Overview of Changes in Pregnancy

There are changes in all your organ systems once conception happens, the body changes occur to accommodate the new human growing inside your uterus/womb. There is need to have additional nutritional and oxygen requirements; a preparation mechanism for delivery, for instance, your blood volume increases in part to prepare when you lose some blood during delivery. Most of the changes will wane off sometime after delivery in uncomplicated pregnancies

Pregnancy leads to changes in the pregnant woman as well as the fetus as fetal development takes place and pregnancy progresses.  Hormonal changes occur to support the pregnancy; increase blood flow to the uterus to supply two humans; prevent rejection of the “foreigner” inside the uterus by reducing uterine cramping; relaxing the pelvic bones to accommodate the growing fetus and preparation for delivery; prepare for the lactation or breastfeeding once the baby is born. The changes are for the good but the symptoms they bring about may not be well tolerated. Different women experience the pregnancy symptoms differently and this may differ even between pregnancies in the same individual. This is because of your uniqueness and the uniqueness of the growing human(s) within you.

Heart and Blood Flow

Cardiovascular, hematologic and hemostatic changes 

Your heart works harder to supply blood for two humans- you and your developing baby. It also does this so as to have some blood in store in anticipation for childbirth. Your heart will beat faster by about 15 beats per minute; it pumps more blood from its chambers with each heart beat as a result of the increased muscle mass. The vessels are less resistant as blood flows in them and the volume of blood volume increases by 50%. The increase in the red blood cell mass is only half the increase of blood volume and this mismatched increase can lead to physiologic anemia of pregnancy. This increase is to help supply oxygen which is increased demand and also is part of your body getting ready for labour and delivery.

These require additional iron, folate and vitamin B12 which is often given as supplements to iron-rich diets that your doctor/gynecologist will recommend. . Your blood pressure would normally reduce only to normalize in the third trimester. By the time you are due you have an additional 1.5 Liters of blood or thereabout. It is magical how your body adjusts

The changes in your heart are brought about by pregnancy hormones and factors that increase with pregnancy

Interested to learn more about different trimesters stages of pregnancy? 

When you are pregnant, your vessels are more likely to form clots since the pro-clotting factors are more than the anti-coagulation/clotting factors in addition to other predisposing factors for thromboembolic events. This is meant to prepare your system to effectively stop bleeding during childbirth. The coagulation system comes in handy! However; on the contrary it predisposes you to clot formation tendencies in the deep leg veins and in the lung vessels (pulmonary thromboembolism).

 

Body Aches and Pains

 

Ever wondered why you may experience back pain or pelvic pain during pregnancy? This is because of Bone, Joints and Muscular Changes in Pregnancy. Your weight increases as a result of the pregnancy and there is a forward shift in your centre of gravity as the pregnancy progresses with change in your body posture. These together with the hormonal changes causes strain of your spine and pelvis. Your weight bearing joints and other joints endure increased weight and become laxed.

Resulting in increased curvature of your lower back which causes back pain; your shoulders are pulled downwards too and you may experience shoulder pains as a result.

What you may do to help:

• Avoid heavy lifting
• Bend your knees and not your waist when picking objects up
• Lightweight pregnancy girdle may help
• Maintain good posture
• Put on flat shoes with good support

Ligaments such as those supporting the uterus may be stretched as the uterus expands causing you discomfort on either side of your abdomen. Ligaments in other areas also become more laxed courtesy of relaxin, one of the pregnancy hormones that is increases when one is pregnant.

Your abdominal muscles are stretched; become weak and may separate leading to abdominal hernias or worsening of pre-existing hernias. The same straining is expected in your other muscle groups

The joints holding your pelvic bone in the middle on the front side (pubic symphysis) and your pelvis to the lower backbone (sacroiliac) become wider and more flexible or laxed. The purpose of the relaxed joints and ligaments is to create more space to accommodate the fetus during labour and childbirth

The vagina lengthens and the posterior vaginal wall muscles relax

 Check different recommended weight gain in pregnancy based on pre-pregnancy BMI.

Breathlessness or SOB

Changes in The Breathing System During Pregnancy

Your breathing rate increases yet you seem to be out of air. Your ribs flare out and your diaphragm move upwards into the ribcage due to the enlarging uterus and the relaxation of the ligaments supporting your lower rib cage. This changes may bring about difficulty in breathing which occurs in three out of four pregnant women. Another reason for this feeling of “air hunger” is because of the increased volume of air you take in and out with each breath

Contact your doctor or obstetrician/gynecologist if you develop sudden onset of shortness of breath or breathing difficulty; chest pains;

 

Frequent Urination

The system that is concerned with part excretion of waste products from your body is not left out either in the changes. Urinary Tract Changes in Pregnancy : Your kidneys enlarge, have increased blood flow and filters more-a more efficient kidney-excretes more! Your ureters (The pipes that drain your kidneys) and your bladder enlarge too. Your bladder is pushed upwards and and is flattened due to the physical effect of the enlarging uterus. The pregnancy hormones at play slow the emptying of the urinary bladder and this may serve as a good culture media for infection. These changes may lead to increased frequency of urination during the day and at nighttime (nocturia), painful urination, urgency, urine incontinence (feeling of inadequate emptying of the bladder); and also increased risk of urinary tract infections during pregnancy with its complications.

Frequency of urination is one of the early signs of pregnancy among others like missed period and nausea of pregnancy

 

“Morning” Sickness

Nausea and/or Vomiting of pregnancy is what is commonly referred to as “morning” sickness which occurs in about 5-9 out of 10 pregnant women. Nausea and /or vomiting can occur at at anytime of the day. Some women experience severe form of nausea and/or vomiting termed as hyperemesis which may lead to dehydration and other complications. This has been linked to the increase in Human Chorionic Gonadotrophin, Estrogen, progesterone and thyroid hormones. Other proposed causes include Helicobacter Pylori bacteria, genetic susceptibility and some vitamin deficiencies. Women with history of motion sickness are at a higher risk of nausea of pregnancy. “Morning” sickness may start as early as week four to six in some women and it peaks as the first trimester(weeks 1-12) comes to a close .

Mid-way through the pregnancy, nausea will have subsided in 8-9 out of 10 women who had it. A small percentage may have nausea extending till the time of delivery.

Read more Here on what you may do to help with morning sickness 

Talk to your doctor incase you have severe forms of nausea and/or vomiting (hyperemesis gravidarum)

Other Gastrointestinal Changes you may experience include bloating and constipation, heartburns, reflux and indigestion.

Bloating and Constipation

These are as a result of slow movement of food in the gut brought about by progesterone. The growing uterus also physically displaces the stomach and the rectum and/or intestines and contributes to the gastrointestinal symptoms by applying pressure on the gut.

What you may do to help:

• Take plenty of water
• Eat foods rich in fibre
• Gentle exercise may help relieve the symptoms

Consult your doctor and /or gynecologist on safe stool softeners to use incase of persistent symptoms

Heartburns, Reflux and Indigestion

Increased reflux of food from the stomach upwards into the esophagus causing a burning sensation due to the as the food has already mixed with the acidic juices in the stomach. This is because of the reduced tone of the esophageal sphincter courtesy of our good hormone, progesterone . The gastric (stomach) emptying time is also increased in pregnancy causing food to remain longer in the stomach

What you may do to help:

• Use of pillow on the head as you lie down
• Avoid going straight to bed immediately after eating; allow some time for food to travel from the stomach before you lie down
• Eat small frequent meals
• Antacids may be used with the guidance of your doctor

Breast Changes

Your breasts will increase in size-become fuller or larger, sore and tender especially in the first few weeks of pregnancy and you may also notice increased sensitivity of your nipples to touch. The skin around your nipples, the areolas, darken and some women may have their breasts leaking milky fluid, colostrum, mostly occurring in the third trimester of pregnancy.

What you may do to help:

In case there is leakage of colostrum or sore and larger breasts,

• Putting on well-fitted bras/maternity bras
• Use of a nursing pad to avoid soiling your clothes

Skin Changes

Skin or dermatological changes in pregnancy

• Darkening of the skin-facial skin (melasma); Darkening of midline skin (Linea Nigra)-is the commonest finding
• Darkening of skin around the areolar, darker nipples, axillae, genitalia, perineum, anus, inner thighs, neck
• Prominent darker demarcation lines especially on legs of black pregnant women
• Stretch marks on the tummy, thighs, lower back, butt, breasts and arms
• Skin tags on the chest, neck, face, armpits and groin

Here is the Good News: Most of the darkened areas become less pigmented over months after delivery. Some few changes may be permanent

Hemorrhoids

Hemorrhoids which are dilated protruding veins in the anal region are found in 7 out of 10 pregnant women. The effects of hemorrhoids are pain in the anal region; pain on defecation; they may bleed and are itchy too. May emanate from straining due to constipation or pressure from your growing bump. This is more common in the third trimester of pregnancy

What you may do to help:

• Prevent constipation by increasing your daily water intake and fiber rich diet
• Stool softeners can be prescribed by your doctor to aid incase of constipation
• Pain relieving suppositories can provide relief
• Warm sitz baths

You may have Vulvar varicosities and they appear like “a bag of worms”

 

Varicose Veins

Lower limb varicose veins which occur in 5 out of 10 pregnant women

What you may do to help:

• Compression stockings
• Elevating your feet on a stool while seated or putting a pillow beneath your calf muscles while lying may help alleviate the discomfort associated with the swollen veins on your legs

Itchy Skin

Itching especially in the tummy occurs in 4 out of 10 pregnant women with majority having no identifiable lesions or pathology. As the skin stretches it may become itchy

What you may do to help:

• Use of moisturizers and antihistamines may help with reducing the itchiness

Tiredness

Pregnant women may experience fatigue/tiredness more so in the first trimester

What you may do to help:

• Have adequate sleep and rest. Having a favorable sleep routine with naps during the day if possible

Weight Gain

This is as a result of increased size of the uterus, breasts; weight of the placenta and amniotic fluid, your growing baby, extra blood volume

The Good News:

• You will lose the weight soon after delivery

Mood Swings

There is heightened emotions with moods oscillating every now and again particularly in the first trimester. One minute you may be happy and the next crying. This is normal and linked to the pregnancy hormones and the bodily changes that you may be experiencing

What you may do to help:

• A supportive partner may help with understanding
• This too shall pass

Loss of Appetite or Food Cravings

You may have reduced appetite or lack appetite for even previously enjoyed foods during the first few months of pregnancy. Some women avoid certain foods as they dislike them and some may have food cravings

What you may do to help:

• Small frequent meals to avoid hypoglycemia, low blood sugars

Other Symptoms of Pregnancy

Dizziness can occur incase of standing quickly from a seated or lying position; upon lying flat on the back during the second half of pregnancy. Sometimes dizziness may be a symptom of anemia in pregnancy.

Weight gain and swelling of your feet, hands and face are common signs of pregnancy.

Tiredness or fatigue is quite a common occurrence in the first trimester with the slowed metabolism from progesterone

 

Your developing baby

Changes in The Embryo or Fetal Development

Results from the dividing cells which start immediately fertilization happens. The division is rapid leading to development of the embryo, placenta and various organs in the embryo/ fetus. Most organ development occurs in the first trimester of pregnancy.

To see your obstetrician and/or gynecologist at Nyalife Women’s Health Clinic; call our dedicated clinic line 0746516514 or book with us here BOOK AN APPOINTMENT.