What women can expect during each trimester of pregnancy
This covers the physical and emotional changes women can expect during pregnancy. It does not cover what is happening to the fetus during this time.
Content
Pregnancy: First Trimester Weeks 1-13 Weight BP Pulse Behavior Emotional 2-4 lbs Normal (90-139/60-89 mm Hg) Tired, ambivalent Surprised, excited, happy, relieved Shocked, scared, unsure Anxious or concerned Teary, mood swings Worried about miscarriage Relationship reactions
Pregnancy: Second Trimester Weeks 14-27 1 lb/week (11 lbs) Lower Introspective, energetic Excited, mixed emotions Forgetful and vague Healthy and 'glowing' I hate being pregnant! Wondering who the baby will look like and which sex Fantastic or scary dreams Body image and sexuality Thinking about relationship with own mother Feeling depressed
Pregnancy: Third Trimester Weeks 28-40 1 lb/week (11 lbs) Normal Restless, preparing for baby, labile moods Excited, can't wait to meet my baby Scared or anxious Feeling teary, mood swings Body image and sexuality Sensitive to what I watch and who I'm with Will my baby be OK? Concerns about relationship changes Parenting, can I do this? Feeling fed up Concerns of dying in labor Mood swings, forgetfulness and excitement Increased fetal movement; Protrusion of navel; Large belly Good appetite, cravings
May increase, 10-15 bpm (normal: 60-90 bpm)
Pregnant Look Eating
Absent
Waistline thickens, pregnancy becomes more obvious Breast enlargement 15% of women will continue to feel nauseous or vomit Appetite returns, food cravings
Morning sickness, increased salivation (ptyalism) Mild cramping, tugging and pulling Straie gravidarum, spider nevi
Skin
Heat and hormonal rashes, oily or dry skin, Linea nigra, straie gravidarum, chloasma, stretch marks, a darkening (or spider nevi pigmentation) of the skin in various areas, skin tags and red spider veins Linea nigra, straie gravidarum, chloasma, spider nevi Aches and pains Backache and sciatica
Physical: General
Increased blood flow to skin (↑ sweating Feel warmer and sweat more and warmer extremities), 'bloated' and Bleeding gums; Nose bleeds
possibly experiencing cramping and/or pelvic discomfort, slight backache Morning sickness Dizziness, fainting PMS-type symptoms: Swollen tender breasts, feeling tired, 'bloated' and possibly experiencing cramping and/or pelvic discomfort
Constipation Longer colds and sinus infections Heightened sense of smell Heartburn Hemorrhoids Indigestion Metallic taste Restless legs; swelling, fluid retention Pain-'stretching and burning' to very mild cramping, to low, heavy aching and 'dragging' or stitch-like pains with tugging and pulling Braxton-Hicks contractions
Breathlessness Carpal tunnel/numb and tingling hands Constipation Frequent urination Hemorrhoids Heartburn Insomnia Leg cramps Nausea/vomiting during late pregnancy Palpitations Restless legs Swelling, fluid retention Symphysis pubis pain Tiredness and insomnia Increased vaginal discharge Varicose veins of the legs Varicose veins of the vulva Increased breast size, tenderness Vagina soft, mucous lining swells to produce more secretions; discharge is usually milky white (known as 'leucorrhoea') or clear and mucous-like (no smell) Vagina and genitals look very purplish or blue in color Heightened sexual sensations Cervix thins, softens and ripens in preparation for labor ↑ urination, constipation woman may start to feel tired, heavy and large. There are often other discomforts such as heartburn, sore hips or back pain, frequent toilet trips, cramps, restless legs or strong Braxton Hicks contractions. All these can contribute to reducing the woman's interest in sex.
Breasts and Vagina
Swollen tender breasts, dark coloring around areola Skin of the nipple and areola may start to darken or 'pigment' Goodell's sign Chadwick's sign Hegar's sign
Breast tenderness, slight increase in breast size; nipples often become very sensitive and the veins under the skin more noticeable Some colostrum expression (nipple secretions) Increased risk of vaginal infections-thrush, gardnerella
GI Sexuality
↑ urination, constipation, gas Extra blood flow to the breasts and genitals can increase sensitivity, sexual arousal and the desire for sex -ORContinual tiredness, nausea and/or vomiting, making sex the furthest thing from their mind
Normal Extra blood supply to the vagina and clitoris increase sensation, genitals softer and more full; nipples can be extremely sensitive to touch, being either more sensuous or perhaps uncomfortable; breasts are larger and sometimes tender
Use Naegele's rule to calculate baby's due date: 9 months + 7 days after the first day of your last NORMAL menstrual period The 'average' weight gain of around 12 to14 kg can be physically attributed to: baby = 3 to 4 kg placenta = 0.5 kg amniotic fluid = 1 kg uterus = 1 kg blood volume = 1.5 kg breasts = 0.5 kg Fat stores for breastfeeding = 3.5 kg Fluid retention = 1.5 kg The 4 or 5 digit system is used to notate a woman's pregnancies: TPAL (4) or GTPAL (5) G: gravity, pregnancy T: term births, born after week 38 to 42 P: preterm births, born between 20-37 weeks A: abortions, miscarriage or elective termination L: living children
Common Indicators for Problems Your entire system is readjusted when you're pregnant. The heart pumps more blood and the lungs work more efficiently, as does the digestive system. With these and more changes occurring, it is no wonder that pregnancy can be uncomfortable. Minor aches and pains can be dealt with; however, you should never ignore pain or extreme fatigue, which can be warning signs of trouble. Always consult your health care provider if you experience any of these changes: Pain or burning during urination Vaginal spotting or bleeding; Leaking or gushing from vagina; Blister or sore in vaginal area Uterine contractions Severe nausea or vomiting; Severe abdominal pain Chills and fever over 100 degrees Dizziness or lightheadedness; Severe headache Swelling of the face, eyes, fingers or toes Sudden weight gain Visual problems Noticeably reduced fetal movement Absence of fetal movement for 24 hours A hot, reddened painful area behind your knee or calf And just when you think you can't take it another day, the biggest changes of all: labor and delivery!
First Trimester 1 - 3 Months Physical and emotional changes that may be happening during this trimester include: Physical & Emotional Changes Fatigue Morning Sickness Relief Measures/Feelings
• • • • • •
rest when possible usually decreases by mid-second trimester small, frequent meals dry crackers drink after eating, not at meals never become hungry
Second Trimester 4 - 6 Months You will be feeling less tired. Often women feel a sense of physical well-being during this trimester. This is a great time for vacations and projects. Physical & Emotional Changes Fetal Movement Steady Weight Gain Relief Measures/Feelings
• • •
excitement affirms the growth of the fetus feels good knowing that eating a balanced diet takes good care of both mother and baby
Third Trimester 7 - 9 Months You will be getting more tired as the baby and your body continue to change, which requires lots of energy. You are becoming more uncomfortable, and your nighttime sleep may be interrupted and not very restful. Naps are helpful midday, if possible. Physical & Emotional Changes Braxton-Hicks Contractions Shortness of Breath Relief Measures/Feelings
• • • •
body preparing for labor if frequent, consult MD avoid rushing and crowded areas sleep with extra pillows
Pregnancy: Second Trimester Weeks 14-27 1 lb/week (11 lbs) Lower Introspective, energetic Excited, mixed emotions Forgetful and vague Healthy and 'glowing' I hate being pregnant! Wondering who the baby will look like and which sex Fantastic or scary dreams Body image and sexuality Thinking about relationship with own mother Feeling depressed
Pregnancy: Third Trimester Weeks 28-40 1 lb/week (11 lbs) Normal Restless, preparing for baby, labile moods Excited, can't wait to meet my baby Scared or anxious Feeling teary, mood swings Body image and sexuality Sensitive to what I watch and who I'm with Will my baby be OK? Concerns about relationship changes Parenting, can I do this? Feeling fed up Concerns of dying in labor Mood swings, forgetfulness and excitement Increased fetal movement; Protrusion of navel; Large belly Good appetite, cravings
May increase, 10-15 bpm (normal: 60-90 bpm)
Pregnant Look Eating
Absent
Waistline thickens, pregnancy becomes more obvious Breast enlargement 15% of women will continue to feel nauseous or vomit Appetite returns, food cravings
Morning sickness, increased salivation (ptyalism) Mild cramping, tugging and pulling Straie gravidarum, spider nevi
Skin
Heat and hormonal rashes, oily or dry skin, Linea nigra, straie gravidarum, chloasma, stretch marks, a darkening (or spider nevi pigmentation) of the skin in various areas, skin tags and red spider veins Linea nigra, straie gravidarum, chloasma, spider nevi Aches and pains Backache and sciatica
Physical: General
Increased blood flow to skin (↑ sweating Feel warmer and sweat more and warmer extremities), 'bloated' and Bleeding gums; Nose bleeds
possibly experiencing cramping and/or pelvic discomfort, slight backache Morning sickness Dizziness, fainting PMS-type symptoms: Swollen tender breasts, feeling tired, 'bloated' and possibly experiencing cramping and/or pelvic discomfort
Constipation Longer colds and sinus infections Heightened sense of smell Heartburn Hemorrhoids Indigestion Metallic taste Restless legs; swelling, fluid retention Pain-'stretching and burning' to very mild cramping, to low, heavy aching and 'dragging' or stitch-like pains with tugging and pulling Braxton-Hicks contractions
Breathlessness Carpal tunnel/numb and tingling hands Constipation Frequent urination Hemorrhoids Heartburn Insomnia Leg cramps Nausea/vomiting during late pregnancy Palpitations Restless legs Swelling, fluid retention Symphysis pubis pain Tiredness and insomnia Increased vaginal discharge Varicose veins of the legs Varicose veins of the vulva Increased breast size, tenderness Vagina soft, mucous lining swells to produce more secretions; discharge is usually milky white (known as 'leucorrhoea') or clear and mucous-like (no smell) Vagina and genitals look very purplish or blue in color Heightened sexual sensations Cervix thins, softens and ripens in preparation for labor ↑ urination, constipation woman may start to feel tired, heavy and large. There are often other discomforts such as heartburn, sore hips or back pain, frequent toilet trips, cramps, restless legs or strong Braxton Hicks contractions. All these can contribute to reducing the woman's interest in sex.
Breasts and Vagina
Swollen tender breasts, dark coloring around areola Skin of the nipple and areola may start to darken or 'pigment' Goodell's sign Chadwick's sign Hegar's sign
Breast tenderness, slight increase in breast size; nipples often become very sensitive and the veins under the skin more noticeable Some colostrum expression (nipple secretions) Increased risk of vaginal infections-thrush, gardnerella
GI Sexuality
↑ urination, constipation, gas Extra blood flow to the breasts and genitals can increase sensitivity, sexual arousal and the desire for sex -ORContinual tiredness, nausea and/or vomiting, making sex the furthest thing from their mind
Normal Extra blood supply to the vagina and clitoris increase sensation, genitals softer and more full; nipples can be extremely sensitive to touch, being either more sensuous or perhaps uncomfortable; breasts are larger and sometimes tender
Use Naegele's rule to calculate baby's due date: 9 months + 7 days after the first day of your last NORMAL menstrual period The 'average' weight gain of around 12 to14 kg can be physically attributed to: baby = 3 to 4 kg placenta = 0.5 kg amniotic fluid = 1 kg uterus = 1 kg blood volume = 1.5 kg breasts = 0.5 kg Fat stores for breastfeeding = 3.5 kg Fluid retention = 1.5 kg The 4 or 5 digit system is used to notate a woman's pregnancies: TPAL (4) or GTPAL (5) G: gravity, pregnancy T: term births, born after week 38 to 42 P: preterm births, born between 20-37 weeks A: abortions, miscarriage or elective termination L: living children
Common Indicators for Problems Your entire system is readjusted when you're pregnant. The heart pumps more blood and the lungs work more efficiently, as does the digestive system. With these and more changes occurring, it is no wonder that pregnancy can be uncomfortable. Minor aches and pains can be dealt with; however, you should never ignore pain or extreme fatigue, which can be warning signs of trouble. Always consult your health care provider if you experience any of these changes: Pain or burning during urination Vaginal spotting or bleeding; Leaking or gushing from vagina; Blister or sore in vaginal area Uterine contractions Severe nausea or vomiting; Severe abdominal pain Chills and fever over 100 degrees Dizziness or lightheadedness; Severe headache Swelling of the face, eyes, fingers or toes Sudden weight gain Visual problems Noticeably reduced fetal movement Absence of fetal movement for 24 hours A hot, reddened painful area behind your knee or calf And just when you think you can't take it another day, the biggest changes of all: labor and delivery!
First Trimester 1 - 3 Months Physical and emotional changes that may be happening during this trimester include: Physical & Emotional Changes Fatigue Morning Sickness Relief Measures/Feelings
• • • • • •
rest when possible usually decreases by mid-second trimester small, frequent meals dry crackers drink after eating, not at meals never become hungry
Second Trimester 4 - 6 Months You will be feeling less tired. Often women feel a sense of physical well-being during this trimester. This is a great time for vacations and projects. Physical & Emotional Changes Fetal Movement Steady Weight Gain Relief Measures/Feelings
• • •
excitement affirms the growth of the fetus feels good knowing that eating a balanced diet takes good care of both mother and baby
Third Trimester 7 - 9 Months You will be getting more tired as the baby and your body continue to change, which requires lots of energy. You are becoming more uncomfortable, and your nighttime sleep may be interrupted and not very restful. Naps are helpful midday, if possible. Physical & Emotional Changes Braxton-Hicks Contractions Shortness of Breath Relief Measures/Feelings
• • • •
body preparing for labor if frequent, consult MD avoid rushing and crowded areas sleep with extra pillows
