Different Stages of Pregnancy and What to Expect

In India, getting pregnant and giving birth are most celebrated milestones in a woman’s life.
Pregnancy, specifically in India, is very important event due to its connection with our history, culture,
religious beliefs and mythology.

However, Pregnancy, being one the most scientifically complicated process in human life, has its own
sets of questions and concerns in the mind of every woman. This article is to give an overview of
Pregnancy lifecycle and address the day to day concerns.

Stages of Pregnancy:

What really happens during the nine golden months in women’s life?

A normal pregnancy lasts for 40 weeks from the first day of your last menstrual period (LMP) to the
birth of the baby. The 9 months of pregnancy are divided into three stages, called trimesters:

  • First trimester – from conception to 12th week
  • Second trimester – from 13th week to 28th week
  • Third trimester – from 29th week to child birth

Stages of Pregnancy, Fetal Growth

First trimester: (from conception to 12th week)

Early Changes in a Woman’s Body – A missed period would most likely be the first noticeable thing in
a pregnant woman. A woman will experience a lot of symptoms during her first trimester as she
adjusts to the hormonal changes of pregnancy, which affect nearly every organ in her body. The
pregnancy may not be showing much on the outside of her body, but inside many changes are taking
place. Some of these noticeable physical and emotional changes during the first trimester are as follows.

  • Extreme fatigue or weakness
  • Tender and swollen breasts and changes in the Nipples.
  • Nausea with or without vomiting (morning sickness)
  • Cravings or dislike to certain foods, loss of appetite
  • Headache
  • Heartburn
  • Constipation
  • Frequent urination
  • Weight gain or loss
  • Emotional changes may range from weepiness, mood swings, anxiety, and excitement

Changes in a Woman’s Daily Routine – Some of the changes that you experience in your first trimester
may cause you to revise your daily activities. You may feel the need to go to sleep early or eat more
frequently or eat smaller portion of meals. Some women experience a lot of discomfort, and others
may not feel any at all. Each pregnancy is unique and even if you’ve been pregnant before you may
feel completely different with each subsequent pregnancy.

The baby development – the first trimester is the most important phase of a baby’s development.

At 8 weeks – The embryo begins to develop into a fetus:

  • All major organs have begun to form.
  • The baby’s heart begins to beat.
  • The arms and legs grow longer.
  • Fingers and toes have begun to form.
  • Sex organs begin to form.
  • The face begins to develop features.
  • At the end of 8 weeks, your baby is a fetus, and is nearly 1 inch long.

The end of the first trimester is at about week 12, at this point in your baby’s development:

  • The nerves and muscles begin to work together. Your baby can make a fist.
  • The external sex organs show if your baby is a boy or girl.
  • Eyelids close to protect the developing eyes. They will not open again until week 28.
  • Head growth has slowed and your baby is about 3 inches long

Second trimester: (from 13th week to 28th week)

Changes a Woman May Experience – Once you enter the second trimester you may find it easier than
the first. the second trimester is generally more comfortable phase of pregnancy with lesser
complications. Your nausea/ vomiting (morning sickness) and fatigue/weakness may lessen or go
away completely. However, you will also notice more changes to your body. That “baby bump” will start to show as your abdomen expands with the growing baby. By the end of the second trimester, you will even be able to feel your baby move and also the first baby kick somewhere after the 18th
week!

Physical and Emotional Changes in a Woman – Some changes you may notice in your body in the
second trimester include:

  • Back, abdomen, groin, or thigh aches and pains
  • Stretch marks on your abdomen, breasts, thighs, or buttocks
  • Darkening of the skin around your nipples
  • A line on the skin running from belly button to pubic hairline
  • Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. This is sometimes called the mask of pregnancy
  • Numbness of hands
  • Itching on the abdomen, palms, and soles of the feet.
  • Swelling of the ankles, fingers, and face.

The 20th week generally marks the halfway point of a woman’s pregnancy. You can plan to take a
“baby-moon” — a mini-vacation or weekend getaway — during the second trimester, as it is
considered the best time to travel. A woman is generally feeling pretty good at this point, there’s a
lower risk of miscarriage and premature labor.

The baby development –

The Baby at 16 Weeks:

  • Skin begins to form and is nearly translucent.
  • Your baby begins sucking motions with the mouth (sucking reflex).Your baby is more active. You might feel movement or kicking.
  • Your baby is covered by fine, feathery hair called lanugo and a waxy protective coating called
    vernix.
  • Eyebrows, eyelashes, fingernails, and toenails have formed. Your baby can even scratch itself.
  • Your baby can hear and swallow.

The Baby at 24 Weeks:

  • Footprints and fingerprints have formed.
  • Hair begins to grow on your baby’s head.
  • The lungs are formed, but do not yet work.
  • Your baby has a regular sleep cycle.

Third trimester: (from 29th week to child birth)

Changes a Woman May Experience – The third trimester is the final stage of pregnancy. Discomforts
that started in the second trimester will likely continue, along with some new ones. As the baby grows
and puts more pressure on your internal organs, you may find you have difficulty breathing and have
to urinate more frequently. This is normal and once you give birth these problems should go away.

Physical and Emotional Changes in a Woman – Some changes you may notice in your body in the third
trimester include:

Child's Growth During Pregnancy

 

  • Swelling of the ankles, fingers, and face.
  • Haemorrhoids/piles
  • Tender breasts, which may leak a watery pre-milk called colostrum
  • Your belly button may protrude
  • The baby is moving towards lower part of your abdomen
  • Contractions, which can be sometimes a sign of false labour
  • Shortness of breath, heartburn, and difficulty sleeping

The baby development –

The baby at 32 weeks:

  • Movements and kicking increases.
  • The eyes can open and close.
  • Your baby is gaining about 200 grams a week and weighs about 1.8 – 2 Kgs

The Baby at 36 Weeks:

  • Body fat increases.
  • Your baby is getting bigger and has less space to move around. Movements are less forceful,
    but you will still feel them.
  • Your baby weighs about 2.5 to 3 Kgs.

The Baby at 37 to 40 Weeks:

  • By the end of 37 weeks, your baby is considered full term.
  • Your baby’s organs are capable of functioning on their own.
  • As you near your due date, your baby may turn into a head-down position for birth.

Diet During Pregnancy

 

Diet During Pregnancy

What to eat and what not to eat?

Pregnancy brings in a lot of emotions. Every one you meet has a piece of advice to give you
regarding what you should do and what you should eat. This brings in even more confusion. This
Indian diet plan for pregnancy will help you clear the air a bit.

What you eat will play a crucial role in your unborn baby’s growth and development. The key to
good nutrition during pregnancy is balance. It is important to eat right types of food in right quantity.
Here are a few food groups to include in your everyday diet.

Milk and Milk Products: This group is a major source of protein, calcium, phosphorus and vitamins.
Dairy products are one of the best sources of calcium and your body needs a lot of it during
pregnancy. Cheese, milk, yogurt and paneer are excellent foods for pregnancy.

Meat, Poultry, Fish, Eggs and Nuts: These foods provide protein, iron and zinc. There is an increased
demand for protein particularly in the second half of pregnancy.

Pulses, Dals, Cereals, Nuts and Wholegrains: If you are not a meat eater, include Pulses, Dals,
Cereals, Nuts and Wholegrains to make up for body’s extra requirement of protein.

If you are a vegetarian, you will need about 45 gms of Nuts and 2/3 rd cups of pulses each day. This
group provide complex carbohydrates (starches), an important source of energy, in addition to
vitamins, minerals and fibre.

Fruits: This group provides Important nutrition during pregnancy like vitamins A and C, potassium
and fibre. Fruits such as oranges, grapefruit, melons and berries are the best sources of Vitamin C. It
is advisable to eat three or more servings of fruit a day.

Vegetables: One should have raw, leafy vegetables like spinach (palak) and other vegetables like
carrots (gajar), sweet potatoes (shakarkand), corn (makka), peas (matar) and potatoes. These foods
contain vitamins A and C, folate, and minerals such as iron and magnesium. They are also low in fat
and contain fibre, which helps to alleviate constipation.

Fats, Oils and Sweets: Use sparingly, since these products contain calories, but few vitamins or
minerals. Fats should not make up more than 30 percent of your daily calories. Try to select low-fat
foods.

Iron-Rich Foods: Pregnant women need 27 milligrams of iron a day, which is double the amount
needed by women who are not expecting. Getting too little iron during pregnancy can lead to
anaemia, a condition resulting in weakness and an increased risk of infections.

For better absorption of the mineral, include a good source of vitamin C at the same meal when
eating iron-rich foods. Food sources for iron are meat, raisins, prunes, beans, poultry, soy products
and spinach. Foods rich in vitamin C – citrus fruits, potatoes and broccoli.

Folic Acid: Folic acid, also known as folate when found in foods, is a B vitamin that is crucial in
helping to prevent birth defects in the baby’s brain and spine, known as neural tube defects. It may
be hard to get the recommended amount of folic acid from diet alone. It is recommended that women who are trying to have a baby should take 400 micrograms of folic acid per day for at least one month before becoming pregnant. Food sources for folic acid are leafy green vegetables, fortified or enriched cereals, breads and pastas.

Calcium: is a mineral used to build a baby’s bones and teeth. If a pregnant woman does not consume
enough calcium, the mineral will be drawn from the mother’s stores in her bones and given to the
baby to meet the extra demands of pregnancy. Many dairy products are also fortified with vitamin D,
another nutrient that works with calcium to develop a baby’s bones and teeth. Pregnant women needs
1,000 milligrams of calcium a day. Food sources for milk, curd, cheese, fruits and vegetables, and fish.

Protein: More protein is needed during pregnancy, but most women don’t have problems getting
enough of these foods in their diets. Protein is described as “a builder nutrient,” because it helps to
build important organs in the baby. Food sources for Protein are pulses, milk & milk products, soya,
meat, fish, beans and peas, eggs, nuts.

Foods to limit: Consumption of Caffeine, sugary drinks, fast food and certain categories of fish
containing high levels of mercury should be limited.

Foods to avoid: Consumption of alcohol, smoking tobacco and unpasteurised food, for ex. raw meat,
raw milk, should be avoided.

Pregnancy Diet Misconceptions:

Morning sickness: When a mother-to-be is experiencing morning sickness, the biggest mistake she
can make is thinking that if she doesn’t eat, she’ll feel better. And the phrase Morning sickness is
definitely not happening only in the morning, It’s any time of day. It is advisable to eat small
amounts of foods that don’t have an odour, since smells can also upset the stomach.

Food cravings: It is common for women to develop a sudden urge or a strong dislike for a food
during pregnancy. Some common cravings are for sweets, salty or spicy foods. This food craving is a
body’s way of saying it needs a specific nutrient, such as more protein or additional liquids to quench
a thirst, rather than a particular food.

Eating for two: When people say that a pregnant woman should “eat for two”, it doesn’t mean she
needs to consume twice as much food or double her calories. It is advisable to add just 300 calories
to her usual dietary intake.

Weight Gain During Pregnancy

Weight Gain During Pregnancy

Weight gain during pregnancy is a continuous process over the nine months. It’s hard to measure
where pregnancy weight is going whether the KGs are going to a woman’s body fat, baby weight or
fluid gains.
When it comes to pregnancy weight gain, women should look at the big picture: During regular
prenatal check-ups, focus on that the baby is growing normally rather than worrying about the
number on a scale.

The total number of calories needed per day during pregnancy depends on a woman’s height, her
weight before becoming pregnant, and how active she is on a daily basis. In general, underweight
women need more calories during pregnancy; overweight and obese women need fewer of them.

Various global guidelines for total weight gain during a full-term pregnancy recommend that:

  • Underweight women, who have a Body Mass Index (BMI) below 18.5, should gain 12 to 18 Kgs
  • Normal weight women, who have a BMI of 18.5 to 24.9, should gain 11. to 16 Kgs
  • Overweight women, who have a BMI of 25.0 to 29.9, should gain 7 to 11 Kgs).
  • Obese women, who have a BMI of 30.0 and above, should gain 5 to 9 Kgs

Exercise During Pregnancy

 

Exercise During Pregnancy

Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel
your best. Regular exercise during pregnancy can improve your posture and decrease some common
discomforts such as backaches and fatigue. There is evidence that physical activity may prevent
gestational diabetes (diabetes that develops during pregnancy), relieve stress, and build more
stamina needed for labour and delivery.

Doctors generally recommend 30 minutes or more of moderate exercise per day, unless you have a
medical or pregnancy complication.

Most exercises are safe to perform during pregnancy, as long as you exercise with caution and do
not overdo it. The safest and most productive activities are swimming, brisk walking, indoor
stationary cycling, step or elliptical machines and Yoga.

However, if you have a medical problem, such as asthma or heart disease, or diabetes, exercise may
not be advisable. Exercise may also be harmful if you have some pregnancy-related conditions such
as bleeding, spotting, threatened or recurrent miscarriage, previous premature births or history of
early labour, etc. It is always advisable to discuss with your doctor before beginning any specific
exercise program.

Notice to reader – the reader is informed that this article is for informational purposes only, and is not meant to
offer medical advice. If at any stage of Pregnancy, the patient feels uncomfortable, she should visit her doctor
for consultation.

Dr. Shweta Upadhyay

 

 

 

 

 

 

 

 

Dr. Shweta Upadhyay

Consultant Gynaecologist, SSD Hospital

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