Pregnancy is a period of joy, expectations and apprehension for a couple. Lets understand the various changes during the period of nine months and associated pregnancy care. Pregnancy is divided into three trimester each of 13 weeks. Total pregnancy is made of 40 weeks.
1st Trimester
The first symptom of pregnancy is missed periods. When you visit the doctor specialised test is done to confirm pregnancy and a review of your personal and family history done to optimise your body for the pregnancy. Some of the common complaints in this initial phase are :
- Breast tenderness: Because of the hormonal changes you might have complains of breast pain and heaviness. These symptoms usually decrease after a few weeks as the body adjusts to hormonal changes.
- Nausea with or without vomiting: Morning sickness, which can happen at any time of the day or night, commonly after 7 to 8 weeks of pregnancy. To reduce this symptom, avoid having an empty stomach. Have frequent but small meals around two hourly interval. Avoid spicy and oily food. Drink plenty of fluids and foods containing ginger might help.
- Urinary complains: Increased in frequency of urination or sense of incomplete emptying of bladder is common. But, the symptoms usually improves with time.
- Urinary complains: Increased in frequency of urination or sense of incomplete emptying of bladder is common. But, the symptoms usually improves with time.
- Heartburn: Is a common complaint due to reflux of stomach acid into the esophagus causing heartburn. Eat small, frequent meals and avoid fried foods, citrus fruits, chocolate, and spicy or fried foods.
Constipation: Progesterone hormone causes relaxation of smooth muscle of intestine causing slow movement of food through your digestive system, resulting in constipation. Include plenty of fiber in your diet and drink lots of fluids, especially water or fruit juices. Exercise also helps.
Antenatal Care
The first visit will be once you missed periods where the doctor confirms pregnancy and start you on folic acid. A early pregnancy scan will be done at around 6 to 7 weeks to confirm the location of pregnancy, number of fetus and cardiac activity.
At 11-12 weeks, fetal screening with the help of NT scan and dual marker are done. In this risk of abnormal fetal syndromes like Down’s, Edward, and Patau syndrome are ruled out.
2nd trimester pregnancy
The second trimester of pregnancy is often the most enjoyable.
The second trimester of pregnancy often brings a renewed sense of well-being. Symptoms of nausea and vomiting have usually passed, there are less respiratory and abdominal discomfort as compared to the third trimester.
During the second trimester of pregnancy, you might experience physical changes, including:
- Increase in the size of breast and abdomen (belly): As your uterus expands to make room for the baby, your belly grows. Your breasts will also gradually continue to increase in size. A supportive bra with wide straps or a sports bra is a must.
- Braxton Hicks contractions: You might feel these mild, irregular contractions as a slight tightness in your abdomen. Contact your health care provider if the contractions become regular and steadily increase in strength. This could be a sign of preterm labour.
- Skin changes: Hormonal changes stimulate an increase in pigment-bearing cells (melanin) in your skin. As a result, you might notice brown patches on your face (melasma). You might also see a dark line down your abdomen (linea nigra). These skin changes are common and usually fade after delivery. Sun exposure, however, can aggravate the issue. When you're outdoors, use sunscreen. You might also notice reddish-brown, black, silver or purple lines along your abdomen, breasts, buttocks or thighs (stretch marks). Although stretch marks can't be prevented, most eventually fade in intensity.
- Dental issues: Pregnancy can cause your gums to become more sensitive to flossing and brushing, resulting in minor bleeding. Rinsing with salt water and switching to a softer toothbrush can decrease irritation. Frequent vomiting could also affect your tooth enamel and make you more susceptible to cavities. Be sure to keep up your dental care during pregnancy.
- Dizziness: Pregnancy causes changes in circulation that might leave you dizzy. If you're troubled with dizziness, drink plenty of fluids, avoid standing for long periods, and move slowly when you stand up or change position. When you feel dizzy, lie down on your side.
- Leg cramps. Leg cramps are common as pregnancy progresses, more commonly felt at night. Stretching exercise of calf muscles before bed and drink plenty of fluids can help to reduce such complains. A hot or cold fomentation of calf muscle might help.
- Vaginal discharge: Sticky, clear or white vaginal discharge. This is normal. Contact your health care provider if the discharge becomes foul smelling, altered in colour, or if it's accompanied by pain, soreness or itching in your vaginal area. This could indicate a vaginal infection.
- Swelling of Lower Limbs: Is common as the pregnancy advances, mainly due to compression of intraabdominal blood vessel resulting in oedema of feet and around ankle.
Antenatal care
During the second trimester, in a normal pregnancy without associated risk factor patient has to visit once a month for check-up. Monitoring of weight, blood pressure, size of the uterus by checking your fundal height and foetal heart rate is checked.
Weight gain should be around 2 kg per month from second trimester till delivery
Anomaly scan is done at 18 to 20 weeks to rule out any congenital malformation in the baby (Fetus).
3rd trimester pregnancy
The third trimester of pregnancy can be physically and emotionally challenging. It’s a very important phase of pregnancy where the woman prepares herself for labour , delivery, breastfeeding. Because of increasing size of abdomen the discomfort is increasing and often tiring.
Your body
As your baby grows, his or her movements will become more obvious. These exciting sensations are often accompanied by increasing discomfort and other signs and symptoms, including:
- Braxton Hicks contractions: Often there are complains of mild, irregular contractions as a slight tightness in your abdomen. Contractions increases in frequency become stronger as you approach your due date.
- Backaches: Due to the hormonal changes the connective tissue become relax, specially in the pelvic area. These changes can be tough on your back, and often result in discomfort during the third trimester. Do regular exercise. If you have severe or persistent pain, contact your health care provider.
- Shortness of breath: With increasing size of the uterus the lung capacity tend to decrease, yoga and breathing exercise will help and practice good posture to give your lungs more room to expand.
- Spider veins, varicose veins and haemorrhoids: Increased blood circulation might cause tiny red-purplish veins (spider veins) to appear on your face, neck and arms. Redness typically fades after delivery. You might also notice swollen veins (varicose veins) on your legs. Painful, itchy varicose veins in your rectal area (hemorrhoids) are another possibility. To ease swelling, exercise and elevate your legs frequently, include plenty of fiber in your diet and drink lots of fluids.
- Frequent urination: Due to downward movement of the baby there is increased pressure on the bladder as a result there is increased frequency of urine.
Prenatal care
During the third trimester, your health care provider might ask you to come in for more frequent checkups — perhaps every two weeks beginning at week 32 and every week beginning at week 36.
Like previous visits, your health care provider will check your weight and blood pressure and ask about any signs or symptoms you're experiencing. Regardless of your vaccination status, one dose of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine is recommended during each pregnancy — ideally during the third trimester, between weeks 27 and 36 of pregnancy. This can help protect your baby from whooping cough before he or she can be vaccinated.
You will also need screening tests for various conditions, including:
- Gestational diabetes. This is a type of diabetes that sometimes develops during pregnancy. Prompt treatment and healthy lifestyle choices can help you manage your blood sugar level and deliver a healthy baby.
- Iron deficiency anaemia. Iron deficiency anaemia occurs when you don't have enough healthy red blood cells to carry adequate oxygen to your body's tissues. Anemia might cause you to feel very tired. To treat anaemia, you might need to take iron supplements.
Your health care provider will also check your baby's size and heart rate. Near the end of your pregnancy, your health care provider will also check your baby's position and ask about your baby's movements. He or she might also ask about your preferences regarding labour and pain management as you get ready for delivery. If you have specific preferences for labour and birth — such as labouring in water or avoiding medication — define your wishes in a birth plan. Review the plan with your health care provider but keep in mind that pregnancy problems might cause plans to change.
As your due date approaches, keep asking questions. Knowing what to expect can help you have the most positive birth experience.