Pregnancy changes

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 to pregnancy in her own unique way. 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 antenatal checks with your doctor or midwife. 

There are no silly questions

It is worth remembering that seeking reassurance from your healthcare provider is an important way to reduce your own stress and maximise 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 antenatal healthcare. 

Physical changes 

Most of the early changes during your pregnancy will relate to the zygote finding its way from your fallopian tube and then nestling into your uterine wall. Sustaining it and maximising 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 fertilised 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 maximise your baby’s chances of survival.  

Don’t forget your folic acid

In the early weeks, try to minimise your exposure to any toxins which could potentially cause developmental problems. Taking folic acid supplements of 500 micrograms/day will help to reduce the likelihood of your baby having 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 14^th 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 say they just know that they are pregnant, or describe a sensation of feeling different or odd.
• 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 odours. 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 your face and chest. 

Later physical changes

• Increasing abdominal size from around the 12^th week of pregnancy. This is when your enlarged womb will start lifting up and out of your pelvic rim and move its way upwards.
• Increasing breast size and darkening of the areola with small pimples appearing. Towards the third 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 10-14 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) between weeks 18-20 of pregnancy. This may occur as early as 16 weeks for mothers who have been pregnant before as they know what signs to be alert for.
• Breathlessness as your enlarging womb 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, haemorrhoids, 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 of blood 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 from 5 litres to around 7-8 litres 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. 

Emotional changes 

Hormones

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 that 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 stabilise after your baby is born. 

Mental health issues

If you have a history of mental health issues such as bi-polar disorder, obsessive compulsive tendencies, depression or mania, your pregnancy could exacerbate your symptoms or initiate a relapse. It is important to maintain contact with your mental health provider throughout your pregnancy and in the early months following delivery. 

If you are prescribed mood stabilising medication it is important to tell your doctor that you are pregnant. Your usual dose may need adjusting or regulating over the course of your pregnancy. 

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 humour. 

Anxiety

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 go over the same thoughts and worries in their minds. At the extreme, this can be a symptom of depression or Obsessive Compulsive Disorder. Speak with your midwife or doctor 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. 

Practicalities

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. 

Who cares?

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. 

Criticism

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 apologise 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. 

Superstitions

Do you 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 that you feel could be bad omens, do so. Historically, superstitions were one way of explaining thing that 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 mothers’ groups operate in your community.