What should you expect?
You think you might be pregnant, but how do you know for sure? Once you find out that you are, what should you expect during each trimester? What diet, exercise and sleep recommendations should you follow? What’s not a normal part of pregnancy?
Are you pregnant?
Even though it might seem like it should be obvious, how do you know if your pregnant? The most common sign would be missing your normal menstrual cycle. Usually, if you’re more than a week late, you might want to take an at home pregnancy test. The only time that this can be misleading is if you normally have irregular periods. There are other common signs that can indicate that you’re pregnant. Due to the hormone changes that occur during early pregnancy, you might find that you’re more tired, you have to go the bathroom more frequently, you have nausea and your breast may be tender and swollen. Some other less common signs are moodiness, bloating, light spotting (aka implantation bleeding), cramping, constipation, aversion to certain foods and nasal congestion. Since many of these symptoms are the same as what you can experience when you have your period, it’s a good idea to take a home pregnancy test if you have any of them and reason to believe that you might be pregnant, particularly if you don’t normally experience these symptoms with your period. Once you know that you’re pregnant, what can you expect to happen? A pregnancy is broken down into three trimesters. During each trimester, there are a lot of changes that take place for you and for your baby. By knowing what to expect, it can help lessen any stress or concerns you might have.
First Trimester
The first trimester includes the first three months of your pregnancy. Some of the signs that indicate that your pregnant can last through out the beginning of your pregnancy. If your breasts are tender and swollen, this will lessen as you get further along. The fatigue that you might experience can be combatted by making sure you rest as much as you can. Unfortunately, if you’re experiencing nausea, even if it’s not accompanied by vomiting, it might not go away right away. Even though this is often referred to as morning sickness, it can occur at any time of day. In order to help reduce it, avoid having an empty stomach by eating small meals every couple of hours. It’s important to eat slowly and choose foods that are low in fat. Avoid any foods/smells that make your nausea worse. If your nausea and/or vomiting is severe, make sure to let your doctor know. The influx of hormones can also relax valve between your stomach and esophagus, which makes you more likely to have heartburn. To help lessen this irritation, avoid foods that are fried, citrus, chocolate or spicy. Another side effect of the increase in hormone levels is constipation. In order to prevent this, drink plenty of fluids, include adequate amount of fiber in your diet and get sufficient amounts of physical activity. Remember, it’s normal to have mood swings during pregnancy. You can feel excited about having your baby and worried all at the same time. The key is to talk to your loved ones and, if needed, talk to your doctor. If you have any questions about what to expect throughout your pregnancy, talk to your doctor. Usually, during the first trimester is when they’ll recommend any screenings for chromosomal abnormalities and discuss any possible impacts your personal health history may have on your and your baby’s health during the coming months.
Now that you know what is going on with you, what is going on with your baby during the first trimester? You might be surprised to learn that you’re not actually pregnant for the first two weeks of your pregnancy. This is because your doctor will calculate your due date based off of the start of your last period. Conception usually happens two weeks after this. Fertilization occurs during week 3 when the egg and sperm meet in your fallopian tube and form a single-celled structure called a zygote. As it travels to your uterus, it begins dividing to form a cluster of cells called a morula. At this point, it might look like a small raspberry. During week 4, the rapidly dividing cells are now called a blastocyst and implant itself in your uterine lining. There are two layers of cells. The inner layer will become the embryo and the outer layer becomes the placenta. During week 5, the blastocyst produces a significant amount of the hormone, human chorionic gonadotropin (HCG), which tells your ovaries to stop releasing eggs and make more estrogen and progesterone (this stops your period and encourages the growth of the placenta). The embryo is now made up of three layers. The top, or ectoderm, will become your baby’s skin, central/peripheral nervous system, eyes and inner ears. The middle, or mesoderm, will become your baby’s heart, circulatory system, bones, ligaments, kidneys and reproductive system. The inner layer, or endoderm, will become your baby’s lungs and intestines. In week 6, the neural tube, which is where your baby’s brain and spinal cord develop from, closes. Other organs start to form, including the heart, eyes and ears. Also, tiny buds appear where your baby’s arms will develop from. In week 7, the arm buds take the shape of paddles and leg buds appear. Also, your baby’s brain and face are growing. During week 8, the leg buds now look like paddles and fingers begin to form from your baby’s arms. The baby’s eyes become obvious and their outer ear begins to take shape. Also, their nose and upper lip are visible. At this point, your baby might be about ½ inch long (measured from the top of their head to their bottom). In week 9, your baby’s arms grow and their elbows become visible. Their toes appear and their eyelids form. At this point they might be ¾ inch long. During week 10, your baby’s head becomes rounder and they can now bend their elbows. Also, their toes and fingers lose their webbing. During week 11, your baby’s eyes are widely separated, eyelids are stilled fused and ears are low set. In addition to buds for teeth emerging, your baby’s liver is being formed and their external genitalia will start developing. Your baby is about 2 inches long (about half of their length is still their head). During week 12, your baby has fingernails, their intestines are in their stomach and their face is more developed. Your baby is about 2½ inches long and weighs about ½ ounce. As you can see, there is a great deal of growth and change going on for your baby during their first 12 weeks.
Second Trimester
The second trimester is months four through six of your pregnancy. The good news is that most of the uncomfortable symptoms that you have in the first trimester disappear. During this phase, you’re more likely to notice physical changes to your body. As your uterus expands to make room for your growing baby, the size of your stomach will start to increase. Your breast will also start to increase in size, so wearing a bra that is supportive is key. Sometimes, you might feel slight tightness in your abdomen occasionally, called Braxton Hicks contractions. They’re typically brought on by an increase in activity level. If your contractions become painful or regular, contact your doctor. You might also notice changes to your skin because the hormones changes of your pregnancy cause an increase in the pigmented cells (melanin) to occur. This increase in melanin can cause brown patches to appear on your face and/or a dark line down the center of your abdomen. Also, you might experience reddish lines along your abdomen, breast, buttocks or thighs, which are known as stretch marks. Most of these discolorations fade or disappear after your pregnancy is over. Be sure to wear sunscreen to protect your skin when outside. In order to make sure that your baby has enough nutrients, your body increases the amount of blood you have. This increase in blood volume can cause a wide variety of side effects. It can cause your mucous membranes to swelling in your nose and mouth making them more susceptible to bleeding and nasal congestion. The changes in your circulatory system can cause you to become easily dizzy, especially if you don’t drink enough fluids, stand for too long or change positions quickly. Another common symptom as your pregnancy progresses is leg cramps. They typically occur at night, so stretching your calves before going to bed can be helpful. Other useful ways to prevent them is to wear shoes that are comfortable and offer a great deal of support, taking a hot shower/bath and having an ice/regular muscle massage. Keep in mind that a sticky clear/white vaginal discharge is normal during pregnancy. Unfortunately, urinary tract infections are also more common. Since during this trimester you feel less tired, it can be a good time to check into childbirth classes, find a doctor for your baby, read about/decide if you want to breastfeed, learn what your employer’s maternity leave policy is and investigate any child care options you may need. One of the exciting things you’ll get to experience during this trimester is finding out what gender your baby is (if you want to).
The second trimester starts at week 13 for your baby, who is continuing to grow and develop. During this week, your baby starts to make urine and releases it into the amniotic sac, where it becomes amniotic fluid. Your baby swallows this fluid and then urinates it back into the amniotic sac, which makes more fluid. Also, your baby’s bones are beginning to harden, especially their head and long bones. In addition, their skin will still seem thin and transparent. In week 14, your baby’s neck is more defined and their lower limbs are well developed. Your baby’s spleen is formed during this week. Often, this is when your baby’s gender becomes apparent. Your baby will be about 3½ inches long and weigh 1½ ounces. During week 15, your baby’s bones continue to develop and their scalp hair pattern becomes more obvious. In week 16, your baby’s head is erect, they can move their eyes slowly and their ears are close to their final position. Also, their limb movement is becoming more coordinated, but might not yet be strong enough to be felt by you. They are 4½ inches long and weigh 4 ounces. In week 17, your baby’s toenails appear and they are becoming more active. During week 18, your baby’s ears begin to stand out on the side of their head and they begin to hear. Also, their eyes are starting to face forward and their digestive system is working. Your baby will now be about 5½ inches long and weigh 7 ounces. In week 19, a greasy, cheese-like substance, vernix caseosa, forms. It protects your baby’s skin from abrasions, chapping and hardening that can occur from being exposed to the amniotic fluid. Also, if you’re having a girl, her uterus and vaginal canal begin forming. At week 20, your halfway through your pregnancy and your baby’s movements might be strong enough for you to feel. They will be exhibiting regular patterns of sleeping and waking, in fact, they might be awoken by noises or your movements. Your baby will be 6 1/3 inches long and weigh 11 ounces. During week 21, your baby has developed their sucking reflex, so now they’ll be able to suck their thumb. Also, your baby will be covered in a fine, downy hair (lanugo), which is used to hold the vernix caseosa on the skin. In week 22, your baby’s eyebrows and hair become visible. Also, brown fat, which is essential for heat production, begins to form. If you’re having a boy, their testes begin to descend. Your baby is about 7 ½ inches long and weighs about 1 pound. During week 23, your baby starts to have the ability to rapidly move their eyes and may start experiencing hiccupping. Also, the ridges that will become their fingerprints and footprints start develop on their hands and feet. In week 24, your baby’s skin will appear wrinkled and pink to red in color because of the visible blood vessels. You baby will be 8 inches long and weigh 1 1/3 pounds. During week 25, your baby might begin responding to familiar sounds and will spend the majority of their sleep time in rapid eye movement (REM) sleep. In week 26, your baby’s lungs start making surfactant, which is vital for allowing their air sacs inside their lungs to inflate and not collapse when they deflate. During week 27, the end of the second trimester, your baby’s nervous system is continuing to develop, they’re gaining fat and their skin starts to look smoother.
Third Trimester
The third trimester can sometimes be challenging because it can be hard to get comfortable due to the size of your stomach. Braxton Hicks contractions will likely increase in frequency, which means you’ll have them even without any increase in activity level. Also, they’ll become strong the closer you get to your due date. At this point, the hormones start telling your body to relax the connective tissue that hold your pelvis in place. This can be hard on your back. If you need to sit, find chairs that offer good back support and apply a heating pad/ice pack to your back. Make sure that your shoes aren’t high-heels and provide good arch support. Since your uterus is pressing on your diaphragm, it can make it hard to take a deep breath, so you might become easily winded. Due to the increase blood circulating throughout your body, your might notice tiny, red veins (aka spider veins) on your face, neck and arms. Sometimes, you might have enlarged veins in your legs, which are called varicose veins. In addition to both of these, the increased blood volume can cause your veins around your rectal area to become enlarged, which can result in hemorrhoids. The key to preventing any of these is to exercise, drink plenty of fluids and eat foods high in fiber. If you do have hemorrhoids, soak the area in warm water or use witch hazel pads. You might also need to use panty liners because of the pressure your uterus is placing on your bladder, you might accidently leak urine, especially if you laugh, cough, sneeze, bend or lift. At this point, the reality of parenthood sinks in and can increase your anxiety level, especially if this is your first child. At this point, you’ll want to make sure that you have everything that you’ll need for after your baby is born, including nursing bras and a breast pump. Also, regardless of your vaccination status, your doctor will recommend that you get a Tdap vaccine at some point between week 27 and 36 in order to protect your baby because they’ll be too young to receive the vaccine when they are born. If you already haven’t been screened for gestational diabetes, iron deficiency anemia or Group B strep, your doctor will recommend that you have this done during your third trimester in order to best prepare for birthing process.
The last trimester starts at week 28 for your baby. In this week, their eyelids can partially open and they’ve developed eyelashes. Also, their central nervous system can regulate body temperature and control rhythmic breathing movements. During week 29, your baby will begin to kick, stretch and make grasping movements with their hands. In week 30, your baby will be able to open their eyes wide, they’ll have a lot of hair on their head and their bone marrow is forming. They will be 10 ½ inches long and weigh about 3 pounds. By the time your baby reaches week 31, the majority of their development will be complete and they’ll begin to gain weight quickly. During week 32, the lanugo starts to fall off and your baby’s toenails will be visible. Your baby will be 11 inches long and weigh 3 ¾ pounds. In week 33, your baby will begin to detect light since their pupils are now reactive and their bones are continuing to harden (except for their skull). During week 34, your baby’s fingernails have reached their fingertips. Your baby will be about 12 inches long and weigh at least 4 ½ pounds. In week 35, your baby’s skin starts to look smooth and their limbs appear chubby. During week 36, your baby will take up most of the space inside the amniotic sac, but will still be very active. In week 37, your baby will have the ability to have a firm grasp and their head might start to descend into your pelvis to get ready for being born. During week 38, your baby’s toenails reach the tips of their toes and all of the lanugo is gone. Also, the circumference of their head and stomach are about the same. They should weigh at least 6 ½ pounds. In week 39, your baby is continuing to pack on the fat in order to help themselves keep warm once they’re born. Also, their chest becomes more prominent and, for boys, their testes continue to descend. Week 40 is finally here and your due date is approaching. At this point, your baby might be 14 inches long (remember that is a measurement from the top of their head to their bottom) and weigh about 7 ½ pounds. The key thing to remember is that every baby is different when it comes to size, weight and what day they’re born (it’s usually before or after their due date since that is just an estimation).
How to Have a Healthy Pregnancy
Now that you’ve got an understanding of how your body is going to change and how your baby is growing, what do you need to do throughout your pregnancy to make sure you both stay healthy? There are three big areas you should take a look at, which are exercise, diet and sleep. While it might seem counterintuitive, exercising during pregnancy is a critical component of being and staying healthy for not only the duration of your pregnancy, but afterwards as well. Exercise can help with reducing backaches, constipation, bloating and swelling. It can also boost your mood/energy levels, help you sleep better, prevent excess weight gain and promote muscle tone/strength and endurance. In addition, if you exercise during pregnancy, you can decrease your risk of developing gestational diabetes, potentially shorten the length of your labor and lessen the risk of needing a C-section. It’s important to check with your doctor before starting any exercise routine because you might have certain factors that could make exercising dangerous. If you are exercising, remember to pace yourself. For most pregnant women, 30 minutes of moderate-intensity exercise is recommended most days of the week. This means that while exercising, you should still be able to carry on a conversation. If you haven’t exercised in a while, start off with less time, like 10 minutes, and slowly work your way up to longer periods of time. You can also do strength training, but don’t go too heavy on the weights. Always warm up first, drink plenty of water during and stretch/cool down after to avoid any injuries. Some activities you should definitely avoid include any that requires you to lay on your back after the first trimester, scuba diving, contact sports, pose a high risk of falling, hot yoga/Pilates, cause direct trauma to your abdomen or exercising at high altitude. If you have any vaginal bleeding, dizziness, headache, chest pain, shortness of breath, calf pain/swelling, painful contractions that continue even after resting, fluid leaking/gushing from your vagina or muscle weakness that affects your balance, you should contact your doctor immediately.
Another key element to having a healthy pregnancy is diet. It’s crucial to eat a diet that is well-balanced in order to get all the nutrients that you and your baby need. Eating grains, especially those that are whole or enriched, is important because they provide the main energy source for you both, carbohydrates. Incorporating a wide variety of fruits and vegetables into your diet is a good way to get a significant number of beneficial nutrients. Protein is essential for your baby’s growth, so eating a diet that includes meat, poultry, fish, eggs and beans is a good way to get enough. A side benefit is that many of these choices are also high in B vitamins and iron. Fish is an excellent source of omega-3 fatty acids, which supports your baby’s brain development. However, it’s essential to avoid fish that are high in mercury, such as swordfish, king mackerel, tilefish and shark. Also, don’t eat raw fish, like sushi. Your body needs calcium not only for your health, but to help your baby’s bones and teeth form. If your stomach can tolerate it, try to drink 3 cups of milk a day. If dairy products are upsetting your stomach, look for options that are fortified with calcium, like certain orange juices. Your body and your baby need fats, but they should be healthy fats, such as nuts, seeds or avocados. Remember, it’s okay to enjoy sweets, but don’t overindulge because it can lead to problems like gestational diabetes. One big thing that most people forget about is drinking enough water. Water helps the nutrients you eat get to your baby. Also, it can help decrease the chances of having constipation, hemorrhoids, excessive swelling and urinary tract infections. You should aim to drink about 10 cups of fluid per day. This can include water, juice, coffee (just be careful with caffeine—no more than 200mg a day), tea and soft drinks (watch out for those with high amounts of sugar). If you’re concerned that you might be missing any essential nutrients, talk to your doctor about talking a supplement, such as prenatal vitamin. If you’re pregnant with more than one baby, you’ll need to significantly increase the amount of nutrients and calories that you take in. Your doctor will help you plan what the appropriate amount is for you at each stage of your pregnancy. With any of your meals, it’s important that all meats, eggs and any other foods that should be cooked are done so thoroughly. Make sure that all raw fruits and vegetables are washed. Avoid any unpasteurized foods, herbal teas and alcohol.
One factor that is critical during pregnancy, but often over looked is sleep. There are several factors that can impact the quantity and quality of your sleep, like morning sickness, frequent urination, physical discomfort, fetal movement, leg cramps, heartburn, irregular uterine contractions, anxiety and shortness of breath. During the early stages of pregnancy, the increase in hormone levels can also make you feel fatigued and sleepy during the day. There are several things that you can do to help minimize the disturbances. Avoid falling asleep on your back and place a pillow between your bent knees and/or under your stomach to provide support. Make sure that your room is dark, quiet and comfortable temperature in order to create a relaxing environment. It can be helpful to go to bed and wake up at the same time each day. Besides eating small, frequent meals throughout the day to avoid heartburn, stop eating three hours prior to going to sleep and sleep on your left side with your head elevated. By getting some physical exertion during the day, you’ll be more tired at night. Another great thing to try is doing relaxation techniques before you go to bed, like mediation.
Pregnancy can be a wonderful experience. If you follow the tips mentioned above and listen to the guidance provided by your doctor, you and your baby will be healthy. If you have any questions or concerns about pregnancy, please speak with your doctor. If you would like more information, please visit the Center for Disease Control’s Pregnancy page at https://www.cdc.gov/pregnancy/index.html