When you become pregnant, you initiate a life-changing journey. You also experience changes in your body, emotionally, and in your lifestyle during pregnancy with your growing baby as he/she passes through each stage of growth. You need to have information to help you make decent decisions for a healthy baby as well as your well-being.

A) Getting Pregnant

Getting Started

If you are considering starting a family, you possibly have speculated how long it will require to become pregnant when to engage in sex, and how many times.

For the majority of couples trying to get a baby, the chances that a woman will get pregnant are 15% to 25% in any specific month.

But some factors can affect your odds of getting pregnant:

  • Age: Your chances of becoming pregnant in any given month decline, after you reach 30 years of age, dropping sharply in your 40s.
  • Irregular menstrual cycles: Having an irregular cycle makes it difficult to ascertain the best time to have sex.
  • Frequency of sex: The chances of getting pregnant increase with the frequency of sex.
  • Amount of time you have been trying to get pregnant: Your chances of becoming pregnant may be lesser if you haven’t become pregnant even after 12 months of trying. Talk to your doctor about tests for female and male infertility.
  • Certain medical conditions can affect your chances of getting pregnant.

Understanding Menstrual Cycles

A woman’s menstrual cycle starts on the first day when they notice bright red blood and it terminates on the day before the next cycle starts. The cycle can be 21 to 35 days long or even more. If their cycle differs in length by a few days from one month to another, that is termed irregular. Numerous women do not have regular cycles and it does not essentially reflect a presence of complication.

Having Sex, Getting Pregnant

Recent evidence has demonstrated the window of opportunity for conceiving is pretty small: Basically, it’s only 3-5 days before ovulation and the day of ovulation itself. Your ideal chances are 1-2 days before ovulation.

Signs of ovulation are as follows:

  • Rise in normal body temperature, characteristically 1/2 to 1 degree
  • Higher levels of luteinizing hormone (LH), measured on a home ovulation kit
  • Clearer and thinner vaginal discharge, resembling raw egg whites
  • Breast tenderness
  • Bloating
  • Light spotting
  • Minor pain or cramping

Sexual intercourse is recommended every alternate day by doctors starting the week before ovulation or beginning after the end of your period. Having sex at least two to three times every week is termed ideal. As long as the man’s sperm count is normal, having sex every alternate day or even every day further elevates your chances of conceiving.

Stopping the Birth Control Pill to Get Pregnant

After stopping the birth control pill consumption, it is possible to conceive instantly, however, it may require a few months for normal ovulation to resume again.

Pre-Pregnancy Checklist for You

Even if you have not conceived yet, you can engage in multiple tasks to achieve the required health for a growing baby. Such tasks are explained below:

1. Consult your doctor.

Even if you are getting pregnant for the second time, it is a commendable indication to consult your gynecologist before conceiving. It is vital to bring your co-morbid health condition under control before getting pregnant, if you have any, as they could decrease your chances of becoming pregnant or make your pregnancy riskier. You should get a pre-conception screening test if your family carries a history of genetic diseases.

2. Visit a dentist.

It is believed that a link exists between good oral health and healthy pregnancy. The disease of gums is associated with premature birth and low birth weight. Hence, it is advisable to consult a dentist to solve any problems before getting pregnant.

3. Quit smoking and drinking.

Tobacco and alcohol during pregnancy are never advisable. They are not good for a baby’s growth and can lead to health problems in them later in their lives. Also, smoking and drinking can make pregnancy tougher and elevate your risks of a miscarriage.

4. Restrict caffeine intake.

Consuming more than 250 mg of caffeine (approximately more than 2 cups of coffee a day) could make pregnancy harder for you and also raise risks of miscarriage.

5. Eat healthily.

Avoid junk food. Consuming lots of fruits, vegetables, whole grains, and lean protein daily is recommended. A healthy diet regimen before conceiving can minimize the risks of diabetes during pregnancy (gestational diabetes).

6. Bring your body weight to a healthy level.

Obesity/overweight can elevate occurrences of conditions like gestational diabetes and high blood pressure during pregnancy. It is not perceived as a good idea to lose weight during your pregnancy, so if you intend to lose weight, begin before getting pregnant.

Exercising every day not only helps you to achieve a healthy weight, but it will also bring you into shape for labor and delivery. Try to find special pre-natal exercise classes, once you become pregnant.

7. Ensure you have taken all your vaccines.

Some diseases during pregnancy might impact your baby. Visit your doctor to inquire about the vaccines you require and when you require them.

8. Inform your doctor about the medicines you consume.

Your doctor must know about all the medicines you are taking, including vitamins and supplements, as some of them could adversely affect your baby. It is suggested to initiate a prenatal vitamin or folic acid supplement to minimize your baby’s risk of birth defects.

9. Choose seafood wisely, if you are a non-vegetarian.

While you are pregnant, avoid consuming fish that are high in mercury. Consuming fish twice a week is acceptable, but avoid fish that have a lot of mercury.

Pregnancy after the age of 35

The majority of healthy women who get pregnant after 35 and even 40 years of age can conceive healthy babies. Problems can arise irrespective of your age during your pregnancy. But some become more probable, after 35 years, including:

  • High blood pressure, causing preeclampsia (seriously high blood pressure and organ damage)
  • Gestational diabetes
  • Miscarriage or stillbirth
  • Labor problems requiring a C-section delivery
  • Premature birth
  • Low birth weight
  • Genetic disorders in the baby

On the contrary, it is also believed that getting pregnant in your 30s is better for some ladies and their babies because of the following reasons.

  • Older moms incline to be better educated and have higher financial earnings, indicating better resources than younger moms.
  • Older moms are more likely to have longer lives.
  • Children of older moms may be healthier, more cooperative, and better educated.

How Can You Increase Your Chances of Conceiving a Healthy Baby?

When you decide you are ready to become a mother, take these steps before you get pregnant.

  • Visit your doctor: Get a checkup done to make sure you are physically and emotionally prepared for pregnancy.
  • Get early and regular prenatal care: The first 8 weeks of your pregnancy are vital for the development of your baby. Regular prenatal care can elevate your odds of having a safe pregnancy as well as a healthy baby. Prenatal care includes regular testing and ultrasound exams, education, and counseling. It lets your doctor stay attentive to many common health conditions. During prenatal visits, the doctor will check your blood pressure, check your urine for protein and sugar, and examine your blood glucose levels.
  • Take prenatal vitamins: All women of childbearing age should include a daily prenatal vitamin with at least 400 µg of folic acid, days before and during the first 3 months of pregnancy. It can support in preventing defects in the baby’s brain and spinal cord. It also adds extra protection for older women who are more probable to deliver babies with birth defects.

How Can I Lower My Risk for Pregnancy Problems?

  • Take care of yourself and manage any existing health problems and protect yourself from pregnancy-related disorders.
  • Be regular with other doctor appointments. If you suffer from a long-lasting health issue, don’t miss your regular doctor visits.
  • Prefer a healthy, well-balanced diet, rich in fruits and vegetables, whole grains, beans, lean meats, and low-fat dairy products. Every day, you should eat and drink ample dairy and other calcium-rich foods that will maintain your teeth and bones’ health, while your baby grows. Include food sources rich in folic acid, like leafy vegetables, dried beans, and some citrus fruits.
  • Gain/lose the amount of weight your doctor suggests.
  • Exercise regularly.
  • Stop smoking and drinking alcohol.
  • Consult your doctor about medicines during pregnancy and while breastfeeding. This includes prescription and over-the-counter medicines, supplements, and natural remedies.

Pregnancy Tests

A pregnancy test can enable you to discover whether you are pregnant. Pregnancy tests check your urine or blood for a hormone called human chorionic gonadotropin (hCG). Your body synthesizes hCG after a fertilized egg attaches to the wall of your uterus, usually happening about 6 days after fertilization. Levels of hCG elevate rapidly, doubling every 2 to 3 days.

  • Blood tests: These tests can detect pregnancy before a home pregnancy test can, about 6 to 8 days after ovulation. However, it takes a lengthier duration to get the results than with a home pregnancy test.

The two types of blood pregnancy tests are:

I) A qualitative hCG test: It just detects the presence of hCG.

II) A quantitative hCG test (beta hCG): It quantifies the precise levels of hCG in your blood. It can detect even very low levels of hCG.

  • Urine tests: You can use these tests at home or in a clinic. Home pregnancy tests are rapid and easy to use, apart from being private and convenient. They are also very precise if directions are followed exactly. All of these tests work comparably. You test your urine in one of these ways:
    • Hold the test stick in your urine stream
    • Collect urine in a cup and dip the test stick into it
    • Collect urine in a cup and use a dropper to put it into another container
    • You’ll need to wait a few minutes before seeing the results.
    • After you take this test, you can confirm your results by seeing your doctor, who can do even more sensitive pregnancy tests.

Urine home pregnancy tests are about 99% accurate. Blood tests are even more accurate.

When to Take a Pregnancy Test?

Some pregnancy tests can detect hCG before a missed period. But if you postpone testing until the first day of a missed period, the results will be more accurate. Results may also be more precise if you perform the test in the morning when your urine is more concentrated.

Early Symptoms that indicate you are Pregnant

  • Spotting and Cramping
  • Changes in Breast Size
  • Fatigue
  • Morning sickness (Nausea)
  • Missed Period
  • Frequent urination
  • Constipation
  • Mood swings
  • Headaches
  • Back pain
  • Dizziness or fainting

B) What to Expect during Different Trimesters of Pregnancy?

First Trimester

The first trimester refers to the first 3 months of pregnancy. It starts on the first day of your last period and continues until the end of the 13th week. Pregnancy differs for every woman. Some women demonstrate a pregnancy glow with good health while others feel depressed. Following changes might be noticed:

I) Bleeding: Around 1/4th of pregnant women experience minor bleeding during their first trimester. Light spotting may direct the implantation of the fertilized embryo in your uterus, early in the pregnancy. However, call the doctor if you experience severe bleeding, cramping, or sharp pain in your abdomen, as these events can indicate a miscarriage or a pregnancy where the embryo implants outside of the uterus (ectopic pregnancy).

II) Tenderness in your Breasts: Painful breasts are amongst the initial signs of pregnancy. They are caused by changes in the hormone levels, which enable your milk ducts to feed your baby. Your breasts will possibly remain sore during the entire first trimester.

III) Constipation: During pregnancy, high progesterone levels delay the muscle contractions that are involved in moving food through your digestive system. Additionally, iron supplements also contribute to constipation and flatulence (gas) which can cause bloating during your pregnancy. Consume more fiber-containing foods and drink additional fluids to ease this condition. Physical activity can also help. Your doctor may prescribe a mild laxative or stool softener during pregnancy.

IV) Discharge: It is common to observe a thin, milky white discharge (leukorrhea) initially in your pregnancy. Call the doctor, if the discharge is stinky, if it looks green or yellow, or if the amount of clear discharge is more than normal.

V) Fatigue: As your body is working more than usual to support a growing baby, you will get tired more quickly than normal. Rest when you feel the need. Ensure you are receiving sufficient iron through food and supplements throughout your pregnancy.

VI) Altered Food Cravings: Greater than 60% of pregnant women experience cravings for food. More than half consume foods which otherwise they don’t like. Giving in to cravings at timely intervals is fine, till you are eating healthy, low-calorie foods on most occasions. If you feel the urge for eating non-foods such as starch, report it to your doctor immediately.

VII) Increased Urination: Your baby is still pretty small, but as your uterus grows, it puts pressure on your bladder. As a result, you may experience the urge to urinate more frequently than normal. Don’t stop drinking water or other fluids, as your body needs them. However, minimizing caffeine intake is advisable, especially before going to sleep. When you feel the urge, use the washroom as soon as possible. Trying to hold the urine is not wise.

VIII) Heartburn: Your body makes extra progesterone hormone during pregnancy. It relaxes smooth muscles, including the ring of muscle in your lower food pipe. These muscles usually keep food and acids down in your stomach. When they get relaxed, you can experience acid reflux or simply, heartburn.

IX) Mood swings: Augmented fatigue and altering hormones can prove to be an emotional disaster for you. Talking to your loved ones or even consulting a specialist can be of great help.

X) Morning sickness: Nausea/Morning Sickness is one of the most frequent symptoms of pregnancy and up to 85% of pregnant women experience it. It occurs as a result of changes in the level of hormones in your body and can continue during the entire first trimester. Nausea is mild in some women, while others can experience aggressive symptoms. Try eating small, bland, or high-protein snacks and sipping water, clear fruit juice or ginger ale to ease your nausea. Avoid any foods that are harmful to your digestive system. Consult your doctor if you experience aggressive symptoms.

XI) Weight gain. Weight gain is considered a good thing during pregnancy but is not considered healthy beyond a certain level. Gaining about 3-6 pounds during the first trimester can be considered OK. You only need about an extra 150 calories per day during the first trimester, despite carrying your baby. You can achieve these levels, by consuming more fruits and vegetables, milk, whole-grain bread, and lean meat to your diet.

First Trimester To-Do’s

Becoming a mother is one of the most jubilant times in many women’s lives. However, you also need to take some practical steps during the first trimester, including:

I) Consult a doctor: As soon as you know you are pregnant, arrange a prenatal visit. The doctor will take a full medical history and discuss your lifestyle and health habits. They will comprehend your due date. You will also undergo blood and urine tests and probably a pelvic exam. Repeat your prenatal visits every 4 weeks. The doctor will check your weight and blood pressure, test your urine and examine your baby’s heartbeat during each visit. Your doctor may also prescribe some additional tests, such as tests to look for genetic problems with your baby.

II) Dietary Supplements: You will be asked to start taking a prenatal vitamin with at least 400 µg of folic acid to help your baby’s brain and spinal cord grow properly. Inquire your doctor regarding the safety of prescription and over-the-counter medicines you can still take. IITake a look at your diet and make any changes you need to make sure you and your baby get the right nutrition. Drink plenty of water.

III) Stop Smoking and Restrict Alcohol/Caffeine

IV) Maintain your Workout Schedule

Emergency Symptoms During the First Trimester

Any of these symptoms could be a sign that something is seriously wrong with your pregnancy. Don’t wait for your prenatal visit to talk about it. Call your doctor right away if you experience:

  • Severe abdominal pain
  • Heavy bleeding
  • Severe dizziness
  • Rapid weight gain or too little weight gain

Tests during First Trimester

I) Blood tests: During one of your initial examinations, your doctor will identify your blood type and Rh (rhesus) factor, screen for anemia, check for immunity to Rubella and test for hepatitis B, syphilis, and HIV and other sexually transmitted diseases.

You may be offered tests and genetic counseling to assess risks for diseases such as Tay-Sachs, cystic fibrosis, and sickle cell anemia. Tests for exposure to diseases such as toxoplasmosis and chickenpox may also be done if needed. Your health care provider may also want to check your levels of hCG, a hormone secreted by the placenta, and/or progesterone, a hormone that helps maintain the pregnancy.

II) Urine tests: You will also be asked to provide your urine sample so that to detect signs of kidney infection and, if essential, to confirm your pregnancy by measuring the hCG level. Urine samples will then be collected regularly to detect glucose and protein.

III) Genetic Testing: You will be presented with genetic testing in the latter part of the first trimester. Some people feel like these tests may cause them unwanted stress and they prefer to ensure the baby is genetically normal post-birth. Discuss with your doctor, whether genetic testing is right for you and your pregnancy. One of the first-semester genetic tests combines a blood test with an ultrasound to screen for Down syndrome. It may be available between 11 and 14 weeks of pregnancy.

IV) Non-Invasive Prenatal Testing (NIPT) screening: This cell-free fetal DNA test can be done as early as after 10 weeks of pregnancy. The test uses a blood sample to measure the relative amount of free fetal DNA in a mother’s blood. It is believed that the test can detect 99% of all Down syndrome pregnancies as well as some other genetic abnormalities.

V) Chorionic villus sampling (CVS): You will be offered this test usually between 10 and 12 weeks of pregnancy in case you are 35 or older, have a family history of certain diseases, or have had positive non-invasive genetic tests. CVS can detect multiple genetic defects, such as Down syndrome, sickle cell anemia, cystic fibrosis, hemophilia, and muscular dystrophy.

Second Trimester

The second trimester of your pregnancy continues from week 13 to 28. It is the middle phase of pregnancy, when you may start to see your “baby bump” and feel your baby move for the first time. The morning sickness and fatigue you may have felt during the last 3 months should diminish, as you enter your second trimester of pregnancy.

The second trimester is the easiest 3 months of pregnancy for many women. Your baby grows rapidly during the second trimester. You will have an ultrasound between your 18th and 22nd week of pregnancy, so your doctor can see how your baby is progressing. You also can learn the sex of your baby, however, it may be prohibited by law. Although you should be feeling better now, big changes are still taking place inside your body. Here’s what you can expect.

Changes in Your Body in Second Trimester

I) Pain in your lower abdomen

II) Backache

III) Bleeding gums

IV) Breast enlargement

V) Congestion and nosebleeds

VI) Discharge

VII) Dizziness

VIII) Frequent urination

IX) Hair growth

X) Headache

XI) Heartburn and constipation

XII) Hemorrhoids

XIII) Leg cramps

XIV) Quickening: By 20 weeks into your pregnancy, you will probably have started to feel the first delicate flutters of movement in your abdomen, which is often called “quickening.” If you aren’t feeling your baby move yet, don’t worry. Some women don’t experience quickening until their sixth month of pregnancy.

XV) Skin Changes:

XVI) Spider and Varicose Veins

XVII) Urinary Tract Infections

XVIII) Weight gain

Emergency Symptoms during Second Trimester

  • Severe abdominal pain or cramping
  • Bleeding
  • Severe dizziness
  • Rapid weight gain (more than 6.5 pounds per month) or too little weight gain (less than 10 pounds at 20 weeks into the pregnancy)
  • Jaundice
  • Vomiting
  • Profuse sweating

Tests during the Second Trimester

Here are the prenatal tests that may be performed in the second trimester of your pregnancy:

Maternal serum alpha-fetoprotein (MSAFP) and multiple marker screening: This test is an optional genetic screening test and as with all screening tests, talk with your doctor about the pros and cons to see if it is right for you. Abnormal levels indicate the possibility (but not the existence) of Down syndrome or a neural tube defect such as spina bifida, which can then be confirmed by ultrasound or amniocentesis.

Non-Invasive Prenatal Testing (NIPT) screening

Ultrasounds: Ultrasounds are commonly offered after week 20. It may be offered for multiple reasons, including verification of a due date, checking for multiple fetuses, investigating complications such as placenta previa or slow fetal growth, or detecting malformations like cleft palate.

Glucose screening: This is a routine test for pregnancy-induced diabetes, characteristically done at 24 to 28 weeks, which can result in overly large babies, difficult deliveries, and health problems for you and your baby.

Amniocentesis: This optional test is usually performed between 15 and 18 weeks of pregnancy for women who are 35 or older, or have a higher-than-usual risk of genetic disorders.

Fetal Doppler ultrasound: A Doppler ultrasound test uses sound waves to evaluate blood as it flows through a blood vessel. Fetal Doppler ultrasound can determine if blood flow to the placenta and fetus is normal.

Third Trimester

The third trimester is the last phase of your pregnancy and lasts from weeks 29 to 40. During this trimester, your baby grows, develops, and starts to change position to get ready for birth.

In the third trimester, your baby keeps growing. By the end, a full-term baby usually is between 19 to 21 inches long and between 6 to 9 pounds.

Your baby begins to turn itself head-down to get ready for delivery. At week 36, the baby’s head should begin to move into your pelvic area, also called lightening. It will stay in this down-facing position for the last 2 weeks of your pregnancy.

Your baby develops in other important ways in the third trimester. During this phase, it’s able to:

  • See
  • Hear
  • Suck on its thumb
  • Cry

Your baby’s brain continues to develop. Its lungs and kidneys mature. The bones at the top of a fetus’s skull are soft to ease delivery. Most babies have blue eyes at this stage, and they’ll stay that color until a few days or weeks after they’re born.

During the third trimester, the vernix caseosa, a protective coating, covers your fetus’ skin. Soft body hair called the lanugo falls out and is almost gone by the end of week 40.

  • Abdominal pain
  • Backache
  • Bleeding
  • Breast enlargement 
  • Nightmares
  • Clumsiness
  • Discharge
  • Fatigue
  • Frequent urination
  • Heartburn and constipation.
  • Hemorrhoids.
  • Leaky breasts.
  • Sciatica.
  • Shortness of breath.
  • Spider and varicose veins.
  • Stretch marks
  • Swelling
  • Weight gain

Red Flag Symptoms

Any of these symptoms could be a sign that something is wrong with your pregnancy. Don’t wait for your regular prenatal visit to talk about it. Call your doctor right away if you experience:

  • Severe abdominal pain or cramps
  • Severe nausea or vomiting
  • Bleeding
  • Severe dizziness
  • Pain or burning during urination
  • Rapid weight gain (more than 6.5 pounds per month) or too little weight gain

G) Third Trimester Tests

These tests are common in the third trimester of pregnancy:

  • Group B streptococcus screening
  • Electronic fetal heart monitoring
  • Non-stress test
  • Contraction stress test
  • Biophysical profile

H) Postpartum Care

Here are some steps you can take to feel better after delivery:

  • Limit visitors so you and baby can rest.
  • Get help with cleaning and meals.
  • Follow your doctor’s instructions for recovery.
  • Keep your feet raised to prevent swelling in your legs.
  • Sit in a warm bath to relieve vaginal discomfort.
  • Use creams or lotions to fade stretch marks.
  • Eat plenty of fruits, vegetables, and whole grains.
  • Wear a supportive bra to relieve sore breasts.
  • If breastfeeding, use nipple cream for sore nipples.
  • Not breastfeeding? Ask your OB about breast care.
  • Drink water and eat fiber to prevent constipation.
  • Schedule a follow-up visit with your doctor.
  • Don’t try to lose baby weight too quickly — go slowly.
  • If you feel sad, talk to a friend or family member.
  • If sadness lasts more than 2 weeks, call your doctor.
  • Take care of yourself so you have more energy for your baby.
  • Talk to your doctor about constipation or hemorrhoids.
  • Make time for yourself and ask for help when you need it.

I) Pregnancy Complications

  • Anemia
  • Bleeding during Pregnancy
  • Abdominal Separation
  • Pre-eclampsia and Eclampsia
  • Bed Rest
  • Premature Labor
  • Miscarriage
  • Ectopic Pregnancy
  • Placenta Previa

Out of everything that we have discussed above, the most important factor is managing stress. And, feeling stressed during pregnancy is quite common because it is a time of many changes including your life, body, family, and emotions. High levels of stress can take a toll on the pregnant mother and increase the chances of a premature baby. Hence, it is paramount to seek quick help if you are experiencing prolonged symptoms. Make sure you are having a decent sleeping cycle, plenty of time with your partner, and accept help whenever on offer from a trusted source.  Attend every prenatal care checkups with your doctor and monitor the baby throughout your pregnancy.

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