Pregnancy and Postpartum: The Complete Guide

Key numbers at a glance

How pregnancy is counted and what each stage brings

Pregnancy is usually counted from the first day of your last menstrual period, not from conception, so by the time a period is missed you are already considered about 4 weeks pregnant. A typical pregnancy lasts about 40 weeks counted this way. Your care team will confirm or adjust your due date, often with an early ultrasound, and that date guides the timing of tests and vaccines throughout pregnancy. Only a small share of babies arrive exactly on their due date; birth anywhere in the weeks around it is normal.

Pregnancy is divided into three trimesters of roughly 13 to 14 weeks each. In the first trimester, from conception to about week 13, the baby's organs form, including the brain and spinal cord in the first month, often before a pregnancy is known. Many people feel tired and nauseated and need to urinate more often. In the second trimester, from about week 14 to week 27, energy often returns, the bump becomes visible and most people begin to feel the baby move. In the third trimester, from about week 28 until birth, the baby gains most of their weight, and backache, heartburn, swelling of the feet and poor sleep become common.

Knowing this timeline explains much of the advice in this guide. Folic acid matters most before you know you are pregnant, because the neural tube closes so early. Screening for gestational diabetes happens in the second trimester, when blood sugar problems usually appear. Vaccines such as Tdap and RSV are timed late in pregnancy so that the most antibodies pass to the baby before birth. And preeclampsia, a serious blood pressure disorder, usually starts after 20 weeks and can appear after delivery, which is why warning signs matter for a full year after birth.

Before pregnancy: planning and folic acid

The healthiest pregnancies often start before conception. A preconception visit with your doctor, nurse practitioner or midwife is a chance to review medicines, update vaccines, check blood pressure and blood sugar, and get chronic conditions such as diabetes, high blood pressure, thyroid disease, epilepsy or depression under good control. Some medicines are not safe in pregnancy, but stopping a needed medicine on your own can also cause harm, so the right move is to plan any change with your prescriber.

Folic acid, the synthetic form of the B vitamin folate, lowers the risk of neural tube defects, serious birth defects of the brain and spine that develop in the first few weeks after conception. The CDC recommends that anyone who could become pregnant take 400 mcg of folic acid every day, and the US Preventive Services Task Force recommends 400 to 800 mcg (0.4 to 0.8 mg) a day for those planning or capable of pregnancy. Start at least 1 month before pregnancy and continue through early pregnancy. In the US, enriched bread, pasta, rice, flour and many breakfast cereals are fortified with folic acid, but guidelines recommend a supplement as well, since food alone is not reliable enough during the most important window.

Some people need a different dose. If you have had a pregnancy affected by a neural tube defect, or you take medicines for seizures or other medicines that affect folate, your doctor may prescribe a higher amount. Check the label of any multivitamin or prenatal vitamin for the folic acid content, and add up the total if you take more than one supplement.

• Ask about vaccines you may need before pregnancy, especially MMR and chickenpox, which are live vaccines that cannot be given during pregnancy.
• Stop smoking, vaping, alcohol and recreational drugs, and ask for help if you find it hard; support is available and works.
• Aim for regular physical activity and a healthy eating pattern now, since habits are easier to keep than to start mid-pregnancy.
• Review your family health history and any genetic conditions with your provider, who can explain carrier screening options.

Prenatal care: the visit schedule and the tests

Prenatal care is a series of checkups with an obstetrician-gynecologist, family doctor, nurse practitioner or certified midwife that runs from early pregnancy until birth. Book your first visit as soon as you have a positive pregnancy test, ideally in the first trimester. Do not wait until you "feel pregnant." Regular visits let your team track your blood pressure, weight and urine, measure the baby's growth, and catch problems such as gestational diabetes or preeclampsia early, when they are easier to manage. High blood pressure and high blood sugar often cause no symptoms, which is why visits matter even when you feel well.

A typical schedule for an uncomplicated pregnancy is a visit about every 4 weeks up to 28 weeks, about every 2 weeks from 28 to 36 weeks, and weekly from 36 weeks until birth. People with health conditions, twins or other higher-risk pregnancies are often seen more often. Ask your team which schedule fits you, write questions down between visits, and bring a list of every medicine and supplement you take, including over-the-counter products.

Common tests and screenings

Early in pregnancy you will usually have blood tests for your blood type, anemia and immunity to some infections, along with screening for infections such as HIV, syphilis and hepatitis B that can be passed to the baby and can be treated or managed. You will be offered optional screening for chromosome conditions and an ultrasound to check the baby's anatomy, usually in the middle of pregnancy. Screening tests estimate risk; if a result is higher risk, your team will explain diagnostic tests and what the results would mean, and you decide which tests to have.

Later checks are timed to when problems tend to appear. Screening for gestational diabetes usually happens between 24 and 28 weeks, earlier if you have risk factors. A swab for group B strep, a common bacterium that can cause serious infection in newborns, is usually done at 36 to 37 weeks; if it is positive, antibiotics during labor protect the baby. Near the end of pregnancy, your provider will also check the baby's position and will discuss options if the baby is breech, or bottom-first.

Costs and coverage

Under the Affordable Care Act, Marketplace plans and most other health plans must cover maternity and newborn care. If cost or insurance is a barrier, ask about Medicaid, which covers prenatal care in every state for those who qualify, often with higher income limits for pregnant people than for other adults, and many states now extend postpartum Medicaid coverage to 12 months after birth. The birth of your baby qualifies you for a special enrollment period for Marketplace coverage, some states also allow enrollment when you become pregnant, and community health centers offer care on a sliding fee scale. The WIC program provides healthy foods, nutrition counseling and breastfeeding support to eligible pregnant and postpartum people and young children.

Eating well and keeping food safe

Pregnancy increases your need for several nutrients, including folate, iron, iodine, choline, calcium and protein, but it does not double your calorie needs. There are no extra calories needed in the first trimester, about 340 extra calories a day in the second trimester and about 450 in the third, according to the American College of Obstetricians and Gynecologists (ACOG). That is roughly a healthy snack or a small extra meal, not "eating for two." Build meals around vegetables, fruit, whole grains, beans, lean protein and dairy or fortified alternatives, and take a prenatal vitamin as your provider advises.

Fish is one of the best sources of omega-3 fats for the baby's brain and eye development, and the FDA advises eating 8 to 12 oz (about 225 to 340 g) a week from lower-mercury choices such as salmon, shrimp, pollock, cod, canned light tuna and sardines. Skip the high-mercury fish: shark, swordfish, king mackerel, marlin, orange roughy, bigeye tuna and tilefish from the Gulf of Mexico. ACOG advises keeping caffeine under 200 mg a day; count coffee, tea, soda and energy drinks together. There is no known safe amount of alcohol at any time in pregnancy, and no safe type.

Pregnancy changes the immune system, making some foodborne infections more likely and more serious. Listeria, for example, can cause miscarriage, stillbirth or severe infection in the newborn even when the pregnant person feels only mildly ill. Listeria can grow even at refrigerator temperatures, which is why ready-to-eat foods such as deli meats, soft cheeses and smoked seafood are the main concern, and why heating them until steaming hot makes them safer. That is why some foods are best avoided or cooked thoroughly during pregnancy.

• Choose pasteurized milk, juice and cheese only; check labels on soft cheeses such as queso fresco and brie.
• Heat deli meats and hot dogs to 165°F (74°C) or until steaming hot.
• Cook meat, poultry, seafood and eggs until fully done, using a food thermometer, and skip raw cookie dough.
• Avoid refrigerated smoked seafood and refrigerated pâté unless cooked in a dish, and raw sprouts such as alfalfa and mung bean.
• Wash fruit and vegetables under running water before eating or cutting them.
• Ask someone else to change the cat litter if you can, or wear gloves and wash your hands afterward, to lower the risk of toxoplasmosis.

Weight gain and staying active

How much weight you should gain depends on your body mass index (BMI) before pregnancy. Gaining much more or much less than the recommended range is linked to complications, including gestational diabetes, high blood pressure, a cesarean birth and a baby who is born small or large. Ask at your first visit what your target range is, and track your weight at prenatal visits rather than daily. Ranges for twins or more are different, so ask your care team. Dieting to lose weight during pregnancy is not recommended unless your team advises it, and comparing your gain with someone else's is not useful, because ranges depend on your starting point.

Physical activity is safe and helpful for most pregnant people. The Physical Activity Guidelines for Americans recommend about 150 minutes of moderate-intensity aerobic activity a week during pregnancy and after birth, such as brisk walking, swimming or a stationary bike, if your provider agrees. Activity is linked to a lower risk of gestational diabetes and excessive weight gain, and it can ease back pain, constipation and low mood. If you were active before pregnancy, you can usually continue with adjustments.

Some activities are best avoided: contact sports, activities with a high risk of falls such as downhill skiing or horseback riding, scuba diving, and exercise in very hot conditions. After the first trimester, avoid long periods lying flat on your back. Stop and call your provider if you have vaginal bleeding, leaking fluid, regular painful contractions, chest pain, dizziness or calf pain or swelling during exercise. People with certain conditions, such as some heart or lung diseases or a risk of preterm labor, may be advised to limit exercise.

• Underweight before pregnancy (BMI under 18.5): 28 to 40 lb (about 13 to 18 kg).
• Healthy weight (BMI 18.5 to 24.9): 25 to 35 lb (about 11 to 16 kg).
• Overweight (BMI 25 to 29.9): 15 to 25 lb (about 7 to 11 kg).
• Obesity (BMI 30 or higher): 11 to 20 lb (about 5 to 9 kg).

Medicines, substances and everyday exposures

Many medicines are safe in pregnancy, some need a change of dose or drug, and a few should be avoided. Check with your provider or pharmacist before starting any new medicine, supplement or herbal product, and do not stop a prescribed medicine on your own when you find out you are pregnant. Conditions such as depression, asthma, epilepsy and high blood pressure need continued treatment, because the illness itself can harm pregnancy. For pain or fever, ask your provider what to use; acetaminophen (Tylenol) is the option most often recommended when it is needed, at the lowest effective dose for the shortest time. NSAIDs such as ibuprofen and naproxen are generally avoided in the second half of pregnancy unless your doctor recommends them.

Smoking in pregnancy is linked to preterm birth, low birth weight, stillbirth and sudden infant death, and secondhand smoke is harmful too. E-cigarettes contain nicotine, which can harm the developing baby's brain and lungs. Cannabis is not considered safe in pregnancy or while breastfeeding. Alcohol can cause fetal alcohol spectrum disorders, which last a lifetime. If you use any of these, telling your provider is the first step to getting effective, nonjudgmental help; quitting at any point in pregnancy brings benefits.

If you use opioids, do not stop suddenly on your own, because withdrawal can be dangerous in pregnancy. Treatment with medicines for opioid use disorder is recommended in pregnancy, and your provider can connect you with care. The SAMHSA National Helpline (1-800-662-4357) is free, confidential and open 24 hours a day. At work and at home, tell your provider about exposure to chemicals, solvents, pesticides, lead or radiation so they can advise you.

Vaccines during pregnancy

Vaccines in pregnancy protect two people at once. They lower your own risk of serious illness, and the antibodies you make cross the placenta to protect your baby in the first months of life, when they are too young for some vaccines. Newborns are especially vulnerable to whooping cough (pertussis), flu and respiratory syncytial virus (RSV), all of which can lead to hospitalization.

Tdap, which protects against tetanus, diphtheria and whooping cough, is recommended during every pregnancy, ideally between 27 and 36 weeks, even if you had it before, because antibody levels fall over time. A flu shot is recommended in any trimester during flu season; pregnant people should get the shot, not the nasal spray. An RSV vaccine is recommended at 32 to 36 weeks for pregnancies in the RSV season, which usually means giving it September through January in most of the US. If you do not get the RSV vaccine, your baby can receive an RSV antibody shot instead; you do not usually need both. COVID-19 vaccine recommendations have changed in recent seasons, so ask your clinician or pharmacist about the current advice for pregnancy.

Live vaccines, such as MMR and chickenpox, are not given during pregnancy; if you are not immune, you will usually be offered them after the birth. Ask family members and caregivers who will be around the baby to be up to date on their vaccines too. Your clinician or pharmacist is a better guide to vaccine safety than social media, and they can explain the evidence behind each recommendation.

Conditions to watch for

Most pregnancies go smoothly, but a few conditions are common enough and serious enough that every pregnant person should know about them. Prenatal visits are designed to catch them early, often before symptoms appear. Knowing the basics of each helps you understand why your team asks certain questions or orders certain tests, makes it easier to spot symptoms that need a call between visits, and explains why some of these conditions matter for your long-term health after pregnancy.

Gestational diabetes

Gestational diabetes is high blood sugar that develops during pregnancy in someone who did not have diabetes before. Pregnancy hormones make the body less sensitive to insulin, and in some people the pancreas cannot keep up. Unmanaged, it raises the chance of a large baby, a cesarean birth, low blood sugar in the newborn and high blood pressure in pregnancy. Screening usually happens at 24 to 28 weeks.

Treatment starts with an eating plan that spreads carbohydrates through the day, regular activity if your provider agrees, and checking your blood sugar at home. The American Diabetes Association suggests targets in pregnancy of a fasting level under 95 mg/dL, and under 140 mg/dL one hour or under 120 mg/dL two hours after meals, unless your team sets others. If diet and activity are not enough, insulin or another medicine is added. The risk does not end at birth: about half of people with gestational diabetes go on to develop type 2 diabetes, according to the CDC, so a glucose test at 4 to 12 weeks after birth and diabetes screening at least every 3 years afterward are recommended.

Preeclampsia and high blood pressure

Preeclampsia is a serious blood pressure disorder that usually starts after 20 weeks of pregnancy and can affect the kidneys, liver, brain and the baby's growth. It can worsen quickly and lead to seizures (eclampsia), stroke or organ damage. In pregnancy, a blood pressure of 140/90 mm Hg or higher is considered high, and 160/110 mm Hg or higher needs urgent care. Preeclampsia can also appear in the days after delivery and up to about 6 weeks later, when people are no longer seeing their prenatal team.

If you are at high risk, for example because you had preeclampsia before or have chronic high blood pressure, diabetes or kidney disease, your clinician may recommend low-dose aspirin (81 mg) daily after 12 weeks; the US Preventive Services Task Force supports this for people at high risk. Do not start aspirin on your own. If you are given a home blood pressure monitor, use it as instructed, and tell anyone treating you in the year after birth that you were recently pregnant.

Other conditions

Severe nausea and vomiting that stops you keeping food or fluids down, called hyperemesis gravidarum, needs medical care, not just home remedies. Anemia is common and is usually treated with iron. Depression and anxiety can begin during pregnancy, not only after it. Preterm labor, before 37 weeks, can sometimes be slowed or its effects on the baby reduced if you get care quickly, so learn the signs listed in the next section.

Warning signs and when to get help

The CDC's Hear Her campaign lists urgent maternal warning signs that can signal a life-threatening problem during pregnancy and for up to a year after birth. Many pregnancy-related deaths in the US are considered preventable, and one common thread is that warning signs were dismissed, by the person themselves or by others, as normal discomforts. Trust yourself. If something feels wrong, call. When you seek care, say that you are pregnant or were pregnant within the last year, because that changes what doctors look for.

Some symptoms during pregnancy need a call the same day: vaginal bleeding, leaking fluid, regular tightening or contractions before 37 weeks, pelvic pressure, a change in vaginal discharge, burning when you urinate, or a baby who is moving less than usual. In early pregnancy, severe one-sided belly pain, shoulder-tip pain or fainting can signal an ectopic pregnancy, which is an emergency.

• A headache that will not go away or gets worse over time, or dizziness or fainting.
• Changes in your vision, such as blurring or seeing spots.
• A fever of 100.4°F (38°C) or higher.
• Extreme swelling of your hands or face.
• Trouble breathing, chest pain or a fast-beating heart.
• Severe nausea and vomiting, or severe belly pain that does not go away.
• Your baby's movement stopping or slowing during pregnancy.
• Vaginal bleeding or leaking fluid during pregnancy, or heavy bleeding or bad-smelling discharge after pregnancy.
• Swelling, redness or pain in a leg.
• Overwhelming tiredness, or thoughts of harming yourself or your baby.

Labor and birth

A pregnancy is considered full term from 39 weeks 0 days to 40 weeks 6 days. Babies born earlier, even at 37 or 38 weeks, may have more breathing and feeding problems, which is why ACOG advises against scheduling a birth before 39 weeks unless there is a medical reason. Labor usually begins with contractions that become regular, stronger and closer together, and sometimes with the waters breaking. Your provider will tell you when to call and when to come in; call right away if your waters break, you have bleeding, the baby is moving less, or you have any warning sign.

Talk through your preferences ahead of time, including pain relief options, who you want with you and how you hope to feed your baby, but hold them loosely, because births do not always follow a plan. Cesarean births are common in the US, sometimes planned and sometimes decided during labor for the safety of the parent or baby. Asking "why" and "what are the alternatives" is always appropriate.

Before you go home, a newborn usually receives vitamin K, eye ointment and screening tests for hearing, heart problems and a panel of rare but treatable conditions, and you will be asked about the hepatitis B vaccine. You will need a rear-facing car seat installed correctly for the trip home. Ask about the signs that should prompt a call to the baby's doctor, and book the baby's first checkup, usually within a few days of going home.

The fourth trimester: recovery, mood and feeding

The weeks and months after birth are sometimes called the fourth trimester, and they bring as many changes as pregnancy itself. Many serious pregnancy-related complications, including high blood pressure, infections, blood clots, heart problems and depression, happen after delivery. Yet this is often the time when parents get the least attention, because the focus shifts to the baby. Plan for recovery the way you plan for the birth: line up help with meals, chores and night feeds, and agree in advance who you will call if you are worried about your own health.

Postpartum checkups

ACOG recommends contact with your care team within the first 3 weeks after birth and a comprehensive postpartum visit no later than 12 weeks after birth. If you had high blood pressure in pregnancy, you may need a blood pressure check within days of going home. Book these appointments before you leave the hospital. The visits cover healing, bleeding, mood, sleep, feeding, contraception and birth spacing, and the follow-up of any condition that started in pregnancy. If you had gestational diabetes or preeclampsia, arrange ongoing care with a primary care doctor, since both raise your long-term risk of diabetes and heart disease.

Baby blues and postpartum depression

The "baby blues," with tearfulness, mood swings and feeling overwhelmed, are very common in the first days after birth and usually ease within about 2 weeks. Postpartum depression is different: it lasts longer, feels heavier and makes daily life hard. About 1 in 8 people who recently gave birth report symptoms, according to the CDC, and it can start during pregnancy or any time in the first year. Symptoms include persistent low mood or anxiety, trouble bonding, hopelessness, and being unable to sleep even when the baby sleeps.

Postpartum depression is common and treatable with talk therapy, medicines or both, and several medicines are considered compatible with breastfeeding. Screening is recommended at prenatal and postpartum visits and at the baby's well-child visits, so your obstetric provider, primary care doctor or pediatrician can all start the conversation. The National Maternal Mental Health Hotline, 1-833-TLC-MAMA (1-833-852-6262), offers free, confidential support by call or text, 24 hours a day. Asking for help is not failing as a parent.

Breastfeeding and feeding your baby

The American Academy of Pediatrics recommends exclusive breastfeeding for about the first 6 months, then continued breastfeeding alongside solid foods for 2 years or beyond, as long as parent and baby wish. Breastfeeding is linked to lower rates of infections and sudden infant death in babies, and to lower rates of breast and ovarian cancer and type 2 diabetes in parents. Newborns usually feed 8 to 12 times every 24 hours. Pain at every feed usually means the latch needs adjusting, so ask a nurse, a lactation consultant (IBCLC) or WIC breastfeeding staff for help early. Breastfed babies need 400 IU of vitamin D a day, starting soon after birth. Federal law requires most employers to provide break time and a private space, other than a bathroom, to pump. If you feed formula, by choice or necessity, your baby's doctor can help you prepare and use it safely.

A practical plan for pregnancy and the year after

Breaking pregnancy into stages makes it more manageable. Use the plan below as a checklist to discuss with your care team, who may adjust it for your health and history. Whatever stage you are at, keep a single place, such as a notebook or a note on your phone, for questions, blood pressure or blood sugar readings, and the names of your medicines.

When you talk to your care team, be direct about symptoms and worries, including mental health and substance use. If you feel you are not being heard, say so plainly, ask what else could explain your symptoms, and bring a support person to appointments if that helps. You are entitled to understand your care. If English is not your first language, ask for a qualified medical interpreter, which most hospitals and clinics must provide free of charge, rather than relying on family members to translate.

• Before pregnancy: start 400 mcg of folic acid daily, review medicines and chronic conditions, update vaccines and stop smoking, vaping and alcohol.
• First trimester: book your first prenatal visit, confirm your due date, discuss screening options and learn the warning signs of miscarriage and ectopic pregnancy.
• Second trimester: have the anatomy ultrasound and glucose screening at 24 to 28 weeks, keep active, and check your insurance coverage and leave plans.
• Third trimester: get Tdap at 27 to 36 weeks and RSV protection as advised, take the group B strep test at 36 to 37 weeks, install the car seat and plan for help at home.
• First 3 weeks after birth: contact your care team, watch for warning signs, check your blood pressure if advised, and get feeding support early.
• By 12 weeks after birth: have your comprehensive postpartum visit and discuss contraception, mood and any conditions from pregnancy.
• Through the first year: keep the urgent maternal warning signs in mind and arrange follow-up with a primary care doctor if you had gestational diabetes or high blood pressure.

Every guide in this topic

• The Evidence on Prenatal Care Schedule, Without the Hype
• Folic Acid Before and During Pregnancy: Sorting the Evidence From the Noise
• Foods to Avoid in Pregnancy: What the Evidence Actually Says
• The Evidence on Pregnancy Weight Gain, Without the Hype
• Gestational Diabetes: Sorting the Evidence From the Noise
• What the Guidance Really Says About Preeclampsia Warning Signs
• Vaccines During Pregnancy: What the Evidence Actually Says
• Postpartum Depression: What Published Guidance Supports
• The Evidence on Breastfeeding Basics, Without the Hype
• What the Guidance Really Says About Postpartum Checkups

Frequently asked questions

When should I see a doctor after a positive pregnancy test?

Call to book your first prenatal visit as soon as you have a positive test, ideally so you are seen in the first trimester. Some offices schedule the first visit a few weeks later, which is normal. In the meantime, start or continue a daily vitamin with 400 mcg of folic acid, avoid alcohol and smoking, and ask before stopping any prescribed medicine.

Is it safe to drink coffee while pregnant?

Moderate caffeine appears to be fine. ACOG advises keeping caffeine under 200 mg a day, which is roughly one 12-oz cup of coffee, though the amount varies by brew. Count all sources together, including tea, soda, energy drinks and chocolate. Energy drinks may also contain other ingredients that have not been studied in pregnancy, so they are best avoided.

Can I keep exercising during pregnancy?

For most people, yes. Guidelines recommend about 150 minutes a week of moderate activity, such as brisk walking or swimming, if your provider agrees. Avoid contact sports, activities with a high fall risk, scuba diving and overheating. Stop and call your provider if you have bleeding, leaking fluid, contractions, chest pain, dizziness or calf pain or swelling.

Do I really need a Tdap shot if I had one in my last pregnancy?

Yes. Tdap is recommended during every pregnancy, ideally between 27 and 36 weeks. Antibody levels fall after vaccination, so a new dose in each pregnancy makes sure your baby receives the highest possible level of protection against whooping cough, which can be life-threatening for newborns who are too young to be vaccinated themselves.

Which fish are safe to eat while pregnant?

The FDA advises 8 to 12 oz a week of lower-mercury fish, such as salmon, shrimp, pollock, cod, canned light tuna, tilapia and sardines. Skip shark, swordfish, king mackerel, marlin, orange roughy, bigeye tuna and tilefish from the Gulf of Mexico. Cook fish thoroughly, and avoid refrigerated smoked seafood unless it is cooked in a dish.

What medicine can I take for a headache or fever while pregnant?

Ask your provider or pharmacist first. Acetaminophen (Tylenol) is the option most often recommended when a pain reliever or fever reducer is needed, at the lowest effective dose for the shortest time. NSAIDs such as ibuprofen are generally avoided in the second half of pregnancy unless your doctor recommends them. A headache that will not go away needs a call, as it can signal preeclampsia.

How do I know if swelling is normal or a sign of preeclampsia?

Mild swelling of the feet and ankles that eases with rest is common late in pregnancy. Sudden or severe swelling of the face or hands, especially with a headache, vision changes, pain under the right ribs or shortness of breath, can signal preeclampsia. Call your provider right away, and call 911 for a seizure, chest pain or trouble breathing.

Can preeclampsia happen after the baby is born?

Yes. Postpartum preeclampsia can appear in the days after delivery and up to about 6 weeks later, even if your blood pressure was normal during pregnancy. Watch for a severe or persistent headache, vision changes, swelling, shortness of breath or upper belly pain, and seek care quickly, telling staff that you recently gave birth.

How can I tell the baby blues from postpartum depression?

The baby blues bring mood swings and tearfulness in the first days after birth and usually fade within about 2 weeks. If low mood, anxiety, hopelessness, trouble bonding or being unable to sleep lasts longer than 2 weeks, or makes it hard to function, talk to your doctor. If you have thoughts of harming yourself or your baby, call or text 988 or call 911.

What if I cannot afford prenatal care?

Ask about Medicaid, which covers prenatal care in every state for those who qualify and often has higher income limits during pregnancy. Many states now extend postpartum Medicaid coverage to 12 months. Some states let you enroll in Marketplace insurance when you become pregnant, community health centers charge on a sliding scale, and WIC helps with food and breastfeeding support.

When to speak to a doctor

Call your prenatal or postpartum care provider promptly for a headache that will not go away, vision changes, a fever of 100.4°F (38°C) or higher, sudden swelling of the face or hands, vaginal bleeding or leaking fluid, contractions before 37 weeks, a baby that is moving less than usual, heavy bleeding that soaks a pad in an hour after birth, a red, swollen, painful leg, or low mood lasting more than 2 weeks. Call 911 for chest pain, trouble breathing, a seizure, fainting, severe belly pain, confusion, or thoughts of harming yourself or your baby; for thoughts of self-harm you can also call or text 988, and the National Maternal Mental Health Hotline is 1-833-TLC-MAMA (1-833-852-6262).

Where this comes from

• American College of Obstetricians and Gynecologists — Having a Baby
• American College of Obstetricians and Gynecologists — Nutrition During Pregnancy
• CDC — About Folic Acid
• CDC — Hear Her: Urgent Maternal Warning Signs
• FDA — Advice About Eating Fish
• CDC — Pregnancy and Vaccination
• American Diabetes Association — Standards of Care in Diabetes
• US Preventive Services Task Force — Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Preventive Medication
• National Institute of Mental Health — Perinatal Depression
• American Academy of Pediatrics — Breastfeeding and the Use of Human Milk

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.