Q. When will our baby start moving in the womb? When should I feel it?

The little kicks you will probably begin to feel after 16 to 20 weeks of pregnancy, referred to as "quickening," are not the first movements, just the first ones you can feel. The uterus, like most internal organs, is insensitive to touch, but when your baby's movements are strong enough to stretch the wall of the uterus, the feeling is picked up by the abdominal wall. By ten weeks, ultrasound reveals a world of smooth (not reflexive), voluntary activity including hand and face contacts, stretches and yawns, jaw opening and tongue movements. By fifteen weeks, the entire repertoire of movement may be complete. Exercise continues for minutes at a time, followed by rest periods. A baby's activity is very individualistic and may continue whether a mother is awake or asleep.

Q. How soon will our baby start hearing our voices or sounds in the room?

A study in Ireland, using ultrasound observation and measured pulses of sound revealed that babies with normal hearing start moving in reaction to sound around 16 weeks gestational age. This was earlier than previous estimates and occurs about two months before completion of the ear, suggesting that there is more to hearing than the ear alone. Babies seem especially interested in parental voices and begin learning the mother's native language (the mother tongue) while in the womb.

Q. Will the baby care about loud noises and music in our home?

Babies show that they can be shocked by big, unexpected sounds, although they tend to adapt to constant sounds in the environment. Studies show that music enters the womb with little distortion: A few indicate that babies prefer quiet, harmonious music. Loud music may produce strong kicks of protest. An earthquake sound in Italy left a group of unborn babies in a hyperactive state for several hours. Lullabies are always appropriate.

Q. When does a baby's brain develop, and do we have to wait for this development before trying to communicate with our baby?

Around the third week after conception, a folding maneuver creates the neural tube from which the brain and spinal cord develop. If all goes well, a rapid, richly choreographed set of movements will put all the basic parts of the brain in place by eight weeks. These will not be replaced. From this foundation, brain parts will send out branches and establish billions of connections necessary for the perfect coordination of the entire nervous system. This process will continue for years after birth. Amazingly, the brain, like the heart, remains active during its own construction. Various experiences the brain has during this period including encounters with food, drink, medicine, games, accidents, and nicotine--will actually determine its final size and organization. Therefore, it is best to assume the brain is already working and to love your baby and communicate with it without any waiting period.

Q. Can our baby feel pain or become emotionally upset in the womb?

Medical specialists and psychologists never thought this would be possible even for a newborn baby, but research now confirms that even babies born very prematurely express a gamut of emotions, and, without doubt, can experience excruciating pain. Ultrasound observations of behavior in utero, especially among twins, reveal a spectrum of emotions including anger, fear, and affection. Babies appear to react to needles that intrude into the womb with a mixture of shock, withdrawal, and aggression. Studies of pregnant mothers watching upsetting videos suggest that babies can become upset along with their mothers. Several studies have revealed that babies tend to become depressed when their pregnant mothers are depressed, an effect which begins in the womb and has been measured after birth.

Q. Is it okay to continue love-making during pregnancy? Will it affect the baby?

The few studies that have actually measured the reaction of prenates to parental intercourse during the third trimester show that babies are intensely involved. Babies react to maternal and paternal orgasms with wildly erratic and plunging heart rates: the fetus experiences bradycardia, tachycardia, accelerations and decelerations greater than 30 beats per minute, and, in some cases, loss of beat-to-beat variability. Ultrasound specialists see male erections before 16 weeks of age, an indicator of sexual feelings long before birth. In late pregnancy, when space is tight and baby senses are keen, intercourse may not be the best way to make love.

Q. We are planning to give up our baby for adoption. Is there a way to reduce the trauma for us and for our baby?

Adoption is a primal wound surrounding a profound fracture of expectations and attachments for both baby and parents. The key to reducing trauma is to adopt the unconventional attitude that the baby knows and feels everything: Use that attitude to communicate honestly your feelings and decisions, allowing no lapses of affection and always affirming the goodness of the child within. Give top priority to locating and engaging the same loving attention from the new parents before the time of birth so that the child has the seamless love of both parties. This is good for everyone involved.

Q. Does it do any good (or harm) to stimulate our baby with talking, singing, and other "games" before birth?

Every baby is stimulated by the natural environment of the womb while being carried about by a normally active, expressive mother. This means exposure to music, singing, voices, rhythmic dancing, exercise, bathing, touching, and all other activities. Harm is not likely unless experiences are taxing, jolting, or violent. Formal programs of prenatal enrichment which have been thoroughly tested in experimental and control groups confirm that prenates are alert, aware, socially oriented, and are learning from experience. Furthermore, test results seem to demonstrate that the extra stimulation has a positive influence on brain development.

Q. Will the baby know if we are not getting along as a couple?

Although it is a new point of view among experts, studies of prenatal sensation, perception, and attachment suggest that babies know and feel more than we ever thought possible. Communication, rather than being simply verbal, is a holistic experience including the ebb and flow of love hormones and stress-reactions. Prenates have their own emotional life and are capable of disappointment, depression, anger, and fear. It is probably naïve for parents to think they could keep their relationship a secret from a baby in the womb.

Q. How can I avoid having a low-weight, premature baby?

To avoid being part of the growing epidemic of low-weight, premature babies may call for both physical and psychological action. Pregnancy does mean eating for you and for a growing baby who needs proper supplies. Set aside whatever concerns you may have about staying skinny through pregnancy and follow the recommended diet of wholesome food, being sure to increase consumption of sea fish high in omega-3 fatty acids. Studies also find a correlation of maternal stress with premature birth. Premature labor can also be halted by judicious use of hypnosis. Obstetrician David Cheek, after a lifetime of experience with birth, concluded that the baby triggers premature labor when it is afraid. He found that if mothers would reassure the babies verbally that they were safe and should remain inside, the premature labor would stop.

Q. Can I safely continue a vigorous program of exercise during pregnancy? Is there a danger of harming the baby?

Guidelines of the American College of Obstetricians and Gynecologists suggest that exercise of moderate intensity is safe during uncomplicated pregnancy and when the maternal heart rate does not exceed 140 beats per minute for longer than 15 minutes. Your own changing weight and shape will probably lead you to more moderate forms of exercise as pregnancy progresses. The baby will be bouncing up and down along with you, and might not appreciate certain bumpy exercises. Walking, stretching (as in yoga), and swimming are often recommended.

Q. Is there any harm in modern obstetrical procedures like ultrasound, electronic fetal heart monitoring, and tests like amniocentesis?

Technology, which can often be put to good use, is not risk-free, and can definitely be overused. Ultrasound has been examined by various official bodies and pronounced safe when not used routinely. In a large study, women who had five ultrasounds during pregnancy produced lower weight babies than women who had only one ultrasound. In animal experiments, ultrasound has produced ominous effects, leading to caution in exposing humans. Fetal heart monitoring is a technology discredited by a series of large studies, but it continues to be used in obstetrics, probably for medico-legal reasons. The high risk of false positive readings has led to an inflated rate of cesarean deliveries. Amniocentesis carries an abortion rate of 1 to 3%, depending on when it is done, but is used to diagnose hereditary birth defects when there is some reason to expect them.

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