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Your Pregnancy At-A-Glance

 

Pregnancy is a mind-body journey likely to include everything from moody blues to the kicks of tiny feet. We asked Chester Martin, M.D., professor of obstetrics and gynecology at the University of Wisconsin, Madison, and Jeanne Waldman, R.N., a certified nurse-midwife with Planned Parenthood for help in compiling a 12-month time line that chronicles how you may feel during your pregnancy. While not a substitute for medical care, this road map may help you distinguish between signs that warn you to call your doctor and signs that indicate everything is normal.

MONTH 1: Weeks 1-4

Possible physical changes

Absence of menstrual period, tingling, tender and/or swollen breasts, fatigue, mild to extreme nausea, with or without vomiting, at any time of day or night, minor uterine contractions

Possible emotional changes

Wondering whether you're pregnant, fear of complications, anxiety about motherhood and how it will affect marriage, career, and lifestyle, crankiness

Possible appetite changes

Food cravings or aversions, increase or decrease in appetite. If you even suspect you're pregnant, start taking 800 micrograms of folic acid daily, the dosage recommended during pregnancy by the March of Dimes, to prevent neural tube defects.

The inside story

The embryo is a tiny speck, the size of a pencil point that is sometimes visible about the fourth week of gestation via vaginal ultrasound.

Sleep/stamina irregularities

Possible fatigue or sleepiness. An hour of extra sleep or taking afternoon naps may help, but don't be surprised if you still feel tired no matter how much sleep you get.

Stress Rx

Instead of wondering or worrying whether you're pregnant, get tested. At-home pregnancy tests are nearly 100 percent accurate 14 days or more after a missed period, and urine tests (done at your doctor's office) are nearly 100 percent accurate 7 to 10 days after conception. Blood tests are 100 percent accurate after 7 days.

Special risks

Early miscarriage

When to call your doctor 

Positive result on home pregnancy test, cramping and spotting or bleeding, which may indicate early miscarriage, lower abdominal pain, continual vomiting, gushing or steady leaking of fluid from vagina, painful or sparse urination.

MONTH 2: Weeks 4-8

Possible physical changes

Menstruation has ceased, but you may experience slight staining, fatigue, sleepiness, frequent urination, nausea, vomiting, heartburn, indigestion, flatulence, breast tenderness.

Possible emotional changes

Irritability, mood swings, weepiness, misgivings, denial, disbelief, anger if the pregnancy is unwanted, joy, elation, excitement.

Possible appetite changes

Aversion to certain foods, morning sickness. Eating mini meals and avoiding greasy foods may help squelch queasiness.

The inside story

By the end of this month, the tiny, tadpole-like embryo is about the size of a grain of rice.

Sleep/stamina irregularities

Your metabolism is working overtime to build the growing fetus, so don't fight or ignore signs of fatigue. Great energy boosters include afternoon naps or breaks, going to bed an hour early, daily aerobic exercise, eliminating chores.

Stress Rx

Relaxation techniques, guided imagery, warm baths (not hot! avoid Jacuzzis, saunas and hot tubs), yoga and low-impact aerobic exercise all help calm frayed nerves. If you're very anxious, or your job is particularly draining take frequent breaks.

Special risks

Early miscarriage (affects 10 percent of pregnant women), "ectopic" or tubal pregnancy (less common, affecting 1 in 100 women).

When to call your doctor 

See Month 1.

MONTH 3: Weeks 8-12

Possible physical changes

See Month 2. In addition, constipation, food cravings, occasional slight headaches, faintness or dizziness, skin problems such as acne or rashes.

Possible emotional changes

See Month 2. In addition, fear of miscarriage, anticipation grows, fear or anxiety about bodily changes, motherhood, finances.

Possible appetite changes

See Month 2. Morning sickness and food cravings may intensify.

The inside story

By the end of this month, the embryo resembles a tiny human, weighing an ounce and measuring about 1/4 inches long from head to buttocks, the size of a small strawberry. The heart is beating, and the arms and legs are formed, with finger and toe buds appearing. Bone is just beginning to replace cartilage.

Sleep/stamina irregularities

See Month 2. Experiment with sleeping on your back, head elevated six inches and legs propped on a pillow, or curl up on your side.

Stress Rx

See Month 2. Read books like What to Expect When You're Expecting, Arlene Eisenberg, Heidi Murkoff and Sandee E. Hathaway, B.S.N. (Workman Publishing, 1991 ), The Good Housekeeping Illustrated Book of Pregnancy and Baby Care (Darling Kindersley Limited, 1990), A Child Is Mom: The Completely New Edition, Lennart Nilsson (Dell Publishing, 1993). Your doctor may restrict sexual intercourse, experiment with "pregnancy safe" alternatives.

Special risks

See Month 2. See a genetic counselor if you're concerned about genetic defects, family medical problems or are 35+.

When to call your doctor 

Fever above 100.4 degrees in absence of cold or flu symptoms, severe headache, blurred, dim or double vision, fainting or dizziness, sudden, unexplained, large weight gain, sudden increase in thirst with sparse and/or painful urination, bleeding or cramping.

MONTH 4: Weeks 12-16

Possible physical changes

See Months 2 and 3. Increase or decrease in sexual drive, frequent nighttime urination.

Possible emotional changes

See Months 2 and 3. Fear or anxiety about bodily changes, motherhood, finances, or new sense of calmness and acceptance, dreams of baby animals, such as kittens or puppies, with their mothers.

Possible appetite changes

Increasing appetite, food cravings, morning sickness, nausea with or without vomiting.

The inside story

Fetus weighs 1/2 ounce and measures 2 1/2 to 3 inches, the size of a large goldfish, with a disproportionately large head. At 13 weeks eyes are developed, although lids stay closed for several months. At 15 weeks ears are fully developed. Most major organs, circulatory system and urinary tract are operating, gender is impossible to determine, even with ultrasound.

Sleep/stamina irregularities

You may suffer from disrupted sleep because of frequent need to urinate. To ease grogginess, retire an hour or two earlier and/or take an afternoon nap.

Stress Rx

Aerobic exercise , guided imagery, meditation, yoga, calisthenics, walking, swimming, gentle indoor cycling, jogging, tennis, cross country skiing (below 10,000 feet), light weight training, outdoor cycling.

Special risks

See Month 3.

When to call your doctor

Pink, red or brown discharge or bleeding, with or without cramping.

MONTH 5: Weeks 16-20

Possible physical changes

See Months 2, 3, & 4. In addition, nasal congestion, nosebleeds, bleeding gums, mild ankle swelling, hemorrhoids, slight, whitish vaginal discharge, mild breathlessness, lackluster or shinier, fuller hair, worsening of allergies, decrease in urination frequency, iron deficiency anemia

Possible emotional changes

See Months 2, 3, & 4. You may also be less focused and more forgetful as well as excited because you're finally starting to show. You may now feel it's safe to share your news.

Possible appetite changes

Morning sickness usually subsides, increasing appetite. You may be tempted to overeat, although you require only 300 extra calories per day. Generally, you should gain 3 to 8 pounds the first trimester, 12 to 14, the second and 7 to 10, the third.

The inside story

The fetus is about 4 inches long, the size of a small avocado, with the body beginning to catch up to the head in size. Fingers and toes are well-defined, tooth buds appear. You'll probably start feeling the first fetal movements.

Sleep/stamina irregularities

Because fatigue typically passes by the end of this month, most women feel more energetic. It's a good time to travel, although avoid flying in planes without pressurized cabins, and foreign locales requiring vaccinations.

Stress Rx

To get a handle on "fuzzy" thinking, keep lists, engage in focusing techniques (yoga, guided imagery), find ways to simplify your life.

Special risks

Gaining too little weight may jeopardize Baby and lead to premature birth, gaining too much may increase risk of backache, leg pain, C- section and postoperative complications.

When to call your doctor

Same as Months 2, 3, & 4.

MONTH 6: Weeks 20-24

Possible physical changes

Same as Months 2, 3, 4 & 5. Distinct fetal movement, lower abdominal achiness, backache, leg cramps, increased pulse or heart rate, skin pigmentation changes, heat rash, heightened sexual response, heartburn, indigestion, bloating.

Possible emotional changes

Growing acceptance of your pregnancy, fewer mood swings, occasional irritability, absentmindedness, crankiness, "fuzzy" thinking due to sleep loss.

Possible appetite changes

Ravenous, intensified food cravings and aversions.

The inside story

The fetus is about 8 to 10 inches long, the size of a little bunny, and covered with a protective soft down. Hair begins to grow on head, white eyelashes appear. The fetus' chance of surviving outside the womb is small, but possible in a hospital intensive care unit (ICU).

Sleep/stamina irregularities

Insomnia or disrupted sleep due to problems adjusting to new sleep positions. To ensure maximum blood and nutrient flow to placenta, avoid sleeping on belly or back, curl up on left side with a pillow between legs. Another good month to travel.

Stress Rx

Same as Months 2, 3, 4 & 5. If you work, start planning your maternity leave, if your job is particularly draining, consider an early leave.

Special risks

Same as Months 2, 3, 4 & 5.

When to call your doctor

After the 20th week, call the doctor if you notice an absence of fetal movement for more than 12 hours.

MONTH 7: Weeks 24-28

Possible physical changes

Same as Months 2, 3, 4, 5, & 6. Itchy belly, increased breast tenderness and fetal activity, tingling, pain or numbness in hands, leg cramps.

Possible emotional changes

Decreasing moodiness and absentmindedness, growing interest in learning about pregnancy, childbirth and babies (your pregnancy books are becoming well-worn), increasing pride in swelling abdomen.

Possible appetite changes

Hearty appetite, queasiness.

The inside story

Fetus is 13 inches long, the size of a kitten, weighs 1 3/4 pounds and is covered with thin, shiny skin. Finger and toe prints have formed, eyelids are parted. Fetus could survive outside the womb in an ICU, with high risk of complications.

Sleep/stamina irregularities

See Months 5 and 6. Disrupted sleep because of difficulty finding comfortable positions. Leg cramps can be a problem, try flexing the foot up to stretch out calves.

Stress Rx

Read The Birth Partner by Penny Simkin, FT. (Harvard Common Press, 1989), talk with mothers about their experiences, sign up for childbirth classes. Ask your doctor for referrals.

Special risks

See Month 6. Pregnancy induced hypertension (PIH), "incompetent cervix" (cervix has "silently" dilated and may require a suture to close and/or bed rest), early labor.

When to call your doctor

See Month 6. Extreme swelling, incompetent cervix can cause spotting, often detected only during vaginal exam, steady, painful contractions may signal early labor.

MONTH 8: Weeks 28-32

Possible physical changes

See Months 2, 3, 4, 5, 6, & 7. In addition, shortness of breath, scattered Braxton-Hicks contractions (uterus hardens for about one minute, then returns to normal), clumsiness, leaky breasts, hot flashes, back and leg pain from weight of baby. Varicose veins may begin to appear, support panty hose helps ease discomfort and aching.

Possible emotional changes

Apprehension may increase, but so may joy and wonder at the active little creature doing "bicycle kicks" in your womb.

Possible appetite changes

See Month 7. Drink a lot of water to counteract the fluid lost through your pores (your temperature is higher when you're pregnant).

The inside story

Fetus weighs about 3 pounds, is the size of a small puppy, and has fat stores under skin. May suck thumb, hiccup or cry. Also may respond to pain, light and sound. Could survive outside womb with hospital support, but with substantial risk of complications.

Sleep/stamina irregularities

May feel less or more tired than you have in months. Stretching, aerobic exercise, additional sleep, naps or frequent work breaks can boost your energy. Heartburn may be severe at night--eat at least three hours before bed, sleep on left side and use pillows to prop yourself up. The need to urinate frequently may wake you at night (but don't reduce fluid intake). Discontinue lengthy travel for remainder of pregnancy.

Stress Rx

Continue stretching/exercise program, childbirth classes, network with mothers-to-be concerning day care options, working women start tying up loose ends at the office.

Special risks

Premature labor.

When to call your doctor

Sudden decrease in fetal movement compared to what 's been normal for you, cramps, diarrhea, nausea, severe lower-back pain, pressure in pelvic or groin area, watery vaginal discharge tinged pink or brown, leaking fluid from vagina, burning sensation during urination.

MONTH 9: Weeks 32-36

Possible physical changes

See Months 7 and 8. In addition, strong regular fetal activity, increasingly heavy vaginal discharge, leaking urine, increased constipation, lower-back pain, shortness of breath, more intense and/or frequent Braxton-Hicks contractions.

Possible emotional changes

Anxiety over you and your baby's safety during delivery, excitement that birth is near, "nesting instincts" increase--you may be spending more time shopping for baby items, at this point, you might also be wondering whether the pregnancy will ever end.

Possible appetite changes

See Month 8.

The inside story

Fetus is about 18 inches long and weighs about 5 pounds. Brain growth accelerates, fetus should be able to see and hear. Most other systems are well-developed, although lungs may be immature. Fetus has an excellent chance of survival outside womb.

Sleep/stamina irregularities

See Month 8. You may be unable to sleep now due to shortness of breath. Prop pillows around you, or think about getting a special pregnancy pillow.

Stress Rx

Walking and gentle exercise , childbirth classes, increased intimacy with partner. To ease Braxton-Hicks contractions, lie down and relax, or get up and walk around. Soak in a warm (not hot!) tub. Firm up hospital plans, complete work projects.

Special risks

PIH, premature labor, "placenta previa" (placenta either close to or covering cervical opening), "abruptio placenta" (placenta separates from the uterus).

When to call your doctor

See Months 7 and 8. Painless vaginal bleeding or severe contractions may indicate complications, severe headaches and visual changes, especially if blood pressure has been a problem.

MONTH 10: Weeks 36-40

Possible physical changes

More Braxton-Hicks contractions (up to two or three times an hour), frequent urination, easier breathing, heavy vaginal discharge, decrease in fetal kicking, but increase in rolling, stretching and quiet periods.

Possible emotional changes

Intense excitement, anxiety, absentmindedness, irritability, apprehension, oversensitivity, restlessness, dreaming about baby and motherhood, fear of missing or misinterpreting the signs of labor.

Possible appetite changes

Increase or decrease in appetite, feeling full due to crowded stomach, cravings change or abate.

The inside story

Fetus is 20 inches long, weighs about 7 pounds and has mature lungs. Excellent chance of survival outside womb.

Sleep/stamina irregularities

See Months 8 and 9.

Stress Rx

Pack your overnight bag, including a few familiar items to help you feel more at home in the hospital: hairbrush, perfume, sanitary napkins, this magazine, lowfat munchies for post delivery (to supplement hospital fare), going-home clothes for you and Baby. Continue gentle exercise; water workouts are especially good.

Special risks

See Month 9. Plus, not getting to hospital on time.

When to call your doctor

 (Quick!) Breaking water before labor (occurs in less than 15 percent of pregnancies), increasingly more frequent and intense contractions that are not relieved by changing position, lower-back pain spreading to abdomen and legs, nausea, diarrhea, pink or blood-streaked mucus leaking from vagina, contractions that last 45 seconds and occur more frequently than every five minutes.

MONTH 11

Possible physical changes

Immediately after delivery: sweating, chills, cramping as uterus returns to normal size, fluid retention, exhaustion or fatigue. Up to first week: body soreness, sore, cracked nipples if breastfeeding. Throughout month: discomfort sitting and walking if you've had an episiotomy or a C-section, constipation and/or hemorrhoids, hot flashes, breast tenderness, engorgement.

Possible emotional changes

Elation, depression or both, alternately, fear of being inadequate, feeling overwhelmed by new responsibilities, feeling that postpartum life is anticlimactic.

Possible appetite changes

May feel ravenous if breastfeeding.

The inside story

Enlarged uterus, which shrinks rapidly (especially if you breastfeed), stretched out abdominal muscles, internal organs are returning to original locations.

Sleep/stamina irregularities

Sleepiness, fatigue and/or exhaustion trying to juggle new duties and rest with Baby's erratic sleep schedule. Grab naps whenever your baby sleeps, try to rest and relax during breastfeeding.

Stress Rx

Join new-mothers' exercise and/or stretching classes for moral support and to ease aches and pains, spend plenty of time with baby to help alleviate anxiety or postpregnancy let down, sleep, get help.

Special risks

Infection at incision sites or breasts if breastfeeding, malnutrition if you are breastfeeding and are not getting enough nutrients or calcium, dehydration.

When to call your doctor

After fourth day following childbirth, heavy bleeding with clots at any time during next six weeks, fever, chest pain, pain or swelling in calves or thighs, lump or localized pain in breast, infected incisions, inability to urinate, painful or difficult urination, prolonged depression.

MONTH 12

Possible physical changes

Fatigue, pain in perineum, constipation, gradual loss of weight, noticeable hair loss, achiness in arms, legs and back from carrying Baby.

Possible emotional changes

Elation, blues, deepening love for and pride in your newborn, growing sense of confidence, feeling pressured to return to normal routine even though you may not be physically or emotionally ready, perception of your body more as a source of nurture (and nutrition) for your newborn and less as a source of sexual pleasure, anxiety about leaving newborn with other caregivers.

Possible appetite changes

Slowly returning to prepregnancy diet, appetite Increases if you're breastfeeding.

The inside story

See Month 11.

Sleep/stamina irregularities

See Month 11. May feel less fatigued as you find ways to match your sleep/rest cycles with Baby's. (Some mothers feel that keeping Baby with them at night helps.)

Stress Rx

See Month 11. exercise , practice relaxation techniques, simplify, prioritize, ease back into being sexually active if it feels right for you, firm up daycare arrangement, make plans to return to work.

Special risks

Lingering postpartum depression .

When to call your doctor

Same as Month 11. Call your physician if you experience two or more signs of chronic postpartum depression: inability to sleep, lack of appetite, no interest in yourself or baby, feeling hopeless, helpless, or out of control.