Morning sickness refers to nausea and vomiting during pregnancy, most often during the first trimester. It is most common in the morning, but some women may experience it at other times or even all day long. Symptoms include nausea, vomiting, and loss of appetite. While most women experience morning sickness during the first trimester of pregnancy and ending in the second trimester, it can continue throughout the pregnancy. You should contact your healthcare professional if you are experiencing any of the following symptoms:

• Your nausea and vomiting are not improving.
• You have lost more than 2 pounds
• You are vomiting blood or material that looks like coffee grounds.
• You are experiencing severe vomiting (more than 3-4 times in 24 hours)
• You are unable to keep any fluids down.
• You are craving something unusual, such as dirt or metal.

For more information and ideas to combat morning sickness, please visit: www.americanpregnancy.org/?s=morning+sickness.

For the chart that shows the developing pregnancy, see and scroll down to the chart: https://courses.lumenlearning.com/suny-lifespandevelopment/chapter/teratogens/

Gonorrhea and Chlamydia

1 in 5 people in the US have an STD.1 Gonorrhea is a sexually transmitted disease caused by a bacterium that grows in the warm, moist areas of the reproductive tract in women and men. It can cause infections in the genitals, rectum, and throat.2 Gonorrhea can be passed from mother to baby during delivery, which can cause serious health problems for the baby. Early testing and treatment is important. For more information on gonorrhea, see: https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm.

1 Centers for Disease Control and Prevention (2021). STI Incidence/Prevalence Estimates. Retrieved February 2024 from http://www.cdc.gov/nchhstp/newsroom/2021/2018-STI-incidence-prevalence-estimates-press-release.html. 2 Centers for Disease Control and Prevention (2021). Gonorrhea: Basic Fact Sheet. Retrieved February 2024 from https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm.

Chlamydia is a common sexually transmitted disease caused by a bacterium which can cause serious, permanent damage to a woman’s reproductive system. Use of hormonal contraceptives increases the risk of contracting chlamydia.3 While most people with Chlamydia do not know that they have the infection, this bacterium has been linked to 30-50% of all ectopic pregnancies, a life-threatening situation for the mother.4 For more information about chlamydia, see: https://www.cdc.gov/std/chlamydia/.

STDs can have serious health consequences. If left untreated, STDs can increase the risk of HIV infection or can cause chronic pelvic pain, pelvic inflammatory disease (PID), infertility, and/or severe pregnancy and newborn complications.5 For more information, see: https://www.cdc.gov/std/default.htm.

For Further STD Testing And Treatment

Berks Community Health Center
838 Penn Street
Reading, PA 19602
610-988-4838

Farias Medical Clinic
525 Penn Street
Reading, PA 19601
610-898-0766
Hours: Monday through Friday, 9AM to 4 PM

Center for Public Health (Tower Health)
301 S. 7th Avenue, Suite 3170
West Reading, PA 19611
484-628-9386
Hours: Monday through Friday, 8AM to 4 PM

Co-County Wellness Services
429 Walnut Street
Reading, PA 19601
610-375-6523
Hours: M, W, Th, F; 9AM to 5PM and T; 11AM to 7PM

What’s Your Sexual Risk Exposure

3 Centers for Disease Control and Prevention (2021). Chlamydia: Fact Sheet. Retrieved February 2024 from https://www.cdc.gov/std/chlamydia/. 4 Nethra, H.S., Praneetha, K., Sreelatha, S., Bhairi, S.S., (2018). A study on risk factors and clinical presentation of ectopic pregnancy. The New Indian Journal of OBGYN; 4(2): 146-149 5 Centers for Disease Control and Prevention (2023). Sexually Transmitted Diseases (STDs), various pages. Retrieved February 2024 from https://www.cdc.gov/std/default.htm.

Take a look at the chart here: https://www.chastity.com/qa/sexual-exposure-chart/.

Abortion and STI’s

WHAT YOU NEED TO KNOW

• No federal regulations exist for quality of care at abortion clinics
• Abortion clinics may or may not test patients for potential STI’s
• Undiagnosed STI’s can spread during a surgical abortion. See here: https://catalog.nucleusmedicalmedia.com/depiction-of-dilation-and-evacuation-abortion-performed-at-9-weeks-gestation/view-item?ItemID=2443.
• There is a possible complication of Pelvic Inflammatory Disease, which can be caused by the spreading of untreated:

1. Chlamydia
2. Gonorrhea
3. Bacterial Vaginosis

All women considering abortion should be tested for STI’s, even if they are not experiencing any symptoms, to ensure that there are no possible complications.

Rh Factor

Have you ever wondered, “What is your blood type?” If you know your blood type, you may answer “O positive, A negative, or B positive.” This is a very important question if you are pregnant, even if you have a miscarriage, an ectopic pregnancy or an elective abortion. Just as there are different major blood groups such as type A and Type B blood, there also is an “Rh factor.” The Rh factor is the type of protein found on red blood cells. Most people have the Rh factor, meaning they are Rh positive. Others do not have the Rh factor, making them Rh negative. Instead of saying, “I’m A, Rh negative,” we simply say, “I’m A negative.” A simple blood test can tell whether you are Rh positive or Rh negative.

The Rh factor causes problems when an Rh negative person’s blood comes in contact with Rh-positive blood. A woman and her pregnancy do not share blood systems. However, a small amount of blood from the pregnancy (whether Rh negative or Rh positive) can cross the placenta into the woman’s system. These Rh negative women become sensitized during their first pregnancy, if the pregnancy is Rh positive. The woman’s body makes antibodies that attack the blood of the Rh positive pregnancy in future pregnancies. When this happens, the antibodies break down the pregnancy’s red blood cells which cause anemia and/or serious illness, brain damage or even death of the pregnancy. The initial pregnancy and each subsequent pregnancy must be treated and in most cases, the condition becomes worse in later pregnancies.

A simple blood test can identify a woman’s blood type and Rh factor. There are even rapid blood typing kits purchasable at stores or online you can take at home for this information. Another blood test, called an antibody screen, can show if an Rh negative woman has developed antibodies to Rh positive blood.

Whether you plan to have an elective abortion or carry your pregnancy to term, you need to have this simple blood test done because without treatment of the antibodies in your system, if you are Rh negative, any subsequent pregnancies will be adversely affected.

Contact your healthcare provider for more information on the Rh Factor. A referral can be given to you by our medical staff. (Source: ACOG (American College of Obstetrics & Gynecology) www.ACOG.org

Miscarriage Precautions +

A miscarriage is the loss of a pregnancy less than halfway (20 weeks) through the pregnancy. Please remember that there is probably nothing you did or did not do that caused the pregnancy to be lost, and most women who miscarry go on to experience full-term pregnancies later. Some miscarriages have no immediate symptoms, but one or more of the following symptoms MAY suggest that you are miscarrying:

• Bleeding greater than your typical menstrual period
• Mild to severe back pain (often worse than menstrual cramps)
• True contractions, very painful, happening every 5-20 minutes
• Bright red bleeding saturating more than a pad with blood in one hour, with our without cramps
• Tissue or clot-like material passing from the vagina
• Sudden decrease in signs of pregnancy

If you experience one or more of these symptoms, seek immediate medical attention at your doctor’s office, or if you do not have one, go to the emergency room. If you are Rh negative [link to Rh factor], you will be given an injection of RhoGAM to prevent Rh problems in the future. For more information: http://americanpregnancy.org/getting-pregnant/pregnancy-loss/signs-of-miscarriage/.

Ectopic Precautions +

An ectopic pregnancy can also be referred to as a “tubal pregnancy.” An ectopic pregnancy is one that is growing in the wrong place in your body. While a pregnancy normally grows inside the uterus, an ectopic pregnancy can be in the fallopian tubes (where the egg and sperm meet) in the ovary, cervix, or the abdominal cavity (belly). An ectopic pregnancy cannot survive outside the uterus and cannot be placed inside the uterus. This can be a life-threatening situation for the woman. Symptoms can include:

• Sharp or stabbing pain on one side only that may come and go and vary in intensity. The pain may be in the pelvis, abdomen, or even the shoulder and neck due to blood from a ruptured ectopic pregnancy gathering under the diaphragm
• Vaginal bleeding, heavier or lighter than your normal period
• Gastrointestinal symptoms
• Weakness, dizziness, or fainting

If you experience one or more of these symptoms, contact your doctor immediately. If you do not have a doctor, go to the emergency room right away. If you are Rh negative [link to Rh factor], discuss this with your healthcare provider. For more information: http://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/ectopic-pregnancy/.

Fetal Development in the first 12 weeks

Week 1 – Last menstrual period. Uterus is thickening to prepare for fertilized egg.

Week 2 – Ovulation and Conception

Week 3 – sperm and egg have merged and travel down the fallopian tube.

Week 4 – Attachment to uterus. Cells start dividing into all future organs. Amniotic and yolk sac are forming.

Week 5 – Two tubes are formed: one for brain and spinal cord development, the other for the heart which then starts beating.

Week 6 – Eyes, lungs, limb buds, and digestive system begin forming. Brain and spinal cord developed.

Week 7 – Limbs are sprouting out. Tongue is forming. Hair growth is starting.

Week 8 – Face is taking shape with eyes, nose, ears, and upper lip. Bones are forming. Webbed fingers and toes are present.

Week 9 – Legs are fully formed. Movement begins. Internal reproductive organs are forming.

Week 10 – Profile is well-defined. Eyes are open. Brain connections are forming. Fingers and toes are no longer webbed. Fingerprint ridges start forming from friction.

Week 11 – Fingernails and irises in the eyes are forming. External genitalia start forming.

Week 12 – Kidneys start producing urine and teeth are forming.

1. Eat a nutritionally balanced diet including plenty of calcium and iron.

2. Drink plenty of water to stay hydrated.

3. Dieting for weight loss is not recommended during pregnancy.

4. Continue exercise in a normal routine unless advised otherwise by your doctor.

5. Your doctor may recommend prenatal vitamins with folic acid and iron.

6. Do not smoke, drink alcohol, or use illegal drugs.

7. Give yourself time to rest.

8. Do not discontinue prescribed medications without consulting a doctor, but also consult with a doctor before taking any non-prescription medications.

9. Create a group of safe people to support you.

10. Follow miscarriage and ectopic instructions if necessary.

Just as all medical procedures have risks, we want to inform you of abortion procedures and risks.¹

· Abortion Pill ($400-$600)
Up to 70 days after last menstrual period. The abortion pill induces a chemical/medication abortion. It involves 2 medications. The first medication is Mifeprex, which blocks progesterone and interrupts pregnancy development, prompting detachment of the implanted embryo. Secondly, Misoprostol is taken up to 48 hours later, inducing contractions to empty the uterus. Because the amount of medication given is many times greater than that of labor induction, you can expect strong cramping, bleeding, nausea, and vomiting. A final visit to the clinic is necessary to ensure the abortion has completed. (8-10% of women will require a surgical abortion to complete the process.)

Risks & Side Effects:

Abortion Failure (Incomplete Abortion)

Bleeding & Hemorrhage

Infection (RU486 suppresses the immune system)

Severe Pain/Cramping

Nausea/Vomiting/Diarrhea/Fever/Chills/Headache/Dizziness

Not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease, or use an intrauterine device (IUD).

CAUTION: A chemical/medication abortion occurs in private; as such, you may not be expecting to see the results of ending your pregnancy. For example, viewing a discernable head and limbs.

· If you have taken the first pill and have changed your mind about the abortion, call (877) 558-0333 or chat online at https://www.abortionpillreversal.com.

Do Not Buy Mifeprex Over The Internet
You should not buy Mifeprex over the Internet because you will bypass important safeguards designed to protect your health.

Mifeprex has safety restrictions on how it is distributed to the public. In addition, drugs purchased from foreign internet sources are not the FDA-approved versions of the drugs, and they are not subject to FDA-regulated manufacturing controls or FDA inspection of manufacturing facilities.
http://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information

· Manual Vacuum Aspiration ($450-$950)
7 weeks after LMP. The cervix is stretched with dilators wide enough to allow the abortion instruments to pass into the uterus. A hand-held syringe is attached to tubing that is inserted into the uterus, and the fetus is then suctioned out.

· Suction Curettage ($450-$950)
6w to 16w6d after LMP. The cervix is opened with a dilator up to 14 weeks. The doctor inserts tubing connected to a suction machine into the uterus. The suction pulls the fetus’s body apart and empties the uterus. Between 14 weeks and 16 weeks 6 days, the cervix will be softened by giving Misoprostol, orally or vaginally, so dilation is easier for the larger fetus.

· Dilation & Evacuation ($1000-$2300)
13w to 20w6d after LMP. In this procedure, the cervix is softened by giving Misoprostol, orally or vaginally, so the cervix can be opened wider than in a first-trimester abortion, allowing the doctor to pull out the fetal parts by a combination of suction, curette, and/or with forceps. The fetus’s skull is crushed to ease removal.

Risks of Abortion:
Heavy or continued bleeding, infection, sepsis (infection entering the blood), incomplete abortion, allergic reaction to drugs, damage to the cervix, scarring of uterus lining, perforation (causing a hole) of the uterus, damage to internal organs, increasing risk of breast cancer, death. Abortion is linked to subsequent preterm births and increased risk for mental health issues.

Effect on Future Pregnancies:
Scarring or other injury during an abortion may prevent or place at risk future wanted pregnancies. The risk of miscarriage is greater for women post-abortion.

REMINDER – It is important to know your blood type and STD status before receiving a chemical or surgical abortion.

¹ Sources:

• www.americanpregnancy.org
• abortionpillrisks.org
• FDA.gov
• AAPLOG article by McCaffrey (PDF)
• abortionprocedures.com/induction

For some women, the signs and symptoms of labor are unmistakable; for others, they are more subtle.

Be on the Lookout for:

· Regular or frequent contractions. You may experience discomfort or a dull ache in your back and/or lower abdomen.

· A sensation of pelvic or lower abdominal pressure

· Mild to strong abdominal cramping

· Diarrhea, vaginal spotting or bleeding

· Watery vaginal discharge (water breaking) – a gush or a trickle. This will be odorless fluid.

· A change in vaginal discharge. During pregnancy, a thick mucus plug protects the cervical opening from bacteria entering the uterus. When your cervix begins to think and relax, the plug is expelled. The plug may look solid like a cork; it is actually stringy mucus discharge. It can be clear, pink, or blood-tinged and can appear minutes, hours, or even days before the onset of labor.

If you are concerned about what you are feeling, especially if you have vaginal bleeding accompanied by abdominal cramps or pain, contact your healthcare provider or go to a hospital right away.