Physiological Changes in Pregnancy: Complete Guide for Expecting Mothers:
Author:
Dr, Humaira Latif .
Registered Medical Practitioner.
Gynae/Obs Specialist.
14 Plus years of Experience in Medical and Practical Field
Medical & Health Content Creator.
Disclaimer:
This article is written for educational and informational purposes only, and it does not constitute medical information. You should consult a physician for any symptom or concern you might experience during pregnancy.
Practicing obstetrics and gynaecology for over 14 years, I often hear first-time mothers ask me the same question,
“Is this normal?” This is usually in reference to an unexpected physical symptom that develops during their pregnancy.
Symptoms such as: nausea that hits them in the evening, not just in the morning; how they feel their heart racing if they climb a flight of stairs; how they have developed a burning sensation (heartburn) in their stomach that showed up out of nowhere at 28 weeks; and how the swelling in their ankles after being on their feet all day is something new.
The answer is yes, for most women — what you are feeling are physiological changes to your body caused by the growth of the baby. Understanding what these changes are and why they are happening will help take away some of the fear that first-time mothers might have with them.
This resource will provide a detailed description of the physiological changes that occur in each of the major body systems during each trimester of pregnancy. By doing so, new moms will be able to better understand how their body is changing during each stage of pregnancy.
Table Of Content:
1) Physiological Changes in Pregnancy;
2) Hormonal Changes Associated with Pregnancy;
3) Cardiovascular System Changes Associated with Pregnancy;
4) Respiratory System Changes Associated with Pregnancy;
5) Digestive System Changes Associated with Pregnancy;
6) Urinary System Changes Associated with Pregnancy;
7) Hematological Changes Associated with Pregnancy
8) Hematological Changes
9) Musculoskeletal Changes
10) Skin Changes of Pregnancy
11) Breast Changes
12) Emotional and Psychological Changes
13) Trimester Based Changes in Pregnancy
14) Warning Signs that Need Medical Attention
15) Healthy Pregnancy Tips
16) FAQs
17) Conclusion
18) Related Articles
19) References
20) Free "Pregnancy Care Guide" PDF
Downloadable Link
1. What Are Physiological Changes During Pregnancy?
Physiological changes occur in a woman’s body through pregnancy to support a developing child, prepare for labour, and prepare for breastfeeding—these changes occur in all the major organs of a woman’s body and begin immediately after conception, often before the woman knows she is pregnant.
Pregnant women experience significant physiological changes that impact nearly all the major systems in their bodies. These physiological changes are driven and coordinated by hormones to promote healthy mothers and healthy babies throughout the nine months of pregnancy—a majority of these changes are reversed shortly after pregnancy.
The study of physiological changes is not a matter of committing large volumes of medical texts; rather, it is a matter of understanding one’s own body.
2. Hormonal Changes During Pregnancy:
Hormones are the driving force behind all physiological changes that occur in the body during pregnancy and are, in fact,
The operating system that drives the entire pregnancy process;
For Example:
- They are responsible for maternal behaviours and responses to the pregnancy process,
- They influence all physiological changes that occur during the pregnancy process (from conception to delivery),
- They are ubiquitously present in a pregnant woman’s blood, urine, and tissues;
- And all other aspects are linked to hormones during pregnancy.
Once a fertilized egg attaches to your uterine lining, it begins producing hCG (the hormone checked in a pregnancy test) which increases rapidly during the first trimester.
Most women suffer from some degree of morning sickness during this period and the nausea usually peaks around weeks 8-10 when hCG levels are at their highest.
1. Progesterone:
Another major hormone contributing to nausea in early pregnancy is progesterone. It causes the smooth muscles of your uterus to relax to help you stay pregnant by preventing contractions.
However, when progesterone relaxes smooth muscles everywhere, many women find themselves suffering from constipation and heartburn due to relaxed gut muscles. In addition, progesterone causes extreme fatigue for many women during the first trimester, making even short walks seem exhausting.
2. Estrogen:
Estrogen complements progesterone's effects, promoting an increase in uterus size, blood flow to the placenta, and breast tissue development.
The production of estrogen can cause the appearance of dark patches on some women's skin, especially along the midline of their abdomen, on their face, and around their nipples.
3. Relaxin:
Relaxin is another hormone often overlooked but can significantly impact a woman during pregnancy. Relaxin loosens ligaments and joints throughout the body (especially in the pelvis), aiding in the birthing process.
4. Prolactin:
Finally, prolactin rises steadily throughout pregnancy, preparing the breast glands for milk production. By the time the baby arrives, the body is already primed and ready.
3. Changes in the Pregnant Cardiovascular System
A woman's cardiovascular system obviously works much harder during pregnancy than it does at almost any other point in a woman's lifetime, but this very normal physiological response is not a problem; it is necessary.
1. Increased Blood Volume:
One of the most significant changes in the pregnant cardiovascular system is that total blood volume dramatically increases (approximately 40-50% greater than pre-pregnancy values). To give you a rough idea of this magnitude, a woman has about 4.5 litres of blood at conception and approximately 6.5 litres of blood at the end of her third trimester.
This change in blood volume serves several purposes:
First, it provides adequate oxygen and nutrients to the placenta (the baby's source of nutrition/hydration);
Second, it compensates for the inevitable blood loss (300-500 ml) that occurs during delivery, especially in vaginal deliveries.
2. Increased Heart Rate:
With this increase in blood volume, the amount of blood that is required to be pumped by the heart at rest increases, and therefore, will increase the resting heart rate (10-20 beats secure than pre-pregnancy values).
Consequently, many women may experience palpitations and/or shortness of breath after usually easy activities during the second trimester of pregnancy.
In most cases, palpitations during pregnancy will never be serious or life-threatening; however, palpitations that feel irregular and/or prolonged or that are accompanied by chest pain require immediate medical evaluation.
4. Changes In The Breathing Process While Pregnant:
While a pregnant woman usually has yet to develop a noticeable bump on her stomach, she may find herself breathless during early pregnancy. Why?
Progesterone And Increased Breathing During Pregnancy:
Progesterone is the cause of this rapid breathing increase. Progesterone tells the brain to change how much you breathe in each minute by making each breath deeper (i.e., tidal volume). This increase in oxygen intake meets the increased demand from pregnancy and, therefore, can create a continuous feeling of shortness of breath due to working harder than usual to get oxygen into the body.
Common Effects Include:
- Deeper breathing
- Increased oxygen intake
- Feeling shortness of breath
- Breathing harder than usual
- Increased respiratory demand
- How The Growing Uterus Affects Breathing
As the pregnancy progresses, the uterus will push up on the diaphragm during the later stages of the pregnancy is the most noticeable change to the way that a woman breathes in daily activities.
This can occur in the third trimester while carrying groceries or climbing stairs, causing a woman to feel winded easily. It can become common for women to experience a 20% increase in their oxygen requirements.
Daily Activities That May Cause Breathlessness:
- Carrying groceries
- Climbing stairs
- Walking long distances
- Performing household activities
- Nasal Congestion And Nosebleeds During Pregnancy
Many women developing nasal congestion while pregnant is also related to the hormone Estrogen because Estrogen causes the membranes inside a woman’s nose to swell, providing a pathway for air to reach her lungs more easily. During pregnancy, it is not uncommon for a woman to have her first and only nosebleed, especially during the winter months or dry weather changes.
Common Nasal Changes During Pregnancy:
- Nasal congestion
- Swollen nasal membranes
- Increased mucus production
- Occasional nosebleeds
- Dry nose during winter weather
- Shortness Of Breath During Everyday Activities.
Women can experience shortness of breath while participating in everyday activities that did not previously cause them shortness of breath.
5. Changes in the Digestive System During Pregnancy:0
The digestive system is likely the first body system to undergo noticeable change during pregnancy. Very few women escape their pregnancy without experiencing some form of nausea, constipation, or heartburn at some point in their pregnancy.
Common Digestive Changes During Pregnancy:
- Nausea
- Constipation
- Heartburn
- Digestive discomfort
1. Nausea - More Than Just a Morning Occurrence:
Some 70-80% of women experience nausea during pregnancy, which makes the term morning sickness as a generalization misleading because nausea can occur at anytime during the day, but for some women wanting to sleep in the evening is the most likely time for nausea to occur too.
Most women first experience nausea at six weeks of their pregnancy and their nausea will end at 12-16 weeks of pregnancy, but there are some women who will have episodes of nausea throughout the second trimester of pregnancy.
Important Facts About Pregnancy Nausea:
- Affects 70–80% of pregnant women
- Can occur at any time during the day
- May also occur in the evening
- Commonly begins around six weeks of pregnancy
- Often improves by 12–16 weeks
- Some women experience nausea into the second trimester
Causes Of Pregnancy Nausea:
The nausea accounted for by pregnancy is caused primarily by the rising levels of hCG and estrogen. Nausea will often worsen due to a strong smell of food, eating fatty foods, or having an empty stomach.
Common Triggers That Can Worsen Nausea:
- Strong smell of food
- Eating fatty foods
- Having an empty stomach
- Hormonal changes during pregnancy
Tips To Help Ease Pregnancy Nausea
For women experiencing nausea keeping plain crackers or dry toast by the bed to eat in the morning will help ease the symptoms and eating small amounts of food regularly will also help ease the nausea associated with pregnancy.
Helpful Tips For Managing Nausea:
- Keep plain crackers by the bed
- Eat dry toast in the morning
- Eat small amounts of food regularly
- Avoid an empty stomach
2. Hyperemesis Gravidarum,
Some women develop hyperemesis gravidarum, severe recurrent vomiting that frequently leads to dehydration and weight loss; this condition is more than just "a really bad case of nausea" and will require medical care, such as medication and IV fluids.
3.Heartburn.
Heartburn is one of the most frequent complaints in late pregnancy, and many women experience it on a daily basis during their third trimester. Progesterone relaxes the valve between the esophagus and the stomach, which allows acid to move up the esophagus; the expanding uterus also pushes up on the stomach, which adds to the problem. Helpful strategies to manage heartburn include eating smaller meals, not lying down for at least an hour after eating, and raising the head of the bed a little at night.
4. Constipation.
Progesterone also slows down gut motility throughout pregnancy, making it take longer for food to transit through the intestines. While food is in transit through the intestines, the colon absorbs additional water from the stool, which makes stool more difficult to expel. The use of iron supplements (which are often prescribed during pregnancy) can exacerbate constipation. Increasing dietary fiber through whole grains, fruit, vegetables, and legumes; drinking plenty of fluids; and taking frequent, short walks are often effective at alleviating any constipation.
6. Changes in Urination During Pregnancy.
The kidneys are among the most important organs during pregnancy, doing a lot of work. The first trimester leads to a notable increase in blood flow to the kidneys, which may increase 50-85% by the end of the first trimester; meaning that the kidneys will filter more blood than before pregnancy.
This great increase in blood filtering ability will be evident in the glomeruli's increased ability to filter (GFR), which may be as much as 40-65% higher.
6.1 Key Kidney Changes in Pregnancy:
- Blood flow to kidneys increases by 50–85%
- Increased glomerular filtration rate (GFR) by 40–65%
- Higher workload on kidneys during pregnancy
- Enhanced blood filtering activity
- Frequent Urination During Pregnancy.
Frequent urination is usually one of the earliest signs of pregnancy (often, before a woman starts to show an increase in belly size), and in the case of early pregnancy, it is hormonal.
In late pregnancy, it will typically return due to pressure on the bladder from the baby's head (as the baby gets lower in the mother's pelvis), which can lead to the bladder not having enough space to resist excessive pressure. During the last few weeks of pregnancy, many women will find that they will have to get up at least once or twice per night to go to the bathroom.
6.2 Common Causes of Frequent Urination:
- Hormonal changes in early pregnancy
- Increased kidney filtration activity
- Pressure from baby’s head in late pregnancy
- Reduced bladder capacity
- Night-Time Urination Patterns:
- Waking 1–2 times at night
- Increased urinary frequency in last weeks of pregnancy
- Increased Risk Of Urinary Tract Infections (UTIs).
An additional thing to keep in mind here is that pregnant women have an increased chance of developing urinary tract infections (UTIs). There is evidence that the increase in progesterone will produce a relaxing effect on the ureters (the tubes that run from the kidney to the bladder) and therefore slow down the flow of urine.
Thus, bacteria may linger inside of the ureters. Finally, there are many pregnant women who will go to the bathroom frequently without any symptoms (asymptomatic bacteriuria).
6.3 Important UTI-Related Changes In Pregnancy:
- Increased risk of urinary tract infections
- Progesterone relaxes ureters
- Slower urine flow
- Bacteria may remain in urinary tract
- Asymptomatic bacteriuria may occur without symptoms
7) Hematological Changes Associated with Pregnancy:
The composition of blood alters greatly during pregnancy, which aids in the interpretation of many routine lab tests.
7.1 The Reason for "Normal" Anaemia During Gestation
During gestation, plasma (liquid portion of the blood) shows an increase of 45 per cent to 50 per cent. The total number of red blood cells rises approximately 20 percent to 30 per cent. Since the blood volume (plasma) expands at a rate faster than the increase in red blood cells, the overall concentration of blood will become lower, making the levels of hemoglobin lower than when compared to the same test performed on a non-pregnant female patient.
Therefore, it is considered physiologic anaemia if the hemoglobin level is below the "normal" cutoff for the laboratory test, and no treatment is needed.
In contrast, true iron-deficiency anaemia is much higher during pregnancy due to maternal iron being utilized by the rapidly developing fetus. Thus, supplementation of iron is essential to treat this problem, as is making dietary changes to improve the intake of iron.
7.2 The Blood Coagulates More Easily:
When a woman becomes pregnant, her blood is in a hypercoagulable state; that is, the tendency of the blood to clot has been intentionally increased by the mother-to-be's producing higher amounts of clotting factors (substances that promote clotting within blood) and producing smaller amounts of natural clotting inhibitors. Therefore, if the mother needs to repair damaged tissue quickly Therefore, allows the body to replace the lost blood that would occur during delivery.
Based upon the increased tendency of blood to form clots, pregnant females are at an increased risk for deep vein thrombosis (DVT) and more seriously, pulmonary embolism.
8. Musculoskeletal changes in pregnancy:
A woman's body experiences substantial change in its structure and postural alignment as she moves through her pregnancy, with many women experiencing these changes through physical discomfort.
As the uterus continues to grow, the balance of the body's center of gravity shifts forward, requiring the lower back to assume an arched position (lumbar lordosis) to maintain the body's center of balance.
The result of this change in posture results in increased strain on the muscles and joints of the lower back, which is thought to contribute to as many as 70 percent of pregnant women suffering from low back pain, with the intensity of pain often increasing as pregnancy progresses.
8.1 Key Postural and Musculoskeletal Changes:
- Center of gravity shifts forward due to growing uterus
- Lower back adopts an arched position (lumbar lordosis)
- Increased strain on muscles and joints of lower back
- Up to 70% of pregnant women experience low back pain
- Pain intensity may increase as pregnancy progresses
Relaxin supports these changes by causing laxity in the ligaments of the pelvis and throughout the rest of the body, which ultimately causes instability of the joints.
As a result of this instability, some women develop pelvic girdle pain, which is described as a deep, often sharp pain in the hips, groin, or pubic area that can make walking, climbing stairs, or turning in bed quite painful.
Effects Of Relaxin Hormone:
- Causes laxity in pelvic ligaments
- Reduces joint stability throughout the body
- Contributes to pelvic girdle pain in some women
Symptoms Of Pelvic Girdle Pain:
- Deep pain in hips
- Groin pain
- Pubic area discomfort
- Pain while walking or climbing stairs
- Difficulty turning in bed
Physiotherapy and the use of pelvic support belts can greatly improve the stability of these joints, and therefore,kq help alleviate pain.
9. Change of Skin During Pregnancy:
Pregnancy is a major hormonal shift, and at least some women undergo some changes in their skin due to the hormonal shifts, including one or more visible signs of skin changes.
1.Melasma:
Melasma (sometimes referred to as "the mask of pregnancy") is patchy darkening of the skin that usually occurs on the cheek, forehead and upper lip and is stimulated by the estrogen in your body, which causes the pigmentation-producing cells in your skin to make even more pigment than normal. Sunlight exposure has a very large effect on melasma; therefore, the use of a good broad-spectrum sunscreen is strongly recommended.
2. Linea Nigra:
The linea nigra is a dark vertical line that travels down the middle of your abdomen from your navel to your pubic bone. The linea nigra is one of the most common signs of pregnancy, but it is generally more visible on women with darker skin tones. After delivery, it will slowly fade away.
3. Stretch Marks:
Stretch marks are probably the most well-known way that women’s skin changes while they are pregnant. When a woman is pregnant, her skin is stretching very rapidly to allow for growth .
For example, on her
- Abdomen,
- Breasts,
- Hips and
- Thighs;
Thus, when her skin gets pulled longer than what it is used to, the skin will pull apart at the deeper levels, causing stretch marks, which initially appear as pink, red, or purple streaks as they are being created. Although stretch marks may primarily due to genetics and how much weight is gained during pregnancy, no topical creams or oils have been 100% proven to prevent them, but keeping your skin well moisturized may improve comfort.
In addition to stretch marks, there are a number of other skin changes which occur during pregnancy; increased sweating, spider veins on the legs and chest, and a number of others.
10. Breast Changes of Pregnancy:
The process of the breast preparing for breastfeeding begins from conception, and breast tenderness can be one of the first signs of pregnancy, sometimes appearing before a woman misses her period.
10.1 Early Breast Changes During Pregnancy:
Through pregnancy, the breasts become much larger as the number of glandular tissues in your breast multiplies and fat deposits form.
Common Early Breast Changes Include:
- Breast tenderness
- Increase in breast size
- Growth of glandular tissue
- Formation of fat deposits
- Changes In The Areola And Nipples
The areola (area of darker skin surrounding the nipple) will get darker in pigment and will also become wider.
Within the areola, Montgomery's glands (small bumps) produce an oily substance that keeps the nipple smooth and clean during breastfeeding.
Common Areola And Nipple Changes:
As well, the veins that carry blood to the breasts become more visible under your skin and your bras will often need to be replaced many more times than you are used to.
Physical Breast Changes During Pregnancy:
- More visible breast veins
- Increased blood supply to the breasts
- Frequent bra size changes
- Breast enlargement throughout pregnancy
- Colostrum Production During Pregnancy.
Around halfway through the second trimester, the glands will begin producing colostrum, which is a thick, yellow-orange fluid that contains antibodies and other nutrients.
Features Of Colostrum:
- Thick consistency
- Yellow-orange color
- Rich in antibodies
- Contains important nutrients
- Nipple Leakage Near The End Of Pregnancy
Near the end of your pregnancy, you may also experience some leaking from your nipples, which is completely normal.
10.2 Common Late Pregnancy Breast Changes:
- Nipple leakage
- Increased colostrum production
- Continued breast enlargement
- Preparation for breastfeeding.
11. Emotional and Psychological Changes in Pregnancy:
Back in 2011, previous research was done what came out that there are emotional and psychological changes during pregnancy.
Pregnancy is filled with physical changes. If you've been pregnant and you're reading this, then you understand that pregnancy also comes with an array of emotional & psychological changes.
11.1 Key Emotional Aspects in Pregnancy:
- Emotional changes are as real as physical changes
- Often not discussed in clinical detail
- Strong impact on daily mood and behavior
The emotional experience of pregnancy is as real and important as the physical changes – but it is not talked about in the same clinical detail as the physical changes of pregnancy.
11.2 Hormonal Mood Changes And Pregnancy Anxiety
The hormonal changes that happen during pregnancy — particularly the increase hCG and progesterone levels during the first trimester — have a direct impact on a woman's mood/emotional sensitivity. You can go from feeling elated to being overwhelmed all in one hour. The primary characteristics of early pregnancy (i.e., mood swings, increased emotion, unexpected crying) are usually somewhat reduced at the end of the first trimester.
Common Hormonal Mood Effects:
- Mood swings
- Increased emotional sensitivity
- Unexpected crying episodes
- Rapid emotional shifts
Anxiety is also very common to have when you're pregnant, but especially if it is your first child; however, it is especially common if you are a mother who has previously experienced either a miscarriage or pregnancy loss.
11.3 Pregnancy Anxiety Risk Factors:
- First pregnancy
- Previous miscarriage or pregnancy loss
- Fear and uncertainty about pregnancy outcome
There is a reasonable level of anxiety for you regarding the pregnancy, but if you are consistently feeling anxious, or intrusive, or your anxiety prevents you from functioning in daily life, then you need to seek medical assistance the same as if you had a physical symptom.
12. Pregnancy Changes Over Trimester.
12.1 Trimester One (Weeks 1 To 12) .
The Introduction.
During the first trimester, women often feel overwhelmed due to the rapid changes happening to their bodies from hormones and physical changes. Levels of hCG and progesterone begin to increase significantly, resulting in many of the symptoms associated with early pregnancy before visible body changes are apparent.
Typical early pregnancy symptoms include:
- Nausea may start as early as six weeks
- Nausea usually peaks between 8-10 weeks
- Fatigue is very common
- Tenderness of the breast may occur
- Frequent urination may occur
- Sensitivity to smells may increase nausea
Women commonly feel very tired during the first few months, with rest not greatly relieving this fatigue. Hormonal and sensitivity to smells may also cause additional nausea at this time period.
- Emotional Issues Associated With Early Pregnancy
- Miscarriage is at its highest risk during the early pregnancy
- Anxiety and emotional stress are quite common
- Regular prenatal visits are very important.
Due to the high risk of miscarriage during this period of time, many women experience anxiety while being pregnant. Regular prenatal visits with a doctor or midwife will help to track the health of both the mother and the fetus.
12.2 Trimester Two (Weeks 13-27): The "Easy" Phase!
Pregnancy's second trimester typically starts to provide mothers some of the first signs of relief from nausea and fatigue, making the second trimester a welcome change. As the pregnancy becomes increasingly visible, it can be a source of joy and reassurance for mothers and their families.
The Second Trimester Brings Changes for Many Families
As the pregnancy progresses into the second trimester:
- The mother will notice that her abdomen is becoming rounder and larger.
- The uterus rises above the umbilicus (the navel) at approximately 20 weeks.
- In addition, most women feel an increase in their energy level during this time.
- The pregnancy also becomes more visible and recognizable by others during this same period.
During this trimester many mothers will start to feel their baby moving, which helps them to develop an emotional bond with the pregnancy.
There may be some common physical symptoms such as:
- Pain from round ligaments
- Sharp stretching type pain is a common experience and usually not a cause for concern
Due to the growth of the uterus, one may experience pain or discomfort due to the sudden stretching of the supporting ligaments.
The anomaly scan is performed between 18-22 weeks of pregnancy and provides parents with an opportunity to review their baby's anatomy in detail and helps parents make an emotional connection with their pregnancy.
12.3 Third Trimester (Weeks 28 until you deliver):
Physically speaking, the third trimester is very taxing for the mother due to rapid growth of the baby and added extra weight put on her body.
Physical Changes During the Last Trimester
- Increased pain in the lower back
- Swelling (edema) in feet and ankles
- Often experience heartburn
- Sleep can be very difficult at times
Posture will change as the baby continues to grow larger and make you feel uncomfortable.
Braxton-Hicks Contractions:
- These contractions are usually found after 28 weeks of pregnancy.
- These are typically very periodically and painless.
- These contractions help prepare your body for actual labor.
- Your true labor contractions will become consistently regular, stronger and more time sensitive.
Moving Lower in the Pelvis Prior to Delivery (Baby Lightening)
Baby may have moved lower into the pelvis area.
- Breathing will be slightly easier.
- Pelvic pressure and urination may increase.
- Fetal Movement Monitoring
Always monitor your baby's normal pattern of movement.
Consult your healthcare provider once you notice a decreased number of movements in the third trimester.
It is essential at this stage of your pregnancy that you keep track of your baby's activity level. If you notice any significant changes in your baby's normal movement, you MUST notify either your midwife or labour ward as soon as possible.
Notes on the Baby’s Movement:
Most new mothers feel the baby move for the first time between 16 and 22 weeks as well as continue to build the emotional bond between them and the baby.
The first time the baby moves, known as “quickening,” is usually referred to as an amazing experience for all new parents!
Common Symptoms Experienced by Mothers:
During the pregnancy there may be signs of round ligament pain, in addition mothers report sharp cramping/stretching pain as they continue to grow, both experiences are considered normal and should not cause the mother any concern.
The pregnant woman experiences these pains because she is growing as the uterus stretches and pulling on the supporting ligaments.
Mother's Fetal Anomaly Scan:
The mother's fetal anomaly scan is typically performed between 18-22 weeks of pregnancy and is performed to check the baby's body parts and organs. In addition to identifying any issues with the baby， it usually will allow the parents to build an emotional connection with their growing child.
13. Signs You Should Seek Medical Attention Immediately:
There are many symptoms experienced during a pregnancy that will be perfectly fine, but there are also some that you should be evaluated by a medical professional in an urgent manner or immediately.
Please do not downplay these symptoms or wait until your next appointment to be seen for them.
You should seek medical help immediately if you experience any of the following:
- Heavy vaginal bleeding at any time during your pregnancy with associated cramping.
- Severe abdominal pain that is persisting or does not get better with resting.
- A sudden onset of a severe headache that you have never had before in combination with other complications; this is especially true for headaches occurring in the later half of your pregnancy.
- Visual changes - such as blurry vision, being able to see blinking lights or some spots in front of your eyes, which may be a sign of preeclampsia.
- Fever greater than 38°C (100.4°F) which may indicate that you have an infection.
- A decrease in fetal movement in the 3rd trimester; either fewer than usual or you no longer feel the baby move.
- Swelling of the face, hands or feet - especially if you also are having a headache or having visual disturbances.
- Chest pain or difficulty breathing at rest; you may be having a blood clot in your lungs and this is a medical emergency.
- Painful urination with fever or back pain; you may have an infection in your kidney and need to be treated with antibiotics.
- Fluid leaking from the vagina before the 37th week of pregnancy; this may indicate that you have ruptured your membranes before your due date.
When in doubt about something, go to a hospital for evaluation and treatment. There is no such thing as a small question when it comes to obstetrics; all patients must see a physician at some point in their pregnancy. By being evaluated by a health professional, you will prevent many complications from occurring during your pregnancy and it will give the patients' families peace of mind.
14. Healthy Pregnancy Tips:
Be sure to attend all your antenatal appointments. Although life can be hectic, it's important for monitoring blood pressure, urine, fetal growth, and overall health during pregnancy.
1. Routine Tests:
Routine tests will assist in diagnosing possibly serious conditions such as preeclampsia and gesture diabetes before you develop any symptoms so please don't miss them.
2. Nutrition Intake:
Eat healthy but not necessarily for two people. The "eating for two" fallacy is incorrect. For the 2nd and 3rd trimesters of your pregnancy, you will need to consume only 300 extra calories a day;
which could be equivalent to a small snack, not a second meal. So rather than focusing simply on how many extra calories you are consuming, paying attention to the type of food you eat will contribute to your overall health.
3. Foods Containing Iron:
Foods containing iron (lentils, red meat, spinach or high iron fortified cereals), calcium (dairy products, leafy greens & tofu), folate (leafy greens, legumes & fortified bread), protein & healthy fats. Avoid eating undercooked meat, raw shellfish, any type of large fish such as shark/swordfish (high mercury), unpasteurized dairy and limit your caffeine intake to 200 mg per day.
4. Prenatal vitamins :
Make sure to take your prenatal vitamins as directed. If you start taking 400 micro gram of folic acid from before conception until week 12 of your pregnancy, the chances of having a child with a neural tube defect will be greatly decreased (by almost 70%). Iron, Iodine, and Vitamin D have all been shown to be very beneficial during all the trimesters of pregnancy; therefore, you should follow your doctor's recommendations regarding taking these vitamins.
5. Stay Active.
Stay active as much as possible. Unless otherwise instructed by your doctor, there is no reason you should limit yourself to having low activity levels during pregnancy; moderate activity is recommended. Activities like walking, swimming, and attending prenatal yoga classes will help alleviate your backache, help with your mood, lower the chance of developing gestational diabetes, and may help lead to a shorter, more manageable labor. You don't need to be active for long periods of time but rather continue gradually and consistently.
6. Hydration.
Drink water frequently. This may sound simple, however, during your pregnancy you may not be drinking enough water. Aim to consume eight to ten cups of water every single day. You may experience a lot of Braxton Hicks contractions due to dehydration, an increase in constipation, headaches, and a decrease in amniotic fluid all during your pregnancy.
7. Adequate Rest
Resting, and asking for help is not a luxury but rather medical advice. Your body is placed under a significant amount of pressure therefore it's important to listen when your body tells you to rest. You should ask family, use daily delegations, and protect your sleeping environment.
15. Frequently Asked Questions:
Q'1' Will my hair fall out or become damaged due to pregnancy?
Answer. It is unlikely for most women to lose hair or have dull or damaged hair due to pregnancy unless they have used hair products that your body does not tolerate well. If you notice more hair than usual falling out, contact your healthcare provider for evaluation and options before doing anything to your hair.
Q'2' Is the swelling in my feet and ankles normal?
Answer. It's a concern of many pregnant women when it comes to foot swelling during pregnancy since it's something that many women experience.
Typically, the swelling in your lower legs and feet, especially as the day progresses to late afternoon or evening, is one of the more common symptoms that women present with in the third trimester of pregnancy due to the combination of more blood circulating in your body and also the added pressure of your increased weight, plus the pressure that the enlarging uterus places on the pelvic veins when you are sitting.
To help relieve some of the swelling in your feet, it is suggested that you elevate your feet while you're sitting, wear comfortable shoes, and remain as active as possible. So, if you've noticed significant increases in the amount of swelling in your feet and/or legs either by the end of the day, as well as experiencing headaches or visual changes, there's a chance that you may have preeclampsia. This would warrant immediate medical attention.
Q'3' Why does heartburn get so bad in the third trimester?
Answer.An important thing to know is that progesterone relaxes the lower esophageal sphincter, which is the muscular valve responsible for preventing the back flow of stomach acid from occurring. As you continue to progress with your pregnancy, as your stomach becomes pushed up due to the growing baby it's located above the diaphragm, and therefore, you may continue to experience acid reflux. This may mean that you will have to remain upright long after eating a meal as a result of having the burning sensation of acid reflux.
Some practical ways to deal with reflux include eating smaller meals than you normally would, avoiding eating spicy or greasy foods, trying not to lie flat for at least one hour following meals, and elevating your head slightly while sleeping can help as well. If your acid reflux symptoms are persistent to the point that you cannot get relief, speak with your physician in regards to prescribing you an antacid that is safe to take during your pregnancy.
Q'4' Can pregnancy really affect my emotions?
Absolutely, and more significantly than is often acknowledged. Hormonal fluctuations, changing body image, interrupted sleep, and the psychological weight of preparing for parenthood all contribute to emotional vulnerability during pregnancy. Mood swings, heightened sensitivity, and anxiety are common and normal.
What is less well recognized is that true clinical depression can occur during pregnancy, not just after it. If you feel persistently low, hopeless, or unable to function — not just tired or occasionally tearful — please talk to your doctor. Antenatal depression is
16. Final Thoughts:
Having a baby represents one of the biggest challenges in life for every woman and for all pregnant women. During 9 months of a healthy single gestation, the following will occur:
- The heart pumps harder and faster than before
- The lungs breathe deeper
- The kidneys filter more waste from the blood
- The gut moves food through more slowly
- The skeleton will move into a new position
- The amount of blood in the body increases
- The skin will stretch considerably
All of these changes occur for a purpose and are nothing short of spectacular!
I have frequently witnessed that pregnant women who seem to be the most comfortable with their experience often are not necessarily the pregnant women who have the fewest number of discomforts. These women understand the changes occurring to their bodies and the reasons for those changes.
This understanding allows a woman to convert fear into knowledge about her body and confusion into decisions based on fact.
Continue to attend your scheduled visits with your obstetrician and take care of yourself. Trust the signals that your body is giving you to determine whether it is time to take a break or call your physician. It is important to listen to your body during pregnancy. The instinct we have regarding our bodies is very important and should always be respected.
17. Related Articles:
1. Understanding the Normal Menstrual Cycle: A Complete Women’s Health Guide.
Published Date: November 2025
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2. Eclampsia: Symptoms, Causes, Diagnosis, Treatment, and Prevention During Pregnancy.
Published Date: October 2025.
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3. Right-Sided Simple Ovarian Cyst: Causes, Diagnosis, Symptoms, and Treatment Options.
Published Date: July 2025
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4. Doctor-Approved Stress Relief Techniques for Better Mental and Physical Health.
Published Date: March 2025.
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5. Nephrolithiasis During Pregnancy: Causes, Symptoms, Diagnosis, and Management.
Published Date: September 2025
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18. References:
1. Cunningham FG, Leveno KJ, Bloom SL, et al.
Williams Obstetrics.
26th Edition. McGraw-Hill Education; 2022
2. Gabbe SG, Niebyl JR, Simpson JL.
Obstetrics: Normal and Problem Pregnancies.
8th Edition. Elsevier; 2021.
3. American College of Obstetricians and Gynecologists (ACOG).
Physiological Changes During Pregnancy.
Retrieved from:
4. World Health Organization (WHO).
Maternal Health and Pregnancy Care Guidelines.
Retrieved from:
5. Open Anesthesia
Maternal Physiology in Pregnancy.
Available at:
https://www.openanesthesia.org
19. Biography of the Author
Dr. Humaira Latif, an MBBS graduate of KMU Peshawar, is a board-certified Obstetrician and Gynecologist with over fourteen years of clinical expertise in female reproductive health, maternal child care, and diagnostic ultrasound.
Her goal is to build credible health information sources based on scientific research to help women learn more about their bodies, take charge of their own health, and find reliable support for all aspects of their reproductive health.
20. Disclaimer:
This article is written for educational and informational purposes only, and it does not constitute medical information. You should consult a physician for any symptom or concern you might experience during pregnancy.
21) Free "Pregnancy Care Guide" PDF Downloadable Link :
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