Pregnancy is divided into three nearly equal trimesters, each with its own challenges and changes for both the pregnant person and baby.
Diagnosing Pregnancy
Pregnancy is usually first diagnosed with a home pregnancy test, which uses urine to detect the presence of the pregnancy hormone human chorionic gonadotropin (hCG). You can take a home pregnancy test from about the time you would expect your period. Once you have a positive pregnancy test, you will make an appointment to see your obstetrician or midwife to confirm the pregnancy and begin your prenatal care. They may have you repeat the test or use physical symptoms to diagnose your pregnancy for the medical record.
Prenatal Care
Prenatal care encompasses the nine months plus of medical care that you receive from a doctor or a midwife over the course of your pregnancy. You will usually see a provider once a month for the first two trimesters of pregnancy, every two weeks during weeks 28 through 36, and then weekly until the birth of your baby. These visits will include routine weight checks, listening to your baby’s heartbeat, routine blood work, and more. You may also receive other tests including:
Blood pregnancy test Genetic testing Non-stress tests (NST) Ultrasound exams
Your practitioner will help you determine which tests are needed for you and your baby in your pregnancy, as recommendations will vary based on many factors. Your provider also will work with any other medical care providers or specialists that you regularly see. They will work together to support a healthy pregnancy.
First Trimester (Weeks 1 to 13)
One of the things that makes the first trimester unique is that based on how healthcare providers calculate your baby’s gestational age, it begins with the first day of your menstrual cycle. You may not even be planning to be pregnant at this point, nor will you know that you are pregnant until around the four-week mark (at the earliest). So, for at least about a third of this trimester, you will identify the weeks retroactively. From the point of a positive pregnancy test, you will be aware of the pregnancy, though it won’t be evident to the outside world just yet. You may not be “showing,” but there is a lot going on inside your body. From those two cells to an embryo with a beating heart, the changes in these first weeks are amazing. Every organ system is beginning to form, as are the baby’s arms, legs, fingers, and toes. You may be feeling the effects of pregnancy starting around the sixth week of pregnancy. This can include a host of things, including:
Morning sickness Sore breasts Fatigue Heartburn Insomnia
You also may be concerned about the pregnancy and its viability, and that concern is not without reason. Miscarriage is most common in this first trimester, with as many as 10% of pregnancies ending before the second trimester. While potentially scary, those stats also mean that a majority of pregnancies are viable and end with a healthy baby.
Second Trimester (Weeks 14 to 27)
The second trimester usually has you feeling a bit better physically. While you may have a bit of nausea in the first weeks of the trimester, most of this is likely to dissipate before too long. You also may have a lot more energy now than you did in the first trimester. Still, there are a few people who simply don’t feel great being pregnant. That doesn’t necessarily mean that anything is wrong. One thing that many people enjoy about the second trimester is that your baby is getting big enough that your abdomen begins to show a little bump. You may not be quite ready for maternity clothes, but you will notice that your clothes fit differently, and others may notice too. You also may begin to feel the first flutters of your baby’s kicks by the end of this trimester, though potentially earlier if you have had a previous pregnancy. While baby has been moving around a lot since last trimester, they are now getting big enough for you to feel these kicks, punches, and flips. Your baby is growing bigger both in size and in maturity. They are busy doing things like forming fingerprints and the permanent teeth behind their baby teeth.
Third Trimester (Weeks 28+)
The end is in sight with this trimester. A healthy goal is to make it to at least 37 weeks. Your baby is growing larger and stronger. There is brown fat being deposited to help the baby maintain a proper temperature after birth. The lungs are maturing, and the brain is growing and becoming more mature as well. All of these continue to develop all the way through labor. Sometimes you will even see a return of the nausea and vomiting you experienced in the first trimester. You may also have a few other symptoms, including leg cramps and Braxton Hicks contractions (“practice contractions”).
Emotional Components of Pregnancy
Many pregnant women and their partners will experience a variety of emotions throughout the pregnancy, some of which may go overlooked. Sometimes you’re super excited about pregnancy and really happy. But you also may have periods of being scared or worried about what your life will look like after the baby. Some people will have weird dreams in pregnancy, which can affect their mood, or they may even experience periods of anxiety and/or depression. Brief periods of sadness or anxiety can be normal. However, having periods of negative feelings that last more than a few days is a reason to talk to your doctor or midwife. They are able to offer advice and screen you for more serious mental health conditions that warrant special attention.
Common Pregnancy Complications
While most pregnancies are free of complications, the goal of prenatal care is to help prevent and detect complications that can occur. Typically, the earlier a complication is discovered, the better the outcome will be. Preterm labor is a good example. If you are able to detect it early enough, you may be able to stop it or delay it long enough to receive additional medication to help mature the baby’s lungs and help prepare them for life outside the womb. There are other complications that are routinely screened for as well. Some include:
Miscarriage Ectopic pregnancy (tubal pregnancy) Gestational diabetes Placenta previa Preeclampsia/eclampsia Group B strep Fetal malpositions
You also may have specific concerns based on your medical history. Your practitioner will be helpful at figuring out what you are at the greatest risk for in your specific pregnancy.
Labor and Birth
Once you have reached 37 weeks, labor will not be stopped once it starts. Many women have their babies sometime between two weeks before and two weeks after their due date. Some mothers choose to labor without medications, instead opting for natural techniques to relieve pain. These can include:
Relaxation techniquesMassagePosition changesAromatherapyHydrotherapy (bath or shower)TENS unitsBirth balls/peanut ballsBreathing techniquesVisualization
Others choose medicinal forms of pain relief, from an epidural to IV pain medications. Many women use a combination of natural and medicinal methods to help cope with labor. This can also include the use of professional labor support from a doula. Taking a childbirth class can help you learn about all of your options. It can also help you figure out what options are the best choices for your family. Your class may include information on making a birth plan and even touring your birth facility.
Induction of Labor
If labor does not start on its own by the end of week 42, or if there is a complication that means it is best for baby to be born before labor begins naturally, your practitioner might suggest an induction of labor.
Cesarean Birth
Sometimes, before or during labor, a decision is made that a cesarean birth (c-section) would be a better option. This is a surgical birth where the baby is born via an incision made in the abdomen and uterus. This may happen for a variety of reasons including, but not limited to:
Fetal distressBreech baby or other positionsMaternal complications, such as high blood pressureFetal anomalies (birth defects)Placental complications
You should talk to your doctor or midwife during pregnancy to figure out what the chances of you needing a c-section are. Sometimes it’s obvious that you are at a higher risk, so it’s good to have information that can help you prepare yourself for the possibility.
Immediate Postpartum Recovery
After giving birth, you will have a period of recovery. This will include the delivery of the placenta, repair of any tearing on the perineum, and suturing of the uterus and abdomen (in cases of c-section). No matter how you gave birth, you will bleed postpartum. This bleeding comes from the site of the placenta in the uterus, which is healing. About an hour after delivery, you will typically be moved to your regular postpartum room. If you are in a birth center, you may be released to go home within about three to six hours after giving birth, assuming you and baby are doing well. If you are in the hospital, you will typically stay for a period of two days for a vaginal birth and four days after a cesarean birth. Your period of postpartum recovery technically will end with your six-week visit with your doctor or midwife. This doesn’t mean that you will be back to your pre-pregnancy weight or shape by then. Remember that it took you nine months to grow a baby and it will take you a while to feel back to normal. For many women, it is a new normal that they will eventually grow accustomed to.
