Enemas for constipation during pregnancy

Enemas for constipation during pregnancy

The more you add One mild laxative, considered to be safe to take during pregnancy, is Milk of Magnesia. This class of drugs is generally exempt from pregnancy classification. Lightheadedness. Avoid refined grains such as white bread, white rice, refined cereals, and pasta which are low in fiber and can cause Constipation during pregnancy occurs in many women, so an enema is the simplest way to solve a delicate problem. And actually, i m not a huge fan of enemas, altho sometimes they help. Add 4 to 8 tablespoons of a mild soap, such as castile soap. Objectives To report pregnant women's knowledge, attitudes, perceptions, pain, and satisfaction associated with the use of RE during labor. This can alleviate discomfort and prevent complications such as hemorrhoids. Some hormones impact how food is digested in the stomach and can slow down the digestion process. Pregnant women should try to consume 25 to 30 grams of dietary fiber each day to How to prevent Constipation during Pregnancy? Foods that are high in fibre, such as wholemeal breads and cereals, fruit and vegetables, and pulses such as beans and lentils. Passing stool is a normal occurrence during labor or delivery. Jan 13, 2012 · The water based enema is the most popular followed by saline enema, mineral oil and coffee enema during pregnancy. You can’t change the way your digestive system works during Nov 5, 2020 · Egg retrieval, a key step in the IVF process, is a treatment commonly followed by constipation, bloating, and cramping. Go-to options are usually bulk-forming laxatives and stool softeners. Being in an almost constant state of dehydration as a result of HG will itself lead to constipation. The mineral oil adheres to the faeces retaining their water content, softening it. Water enemas have been used for centuries to naturally relieve constipation. Slowly withdraw the nozzle. Investigate the cause of pain during defecation. When the alarm goes off, use the toilet. Read ACOG’s complete disclaimer. Try to have 10 to 12 cups of water or other beverages daily. 3 If these are ineffective, laxatives are the second line of therapy (). It is thought to be caused by progesterone-induced intestinal smooth muscle relaxation. Avoiding constipation is a core part of taking care of yourself during pregnancy. Talk to your healthcare provider before taking any new medications during pregnancy. Eating more foods with fiber can help fight constipation. Treating constipation might help reduce the risk of these problems. Encourage responding to the urge to defecate immediately. However, the constant application of this procedure is not approved by specialists. Coffee enema: Generally employed for detoxifying the body. In some cases, these problems can be a sign of more serious medical conditions. US FDA pregnancy category: C. Constipation alternating with diarrhea. This usually happens when there has been a build-up over time and is often a result of fecal impaction. Constipation is common near the end of pregnancy. MYTH 2: Enemas wash away your good gut microbes. Sep 4, 2015 · Background: Constipation is a common symptom experienced during pregnancy. Jul 18, 2019 · Fiber helps to increase the size of your stool, which can help it move easily through your digestive system. Pregnancy hormones can cause your poo move more slowly through your intestine. In addition, quite many pregnant women in the third trimester suffer from constipation, in which case an enema is simply necessary. Yogurt enema: Best known for treating soft constipation and irritable bowel syndrome. The bowels can absorb more water when administered a mineral-oil enema. uktis. Stool softeners, such as docusate sodium (Colace) and docusate calcium (Surfak), moisten the stool and make it easier to pass. Oct 21, 2023 · A saline enema is safe and recommended during pregnancy to alleviate constipation and promote bowel movements. Since mineral oil has laxative properties and acts as an lubricant it is used in the treatment of constipation. org. Set an alarm for the recommended amount of time before going to the bathroom (see chart below). Worldwide, the prevalence of constipation in all ages lies between 4. Severe, painful bulging in the vagina, vulva, and/or perineum. Keywords: Gastrointestinal, pregnancy, constipation, inflammatory bowel disease. Oct 20, 2022 · What has been heavily documented is that severe constipation can create issues like anal fissures and haemorrhoids. Constipation is one of the most common reasons for an over-the-counter (OTC) at-home enema. Exercise regularly (at an appropriate level). But it can also lead to a degree of laxity and relaxation within the bowel walls. How common is constipation in pregnancy? About 16 to 39% of people get constipated at some point during pregnancy. Dark urine. IUI can also lead to a change in bowel movements which can include constipation or diarrhea. Encourage adequate fibre intake (e. However, since everyone's body is different Oct 19, 2012 · Since constipation is one of the signs of pregnancy, many women check with their doctors if it is safe for them to use a fleet enema during pregnancy. These include: Nausea: A buildup of stool in your intestinal tract can cause nausea. As a result, some pregnant women may consider using enemas to alleviate discomfort and promote regular bowel movements. May 19, 2023 · Bisacodyl rectal is an over the counter (OTC) laxative medication available as a suppository or an enema to treat occasional constipation and irregularity in bowel movement. Many patients find relief from constipation with an increase in dietary fibre and fluids, as well as daily exercise. 1 day ago · After insertion, squeeze the enema container to push the liquid into the rectum. Enema while pregnant should only be used under the guidance of a healthcare professional Typically, enemas are not the first choice for dealing with constipation during pregnancy. There are a range of suggested treatments with drugs, supplements or dietary modifications. Is constipation in pregnancy harmful? May 12, 2023 · It is safe to use mineral oil enemas during pregnancy. Learn About the Book. Fiber is found in fruits, vegetables, whole grains, beans, nuts, and seeds. Soap suds enema: Often used for cleansing the rectum. Your doctor may also recommend taking a bulk-producing agent like Metamucil. Preferably, bowel movements should be improved in pregnancy and enemas should be avoided as far as possible. However, there is also research that enemas are safe and can have positive benefits during pregnancy and labor, such as reducing the risk of C. Constipation is common during pregnancy and for 6 weeks after giving birth. Likewise enemas and suppositories should only be used under medical supervision and guidance. Sep 13, 2020 · Updated November 12, 2021 At least once per day, I get a cry for help from Hyperemesis Gravidarum (HG) sufferers about how to relieve constipation during pregnancy, often due to a side effect from taking ondansetron (Zofran). Apr 23, 2024 · Sodium biphosphate / sodium phosphate Pregnancy Warnings. difficile infection in newborns. MICROLAX ® Enema has established itself as a laxative for pregnant women over many years and is well tolerated, even by children under 3 years old. The enema makes the colon expand and initiates a bowel movement. Oct 15, 2021 · Rare Symptoms. Also, constipation is a common problem faced by many women during the course of pregnancy and a choice of laxatives must be made by the physician. In my first pregnancy I suffered terribly from constipation. However it is best to check with your doctor before doing this as enemas can induce premature labor. Progesterone – a hormone released during pregnancy slows the muscle action of the bowels. Most doctors have a list of pregnancy approved OTC medications. Dec 25, 2023 · One of the primary benefits of using an enema during pregnancy is its ability to relieve constipation. […] Mar 23, 2022 · Adequate fiber and water intake help prevent and treat constipation during pregnancy. The client can neglect to schedule time for regular bowel movements and have gastrointestinal side effects from stress. 2, 5, 6 In general, there are insufficient data on the use of Feb 6, 2019 · Constipation is a very common symptom that many people experience during pregnancy. Many medications can also treat constipation during pregnancy when needed. Aug 1, 2012 · Treatment. Animal studies have not been conducted. Mix a couple drops of an essential oil of your choosing, such as lemon or bergamot oil, with a teaspoon of a carrier oil, and then add the mixture to your warm bath. Jul 20, 2023 · Last Updated on July 20, 2023. Lastly, your doctor may suggest a stool softener, which contains docusate, to reduce constipation. Drink plenty of water. An understanding of the effectiveness and safety of treatments for constipation in pregnancy is important for the clinician managing pregnant women. Constipation during pregnancy. Enemas generally are not recommended as a first line treatment. Eat fiber-rich foods, such as fresh or dried Nov 30, 2023 · While enemas can provide temporary relief from constipation, it is important to address the underlying causes of constipation during pregnancy. (Or sip throughout the day until your urine is clear or pale yellow in color – a sign of adequate hydration. AU TGA pregnancy category: Not formally assigned to a pregnancy category. Eating at least 28 grams (g) of fiber per day is recommended. Causes of Postpartum Abdominal Pain. Jun 18, 2009 · Barium enema: Mainly used for enhancing colon visibility during a medical exam. Pregnant women feel significant relief after the procedure and normal bowel movements. Relieve pregnancy constipation safely and conveniently at home with all natural water enemas and gut support products. Exercise regularly, a walk during pregnancy is most Apr 30, 2024 · While during early childhood, risk factors such as premature toilet training or difficulty with toilet training, dietary transitions from breast milk to formula or from liquid to solid foods, or painful defecation contribute to childhood constipation. My experience with pregnancy, constipation, uterine contractions, and enemas . Stagnation of feces can cause poisoning of the body. Methods A prospective study was conducted between 20 It is important to consider the benefits of treating constipation during pregnancy. Some of the most common reasons you might be experiencing diarrhea during pregnancy include: Hormones: Hormone levels fluctuate during pregnancy. o. Metamucil got me moving. Treatment & Remedies for Pregnancy Constipation Chart. It occurs due to hormonal changes, iron supplements, and the growing uterus putting pressure on the bowels. However, it is essential to use enemas with caution and under the guidance of a healthcare Dec 4, 2023 · Doctors may recommend enema for those who have constipation before labor. Constipation is a common problem in pregnancy and some expectant women have been known to use enemas during pregnancy. Also, the enema does not eliminate the cause of constipation. I would ask your OB before trying that. Sep 21, 2023 · Mineral oil Pregnancy Warnings. Constipation is common in pregnancy and affects approximately 40% of women. Phosphate enema stimulates the muscles of the colon. Answer: Although the recommended first-line therapy for constipation includes increasing fibre, fluids, and exercise, these are sometimes ineffective. In part, this occurs because of physiologic changes or coexistent conditions associated with pregnancy, as summarized in Box 1. Oct 19, 2021 · When does constipation in pregnancy start? You may start to feel constipated once the hormone levels in your body increase to support your pregnancy. burping. Constipation is a common issue during pregnancy, primarily due to hormonal changes that slow down the digestive system. The procedure can be either ther-apeutic to relieve constipation or diagnostic for imaging studies such as barium enemas. Indeed, in 100% of cases, the intestines are emptied during delivery involuntarily. ) Drinking a glass of fruit juice every day, especially prune juice, can also be helpful. For information on the safety of specific laxatives, see the website at www. Around 25% of women may experience what is called fecal incontinence or accidental bowel movement when they are in labor (5). Excessive rectal bleeding. It is important that all women consult a doctor to rule out any other underlying causes for a change in their bowel habits in pregnancy. Therefore, laxatives such as bulk-forming agents, lubricant laxatives, stool softeners, osmotic laxatives, and stimulant laxatives might be considered. It also supplies pregnant women with vitamins and antioxidants. An enema is fluid that is injected into the rectum so that the bowels can be cleaned out. pregnancy, antacids for heartburn, strong pain killers, multivitamins, iron and calcium tablets. Common side effects of bisacodyl rectal include rectal burning, abdominal cramps, abdominal discomfort, gas (flatulence), excessive diarrhea, dehydration, electrolyte imbalance, vomiting, headache, vertigo, and faintness. passing gas. Women primarily try to take coffee enemas while pregnant as a form of constipation relief. Lower levels of magnesium salt in the blood. Excessive or prolonged intake of laxatives could result in the following side effects. To avoid this and save themselves from the embarrassment, some women prefer to get Kristina Amelong, CCT, CNC, owner of the Optimal Health Network, addresses the common question, "Are enemas safe during pregnancy?" She discusses the importance of avoiding severe constipation during pregnancy, explains how to safely use enemas to help relieve constipation during pregnancy, and outlines alternative ways to relieve constipation if you decide that enemas aren't for you. Benefits and Risks of Using Enemas During Pregnancy. Pregnancy constipation, defined as having fewer than three bowel movements a week, can be uncomfortable. Remedy. Sep 8, 2015 · A diet high in fiber helps prevention constipation. Facebook-f Twitter Linkedin-in Instagram. Robert Burakoff, MD. This added ease is especially important during your period, when your system may slow Nov 27, 2023 · Common Causes. It may take a few days before anything moves, but it works! You should talk to your doctor. Introduce these foods gradually if the woman is not used to these foods as bloating and flatulence may occur otherwise. Late in pregnancy, constipation may become even more of a problem due to the enlarge d uterus pressing on the lower intestine. cramps. It takes effect locally in the rectum, so there is no fear of it having any effect on your unborn Benefits of Enemas During Pregnancy. An enema is a process where fluids are injected into the rectum to cleanse the colon, stimulate defecation, or administer medication. Constipation can b terrible i had to use n enema 1x a week during pregnancy cuz the meds i was on made me b backed up bad n no stool softner fiber fruit veggies coffee miralax m. Drink plenty of fluids. Aug 5, 2020 · Functional constipation is common across the general population, and is a source of concern during pregnancy and the postpartum period. During pregnancy, hormonal changes can lead to slower digestion and increased water absorption, which can contribute to constipation. Get regular exercise. Enemas can provide relief from constipation during pregnancy by stimulating bowel movements and helping to soften the stool. Constipation is common in pregnancy. Brand: Microlax. 9. Gastrointestinal motility is believed to be somewhat inhibited during pregnancy. It occurs due to increased hormone production, which reduces muscle tension and slows intestinal activity. Only take iron supplements if your GP or midwife has said you need them. 1% and 25. Wear your masks, wash your hands, and be excellent to each other. In 2018, Ferdinande et al reported that the incidence tion during pregnancy of constipation during pregnancy and the post-partum period was even as high as 60. US FDA pregnancy category: Not formally assigned to a pregnancy A rectal enema (RE) is a procedure where a fluid is injected into the lower part of the large intestine via the anal canal (Hinkle & Smeltzer, 2014). Constipation during pregnancy is associated with impaired quality of life and distress for pregnant women as well as physical problems including, occasionally, haemorrhoids. Constipation is common in pregnancy, affecting 20% of women, due to hormonal changes that slow digestion and increased pressure on the abdomen. You definitely cannot restrain it. It's a good idea to avoid foods that made your pre Feb 22, 2023 · Sodium Phosphate Enema: This enema is a medication prescribed by the doctor to treat constipation. If there is uncertainty about the use or safety of laxatives during pregnancy, contact the UKTIS: To discuss with a teratology specialist, telephone 0344 892 0909. Fill a clean jar or bowl with 8 cups of warm, distilled water. Nov 17, 2023 · Increase your fiber intake. Nov 14, 2023 · Medically reviewed by. Having a sore perineum because of hemorrhoids, an episiotomy, or a tear. 2. Consuming a high fiber diet of 25 to 30 grams per day of dietary fiber. 6% and 26. An enema for constipation in pregnant women is put as an exceptional method of improving bowel function. Colorectal cancer is rare during pregnancy, but with expected poor outcome. Jun 1, 2024 · Enemas can be used to treat constipation during pregnancy Pregnancy is a time of great change, and constipation is a common issue that can leave you feeling heavy and uncomfortable. There is very little published epidemiological information available on laxative exposure during pregnancy; however, most have minimal systemic absorption and are commonly used Nov 20, 2022 · It is therefore imperative to implement interventions such as a high-fiber diet and exercise during pregnancy to reduce the risks of constipation and subsequently the increased rates of REs (Shi et al. Can I use MICROLAX® in pregnancy? Using a laxative for constipation during pregnancy can be a gentle way to quickly get you back into a natural digestive rhythm. 6 Sources. The saline enema during pregnancy is a salt water enema while the coffee enema employs caffeine to stimulate the liver to release more bile. Either you or a Aug 6, 2019 · The bottom line. This drug should be used during pregnancy only if clearly needed. Enemas have been used for centuries to relieve constipation and promote bowel movements. Learn what causes constipation and get tips for preventing and easing the discomf Most moms-to-be will get constipation at some point during their pregnancy. This may lead to constipation if you're afraid of more Oct 30, 2022 · Blood or mucus in your stool. How To Prevent Constipation In Pregnancy? Drink plenty of water and fluids. Jhaveri says. It has a range of consequences from reduced quality of life and perception of physical health to haemorrhoids. If you want a fast-acting, gentle solution that’s recommended as an effective relief for constipation consult your doctor to see if MICROLAX® could work for you. With good reason, only a few medicines are licensed for the treatment of constipation in pregnancy. Relax and massage your stomach gently while in bath. 3 If these are ineffective, laxatives are the second line of therapy ( Table 1 ). Yes, taking an enema while pregnant is generally safe but should only be done under medical supervision. whole grains, rice, bran, beans, lentils, nuts, dried fruit, fresh fruit and vegetables. AU TGA pregnancy category: Exempt. Eat more fruits, vegetables, high fiber cereals, whole-grain bread, prunes, and bran. It defines constipation as infrequent or difficult bowel movements, occurring 3 times or fewer per week. Treatment. You should aim for about 25 grams of fiber in your diet each day. The authors review several gastrointestinal conditions encountered during pregnancy and address presentation, diagnosis, and treatment of each condition. Sugary, fried, spicy, or fatty foods can also cause gas. Although enemas can provide temporary relief by softening and lubricating the stool, it I had a previous OB recommend a fleet enema to help with impaction (which I’ve had to use 2x so far) but today a different OB recommended against the saline enema and told me to try a mineral oil one. Although a high fibre diet and increased fluid intake is encouraged to assist defecation in the puerperium, pain‐relieving drugs and laxatives are common drugs of choice to alleviate Aug 19, 2022 · An enema is the insertion of a liquid into the rectum or colon through the anus. Oct 15, 2021 · Constipation can be caused or worsened by pregnancy, travel, trauma, changes in personal relationships, occupational factors, or financial worries. Mild enemas Sep 12, 2016 · This document discusses constipation during pregnancy. Sometimes people present with more rare symptoms of constipation. Reduced absorption of nutrition and other medicines into the blood as laxatives increase the rate of food passage through the intestinal tract. Mineral oil enema: Useful in curing fecal impaction. Google says NOT to use mineral oil enemas during pregnancy. Oral laxatives or natural remedies like dietary changes and physical activity are often recommended initially. Know more on the causes of the constipation during pregnancy, how to avoid enema and how natural diets can help to control over the condition. Unfortunately, the practice is deemed unsafe especially during the first trimester when the risk of complication and miscarriage is at its greatest. There are remedies for constipation: Drink 8 to 10 glasses of water daily. We acknowledge we have not compared enema administration in women with and without constipation during pregnancy as all women in our 5 days ago · You should avoid enema during pregnancy, and instead, deal with your constipation naturally. Oct 12, 2021 · Pregnancy constipation relief: Ways to feel better. The changes can happen as early as the second or third month of your first trimester. You do not have a bowel movement by the 3rd day after having your baby. While occasional constipation is common in pregnancy, talk with Enemas can be used to treat constipation during pregnancy Pregnancy is a time of great change, and constipation is a common issue that can leave you feeling heavy and uncomfortable. Everything I’m seeing on Dr. Causes of constipation in adults Mar 31, 2010 · In the third semester of pregnancy, the size of baby increase and puts pressure on the intestines of mother that lead to slowing down the movement of the mother's bowel muscles. Severe rectal pain. 9% in those using the Rome criteria The answer isn’t a simple yes or no. Using simply purified water and a gravity flow, enemas can safely provide constipation and bloating relief during pregnancy. Keep reading to learn about the types of enema, their purpose, how they are performed, benefits There seems to be a number of contributing factors that lead to constipation during pregnancy and these include: The Progesterone hormone plays a role in softening the ligaments in preparation for childbirth. Prenatal iron and vitamins may also be constipating for some women. Jan 25, 2018 · A slower digestive system during the second trimester can lead to gas buildup that causes: belly pain. Comments: -It is unknown if this drug can cause fetal harm when given to a pregnant woman. Drink at least 8 glasses of water or other Jun 16, 2009 · It avoids strong contractions and cramps associated with other enema (castor oil and soap water enemas). g. We are pro-choice, pro-LGBTQIA, pro-science, proudly feminist and believe that Black Lives Matter. Constipation may cause pain and other health problems in pregnancy such as cramps, hemorrhoids, and breakdown of the anal tissue. The pressure of the growing uterus can also contribute to the problem. Nov 3, 2023 · That is why it is better to prevent possible embarrassment during childbirth - to make an enema. It is important to rule out other medical conditions which may be causing constipation during pregnancy. 10. While REs have been used during labor for a long time, their use is not Mar 14, 2022 · What causes constipation after a c-section or vaginal birth? Taking systemic narcotics (such as morphine, Vicodin, or Percocet) during labor or for postpartum pain because these can slow down your digestive system. This can be true actually, but doing a regular number two does the same thing. Some research also explains that constipation may be tied to sex hormones seen during early pregnancy. Constipation may occur de novo during pregnancy, or chronic constipation may increase in severity during pregnancy. Although few of the various types of Moderate to severe constipation, or constipation that does not respond to self-treatment with simple bulking agents that provide fiber; Constipation that is accompanied by rectal bleeding, abdominal pain and cramps, nausea and vomiting, or involuntary weight loss; Constipation during pregnancy or while breastfeeding. Enema helps to get rid of harmful micro flora and toxins. Understanding Enemas and Pregnancy. During pregnancy, constipation is a common issue due to hormonal changes and pressure on the intestines. Tips. This drug should not be used during pregnancy unless the benefit outweighs the risk to the fetus. For the management of constipation during breastfeeding: Welcome to r/pregnant!This is a space for everyone. It works by drawing water in the large intestine and causes a bowel movement within 5 minutes of administering it. If none of these products work, a stronger medicine might be considered. Water- or oil-based solutions are injected into the bowel through your rectum to expel impacted waste. Fecal impaction is a complication of constipation that should be evaluated . While this can lead to constipation in some people, others may experience diarrhea. Probiotics that alter the colonic flora might also improve bowel function. You can say the same thing about pregnancy during the third trimester as an enema may induce premature labour. An enema can help relieve constipation by softening the stool and facilitating its passage. Enemas are used to relieve constipation and cleanse the colon. Your doctor may recommend an enema for therapeutic or diagnostic purposes. 6%, in studies using self‐reported measures of constipation, and between 2. [3] constipation during pregnancy can reach more than 50%, which is the second only to nausea during pregnancy and is one of the most com-mon gastrointestinal dysfunctions [4]. Oct 20, 2023 · Enemas involve the insertion of a solution into the rectum to stimulate bowel movements and relieve constipation. Treat constipation with nutrition and movement as follows: Fiber intake: High-fiber foods are rich in whole grains, legumes, seeds, nuts, fruits, and vegetables. Severe stomach pain. Mechanically – the uterus puts pressure on the bowels. Generally, non-pharmacological interventions (changes in diet, water intake and Get moving: “Regular exercise during pregnancy has lots of important benefits, including helping to relieve constipation,” Dr. Even a brisk walk can help. 2,5,6 In general, there are insufficient data on the use of laxatives in pregnancy; however, limited studies have been MiraLax is safe. During pregnancy, constipation is a common issue due to hormonal changes and increased pressure on the intestines. Feb 20, 2024 · Dehydration. 7% [5]. Haemorrhoids, pain at the episiotomy site, effects of pregnancy hormones and hematinics used in pregnancy can increase the risk of postpartum constipation. Unfortunately, there are many side effects that can be experienced after using a fleet enema during pregnancy such as, rectal bleeding, shortness of breath, nausea and vomiting, loss of appetite Mar 19, 2024 · Some foods tend to make more gas, such as broccoli, Brussel sprouts, cabbage, and beans. Dec 12, 2007 · On some occasions pregnant women will require colonoscopic evaluation and the clinician will be faced with a decision on what type of bowel preparation to use for flexible sigmoidoscopy or colonoscopy. They are a life saver and safe to use during pregnancy. If you experience constipation whilst taking iron supplements, talk to your doctor to see if you can Hormonal changes occur during pregnancy which may cause constipation (difficulty in having bowel movements). Sometimes changing the medication or formulation may reduce constipation. 5. Home remedies, such as drinking enough water and getting enough physical activity or exercise, may help relieve May 28, 2022 · Stool softeners are generally considered safe during pregnancy. Tap Water Enema: It is an injection of tap water into the rectum. Changes in movement, dietary intake, nausea and vomiting. Squeeze from the bottom to the top and empty the container. Castor Oil or other mineral based oils are not safe to take during pregnancy and should be avoided. m helped enema just got me by. Nov 6, 2018 · Follow these steps to make a soap suds enema: 1. , 2015). Most common digestive problems are short term and easy to control with lifestyle changes and sometimes medication. This occurs for basically three reasons: Iron – in the prenatal vitamins. Read more about constipation in pregnancy. Assess for laxative abuse or enema use. Pregnant women can further promote regular bowel movements by staying hydrated, consuming a fiber-rich diet, exercising regularly, and practicing good bowel habits. Good sources of fiber include: Check the labels on packaged foods and choose higher-fiber May 23, 2012 · Enema During Pregnancy. For trusted, in-depth advice from ob-gyns, turn to Your Pregnancy and Childbirth: Month to Month. wb oj um hh fl hk bf dv az pz