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1st trimester (first 12 weeks)
Usually the first sign to make you aware that you may be pregnant is a missed period. At this point a positive home pregnancy test may prompt a visit to the doctor for further blood testing to confirm it. If you were not planning the pregnancy, now is a good time to start taking a multivitamin tablet each day. (If you are planning to conceive, it is advisable to start taking multivitamins a month or two before conception).
Throughout your pregnancy, it is likely you will experience symptoms that are common among expecting mums. Here is a rundown of how you might feel and what you might experience, as your pregnancy develops:
Early on, it is very common to feel the need for extra visits to the toilet, due to an increase in blood circulation.
You may feel emotional or moody at this early stage. Due to the surge in hormones, progesterone and oestrogen in particular, morning sickness may affect you as well. Try to reduce the effects by avoiding the following: getting overtired, waiting too long between meals, strong odours and tight clothes.
Some pregnant women experience an unpleasant taste in their mouths; we don’t really know why this occurs but it is quite common. Women also often have tender breasts and feel very tired. Some women complain of abdominal cramping, which can be caused by the growth in the uterus.
The increase in circulation in a pregnant body can also cause dizziness. Don’t let yourself get dehydrated – always drink plenty of water, at least two litres per day. Keep some snacks in your bag such as dry biscuits or sweets so as not to let your blood sugar drop. By this stage, you might notice that your clothes are a bit tight.
Some women experience bleeding gums or nosebleeds, again due to the increase in circulation. If you haven’t had spots since you were a teenager, it may come as a surprise to notice some skin changes and acne – blame it on the hormones. Progesterone allows the uterus to grow but it relaxes organs such as your bowel, which could mean constipation. To combat this, you should try and eat a high-fibre diet, take daily exercise such as walking and stay well hydrated. The sphincter that closes the stomach to the oesophagus is also more relaxed, which means that heartburn is a possibility.
Reaching the end of the first trimester brings some very good news – if you have suffered from morning sickness, your nausea should start to ease about now. It is also time for the first key scan (in the public system), which is a very exciting moment for both parents and it marks the moment of significant decline in the chance of miscarriage. For this reason, many expecting parents choose this time to go ahead and share their good news with friends, family, and anyone who will listen!
2nd trimester (13-28 weeks)
At this stage, your belly will be showing. Nosebleeds, a blocked nose and dry eyes could all still be present, but overall you should be feeling good.
Your baby will be active and you may have felt some ‘flutters’ by now. Your centre of gravity is shifting due to the growing bump, so you might be a bit off balance. It’s a good idea to wear flat shoes and possibly see a pregnancy physiotherapist who can help you with your posture if necessary. Because your circulation is focused on the baby, you should lie on your side and get up slowly to allow your body to adjust to the changes in your blood pressure.
If you are prone to skin pigmentation changes (this usually affects darker skinned women the most), you might notice these now. Chloasma or ‘the mask of pregnancy’ is a skin condition that can affect 50-70% of pregnant women. It is characterised by symmetrical patches of dark skin on sun-exposed areas, mainly the face. The linea nigra is a dark straight line that forms from the top of the pubic bone to the umbilicus or even further to the top of the stomach. There is no need to worry about these skin changes as they usually settle and disappear within a few months after delivery.
20 weeks Half way! Time for your second scan (in the public system).
Keep exercising daily and elevate your legs to help ease the pressure and prevent varicose veins from developing or worsening. Start to wear supportive underwear such as support knickers or belts with lycra and support stockings, though of course this might be difficult in the heat of Hong Kong. Stretch marks might develop as your belly continues to expand. You might retain some fluid and be a bit swollen, typically in your ankles, which is another good reason to elevate your legs and take the weight off your feet by lying down. Keep drinking plenty of fluids.
Indigestion and heartburn might get worse again, not only due to hormones, but also as a result of the baby growing and putting more pressure on your stomach. You can feel compensated by the fact that your hair is now thicker and more lustrous.
Backache due to posture changes might be uncomfortable. Don’t sit or stand in one position for too long. Because of the extra weight you are carrying and the pressure this weight puts on veins and nerves you may experience cramps in your legs or a syndrome known as ‘restless legs’. Stretching and massaging the affected area can help. You will also have some more blood tests at 28 weeks, the results of which will give your healthcare provider an indication of your supplement needs. It’s a good idea to increase your iron intake at this stage.
3rd trimester (29-40 weeks)
Heartburn and constipation continue but you can now add haemorrhoids to your list of irksome body changes, again because of the extra weight your body is carrying and because of the excess progesterone relaxing your blood vessels. Speak to your healthcare provider about treatment options.
Did you know that your feet get bigger while you’re pregnant? You may go up half a size or more, and need new shoes – make sure they have good arch support. Tiredness might affect your mood and anxiety might increase as the reality of parenthood approaches. Go to antenatal classes around now. Ask lots of questions and learn as much as you can about your impending labour. Consider the benefits of a doula or birth support person.
You might notice your belly tightening and becoming very firm occasionally. These tightening sensations are infrequent and painless and are known as Braxton Hicks or practice contractions.
As your baby takes up more and more space and pressure on your diaphragm increases, you may feel short of breath. Swelling in your hands and wrists might mean you need to remove jewellery such as rings. Occasionally the swelling compresses the tendons and nerves causing pins and needles or even pain in your hands and fingers. This is known as carpal tunnel syndrome, and you will most likely be referred to a physiotherapist for treatment if necessary.
Some women complain of feeling itchy on their stomach and may even get a rash. Always report this to your obstetrician, especially if the itchiness is felt all over or in particular on the palms of your hands and soles of your feet.
Your bladder holds less urine as the baby is pressing against it, so you may be making even more trips to the toilet.
The big day will soon arrive and you may be having more intense dreams. Your ‘nesting’ instincts might have you cleaning out cupboards or rearranging furniture. Don’t forget to take some time out though, get plenty of rest and conserve your energy. Braxton Hicks continue until labour begins.
The levels at which these changes affect pregnant women are of course varied and individual. At every antenatal visit (guided by your healthcare provider) your urine is tested for sugar and protein and your blood pressure is always taken. This is done to detect a couple of other, less common changes that can occur while you are pregnant. The development of gestational diabetes (a type of diabetes present during pregnancy only) or an increasing blood pressure will be managed by your obstetrician as necessary.
Always let your obstetrician or midwife know of any concerns you might have. Try not to ‘Google’ too much, as this could leave you feeling confused or stressed out! And despite these daunting changes to your body this will be a lovely period of your life, bettered only by becoming a mother – the most difficult and rewarding job you will ever undertake.