Pregnancy Calendar – Week Three

Although designated as “Week Three,” this is the week when ovulation and conception actually take place. Sometimes you hear that a woman “had a feeling” or “just knew” she was pregnant from the moment of conception. Usually this is not the case, but if you are expecting or hoping to get pregnant, every twinge you feel might make you think you are pregnant! You will not even have missed your period at this point, and most pregnancy tests advise that you wait until you are at least one day late before you take the test. A few pregnancy tests available online report accuracy six to eight days after conception.  But the earlier you test, the higher chance you have of a false negative (when the test says you are not pregnant but you really are pregnant), so you will probably want to wait until at least a few days after your late period.

Ovulation takes place around the beginning of this week. The average day for ovulation is day fourteen of the menstrual cycle, but the egg could be released between days twelve and eighteen. (For more information, see “Charting Ovulation.”) After conception, it takes up to one week for the fertilized egg to travel down the fallopian tube and reach the uterus. During this course, the rapidly dividing cells will still be as small as a grain of sand.

This is a good time to review some healthy habits to start or continue during pregnancy.  Eat a balanced diet, including prenatal vitamins with at least 400 micrograms of folic acid. Folic acid is essential in early pregnancy as it ensures against neural tube defects. (For more specific information, see “Top Nutrients for Healthy Mom and Baby.”) Drink plenty of water and other fluids to maintain adequate hydration. Wash your hands often to prevent common infections and avoid ingesting harmful substances such as tobacco, alcohol, lead, mercury (in large fish and tuna), and pesticides. Floss and brush regularly—at least twice a day. If you have an established an exercise program, you should continue exercising at a low to moderate level. If you are not in the habit of regular exercise, you can still start with low-impact exercise, such as walking or swimming. Starting these healthy steps now will help you as your pregnancy progresses.

Fast Fact: According to large blood-drawing surveys conducted by the Centers for Disease Control (CDC) between 1999 and 2004, there has been an 8 percent to 16 percent decline in folate levels in US women of childbearing age. 


Q&A: Sarah Maddison, MD an experienced obstetrician from Raleigh, North Carolina, answers our top questions regarding pregnancy.

Q: What is the best way to get enough folic acid?

A: Four hundred micrograms started a month or two before conception is the recommended amount. So many foods are fortified with folic acid that I would agree that we all probably consume at least this amount on a daily basis.

Prescription prenatal vitamins contain 1 milligram (or 1000 micrograms) of folic acid. The pharmaceutical companies show a further decrease in the incidence of spina bifida with the higher dose, but the change is almost minimal. I think they pick this dose, because you can’t sell 1 milligram over the counter; it requires a doctor’s prescription. Personally, I think this is solely for their profit margin, with little to no clinical benefit.

Patients are convinced a prescription means it’s better, but I am all for an over the counter prenatal multivitamin or generic.

If women have a personal or family history of spinal bifida, they should take a total of 4 milligrams a day. Women who are overweight or take seizure medications should take extra.


Eating For Two: Staying Hydrated

The amount of blood in your body needs to increase by about 40 percent during pregnancy to maintain the fluids for the baby as well as for your own system. Drinking lots of water and other liquids also helps prevent urinary-tract infections and constipation. You will need eight 8-ounce glasses of fluid a day to keep your body and your baby well hydrated. In addition to filtered tap water and plain bottled water, here are some other ideas: