Normal Pregnancy

  The First Trimester 
  The First Trimester of Your Pregnancy
Pregnancy is a time of major change. From the very beginning of your pregnancy, your baby alters your body and the way you live. During the first three months of your pregnancy, called the first trimester, you won't see most of the physical changes your body is going through. However, there's no doubt that you will feel the changes.

What You May Feel
Your first trimester occurs from the time of conception to approximately the 13th week of your pregnancy. During this time, your body undergoes many changes as your baby begins to grow and develop.

Although the symptoms of early pregnancy vary tremendously from woman to woman-and even from pregnancy to pregnancy-most women can expect to experience one or more of these signs of early pregnancy:

• No period.

• Breasts may become larger and more tender.

• Nipples may stick out more. 

• Need to urinate more often.

• Feeling very tired.

• Nauseated and even vomiting.

• Craving certain foods or loss of appetite.

• Heartburn or indigestion.

• Constipation.

• Feeling bloated or heavy.

• Gain or loss of a few pounds.

When To Call The Doctor
While most women have few problems during their first trimester, you should call your doctor if you experience any of the following:

• Heavy vaginal bleeding or clotting.

• Lighter bleeding that lasts for more than one day.

• The passage of grayish or pinkish tissue

• Any amount of bleeding that is accompanied by cramps, fever, chills, or dizziness

• Severe pain in abdomen or in your shoulder area

• Dehydration

• A fever of more than 101°F

• Painful urination

• A watery discharge from the vagina.

How Your Baby Grows
The first trimester of your pregnancy is a time of rapid development for your baby. During the first month of your pregnancy, your baby (officially called a fetus at this point) is 1/2 inch long and weighs less than one ounce. However, by the 14th week of your pregnancy, all of your baby's major organs are developed.

Here's what your baby is doing during the first month you are pregnant:

• Arms and legs begin to form.

• Brain and spinal chord begin to form.

• Heart and lungs begin to develop.

• The baby's heart begins to beat during the end of the first month.

At the end of the second month, your baby is one inch long and still weighs less than one ounce. Other developments include:

• Eyelids form, but remain closed.

• Inner ear begins to develop.

• Bones appear.

• Ankles, wrists, and toes form.

• Genitals begin to develop.

The third month is a time of rapid growth for your baby, who is most likely now 3 1/2 inches long and weighs just over an ounce. Other changes occurring during the third month include:

• Twenty buds for future teeth appear.

• All internal parts are formed, but not fully developed.

• Fingers and toes continue to grow and soft nails begin to form.

• Intestines begin to form.

• Backbone is soft and can flex.

• Skin is almost transparent.

• Hands are more developed than feet.

• Arms are longer than legs.
 

 The Second Trimester 
  The Second Trimester of Your Pregnancy
The second trimester is often referred to as the Golden Age of pregnancy. For most women, the nausea and extreme fatigue of the first trimester have ended and the third trimester aches and pains have not yet begun. The risk of miscarriage also declines significantly at this point in your pregnancy.

Sometime between weeks 16 and 20 of the second trimester is also when you get to experience those exciting first feelings of your baby. The second trimester is also the time when many women experience increased energy levels.

What You May Feel
Be sure to note the date on which you first feel fetal movement. This can help your doctor to accurately date your pregnancy.

Although you'll likely lose a few of the more bothersome symptoms of the first trimester such as nausea and extreme fatigue, the second trimester has some physical feelings all its own. While every pregnancy is unique, here are some of the changes you may see during weeks 15 through 27 of your pregnancy:


• Increased appetite and easing of nausea and fatigue.

• Abdomen beginning to expand - by the end of this trimester, the top of your uterus will be near the rib cage.

• Abdominal and breast skin stretching and may feel tight and itchy, possibly with stretch marks.

• Abdomen aches on one side or the other as the ligaments that support the uterus are stretched.

• A dark line, known as the linea nigra, may appear down the middle of the abdomen, from navel to pubic bone.

• Brown patches of skin on the face, known as the "mask of pregnancy."

• The darker skin around the nipples, the areolas, may darken.

• Swelling of feet and ankles.

• Hip and back pain.

• Feeling the uterus in the lower abdomen.

When To Call The Doctor

While your body undergoes many changes during your second trimester, there are some things that warrant a call to your doctor:

• Heavy vaginal bleeding or clotting

• Lighter bleeding that lasts for more than one day

• Any amount of bleeding that is accompanied by pain, fever, or chills

• Severe abdominal or shoulder pain

• A severe or persistent headache, particularly one that is accompanied by dizziness, faintness, or visual disturbances

• Dehydration

• A fever of more than 101°F

• Painful urination

• A watery discharge from the vagina

• Sudden swelling of the face, hands, or feet

• The signs of premature labor: regular uterine contractions, lower back pain, a feeling of heaviness in the lower pelvis or abdomen, diarrhea, slight spotting, or bleeding, or a watery fluid or mucus discharge

• A significant decrease in fetal movement after the 24th week of pregnancy.

Screening Tests
The First Trimester or “Nuchal Translucency” Screen is offered at the end of the first or beginning of the second trimester to screen for chromosomal abnormalities like Down’s syndrome. If it is positive or if you will be over 35 years old when the baby is born then you may also want to consider more definitive testing like chorionic villus sampling or amniocentesis

Later in your second trimester your doctor may recommend screening tests for gestational diabetes and anemia. Your doctor will explain each of the screening tests and advise you of the precautions you must take if any of the test results are positive.

Gestational diabetes is caused by the hormonal and metabolic changes of pregnancy. It occurs in 2 to 10% of pregnant women, often with no warning signs. Generally, all pregnant women are screened for this condition because the screening test is relatively simple and the disease can be difficult to diagnose without the test.

Your doctor may also screen you for anemia at the same time as you are screened for gestational diabetes. Although you may have started your pregnancy with no signs of anemia, pregnancy can cause some women to develop iron deficiency.

If you are diagnosed with gestational diabetes, your doctor will closely monitor you during pregnancy to ensure that you and your baby have no health problems. If you are found to be anemic, your doctor will advise you on the steps you should take to ensure that you and your baby are getting adequate supplies of iron.

How Your Baby Grows
During the second trimester, your baby is growing at an incredible rate. By the end of the 27th week, your baby will be nearly 12 inches long and may weigh 1 1/2 pounds.

During the fourth month of your pregnancy, here are some of the developments your baby is undergoing:

• Eyebrows, eyelashes, and fingernails form.

• Arms and legs can flex.

• External sex organs are formed.

• The skin is wrinkled and the body is covered with a waxy coating and fine hair.

• The placenta is fully formed.

• The outer ear begins to develop.

• Your baby can swallow and hear.

• The neck is formed.

• Kidneys are functioning and begin to produce urine.

• At the end of the fourth month, your baby will be six to seven inches long and weigh five ounces.

Here's what your baby is doing during the fifth month you are pregnant:

• The sucking reflex develops. If the hand floats to the mouth, the baby may suck his or her thumb.

• Your baby is more active and you may be able to feel the baby move.

• The baby sleeps and wakes regularly.

• Nails grow to the tips of the fingers.

• Gall bladder begins producing bile, which is needed to digest nutrients.

• In girls, all her eggs have formed in the ovaries.

• In boys, the testicles begin to descend from the abdomen into the scrotum.

• At the end of the fifth month, your baby will be nearly 10 inches long and weigh 1/2 to 1 pound.

At the end of the sixth month, your baby is 12 inches long and weighs between 1 1/2 and 2 pounds. Other developments include:

• Real hair begins to grow.

• The brain is rapidly developing.

• The eyes begin to open.

• Finger and toe prints can be seen.

• The lungs are fully formed, but not yet functioning.
 

 The Third Trimester 
  The Third Trimester of Your Pregnancy
The third trimester of your pregnancy spans from week 26 to the birth of your baby. Although your due date marks the end of your 40th week, a full-term pregnancy can deliver between the 37th and 42nd weeks of pregnancy. During this final trimester, your baby grows larger and the body organs mature. The baby moves frequently, especially between the 27th and 32nd weeks.

At the end of the third trimester, your baby will most often settle into a head-down position in your uterus, preparing for birth. This position will likely cause you some discomfort as you get close to delivery.

What You May Feel
Your third trimester is a time of rapid weight gain for your baby. The baby's increasing size and the many changes your body goes through to prepare for labor and delivery may cause the following to occur.

• Feeling the baby's movements strongly.

• Shortness of breath because the top of your uterus now rests under your rib cage.

• Need to urinate more often as the baby drops and puts more pressure on your bladder.

• Colostrum (a yellow, watery pre-milk) may leak from your nipples.

• Navel sticking out.

• You may have contractions. These can signal false labor or real labor.

Prior to pregnancy, your uterus weighed two ounces and was capable of holding half an ounce of liquid. By the time you deliver, it will weigh over two pounds and hold a quart of amniotic fluid.

When To Call The Doctor
Many physical changes occur during your third trimester. While most of these changes are to be expected, you should call your doctor if you experience any of the following symptoms.

• Heavy vaginal bleeding or clotting

• Lighter bleeding that lasts for more than one day

• Any amount of bleeding that is accompanied by pain, fever, chills, or severe abdominal or shoulder pain

• A severe or persistent headache, particularly one that is accompanied by dizziness, faintness, or visual disturbances

• Dehydration

By the start of the third trimester, your uterus is large and hard, your baby's movements are visible, and you may be experiencing false labor.

• A fever of more than 101°F

• Painful urination

• A watery discharge from the vagina

• Sudden swelling of the face, hands, or feet

• The signs of premature labor: regular uterine contractions, lower back pain, a feeling of heaviness in the lower pelvis or abdomen, diarrhea, slight spotting or bleeding, or a watery fluid or mucus discharge

• A significant decrease in fetal movement after the 24th week of pregnancy.

Screening Tests
Women with group B strep bacteria may experience no complications at all or develop bladder, uterine, or other infections.

The American Academy of Pediatrics recommends that all pregnant women be screened for group B strep bacteria between 35 and 37 weeks of pregnancy. This type of bacteria is carried by 10% to 30% of pregnant women and is found most often in the vagina and the rectum. Your doctor will talk with you about the risks this bacteria poses to you and your baby and how to prevent them.

Because you can pass the group B strep bacteria to your baby during pregnancy, delivery, or after birth and a baby infected with group B strep may end up with blood, lung, brain, and spinal-cord infections, it is especially important to be screened for this type of bacteria.

The group B strep test involves taking a culture from your vagina, perineum, and rectum during pregnancy. The results of the culture are available within two days. If your test comes back positive, your doctor will recommend that you take antibiotics during your labor to minimize the risk of passing group B strep to your baby.

How Your Baby Grows
Your baby continues to gain about 1% of its weight each day during the third trimester of pregnancy. Males tend to be slightly heavier than females.

During your third trimester, your baby will more than double in size. In fact, by the ninth month, your baby may be gaining more than a half-pound per week.

Here's what your baby is doing during the seventh month of your pregnancy:

• Eyes can open and close and sense changes in light.

• Kicks and stretches.

• Grasping motions and response to sound.

• By the end of this month, your baby will be 14 inches long and weigh between 2 and 2 1/2 pounds.

At the end of the eighth month, your baby is 18 inches long and weighs approximately 5 pounds. Other developments include:

• Your baby is gaining weight very quickly.

• Bones harden, but the skull remains soft and flexible for the delivery.

• The different regions of the brain are forming.

• Taste buds develop and the baby can now taste sweet and sour.

• Your baby may now hiccup.

Here's what your baby is doing the ninth and final month of your pregnancy:  Although you might feel a little odd interviewing caregivers for your baby before he or she arrives, this is one task that needs to be handled before the birth.

• Your baby usually turns into a heads-down position for birth.

• The skin is less wrinkled.

• The lungs mature and are ready to function on their own.

• Sleeping patterns develop.

• Your baby will gain about a 1/2 pound per week.

• By the end of your pregnancy, your baby will be approximately 20 inches long and weigh between 6 and 9 pounds.