Pregnancy is generally divided into three trimesters, or three periods of 3 months each, for purposes of discussion. This is done because most women experience the same general changes during each trimester. During pregnancy, two kinds of development go on at once—the physical changes in the mother-to-be and the physical changes in the fetus. Along with the physical changes the woman experiences, some emotional changes take place. You and your partner can use these changes as opportunities to grow, to expand your awareness of yourselves and of each other, to deepen your sense of responsibility, and to become aware of what millions of other parents-to-be have experienced.
The first trimester of pregnancy is the first 3 calendar months, or through the fourteenth week of gestation. You will experience many physical and emotional changes during this time, although most of the physical changes will be more noticeable to you than to anyone else.
The major physical changes that women experience during the first trimester include the following:
• Uterus. For many women, a missed menstrual period is the first sign of pregnancy. Other women continue to have very light periods for the first 2 to 3 months. This lack of a regular period is due to the high levels of estrogen and progesterone that the body produces to maintain the uterine lining that nourishes the developing embryo. Many women spot slightly on the day the ovum attaches itself to the uterine wall. This is not menstrual bleeding; rather, it is called implantation bleeding.
By the time the fetus is 12 weeks old, the placenta, or afterbirth, has formed. The uterus has grown to the size of a grapefruit, with its top reaching to just above the pubic bone. The cervix has already begun softening.
• Vagina. The vagina has begun thickening and softening because of the increase in maternal hormones. It has also turned blue to violet in color as a result of the increased blood supply to the area. Vaginal secretions have become more noticeable and will increase in amount as the pregnancy progresses.
• Breasts. A tingling or prickling sensation is often felt in the breasts during the early weeks of pregnancy. This is because the blood supply is increasing and the milk-secreting glands are growing. After a few weeks or months, the tingling or prickling will disappear, but the breasts will usually continue to enlarge until the third trimester.
Around the eighth week, veins may become visible under the skin, and small round elevated areas appear on the areola, the dark area surrounding the nipple. These elevated areas are the Montgomery glands, which secrete oil to help keep the nipples soft and pliable in preparation for breastfeeding.
• Urination. Many women experience an increased need to urinate during the first trimester because the enlarging uterus is pressing on the bladder. This need usually eases during the second trimester, as the uterus rises out of the pelvis. Even though it means more trips to the bathroom, you should drink plenty of fluids to maintain good kidney function and to provide the water necessary to metabolize the protein you eat.
• Digestion. About half of all pregnant women feel nauseated and may vomit during early pregnancy, and sometimes also in later pregnancy. This condition is called morning sickness, although it can occur at any time during the day. Morning sickness is attributed to an increase in hormone levels, a lack of vitamin B6, and/or low blood sugar. Eating foods high in B vitamins and consuming small high-protein meals throughout the day usually help this condition. (For a further discussion of morning sickness, see “First Trimester“.)
In addition to nausea, some women also have trouble with indigestion and heartburn. The hormones relaxin and progesterone relax the smooth muscles in the body, including the sphincter at the top of the stomach, which keeps food in the stomach. Progesterone is also responsible for relaxing the intestines somewhat, thereby slowing digestion and making constipation more likely. Eating a diet high in fiber (fresh fruits and vegetables, and whole grains), drinking plenty of fluids, and exercising regularly help to minimize constipation. For some additional heartburn preventatives and remedies to try, see “Heartburn Fighters“.
• Skin. The hormones of pregnancy can affect your skin either positively or negatively. Many women experience the glow of pregnancy, and their skin radiance. Others are not so fortunate and develop acne. Continue to eat a good diet and drink plenty of water. Wash your face two or three times a day with a gentle cleanser and apply moisturizer to dry areas. Avoid the temptation to pick at or squeeze the blemishes. This will only increase the likelihood of infection and scarring. Choose makeup that does not clog the pores or try to limit the time you wear it. Wash the applicators or purchase new blush brushes or powder “puffs”. If the acne is severe, you may need to see a dermatologist. Make sure that he knows you are pregnant. Two common medications used for acne, Accutane and Retin A, should not be used during pregnancy.
• Fatigue. Pregnancy brings changes to every system in the body, and these changes require a great deal of physical and emotional energy. Proper rest is extremely important for an expectant mother. You should not feel guilty about resting during the day or about going to bed early. You need rest for your body to adjust to pregnancy.
Many expectant mothers spend the first trimester accepting the fact that they are pregnant and coming to terms with the implications. This is true for other family members as well. You may find yourself drawing inward and focusing on the changes in your body and on your fears and dreams. You may feel increasingly vulnerable to danger and may also fear miscarriage.
Even when the pregnancy is wanted, expectant parents usually have many questions: Can we afford a child? How will our lifestyle change? Will you have jealousy problems with our other children? The woman may wonder: Will I quit work? Both parents-to-be may feel a sense of panic at the additional responsibilities. Ambivalent feelings toward the pregnancy are very common in the early months. These feelings are not bad or wrong. By acknowledging and talking about them, you and your partner may find yourselves better able to cope with them and to accept the pregnancy. Facing your doubts and fears about pregnancy aids in emotional growth.
Many couples enjoy more sexual activity during this time of adjustment, while other couples may desire less sex. You and your partner should talk to each other openly about your feelings to prevent pent-up fears from damaging your relationship.
By the end of this first trimester, you may find that you have begun to sort out and examine your feelings toward your own parents. Think about how you will be different from or similar to them. Among the other feelings you may experience during the first trimester are excitement, increased creativity, and increased sensuality. You may feel “special” during this time.
Mood swings sometimes become more extreme during pregnancy. You may find yourself laughing or crying over insignificant things. This problem is related to the increasing levels of hormones. Researchers believe that these hormones do not cause the moods, but probably increase the intensity of the feelings. Some evidence has shown that expectant mothers feel more anxiety if the baby is a boy, but the reason for this is unknown.
Women experiencing a second or later pregnancy often find that they are less preoccupied with the pregnancy than they were with their first. The major adjustment to parenthood seems to come with a first pregnancy. With later pregnancies, women have less time available and feel less of a need to ponder the meaning of each physical change.