How Your Body Changes

The First Trimester

Motherhood, for many expecting mothers, can spark a storm of emotions ranging from joy and ending in stress. During these changes, the body is in a fury of hormonal and physical changes to prepare for the child. Navigating the emotional and physical changes is overwhelming for anyone. Educating yourself on what to expect during the first trimester, however, can help you be prepared to begin the journey into motherhood.

Emotionally, motherhood could become a source of stress and happiness. Many new or expecting mothers can experience multiple emotions at once: delight, anxiety, exhaustion, etc. What’s important to remember is that any emotion any expecting mother feels is normal. Worrying about balancing work and life or the child’s health is natural. Take time now to begin adjusting your lifestyle and prepare to welcome your new child.

Physically, there are some changes one can expect to happen. Here are some common symptoms you might experience during early pregnancy stages:

· Tender, Swollen Breast

The breasts will start to feel sensitive or sore due to hormonal changes. The tenderness will go down as your body adjusts to the hormones.

· Nausea

While commonly called “Morning Sickness,” nausea can hit at any moment of the day and typically occurs one month after you become pregnant. Avoid having an empty stomach by eating slowly and in small amounts every 1-2 hours. Avoid smelly, fatty food, and drink plenty of fluids.

· Fatigue

The pregnancy hormone progesterone soars, which can make you sleepy. A healthy diet and exercise can increase energy but be sure to rest as much as possible.

· Increased Urination

The amount of blood in the body increases during pregnancy and your kidneys process the extra fluids that end up in your bladder. As such, you might find yourself using the bathroom more often

· Food Cravings/Aversions

You might become more sensitive to certain odors and tastes—changing what you want to eat and what makes you disgusted.

· Constipation

Due to the high progesterone hormone levels, food movement can slow down, causing constipation. Be sure to have plenty of fiber in your diet and drink lots of fluids.

With all these changes, it is vital to consult a medical professional to ensure everything is developing accordingly. During these visits, your provider may ask for your medical history and your family’s medical history. Additionally, there will be exams and tests: pelvic exams to get information regarding the fetus, lab tests such as urine and blood test, blood screenings, genetic test, and other screening tests. If there are any questions, be sure to reach out to your MyPrenatal Care provider to schedule an appointment to alleviate any doubts.

While becoming a mother may seem daunting, it is important to remember that expecting mothers are not alone. These physical changes and emotional turbulence are normal. Seek help from your partner, family, and friends, or your MyPrenatal Care provider. Additionally, support networks are there to help mothers every step of the way.

The Second Trimester

The second trimester starts at 13 weeks into pregnancy. These times are the most enjoyable, with some of the “morning sickness” fading off. It is also said that the second trimester is one of the easiest as your body adjusts to the increased hormone levels. Moreover, some women have noticed their baby’s growth with the arrival of baby bumps. With so many exciting changes occurring, here is what to expect while entering the second trimester of pregnancy. Emotionally, many women feel much less overwhelmed. The first trimester is filled with emotional turmoil as mothers stress over whether they are prepared for a child. During the second trimester, many mothers have gotten used to the idea of being pregnant; moreover, the feelings of exhaustion from the influx of hormones have lessened. The renewed sense of energy and getting used to the idea of being pregnant make many mothers feel much less overwhelmed. There may still be anxiety, but these feelings are normal and can be dealt with by setting yourself up for pregnancy (i.e., learning about your company’s maternity leave policy).

Physically, there still some big changes occurring:

Growing Belly and Breasts

To make room for your growing baby, your uterus will expand, making the belly area grow. Also, breasts will continue to increase in size as well. Pro tips: a supportive bra with wide straps or a sports bra will help with support!

Braxton Hicks Contractions

You might feel mild, irregular contractions—these contractions usually occur in the abdomen as a slight tightness. These contractions generally occur in the afternoon or evening, after physical activity or sex. If these contractions become regular and steadily increase in strength, contact your MyPrenatal Care provider, as this could be a sign of preterm labor.

Skin Changes

The hormonal change during pregnancy increases specific skin cells, resulting in brown patches on your face or a dark line down your abdomen. These changes are common and tend to fade after delivery. It is important, however, to limit sun exposure as it can darken these marks. Finally, stretch marks may appear throughout the body and cannot be prevented. A lot of the stretch marks, however, fade in intensity.

Nasal Problems

With the rise of hormone levels, the body responds by making more blood which causes the mucous membrane to swell and bleed easily. This can result in stuffiness or nosebleeds. Saline drops, hydration, or humidifiers can help lessen congestion.

Dental Issues

Gums become more sensitive to flossing and brushing, and frequent vomiting can affect your tooth enamel. Switching to a softer brush and rinsing with salt water can help decrease irritation, but it is essential to be up to date with dental care during pregnancy.

Dizziness

The body undergoes changes that affect blood circulation within the body—the result is a feeling of dizziness. Be sure to drink plenty of fluids, avoid standing for long periods, and slowly stand up or change positions.

Leg Cramps

Leg cramps are common and usually occur at night. To prevent leg cramps, have routine stretches before bed while maintaining an active lifestyle. If a cramp does strike, be sure to stretch the affected calf muscle. Hot showers, warm baths, and ice massages have also been shown to help.

Vaginal Discharge

You might notice a sticky, clear, or white vaginal discharge. This is normal, but be sure to contact your MyPrenatal Care provider if the discharge becomes strong smelling, changes colors, or is accompanied by pain/itchiness. These could indicate a vaginal infection.

Urinary Tract Infections

UTIs are common during pregnancy. Be sure to contact your MyPrenatal Care provider if you have a strong urge to urinate or can’t delay urination, experience sharp pain when you urinate, have cloud urine, have strong smelling urine, notice blood in your urine, experience a fever, or a backache. If left untreated, UTIs can become severe and result in a kidney infection.

The second trimester is met with a lot of growth and changes, but it is an exciting and wonderful time. With so many changes, it is essential to stay up to date with your prenatal appointments. These appointments help by ensuring all the growth and symptoms of the second trimester are normal. These appointments also allow expecting mothers to hear their child’s heartbeat and find out the sex. While overwhelming at some points, this trimester is met with many wonderful opportunities to recognize how much closer you are to meeting

The Third Trimester

Mothers enter the third trimester at 28 weeks of being pregnant and stay in this trimester until delivery day. With the second trimester being considered one of the most comfortable, the third trimester is tiring and uncomfortable. The baby’s size and position limit comfort, and many feel eager to hold their baby. The anticipation builds up, which makes many mothers want to be ready to know what to expect during the third trimester.

Emotionally, expecting mothers could experience some fears regarding delivery. What does childbirth look like? What will happen, and how long will it take? The anticipation, while exciting, can cause anxiety in some expecting mothers. Many may be dealing with the reality of motherhood and think of the future after the baby is here. To help soothe your thoughts, consider journaling down persistent fears and ideas. Consider talking to other expecting mothers to share your excitement and fears; speak to others with positive birth experiences. Physically, there are still changes occurring in the body:

Braxton Hicks Contractions

You might feel mild, irregular contractions—these contractions usually occur in the abdomen as a slight tightness. These contractions usually occur in the afternoon or evening, after physical activity or sex. If these contractions become regular and steadily increase in strength, be sure to contact your health care provider, as this could be a sign of preterm labor.

Backaches

Pregnancy hormones relax the connective tissues that hold your bones together. With the added weight of a child, these changes can be tough on your back. Make sure to sit in chairs with good back support and regular exercise. Wear low-heeled shoes with good arch support,but make sure they are not completely flat.

Shortness of Breath

It is normal to get winded easily. Maintain good posture to help give the lungs room to breathe and slow down.

Heartburn

With the pregnancy hormone relaxing the valve between your stomach and esophagus, stomach acid may reflux into your esophagus and cause heartburn. To prevent heartburn, eat small, frequent meals, and avoid fried foods, citrus, chocolate, and spicy foods.

Spider veins, varicose veins, and hemorrhoids

The increased blood circulation can cause tiny, red-purplish veins to appear on your face, neck, and arms (spider veins). You might also notice swollen veins on your legs (varicose veins). Painful, itchy varicose veins in your rectal area can also occur (hemorrhoids). To help with the swelling, exercise and elevate your legs frequently while incorporating fiber and water into your diet.

Frequent Urination

As the baby moves deeper into the pelvis, you’ll feel more pressure on your bladder. As a result, you find yourself urinating more and sometimes leaking urine when you laugh, cough, sneeze, bend, or lift. Panty liners are a must if this becomes an issue.

As the delivery date comes closer, your MyPrenatal Care provider might ask you to come in more often. These visits will include regular check-ups to monitor weight, blood pressure, and any symptoms you may be experiencing. These physicals will also occur for your child as the provider will monitor the baby’s position and movement. Additionally, you may need to take vaccinations during your third trimester to help protect your child. Finally, there will be screening tests for various conditions such as: gestational diabetes, iron deficiency anemia, and group b strep. While many mothers are eager to hold their baby, they must ensure they maintain consistent check-ups to make sure their baby is healthy once they arrive.

The Fourth Trimester

Many people think there are only three trimesters in the journey of motherhood. The last trimester (delivery to 12 weeks after delivery) is a critical time for the mother and child. This 12-week period sets the stage for long-term health and well-being while the mother’s body undergoes physical changes. In the fourth trimester, it is not only important to take care of your new baby but of your body as well.

Physically, the body undergoes tremendous stress and changes when delivering the baby. Depending on the delivery method, what to expect varies as new mothers undergo recovery. The largest difference between a c-section recovery and a vaginal birth recovery is the aftercare to prevent infection.

After a C-section, be sure to treat the incision with care: take it easy and rest whenever possible. Avoid lifting anything heavier than your baby while monitoring your incision for any redness, swelling, or leakage, as it may be a sign of an infection. Be sure to experiment with proper breastfeeding positions that work well with C-section recovery.

For vaginal births, vaginal soreness may occur for a few weeks after delivery, especially after an extensive tear. To help with vaginal soreness, mothers should sit on pillows or padded rings.

If the area is sore, use an ice pack or a chilled witch hazel pack between a sanitary napkin on the area between your vaginal opening and anus (perineum). Sit in a warm bath that just covers your buttocks and hips for five minutes. You can also use cold water if you find it more soothing. Finally, be sure to use over-the-counter remedies for general pain or constipation. Be sure to talk to your health care provider if you experience severe, persistent, or increasing pain.

There are several common postpartum signs and symptoms:

Vaginal Discharge Contractions “After Pains”

Tender Breasts

Hair loss and skin changes Mood Changes Weight Loss

The early post-partum period is a time of great joy. While the joy is there, it is also a time when new mothers are most vulnerable to Postpartum

Depression or infection. Thus, it is important to prioritize postpartum health. After childbirth, talk with your MyPrenatal Care provider about risks of pregnancy-related complications and if you need any special follow-up care. Rather than having a single visit after your delivery, have contact with your provider within the first 3 weeks after delivery.

Within 12 weeks after delivery, have your MyPrenatal Care provider conduct a comprehensive postpartum evaluation.

Although the 4th trimester is focused on keeping the newborn as healthy as possible, it is equally important that we protect our new mothers. By staying up to date with post-partum visits with primary care professionals, mothers can limit their risk of post-partum complications and infections.

4th-trimester care doesn’t only happen for the baby. Mothers must also care for themselves to keep their baby happy and healthy.

Avoiding Postpartum Complications

The early postpartum period is a time of great joy. While joyful, it is also a time when new mothers are at an increased risk for postpartum complications.

Maternal Mortality Rates in the US, 2020

• In 2020, 861 women were identified as having died of maternal causes in the United States, compared with 754 in 2019. The maternal mortality rate for 2020 was 23.8 deaths per 100,000 live births compared to a rate of 20.1 in 2019.

• The maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 live births which is 2.9 times the rate for non-Hispanic White women.

• Rates for non-Hispanic Black women were significantly higher than rates for non-Hispanic White and Hispanic women.

MyPrenatal Care is committed to closing the racial disparities and decreasing maternal morbidity and mortality. Thus, it is important to prioritize postpartum health. After childbirth, talk with your provider about the risks of pregnancy-related complications and if you need any special follow-up care.

Rather than having a single visit after your delivery, you should have contact with your provider within the first 3 weeks after delivery. This can be an in-office visit or even by tele-health. However, if your MyPrenatal Care provider determines that you are at high-risk for postpartum complications, the provider may recommend an office visit 3 to 10 days after delivery.

Within 12 weeks after delivery, an appointment should be scheduled with your MyPrenatal Care provider to conduct a comprehensive postpartum assessment. During this assessment, your provider will evaluate:

• Your mood and emotional well-being

• Screen for postpartum depression

• Assess your comfort and confidence for caring for your newborn

• Assess comfort and confidence with breastfeeding

• Assess material needs (such as stable housing, utilities, food, and diapers) and provide referrals to resources as needed

• Provide guidance regarding sexuality

• Discuss birth spacing (avoiding pregnancy sooner than 18 months after delivery)

• Assess desire for future pregnancies

• Discuss coping options for fatigue and sleep disruption

• Assess and discuss physical recovery from birth

• Chronic disease management (hypertension, diabetes, thyroid disease, etc.)

• Review vaccination history and provide immunizations if needed well-woman screening (including PAP test, if needed)

Baby Blue and Postpartum Depression

The “4th trimester” or postpartum period is both exciting and overwhelming. Having a baby is a life-changing experience and almost every mom faces a period of the “baby blues” due to the roller coaster of hormones, lack of sleep and the struggle to adjust to a new baby in the home. While having the baby blues, a new mom experiences a period of anxiety, feeling down, mood swings, crying spells, and difficulty sleeping. Baby blues can start 2-3 days after delivery and typically lasts for less than two weeks. During this time, take care of yourself and be kind to yourself. Share your feelings with your loved ones and ask do help.

With that said, some moms experience a more severe, long-lasting form of depression known as postpartum depression (PPD). Moms with PPD can experience severe mood swings, irritability, loss of appetite, overwhelming fatigue, and a lack of joy in life shortly after childbirth. PPD affects up to 20% of postpartum moms. It is not a character flaw or a weakness. PPD is not your fault and is nothing to be ashamed of.

If you feel that you may be experiencing postpartum depression (PPD) symptoms, ask yourself the following questions and review your score with your MyPrenatal Care provider: I have been able to laugh and see the funny side of things.

(0) As much as I always could

(1) Not quite so much now

(2) Definitely not so much now

(3) Not at all

I have looked forward with enjoyment to things.

(0) As much as I ever did

(1) Rather less than I used to

(2) Definitely less than I used to

(3) Hardly at all

I have blamed myself unnecessarily when things went wrong.

(3) Yes, most of the time

(2) Yes, some of the time

(1) Not very often

(0) No, never

I have been anxious or worried for no good reason.

(0) No, not at all

(1) Hardly ever

(2) Yes, sometimes

(3) Yes, very often

I have felt scared or panicky for no very good reason.

(3) Yes, quite a lot

(2) Yes, sometimes

(1) No, not much

(0) No, not at all

Things have been getting on top of me.

(3) Yes, most of the time I haven’t been able to cope

(2) Yes, sometimes I haven’t been coping as well as usual

(1) No, most of the time I have coped quite well

(0) No, I have been coping as well as ever

I have been so unhappy that I have had difficulty sleeping.

(3) Yes, most of the time

(2) Yes, sometimes

(1) Not very often

(0) No, not at all

I have felt sad or miserable.

(3) Yes, most of the time

(2) Yes, quite often

(1) Not very often

(0) No, not at all

I have been so unhappy that I have been crying.

(3) Yes, most of the time

(2) Yes, quite often

(1) Only occasionally

(0) No, never

The thought of harming myself has occurred to me.

(3) Yes, quite often

(2) Sometimes

(1) Hardly ever

(0) Never

Score: __________________