​When you want to become pregnant, proper preparation is important. Fortunately, you don't have to go through your pregnancy alone. Your healthcare team at The Christ Hospital Health Network will join you every step of the way. We will answer your questions and help you prepare for your pregnancy at each stage.

Whether this is your first child or you've had children before, you should feel educated and empowered before, during and after your pregnancy, according to Jenny Demos-Bertrand, DO, Stacy Hudepohl, CNM, Suma Reddy, MD, and Charla Payne, BSN, RNC-MNN.

What is preconception care?

Preparing for a baby starts before you try to conceive. Some women start a conversation with their doctor during their annual exam, says Hudepohl. This conversation sets the stage for preconception care, which focuses on a woman's health before pregnancy.

During a preconception care visit, you and your doctor will discuss:

• Personal and medical history
• OB/GYN history
• Review of your menstrual cycle
• Review of your family history and genetic history
• Lab work
• Diet, exercise and prenatal vitamins

Your physical health plays a major role in preconception care. Talk to your doctor if you have high blood pressure, diabetes or autoimmune diseases. Mention any medications you are taking as well.

Your mental health is also important since pregnancy brings many hormonal changes. Your doctor will ask if you have a good support system. They'll also help you address any anxiety or depression. Once you decide to get pregnant, you'll experience many different emotions.

“Getting pregnant is kind of like jumping into a cold swimming pool," Hudepohl says. “Sometimes you just have to go for it because there'll be many reasons why you don't want to do it."

Who is on my pregnancy care team?

Women need support before, during and after childbirth. You'll meet with several healthcare providers throughout your maternity journey. Each team member has a unique skill set to support your needs and those of your growing baby. Your care team may consist of the following team members:

• OB/GYN—A physician who completes specialized education and training in female reproductive health
  
• Certified nurse midwife (CNM)—An advanced registered nurse who specializes in pregnancy and the female reproductive system
• Labor and delivery nurse—A nurse who provides care for mothers during labor and childbirth and provides the infant with initial care after delivery
  
• Lactation consultant—A certified health professional who specializes in breastfeeding
• Doula—A non-medical companion who provides physical and emotional support during childbirth
• Genetic counselor—A healthcare professional who can identify how genetic conditions may affect you and your family

What lifestyle modifications should I make?

When trying to conceive, it's important to create a healthy environment in your body for your baby. That can mean changing your lifestyle and what you eat. It's best to keep your diet goals simple by focusing on quality food, Hudepohl says.

“Protein needs to be your biggest resource, followed by fruits and vegetables and a small amount of carbs," she says. You should have smaller meals more frequently and stay well-hydrated.

You can continue, or start, to exercise while pregnant. Try to avoid rigorous workouts. Keep it simple with a walk around the block four times a week or light yoga.

Quit smoking or vaping and stop drinking alcohol as soon as you become pregnant or while you are actively trying to conceive, Hudepohl says.

If you want to have more than one baby, the American College of Gynecologists recommends spacing pregnancies by at least 18 months to allow your body to recover fully. Close pregnancies can increase the risk of miscarriage.

What can I expect during each trimester?

Doctors break pregnancies into three stages: first, second and third trimesters. Each trimester of pregnancy brings different changes, and here's what you can expect during each trimester.

First trimester—0 to 14 weeks pregnant

You will have multiple healthcare appointments throughout your pregnancy. At your first appointment, an ultrasound will confirm the doctor dated your pregnancy correctly. You and your doctor will also go over the same questions from your preconception care visit. That first appointment is a good time to ask your care team any questions.

“Pregnancy brain is real, and I recommend writing down your questions or putting them in your phone," says Dr. Demos-Bertrand.

During the first trimester, you can expect to experience changes such as:

• Breast tenderness
• Constipation
• Fatigue
• Feeling exhausted
• Food aversions
• Frequent urination
• Insomnia
• Light spotting
• Mild cramping
• Nausea
• Vivid dreams

However, certain changes may be cause for concern, says Dr. Demos-Bertrand.

“Some people may vomit a couple of times every day, and they're doing OK. What's not normal is if you're unable to keep food or water down for more than 24 hours," she says.

It's also not normal to have heavy vaginal bleeding. If you are bleeding heavily, call your healthcare provider. Other changes to look out for include severe cramping and an inability to empty your bladder.

Second trimester—14 to 27 weeks pregnant

“Once you've finished your first trimester and entered the second trimester, this is one of the better periods of your pregnancy," says Dr. Reddy.  “Your nausea tends to get better, and your energy levels come back."

You'll have appointments every four weeks in the second trimester. You will get an anatomy ultrasound to make sure the baby is developing properly and can also find out the baby's gender during this time.

At 24 weeks, your doctor will test you for gestational diabetes, a type of diabetes that occurs in pregnant women who don't already have diabetes. You'll drink a liquid containing glucose to measure your body's response to sugar.

Changes you can expect during the second trimester include:

• Abdominal discomfort
• Baby bump starts showing
• Dizziness, especially when standing for long periods
• New constipation
• New frequent urination

If this is your first pregnancy, you'll feel your baby move by 22 weeks. For second pregnancies and beyond, your baby will move even earlier.

Third trimester—28 weeks to 40 weeks

In the third trimester, you may start to feel uncomfortable as your abdomen gets bigger. You may also feel more tired, and you may be sick of sleeping on your side.

During your third trimester, you will have appointments every two weeks until 36 weeks. At that point, you'll have weekly appointments, although women with medical issues may visit their care team more often. If your baby isn't measuring as expected, you may get extra ultrasounds.

“Care gets individualized and tweaked according to the needs of the patient," Dr. Reddy says. At 36 weeks, you and your care team can discuss your birthing plan. At 37 or 38 weeks, you and your doctor can discuss dates for when you want to come into the hospital to have your baby. A full-term pregnancy can range from 38 to 42 weeks. Most babies are born within two weeks of their due date.

Changes you can expect during the third trimester include:

• Ankle and leg swelling
• Stronger fetal kicks
• Tinkling or numbness in your fingers and toes

If you stop feeling your baby move at any point during your third trimester, call your doctor. You'll also need to go to the hospital if your water breaks. This is the first sign you're ready to start labor.

Call your doctor right away if you experience any of the following symptoms:

• High blood pressure symptoms such as headaches that don't go away
• Painful uterine contractions
• Vaginal bleeding
• Vision changes such as double vision

What can I expect at the hospital?

You may be anxious when the time comes to have your baby. The Liberty Family Birthing Center​ at The Christ Hospital Medical Center in Butler County offers childbirth education classes to help you stay informed and make sure you have everything you need for your baby to come home.

Labor, delivery and recovery take place in the same room so you can be as comfortable as possible. If you're having a C-section, there is also a separate viewing room where your loved ones can watch the procedure.

“The other unique thing about The Liberty Family Birthing Center is that all of our nurses have training in a variety of different OB areas," Payne says. “You may see the same nurse in triage, during labor and after delivery." During triage, your nurse will assess how far along you are in the laboring process.

The hospital also provides inpatient and outpatient support to help with breastfeeding. An OB/GYN or midwife, a neonatologist—a doctor who specializes in caring for newborns—and someone from anesthesia are always onsite at The Liberty Birthing Center, as well.

Patients also have access to mental health counselling with the Galia Collaborative​. The partnership provides no-cost mental health sessions to patients who need support with:

• Infertility
• Postpartum depression
• Pregnancy
• Pregnancy loss

Pregnancy is an exciting and emotional time for women. Knowing what to expect can help ease the transition into motherhood. If you have questions at any point during your pregnancy, call your healthcare provider.