Pregnancy is one of the most important life events. It brings along a lot of emotions. News can create anxiety, happiness, stress, confusion, expectations and many more feelings all at the same time. There are many new changes that a female undergoes physically, mentally, emotionally and socially to prepare for the coming life. It’s important to know the normal changes to flag out anything abnormal happening to the body.
Here are 10 physiological changes that are natural and common.
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Missed period-
Amenorrhea or missed period is usually the first symptom experienced during pregnancy. Pregnancy is the most common cause of amenorrhea in young, reproductive females. Many females may have slight bleeding coinciding with their periods for the initial few months. This kind of spotting is generally normal. Though bleeding is usually for a short duration and is harmless but any episode of bleeding during pregnancy needs evaluation.
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Morning sickness-
Morning sickness is present in more than 50% of all pregnancies. It varies from mild nausea in the morning to occasional vomiting to throwing up everything all through the day, for a few days. Symptoms subside between 12-20 weeks. Rarely it lasts all through the pregnancy. Morning sickness doesn’t have any adverse effect on women’s health. Only in a few cases where there’s constant vomiting for days, females may require hospitalisation and monitoring.
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Fatigue-
Fatigue is an important symptom of pregnancy especially in early months. It can range from mild morning laziness to a feeling of sleepiness, dizziness and tiredness all day long. Like most symptoms it also improves in the second trimester. Fatigue during the second trimester needs evaluation for anaemia or any other pathological cause. Physiological/ harmless fatigue may return in the last few weeks due to growing belly, postural changes, increased demands of fetus, orthostatic hypotension, disturbed sleep and many more physical discomforts.
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Frequent urination-
Increased frequency of micturition is seen in initial weeks as the size of the uterus grows. Growing uterus presses the bladder as it is inclined forward in initial weeks. The symptoms are initially present till 12 weeks. As the uterus starts to grow upwards in the abdomen, these symptoms subside. Frequency of micturition again increases in the third trimester. It occurs as the growing uterus starts pressing the bladder again due to decreased space. Increase in frequency of urination is normal in initial few weeks and last few weeks but presence of burning or itching with micturition or dark coloured urine are not normal and needs evaluation.
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Breast discomfort-
Breast changes are evident more in primigravidae or first time pregnant females. There is a feeling of fullness with a pricking sensation. These changes appear around 5-8 weeks. Visible signs like enlarged veins, pigmentation of nipples and areola also appear around 12 weeks. Secondary areola is seen around 20 weeks. It’s an extension of areola and generally appreciated in the first pregnancy. Small protruded circular prominence called Montgomery’s tubercles also appear around 20 weeks and extend till secondary areola. Colostrum or first milk can be seen as early as 12 weeks on squeezing the breasts. Stretch marks also appear with growing breasts in advanced weeks.
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Growing abdomen-
There’s progressive upwards and outwards uterine enlargement, corresponding to baby’s growth. This uterine enlargement is seen as a belly bump. Its height progresses along with the pregnancy weeks. It’s just palpable in the lower abdomen around 12 weeks. At 16 weeks the height of the uterus is midway between umbilicus and pubic bone and it’s at the level of umbilicus at 24 weeks. After that, the fundal height in cms is the same as the number of weeks with 2cms on either side. At 36 weeks, fundus touches the sternum or the breastbone. After that the baby starts to descend down in a process to prepare itself to come out. Around 40 weeks, the fundal height is the same as at 36 weeks. Size of the uterus can be small for the gestation weeks in few cases like mistaken dates, oligohydramnios or decreased liquor, fetal growth retardation or intrauterine fetal death. Size of the uterus can also be large for the gestation weeks in case of mistaken dates, twin pregnancy, increased liquor or polyhydramnios.
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Weight gain-
Weight gain is an integral part of pregnancy. On an average total weight gain during pregnancy is 10-12 kgs. Out of this around half is the reproductive weight gain which includes weight of the fetus, placenta, amniotic fluid, breasts and uterus. The remaining half is maternal weight gain of blood volume and extracellular fluids. Recommended weight gain during pregnancy depends on the pre pregnancy BMI. In females whose BMI is on the higher side preconception, should restrict their pregnancy weight gain to 7-10 kgs. Females with BMI < 20, can have a weight gain even upto 18 kgs. Those with BMI more than 30, a weight gain upto 7 kgs is good enough.
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Skin changes-
Skin changes are due to various reasons including hormonal changes, stretching of skin and venous obstruction. There’s pigmentation over the face including cheeks, forehead and eyes. Linea Nigra is a brownish black pigmented line that develops from xiphisternum or the breast bone to the symphysis pubis or the pubic bone. This is due to melanocyte stimulating hormone effect. Linear marks over abdomen, thighs or breasts are due to scarred tissues in deeper layers of skin. These are called Striae gravidarum or stretch marks. These are pinkish initially but become white with time as the vessels get obligated.
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Fetal movements-
Feeling of the fetus moving inside the womb is an important indicator of pregnancy. Initially the movements feel like a flutter which increases in intensity as the baby grows. First active movement perceived by the mother is called Quickening. It’s felt around 18-20 weeks in first time moms and a little early in subsequent pregnancies. Active fetal movements can be felt by placing a hand over the abdomen after 20 weeks.
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Uterine contractions-
In early weeks of pregnancy, the uterus experiences irregular, spasmodic, infrequent and painless contractions. These are called Braxton Hicks Contractions. Due to less intrauterine pressure, the mother is not aware of these contractions generally. But sometimes females may feel a little discomfort in the stomach. These contractions can be felt by mother as irregular, spasmodic contractions generally after second trimester. The contractions increase in intensity while reaching the term and merge with uterine contractions of labor near term.
All these are common pregnancy symptoms experienced by most females. But each pregnancy is different and unique. Symptoms can vary from mother to mother and in each pregnancy. Anything abnormal needs evaluation by a trained person. Pregnancy is a unique and wonderful experience. It’s one of the most beautiful times to embrace the power of womanhood and motherhood. Most discomforts during pregnancy are short lived and generally harmless. So enjoy being a mother!!
