For the majority of women, pregnancy is a normal, healthy, low-risk life event. Midwives view pregnancy and birth as normal life events during which you need special attention, support, guidance, and care to prevent problems. For most women pregnancy is a time of wellness. It is a time of change when you and your baby should be supported so you both can be as healthy as possible.
It may be up to 4 to 6 weeks from the time you become pregnant until you know for sure that you have conceived. A positive pregnancy test can tell you for sure, but many women experience signs of pregnancy in the first few weeks after conception. Some of the early signs and symptoms that might tip you off include:
- Nausea and/or vomiting
- Tender, swollen breasts
- Increased urination
- Mood swings
Many of the signs of early pregnancy are also signs that your period is approaching. Trying to conceive can be an emotionally taxing journey. If you’re having trouble coping, ask your midwife for tips and resources.
Your regular check-ups during pregnancy are good times to talk with your midwife about your health, your emotions, and the normal changes that come with pregnancy. At each visit, your midwife will review your and your baby’s health. This includes checking your blood pressure and weight, measuring the growth of your baby, listening to your baby’s heartbeat, and ordering and reviewing needed tests. These steps help ensure that any problems are identified and treated early before they become serious.
During your regular visits, your midwife will provide information and resources to help you decide how to maximize your chances for a healthy pregnancy. These include healthy lifestyle choices such as eating nutritious food, exercising, managing stress and taking prenatal vitamins. Your midwife will also help you with the normal physical and emotional changes that may come with pregnancy. Many midwives also suggest childbirth education and parenting classes. These classes are a good way to learn more about labor, birth, caring for your new baby, breastfeeding, and becoming a mother or preparing siblings for the upcoming change.
Many pregnancy books and websites tend to focus on the various problems to expect with each week and trimester of pregnancy. It’s important to balance the negative information by making a point to learn about the positive, awe-inspiring changes you can expect to experience throughout your pregnancy. If you’re looking for a positive guide to what your mind and body are likely to experience during pregnancy, the classic book Our Bodies, Ourselves is a good place to start.
Pregnancy is divided into 3 trimesters, which last about 12 to 14 weeks each. Some of the physical and emotional changes you may experience throughout each trimester of pregnancy are:
First Trimester: During the first 3 months of pregnancy, strangers aren’t likely to notice any obvious signs that you are pregnant. You, however, are likely to notice a host of physical and emotional changes as your body gears up to grow a baby. Some of the classic changes you’ll likely notice include sore or tender breasts, nausea, and fatigue. Because of the hormones of pregnancy, you may also experience frequent urination and constipation. Your baby is developing before you even realize you are pregnant, just 4 weeks after conception, the neural tube along your baby’s back is closing and your baby’s heart is beating. Notable milestones for your developing baby include development of the placenta, a detectable heartbeat, and formation of all the essential organs.
Second Trimester: Many women experience relief from nausea and fatigue during the second 3 months of pregnancy and are rewarded with being able to feel the first flutters of fetal movement. Initially, fetal movements may be so gentle that you may not be sure of what you are feeling. Strangers may notice your growing baby bump and maternity clothes are likely to be a necessity. Your baby forms eyebrows, eyelashes, and tiny fingernails and toenails. By the end of the second trimester, your baby is starting to look more and more like a newborn. You may also have a welcomed surge of energy in the second trimester.
Third Trimester: During the last 3 months of pregnancy, you may experience shortness of breath, hemorrhoids, urinary incontinence, varicose veins, back pain, heart burn, and sleeping problems. Many of these symptoms are due to the sheer amount of space your baby is taking up inside of you. Because there is less room, your baby may seem to move less, but you should still feel movement. Most healthy babies should move 10 times over the span of 2 hours. You are also likely to experience the return of fatigue, or feel winded after climbing stairs or other physical exertion, though you may get a burst of energy toward the very end of pregnancy. Your baby accumulates fat, practices breathing, opens the eyelids, and descends into a head-down position for birth. Baby’s lungs continue to mature right up to the day of birth.
Some of the first decisions you make when you are pregnant will be what—if any—tests you have to check for birth defects in your baby. Most women will be offered a “triple marker” test. Some women (those over age 35 or those with a family history of birth defects) may be offered amniocentesis, chorionic villus sampling, or high-resolution ultrasound. You do not have to have any of these. You get to decide whether you will have one or more of these tests.
Some important questions to ask when making decisions about these tests are:
- What information will the test give us?
- How accurate is this test?
- What risks are there for my baby and for me if I have this test?
- Will I do anything different if the test results are abnormal?
It may help you to use the decision-making process on this Share With Women handout on Prenatal Tests for Birth Defects. You can also read about tests for Down Syndrome here.
It’s easy to get confused by the large amount of conflicting information about vaccines. Learning the facts will help you understand the bottom line—vaccines are safe and vital for good health. If you are pregnant, it is even more important to protect yourself, your baby, and your family.
The Journal of Midwifery & Women’s Health offers a collection of free handouts called Share With Women covering common questions you might have during pregnancy. Several of the handouts have been translated into Spanish. Topics include prenatal testing, vaccines, weight gain, back pain, medications, writing a birth plan, avoiding alcohol in pregnancy, and more. See the complete list of offerings at www.sharewithwomen.org.