High-risk pregnancy doctor Shilpi Mehta-Lee joins WIRED to answer the internet's burning questions about pregnancy. Do babies cry in the womb? How do ultrasounds work? What is Vanishing Twin Syndrome? Is it okay to exercise during pregnancy? Answers to these questions and many more await on Pregnancy Support.Shilpi Mehta-Lee is site Director, Division of Maternal Fetal Medicine, NYU Langone Hospital—Brooklyn.Director: Anna O'DonohueDirector of Photography: Charlie JordanEditor: Richard TrammellExpert: Dr. Shilpi Mehta-LeeLine Producer: Joseph BuscemiAssociate Producer: Jasmine Breinburg; Paul Gulyas; Brandon WhiteProduction Manager: Peter BrunetteCasting Producer: Nicole FordCamera Operator: Christopher EustacheSound Mixer: Sean PaulsenProduction Assistant: Ryan CoppolaPost Production Supervisor: Christian OlguinPost Production Coordinator: Ian BryantSupervising Editor: Doug LarsenAdditional Editor: Paul TaelAssistant Editor: Justin Symonds
Category
🤖
TechTranscript
00:00I'm Shilpi Medeli and I'm a high-risk pregnancy doctor.
00:03I'm here today to answer your questions from the internet.
00:06This is Pregnancy Support.
00:07King Aniola asks,
00:13apparently I can up my chances of having twins
00:16if I eat loads of yams.
00:17Please confirm.
00:18It turns out probably not.
00:20Where this comes from is the Yoruba people of Nigeria
00:24have a specific yam that has a lot of estrogen-like
00:27chemicals in it.
00:28And that area of the world
00:30has a really high incidence of twinning.
00:32And it's thought that perhaps this particular white yam
00:35cause twinning to be increased in that patient population.
00:39Whether you eat yams from your local grocery store
00:43and that causes twinning is yet to be determined.
00:46At Ali Barrington asks,
00:47did you know they had pregnancy tests
00:49in ancient Egyptian society?
00:51This stuff is so damn cool.
00:52Yes, in fact, they did have pregnancy tests
00:55in ancient Egyptian society.
00:57Women would urinate on these two bags of grain,
01:01barley and wheat that were responsive to estrogen.
01:04And if those grains sprouted,
01:07it meant that the mother was pregnant.
01:08It's thought to have been about 70 to 80% accurate
01:11at detecting pregnancy, which is really quite amazing.
01:15Now we have a filtration type of lab
01:17that you can do literally at home.
01:19You pee on a stick, the beta HCG,
01:22the human chorionic gonadotropin that is formulated
01:25when the embryo is forming in your uterus
01:28is excreted really early on.
01:30So probably not the first two to three days after
01:34you conceive, but pretty much right after that.
01:37And when you have high levels of HCG
01:39as it's filtering through that stick,
01:42if there's a positive result, you'll see two lines
01:45because the HCG will bind to one of the lines.
01:48If it's a negative result, you'll only see one line
01:51because it's just the control.
01:52At K Cinema asks, how the hell does an ultrasound work?
01:56It's like a hack where they see right through you.
01:58It kind of is a hack where we do see right through you.
02:00This all started in the time of World War I
02:03and World War II where you were using sound waves
02:05through water to detect a submarine.
02:07They recognized that there was a medical application
02:10to this where you could use sound waves
02:12to hit the fetal skin and walls
02:15and really create an image on a computer screen.
02:18This is a two-dimensional image.
02:19The probe is coming through the maternal skin
02:21from about here and reflecting sound waves
02:24through the amniotic fluid back onto the probe
02:27in order to create a computer generated
02:30two-dimensional image.
02:31More recently, there's been a development
02:33of three-dimensional fetal imaging
02:35that still uses that same sound wave technology
02:38to create a three-dimensional image of your fetus.
02:40Now on these 3D images,
02:42you can see more lifelike fetal images,
02:44but we don't use them so much
02:46in diagnosing medical problems.
02:48We really still rely very heavily
02:50on those two-dimensional images to diagnose fetal issues.
02:53At ToeDevB asks,
02:55is it okay to exercise during pregnancy?
02:58Regular and routine exercise in pregnancy
03:00is completely safe.
03:01The fetus is in a pool of amniotic fluid.
03:04It's always moving.
03:05It's in a constant state of sort of anti-gravity.
03:07So we don't really think that it feels
03:09the jostling of movement up and down
03:12when you go for a 5K run or any sort of run.
03:15At Simply Tootsie asks,
03:17why TF when you pregnant?
03:19Everything smells so effing weird.
03:21All of my patients say, I can smell so much more.
03:24It smells different.
03:25It smells funny.
03:26There is an evolutionary theory about this.
03:29It may help you to prevent eating something
03:32that's toxic to either yourself
03:34or the pregnancy during that time.
03:36At HoneyMW asks,
03:37what is vanishing twin syndrome and what are the causes?
03:40This is the uterus and there is a fetus here
03:43and this is one gestational sac
03:45and then there's a second empty gestational sac.
03:48And what that means is this pregnancy
03:50most likely formed two embryos,
03:53but only one made it to the stage
03:55where you can see a small embryo and a heartbeat.
03:58And that's called a vanishing twin.
04:00That twin vanished.
04:01The other twin will go on to form a totally normal embryo.
04:05A vanishing twin in the first trimester
04:07is not considered to be a dangerous outcome
04:10that causes an adverse pregnancy outcome.
04:12A lot of times when a twin gestation forms,
04:1620 or 30% of the time, there's a vanishing twin.
04:18It's thought to be the main driver of this test
04:20that we now do on most pregnant women
04:23called non-invasive prenatal testing,
04:25being falsely positive.
04:27Every once in a while, when we do that test
04:30and we sequence that DNA,
04:31there's an extra chromosome 21, 13, or 18
04:35or a change in the sex chromosome material.
04:38That's thought to be because in vanishing twin syndrome,
04:41the DNA may still be floating around
04:43in the maternal bloodstream
04:45and cause a false positive result
04:47if that vanished twin was actually abnormal.
04:51At Blue Neptune asks,
04:52do you think babies can taste in the womb?
04:54Like damn, that is eating spaghetti again.
04:57Actually, flavor molecules can pass
05:00from the maternal bloodstream through the placenta
05:02and into the amniotic cavity.
05:04It's possible that there are flavor molecules
05:07passing into the fetal mouth and through the nose
05:10so that they can smell and taste what the mom eats.
05:14Infants do gravitate towards similar food choices
05:17as their moms do.
05:18So it's possible that that flavor conditioning
05:21and flavor imprinting happens in utero
05:24rather than just after they're born.
05:26At me so pissed asks,
05:28how the am I supposed to know if I'm going into labor
05:31when I've never been in labor before?
05:33This is a tough question because it's true.
05:35The vast majority of first time moms
05:37don't really know what labor feels like.
05:39There's one really great rule of thumb
05:41in explaining how a patient can know
05:43that they're in labor.
05:44We use the 5-1-1 rule.
05:46That's where a patient feels cramping and contractions
05:49and pain in their abdomen and in through their pelvis
05:52every five minutes.
05:53And that pain lasts approximately one minute
05:55and it lasts for over an hour.
05:57And if it's happening and you have an hour of contractions,
06:00you might wanna head to the hospital
06:01or at least call your doctor.
06:03Mind tracked asks, wait, do babies cry in the womb?
06:06The amniotic fluid that is in the mother's uterus
06:08makes it so that babies can't make really any sound.
06:11But there are some studies to show
06:13that perhaps at 28 weeks,
06:16babies can start doing practice grimacing in the womb.
06:20When we're performing ultrasound,
06:21we actually look for different kinds of practice movements.
06:24So we're looking for practice breathing,
06:26which is where the diaphragm goes up and down.
06:28And you might be able to see fluid
06:30coming in and out of the nostrils,
06:32but we don't usually look for practice crying.
06:34At VHUSEN says, cryptic pregnancy will always shock me.
06:38Because what do you mean you had cramps
06:40and the next thing you were giving birth?
06:42A cryptic pregnancy is where you don't know you're pregnant
06:44until the end of the pregnancy or the third trimester.
06:47Cryptic pregnancy probably happens about one in 500 times.
06:50We think that it most likely happens
06:52for one of two sets of reasons.
06:54One, there was some irregularity in your periods
06:57or you were breastfeeding so that you didn't get periods
07:00or you had bleeding in the early part of your pregnancy
07:03so you didn't know you were missing a period.
07:05And the other part of cryptic pregnancy
07:06probably has to do with mental health.
07:08Patients who didn't recognize they were pregnant
07:10due to mental health condition.
07:12At Ali Kato asks, are you telling me
07:15that the easiest way to avoid cleaning cat litter
07:17is to be pregnant?
07:18We really do advise women
07:20not to change cat litter in pregnancy.
07:22That's because some cats carry a parasite
07:24called toxoplasmosis and it can cause birth defects.
07:28Toxoplasmosis isn't only found in the cat litter.
07:30It can be found in the ground and in undercooked foods.
07:33In other countries, like in Europe, specifically France,
07:36there can be a higher level of exposure to toxoplasmosis
07:39because of undercooked meats and cheeses
07:41and things that may expose patients to parasites.
07:44They actually test for it.
07:45In the United States, it's less ubiquitous
07:48and we don't find that there's a need to test for it.
07:50At Finsfan SG says, at how many weeks
07:53do you think a fetus becomes viable?
07:56The early third trimester, probably at about 24 weeks.
08:00That's when a fetus can survive outside of the uterus.
08:03That may change with advances in neonatology
08:07and in technologies that can help
08:07earlier and earlier fetuses survive.
08:10At Kofi 99 asks, babies can poo inside the womb?
08:14Yes, babies can poo inside the womb.
08:17We call it meconium.
08:19Meconium is really a natural by-product
08:21of swallowing the skin cells and the hair cells
08:24and the amniotic fluid all the way through
08:26the first, second and third trimesters of pregnancy.
08:29This happens about 13% of the time
08:32and we can see that greenish tinge
08:34to the amniotic fluid at birth.
08:37It can be important in the neonatal period
08:39because an increase in meconium
08:41can sometimes make it more difficult
08:43for babies to breathe once they're born.
08:45At Trash Netflix says, how does plan B work?
08:48It basically delays ovulation for about 72 hours.
08:51In a normal pregnancy, we wanna ovulate from our ovary
08:55and that egg comes into the tube
08:57and that's where it meets the sperm,
08:58either in the tube or in the uterus.
09:01What plan B does is it basically prevents ovulation
09:04so that there is no egg to meet the sperm during this time,
09:08which means you can't conceive
09:10during the most important 72 hours after sex.
09:13At Janelle Angeli asks, why does no one talk about
09:16how terrible the first trimester is?
09:18In the first trimester of pregnancy,
09:19a lot of things are happening.
09:21Your body is changing so much.
09:23You're getting all that progesterone,
09:24all that estrogen into your bloodstream.
09:26The embryo is growing from a really small size.
09:29The vast majority of the fetal organs are forming.
09:32Up to about 12 weeks of pregnancy,
09:34you're seeing bone and skin and heart structures.
09:38And so organogenesis, that early part of the pregnancy
09:41is super, super important.
09:42And it probably does make you feel a little terrible.
09:45Atkinsetsu6 asks, what happens in the second trimester?
09:48There's continued formation of the organs
09:50through the second trimester.
09:52That's when neurodevelopment begins,
09:53when the brain starts developing.
09:55There's also development of teeth and other organs.
09:57This is probably about a late second trimester fetus.
10:01It's no longer the size of a small embryo.
10:03It's really growing up to about
10:05the mother's belly button or beyond.
10:07Also, in the second trimester,
10:09people start to feel a little bit better about the pregnancy.
10:12They're not feeling that surge of hormones.
10:14They've sort of acclimated to that surge.
10:16It's kind of called the golden trimester
10:18because people feel less nauseated,
10:19they have more energy, and they're less fatigued.
10:21AtKBarnesia says, last trimester of pregnancy,
10:25zero out of 10 do not recommend.
10:28The third trimester of pregnancy,
10:29somewhere around 25 to 28 weeks,
10:31going all the way to when you deliver.
10:33Can be really difficult.
10:34The fetus is growing about a half a pound a week.
10:37Your uterus is coming up to your diaphragm.
10:39The uterus is pretty large, like the size of a watermelon.
10:42The uterine walls are really thinned out.
10:44You're feeling heavier, you're feeling more tired.
10:47This is when all your organs are being sort of pushed
10:50in different directions.
10:51You might notice a difference in how you walk and move
10:54because there's a change in the curvature of your spine.
10:56There is a lot of fetal development
10:58happening in the third trimester.
11:00There's vision developing, there's taste buds developing.
11:03Most importantly, at the very tail end
11:05of the third trimester,
11:06you're gonna get fetal lung maturity.
11:08After the baby's born,
11:09they have to be able to take that first breath
11:11and use those lungs.
11:13So the third trimester is really,
11:14really important for that time.
11:16AtBreeDP says, why do so many people get pregnant
11:19with quadruplets?
11:21Eh, I don't really think it's true,
11:23but there is a lot of media attention
11:25on higher order multiples,
11:27multiples that are more than twins.
11:29And that's usually more common
11:30using assisted reproductive technology.
11:33Current technologies really try to avoid
11:35more than two fetuses in the uterus.
11:38When you use in vitro fertilization or IVF,
11:41you might get pregnant with one, maybe two fetuses.
11:44But if you use different types
11:47of assisted reproductive technology
11:49that make your ovaries excrete more eggs,
11:52you might get pregnant with triplets or quadruplets.
11:56And we really, really, really try to avoid that
11:58because it's not that safe
11:59for either the fetuses or the mother.
12:01Before IVF, the most common reason
12:04was kind of an error in ovulation.
12:06You released two eggs at the time you conceived
12:09and you created twins.
12:10So it was more common in older patients,
12:14in patients nearing menopause, to have twins.
12:17Atmanji asks, the mortality rate with black women
12:19during pregnancy and delivery
12:21is way higher than any other race.
12:23That's true.
12:24Black women have higher risks of maternal morbidity
12:26and mortality in pregnancy
12:28as compared to their white and Hispanic counterparts.
12:31We're still working on why that is and what the reasons are.
12:34One is possibly just structural racism
12:37within the health community
12:39and the ways we learn about health and healthcare.
12:42Other things include this idea of weathering,
12:45where if you face racism every day,
12:48you actually may have worse health outcomes.
12:50Atcashmadonna asks, do the second pregnancy
12:53make you show faster or something?
12:55There is some plausibility to this.
12:57When you're pregnant the first time,
12:59your muscles haven't spread.
13:00There hasn't been that diastasis of the muscles
13:03in the front of the abdomen yet.
13:04But in the second pregnancy,
13:06all of that musculature is already sort of stretched
13:08and moved.
13:09And so that growing uterus shows more quickly
13:12because there isn't as much of a force downward
13:15as there would be in the first pregnancy.
13:17Atneomanco asks, guys, is there a difference
13:20between termination of pregnancy and abortion?
13:22Yes, there is a slight difference
13:24between termination of pregnancy and abortion.
13:27Abortion can be either spontaneous,
13:29which means you miscarry,
13:30or it can be a termination of pregnancy
13:33where you elect to terminate
13:35because there's an abnormality
13:37or for any number of family reasons.
13:39Atdylene asks, as I keep getting further along
13:43in this pregnancy, all I want is junk food.
13:45That is so off brand for me.
13:47I'm a healthy girl.
13:48In the beginning of pregnancy,
13:49a lot of women do just eat crackers
13:51because they're feeling so nauseated.
13:53During that early part of pregnancy,
13:55fetuses are very parasitic.
13:56They're gonna take all the nutrients they need
13:59from the female body,
14:00and they're gonna use it to create this embryo
14:02and this fetus.
14:03What's really, really, really important in pregnancy
14:06is to eat a healthy and well-balanced nutritious diet.
14:08Nutrient-dense foods, so whole grains,
14:11green leafy vegetables, things that have protein,
14:14omega-3 fatty acids, anything that has vitamins.
14:18As a mom, you're expanding your blood volume,
14:20but also the fetus is actually making
14:22its own new blood cells.
14:24It needs the components to do so, right?
14:26And so do you.
14:27You need iron, you need B12, you need folic acid.
14:30At Rufus J. Bacon asks, what is a pregnancy glow?
14:34I, for one, have never seen a pregnant person glow.
14:37There is sort of a pregnancy glow.
14:39It's one of just those biological things that's happening
14:42as you're getting pregnant and being pregnant.
14:44Your skin might get a little oilier.
14:45Your face might get a little rounder
14:47as you increase the fat content of your subcutaneous tissue.
14:51You also notice, many times, stronger nails,
14:54thicker hair, fuller hair,
14:56because you're not losing hair as much during pregnancy.
14:58At TheRealRambo951 asks, what happens to the baby
15:02if you smoke while pregnant?
15:04Babies can be smaller than they would be expected to be.
15:06That's called small for gestational age,
15:08babies that don't weigh quite as much
15:10as they should at birth.
15:11There are also a host of other adverse outcomes
15:13that we think are associated
15:14with tobacco smoke during pregnancy.
15:16Increased risk of abruption,
15:17that's where the placenta separates from the uterine wall
15:20before it's time to deliver,
15:22and can cause significant bleeding behind the placenta
15:25and even fetal loss, so it's really important
15:28to consider quitting smoking during pregnancy.
15:30At JacobSCTG asks, like, have you seen what happens
15:34to your stomach on the inside as a baby grows?
15:36Where do your organs shift and move?
15:38In the very beginning of pregnancy,
15:40your uterus is really, really small.
15:42It's just sort of sitting in the lower pelvis.
15:44It's only about the size of a lemon,
15:46but as the uterus grows,
15:47it's growing up to your belly button or even higher.
15:51There are a lot of effects on all of your organs.
15:53Most of the early effects are from progesterone.
15:55So progesterone is a hormone that's secreted
15:57by the placenta into the maternal bloodstream.
16:00It sort of laxens all of the cartilage
16:02and those ligaments that are all over your body,
16:05and it makes things looser.
16:06It makes us able to adapt.
16:07Your intestines, which are really just flexible
16:10and no problem, really, they can just move aside
16:13and push to the sides, but over time,
16:15in the third trimester, really late,
16:17you might see that the pregnancy's really coming up
16:19into your diaphragm.
16:20You might even feel a little short of breath
16:22as the liver and the lungs are pushed upward.
16:24It's not an instant, quick change
16:27back to its normal shape and size.
16:29At the end of the pregnancy,
16:31women leave the hospital really feeling
16:33like they still look pregnant.
16:34The uterus looks about 20 weeks pregnant,
16:36and as it shrinks down, all those organs shift and go down.
16:39At Mama Moxie B asks,
16:41I really need answers as to WTF preeclampsia is,
16:45definitively, preeclampsia is where you have
16:47an abnormal rise in your blood pressure
16:49at the end of pregnancy,
16:51and most likely, it's happening
16:53because you are having all of these cytokines
16:57and inflammatory markers increasing disproportionately
17:00at the end of pregnancy, causing your body to react,
17:03almost like it's an autoimmune response.
17:05Preeclampsia is basically caused by endothelial damage,
17:10damage to the vascular system,
17:12and you can see signs of preeclampsia
17:15with platelets dropping, with your liver enzymes going up,
17:18people can develop headaches.
17:20People ask if preeclampsia is on the rise,
17:22and it turns out that probably preeclampsia
17:25is somewhat on the rise.
17:26There's just more recognition
17:29of hypertensive disorders of pregnancy,
17:31patients getting pregnant later in life
17:33or using assisted reproductive technology to get pregnant.
17:36There's also more obesity,
17:38which we think is a risk factor
17:39for developing preeclampsia.
17:41There's ongoing research to sort of describe
17:43how and why preeclampsia happens in certain patients
17:47and not in others.
17:48At LSNXXXX asks,
17:52okay, but like, is pregnancy brain real?
17:54Because during my pregnancy, I swear I felt illiterate.
17:57There is like 15 to 40 times more progesterone
18:01floating around in your body,
18:02and it does change your brain and the way you think.
18:05And by the time the woman delivers,
18:07there are these huge surges in oxytocin,
18:09which can really change the way you're thinking
18:12because oxytocin is a pleasure hormone.
18:14It's really, really possible
18:15that as we focus more on our pregnancy,
18:18some of the other extraneous stuff
18:20that we used to have at top of mind no longer is.
18:23Now, what's more important
18:25is what we're carrying in the uterus.
18:26And so there are pregnancy changes.
18:29At Deltrick asks,
18:30why do babies in the womb kick when they hear certain music?
18:33Surely they can't have that much experience
18:35being not born yet.
18:36Later in pregnancy, probably around 28 weeks,
18:39the fetal auditory system really starts forming.
18:42So they can start to hear.
18:43They can hear music, maternal organ movement.
18:46And there are some studies to suggest
18:49that auditory stimuli can make your baby move
18:52or kick in a different way,
18:53and that there may be some recognition
18:55of even the maternal voice or the paternal voice
18:58after birth.
18:59At Alevo22 underscore VO asks,
19:02why do you think it's important
19:03for women to take prenatal vitamins when pregnant?
19:06Every pregnancy really should have a prenatal vitamin.
19:10We recommend them not just during pregnancy,
19:12but in the three months before you conceive.
19:14You need to be storing all these vitamins early
19:17in order to form the best and the healthiest fetus
19:19and to keep yourself healthy.
19:21If you don't have enough folic acid in your bloodstream,
19:23you're at higher risk
19:25for developing neural tube complications,
19:27complications with your brain and the spine of the fetus.
19:30At Siri Low asks,
19:32us being pregnant, an excuse to eat more,
19:34or do pregnant women really need to eat for two?
19:36You don't need to eat for two during pregnancy.
19:39What we really want is to see
19:41maybe a slight increase in caloric intake,
19:43but not that much.
19:44The fetus is gonna develop and grow as it normally would
19:48if you just eat your normal healthy diet.
19:50At Dong Dang Sig asks,
19:52three months pregnant and I don't see any baby bump yet.
19:56Is that normal?
19:57It's pretty common not to see a bump
19:59because the pregnancy is really only to about this level
20:03in your pelvis.
20:04Some women show really early,
20:05especially patients in their second pregnancy
20:08can really show even at three months pregnancy,
20:11but others won't show that early.
20:13At Tayfeg asks,
20:15the only thing I've been missing
20:16this whole pregnancy is sushi.
20:18Your obstetrician or your provider
20:20is not gonna want you to eat sushi during pregnancy.
20:23It's because it's undercooked
20:24and you have a higher risk of being exposed
20:27to things that aren't safe for the pregnancy
20:29like listeria or parasites.
20:31There are some forms of sushi
20:33that you probably can eat.
20:34Vegetarian sushi, eel, those are cooked.
20:37So if you're really missing sushi,
20:39you could try those things.
20:40At Moons Young asks,
20:42does pregnancy change your voice?
20:44The short answer to that is probably yes.
20:45Pregnancy does change your voice.
20:47There is a change in sort of that nasal congestion
20:50during pregnancy as all the blood vessels
20:52come to the surface.
20:53Your nose can kind of feel stuffy
20:55and make your voice sound different.
20:57But there's also probably some voice box changes
20:59happening as that progesterone and estrogen
21:02is increasing in your bloodstream.
21:04At You Addicted To Me says,
21:05nobody talks about how your teeth shift so bad
21:08during and after pregnancy enough.
21:10As the early part of pregnancy has a lot of progesterone,
21:13there's a change in your gums
21:15and your teeth can move and shift during pregnancy.
21:18It's not uncommon.
21:20And maybe we don't talk about it enough.
21:21The one thing that a lot of patients notice
21:24is that when they brush their teeth,
21:25they see a little bit of extra gum bleeding.
21:28That's completely normal in pregnancy.
21:30At Cake Here asks, I don't know why,
21:32but I love that little dark line
21:34that bee on pregnant bellies.
21:36That little dark line is called a linea nigra.
21:39And it's essentially where the two parts of your abdomen
21:42came together when you were in your own mother's uterus.
21:45During pregnancy, all the hormones can make it
21:47so that melanocytes come to the surface,
21:50not only in that linea nigra,
21:52but you can notice darker areas in your skin,
21:54on your face and other places.
21:56At Lin Dan Bui asks, I was today years old
22:00when I learned about fetal microchimerism.
22:02As a mother, I'm simultaneously awed, happy, and terrified.
22:06Fetal microchimerism is where there are fetal DNA
22:09or particles in the maternal bloodstream.
22:12The mother, after she has the fetus,
22:14can have those cells and that DNA
22:17in her maternal bloodstream forever.
22:19When a woman is donating organs to somebody
22:23that she's a genetic match for,
22:25fetal microchimerism can make that match
22:27a little bit more tenuous
22:28because she's got some DNA from her fetuses
22:32in her bloodstream, so she may not be an exact match.
22:35So those are all the questions for today.
22:37Thanks for asking such fun and interesting questions.
22:40And thanks for watching Pregnancy Support.