Pregnancy is a beautiful period of a woman’s life, but it can be difficult to know what to expect. Many physical and psychological changes take place in the body. A normal pregnancy should last between 38-42 weeks, ideally, 40 weeks. The date of pregnancy is calculated from the first day of the last menstrual cycle. When the date of the last menstrual cycle is unknown, your OBGYN will calculate an estimated pregnancy date based on the ultrasound findings.
During pregnancy, the body of the woman has to adapt to nourish the future baby; therefore, the future mom has to work hard to support their needs and the baby’s. Some of the most known changes are weight gain, fatigue, nausea and food cravings; but there are so many changes that happen during pregnancy, and it is important for women to know what to expect during pregnancy.
What To Expect During The First Trimester Of Pregnancy (Week 1-12)
The first trimester begins on the first day of the last menstruation. After the conception, the fetus begins to develop slowly and some essential structures start to form. The most notable system that starts to develop is the nervous system. Another system that begins to form is the cardiovascular system. The primitive form of the heart starts beating as early as day 21 of pregnancy. During the first trimester of pregnancy, the eyes and ears of the fetus start forming, as well as the future arms and legs.
The first trimester is key for the early development of the anatomy of the baby; alterations during the first trimester (like infections, or use of alcohol) can leave serious repercussions on the baby’s life. Additionally, the first trimester has the highest risk of miscarriages, because the pregnancy is still fragile.
During this time, the production of hormones increases to support the expected pregnancy, your ovaries will increase the secretion of progesterone. Progesterone is necessary to make sure that the uterus keeps adequate conditions to hold the pregnancy, but this hormone also has a lot of side effects that translate to the most common pregnancy symptom, morning sickness. Progesterone affects the muscle contraction of the muscles of the digestive symptom, this leads to feeling nauseous, and vomiting. These symptoms typically go away by the second trimester, but every pregnancy is different and women will feel nauseous and vomiting for the remainder of the pregnancy.
Along with these symptoms, the breast becomes tender and becomes bigger since the first stage breast milk (colostrum) starts to fill them. Additionally, the metabolic rate of the mother will increase, causing her to be hungrier, and more tired.
On the first visit, the doctor will explain the changes on habits that need to be done –no alcohol, no smoking, no curated meats, no drugs, no raw meat, less caffeine – as well as prescribing nutritional supplement pills like folic acid and iron. The doctor will also prescribe routine blood work, to evaluate the hemoglobin levels, and any possible alteration. Additionally, the doctor will order a blood type test, since it is very important to know if the mom has a negative blood type that could cause complications in the future. Urine tests are done as well, since pregnant women are at higher risk of urinary tract infections (UTI) and these can be dangerous for the baby. Stool exam is required to discard any kind of parasite infections.
At this point it is necessary to know if the mom is infected with any infections that could be harmful for the baby, like HIV or Hepatitis B and C. Other infections can be dangerous and potentially deadly for the baby when the mom acquires them during pregnancy (TORCH infections), such as toxoplasmosis, rubella, mumps, cytomegalovirus, and herpes. The doctor needs to know if you have had any of these infections before, or if you are susceptible to acquiring them, thus a serology test of the infections is prescribed.
The appointment with the doctor will be every 4 weeks; an ultrasound should be done on each of them to ensure the proper growth of the baby. The doctor will explain to you how much weight you should gain during your expected pregnancy, the dietary changes needed, and depending on the age of the mother, genetic testing of the baby might be necessary.
What To Expect During Your Second Trimester (Week 13-27)
This is generally the most comfortable time for pregnant women, the morning sickness and nausea should be better by now, and the future mom is more adapted to the pregnant life. The second trimester is when your baby will form the rest of the structures, and will start looking more like a baby; you will probably manage to see the baby during the ultrasounds very clearly.
The fetus will grow exponentially, and the weight will increase seven times. The eyes and ears will move to their final position on the head, the nails will grow, and the fingers and toes will separate and define. The hair of the baby will grow, the fingerprints are defined, and the baby will gain fat.
By week 20, mothers should be able to start feeling the baby kick and move for the first time. He can hear and recognize the mother’s voice, and respond to stimuli. The baby will also develop reflections like swallowing and sucking. The placenta is fully formed at this point, and a liquid called amniotic liquid surrounds the baby. Which provides him nutrition, and acts as an air bag, to keep the baby safe. The heart continues to grow, and the structures of a mature heart begin to form.
Even though the baby is not fully ready, a 24 weeks old baby could potentially survive in neonatal intensive care. By the end of the second trimester, all the systems are formed, and just need to grow and mature during the third trimester; however, the last structure to form are the lungs, and these will only start by week 28.
The mother will gain weight more quickly than before, and by week 15, the baby bump should be evident. By the end of the second trimester, the mother should have gained between 16-22 pounds. The breast will go at least two bra sizes up during this period. Some mothers will experience trouble sleeping, leg cramps, and will urinate more often, but in general, the second trimester is an enjoyable time for the future mother.
The doctors’ appointments will be every 4 weeks and halfway through the trimester the sex of the baby can be identified. If the mother has a family history of genetic defects, or if she is above 35 years old, genetic testing on the baby is done to identify conditions like Down Syndrome, Cystic Fibrosis, and Spina Bifida. Routine blood tests and urine tests are also done to evaluate the mother’s condition. Moreover, a blood sugar test will be done by weeks 24-28 to discard gestational diabetes.
By week 22 onwards, mothers should be able to get a 4D ultrasound for the baby; this is an exciting time for the parents. A 4D ultrasound shows the structure of the baby in three dimensions and the movement of the baby. Parents will get to see their future baby face and features. Studies show that parents that use 4D ultrasound have a deeper initial bond with the baby than those who do not.
What To Expect In Your Third Pregnancy Trimester (28-42 weeks)
The third trimester is probably the most uncomfortable one for the mother, but also the most exciting. The time of having the baby is rushing by, and parent’s can finish planning for their new child.
During this phase, the baby will continue to grow, and by week 28, the lungs will finally start to form. At this point, the baby can technically survive if it is born after 28 weeks, but of course it will need urgent care and it can be very risky. The ideal due time for baby’s is between 38 up to 48 weeks, any baby that is born outside of that time will face significant risks.
The body of the baby will continue to grow, and the movements will be rougher, as the space inside the uterus is limited because of the baby’s size. Mothers will feel harder and more frequent kicks. At this point, the baby is also trying to find its final position before the delivery, and that can be quite uncomfortable and painful for the mom. The size of the uterus will cause it to press the bladder, leading to the mother having to urinate a lot more frequently. It can also push to the rectum, making the mother have gases and diarrhea. The size of the pregnant belly can also cause back pain, and the breast becomes up to four bra sizes bigger than before pregnancy, contributing to the back pain as well. Mothers can also have more cravings than before, and even ask for weird combinations. Cravings are a way for the body to ask for a nutrient that it needs at the time. For example if you are feeling like chocolate, your body probably needs magnesium.
During the third trimester of the expected pregnancy, the mother will experience something called Braxton-Hicks Contractions. These are fake contractions that happen as preparation from your uterus to the delivery of the baby. Some mothers will confuse the Braxton-Hicks Contractions with proper contractions and visit the emergency room. The doctor will most likely help you differentiate them, and teach you how to recognize that you are in labor.
The doctors’ appointments will go from every 4 weeks, to every week-by-week 36. Close monitoring of the baby’s growth and vital signs is made. These medical appointments are also important for the mothers; the doctor needs to monitor the blood pressure, because it can get higher during this phase representing a huge risk for the baby and mothers life.
Closer to the delivery date, the mother will experience some changes. First, the mucus plug will be lost. This is a mucous substance that is on the uterus to prevent infections, as we get closer to the end of the pregnancy, this plug is lost to open the pathway for the baby. Second, Braxton-Hicks contractions will become more apparent and intense.
The mother will be instructed to visit their doctors if she experiences bleeding, contractions, or loss of amniotic liquid. Once this occurs, it is time for your baby to be born.
The Labor Plan
Pregnancy is a beautiful time in the life of a woman that desires to have children, but it is also challenging. The future mother will experience many changes in her body that are not only uncomfortable, but that can also be painful and stressful for her and the baby. Majority of pregnancies will have a happy outcome, but future mothers need to understand that complications can happen and that the birth plan that they chose might not be able to happen. Planning for pregnancy and birth is a good step because it gives the mom control over her experience, but it is important to know and be aware that plans do not always work. At the end of the day, the priority should be the health of the mother and the baby, instead of a set plan. Trust the professional’s advice, because they have the best interest of the mother and future baby in mind.
Lastly, the body of a pregnant woman goes under incredible changes to accommodate and sustain the life of another human being. It is important to understand that the after pregnancy body will most likely not be the same, and that is perfectly fine. Stretch marks, melasma, loose skin, and belly button hernias are some of the most common post pregnancy changes.During pregnancy, you can expect to feel tired, dizzy, sleepy, heavy, nauseous, and uncomfortable; but you will also experience love for the new baby, a new appreciation for life, a new sense of responsibility, and happiness. The pregnancy might not always go according to the plan, but that is ok. The important thing is for the baby and mother to come out healthy and strong. It helps to have the ability to connect and share with others who are also pregnant or who have previously been. There are also plenty of resources online, apps and videos to further guide you into this exciting time of your life!