Changes in first trimester of pregnancy

Pregnancy stages and changes - Better Health Channel

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Summary

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Your body changes during pregnancy. You may love some changes and feel uncomfortable with others.
You may experience of a lot of physical changes during pregnancy, or only a few.
You will probably have emotional ups and downs during pregnancy.
If you have depression or a mental illness during pregnancy, you need specialist care and treatment.
Some physical and emotional experiences are common to a particular trimester (stage) of pregnancy.

If you are pregnant, your body is experiencing major change. From symptoms that you might expect, to ones that are completely out of the blue, every woman will have a different pregnancy experience.

It’s helpful to have an idea of how your body may react to the different stages of pregnancy. It also helps to know how pregnancy may affect your emotions and feelings.

Changes to your body that may indicate pregnancy

You may first realise that you’re pregnant when you miss your period. That’s a good time to take a pregnancy test or speak with your doctor.

In early pregnancy, you may experience some (or all, or even none) of the following symptoms:

aches and pains (possibly in your lower abdomen and in your joints)
morning sickness, which may be nausea or actual vomiting, and does not just happen in the morning
constipation
food cravings and aversions
heartburn and indigestion
a need to urinate more often
back pain
tiredness
vaginal thrush
skin changes and itching, and possibly skin tags
haemorrhoids (also known as piles)
leg cramps
restless legs (leg twitching at night)
varicose vein
swelling in your ankles, feet and hands
dizziness or fainting
fatigue, or lack of energy
nasal problems, or shortness of breath
larger, tender breasts.

Better Health Channel has more information about these pregnancy symptoms.

If any of the symptoms become difficult to manage, talk to your doctor about what to do. In particular, if any morning sickness, aches and pains, dizziness or breathing difficulties make it hard to get through your normal day, ask for advice.

More about morning sickness

The first thing to know about morning sickness is that it can hit you at any time of day.
Probably a result of your changing hormones, it usually starts about week six and settles by week 14. The good news is that you may feel better if you:

drink small amounts of fluid, often. Try flat lemonade, sports drinks, diluted fruit juice, weak tea, clear soup or a hot drink make of stock
suck on ice or ice-blocks (if you can’t keep down other fluids)
try ginger tablets, dry ginger ale or ginger tea
eat small amounts of food more often, so you don’t have an empty stomach
eat a dry biscuit when you wake up in the morning, to avoid feeling sick when you get out of bed
try salty foods such as potato crisps or salty biscuits
suck on barley sugar or boiled lollies
avoid fatty, rich or spicy foods
avoid the smell of hot food
avoid cooking dishes with strong smells
rest as much as you can.

A small percentage of women have prolonged and excessive vomiting (called hyperemesis), which can lead to dehydration if it is not treated. See your doctor if you have severe morning sickness.

In some extreme cases, women need to be rehydrated in hospital, using intravenous fluids.

Pregnancy stages

We talk about three stages of pregnancy: first trimester, second trimester and third trimester. Some physical and emotional experiences are more common in each of these trimesters.

First trimester

In the first trimester:

You feel really tired and possibly nauseous.
You gain 1 or 2 kilograms, or maybe less if you have morning sickness. Most of this weight is in the placenta (which feeds your baby), your breasts, your uterus and extra blood.
Your heartbeat and breathing rate are faster.
Your breasts become tender, larger and heavier.
Your growing uterus puts pressure on your bladder, so you feel like you need to urinate a lot.
You may feel swinging moods.
You know exactly how you feel about having a baby, or you have no idea how to feel!

Second trimester

In the second trimester:

You start to feel better, with less fatigue, morning sickness and moodiness.
You may feel your mind is wandering and not focused at work or at home.
You gain about 6 kilograms.
You may feel anxious about tests (including an ultrasound) done at this stage. But, if they find any health issues, these tests will ensure you and your baby receive the right care.
Your hair may become thicker and your fingernails may become stronger. Or, your nails may be softer and break more easily.
You may crave some foods, such as sweet, spicy or fatty foods.
You may not like the taste or smell of some foods.

Third trimester

In the third trimester:

Forgetfulness may continue.
You feel tired and probably uncomfortable.
You may be annoyed by the discomfort.
You may start to worry about labour as it nears.
You probably gain about five kilograms. Much of this weight is your baby, but also amniotic fluid, the placenta, your breasts, your blood and your uterus.
You may have back pain.
You may find it hard to sleep because you are uncomfortable.
The baby may be placing pressure on your lungs, making it harder to breathe.
You may feel Braxton Hicks contractions (tightening of the muscles of the uterus). They do not mean labour is starting.

Your feelings and emotions during pregnancy

During pregnancy you will probably feel many ups and downs. You may experience some or all of these emotions (and they may change quickly):

surprise – if your pregnancy is unexpected. You may then feel joy (if you welcome the pregnancy) or fear (if you are unsure about the change to your life) or both
happiness, particularly if you have been trying to have baby and you feel well
anger, which can result from your body’s hormonal changes, from a sense of being vulnerable, or from pregnancy symptoms that are uncomfortable or painful
fear for the baby’s health, if you have concerns about your baby having an illness or disability. If you are worried about a particular risk, talk to your midwife or doctor
fear of birth, which is a recognised psychological disorder. Counselling and talking with your midwife or doctor can help you overcome this fear
love for your baby, your partner and your family
sadness or disappointment if you have illness or complications during your pregnancy, or you can’t have the birth plan that you would prefer
general sadness about the world, whereby you find it hard to watch the news or hear sad stories about children or families
grief, if you suffer a miscarriage, a loss at a later stage of pregnancy, or a stillbirth
prolonged sadness from perinatal depression. In this case, you will need the help of health specialists.

Mood swings during pregnancy

The hormones changing in your body mean you will probably have heightened emotions, both positive and negative. And you will probably swing between these emotions.

While you may be overjoyed about having a baby, you may also be stressed and overwhelmed. You may feel worried about whether:

your baby will affect your relationship with your partner
you will cope financially
you will be able to juggle work and parenting
you will be a good mother
the baby will be healthy
your other children will accept and love the new baby.

You may also feel unimpressed with your changing body. You may be worried about putting on too much weight, or not enough. Or not being able to do the physical activity that you usually do. Or not looking attractive to your partner.

Add the hormone-induced fatigue, forgetfulness and moodiness, and you may feel completely out of control. This is all common.

Depression during pregnancy

About 15 per cent of women will have depression or anxiety during pregnancy. And even more will suffer from these conditions after giving birth.

Many women don’t seek help because they feel embarrassed or guilty about feeling so awful when are they are supposed to be happy. But depression is not something that you can control in this way.

Because an untreated mental illness can have long term effects on your health and wellbeing, and on your baby too, getting the right treatment is vital. Talk to your doctor if you are:

depressed or miserable for most of the day and on most days
annoyed, angry or anxious a lot of the time
crying a lot (and not always for a reason)
losing interest in activities that you usually like
struggling to sleep (even when your baby is sleeping), or sleeping more than usual
under- or over-eating
feeling tired most the time
not able to concentrate
preoccupied or anxious about things going wrong with your pregnancy, you, your baby or your partner
feeling that you have not bonded with your baby, or that you have no maternal feelings
feeling guilty, or feeling that you are failing as a mother
thinking about harming yourself
thinking it would be better if you or your baby were dead
thinking about suicide.

Remember, tell someone if you feel depressed, because early treatment is the best treatment.

Plenty of safe and effective treatments are available for depression during pregnancy and while breastfeeding. But herbal and complementary treatments such as St John’s wort may not be safe in pregnancy.

Anxiety during pregnancy

You may be feeling quite anxious about your pregnancy and about being a parent. Many pregnant women feel some anxiety, but a few develop an anxiety disorder that needs treatment.

Symptoms of an anxiety disorder include:

constant worry, stress or nervousness
muscle tension and teeth clenching
not ever feeling calm
not being able to sleep well or for long
panic attacks.

Other serious issues during pregnancy

Some pregnant women develop mental illnesses that are a significant risk to both them and their child. Other women may already have a mental illness that is more difficult to manage during pregnancy.

In particular, specialist health care is needed for pregnant women with:

bipolar disorder (of which pregnancy may trigger the first episode), with manic highs and depression lows
schizophrenia
eating disorders, including anorexia nervosa and bulimia nervosa. The risks include a loss of nutrition for your baby, an increased risk of miscarriage, and anaemia.

Where to get help

Your GP (doctor)
Midwife
Obstetrician
PANDA (Perinatal Anxiety and Depression Australia) Tel. 1300 726 306
Lifeline Tel. 13 11 14 for crisis support and suicide prevention
beyondblue Tel. 1300 22 4636

Common concerns in early pregnancy, Royal Women’s Hospital, Victoria, Australia.
Mental health and pregnancy, Royal Women’s Hospital, Victoria, Australia.
Pregnancy: the first 3 months – the first trimester, Women’s and Children’s Health Network, Government of South Australia.
Pregnancy: the second 3 months – the second trimester, Women’s and Children’s Health Network, Government of South Australia.
Pregnancy: the last 3 months – the third trimester, Women’s and Children’s Health Network, Government of South Australia.
Emotions during pregnancy, National Childbirth Trust, UK.
First trimester of pregnancy, 2016, WebMD, USA.

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Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

Reviewed on: 25-05-2018

Changes in Your Body During Pregnancy: First Trimester

Path to well being

How do I know I’m pregnant?

A missed period is often the first sign of pregnancy. You may have some other physical signs as well. These include mild cramping and a little bleeding when the fertilized egg implants itself in your uterus.

If you’ve missed your period and think you may be pregnant, you can take a home pregnancy test. These tests are very accurate if you take them a few days after you expected to get your period. Call your doctor if the test is positive.

Why do I feel so tired?

Feeling very tired is another common symptom of early pregnancy. Your body is working hard to adjust to all the new physical changes. This can cause extreme fatigue. You may need to sleep longer than usual at night. If possible, you can take short naps during the day. Your energy will most likely return in the second trimester of pregnancy.

What is morning sickness?

Morning sickness consists of nausea and vomiting. It is caused by pregnancy hormones. Many pregnant people have it to some degree in their first trimester. Despite what it sounds, morning sickness can occur at any time of day. Certain foods or smells might make you feel sick and sometimes vomit. Some people seem to feel sicker when their stomachs are empty. Morning sickness usually goes away by the second trimester.

There are over-the-counter vitamins and herbal supplements that may help with morning sickness. Taking vitamin B6 may help with nausea, even though it may not prevent vomiting. Ginger supplements also may relieve nausea.

What other changes can I expect during the first trimester?

Frequent urination. Towards the end of the first trimester, you will feel like urinating more often. This is because your growing uterus pushes on your bladder. You may even leak a little urine when you cough or sneeze.

Lightheadedness. Your body is working overtime to make extra blood to support your baby. This can cause you to feel dizzy or lightheaded. Hunger, weakness, or stress can cause these symptoms as well.

Heartburn. The muscles that break down food become more relaxed during pregnancy. Hormone changes also slow down this process. Food also stays in your stomach longer to give your body more time to absorb nutrients. All these things can cause or worsen heartburn.

Constipation. You should be taking a daily prenatal vitamin that contains iron. The iron in the vitamin can lead to constipation. The slow process of breaking down food also can cause constipation, gas, and bloating. Your doctor may suggest taking fiber supplements or a stool softener to provide relief. Make sure you drink plenty of water (about eight glasses per day). Tell your doctor if you have severe problems. They may switch you to a different prenatal vitamin.

Visible veins. Your body makes extra blood and your heart pumps faster to meet the needs of pregnancy. This can cause the blue veins in your belly, breasts, and legs to become more noticeable. You may develop spider veins on your face, neck, or arms. These are tiny blood vessels that branch out from a central area, like the legs of a spider.

Skin changes. You may notice that your skin looks more rosy and shiny. Some people call this a “pregnancy glow.” It is caused by increased blood circulation. Pregnancy hormones can cause extra oil on your skin. It may cause you to have flares of acne.

Breast changes. Most people notice changes in their breasts early in pregnancy. The hormones in your body change to prepare for breastfeeding. As this occurs, your breasts may feel tender and swollen. You might notice small bumps forming in the area around your nipples. Your breasts will continue to grow and change throughout your pregnancy. They may feel even bigger and fuller later on.

Vaginal changes. The lining of your vagina will become thicker and less sensitive. You may notice a thin, white discharge. This is normal during pregnancy. Mild vaginal bleeding (spotting) is also normal and common. However, you should call your doctor if you have vaginal bleeding. If the bleeding is heavy or painful, go to the emergency room.

A growing belly. Your waistline will begin to expand as your baby and uterus grow larger. Depending on your size before pregnancy, you may not notice this change until the second trimester. It is normal to gain no or little weight in your first trimester.

Emotional symptoms. Your hormones are on overload during pregnancy. You might feel moody, forgetful, or unable to focus. Fatigue and stress can increase these symptoms.

Things to consider

Keep in mind that each pregnancy experience is unique. Even the same person may have different changes in their multiple pregnancies. For each change, your symptoms may be mild or severe. Do not worry if the changes do not happen at a certain time. Talk to your doctor if you have any concerns.

When to see your doctor

Contact your doctor if you think or know you are pregnant. They will make an appointment to confirm your pregnancy and talk to you about prenatal care.

You should also contact your doctor if your morning sickness and vomiting are severe enough to cause weight loss.

Questions to ask your doctor

Am I pregnant?
How far along am I in my pregnancy?
What kinds of physical and emotional changes should I expect?
Are my symptoms normal?
Are there any risks that I should be aware of?
Which prenatal vitamin do you recommend I take?

Resources

American Academy of Family Physicians: Taking Care of You and Your Baby While You’re Pregnant

1st trimester of pregnancy: what happens to the fetus

1st trimester of pregnancy: what happens to the fetus - Private maternity hospital Ekaterininskaya Clinics

1st trimester: 1st-12th weeks

The gestational age is calculated from the first day of the last menstruation, since it is difficult to determine the exact day of conception. Since conception usually occurs in the middle of the menstrual cycle, you are not actually pregnant during the first two weeks, but this period is counted as the beginning of pregnancy. nine0005

As soon as the fertilization of the egg takes place around the 3rd week, the hormones begin to produce changes in your body little by little. As a result, you may experience some of the following symptoms:

Morning sickness. As a result of rising levels of hormones characteristic of pregnancy, up to 80% of women in the 1st trimester experience morning sickness with symptoms such as nausea and vomiting. The idea that such malaise is observed only in the morning is a common misconception. In fact, symptoms can appear at any time of the day or night. Up to 1 in 5 women experience morning sickness in the 2nd trimester of pregnancy and can sometimes persist throughout pregnancy. nine0002 If you experience morning sickness, avoid foods that make you sick, eat little and often, avoid fatty and spicy foods, drink more water. If you experience severe symptoms or symptoms that bother you, see your doctor.
Breast changes. The mammary glands will begin to increase in size, soreness may appear. The nipples will increase in size, become darker and more protruding.
Fatigue. High levels of the hormone progesterone can make you feel tired and sleepy. Rest as often as possible in a horizontal position with your legs up and eat as well as possible, which is not easy if you are experiencing morning sickness! nine0016
Increased emotionality. A higher level of emotionality, manifested as a result of an increase in hormone levels, is normal. Understanding and patience on the part of your partner and loved ones is very important here.
Food likes and dislikes. You may find yourself intolerant of one food and addicted to another. This is usually not a problem, unless you feel like eating weird foods like chalk. If you are concerned about the situation, contact your doctor. nine0016
Frequent urination. As your fluid levels increase and your uterus puts pressure on your bladder, you will become more likely to visit the toilet. Go to the toilet as soon as you feel the need - this minimizes the pressure on the bladder.
Feeling of dizziness. Sometimes you may feel a little dizzy (this is due to hormonal changes). Try not to stay on your feet for a long time and slowly rise from a sitting or lying position. If you experience severe dizziness, contact your doctor immediately. nine0016
Heartburn and constipation. Your digestive system will slow down to give you more time to digest your food. This can lead to heartburn and constipation. To help manage heartburn, try to eat small meals at regular intervals and avoid fried or spicy foods and carbonated drinks. Constipation is helped by eating a diet rich in fiber, maintaining physical activity and drinking plenty of water.

1st trimester milestones

Approximately 7 days after fertilization, the embryo implants in the uterine wall. The placenta, umbilical cord and amniotic sac will begin to form to provide nourishment and protection to the embryo.
By the end of the first 12 weeks of pregnancy, the uterus is palpable through the wall of the abdomen, the abdomen will begin to grow.

Child development in the 1st trimester of pregnancy

By the end of the 1st trimester:

All the main organs of the baby are formed, the circulatory system works.
The development of the sexual organs has begun.
Fingers are formed on the hands and feet, nails have appeared.
Facial features have formed.
The length of the baby's body is about 6 cm from the head to the lower part of the body, he is already recognizable. The baby moves in the amniotic sac, but you don't feel it move yet.

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Physiological changes in the body during pregnancy

From the very first days of pregnancy, a woman's body undergoes profound transformations. These transformations are the result of the coordinated work of almost all body systems, as well as the result of the interaction of the mother's body with the child's body. During pregnancy, many internal organs undergo significant restructuring. These changes are adaptive in nature, and, in most cases, are short-lived and completely disappear after childbirth. Consider the changes in the basic systems of the vital activity of a woman's body during pregnancy. nine0005

The respiratory system during pregnancy works hard. The respiratory rate increases. This is due to an increase in the need of the mother and fetus for oxygen, as well as in the limitation of the respiratory movements of the diaphragm due to an increase in the size of the uterus, which occupies a significant space of the abdominal cavity.

The mother's cardiovascular system during pregnancy is forced to pump more blood to ensure an adequate supply of nutrients and oxygen to the fetus. In this regard, during pregnancy, the thickness and strength of the heart muscles increase, the pulse and the amount of blood pumped by the heart in one minute increase. In addition, the volume of circulating blood increases. In some cases, blood pressure increases. The tone of blood vessels during pregnancy decreases, which creates favorable conditions for increased supply of tissues with nutrients and oxygen. During pregnancy, the network of vessels of the uterus, vagina, and mammary glands decreases sharply. On the external genitalia, in the vagina, lower extremities, there is often an expansion of the veins, sometimes the formation of varicose veins. Heart rate decreases in the second half of pregnancy. It is generally accepted that the rise in blood pressure over 120-130 and a decrease to 100 mm Hg. signal the occurrence of pregnancy complications. But it is important to have data on the initial level of blood pressure. nine0005

And changes in the blood system. During pregnancy, blood formation increases, the number of red blood cells, hemoglobin, plasma and bcc increases. BCC by the end of pregnancy increases by 30-40%, and erythrocytes by 15-20%. Many healthy pregnant women have a slight leukocytosis. ESR during pregnancy increases to 30-40. Changes occur in the coagulation system that contribute to hemostasis and prevent significant blood loss during childbirth or placental abruption and in the early postpartum period. nine0005

Kidneys work hard during pregnancy. They secrete decay products of substances from the body of the mother and fetus (the waste products of the fetus pass through the placenta into the mother's blood).

Changes of the digestive system are represented by increased appetite (in most cases), craving for salty and sour foods. In some cases, there is an aversion to certain foods or dishes that were well tolerated before the onset of pregnancy. Due to the increased tone of the vagus nerve, constipation may occur. nine0005

The most significant changes, however, occur in genitals of pregnant women. These changes prepare the woman's reproductive system for childbirth and breastfeeding.

The uterus of a pregnant woman increases significantly in size. Its mass increases from 50 g - at the beginning of pregnancy to 1200 g - at the end of pregnancy. The volume of the uterine cavity by the end of pregnancy increases by more than 500 times! The blood supply to the uterus is greatly increased. In the walls of the uterus, the number of muscle fibers increases. The cervix is filled with thick mucus that clogs the cavity of the cervical canal. The fallopian tubes and ovaries also increase in size. In one of the ovaries, there is a "corpus luteum of pregnancy" - a place for the synthesis of hormones that support pregnancy. Walls vaginas will loosen and become more elastic. External genitalia (labia minor and major), also increase in size and become more elastic. The tissues of the perineum are loosened. In addition, there is an increase in mobility in the joints of the pelvis and a divergence of the pubic bones. The changes in the genital tract described above are of extremely important physiological significance for childbirth. Loosening the walls, increasing the mobility and elasticity of the genital tract increases their throughput and facilitates the movement of the fetus through them during childbirth. nine0005

Skin in the genital area and in the midline of the abdomen usually becomes darker in color. Sometimes "stretch marks" form on the skin of the lateral parts of the abdomen, which turn into whitish stripes after childbirth.

Mammary glands increase in size, become more elastic, tense. When pressing on the nipple, colostrum (first milk) is released.

Changes of the bone skeleton and muscular system . An increase in the concentration of the hormones relaxin and progesterone in the blood contributes to the leaching of calcium from the skeletal system. This helps to reduce the rigidity of the joints between the bones of the pelvis and increase the elasticity of the pelvic ring. Increasing the elasticity of the pelvis is of great importance in increasing the diameter of the internal bone ring in the first stage of labor and further reducing the resistance of the birth tract to fetal movement in the second stage of labor. Also, calcium, washed out of the mother's skeletal system, is used to build the skeleton of the fetus. nine0005

It should be noted that calcium compounds are washed out of all maternal bones (including the bones of the foot and spine). As shown earlier, a woman's weight increases during pregnancy by 10 -12 kg. This additional load against the background of a decrease in bone stiffness can cause foot deformity and the development of flat feet. A shift in the center of gravity of the body of a pregnant woman due to an increase in the weight of the uterus can lead to a change in the curvature of the spine and the appearance of pain in the back and pelvic bones. Therefore, for the prevention of flat feet, pregnant women are advised to wear comfortable shoes with low heels.