A Guide for Expecting Parents

THE PREGNANCY EXPERIENCE

First Trimester
Second Trimester
Third Trimester

We consider pregnancy to be a normal physiological event in the life of a woman. Structural and hormonal changes that accompany the development and growth of a baby within the uterus occur rapidly. It is helpful if you know about these changes in advance and understand their effects. We are always available to answer your questions and discuss your concerns.

The Due Date
The due date, or estimated time of delivery, is calculated by adding 280–287 days to your last normal menstrual period. Adjustments may be made if you have menstrual cycles longer than 28 days, or if you were taking oral contraceptive pills just before you conceived. Although most lay people consider a pregnancy to last nine months, we have found that dating the pregnancy in terms of months is not precise enough. Instead, we prefer to date the pregnancy in weeks, beginning with the first day of your last normal menstrual period.

Most women will deliver within two weeks before or after the 40th week. Due dates, therefore, are only an approximation, and you should not fix your expectations on a specific day.

Pregnancy is divided into three approximately equal periods called trimesters. The first trimester extends from the first day of the last menstrual period to 12 weeks, the second trimester from 13–27 weeks, and the third trimester from 28 weeks until delivery. 

The First Trimester

The first sign of pregnancy is usually the missed menstrual period. A few weeks later, other symptoms begin to develop that help to confirm that you are pregnant. 

Although most women do not have any bleeding during pregnancy, occasionally a woman will continue to bleed very lightly at the usual time of menses for the first two to three months of pregnancy. It is even more common to have some slight spotting during the time the placenta is attaching to the uterine wall. 

By the end of the first trimester, the uterus has grown so that it can be felt just above the pubic bone.

During these first 12 weeks of pregnancy, the fetus grows from a single cell to a fully formed fetus with developed arms and legs. The heart is beating and circulating blood through the fetus. By the 12th week, the heartbeat can usually be detected by a Doppler ultrasound. Facial features, as well as fingers and toes, have formed. With ultrasound, the movement of the arms and legs can be seen, although the mother does not usually feel them.

An early symptom of pregnancy is a tingling or prickling sensation in the breasts that results from growth of the milk-secreting glands. The breasts feel swollen and engorged. At about the eighth week, veins on the breasts may become visible beneath the skin. At about the same time, small, round, elevated areas appear on the areola, which are enlarged oil-secreting glands called Montgomery’s tubercles.

Blood vessels in the pelvis begin to enlarge, creating a sensation of fullness in the pelvis. There is also an increase in the amount of secretions from the vagina.

With the realization that you are pregnant, it is natural to feel vulnerable to danger and afraid of miscarriage. Feelings of panic in the face of additional responsibility and anticipated lifestyle changes are also natural. It is common in the early stages to feel ambivalent toward the pregnancy. Mood swings become more extreme, and many women find themselves laughing or crying over seemingly insignificant events.

Fatigue often occurs because the physical changes that pregnancy brings require a great deal of physical and emotional energy. Your body needs more rest to adjust to the pregnancy, so try not to feel guilty about resting during the day or going to bed early at night.

Nausea and vomiting are symptoms that about half of all women experience during early pregnancy. This is commonly called morning sickness, although it may actually occur at any time during the day. Following are two probable causes of this nausea: (1) the placenta produces the hormone progesterone, which slows the emptying of the stomach and the movement of the intestines; (2) low blood sugar levels, which are common in early pregnancy. 

If you are troubled by nausea during your pregnancy, try the following:

• Keep spearmint starlight mints at your bedside to eat before rising; this will quickly raise the blood sugar level after the overnight fasting
• Eat small amounts of high protein foods at frequent intervals throughout the day and just before you go to bed
• Do not take your iron pills until the nausea has gone away
• Drink fluids between rather than with meals to help digestion
• Remember that the nausea won’t last forever; it usually subsides after the first trimester

If dietary measures fail to relieve nausea and vomiting, medication may be necessary. Pyridoxine (Vitamin B-6) may be purchased without prescription and taken at the dosage of 50–200 mgs per day. Should nausea and vomiting persist, we can provide you with prescription medications to help your symptoms.

Urinary frequency occurs in about two-thirds of pregnant women, because the uterus falls forward and lies directly on the bladder. As the uterus grows it places increasing pressure on the bladder, limiting the amount of urine the bladder can comfortably hold.

These symptoms usually let up after the first trimester, but they may recur during the last few weeks of pregnancy, when the baby’s head begins to push on the bladder. Urinary frequency, therefore, can be entirely normal and no treatment is required. 

If the frequency is accompanied by a burning sensation during urination, an urgency to urinate, blood in the urine, fever, chills, or low back pain, an infection may be present. You should be examined and appropriately treated.

Vaginal secretions, increased mucous secretions from the vagina, are normal during pregnancy. No treatment is required. If irritation develops, please notify us so that we can perform an examination to see if an infection is present and prescribe the appropriate medications.

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