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Prenatal Care | What to Expect | Prenatal Medication

Obstetrics - What to Expect

Knowing what to expect during pregnancy helps to ease fears and allows you to fully enjoy this exciting and joyous time. Understanding how to prepare lets you to relax and take comfort in normal progression of your pregnancy.

The First Trimester (1 to 12 Weeks)
A healthy first trimester is crucial to the normal development of your baby. Although you may not be showing much on the outside, inside the baby’s organs and systems are forming. Every woman experiences pregnancy changes differently, but normal symptoms during this time may include:

  • Breast swelling and tenderness due to an increased amount of the hormones estrogen and progesterone.
  • Needing to urinate more frequently as the uterus grows and begins to press on the bladder.
  • Mood swings similar to premenstrual syndrome.
  • "Morning sickness," which is feelings of nausea and sometimes vomiting.
  • Constipation due to the growing uterus pressing on the rectum and intestines.
  • Heartburn, indigestion, constipation, and gas due to slower muscular contractions in the intestines because of higher levels of progesterone.
  • Fatigue due to the physical and emotional demands of pregnancy.
  • An increased cardiac output may cause an increased pulse rate during pregnancy. Cardiac volume increases by approximately 40 to 50 percent from the beginning to the end of the pregnancy. The increase in blood volume is needed for extra blood flow to the uterus.
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The Second Trimester (13 to 26 Weeks)
The second trimester is the most physically enjoyable for most women, and marks a turning point as the baby begins to focus on growing in size and weight. Mothers usually begin to feel better as morning sickness, extreme fatigue and breast tenderness usually subsides. You may start showing the pregnancy more during this time. Some changes to expect include:

  • Possible increase in appetite.
  • Ability to feel the movement of the fetus for the first time - a phenomenon called quickening - around 20 weeks.
  • Skin discomfort on the abdomen as it grows, and there may be pain down the sides of the body as the uterus stretches. Your lower abdomen may ache as ligaments stretch to support the uterus, and backaches may occur from the increasing weight.
  • The need to frequently urinate may decrease as the uterus grows out of the pelvic cavity, relieving pressure on the bladder.
  • You may experience congestion and nosebleeds because the increase in hormones affects the mucous membranes in the nose.
  • Varicose veins and hemorrhoids may appear, and skin pigmentation on the face or abdomen  may change.
  • A white-colored vaginal discharge called leucorrhea is normal, but if you have colored or bloody discharge it may signal possible complications and should be examined immediately.
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The Third Trimester (27 to 42 Weeks)
The third trimester marks the home stretch as you begin to prepare for delivery of your baby. You may feel more uncomfortable now as you continue to gain weight, and may begin to have false labor contractions, called Braxton-Hicks contractions. Some mothers-to-be have difficulty taking deep breaths or getting comfortable at night for sleep, while others are free from any discomfort as they anxiously await the arrival of their new son or daughter. Some other normal changes may include:

  • Increased skin temperature as the fetus radiates body heat.
  • Return of increased urinary frequency due to increased pressure being placed on the bladder.
  • Blood pressure decrease as the fetus presses on the main vein that returns blood to the heart.
  • Swelling of the ankles, hands, and face may occur as you continue to retain fluids, and more frequent leg cramps.
  • Continued weight gain, with the normal amount totaling 25 to 35 lbs.
  • Braxton-Hicks contractions (false labor) occurring at irregular intervals in preparation for childbirth.
  • Appearance of stretch marks on the abdomen, breast, thighs and buttocks.
  • Colostrum, a fluid in the breasts that nourishes the baby until the breast milk becomes available, may begin to leak from the nipples.
  • A possible decrease in libido (sexual drive).
  • Skin pigmentation may become more apparent, especially dark patches of skin on the face.
  • Increase in the white-colored vaginal discharge, leucorrhea, which may contain more mucus.
  • Backaches and hemorrhoids may persist and increase in intensity.
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During this trimester, it is a good idea to start taking childbirth classes in preparation for the big day - especially in the case of first pregnancies. If you plan to breastfeed, taking a breastfeeding class may be helpful. Please call (302) 744-7135 to register for childbirth classes, breastfeeding classes and/or sibling preparation classes offered at Bayhealth.

Although we can generalize what to expect during each trimester, every woman carries her baby differently and each is a unique experience. If you have any questions or concerns don’t hesitate to give us a call.



Khan Obstetrics and Gynecology Associates, P.A. | 1113 S. State Street, Dover, DE | Phone (302) 735.8720 | Fax (302) 735.8724