis

Integument and
thermoregulation|

* Erythema toxicum
* Sclerema neonatorum

Nervous system|

* Perinatal asphyxia
* Periventricular leukomalacia

Musculoskeletal|

* Gray baby syndrome
* muscle tone
* Congenital hypertonia
* Congenital hypotonia

Infectious|

* Vertically transmitted infection
* Neonatal infection
* Congenital rubella syndrome
* Neonatal herpes simplex
* Mycoplasma hominis infection
* Ureaplasma urealyticum infection
* Omphalitis
* Neonatal sepsis
* Group B streptococcal infection
* Neonatal conjunctivitis

Other|

* Miscarriage
* Perinatal mortality
* Stillbirth
* Infant mortality
* Neonatal withdrawal

* v
* t
* e

Reproductive health

Rights|

* Compulsory sterilization
* Contraceptive security
* Genital integrity
* Circumcision controversies
* Genital modification and mutilation
* Intersex

Education|

* Genetic counseling
* Pre-conception counseling
* Sex education

Planning|

* Assisted reproductive technology
* Birth control
* Childfree/Childlessness
* Parenting
* Adoption
* Childbirth
* Foster care
* Safe sex

Health|

* Men's
* Women's
* Vulvovaginal
* Research
* Self-report sexual risk behaviors

Pregnancy|

* Abortion
* Birth spacing
* Maternal health
* Obstetrics
* Options counseling
* Pregnancy from rape
* Pregnant patients' rights
* Prenatal care
* Teenage pregnancy
* Preteen pregnancy
* Unintended pregnancy

Medicine|

* Andrology
* Genitourinary medicine
* Gynaecology
* Obstetrics and gynaecology
* Reproductive endocrinology and infertility
* Sexual medicine

Disorder|

* Disorders of sex development
* Infertility
* Reproductive system disease
* Sexual dysfunction
* Sexually transmitted infection
* Clinic

By country|

* China
* India
* Iran
* Ireland
* Pakistan
* Philippines
* Singapore
* United Kingdom
* Teen
* United States
* Teen pregnancy
* Birth control

History|

* Birth control movement in the United States
* History of condoms
* Social hygiene movement
* Timeline of reproductive rights legislation

Policy|

* One-child policy
* Two-child policy
* Financial
* Baby bonus
* Bachelor tax
* Child benefit
* Tax on childlessness

* v
* t
* e

Human physiology of sexual reproduction

Menstrual cycle|

* Menarche
* Menstruation
* Follicular phase
* Ovulation
* Luteal phase

Gametogenesis|

* Spermatogenesis
* spermatogonium
* spermatocyte
* spermatid
* sperm)
* Oogenesis (oogonium
* oocyte
* ootid
* ovum)
* Germ cell
* gonocyte
* gamete)

Human sexual activity|

* Sexual arousal
* Sexual intercourse
* Masturbation
* Erection
* Orgasm
* Ejaculation
* Insemination
* Fertilization / Fertility
* Implantation
* Pregnancy
* Postpartum period
* Mechanics of sex

Development of the reproductive system|

* Sexual differentiation
* Sexual dimorphism
* Feminization
* Virilization)
* Puberty
* Gonadarche
* Tanner scale
* Pubarche
* Menarche
* Spermarche
* Adrenarche)
* Maternal age / Paternal age
* Menopause

Egg|

* Ovum
* Oviposition
* Oviparity
* Ovoviviparity
* Vivipary

Reproductive endocrinology
and infertility|

* Hypothalamic–pituitary–gonadal axis
* Hypothalamic–pituitary–prolactin axis
* Andrology
* Hormone

Breast|

* Thelarche
* Development
* Lactation
* Breastfeeding

Human reproductive system|

* Male
* Female

* v
* t
* e

Development of the human body

Before birth|

* Development
* Embryo
* Fetus
* Gestational age

Birth and after|

* Birth
* Child development
* stages
* Puberty
* Adult development
* Ageing
* Senescence
* Death

Phases|

* Infant
* Toddler
* Early childhood
* Childhood
* Child
* Preadolescence
* Adolescence
* Adulthood
* Middle age
* Old age

Social and legal|

* Minor
* Age of majority

* v
* t
* e

Outline of human sexuality

Physiology and biology|

* Erection
* Insemination
* Intersex
* Libido
* Nocturnal emission
* Orgasm
* Female and male ejaculation
* Pelvic thrust
* Pre-ejaculate
* Pregnancy
* Sexual arousal
* Sexual stimulation

Health and
education|

* Birth control
* Condom
* Masters and Johnson
* Reproductive medicine
* Andrology
* Gynaecology
* Urology
* Safe sex
* Sex education
* Sex therapy (PLISSIT model)
* Sexology
* Sexual dysfunction
* Erectile dysfunction
* Hypersexuality
* Hyposexuality
* Sexual medicine
* Sexual surrogate
* Sexually transmitted infection

Identity and diversity|

* Gender binary
* Gender identity
* Men who have sex with men
* Sexual identity
* Sexual orientation
* Women who have sex with women

Law|

* Age of consent
* Criminal transmission of HIV
* Child sexual abuse
* Incest
* Indecent exposure
* Obscenity
* Sexual abuse
* Cybersex trafficking
* Rape
* Sex trafficking
* Sexual assault
* Sexual harassment
* Sexual misconduct
* Sexual slavery
* Sexual violence

History|

* Blue Movie
* Counterculture of the 1960s
* Feminist sex wars
* Golden Age of Porn
* History of erotic depictions
* Sexual revolution

Relationships
and society|

* Anarchism and love/sex
* Extramarital sex
* Family planning
* Flirting
* Free love
* Marriage
* Modesty
* Polyamory
* Premarital sex
* Promiscuity
* Romance
* Sex-positive movement
* Sexual abstinence
* Sexual addiction
* Sexual attraction
* Sexual capital
* Sexual ethics
* Sexual objectification
* Sexual slang

By country|

* Ancient Rome
* China
* India
* Japan
* Philippines
* South Korea
* United States

Sexual activities|

* Conventional sex
* Anal sex
* Bareback
* BDSM
* Child sex
* Creampie
* Edging
* Erotic sexual denial
* Fetishism
* Fingering
* Fisting
* Gang bang
* Group sex
* Masturbation
* Mechanics of sex
* Nipple stimulation
* Non-penetrative sex
* Facial
* Foot fetishism
* Footjob
* Forced orgasm
* Frot
* Handjob
* Mammary intercourse
* Sumata
* Oral sex
* 69
* Anilingus
* Cunnilingus
* Fellatio
* Irrumatio
* Paraphilia
* Pompoir
* Quickie
* Sex in space
* Sex positions
* Sexual fantasy
* Sexual fetishism
* Sexual intercourse
* Foreplay
* Sexual penetration
* Swinging
* Tribadism
* Urethral intercourse
* Urolagnia
* Virtual sex
* Cybersex
* Erotic talk
* Wet T-shirt contest

Sex industry|

* Red-light district
* Adult video games
* Erotica
* Pornography
* Film actor
* Prostitution
* Survival sex
* Sex museum
* Sex shop
* Sex tourism
* Child
* Female
* Sex worker
* Sex toy
* doll
* Strip club
* Webcam model

Religion and
sexuality|

* Buddhism
* Christian demonology
* Daoism
* Islam
* Mormonism
* Sex magic

* v
* t
* e

Human sexuality and sexology

Sexual relationship
phenomena

* Asexuality
* Gray asexuality
* Bisexuality
* Casual relationship
* Casual sex
* Celibacy
* Celibacy syndrome
* Herbivore men
* Committed relationship
* Conventional sex
* Free love
* Foreplay
* Heterosexuality
* Homosexuality
* Hypersexuality
* Marriage
* One-night stand
* Polyamory
* Promiscuity
* Female
* Romantic love
* Romantic orientation
* Flirting
* Sex life
* Sexual abstinence
* Sexual orientation
* Sexual partner
* Single person
* Swinging

Sexual dynamics|

* Hypergamy
* Intersex
* Physical attractiveness
* Sexual attraction
* Sexual capital
* Sexual ethics
* Sexual frustration

See also|

* Sexual addiction
* Sex Addicts Anonymous
* Sexual surrogate

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