Once upon a time, before pee-on-a-stick tests that checked for HCG and told you for sure if you were pregant or not (except when they didn't) and ultrasound, which showed you pictures of what you are pregnant with (preceded by the definitely more dangerous pelvic x-ray), mothers-to-be, midwives, doctors and random commentators like family and friends had a lot of different ways to detect pregnancy. Most books and classes that teach you about pregnancy and childbirth cover many of these: chloasma or melasma, the mask of pregnancy, a change in facial pigmentation, a pigmentation change on your belly called linea negra, the weird nausea, vomiting and sensitivity to food smells and tastes so characteristic of the first few months of pregnancy, many changes in breast size, sensitivity, texture and structure and so on.
Once a woman knows she is pregnant, and she and those various commentators are usually pretty fascinated by the changes that happen to her body. Unfortunately, a lot of people get very set ideas about what those changes should and shouldn't be, and will intervene in dangerous ways when a woman's body deviates from that expectation. While it is very helpful to listen to other mothers and learn what they went through, and somewhat helpful to research what happens during pregnancy, whether through classes, books or other resources, it is best to pay close attention to how you feel, and to avoid those things that make you feel bad, and do more of those things that make you feel healthy.
It is common to divide pregnancy up into three slices. The first trimester has a high likelihood of miscarriage, fatigue, vomiting, nausea, food sensitivities. Some women may notice other things like changes in their skin, hair, breasts. The may also develop leg cramps, lower back pain, constipation, and a whole host of other changes. It's really nice having hair that doesn't fall out and looks lustrous and beautiful. The itchy skin can be annoying, as can the change in hair growth patterns over the body, but it was nice that a lot of surface blemishes cleared up on my face and upper arms (I did not appreciate the pimples on my inner thighs just above the knees). The visible Montgomery's glands on my breasts were weirdly confusing initially, as was the flaking skin on and around my nipples, but once I knew this was normal, it merely became another change to watch go by. The first several leg cramps sent me in search of bananas, a time-honored cure for cramps for me, and for the first time in my life, bananas did nothing. Not pointing my toes did prevent recurrence, but it meant I had to consciously not stretch my legs in particular ways. The pain in my pelvis and lower back was worrisome, until various women told me it was good that my pelvis was adjusting so early and so readily. I have not yet suffered from constipation, but my diet is very high in fiber.
The second trimester has a lower risk for miscarriage and the third has none. This is because miscarriage is defined as early, spontaneous loss of pregnancy before 20 weeks (after about 20 weeks, the resulting tragedy comes under the definition of perinatal mortality. I lack the experience or knowledge to say anything on this unimaginably sad topic.). The fetus has some chance of surviving birth towards the end of the second trimester, often with terrible disability. With increasing age, the odds of survival, thriving and more normal life improve. For many women, the nausea, vomiting, exhaustion, and food sensitivities decrease some time during the second trimester (for others, this will continue throughout the pregnancy), and she often has a lot more energy. She is also much more visibly pregnant. Sometime during the second trimester, she will probably feel the baby move, initially in a way that is suspicously like gas or indigestion (which she probably has also had a lot of) and eventually in a clearly different way. The water retention/swelling/edema while walking was much worse than hot weather and exercise had previously caused. My usual management techniques (carefully managing salt, drinking plenty of fluids, elevating my legs and taking my ring off before it got too bad) were relatively effective, but had to be used much more consistently than before pregnancy. Standing became very difficult for me.
The third trimester has a risk of preterm labor and/or preterm birth. Throughout the pregnancy, the uterus may contract, usually without pain early in the pregnancy, and without pattern until birth is near. There are a number of guidelines for when to worry about contractions. These guidelines do little to reduce my concern. Staying well-hydrated helps. Towards the end of the second trimester and the beginning of the third, I noticed I tended to be quite warm in situations I would never have been so before, particularly noticing the heat on my face and around my abdomen. The latter is surely due to the extra person's metabolism, increased blood volume and higher volume to surface ratio. It has also become difficult to get enough food in me. Even eating frequently tends to result in a physical fullness before my hunger is completely assuaged; if I eat until I am no longer hungry, I may get reflux or heartburn. Also if I go too long between meals, I get heartburn or reflux. My husband and I recently noticed that if he rubs up along my lower back on both sides of the spine, that makes the reflux stop for about ten minutes or so.
Because there's a baby, a uterus, a placenta and a lot of support systems (like more blood vessels and blood) in your belly, lying on your back can put a lot of pressure on your diaphragm (impacting breathing) and some important nerves and blood vessels. Because this can reduce oxygen for you and/or the baby, people will start telling you from quite early on in pregnancy that you should not lie flat on your back and should not sleep on your back. I figure that since doctors strapped down most of our mothers on their back, drugged them to near insanity and then ignored them for hours without any vital signs checking on them or the about-to-be-born baby, this is advice we can afford to ignore at will. They were way worse behaved than anything we might do. Be aware of the issue and prop yourself up as comfortably as you can manage, in whatever position you choose to sleep or rest in. Doctors and other health care professionals persist in making pregnant women lie flat on their backs for various exams. Lobby for more comfortable positions when possible, and adjust your position to something more comfortable whenever you can, as soon as you can. Don't just lie there passively while they monkey around with the machinery as you are about to pass out from difficulty breathing.
While I am still trying to find out the details, it seems that in the past, doctors and other medical professionals thought it would be best for the baby if the mother was on her back to rest or labor. The idea may have been that being on one's belly (unimaginable for me) or side (where they now encourage very pregnant women to rest) puts pressure on the baby in a dangerous way. Advice aimed at childbearing women and their babies changes over time. This is why I think it is so important to do what feels right and healthy for you, and avoid what feels dangerous or painful.
Exercise is a high priority for me. It keeps me physically, mentally and emotionally healthy and calm. During the first trimester, I felt too ill and tired to want to exercise. Sometimes when I walked anyway, I felt better; sometimes I felt worse. During the second trimester, I did not feel ill or tired, but often when I walked (particularly down hill or stairs), I developed horrendous cramps. I eventually realized this was because the beast within was lying sideways. Towards the end of the second trimester, the wee one started shifting upright when I walked and the cramps no longer returned. By the beginning of the third trimester, the wee one was upright (and head down, thank goodness) almost all the time. Swimming is weird, because the belly is like a pool float strapped in front; it is difficult to float on my back as I tend to tip. However, using a kickboard and crawl stroke remain possible and help me with swelling and energy levels. Until the end of the third trimester, when I was carrying a lot of fluid in my belly, it was tremendously easy to stay high in the water swimming on my front. Sitting in a kayak was quite possible into the third trimester. Getting in was not too difficult; getting out was very awkward. I could not paddle as hard as before, in part because rotation is weird, and in part because my obliques and abs are so thoroughly stretched out. A tandem and a non-pregnant, fit partner are wonderful.
Unless something has happened to break your membranes early, there isn't any compelling medical reason not to have sex. On the other hand, you've got enough going on without putting up with pressure to do something you may or may not want to do. Between prudishness and a kindhearted desire to help women say no to partner pressure, a number of health care professionals over the years have said a number of less than completely true things about whether or not a pregnant woman should be having sex. You can basically ignore all of them, unless you want to use one as an excuse to avoid doing something you are having trouble saying no to. Because of the massive hormone cocktail modifying your body in support of growing a new human, your libido will probably fluctuate in new and unexpected ways. To the extent that you can convey some of this to your partner in a compassionate fashion, and to the extent that your partner is considerate of you, your changing body and your feelings, sex can continue to be a positive part of your life and your relationship, a source of joy, intimacy and simple stress relief. To the extent that your partner is not considerate, or unable to absorb this message, sex can become a negative. I'd like to urge you to take this opportunity to improve communication with your partner if the latter is the case, but you do have a lot going already, and that's just one more task to feel guilty about. So rather than take it all upon yourself, I'd suggest handing some useful written material to your partner and/or signing your partner up for classes. In an ideal world, your non-pregnant partner would figure all this out without you having to direct it. Unfortunately, this is not always the case.
Copyright 2005 by Rebecca Allen
Created June 13, 2005 Updated September 13, 2007