Pregnancy: Changing moods and shapes

By Smriti Daniel

To the uninitiated, the most obvious change in a pregnant woman is the appearance of a big baby bump. But a rapidly expanding waistline is only one of the changes your body will undergo through the next 37 – 42 weeks. Stretch marks? Weight gain? Heartburn?

You’re still only scratching the surface, says Dr. Nalinda Rodrigo, Consultant Obstetrician and Gynaecologist. Many of these symptoms will come and go as your due date approaches, but here is a rough guide to what to expect when - hopefully, you’ll not only be more prepared, you’ll also be in better shape when your little one finally arrives.

The first trimester (week 1-week 12):

In some ways, the first trimester is the hardest. Pregnancy triggers a flood of different hormones in your body, and you’re likely to start feeling their effects within the very first weeks. Many women will find their bodies becoming warmer – mistaking this for fever, they may seek treatment and undergo tests that expose the developing foetus to harm. If you have missed your period, it’s important you first rule out pregnancy before you seek any treatment, cautions Dr. Rodrigo.

With the cessation of your period, your body focuses on nurturing the foetus. Over the next months, your breasts will become tender and swell in preparation for breastfeeding. Invest in a good support bra. Later in your pregnancy, you might need to add pads to absorb the flow of pre-milk. Morning sickness is common during this time. Eating small, light meals and avoiding smells that upset your stomach will help.

Throughout their pregnancy, many women also experience constipation. This is because the hormones rushing through your body have slowed down digestion and relaxed muscles in the bowels. In later months, the pressure of the expanding uterus on the bowels can contribute to constipation. Drinking plenty of water, avoiding caffeine and consuming more fibre rich foods will help.

This same hormone triggered muscle relaxation can also cause heartburn as the valve that separates the oesophagus from the stomach loosens. Acid and food move up the wrong way creating discomfort. Your growing baby is likely to leave even less space for your stomach, so compensate by eating smaller meals and avoiding greasy and acidic foods.

Your perception of smell may be affected, explains Dr. Rodrigo, adding that this leads to an alteration in eating patterns. You might crave exotic, new foods, rather than the more standard home cooked fare. Nosebleeds and nasal stuffiness are common – to stop a nose bleed squeeze your nose between your thumb and forefinger for a few minutes.

Adapt to your new circumstances. Adjust your daily routine so that you eat smaller, frequent meals and get plenty of rest. Take heart, some of your discomfort will ease as your pregnancy progresses.

The second trimester (week 13-week 28):

For many women, the second trimester is easier than the first, says Dr. Rodrigo. You’re likely to feel a sense of wellness and a boost of energy replaces fatigue. Even better, before the end of this trimester you’re going to feel your baby’s first movements.

Many women complain of aches and pains in the back, abdomen, groin area, and thighs – this is the result of an expanding uterus. Increased weight, loosening joints and the pressure of the baby’s head might also result in backaches and pain near your pelvic bone. For some women, pain that runs from the lower back, down the back of one leg, to the knee or foot is an indication that the uterus is putting pressure on the sciatic nerve. Resting frequently and applying a warm compress will help, but if the pain is severe bring it to your doctor’s attention.

A line on the skin running from belly button to pubic hairline - the linea nigra - will appear. As your stomach and breasts increase, you’ll also notice the appearance of stretch marks on your abdomen, breasts, thighs, or buttocks. If you’ve decided to use cosmetic creams to prevent these, now is the time to begin, says Dr. Rodrigo, cautioning that it is unsafe during the first trimester.

Patches of darker skin, known as the “mask” of pregnancy, can appear on your cheeks, forehead, nose, or upper lip. Don’t worry about them too much – they will most likely go away after the birth of the child. Ditto for the numbness or tingling you might experience. The swelling in your hands might press on nerves in your wrist, resulting in a temporary case of carpal tunnel syndrome. This swelling is likely to affect your face and ankles as well, but if it is severe, consult your doctor. It could be a sign of preeclampsia (pregnancy induced hypertension).

Some mothers to be might also experience itching across the abdomen, palms, and soles of the feet. Pregnancy hormones and stretching skin are probably to blame for most of your discomfort. Using gentle soaps and moisturizing creams, avoiding hot showers and uncomfortable fabrics will help.

The third trimester (week 29-week 40):

You and your baby are nearly ready. Expect some of the same discomforts that marked your second trimester to carry into the third. As your baby grows, many women complain of breathing difficulties, says Dr. Rodrigo. Such ‘breathlessness’ forces you to take in quick, almost panting breaths to compensate.
Thanks to the pressure on it, be prepared to have some trouble controlling your bladder. Many women complain of urine leaking when sneezing, coughing, or laughing.

Frequent bathroom breaks and a panty liner will help, but Kegel’s exercises will tone your pelvic muscles and prove useful in many ways. Many pregnant women complain of dizziness and light-headedness throughout their pregnancies. Simple practices such as avoiding over exertion, standing slowly, wearing comfortable clothing will help you avoid this.

Haemorrhoids are among the more unpleasant effects of pregnancy. Constipation can worsen haemorrhoids, so try to nip it in the bud. Haemorrhoids are caused in part by the increased volume of blood in your body. The pressure of the swelling uterus is felt on the large veins behind it - ensuring the blood is slower as it returns to the heart. This also explains the appearance of varicose veins on your legs and sometimes on the vulva as well.

In preparation for breastfeeding, your breasts might begin to leak pre-milk called colostrum.This is quite normal and is no cause for concern, says Dr. Rodrigo.

As your pregnancy progresses, rest might be hard to come by. If possible sleep on your side, is his advice. Getting a good night’s rest might be made harder by leg cramps. These muscle spasms are most common at night and are caused by the change in the way your body processes calcium. Flex your foot forward to experience some relief, and try to consume calcium rich foods.

Towards the end of the third trimester, many women experience a sudden feeling of lightness. This has to do with the baby’s head moving into place for labour, along with a decrease in the fluid in the womb. Some women might experience what is known as the ‘Braxton-Hicks’ contractions. These painless uterine contractions are sometimes a precursor to false labour (35 - 37 weeks) after which you can expect true labour.

As the culmination of your pregnancy nears, your body continues to prepare for a natural birth. For instance, in a process known as ‘effacing’ the cervix becomes thinner and softer.

An emotional rollercoaster?

The hormones rushing through your body affect your emotions as well. Women might experience the entire spectrum of emotions – from bliss to despair – as they near their due date. These tend to be more intense in the first trimester, with women in their second trimester settling into a more stable pattern.

Interestingly, women are known to “slow down” says Dr. Rodrigo, explaining that they can take longer to make decisions. He advises women to avoid competitive exams and demanding work assignments, because they can perform significantly poorer than they would otherwise.

Some women experience mood swings and feelings of depression. This is to be expected, says Dr. Rodrigo. However, in a small percentage of women, this is severe. If this continues, particularly after delivery, it might be a sign of post-natal depression that requires the intervention of a professional.

What does labour have in store? Check MediScene next month for the final part of our series.

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