For more information, call: 573-331-3000
pregnancy_stages_

Stages

Every newborn is a blessing, and every birth is unique. Part of our goal at the Family BirthPlace is to encourage your family members to participate throughout your entire pregnancy. Pregnancy, labor, and delivery are part of a major life change, and the process can be filled with anticipation, questions, and concerns. We’re here to offer pregnancy advice and support along the way.

Here’s what you can expect during each stage of pregnancy, labor, and delivery.

First Trimester (1–14 Weeks)

During the first three months of pregnancy (or the first trimester), your body goes through many changes as it adjusts to your growing baby.

Physical Symptoms:

  • Absence of menstrual period
  • Feeling tired and sleepy
  • Frequent urination
  • Heartburn, indigestion
  • Food aversions and cravings
  • Constipation
  • Nausea with or without vomiting
  • Gas, bloating
  • Breast changes

Emotional Symptoms:

  • Mood swings
  • Weepiness
  • Irritability
  • Misgivings and fear
  • Joy

First Trimester Care and Changes

Vitamin Intake: Taking the vitamins ordered by your doctor is extremely important. The vitamins may cause your stool to be darker, and you may have problems with constipation. If you experience these problems, talk to your doctor. Do not take any medications (including over-the-counter medications) without asking your doctor.

Exercise: Continue your usual physical and household activities. Walking is great exercise that requires no training or equipment. We also suggest swimming in shallow water (that is neither hot nor cold), riding a stationary bike, (at a comfortable speed and tension) and performing exercises especially designed for pregnant women. You should now begin pelvic toning (Kegel exercises) and relaxation exercises daily.

Diet: During the first trimester, you need to consume an extra 300 calories each day.

Sexual Relations: Most experts agree sex and orgasm during a low-risk pregnancy are safe. Sexual relations are important to a marriage or relationship, so here are our recommendations:

  • Emphasize love rather than love making
  • Frequency is less important than quality
  • Stay rested; get your sleep
  • Try new positions if you are uncomfortable

If you have a history of miscarriage or signs of a threatened miscarriage, your doctor may recommend some restrictions.

Common Concerns

Fatigue: Take care of yourself and let others help you. Try to get more sleep and eat a proper diet. Check your work and home environment for poor ventilation, poor lighting, or excessive noise that add to fatigue.

Mood Swings: Avoid sugar, chocolate, and caffeine. Proper diet, rest, sleep and exercise may help.

Morning Sickness: Eat a high-complex-carbohydrate diet; drink plenty of fluids; take your vitamins; and try to avoid the sight, smell, and taste of foods that make you queasy. Try eating crackers 20 minutes before rising in the morning, and get up slowly. Brush your teeth or rinse after each bout of vomiting. Minimize stress and practice relaxation techniques. Sea-Bands (bands worn on the wrist for motion sickness) are available at drug stores and may offer some relief.

Excessive Saliva: Also called ptyalism, an excessive flow of saliva is common and harmless. Frequent brushing and rinsing with a mint-flavored toothpaste or mouthwash and chewing sugarless gum may help.

Frequent Urination: This condition is caused by an increase in body fluid and pressure from your growing uterus. Lean forward when you empty your bladder.

Headaches: Your increasing hormone levels may lead to headaches. Try to relax, seek quiet places, get enough rest, eat regularly, don’t get overheated, and stay away from unventilated areas. Alternately apply hot and cold compresses to the aching area every 30 seconds. And stand tall: slouching and looking down causes headaches.

Breast Changes: Your breasts will enlarge and become very tender due to your increased hormone levels. The areola (dark area around nipple) will darken, and you may notice little bumps, which are tiny glands. The veins become more visible. Increased weight from your enlarged breasts may cause some back discomfort that a well-fitted support bra can help alleviate.

Gas and constipation: Constipation, which is common during pregnancy, can cause gas and bloating, so eat less and more often. You can cut down on constipation by drinking warm liquids in the morning, developing a regular bathroom schedule, drinking more fluids, and eating more fruits and vegetables. It is important to avoid gas-producing foods.

Warning Signs

Warning signs of a potential problem or miscarriage during the first trimester may include mild cramps or spotting. Lie down and rest if this occurs. Spotting is common during pregnancy—especially around the time you would normally expect your period. If pain increases and bleeding is similar to your period, contact your healthcare provider.

If you experience any of the following signs, go to the Level III Emergency and Trauma Center at Saint Francis Medical Center:

  • Heavy vaginal bleeding with cramps or pain in the center or one-side of your lower abdomen
  • Pain that continues for more than a day, even if there is no bleeding
  • Passing clots or grayish-pink material
  • A temperature more than 100 F and no flu symptoms, or a temperature that lasts more than one day

Second Trimester (15–27 Weeks)

During your second trimester of pregnancy, you will feel better and your growing baby will not cause you discomfort. Every three weeks, you should meet with your doctor to test your weight, blood pressure, and urine; measure the height of your uterus; check your baby’s heart rate; and check for signs of swelling.

Your doctor may order special tests (such as a sonogram) to determine the size, age, and growth of your baby. A sonogram is a painless test used to locate the placenta (afterbirth) and is not harmful to your baby. A fetal activity test (FAT) monitors your baby’s heart rate and movements. We will perform your FAT and sonograms at Saint Francis Medical Center.

Physical Symptoms:

  • End of or decrease in nausea and vomiting, and a decrease in urinary frequency
  • Fatigue, constipation, heartburn, indigestion, and gas
  • Breast enlargement, though they will be less tender
  • Slight whitish vaginal discharge
  • Occasional lightheadedness, dizziness, nasal congestion, nosebleeds, bleeding gums, increase in appetite, mild swelling of ankles and feet, swelling of the hands and face, varicose veins, and hemorrhoids
  • Fetal movement, backache, skin pigmentation changes, and increased pulse rate
  • Dropping things

Emotional Symptoms:

  • Mood swings (less severe)
  • Joy and/or fear as you become more aware of your pregnancy
  • Frustration and boredom
  • Forgetfulness or having problems concentrating

Second Trimester Care and Changes

Exercise: Exercise is still important, but do not exhaust yourself. Walking is one of the best choices, so take a daily walk at a comfortable rate if weather permits. Keep up your Kegel exercises as well as pelvic rocking. Maintain correct posture.

Diet: Eat smaller but more frequent meals. Fresh fruits and vegetables should help you maintain regular bowel movements. Increase your fluids.

Common Concerns

Breathlessness: This is due to an increased level of hormones in your body. As your pregnancy advances, your uterus pushes up against your diaphragm.

Forgetfulness: Forgetting an appointment, losing things and having problems concentrating are normal and temporary. Recognize these problems as a normal part of pregnancy and try to reduce your stress. Keep a good sense of humor—and checklists.

Hair Dyes and Perms: It is best to avoid hair dyes and/or perms during your pregnancy. If you are concerned about gray hair, try a pure vegetable coloring.

Nasal Stuffiness: Nasal stuffiness often occurs with pregnancy. If pollen affects you, drink more fluids and stay indoors with a filtered air conditioner. Avoid animals and dust. Nosebleeds may occur. Try applying Vaseline in each nostril, squeeze your nose for a few seconds, and apply a cold cloth. Use a vaporizer or humidifier.

Vaginal Discharge: A thick, milky, mild-smelling discharge is normal throughout pregnancy. Do not douche unless prescribed by your doctor. If the discharge is yellowish, greenish, or thick and cheesy; has a foul odor; or is accompanied by burning, itching or soreness, you likely have an infection. Notify your doctor for treatment. Good hygiene habits, a good diet, and avoiding refined sugar can hasten your recovery.

Fetal Movement: Fetal movement indicates your baby is healthy and active. The first time your baby moves can be very exciting and usually occurs between 14 and 22 weeks. By 23 or 24 weeks of pregnancy, fetal movement is well established. Your doctor will ask you about your baby’s activity at your appointments. As your pregnancy progresses, try to be very aware of your baby’s movements.

Appearance: You will obviously look pregnant and may find loose clothing or maternity clothes are more comfortable.

Advice: Everyone has advice for an expecting mother, including your mother, mother-in-law, family, and friends. Your doctor, childbirth educator, and nurse are your best resources.

Fatigue: Your body is working harder. Slow things down but do not stop. Make sure to monitor your activities and exercise. Try sleeping on your left side with a pillow between your legs. A good night of sleep and an afternoon nap are the best medicine for fatigue.

Backache: Your growing uterus is placing more pressure on your lower back, so good body mechanics are important—and watch your weight gain. Also, do not wear high heel shoes and avoid heavy lifting. Try to relax, and have your partner massage your back.

Sore feet: As your pregnancy advances, your feet may become slightly larger. Wear comfortable shoes with low heels. Foot massages will also help.

Travel: Check with your doctor before making plans, and make sure to carry a copy of your obstetrical history if you travel. Don’t sit for a long time. Eat a good diet and drink plenty of fluids. If you must travel outside the country, drink bottled water and avoid uncooked foods.

Dental Problems: Your gums may be swollen and bleed. Floss and brush regularly, and attend to any other dental problems.

Itchy Abdomen: Pregnant bellies become itchier as the months progress. Try not to scratch. Ask your doctor to prescribe a lotion that may help.

Overheating: During pregnancy your metabolic rate is higher, so you feel warmer. Bathe often, use a good antiperspirant, and dress in layers so you can remove some clothing if you feel warm.

Premature labor: Premature labor is when labor starts before week 36 of your pregnancy. If premature labor is not stopped, it will result in the birth of a baby who is too small and may have difficulty breathing. There are many factors that can increase the risk of premature labor:

  • Smoking: Stop now.
  • Alcohol and Drugs: Avoid completely. Do not take any medications, including over-the-counter medicines, without the approval of your doctor.
  • Infection: Reduce your risk of infection by staying away from crowds. Don’t hold your urine, as it may increase your risk of infection.
  • Incompetent Cervix: This is when the cervix opens prematurely. If undiagnosed, it can lead to a late miscarriage or early labor. If diagnosed, you can avoid premature labor by having your cervix sutured closed around week 14.
  • Heavy Physical Work: Premature labor may be caused by heavy work and standing too long. Avoid these activities.
  • Poor Diet and Poor Weight Gain: Women who do not eat well and do not have an adequate weight gain are at risk for premature labor.
  • Previous Premature Labor: If you have a history of premature delivery, abstain from sex during the last two to three months of pregnancy. If you think you are having premature labor, contact your doctor immediately. After 20 weeks of pregnancy, all emergency care is provided at the Saint Francis Family BirthPlace. Go there immediately.

Premature Rupture of Membranes: When the bag of water surrounding your baby breaks or starts to leak before 37 weeks, it is referred to as premature rupture of membranes. The membranes serve as protection against infection for your baby. Signs of premature rupture include any leakage, a sudden rush of fluid, a small tickle or if you feel wet. Do not wait for labor or hope it will stop. Come to the Saint Francis Family BirthPlace immediately. Infection can happen quickly, harming you and your baby.

Urinary Tract Infections: If you have any of these symptoms, see your doctor immediately:

  • A feeling you have to urinate all the time
  • A burning sensation when you pass urine
  • Only passing a drop or two of urine
  • Sharp lower abdominal pain
  • Elevated temperature

To prevent urinary tract infections:

  • Drink lots of water, unsweetened citrus or cranberry juice
  • Avoid coffee, tea (even decaffeinated) and alcohol
  • Do not hold your urine
  • Take your time, lean forward to help empty your bladder
  • Wear cotton or cotton-lined panties
  • Don’t wear tight pants or pantyhose under your pants
  • Sleep without panties
  • Avoid perfumed soaps, sprays or powders
  • Wipe from front to back
  • When taking antibiotics, eat unsweetened yogurt or frozen yogurt, which contain active cultures that help protect against getting a urinary tract infection
  • Get plenty of rest and sleep
  • Do your relaxation exercises and avoid stress

Warning Signs

Warning signs of a potential problem during the second trimester of pregnancy may include:

  • A gush or steady leaking of fluid from the vagina
  • Pain or burning when urinating and/or fever more than 101 F
  • Vision problems, blurring
  • Severe headache for more than 2 to 3 hours
  • Swelling or puffiness of hands and face, especially with a headache
  • Sudden weight gain if you haven’t overeaten
  • Coughing up blood

If you experience any of these signs before your 20th week, go to the Level III Emergency and Trauma Center at Saint Francis Medical Center. After 20 weeks, go directly to the Saint Francis Family BirthPlace.

Third Trimester (28–40 Weeks)

During the third trimester of pregnancy, you will visit the doctor every two weeks and then once a week beginning at week 36. Visits will include weight, blood pressure, and urine testing; measuring the height of the uterus, the size/position of your baby, and the baby’s heart rate. We will also be checking for signs of swelling and asking about Braxton Hicks contractions. At 36 weeks your doctor will perform blood work, an internal examination and repeat cultures.

Physical Symptoms:

  • Fatigue (report extreme fatigue to your doctor, as it may be a sign of anemia)
  • Changes in fetal movement; more squirming due to less room
  • Increase in whitish discharge
  • Lower abdominal ache
  • Constipation
  • Occasional headaches and nasal congestion
  • Occasional nosebleeds and bleeding gums
  • Leg cramps and backache
  • Discomfort and achiness in the buttocks and pelvic area
  • Mild swelling of the ankles and feet
  • Varicose veins and hemorrhoids
  • Shortness of breath
  • Difficulty sleeping
  • Braxton Hicks contractions
  • Clumsiness
  • Colostrum
  • Loss or gain of appetite

Emotional Symptoms:

  • Increased apprehension and irritation
  • Absentmindedness
  • Increased dreaming, fantasizing and boredom
  • Feeling tired may or may not increase as you carry more weight
  • Trouble sleeping (try sleeping on your left side with a pillow between your legs)

Third Trimester Care and Changes

Exercise: There are several exercise programs for expecting and post delivery mothers. Your doctor can suggest some, but you’ll need to know your own limitations. This is not the time to start an exercise program if you have never exercised before. Try walking.

Diet: A balanced diet is still key. Frequent, smaller meals will make you feel more comfortable. After your baby drops, you will experience less stomach discomfort. Before labor begins, many mothers actually lose weight or stop gaining.

Sexual relations: If you have a normal pregnancy you can have sex, but you may have to look for a more comfortable position. It’s normal to lose temporary interest in sex. If you have risk factors for premature labor, have any bleeding or are carrying multiples, sex may be restricted. Check with your doctor.

Regular activities: Continue with your activities of daily living, as long you do not tire. Take rest periods throughout the day. Get off your feet, raise your legs, listen to relaxing music or take a nap. Slowly decrease the amount of bending, lifting, stooping and pushing you do as your pregnancy advances. Avoid carrying heavy laundry baskets and groceries, especially in your last trimester. Keep yourself hydrated by drinking lots of fluids, especially in warmer weather. By taking care of yourself you are taking good care of your baby.

Common Concerns

Swelling (Edema): Swelling is very common late in your pregnancy, especially in the evenings, during warm weather and after standing or sitting for a long time. Most swelling disappears overnight or if you lie down for a long time. Prevent swelling by wearing comfortable shoes, avoiding elastic-top socks and stockings, and wearing support hose. Fluids to help flush out wastes and avoiding excessive salt should help control swelling. If swelling lasts more than 24 hours with a rapid weight gain, headaches, or vision problems, see your doctor.

Safety: Your balance is poor because your center of gravity keeps shifting and your joints are less stable. Daydreaming may cause accidents. Be careful and report any falls to your doctor. If you notice vaginal bleeding, leaking fluid, abdominal tenderness or uterine contractions, come directly to the Saint Francis Family BirthPlace.

Hiccups: Believe it or not, your baby can get hiccups while in the womb. Don’t panic. This will not hurt your baby.

Backache: The pressure of your growing uterus can affect the sciatic nerve, causing low back, buttock and leg pain. Get off your feet, lie down, rest and relax. Warm compresses may reduce pain.

Dreams and Fantasies: Dreams give clues into your feelings that can help you with your transition to motherhood. You can expect them during your last trimester. They can be both horrifying and pleasant and occur during the day and night. Each dream and fantasy may express one or more of these concerns:

  • Being unprepared, losing things, forgetting things
  • Being attacked or hurt by intruders/animals or falling
  • Gaining too much weight, forgetting to drink milk
  • Losing appeal, not being attractive
  • Sexual encounters, both positive and negative, pleasure or guilt provoking
  • Death, loss, resurrection
  • What your baby will be like

Stress Incontinence: The pressure of your growing uterus on your bladder can cause stress incontinence (leaking urine when you laugh, cough or sneeze). Kegel exercises may help prevent incontinence.

Braxton Hicks Contractions: These contractions are usually painless but may be uncomfortable because of the tightening of your uterus. They become more frequent as you get closer to delivering. Changing your position may stop them completely. Try lying down and relaxing or getting up and walking. Report these contractions to your doctor if they are very frequent, are accompanied by pain or unusual vaginal discharge, or if you are at high risk for premature labor.

Bathing: Tub bathing is safe in normal pregnancies until your membranes rupture or the mucous plug is expelled. Safety is most important. Make sure someone is available to help you in and out of the bathtub. When showering, make sure there is a nonslip surface to help prevent falls.

Lightening (engagement): This is when your baby drops into the pelvis. With a first pregnancy, this usually happens two to four weeks before delivery. In women who already have had children, it rarely occurs until they go into labor. Your belly seems lower and tilted forward and you can breathe easier. There is less discomfort when you eat but more pressure on your bladder. Your center of gravity shifts again, and you may feel off balance, so be cautious.

Urinary Tract Infections: If you have any of these symptoms, see your doctor immediately.

  • A feeling you have to urinate all the time
  • A burning sensation when you pass your urine
  • A small amount or only drops of urine
  • Sharp lower abdominal pain
  • Elevated temperature
  • Blood in your urine

Prelabor Symptoms:

  • Lightening (engagement)
  • Sensation of increased pressure in the pelvic and rectum area
  • Loss of weight or cessation of weight gain
  • Change in energy level (energy spurts, nesting instinct)
  • Change in vaginal discharge, loss of mucous plug, pink or bloody show
  • Braxton Hicks contractions increase
  • Diarrhea

False Labor Symptoms:

  • Contractions are not regular and do not get longer or stronger
  • Pain is in your lower abdomen rather than your lower back
  • Contractions stop if you walk around or change positions
  • Fetal movements increase briefly with contractions (A lot of activity or movement could mean your baby is in distress and you should see your doctor.)

Real Labor Symptoms:

  • Contractions get longer, stronger and closer together and get stronger when you change positions or activity
  • Pain begins in the lower back and spreads to the lower abdomen and may radiate to your legs
  • Pinkish or blood-stained show is present
  • Before labor begins, membranes may rupture in a gush or a trickle.

Warning Signs

Warning signs of a potential problem during the third trimester of pregnancy include bleeding and spotting. The answers to “Is it time to have my baby?” and “Is something wrong?” depend upon the type of bleeding. Pinkish-stained or red-streaked mucous appearing soon after sex or vagina examination or brownish spotting 48 hours later is normal and not a warning sign, but you should report it to your doctor. Bright red bleeding or persistent spotting needs immediate attention. Come to the Saint Francis Family BirthPlace. Pinkish or brownish tint or bloody mucous along with contractions could mean labor is starting.

Signs of premature labor (labor pains before 37 weeks) include:

  • Menstrual-like cramps with or without diarrhea, nausea or indigestion
  • Lower back pain or pressure
  • An achiness or pressure in the pelvis, thighs or groin
  • A watery or brownish discharge or passage of a thick gelatin-like plug (mucous plug)
  • A trickle or gush of fluid (rupture of membranes)

If you think your membranes have ruptured, go to the Saint Francis Family BirthPlace immediately. If you have leakage, trickles, a sudden gush or feel very wet, you must see your doctor. Infection can happen quickly and can harm you and your baby.

Warning signs during late pregnancy include:

  • Heavy vaginal bleeding
  • A gush or steady leaking of fluid
  • Painful burning when urinating and/or temperature more than 100.4 F
  • Blurred vision
  • Severe headache for more than 2 or 3 hours
  • Swelling or puffiness of hands and face, especially with a headache
  • Sudden weight gain
  • Coughing up blood

Contact

To learn more about how the Family BirthPlace at Saint Francis Medical Center supports mother and baby through all pregnancy stages, call 877–231-BABY (2229).