Pregnancy is a subject that generates a lot of paper. Bookstores
and libraries devote not just shelves but entire aisles to it. At
your first
prenatal visit
, your doctor will likely load you down with armfuls of pamphlets
that cover every test and trimester. But despite all this
information, pregnancy can take any soon-to-be parent by
surprise.
What the Doctor May Leave Out
If your doctor hasn't mentioned the following topics during
your visits, he or she isn't purposefully omitting the
information. More likely, your doctor hasn't brought them up
because pregnancy affects women in different ways. For example,
some pregnant women experience morning sickness in the morning,
some feel it all day, and some never have it. Or your doctor might
not mention something because it doesn't have a medical focus -
a doctor may not have any more insight into your increasing shoe
size than your neighbor does! Also, some women may think questions
about breast size or hemorrhoids are too personal or embarrassing
to ask their doctors.
Any concerns you have about your or your baby's emotional or
physical health, regardless of how unrelated or trivial they may
seem, should be discussed with your doctor. He or she has seen many
expectant parents, some less worried and some more worried than
you, and can reassure you when there is no problem or give you more
information when there is one. And if your doctor doesn't take
the time to listen to your concerns or doesn't seem to take
them seriously, you should feel free to get a second opinion.
Altered States
Pregnancy doesn't just change your body - it affects the
rest of you, too.
1. The Nesting Instinct
Many pregnant women experience the nesting instinct, a powerful
urge to prepare their home for the baby by cleaning and decorating.
Or perhaps you'll want to tackle projects you haven't had
time to do, like organizing your garage or closets.
As your due date draws closer, you may find yourself cleaning
cupboards or washing walls - things you never would have imagined
doing in your ninth month of pregnancy! This desire to prepare your
home can be useful because it will give you more time to recover
and nurture your baby after the birth. But be careful not to overdo
it.
2. Inability to Concentrate
In the first
trimester
, fatigue and morning sickness can make many women feel worn out
and mentally fuzzy. But even well-rested pregnant women may
experience an inability to concentrate and periods of
forgetfulness. A preoccupation with the baby is partially the
cause, as are hormonal changes. Everything - including work, bills,
and doctor appointments - may seem less important than the baby and
the impending birth. You can combat this forgetfulness by making
lists to help you remember dates and appointments.
3. Mood Swings
Premenstrual syndrome and pregnancy are alike in many ways. Your
breasts swell and become tender, your hormones fluctuate, and you
may feel moody. If you suffer from premenstrual syndrome,
you're likely to have more severe mood swings during pregnancy.
They can make you go from feeling happy one minute to feeling like
crying the next. You may be irrationally angry with your partner
one day, then a coworker may inexplicably irritate you the
next.
Mood swings are incredibly common during pregnancy, although
they tend to occur more frequently in the first trimester and
toward the end of the third trimester.
About 10% of pregnant women experience
depression
during pregnancy. If you have symptoms such as sleep disturbances,
changes in eating habits (a complete lack of appetite or an
inability to stop eating), and exaggerated mood swings for longer
than 2 weeks, you should talk to your doctor.
Unexpected Effects of Pregnancy
4. Bra Size
An increase in breast size is one of the first signs of
pregnancy. Breasts usually become swollen and enlarged in the first
trimester because of increased levels of the hormones estrogen and
progesterone. That growth in the first trimester isn't
necessarily the end, either - your breasts can continue to grow
throughout your pregnancy!
In addition to the size of your breasts, your bra size may be
affected by your rib cage. When you're pregnant, your lung
capacity increases so you can take in extra oxygen for yourself and
the baby, which may result in a bigger chest size. You may need to
replace your bras several times over the course of your
pregnancy.
5. Skin
Are your friends saying you have that pregnancy glow? It's
only one of many skin changes you may experience during pregnancy
due to hormonal changes and the stretching of your skin to
accommodate a larger body. Pregnant women experience an increase in
blood volume to provide extra blood flow to the uterus and to meet
the metabolic needs of the fetus. They also have increased blood
flow to their other organs, especially the kidneys. The greater
volume brings more blood to the vessels and increases oil gland
secretion.
Some women develop brownish or yellowish patches called
chloasma, or the "mask of pregnancy," on their faces. And
some will notice a dark line on the midline of the lower abdomen,
known as the linea nigra (or linea negra), as well as
hyperpigmentation (darkening of the skin) of the nipples, external
genitalia, and anal region. These are the result of pregnancy
hormones, which cause the body to produce more pigment. The body
may not produce this increased pigment evenly, however, so the
darkened skin may appear as splotches of color. Unfortunately,
chloasma can't be prevented, but wearing sunscreen and avoiding
UV light can minimize its effects.
Acne
is common during pregnancy because the skin's
sebaceous glands
increase their oil production. And newly formed pimples might not
be the only evolving spots on your face or body - moles or freckles
that you had prior to pregnancy may become bigger and darker. Even
the areola, the area around the nipples, becomes darker. Except for
the darkening of the areola, which is usually permanent, these skin
changes will likely disappear after you give birth. Many women also
experience heat rash, caused by dampness and perspiration, during
pregnancy.
In general, pregnancy can be an itchy time for a woman. Skin
stretching over the abdomen may cause itchiness and flaking. Your
doctor can recommend creams to soothe dry or itchy skin.
6. Hair and Nails
Many women experience changes in hair texture and growth during
pregnancy. The hormones secreted by your body will cause your hair
to grow faster and fall out less. But these hair changes usually
aren't permanent; most women lose a significant amount of hair
in the postpartum period or after they stop
breastfeeding
.
Some women find that they grow hair in unwanted places, such as
on the face or belly or around the nipples. Others experience
changes in hair texture that make hair drier or oilier. Some women
even find their hair changing color.
Nails, like hair, can change noticeably during pregnancy. Extra
hormones can make them grow faster and become stronger. Some women,
however, find that their nails tend to split and break more easily
during pregnancy. Like the changes in hair, nail changes aren't
permanent. If your nails split and tear more easily when you're
pregnant, keep them trimmed and avoid the chemicals in nail polish
and nail polish remover.
7. Shoe Size
Even though you can't fit into any of your prepregnancy
clothes, you still have your shoes, right? Maybe - but maybe not.
Because of the extra fluid in their pregnant bodies, many women
experience swelling in their feet and may even have to start
wearing a larger shoe size. Wearing slip-on shoes in a larger size
will be more comfortable for many pregnant women, especially in the
summer months.
8. Joint Mobility
During pregnancy, your body produces a hormone known as relaxin,
which is believed to help prepare the pubic area and the cervix for
the birth. The relaxin loosens the ligaments in your body, making
you less stable and more prone to injury. It's easy to
overstretch or strain yourself, especially the joints in your
pelvis, lower back, and knees. When
exercising
or lifting objects, go slowly and avoid sudden, jerky
movements.
9. Varicose Veins, Hemorrhoids, and Constipation
Varicose veins, which are usually found in the legs and genital
area, occur when blood pools in veins enlarged by the hormones of
pregnancy. Varicose veins often disappear after pregnancy, but you
can lessen them by:
- avoiding standing or sitting for long periods of time
- wearing loose-fitting clothing
- wearing support hose
- elevating your feet when you sit
Hemorrhoids - varicose veins in the rectum - frequently occur
during pregnancy as well. Because your blood volume has increased
and your uterus puts pressure on your pelvis, the veins in your
rectum may enlarge into grape-like clusters. Hemorrhoids can be
extremely painful, and they may bleed, itch, or sting, especially
during or after a bowel movement. Coupled with constipation,
another common pregnancy woe, hemorrhoids can make going to the
bathroom downright unpleasant.
Constipation is common throughout pregnancy because pregnancy
hormones slow the rate of food passing through the gastrointestinal
tract. During the later stages of pregnancy, your uterus may push
against your large intestine, making it difficult for waste to be
eliminated. Constipation can contribute to hemorrhoids because
straining may enlarge the veins of the rectum.
The best way to combat constipation and hemorrhoids is to
prevent them.
Eating
a fiber-rich diet, drinking plenty of fluids daily, and exercising
regularly can help keep bowel movements regular. Stool softeners
(not laxatives) may also help. If you do have hemorrhoids, see your
doctor for a cream or ointment that can shrink them.
Birth Day Surprises
10. Things That Will Come Out of Your Body
So you've survived the mood swings and the hemorrhoids, and
you think your surprises are over. Guess again - the day you give
birth will probably hold the biggest surprises of all.
Only 1 in 10 mothers' water breaks before labor contractions
begin. Some women never experience it - a doctor may need to
rupture the amniotic sac (if the cervix is already dilated) when
they arrive at the hospital. How much water can you expect? For a
full-term baby, there are normally about 2.1 to 5.9 cups of
amniotic fluid. Some women may feel an intense urge to urinate that
leads to a gush of fluid when their waters break. Others may have
only a trickling sensation down their leg because the baby's
head acts like a stopper to prevent most of the fluid from leaking
out. In any case, amniotic fluid is generally sweet-smelling and
pale or colorless and is replaced by your body every 3 hours, so
don't be surprised if you continue to leak fluid, about a cup
an hour, until delivery.
Other unexpected things may come out of your body during
labor
in addition to your baby, blood, and amniotic fluid. Some women
experience nausea and vomiting. Others have diarrhea before or
during labor, and flatulence (passing gas) is also common. During
the pushing phase of labor, you may lose control of your bladder or
bowels. A
birth plan
can be especially helpful in communicating your wishes to your
health care providers about how to handle these and other
discomforts of labor and delivery.
Lots of surprises are in store for you once you become pregnant
- but none sweeter than the way you'll feel once your newborn
is in your arms!
Reviewed by:
Steven Dowshen, MD
Date reviewed: June 2008
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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