What to Expect when you get Pregnant
Pregnancy is a normal state and in the majority of fit and healthy women there are few, if any, complications. Even so, your body will undergo significant changes from the way it usually functions so it will help to have some understanding of what to expect when you are pregnant.
It is important to remember that every woman is an individual and will respond in her own unique way to pregnancy. If this is your first pregnancy you are likely to be alert to any new changes you experience. Some will be hard to ignore, such as your increasing size, while others may be more subtle and you may not even be conscious of them.
When will I need to worry?
The line between knowing what is normal and when to be worried can be very blurred. Some changes are obviously concerning, such as bleeding, abdominal pain or a slowing down in the baby’s movements. But other changes, for example, an increase in your blood pressure or protein in your urine will be harder to detect yourself. This is one of the reasons why it is so important to attend regular ante-natal checks with your maternity care provider.
There are no silly questions
It is worth remembering that seeking reassurance from your maternity care provider can be an important way to reduce your own stress and maximize the enjoyment of your pregnancy. Part of their role is education and support so make a list of what you want to know and become actively involved in your own ante-natal health care.
Most of the early changes during your pregnancy will relate to the zygote finding its way from your fallopian tubes and then nestling into your uterine wall. Sustaining it and maximizing its survival will become your body’s number one priority.
What about me?
In the early weeks of your pregnancy, it will seem as if your body just goes onto auto-pilot. Years of evolutionary biology means that your body will know how to nurture your fertilized egg and support it until it is fully developed. All of this means of course, that you and your needs will have to take a back seat for a while. Over the duration of your pregnancy, your comfort, mobility, digestion and metabolism will all change to maximize your baby’s chances of survival.
Don’t forget your folic acid
In the early weeks try to minimize your exposure to any toxins which could potentially cause developmental problems. Taking a folic acid supplement of at least 400 micrograms for one month before conceiving and the first three months of pregnancy will help to reduce the chances of your baby developing a neural tube defect.
Early physical changes
- A missed period. If you have a 28 day cycle, you are likely to have ovulated on around the 14th day after the first day of your last period. Conception usually occurs within a couple of days of ovulation.
- A slight vaginal bleed around 5-10 days after conception. This is known as an implantation bleed and occurs as the zygote nestles into the highly blood infused uterine lining. Less than 50% of women will have an implantation bleed so don’t be alarmed if you don’t.
- Breast and nipple changes. Increased sensitivity, enlargement, darkening of the nipples and a feeling of heaviness in the pelvic region is normal.
- A metallic or strange taste in the mouth.
- Many pregnant women describe a sensation of feeling different, odd or just know that they are pregnant.
- Urinary frequency. Not being able to hold on for as long when you need to go to the toilet and empty your bladder.
- Feeling exhausted and overwhelmed with tiredness.
- Feeling nauseated and experiencing changes in your normal appetite. Developing an acute sense of smell and not being able to tolerate some odors. Red meat, raw chicken, fish and eggs can be particularly hard to tolerate in the early months of pregnancy.
- Developing more pimples and fine veins across the face and chest.
Later physical changes
- Increasing abdominal size from around the 12th week of pregnancy. This is when your enlarged uterus will start lifting up and out of your pelvic rim and moving its way upwards.
- Increasing breast size and darkening of the areola with small pimples appearing. Towards the 3rd trimester of pregnancy, production of colostrum with occasional leakage. These changes will be happening as your breasts prepare for breastfeeding.
- Weight gain. A normal and healthy weight gain in pregnancy is 10-12 kilograms. There is usually little gain in the first trimester, more in the second and the greatest amount in the third trimester.
- Baby movements which can be felt and seen. Most first time mothers can feel their baby moving (known as quickening) from around 16 weeks of pregnancy. This is earlier for mothers who have been pregnant before as they know what signs to be alert for.
- Breathlessness as your enlarging uterus displaces your lungs and diaphragm. From around week 36, there can be a “lightening” as your baby drops into your pelvis in preparation for childbirth. This tends to happen with first time mothers more commonly than those who’ve had babies before.
- Varicose veins, hemorrhoids, stretch marks, indigestion, heartburn, flatulence, constipation and swollen feet. When listed all together it does make you wonder what possesses women to reproduce doesn’t it? Trite as it sounds though, it is all worthwhile when you are holding your own baby in your arms.
- The amount your heart is pumping every minute will increase by around 40% before you are even 20 weeks pregnant. The total volume of your blood will increase by around 50% by the time your baby is due. Which means your heart and entire circulatory system increases its capacity and function to meet all the extra demands your pregnancy will make. No wonder you feel tired sometimes.
During your pregnancy, it may feel as if hormones are ruling your life. They will play a major role in sustaining your pregnancy and ensuring your baby’s chances of survival are as high as possible. But, hormones can also be responsible for mood swings and emotional instability. If you’re not usually prone to tears and are fairly even tempered, pregnancy could bring out a whole new side in you.
You may even feel depressed at times and a little overwhelmed by all the changes going on within your body. Be reassured that these mood changes will not be permanent and will stabilize after the baby is born.
As pregnancy involves the beginning of many adjustments to your life, physically, mentally and emotionally, at times this may feel a little overwhelming and it is common for women to experience higher levels of stress in pregnancy.
The level of stress you may experience may depend on a range of factors, but there are a range of things that you can do to minimize you levels of stress, including:
- being aware of your expectations
- avoiding alcohol or drugs
- addressing any relationship issues that may be causing added uncertainty or stress
- looking after yourself – taking time for you to do things to help you relax.
Whilst some degree of stress is normal in pregnancy, if you find that this starts to become overwhelming or that you are finding it difficult to cope from day-to-day, this may be a sign that you are experiencing anxiety or depression.
We know that the women are more likely to experience mental health problems in pregnancy and in the year following a baby – more so than at any other stage of her life. There are a range of different types of mental health conditions that can arise in pregnancy, including a range of anxiety conditions and depression. This is more likely if you have experienced these conditions in the past and/or have a family history. Women who have bipolar disorder may also be at particular risk, so it’s important to talk to your doctor about any history as this can also affect what medications are safe to use in pregnancy.
The most important thing is be informed so that you can identify early signs of a mental health condition and seek help early. The faster you seek help, the faster you can recover and be in best prepared for the arrival of your baby.
Loss of control
If you’ve always enjoyed a certain feeling of control over your eating patterns, your size and general appearance, pregnancy could mean you feel you have lost a great deal of power. It is inevitable that your shape and size will change during your pregnancy. But this does not mean you need to forgo all personal investment in looking good.
Focus on your grooming, looking well dressed and maintaining a healthy weight gain. Feeling resentful about your pregnancy will only make you feel worse and there is nothing to gain from this. Try to view this time in a positive way and don’t lose your sense of humor.
Anxiety is a common emotion during pregnancy. It can be free floating and fairly general or more specific and targeted such as fear of labour and childbirth. Pregnant women can ruminate e.g. go over the same thoughts and worries in their minds. At the extreme, rumination can be a symptom of depression or Obsessive Compulsive Disorder. Speak with your maternity care provider about your feelings. They will have heard similar stories many times before and you owe it to yourself and your baby to ensure your mental health is stable.
Practical concerns such as how to cope on a reduced income, housing, budgeting, child care and simply providing for another little person in the house can all cause great concern. Speak with your partner and your family. Work out practical, realistic ways to ease the burden.
It is common for pregnant women to feel ambivalent at times. Sometimes you may feel overwhelmed with excitement for the new baby and other times you may just feel very neutral about it. Guilt may creep into your mind, especially in the early morning hours when you may be unable to sleep. You could worry that the baby knows if it wasn’t planned, if its arrival will be sooner than you or your partner were planning for or even if your relationship with your partner is not as secure as you’d like it to be. Confusion, guilt, regret and even a little panic are all common emotions during pregnancy.
It is very common for pregnant women to become extra sensitive to criticism. You may find yourself perceiving criticism when in fact, it was never intended as such. Being ultra sensitive and emotionally touchy is a common state, so give yourself permission to not get it right all the time.
Be adult enough to apologize to someone when you feel you were wrong. This helps to build empathetic relationships and you’ll be amazed by how understanding most people can be.
Do you now find yourself avoiding black cats, not walking under ladders and never opening umbrellas in the house? Superstitions can reign during pregnancy and even if you’ve never worried about putting new shoes on a table before (bad luck you know), you’ll find yourself being a little more aware. So, if it makes you feel better to avoid triggers which you feel could be bad omens, do so. Historically, superstitions were one way of explaining what science now can.
Isolation and loneliness
Avoid isolating yourself during your pregnancy. This is easier said than done if you have other small children at home. Simply getting out of the house with young children is very difficult and it is often easier just to give in and stay home. But for your own socialisation needs it is important that you talk and connect with other women. Look for playgroups in your local area and speak with your early childhood nurse about what mother’s groups operate in your community.
Teresa first felt the lump in her breast while she was breastfeeding her 4 month old daughter Briony. Initially, she dismissed it as being a cyst caused by a thickened milk duct. However, when she mentioned her concerns at Mother’s Group the following week, the advice was the unanimous: “Get it checked at the doctor.” While her doctor thought it might be just a blocked milk duct she referred her for an ultrasound anyway.
It is easy to neglect breast self examinations during pregnancy and breastfeeding. The huge changes to your body and often lack of sleep make it hard to continue doing so. There are also many different lumps in your breast that can occur during this time, including plugged ducts and lipomas.
For women who are breastfeeding, it can be difficult to know if lumps in the breast are harmless or sinister. Usually your GP will take what is known as the triple test approach, which includes a breast exam and taking your personal history. This will then be followed up with an ultrasound and a biopsy if required.
If the diagnosis is one of breast cancer it is important to seek support. The cancer council in your country will be able to provide you with helpful links and resources at a difficult time. They will be able to help you access help with caring for your children and further information on your treatments. Organizations are especially designed to provide practical support for mums with young children during their treatment.
Sharing this information with your children can be very challenging especially if they are very young. There are some books especially designed for them that can be very helpful to read with them. It will allow them to access this information at a level they can understand.
If you have a friend who is diagnosed with breast cancer it is extremely useful to ensure you are able to provide practical support if needed. Offering to help out with shopping, the school run or keeping your friend’s spirits up is important to their treatment and recovery. You can also be an advocate for your friend by seeking out services for them to use as well.The crucial thing is to talk to your doctor if you find any lumps you are unsure about. It is important to be pro-active about self breast examination and seek a second opinion if necessary.