First time pregnancy – What do I need to know?

Understanding the Basics of Pregnancy: A Comprehensive Guide

Pregnancy Basics

Introduction:

Pregnancy is a journey marked by excitement, anticipation, and a range of physical and emotional changes. Whether you’re planning to conceive or already expecting, understanding the fundamentals of pregnancy is crucial for a healthy and smooth experience. In this guide, we’ll delve into the basic facts of pregnancy, shedding light on everything from conception to childbirth.

What is Term in Pregnancy?

Pregnancy has historically been dated from the last menstrual period (LMP) with a duration of 40 weeks to give an estimated date of delivery (EDD) as a specific date. In fact term is usually a range from 37 – 42 weeks and these days pregnancy dates are usually set by ultrasound measurement.

The American College of Obstetricians and Gynecologists, the American Institute of Ultrasound in Medicine, and the Society for Maternal-Fetal Medicine recommend that –

Ultrasound measurement of the embryo or fetus in the first trimester (up to and including 13 6/7 weeks of gestation) is the most accurate method to establish or confirm gestational age.

A new formula for estimating gestational age based on ultrasound examination was reported in – Obstet Gynecol. 2017;130:433-441

Preconception Care

Medical assessment prior to becoming pregnant. The Centers for Disease Control and Prevention (CDC) has defined preconception care as “a set of interventions that aim to identify and modify medical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management.”

Pre-conception care includes –

  1. Optimizing the management of chronic maternal health problems.
  2. Providing lifestyle advice to avoid behaviours hazardous to a pregnancy, such as smoking, drinking excessive alcohol, or taking drugs.
  3. Providing advice to optimize the health of the mother and baby, such as guidance on taking folic acid supplements.
  4. Identifying couples who are at increased risk of having a baby with a genetic or chromosomal malformation and providing them with sufficient knowledge to make informed decisions.

Medical History

A number of factors have to be considered early in pregnancy, if not addressed at the pre-pregnancy stage.

Pre-existing medical conditions in the individual, such as diabetes, renal disease, hypertension, HIV, previous thrombosis and epilepsy, would have to be considered in managing the pregnancy. Congenital abnormalities and genetic problems have to be considered in both parents.

Obesity – a BMI of over 30 carries an increased risk of complications such as hypertension, diabetes, and caesarean delivery also attainment of a normal pre-conception BMI will also likely prevent obesity and related long-term health effects in the developing child.

Screening

Antenatal screening is usually offered for –

  • Foetal anomalies by ultrasound
  • Down’s syndrome
  • Haemoglobinopathies
  • Rubella status
  • HIV
  • Hepatitis B
  • Tay-Sachs disease in high risk individuals

Pregnancy

  1. Conception: Pregnancy begins with conception, the moment when sperm fertilizes an egg. This typically occurs during ovulation when a woman releases an egg from her ovary. Once fertilized, the egg travels through the fallopian tube to the uterus, where it implants into the uterine lining. Conception marks the beginning of pregnancy, initiating a series of rapid changes within the female body.
  2. Pregnancy Trimesters: Pregnancy is divided into three trimesters, each spanning approximately three months.
    1. First Trimester (Weeks 1-12): This is a critical period marked by rapid fetal development. Common symptoms include morning sickness, fatigue, and tender breasts.
    1. Second Trimester (Weeks 13-26): Many women find this trimester more comfortable as nausea subsides and energy levels increase. The baby’s movements become noticeable, and the bump begins to show.
    1. Third Trimester (Weeks 27-Birth): The final stretch is characterized by significant fetal growth and preparations for birth. Women may experience backaches, frequent urination, and Braxton Hicks contractions.
  3. Physical Changes: Pregnancy brings about a myriad of physical changes in the mother’s body. Hormonal fluctuations can cause symptoms such as morning sickness, fatigue, and mood swings during the first trimester. As the pregnancy progresses, the abdomen expands to accommodate the growing foetus, leading to weight gain and changes in posture. Additionally, women may experience symptoms such
  4. Nausea and vomiting (morning sickness)
  5. Fatigue
  6. Increased urination
  7. Breast tenderness
  8. Mood swings
  9. Food cravings and aversions
  • Prenatal Care: Prenatal care is essential for ensuring a healthy pregnancy and childbirth. This includes regular check-ups with a healthcare provider, prenatal vitamins, and screening tests to monitor the mother and baby’s health. Proper nutrition, exercise, and avoiding harmful substances such as alcohol and tobacco are also crucial components of prenatal care. By receiving adequate medical attention throughout pregnancy, women can reduce the risk of complications and promote the well-being of both themselves and their babies.
  • Foetal Development: Throughout pregnancy, the foetus undergoes remarkable development, progressing from a tiny cluster of cells to a fully formed baby. During the first trimester, the foetus develops basic structures such as the brain, heart, and limbs. By the second trimester, organs continue to mature, and the foetus begins to exhibit reflexive movements. In the third trimester, the foetus gains weight rapidly and prepares for life outside the womb by practicing breathing and swallowing.
  • Labor and Delivery: Labor is the process by which the uterus contracts to expel the foetus and placenta from the mother’s body. This typically occurs around 40 weeks gestation, although it can vary from woman to woman. Signs of labour include regular contractions, rupture of the amniotic sac (also known as the water breaking), and cervical dilation. During childbirth, women may opt for natural childbirth, epidural anaesthesia, or other pain management techniques to ease the process.
Maternity Wear
Maternity Clothing

Body Changes in Pregnancy

 Blood volume increases during pregnancy, beginning at 6-8 weeks gestation, which accounts for part of the weight gain. The increase is mainly in the plasma rather than the cellular constituents of the blood leading to a fall in haemoglobin and the possible need for iron.

As the uterus grows pushing up the diaphragm there may be some breathlessness, light headedness and possible fainting. Palpitations and irregular heartbeats are also not uncommon in pregnancy.

Nutrition in Pregnancy

During early pregnancy, most women experience an increased appetite, with extra caloric needs of approximately 300 kcal/d. Some women have nonfood cravings, known as pica.

Should certain foods be avoided during pregnancy?

What shouldn’t I eat when pregnant?

Pregnant women are at increased risk of bacterial food poisoning. For the safety of both mother and fetus, it is important to take steps to prevent foodborne illnesses, including the following

  • Properly cook food to kill bacteria.
  • Cook eggs until they have a firm yolk and are white. Eggnog and hollandaise sauce have raw or partially cooked eggs and are not considered safe.
  • Eat liver in moderation. Liver can contain extremely high levels of vitamin A.
  • Avoid products containing unpasteurized milk, including soft cheeses like brie, feta, and blue cheese. Also avoid unpasteurized juice.
  • Carefully wash all fruits and vegetables to eliminate harmful bacteria.
  • Longer-lived and larger fish, such as shark, swordfish, king mackerel, and tilefish, have increased mercury levels and the FDA advises that they should not be eaten by pregnant or nursing women.

Conclusion:

Pregnancy is a remarkable journey filled with anticipation, wonder, and a profound sense of responsibility. By understanding the basic facts of pregnancy, expectant parents can navigate this transformative experience with confidence and knowledge. From conception to childbirth and beyond, embracing the joys and challenges of pregnancy lays the foundation for a healthy and fulfilling parenting journey.

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