PREGNANCY CHECKLIST

PREGNANCY EXPERIENCE

Now that it’s official, it is time to plan the next eventful nine months of your life. We’ll help you take care of the essentials and be with you all the way, towards a healthy pregnancy and delivery. Your physical and emotional well-being is your top priority. And so is ours.Now that it’s official, it is time to plan the next eventful nine months of your life. We’ll help you take care of the essentials and be with you all the way, towards a healthy pregnancy and delivery. Your physical and emotional well-being is your top priority. And so is ours.

Pregnancy heralds the onset of many changes, physical, mental and psychological, in a woman. Knowing what to expect while you are expecting helps you tackle these changes better. A brief overview of the three phases of pregnancy is as follows:

  First Trimester:

First sign of pregnancy:

The first sign of pregnancy is usually a missed period. When a sexually active woman does not get the period around the expected date, she is most probably pregnant. It is correct the other way too: Pregnancy is the commonest cause of a missed period. Pregnancy should be confirmed if a period has been missed or delayed. This is done by testing for Human Chorionic Gonadotropin (HCG) in urine. Some women, however, may experience spotting or little bleeding in the early months of pregnancy. This is not the usual bleeding. Some bleeding may be noticed even if pregnancy has been confirmed. This is called ‘implantation bleeding’ and may occur few days after conception. This occurs because the fertilized egg implants in the womb.

Feeling tired

Feeling tired is usual in the early weeks of pregnancy. This happens as the body prepares to adapt to the requirements of supporting a growing baby. The heart beat may increase. You may feel constantly drained of energy. You may feel like sleeping. You should take ample rest and not tire yourself unnecessarily. You may also feel exhausted if you have repeated vomiting or you have not been able to eat due to the persistent feeling of vomiting.

Morning sickness

Morning sickness is vomiting or a feeling of vomiting experienced by pregnant women in the morning hours early in pregnancy. It may last all throughout the day. This is due to the changes in blood hormones seen in pregnancy. The feeling may go away after the 12th week of pregnancy but it may be felt even later by some women. It can be helped by eating light and easy digestible food that is not fried or spicy, having plenty of fluids in small sips, eating small frequent meals, and avoiding odors that can trigger the feeling.

Other changes in the first trimester

Your breasts may enlarge, become sensitive, feel full and slightly painful, and the area around the nipple may get darker. You should wear comfortable supports to help this.

If you have been charting your body temperature during the previous cycle, a persistent rise in temperature for more than 15 days may mean that you are pregnant. The hormonal changes prevent the temperature from dipping towards the end of the menstrual cycle.

You may have urge to pass urine frequently. This is because the growing womb presses upon the urinary bladder in the vicinity. Empty your bladder whenever you have an urge, and keep clean to avoid any infections.

You may experience constipation. This is because the rising levels of the hormone progesterone slow the movements of the gut. The stomach may take longer to empty. The intestines move slow and do not empty at the usual frequency. Having fruits, fiber, and fluids can help to overcome this. Getting active helps too. A walk or some exercises can be useful. You may even experience heartburn and fullness after meals. Eat small frequent meals, and avoid the fried stuff and fizzy carbonated drinks.

You may feel dizzy. This is because the hormones affect circulation and act on the blood vessels in the body and cause them to dilate. To prevent this, you should avoid prolonged standing. Always be slow to get up from sitting position or rising from lying down. Take rest during the day. Stress, tiredness, and hunger can also lead to dizziness.

You may experience mood changes. This is again the interplay of hormones. You may feel happy one moment and sad and weepy in another. Do not panic. Try some relaxation techniques like meditation or yoga. You can join a club and keep yourself busy in some activities. Seek help of your partner and family. Engaging in a regular walk or some fun activity can help you to beat the blues. If you work, avoid stress by planning your schedules.

Take adequate rest. Try moderate exercise like a relaxing walk. Exercise can help you to overcome many complaints like constipation, sick feeling, and the pregnancy blues. Week by week your baby grows. It is miraculous! The baby will slowly gain length and develop some vital organs like the brain, heart, and limbs. Your womb grows inside the pelvis and may not really give an evident bulge in tummy.

Enjoy your pregnancy

This is your early pregnancy. Until you complete 12 weeks, you are in the first trimester of pregnancy. A normal pregnancy of 9 months is divided into 3 trimesters of 3 months each. Your body will undergo unique changes in each phase as your pregnancy advances. The first trimester is most crucial. Your body adapts to receive and support the growing baby. The baby’s organs begin to form in this trimester. You should take care to make this period easier for both yourself and your baby. Getting pregnant is indeed the most wonderful feeling.

Uterus, an organ in the female reproductive system, is amazing. It houses the product of conception, and provides it with all nourishment needed to grow and develop into a healthy baby. The uterus expands gradually to accommodate the growing baby, and provides the necessary environment, so that the embryo undergoes the various stages of development, till it becomes a baby and is able to survive outside the mother’s body.

The fetus undergoes innumerable changes throughout its development from first to the third trimester.

Conception of life

When a sperm from the man fertilizes or unites with the ovum or egg of the woman, the conception of life takes place in the womb, and this is when pregnancy starts. The doctor calculates the exact date of conception based on the first day of your last menstrual period. To calculate the delivery date, the doctor will count 40 weeks from the last menstrual period. After fertilization, the embryo forms, and undergoes many changes over the period from 5th week to 10th week of pregnancy or the first trimester of pregnancy.

Changes during embryonic stage

During the embryonic stage, all the major organs of the baby start to develop. The embryonic stem cells which are cells in the embryo multiply themselves many times over, and also change into different types of cells to make a complete human body. The development of placenta also takes place in this stage.

The baby derives all the nutrients, water and oxygen from the mother through the placenta. Waste materials from the baby also pass out through the placenta. The development of amniotic sac also takes placed during this stage. The amniotic sac consists of the amniotic fluid that surrounds and protects your baby.

Development during embryonic stage

Various organs and body parts develop during this stage. The embryo consists of three layers of cells. The outermost layer of the embryo is known as ectoderm which gives rise to eyes, inner ear, skin, connective tissues, central and peripheral nervous system. The middle layer of the embryo is known as mesoderm which gives rise to circulatory system, heart, muscles, kidney, bones and most of the reproductive system.

The endoderm is the innermost layer of the embryo that gives rise to urinary bladder, intestines and lungs of the baby.

In front of the embryo an ‘S’ shaped tube is formed which develops into the heart of the baby. Initially the heart does not beat but soon it starts beating and pumping. The baby’s brain, spinal cord and associated nerves develop during this stage. The eyes and ears of the baby develop on the sides of the head, and then gradually the eyes move forward which are protected by eyelids. The forehead, cheeks, lips, jaw, nasal passages, mouth, tongue, taste buds, and tooth bud also develop during the embryonic stage. The embryo develops arms and legs from its sides which look like buds initially. These buds gradually grow into the arms and legs of the baby.

At the end of the embryonic stage, the development of baby’s vagina or penis takes place depending on the sex of the baby. The baby’s eggs or sperm formation also takes place in this stage itself depending on the sex of the baby. In the final stages, the development of muscles also takes place due to which the embryo begins to move and twitch. At the end of 10th week, the embryo is 1 inch long.

After the Embryonic stage

The fetal stage starts after the embryonic stage and the baby is now called as a fetus. The fetal stage starts at the last 2 weeks of first trimester. During this stage, the fetus gains weight, grows longer and continues to develop all the body parts and organs. By the end of the 10th week the vital organs begin to work.

First prenatal visit

On your first prenatal visit to the doctor’s office, the blood pressure, height and weight are checked. To check the position of the baby and its size, external abdominal examination is done. In internal examination, the cervix (opening to uterus) and vagina are checked for any abnormalities or infections. The size of the uterus and changes in the cervix can tell you about the stage of pregnancy you are in. The urine is tested to check if you have diabetes, kidney disease or bladder infection.

The doctor will ask you questions regarding your health and family history of any genetic disorders. This is to determine if the baby has any risk of getting genetic diseases. You will be asked about any previous history of miscarriages, your birth control methods, hospitalizations if any, medications you are taking and history of any allergies.

In the first prenatal visit, you can hear the baby’s heart beat for the first time with the help of a Doppler stethoscope. Before you leave the doctor’s office, you will be sent for a blood test to check if you are immunized against illnesses like rubella (German measles), mumps, measles and varicella (chicken pox), syphilis, hepatitis B and also tested for HIV (AIDS). Your blood is also given for testing to determine your blood group and Rh factor.

  Second Trimester:

Changes in the mother's body during second trimester:

As you complete 12 weeks of pregnancy, you advance into the second trimester. This begins in week 13 and last up to week 27 of your pregnancy. This is going to be a relatively easy and pleasant experience as compared to the first trimester. You and the growing baby will undergo some incredible changes!

Feeling of wellness

The second trimester is a period of feeling of wellness. You may feel more energetic, fresh, and active. Your feeling of vomiting will subside. So, the sickness will disappear. Other features of the first trimester like dizziness and frequent urination will disappear.

You will gain weight more rapidly. You will also develop a bulging tummy and start looking pregnant. Your womb will grow out of the pelvis higher into the belly. By 16th week, the top of the growing womb can be felt midway between the pelvic bone and navel; by the end of the second trimester, it would have reached around 2 inches above the navel. You can make a choice of some good and comfortable maternity dresses

Movement of the baby

Your baby constantly moves in the womb and is surrounded by water. The feeling of these movements is called ‘quickening’. You may feel your baby move several times in a day. If any day, you feel the baby isn’t moving just enough, you should contact your doctor.

Changes in Breasts

Your breasts will continue to get bigger and heavier, as they accumulate fat and mature to produce milk. The pain and unease you felt in the breasts will however decrease. Some blue vessels will be visible under the skin of the breasts, and stretch marks may develop. Around 16 to 19 weeks, you may notice a thin yellow discharge from the nipples. This is called ‘colostrum’. Your breasts are now preparing to nurture the baby when born.

Stretch marks

Stretch marks are pink, red, or silvery white streaks that develop on the skin of the breasts, abdomen, thighs, or arms. These are believed to develop due to the action of hormones that stretch the tissues under the skin. Some may itch. These are also called ‘striae gravidarum’. Stretch marks may fade with time after delivery. Some creams and oils may help.

Other skin changes

Your skin may show some peculiar changes. You may develop dark patches on your face. This is called ‘mask of pregnancy’ or ‘chloasma’. A dark line called ‘lineanigra’ may develop on your growing belly from navel to the pelvis. These fade away after delivery. These are pigment changes and may be caused by pregnancy hormones stimulating the production of pigment in the skin. Increasing levels of the hormone estrogen can cause your palms to become red. Tiny red radiating thread like vessels may be visible under the skin of chest, neck, or face. These are called ‘angiomas’ or ‘vascular spiders’ and may go away after delivery. Besides these, your skin may become itchy, blotchy, or develop acne. If any of these get too distressing, it is good to see a doctor. Large blue vessels may become evident in the legs. Again it is due to hormonal changes. You should avoid standing for very long periods to prevent them.

Other second-trimester changes

Your growing womb may show some mild and intermittent contractions called the Braxton Hicks contractions. These are infrequent and not rhythmic. You may just relax and change your posture or activity. These are practice contractions as your womb has started to prepare to contract for the delivery of the baby after pregnancy is complete.

You may develop nose bleeds and bleeding from gums and teeth. This happens because the blood flow to them increases. The lining of the nose swells and begins to bleed and the gums get soft. These may bleed when brushing, flossing, or even spontaneously. Use a soft toothbrush and maintain hygiene in the mouth. You can gently pinch your nose and avoid blowing when it bleeds.

You may develop leg cramps. This is because of circulatory changes that cause blood to accumulate in the legs. You can just massage your legs and talk a short walk. If however, you develop painful swollen calves with fever, you probably are developing clots in the vessels of the legs. You should see a doctor without any further delay.

You may develop a short breath as the hormones stimulate the respiratory center in the brain and the lungs to breathe deep to enable better oxygen supply to the growing baby.

You may develop a thin, watery, and odorless discharge from the vagina due to hormonal changes affecting your genitals. This discharge is acidic in nature and keeps your birth canal sterile and free of infections. If however, the discharge gets foul-smelling, greenish or yellowish, thick, or your genitals start to itch or burn, you should see a doctor.

As your womb grows out of the pelvis, it no longer irritates the urinary bladder to increase the frequency of urination. The growing womb may press upon the bladder and lead to stasis. In addition, the hormone, progesterone relaxes the bladder and the ureters, pipes that carry urine from kidneys to the bladder. This predisposes to urinary infections. If you have pain or burning when passing urine, you need to see a doctor.

The feel good factor

The second trimester gives you a pregnant look and feel. You may be exhilarated to feel the kicks of your baby in the womb. Your baby grows amazingly and gains weight and length. The baby develops eyes, ears, fingernails, and genitals. Urine formation begins and the baby can now swallow. By the end of the second trimester, your baby will weigh around 2 to 3 pounds and will be 13 to 16 inches long.

Growth and development of the baby

The doctor estimates the length of the baby from its head to the bottom instead of toes as the baby’s legs are curled up to the stomach. The length of the baby measures around 3 inches at the beginning of the second trimester and reaches upto 9 inches or even longer by the end of the trimester.

In the 13th week of pregnancy, the baby starts to form urine which is discharged into the amniotic fluid in the amniotic sac that contains the baby.

In the 14th week of pregnancy, the arms of the baby develop to the full length and the sex of the baby can be figured out.

In the 15th week of pregnancy, the baby’s bones develop which can be clearly seen in the ultrasound. The hair pattern of the baby also starts forming.

In the 16th week, the eyes come forward and the ears take their position. Facial expressions like frowning and squinting can be seen. The baby performs sucking motion with its mouth.

The 17th week sees fat accumulation on the baby which keeps it warm.

In the 18th week, the baby begins to hear sounds of the mother’s heart beat and stomach rumblings.

In the 19th week, the uterus and vagina of the female baby develops.

The movements of the baby can be felt in the 20th week. The baby’s skin is also protected by a cheesy white coating.

In the 21st week, the baby grows in size and can swallow.

In the 22nd week, the baby is completely covered by fine hair called lanugo.

In the 23rd week rapid eye movements are seen. Foot prints and finger prints begin to form. The uterus in the baby girl is completely formed with ovaries and eggs needed for the entire lifetime while in the baby boy the testis starts to descend from the abdomen.

In the 24th week of pregnancy, the baby grows real hair and the baby sleeps and wakes up regularly. The baby is now 8 inches in length and weighs more than 1 1/3 pounds.

In the 25th week, the baby’s hands are completely developed and it starts exploring the structures in your uterus.

In the 26th week the fingernails of the baby develop and its lungs start producing surfactant which is a substance that makes sure that the lungs do not collapse.

By the 27th week your baby’s immune system, lungs and liver keep maturing and this marks the end of the second trimester of pregnancy.

Changes in your body

In the second trimester of pregnancy, various changes take place in your body as well. The breasts enlarge in size due to the enlargement of milk glands in them and fat deposition around the breasts. This is your body’s way to prepare you for breastfeeding when the baby arrives. The nipples darken and you have bumps around them which are nothing but tiny glands that make oil to prevent the nipples from drying up.

Colostrum, a yellow colored fluid makes its first appearance from the nipple during this time. As your abdomen grows in size, stretch marks appear on your stomach and breasts which are nothing but the elastic fibers in your skin stretching. There can be itching near the stretch marks and also where ever the skin has become dry.

Starting from your navel to the pubic hair a dark line emerges which is called as lineanigra. There is increased sensitivity of skin to sun light and palms are itchy and red. Patches of dark skin also known as ‘masks of pregnancy’ appear on the forehead, cheeks, upper lip and nose. The desire for sex returns in the second trimester of pregnancy.

Other body changes you may see are puffy hands, legs and face due to fluid retention; pelvis, hips and back begin to ache; leg pain; Deep Vein thrombosis can occur which is blood clot formation in the leg leading to its swelling and pain; inflammation of gums leading to loose teeth and bleeding gums; abdominal pain; bleeding from nose; heartburn (burning feeling of esophagus which is the tube connecting stomach and mouth); infections of the urinary tract and Braxton hicks contractions which are contractions of the muscles of the uterus which is also called as ‘false labor’.

Golden trimester

The second trimester of pregnancy is also known as the golden trimester, as it is the most comfortable time of the pregnancy compared to other trimesters. During your regular visits to the hospital during this time, the doctor will check the baby’s growth, heartbeat and fetal movements. You may need to go for blood tests to check whether you have gestational diabetes (type of diabetes that may occur during pregnancy) or low iron levels. The Golden trimester is the best time to enjoy being pregnant and plan for your baby’s arrival.

  Third Trimester:

You have finished two-thirds of your journey through pregnancy. Now you are in the third trimester that spans from 28 weeks to the birth of your baby. You will experience several changes in these last few weeks of pregnancy. Above all, you are excited to prepare your home to welcome your baby and anxious about the birth process too.

Major changes in the third trimester

In the third trimester, your baby grows bigger still and you develop a real bulge in your tummy. You may experience discomfort due to the huge belly. The baby may move frequently in the initial part of the third trimester. Later, the baby may grow too big to move inside and the movements may become less. Eventually, the baby settles in the womb with head in downward position towards the end of the third trimester.

You certainly will gain weight and get more bulky in the tummy. By the 9th month, you would have gained around 24 to 29 pounds.

Sleeping

Sleeping can be difficult with a protruding belly. Lying on the back interferes with blood circulation and you certainly cannot lie on your stomach. It is best to sleep on the sides. You may support your belly with a pillow and place another one between your legs. It is best to sleep on your left to maintain blood flow. Sleep can be disturbed because of frequent urination, heartburn, backache, and shortness of breath. Stress, vivid dreams, and anxiety about child birth can also interfere with a sound sleep.

Other changes

You may experience backache as you adopt a wrong posture due to the large belly. As pregnancy advances, the hormones may relax the joints of pelvic bones and hurt the back. You may use heat pads or ice packs and opt for a relaxing massage. You may do some exercises after consulting your doctor.

You may develop shortness of breath as the growing womb presses upon the lungs and the diaphragm, the muscle that separates the lungs from the abdomen and helps in respiratory movements.

You may develop indigestion and heartburn as the enlarging womb pushes the stomach and intestines out of position and presses upon them. In addition, hormonal changes can cause the digestive system to slow down. You may try some small and frequent meals throughout the day, and avoid fried food.

You may notice some dilated and tortuous blue vessels in your legs. These are called varicose veins. The growing womb presses upon the bigger vessels in the pelvis and interrupts the flow of blood from the legs upwards. Similar dilated vessels may develop in the rectum, the part of the intestine that acts as a storehouse for fecal matter. These are called hemorrhoids and may bleed painfully.

Your breasts will grow bigger and you may even notice yellowish milk like fluid called colostrum from your nipples. The breasts are just preparing to feed the baby soon.

You may have frequent urge to pass urine. This is because the baby settles in the pelvis and irritates the bladder.

You may experience some infrequent contractions of the womb. These are called the ‘Braxton Hicks’ contractions. These are a practice for the final contractions of labor. These may become more frequent as the third trimester approaches an end.

You may have increase in vaginal discharge which is usually white in color and odorless.

You may have swollen feet because the enlarging womb may press upon the blood vessels in the pelvis and hinder the drainage of blood. This will disappear if you take some rest and keep your legs elevated.

Signs that labor might start soon

You can sense an approaching labor if you are a little watchful. The most common felt sign of labor are more frequent contractions of your womb. You may feel a gush of waters. This is because the water filled sac in the womb in which the baby is contained has burst. You should consult your health professional without delay.

In the last few weeks, your baby may settle into your pelvis and stop moving. This is called dropping or lightening.

Your health professional may examine your cervix, the lower part of the womb that opens into the birth canal. A cervix that begins to open and thin down, is a sign that labor is near. This is called dilatation and effacement of the cervix. As the cervix ripens, you may notice the mucus plug being expelled. This seals the canal of the cervix during pregnancy.

The most certain indication of labor is regular and frequent contractions of the womb. These gradually become stronger and are felt in abdomen and back. Unlike Braxton Hocks contractions, these do not lessen with change in activity. Cervical dilatation and effacement is another sign that confirms labor.

Missed due date

Since the beginning of your pregnancy, you have been calculating your due date. In a normal pregnancy, this date is the end of 40 weeks of pregnancy. You may not strictly deliver on your due date as it is perfectly fine to deliver anywhere between the 37th and 42nd weeks of pregnancy. You are bound to be anxious, if you do not go into labor in time. If you overshoot your due date, you should consult your health professional. You may need labor to be stimulated if you are over 42 weeks. This is done by medical and surgical methods by either giving medicines that stimulate contractions or by artificially rupturing the membranes. This is called ‘induction of labor’.

The last milestone

Pregnancy can be a wonderful experience as you see motherhood unfurl. You have felt, seen, and experienced your baby grow, and have borne pain to get the baby into this world. It is indeed great to be a mom! Happy parenting.

The third trimester is the last leg in your pregnancy. It starts from the 27th week of pregnancy to the end of pregnancy. By now all the organs and parts of the baby have formed and have also started working. You will feel heavy during this trimester and even small things like getting up from a chair or bed will require effort. You will be mentally and emotionally getting prepared during this time to welcome your baby.

Growth and development of your baby

In the 28th week of pregnancy, your baby weighs around 1000 grams and is around 10 inches in length from crown to rump (head to bottom). Your baby’s eyes are open partially and eyelashes are fully formed. The baby also gains weight.

In the 29th week, the bones of the baby are fully formed and the baby starts storing phosphorous, calcium and iron in the body.

By the 30th week of pregnancy, the baby weighs around 1300 grams (3 pounds) and measures up to 101/2 inches (270 mm) in length. In this week, the baby has developed good amount of hair on the head and eyes are wide open.

In the 31st week, the clitoris (button like structure in vulva) becomes prominent in a baby girl while in a baby boy, the testicles move into the groin.

In the 32nd week, the baby practices to breathe though the lungs though they are not completely formed. The soft hair covering called lanugo on the baby’s skin falls off during this week. The baby’s body starts absorbing calcium and iron into the body. Kicks and jabs of the baby become strong during this week.

In the 33rd week, the baby can detect light entering the eye, and the baby begins to constrict and dilate his or her pupils as a reaction to light.

In the 34th week of pregnancy the baby’s fingernails reach the finger tips. The baby now weighs more than 2100 grams (4½ pounds).

In the 35th week of pregnancy the vernix caseosa, which is the pasty coating on the baby’s body becomes thicker.

There is rapid weight gain of the baby in the 36th week of pregnancy, and the uterus becomes ‘crowded’ with your baby.

In the 37th week, the baby is fully formed and ready to come out into the world. It positions itself with head towards the cervix (opening of the vagina).

In the 38th week the toe nails of the baby reach the tips of the toes. The baby now measures 2900 grams (6 ½ pounds).

In the 39th week the baby is supplied with antibiotics through the placenta. In baby girls the labia major (cutaneous folds covering urethra) develops well while in baby boys the testis descends into the scrotum.

The 40th week is the week you are going to deliver. The baby now weighs around 3400 grams (7½ pounds) and all set to come out into the world.

Prenatal visits

The doctor will continue monitoring your blood pressure, weight, and the baby’s movements and heart beat. You are asked to feel the movements of baby, and if you feel that the baby has stopped moving you must inform the doctor immediately. The doctor looks for signs of preeclampsia (medical condition with hypertension during pregnancy) like swelling in the hands, face, sudden weight gain changes in vision, headache, protein in urine, and high blood pressure. These symptoms are harmful to the mother and child and so needs immediate attention from the doctor.

Vaginal and rectal swabs are taken and tested for group B streptococcus bacteria. This bacterium is not harmful to the mother but if the baby gets infected then the baby becomes seriously ill. If the test comes out positive, then the mother is given antibiotics intravenously to protect the baby from the bacterium.

Labor

When the due date is approaching you will notice that your belly is lower. False uterine contractions known as Braxton Hicks contractions take place. You will have a constant problem of backache, diarrhea, cramping, and gas formation before the beginning of delivery. When the true uterine contractions start, they are more painful than the false labor contractions, and they happen at regular intervals where the gap between them decreases. This is a sign of recognizing that you are in true labor.

If there is a rupture in the amniotic sac that holds the baby you can see fluid coming out which is known as ‘water breaking’. This is a sign of beginning of labor and it is time for you to go to the hospital. It is common for all women to feel anxious on the delivery day but if you know about the procedure you will feel less anxious and replace your fear with excitement and eagerness to hold your baby in your arms.

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