Stages of Pregnancy

Pregnancy will bring many changes to your relationships, your emotions and your body!

Your pregnancy is divided into three trimesters of approximately three months each. Each trimester of pregnancy brings new changes. You will experience different emotions and have different physical signs of advancing pregnancy. Your fetus will grow and develop with each passing month.

Pregnancy may also bring changes to your relationship with your partner. You are both thinking about what it will mean to be a parent. If you have lost a child before or if one of you has recently lost a family member, you may be especially anxious during the pregnancy. It is important to feel love and support to help you cope with these feelings.

Some of the hormonal changes of late pregnancy inspire a woman to begin nesting – preparing a place for her baby. These feelings may be accompanied by a burst of energy. This is a good opportunity for you and your partner to work together to prepare for the baby.

Your sexual relationship with your partner may change during pregnancy. Some couples experience a decrease in their sexual activity during the first trimester of pregnancy, which levels off during the second trimester. Others find that their sex lives improve – that their desire increases, their bodies become more sensitive, and their orgasms more intense. During the third trimester, you may have to be more creative with your sexual activity as your body expands and makes some positions uncomfortable.

First trimester

Second trimester

Third trimester

First Trimester

First Trimester
During the first trimester of pregnancy, you are just learning you are pregnant and coming to terms with both your fears and your hopes for the future. You may have been surprised to find out you were pregnant, and you or your partner may have some ambivalent feelings about the pregnancy. You may also begin to have fantasies and dreams about your child.

Many couples find they are less sexually active in the first trimester. As a result of their fluctuating hormones, fatigue and nausea, some, though not all, women find they are less interested in sex.

During these first three months, you will likely also notice the changes that are happening in your body. Most women will experience some of these physical changes during the first trimester:

missed menstrual periods
breast tenderness
nausea and vomiting, also known as “morning sickness”
urinary frequency
fatigue
increased basal temperature
weight gain
To learn more about how the discomforts you may experience, such as nausea and vomiting, can be treated, click here.

During the first trimester, the embryo, which began as a tiny cluster of cells, becomes a fetus and develops all of the major organ systems. Here is what is happening:

First Month (1-4 weeks)
embryo implants (attaches) to the wall of the uterus and develops rapidly
heartbeat begins on the 25th day
arm buds appear on the 26th day
leg buds appear on the 28th day
digestive system starts to develop
The embryo is 1/5th of an inch long.
Second Month (5-8 weeks)
the face is forming
ears covered by thin membrane, continue developing
spine begins to form
brain, liver, kidneys, bloodstream and digestive system are developing
arms and legs develop
By the end of the second month, the embryo has become a fetus. It is about 1 and 1/8th inches long and weighs 1/30th of an ounce.
Third Month (9-12 weeks)
the fetus' eyelids are fused
facial features are present, the nose and outer ears form
nail beds established
movement, such as head turning or sucking, begins
teeth buds form
all internal organs form
swallows amniotic fluid
The fetus is about three inches long and weighs one ounce. The placenta is fully developed and also weighs about an ounce. One to three ounces of amniotic fluid are present. By two months, a rudimentary umbilical cord has begun to circulate blood and nourishment to the fetus. At 12 weeks, the uterus is just above the pubic bone.

Second Trimester

Second Trimester
During the second trimester, your pregnancy will start to show. You will become more aware of the changes happening to your body. Support and encouragement from your partner and others around you will become more important. For many, morning sickness and fatigue ease up.

Although women’s experiences vary widely, many women find that their desire for sex increases during the second trimester. Increased bloodflow to the sexual organs and breasts, which heightens sensation, and less fatigue and nausea, make many women enjoy sexual activity more during these months.

In the second trimester, you will feel the fetus moving and you will become more aware of its development. You may begin to have vivid dreams about your child.

Expect the following physical changes:

The uterus grows to your navel between 20 and 22 weeks.
You will have colostrum (pre-milk) in your breasts.
Your nipples may begin to get darker and the areolas will get larger.
You may experience changes in the foods your body can digest.
Pressure on the blood vessels in the lower part of your body increases and may result in hemorrhoids, varicose veins and other discomforts.
You may notice your skin changing, particularly on your face. For example, dark splotches may appear on your forehead and cheeks, especially if you are a woman of colour. The medical name for this is chloasma. These will fade after the birth, but may not disappear completely. People may also tell you that you have a “glow” about you – this is caused by your increased hormone levels and increased bloodflow.
During the second trimester, the fetus continues to grow and begins to respond to its environment. This is what is happening:

Fourth Month (13-16 weeks)
strong heart beat begins
lanugo, or fine body hair, develops
At the end of the fourth month, the fetus is about 6 inches long and weighs four ounces.

Fifth Month (17-20 weeks)
heartbeat can be heard with a stethoscope
finger and toe nails form
sucks thumb
responds to noise
grows hair and eyebrows
movements become increasingly vigorous
At the end of the fourth month, the fetus is about ten to twelve inches long (half its length at birth) and weighs eight ounces to one pound.

Sixth Month (21-24 weeks)
eyes are open
a creamy substance, called vernix, covers the skin
skin is wrinkled and the fetus appears very thin
At the end of the sixth month, the fetus is about 11 to 14 inches long and weighs 1½ pounds. The placenta and umbilical cord are now fully developed and continue to increase in size. By the fourth month, eight gallons of blood flows through the placenta each day. More than a pint of amniotic fluid is usually present by the sixth month.

Third trimeseter

Third Trimester
By the third trimester, both you and your partner are anticipating the birth of your child. You may be becoming impatient with your body and feeling vulnerable and dependent on others. During the last part of the third trimester, many women experience a burst of energy and start “nesting” – setting up and preparing their home for a child. Both you and your partner may be feeling excited, as well as somewhat anxious, about the quickly approaching arrival of your baby. You may continue to have vivid dreams about your child, especially if it is your first pregnancy.

Your growing and changing body may make some lovemaking positions uncomfortable; this may be a time to try some new positions. Or you may find that the back pain and other discomforts that many women experience towards the end of the pregnancy make you less interested in sex.

Physically, the third trimester tends to be more uncomfortable. You may experience some of the following:

backache
leg cramps
heartburn
a dark line, called linea nigra, which runs vertically from your belly button to your pubic bone
shortness of breath
the need to urinate frequently
the loss of bladder control when you sneeze or cough
Braxton-Hicks contractions (painless contractions of the uterus)
If you’re concerned about something but not sure whether or not you should call your doctor or midwife, click here.

At 38 weeks, the top of your uterus will have reached your breastbone and you may begin to experience early signs of labour.

During this period, the most dramatic change in the fetus is its continued growth. By the seventh month, it weighs about two and a half pounds, and is approximately 15 inches long. By the eighth month, the fetus weighs about 5 pounds and is 16 to 18 inches long. During the last month of pregnancy the fetus weighs seven or eight pounds and may be more than 20 inches long. In addition:

the fetus’ skin wrinkles become less pronounced as body fat accumulates and begins to smooth out the body
eyes open and close
fetus responds to light
lanugo disappears
fetus stores iron and builds skeleton
The head (or whatever part will be born first) settles into the pelvic canal between 37 and 40 weeks. This is called engagement or lightening. You will likely notice that the fetus' position has changed, which can cause you to feel increased pressure on your bladder.

Miscarriage causes

Miscarriage is caused by the separation of the fetus and placenta from the uterine wall. Although the actual cause of the miscarriage is frequently unclear, the most common reasons include the following:



•An abnormal fetus causes almost all miscarriages during the first three months of pregnancy (first trimester). Problems in the genes are responsible for an abnormal fetus and are found in more than half of miscarried fetuses. The risk of defective genes increases with the woman's age, especially over if she is older than 35 years.
•Miscarriage during the fourth through sixth months of pregnancy (second trimester) is usually related to an abnormality in the mother rather than in the fetus.


◦Chronic illnesses, including diabetes, severe high blood pressure, kidney disease, lupus, and underactive or overactive thyroid gland, are frequent causes of a miscarriage. Prenatal care is important because it screens for some of these diseases.


◦Acute infections, including German measles, CMV (cytomegalovirus), mycoplasma ("walking" pneumonia) and other unusual germs, and severe emotional shock, can also cause miscarriage.


◦Diseases and abnormalities of the internal female organs can also cause miscarriage. Some examples are an abnormal womb, fibroids, poor muscle tone in the mouth of the womb, abnormal growth of the placenta (also called the afterbirth), and multiple gestations that place a stress on your system.


◦Other factors, especially certain drugs, including caffeine, alcohol, tobacco, and cocaine, may be related to miscarriage

Miscarriage Overview
A miscarriage (also termed spontaneous abortion) is any pregnancy that spontaneously ends before the fetus can survive. Any vaginal bleeding, other than spotting, during early pregnancy is considered a threatened miscarriage. Vaginal bleeding is very common in early pregnancy. About one out of every four pregnant women has some bleeding during the first few months. About half of these women stop bleeding and complete a normal pregnancy.



•Threatened miscarriage - Vaginal bleeding during early pregnancy. The bleeding and pain with threatened miscarriage are usually mild and the cervical os (the mouth of the womb) is closed. Your health care provider will be able to determine if the cervical os is open upon performing a pelvic exam. Typically, no tissue is passed from the womb. The womb and Fallopian tubes may be tender.


•Inevitable miscarriage - Vaginal bleeding along with opening of the cervical os. In this situation, vaginal bleeding is present, and the mouth of the womb is open (dilated). Bleeding is usually more severe, and abdominal pain and cramping often occur.


•Incomplete miscarriage - Expulsion of some, but not all, of the products of conception before the twentieth week of pregnancy. With incomplete miscarriage, the bleeding is heavier, and abdominal pain is almost always present. The mouth of the womb is open, and the pregnancy is being expelled. Ultrasound would show some material still remaining in the womb.


•Complete miscarriage - Expulsion of all products of conception from the womb including fetus and placental tissues. Complete miscarriage is just as it sounds. Bleeding, abdominal pain, and the passing of tissue have all occurred, but the bleeding and pain have usually stopped. If you can see the fetus, you have miscarried. Ultrasound shows an empty womb.
A miscarriage occurs when a pregnancy ends without obvious cause before the fetus is capable of survival, typically corresponsing to the twentieth to 22nd week. This time is measured from the first day of your last menstrual period. Miscarriage is a common complication of pregnancy. It can occur in up to 20% of all recognized pregnancies. This ending of pregnancy is called a spontaneous abortion. In the medical field, the term abortion is often used to describe a miscarriage.

Miscarriage Overview
A miscarriage (also termed spontaneous abortion) is any pregnancy that spontaneously ends before the fetus can survive. Any vaginal bleeding, other than spotting, during early pregnancy is considered a threatened miscarriage. Vaginal bleeding is very common in early pregnancy. About one out of every four pregnant women has some bleeding during the first few months. About half of these women stop bleeding and complete a normal pregnancy.



•Threatened miscarriage - Vaginal bleeding during early pregnancy. The bleeding and pain with threatened miscarriage are usually mild and the cervical os (the mouth of the womb) is closed. Your health care provider will be able to determine if the cervical os is open upon performing a pelvic exam. Typically, no tissue is passed from the womb. The womb and Fallopian tubes may be tender.


•Inevitable miscarriage - Vaginal bleeding along with opening of the cervical os. In this situation, vaginal bleeding is present, and the mouth of the womb is open (dilated). Bleeding is usually more severe, and abdominal pain and cramping often occur.


•Incomplete miscarriage - Expulsion of some, but not all, of the products of conception before the twentieth week of pregnancy. With incomplete miscarriage, the bleeding is heavier, and abdominal pain is almost always present. The mouth of the womb is open, and the pregnancy is being expelled. Ultrasound would show some material still remaining in the womb.


•Complete miscarriage - Expulsion of all products of conception from the womb including fetus and placental tissues. Complete miscarriage is just as it sounds. Bleeding, abdominal pain, and the passing of tissue have all occurred, but the bleeding and pain have usually stopped. If you can see the fetus, you have miscarried. Ultrasound shows an empty womb.
A miscarriage occurs when a pregnancy ends without obvious cause before the fetus is capable of survival, typically corresponsing to the twentieth to 22nd week. This time is measured from the first day of your last menstrual period. Miscarriage is a common complication of pregnancy. It can occur in up to 20% of all recognized pregnancies. This ending of pregnancy is called a spontaneous abortion. In the medical field, the term abortion is often used to describe a miscarriage.

Pregnancy tests

Pregnancy Tests
Some women approach the prospect of pregnancy with excitement, others with worry. No matter how you feel about the idea of being pregnant, a pregnancy test may let you know, one way or the other, if you are pregnant.

If you have symptoms of pregnancy such as these, pregnancy testing can confirm your suspicions:

missed period
nausea
breast tenderness
fatigue
Here are answers to some of the most common questions about pregnancy tests.

What is a pregnancy test and how does it work?
Pregnancy tests are designed to tell if your urine or blood contains a hormone called human chorionic gonadotropin (hCG). This hormone is produced right after a fertilized egg attaches to the uterus. This usually happens -- but not always -- about six days after fertilization. If you're pregnant, levels of hCG continue to increase rapidly, doubling every two to three days.

What types of pregnancy tests are available?
Two main types of pregnancy tests can let you know if you're pregnant: urine tests and blood tests.

Urine tests can be done at home or in a doctor's office. Many women first choose a home pregnancy test (HPT), about a week after a missed period. Home pregnancy tests are private and convenient.

These products come with instructions. Follow them closely for the most accurate results. After testing, you can confirm results by seeing your doctor, who can perform even more sensitive pregnancy tests.

Blood tests are done at your doctor's office, but are used less often than urine tests. These tests can detect pregnancy earlier than a home pregnancy test, or about six to eight days after ovulation. But with these tests, it takes longer to get the results than with a home pregnancy test.

Two types of blood pregnancy tests are available:

A qualitative hCG test simply checks to see if hCG is present. It gives a "yes" or "no" answer to the question, "Are you pregnant?" Doctors often order these tests to confirm pregnancy as early as 10 days after a missed period. However, some of these tests can detect hCG much earlier.

A quantitative hCG test (beta hCG) measures the exact amount of hCG in your blood. It can find even very low levels of hCG. Because these pregnancy tests can measure the concentration of hCG, they may be helpful in tracking any problems during pregnancy. They may also be used to rule out a tubal (ectopic) pregnancy or to monitor a woman after a miscarriage when hCG levels fall rapidly


How accurate are pregnancy tests?
You should know that waiting at least a week after a missed period may give you the most accurate result. Results may also be more accurate if you do the test first thing in the morning, when your urine is more concentrated.

Urine home pregnancy tests are about 97% accurate. Blood tests are even more accurate than this.

How accurate a home pregnancy test is depends upon:

How closely you follow instructions
When you ovulate in your cycle and how soon implantation occurs
How soon after pregnancy you take the test
The sensitivity of the pregnancy test


Is it expensive or hard to do a home pregnancy test (HPT)?
You can buy a home pregnancy test in a drugstore without a prescription. The cost depends on the brand. But most tests are relatively inexpensive -- from $8 to $20.

Home pregnancy tests are quick and easy to use. They are also very accurate if you carefully follow directions. These pregnancy tests all work in a similar way. You test the urine in one of these ways:

Hold a stick in your urine stream.
Collect urine in a cup and then dip a stick into it.
Collect urine in a cup and use a dropper to put urine into another container.
With all of these techniques, you need to wait a few minutes before seeing the results. Results may show up as a line, a color, or a symbol such as a "+" or "-" sign. Digital tests produce the words "pregnant" or "not pregnant."

If you have any questions about the pregnancy test or the results, call your doctor or the 800 telephone number listed with the home pregnancy test.

What do the pregnancy test results mean?
It's important to know what a positive or negative result means.

If you get a positive result, you are pregnant. This is true no matter how faint the line, color, or sign is. If you get a positive result, contact your health care provider right away.

In very rare cases, you can have a false-positive result. This means you're not pregnant but the test says you are. You could have a false-positive result if blood or protein is present in your urine. And certain drugs, such as tranquilizers, anti-convulsants, or hypnotics, may also cause false-positive results.

If you get a negative result, you are likely not pregnant. However, you may still be pregnant if:

The test is past its expiration date.
You took the test the wrong way.
You tested too soon.
Your urine is too diluted because you consumed large amounts of fluid right before the test.
You are taking certain medications, such as diuretics or antihistamines.
If you get a negative pregnancy test result, try retesting within about a week. Some home pregnancy tests suggest doing this regardless of your results. If you turn out to be pregnant, your earlier negative test is considered a false-negative result.

What if you get two different results? Call your doctor. A blood test is a good idea to confirm results.