Menses during early pregnancy. Scanty periods as a sign of pregnancy

This is an important topic for women.

Often the question arises, is pregnancy possible during menstruation? You can hear many stories about women you know for whom menstruation is the best method of contraception. Gynecologists, on the contrary, argue that menstruation is not protection against pregnancy, and sexual intercourse itself on critical days is fraught with many infections.

Anatomy and physiology of the female body

Nature prepares a girl to be a mother even during fetal development. Many eggs are laid in the ovaries, and after puberty, every month one of them goes on a journey - to meet with the sperm. In case of fertilization, the fetal egg descends through the fallopian tube to the uterus, where it is implanted, this moment is considered

If this does not happen, the egg is destroyed and the inner layer lining the uterus is separated. All this is excreted along with the blood, menstruation begins. There may be such an option as pregnancy during menstruation. The implantation was successful, but part of the endometrium still flakes off, causing bleeding.

The possibility of conception on critical days

Contrary to popular belief that pregnancy during menstruation is impossible, there are many living examples that prove the opposite. The complexity of the female body and instability also complements the vitality of spermatozoa. They can remain active and fertile for up to 8 days, as you understand, during this time the menstruation will have time to end and a new egg can come out.

In modern life, stress, malnutrition, various diseases and many other factors contribute to hormonal failure and cycle disruption, which means that it is almost impossible to accurately calculate when ovulation occurs.

Safe days - can this method be trusted

We often receive important information from unreliable sources. So the girls tell each other that on critical days (as well as on the last before them) they are reliably protected from conception by nature itself. This is fundamentally wrong. Pregnancy the day before menstruation is just as possible as during them.

Only the first day, when menstrual flow is especially abundant, are relatively safe. But often a woman's well-being is not conducive to sexual intercourse on this day.

It is safer to always use suitable contraception than to rely on chance.

Are menstruation and conception mutually exclusive?

Theoretically, these concepts are incompatible, but in practice, pregnancy during menstruation is possible, and spotting (in rare cases) can accompany a woman throughout the entire period of bearing a child. All cases can be divided into two categories:

  • The woman knows about her interesting situation, and suddenly bleeding begins.
  • The expectant mother does not suspect that she is not alone, menstruation is regular, on time, without suggesting such thoughts.

If the first case requires urgent medical intervention, then the second is more difficult. They give rise to numerous questions for expectant mothers - are there periods during pregnancy? This phenomenon occurs, but occurs infrequently, usually in the first trimester. Only an examination by your gynecologist will help eliminate cause for concern, so do not neglect the consultation.

If a woman carefully monitors her cycle, then she will surely notice the difference between normal menstruation and they differ in a number of ways: duration, abundance, color, smell.

Normal periods or spotting

From the point of view of physiology, habitual menstruation is incompatible with pregnancy. Because if there is a rejection of the inner lining of the uterus into which the embryo is implanted, then there is a threat to his life. Therefore, gynecologists call any discharge during pregnancy more correctly - bleeding.

Why does spotting start right on time, according to the usual cycle? It's all about hormones: somewhere the pituitary gland has failed and, according to old memory, starts the usual process. Because of this, some women cannot recognize pregnancy, their stomach hurts, as menstruation begins, all the sensations during PMS and pregnancy can also coincide (weakness, drowsiness, nausea, breast swelling), but a test or examination by a doctor will put everything in its place.

What do these periods mean?

Often, bleeding during pregnancy does not pose a threat to the life of the mother and child. But a woman needs to focus primarily on her well-being. The absence of pain, cheerfulness and a good appetite say that everything is fine with both of you, and a small hormonal shift is not a problem at all.

However, be very careful, heavy bleeding, too dark or watery discharge, especially if accompanied by acute pain, is a reason to immediately call an ambulance. Such symptoms may indicate a threatened miscarriage, serious inflammation, or an ectopic pregnancy.

Reasons for menstruation during this difficult period

Whether there are periods during pregnancy, or not - this does not mean that your baby cannot be born full-term and healthy. What could be the reason?

  • The very first thing that can be assumed is an error in the calculations. That is, the last critical days are included in the period of pregnancy, although it came immediately after them.
  • - this is the moment of direct attachment of the embryo to the wall of the uterus. Usually only a few drops of blood are released, which are mistaken for the beginning of critical days.
  • The first menstruation during pregnancy can occur due to the fact that the egg was fertilized at the very end of the cycle, and by the time it was implanted in the uterus, the menstruation process was started automatically.
  • Quite rarely, another scenario happens. Of the two mature eggs, only one was fertilized, however, according to the laws of physiology, they both return to the uterus, where one is implanted and the other is destroyed, causing menstrual bleeding.
  • Mechanical damage to the cervix during intercourse.
  • Serious hormonal failure, a decrease in estrogen levels.

The pace of modern life, constant stress, hormonal drugs make any of these reasons possible. Therefore, only a gynecologist can find the only one, yours.

Menstruation in the first months after conception

Usually this problem concerns the first trimester, when the body did not have time to properly respond to pregnancy. Menstruation has begun, but the embryo continues to develop in the uterus, and by the next month the hormonal background will even out, which will not allow the mistake to be repeated.

Often the cycle fails, for example, menstruation began ahead of schedule. Pregnancy at the same time goes on as usual, although the mother does not yet suspect it. If bleeding continues at a later date, then the doctor should choose a program to correct the hormonal background.

Do periods during pregnancy pose a risk to the fetus?

As noted earlier, bleeding during this period is not something out of the ordinary. Mom needs only to soberly assess the situation. So, discharge, in strength and duration comparable to menstruation, in almost 100% of cases means the loss of a child. The same can be said about bleeding with strong, cramping pains.

Scanty discharge, even appearing with enviable regularity, does not pose a threat to the life of the fetus, but still is the reason for a visit to the gynecologist. There are unique cases when menstruation goes on throughout the entire period, and everything ends with the birth of a healthy child, but this is more an exception than a rule. Why is this happening? The body, according to old memory, monthly creates a hormonal background that is critical for bearing a child.

Menstruation during early pregnancy is a fairly frequent phenomenon that does not harm either mother or child.

What to do if you are in a position and menstruation has begun?

Assess the nature of the discharge and your well-being. If they are minor and you feel great, you can ask about the reasons during the next consultation. At the slightest change for the worse, call an ambulance, do not take risks without special need. Let the doctors evaluate your condition.

Sharp pain, bright scarlet copious discharge - all this indicates immediate hospitalization. Usually prescribe hormonal drugs, treatment of existing infections and long-term maintenance therapy.

Important date, last period before pregnancy

The doctor will ask this question first of all when registering. With the help of this date, obstetricians calculate the date of birth of the child and the release of the mother on maternity leave. If menstruation continues during pregnancy, then it will be determined based on the results of the examination.

The gestational age for the last menstruation is calculated from the first day of the last menstruation. This is easy to do, it is enough to know this date and the duration of pregnancy, namely 280 days or 40 weeks. Count 40 weeks from her and get the date of birth of the baby.

What to do if the pregnancy has already begun, and the critical days are still going on? It will help to determine the duration of the ultrasound, and with greater accuracy than the calculation of the last menstruation. In addition, by waiting for the first movement, you can confirm the date of the birth of the baby. You just need to add 20 weeks to this day.

Summing up

A woman can become pregnant on any day of the cycle, the complexity of the reproductive system and its close relationship with hormones do not allow us to reliably calculate safe days. In the early stages of pregnancy, it is not uncommon to experience bleeding that is different from normal menstruation, which can be considered normal. But if it appears in the later stages (more than 12 weeks), you should consult a doctor.

If bleeding is comparable to menstrual bleeding, it cannot be considered acceptable during pregnancy - this is a myth. It endangers the lives of women and children. Even the slightest bleeding requires a competent study, the search for its causes. Abundant and prolonged discharge (as with normal menstruation) indicates an abortion.

If, against the background of the development of your baby and good general well-being, regular spotting (menstruation) continues, then your body categorically does not want to say goodbye to its hormonal regimen. At the same time, you fall into the number of unique women, and here, no matter how many doctors say that this does not happen, the main criterion is how you feel.

Regularly visit a gynecologist, take the necessary tests and listen to yourself. A good mood and an optimistic attitude will only benefit you and your unborn child.

Can menstruation occur during pregnancy?

In this material, we will tell you in detail about and in what cases bloody discharge can be dangerous for a woman during this period.
It is generally accepted that during pregnancy There can be no menstruation, and if spotting appears, then the woman is not pregnant. But sometimes in the first trimester, menstruation goes on as usual, and the expectant mother is not even aware of her situation.

If fertilization occurs in the last days of the cycle, the body does not have time to rebuild, the hormonal background remains at the same level and menstruation appears at the appointed time . After 4 weeks, the woman will have a delay and she will find out that she is carrying a child for the second month. In pregnancy time you need to carefully monitor your condition and register at the antenatal clinic as soon as possible. Pregnancy during menstruation may not manifest itself in any way and the woman does not even suspect that she is already in a position.

Menstruation in the first month is normal. The discharge is not as copious as usual.
Most women ovulate 7-9 days after their period. When the fertilizing egg reaches the uterus and attaches to its wall, the embryo acts on the blood vessels and they signal the onset of pregnancy . If the body did not have time to recognize the signal, the hormonal background does not change, the next menstruation begins.

Can menstruation go on later in pregnancy? In the second month of pregnancy or later, there should be no discharge. This is a deviation from the norm, which indicates a problem with sex hormones, and in this case, you should not delay a visit to your gynecologist. Discharge may be a precursor to a miscarriage , not everyone sees the difference between menstruation and bleeding. Miscarriages are more common in the first trimester. When threatened, copious bleeding is accompanied by heaviness in the abdomen and painful sensations similar to contractions.

Causes of menstruation during pregnancy:
- menstruation during pregnancy can occur if the egg is attached not far from the myomatous node, or there is a focus of endometriosis next to it.
- Light brown discharge occur during ectopic pregnancy. Another common symptom with this diagnosis is a sharp pain in the lower abdomen.
- When the level of the sex hormone androgen in a woman's body significantly exceeds the norm (hyperandrogenism), the fertilized egg may exfoliate, and discharge will occur.
- Fetal malformations, fetal fading and genetic disorders can lead to termination of pregnancy, which will be manifested by discharge.
- If the corpus luteum does not function well, the level of progesterone in the female body is underestimated, pregnancy develops insufficiently, and menstruation occurs.

Can menstruation go on a month after conception during pregnancy? As we explained above, if menstruation during pregnancy are due a month later, then we can talk about a possible pathology in the body of a woman, dangerous bleeding. It is imperative to seek advice from a gynecologist if the ultrasound revealed pregnancy, and bleeding continues. Next, we will tell you in more detail why pregnancy during menstruation is the reason for an immediate appeal to a specialist and due to what reasons during pregnancy menstruation can occur.


We have detailed why some women continue to menstruate during pregnancy. I would like to emphasize again that regular gynecological examinations can minimize the risk of the consequences of an ectopic pregnancy and prevent the threat of miscarriage if the pregnancy is confirmed. Now you know can menstruation occur during pregnancy and in what cases bleeding poses a threat to the health of the expectant mother and the fetus developing in her womb.

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The uterus has three layers - outer, middle and inner mucous. The endometrium is the most mobile layer of the uterus, and as soon as new life is born, it thickens so that it does not stop.

If pregnancy does not occur, the endometrium detaches, and menstruation begins. That is why menstruation is not possible during pregnancy. Do periods in early pregnancy always warn of danger?

Causes of menstrual bleeding

Indeed, during early pregnancy, menstruation may indicate danger, but not always. Of course, if menstruation appears at the beginning of pregnancy, this is a kind of pathology, but it may not carry a threat in itself.

Be sure to see a doctor

Scanty periods during pregnancy do not pose a threat if.

  1. A fertilized egg does not yet have time to attach to the walls of the uterus before the onset of menstrual bleeding in the mucous layer. Then, it is likely that menstruation can go early in pregnancy. This stage does not involve hormonal changes in the body, so menstruation can continue.
  2. In different ovaries, two eggs matured at once, one of which was fertilized. Then the second is rejected and can cause menstruation in the early stages of pregnancy.
  3. The hormonal background is broken. For example, a woman is dominated by androgens - male hormones, or an insufficient level of progesterone. Both cases do not pose a threat to the unborn child. These problems are easy to fix with the help of hormonal agents, the main thing is to consult a specialist.

Pathologies that can cause menstruation at the beginning of pregnancy.

  1. Menstrual bleeding, which is observed at the beginning of pregnancy, may indicate detachment of the ovum, which leads to miscarriage.
    The body itself can solve this problem if the detachment is small. Then progesterone begins to be actively produced, and the discharge has a meager, smearing character. If the case is more serious, then pain, profuse bleeding are observed.
  2. It happens that during pregnancy in the early stages there are minor periods, which appear due to mechanical damage to the vagina, cervix. For example, after examining a doctor and taking smears, a girl may have a small amount of blood.
  3. Minor bleeding may occur during intercourse. This should not cause concern, but to be sure, you need to undergo an ultrasound scan, as well as monitor the development of the embryo.
  4. Abundant periods during pregnancy can be observed due to ectopic development of the fetus. In this case, the fertilized egg is attached to the fallopian tube, and as soon as the fetus begins to grow, it becomes crowded, so the tube may burst. This leads to internal bleeding, which is life-threatening. In almost all cases, a woman's life can be saved, but her reproductive system can be truncated, because the fallopian tube cannot be restored.
  5. Menstruation during early pregnancy can occur if there are any genetic disorders, or pathological conditions of the fetus caused by intrauterine diseases. It is almost impossible to save a child in such cases.

Uterine damage

Is it worth it to call the loop yourself?

The absence of menstrual bleeding, breast swelling, nervousness and early toxicosis may indicate the development of a new life inside you, sometimes not entirely desirable. Then many begin to wonder: "How to provoke menstruation?".

As a rule, few people go to the doctor, because everyone is trying to find ways on the Internet using various herbs and drugs. Every woman understands that if menstrual bleeding begins, the pregnancy will stop, so they are trying by all means to purchase the necessary collection or pills at the pharmacy.

This is fundamentally the wrong decision. First of all, you should contact a specialist for advice, who will tell you the most effective and safe way for you. For example, for some, an injection that will provoke the onset of menstruation will do just fine. As a rule, oxytocin is used for this purpose - a medical drug that causes a rapid contraction of the uterus.

No less effective drugs that can promptly induce menstruation are Pulsatilla, Postinor, Norkolut. It is also possible to cause menstruation with Duphaston or Utrozhestan.

Do not call yourself - it is dangerous

All of the above drugs are very dangerous for a woman's health, because they radically change the hormonal background and can lead to subsequent infertility. That is why, before taking any medication, visit a doctor.

How to prepare yourself?

The key to the health of the unborn child is not only the physiology of the mother, but also her emotional state. All experts recommend thinking through some aspects in advance. If you have a feeling of doubt, discomfort - wait a little with conception.

As sociological statistics show, prenatal depression is known to about 10% of pregnant women. Having well studied all the early signs of pregnancy before the start of a delay in menstruation, they are often not ready for what lies ahead, because they will no longer be able to control their body and life.

State of depression

The state of depression, despondency is transmitted to the growing fetus. To avoid negative consequences, it is necessary to psychologically prepare yourself for this event.

Causes of prenatal depression can be.

  1. High expectations. Some girls are sure that preparing for bearing a baby implies a kind of plan according to which everything goes. The only thing they need is to exercise control over all aspects from the moment of conception to the day of birth.
  2. Unforeseen changes in the process of bearing a child can provoke high anxiety, stress, or a nervous breakdown. It is necessary to accept in advance the moment that it is impossible to control all aspects of life, therefore, all situations that arise should be taken calmly.
  3. social interest. Not every girl is ready for the fact that her position will cause increased attention of people around her. Bad advice, intimate questions are sometimes asked not only by close people, but also by colleagues and acquaintances.
  4. As soon as the earliest signs of pregnancy appeared even before the delay in menstruation, you must immediately tune in to the fact that you may have to learn how to give a correct rebuff if the recommendations of strangers are inappropriate.
  5. Family problems. The tale that a child is able to save a family is known to this day. Sometimes boundless faith in her leads to unjustified hopes. That is why, at the first signs of early pregnancy, even before menstruation, it is necessary to solve all problems with your partner in order to know for sure whether you need this child, whether he will be desired.

Consider a few reviews of women who had periods at the beginning of pregnancy.

To the question “Can there be menstruation during pregnancy”, any specialist in the field of gynecology will answer that from a theoretical point of view this is impossible. The explanation for this is simple: during the menstrual cycle in the female body, namely in the reproductive organ, the inner layer grows. When a certain moment comes, the unfertilized egg, along with the contents of the endometrium, comes out. Accordingly, if conception has occurred, then the endometrium is not rejected. But! There are many cases when, in the early stages of bearing a child, expectant mothers discover bloody discharge from the vagina.

Menstruation in the first weeks of bearing a child occurs when fertilization occurred in the previous cycle. This explains the fact that the fetal egg did not have time to get to the place of its "deployment". That is why doctors determine the gestational age by the first day of the last menstruation. The exception is in vitro fertilization.

Bleeding at different stages

Scanty discharge with blood impurities can be even if the fetal egg already exists. As we have already figured out, this is possible if fertilization occurs at the end of the cycle. But there is another "scenario" for the development of events. The female reproductive system includes two ovaries. So, in each of them, eggs can mature. The one that is fertilized is fixed on the wall of the uterus, the other comes out, provoking bleeding.

Is it possible to have periods in the first 4 weeks of pregnancy? They can, and it's a common occurrence. Under such circumstances, a woman may not be aware of her interesting position. But, if spotting occurs during the first trimester, then this is considered to be a dangerous condition. The fact is that there is a high probability of termination of pregnancy even without a failure of the menstrual cycle. The cause of pathological changes is a violation of the hormonal background. This often happens with those who take birth control pills, so preparing for the conception of a child, it is better to stop taking them at least six months in advance.

Another reason for menstruation at the beginning of the period of bearing a child may be the rejection of the embryonic organ, which ensures the delivery of nutrients and oxygen to the fetus. Such pathological changes are one of the reasons for abortion. In the second trimester, bleeding is also dangerous. Placental abruption after 12 weeks is unlikely, but possible. Sometimes scanty discharge in the middle of the term is a symptom of an infectious lesion of the vaginal area.

In no case should such violations be ignored. It is necessary to pass urine, blood, a smear from the cervical canal for analysis. This will allow you to clarify the diagnosis, determine the treatment.

Reading the reviews of moms on the forums, you can find out that bloody daub happens at the end of pregnancy. The reasons are different:

  • placenta previa/abruption;
  • rubbing of the cervix during sex, which is very sensitive;
  • earlier discharge of the cork.

The relationship between missed pregnancy and menstruation

Unfortunately, situations are not uncommon when, while still in the womb, the fetus stops developing. It is no longer possible to save him, and the woman's health becomes the first place. It is difficult to name the exact cause of the pathology. This may be caused by:

  • uncontrolled medication;
  • infectious lesions of the body;
  • bad habits;
  • shocks of the nervous system.

The impact of negative factors does not always take place, sometimes the development of the embryo stops without their participation. The only way out of this situation is scraping. After cleaning, a few weeks later, an ultrasound is done to assess the current condition. In most cases, antibacterial, hormonal therapy is carried out in relation to the patient.

When menstruation begins after surgery, it depends on the following indicators:

  • the level of hormones in the blood;
  • the age of the patient;
  • duration of pregnancy.

It usually takes 30 to 45 days for the upper layer of the uterine lining to grow and then be replaced, but this is provided that there are no health problems. Sometimes spotting occurs earlier, their presence indicates the healing of the damaged surface of the reproductive organ.

  • Such cases, of course, are not frequent. The presence of menstruation during pregnancy depends on the duration and health of the woman's hormonal system. Sometimes bleeding tends to be confused with menstruation, when the presence of pregnancy is still unknown.
  • To deal with such a difficult problem as the presence of menstruation during pregnancy, it is necessary to consider various causes and situations.

Is it possible to have periods in early pregnancy?

  • From an anatomical point of view, menstruation during pregnancy is impossible. It is necessary to remember the course of anatomy in order to understand that a full period in the presence of a fertilized egg in the uterus is fraught with miscarriage
  • However, on the other hand, the process of pregnancy does not occur instantly. It takes 7 to 14 days for a fertilized egg to reach the uterus
  • So, if the egg is still “making its way”, and menstruation should begin according to the schedule, then in principle, this is quite possible
  • In fact, you will not yet be pregnant during this period. The egg will get to the right place already before the bleeding stops
  • In rare cases, menstruation occurs during pregnancy if two eggs have matured, and only one has been fertilized.

Why do menstruation occur during pregnancy?

  • Quite often, menstruation is simply confused with bleeding. This happens especially often in the early stages, when pregnancy is unknown.
  • In the first month of pregnancy, menstruation is quite acceptable. Further, it is simply impossible
  • In late pregnancy, there are also spotting from the vagina. This is not menstruation, but only discharge from damaged vessels
  • Sometimes discharge can begin due to hormonal failure in the body.

Why do menstruation clots during pregnancy?

  • Excessive bleeding with blood clots is abnormal for pregnancy. This indicates serious violations in the course of pregnancy.
  • A miscarriage is often accompanied by heavy bleeding with clots, as well as severe pain in the lower abdomen.
  • Another pathology is the death of the embryo due to a lack of development or other pathologies.
  • An ectopic pregnancy can sometimes be accompanied by bleeding and severe pulling pain in the abdomen.
  • Placental presentation during pregnancy also causes bleeding


Abundant periods during pregnancy

  • Menstruation during pregnancy from 2 months is no longer normal
  • To find out exactly the cause of the appearance of profuse bleeding, you need to consult a doctor.
  • If the pregnancy test shows a negative result, but the menstruation has changed (color of discharge, pain), then you should also consult a doctor. Very often the test is negative in ectopic pregnancy

How long are periods during pregnancy?

  • Pregnancy and the presence of bleeding during the first period of gestation is quite a common problem. However, if you do not adjust the hormonal background, then there may be tragic consequences.
  • At a later date, the presence of bleeding is already a dangerous sign - this can pose a serious threat to miscarriage
  • There are no full periods during pregnancy. Bleeding during pregnancy differs in color, texture and pain


Periods and ectopic pregnancy

  • An ectopic pregnancy is a pathological course of pregnancy. It carries the loss of the fetus and a number of complications for the mother.
  • In the early stages, it is very difficult to recognize an ectopic pregnancy. She either does not manifest herself in any way, or proceeds as a normal pregnancy.
  • The essence of an ectopic pregnancy is that the fertilized egg did not reach the uterus, but attached to the fallopian tubes
  • In the future, an ectopic pregnancy leads to an inflammatory process, internal bleeding, and often to infertility.
  • Full menstruation, even with an ectopic pregnancy, is impossible. The discharge that will appear is just a little bleeding
  • Discharge during an ectopic pregnancy will occur spontaneously, and not on time with menstruation. In addition, they are often accompanied by severe pain in the lower abdomen.

  • Quite often, women themselves confuse menstruation with bleeding.
  • This happens due to irregular visits to the gynecologist and not monitoring your menstrual cycle.
  • If the pregnancy test showed a negative value (and this happens quite often), then the woman may not be aware of her situation.
  • Sometimes a woman is quite fat, and her position is not detected until 4 - 5 months of pregnancy
  • There are quite a few such cases in medical practice. Therefore, in order to avoid this, regular examination by a gynecologist is necessary.


How to distinguish between menstruation and bleeding during pregnancy?

  • By color. Menstruation usually has a darker burgundy hue. And the color of bleeding is scarlet
  • By pain. With bleeding, the pain is usually much more noticeable than with menstruation.
  • By consistency. Menstruation is thicker than blood when bleeding
  • Menstruation and bleeding differ in the way they occur. As a rule, menstruation has 1 day, when the discharge is small. Bleeding usually starts spontaneously

Why induce menstruation during pregnancy?

  • The main purpose of calling menstruation during pregnancy is to interrupt it.
  • However, this process is not as simple as it seems at first glance. Moreover, it is not harmless. It is fraught with great health complications for a woman.
  • As a rule, menstruation is caused by special preparations under the supervision of a doctor. This is a kind of medical abortion. Possible in early pregnancy
  • There are also folk ways to induce menstruation during pregnancy. But by no means should they be used.


  • Anatomically, menstruation during pregnancy is impossible
  • During pregnancy, periods are often confused with bleeding or discharge.
  • Menstruation in the first month of pregnancy is possible with a long journey of the egg to the uterus and with a short menstrual cycle (21 days)
  • Bleeding is abnormal at any stage of pregnancy. If you have them, you need to see a doctor
  • If you are not sure about the absence of pregnancy, and your menstruation has changed its character, be sure to be examined by a gynecologist
  • The presence of bleeding during pregnancy is fraught with miscarriage and a number of health complications
  • To induce menstruation during pregnancy means to stop it

Video: Menstruation during pregnancy

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