Trimester One

Your mind is reeling with the newness of it all and questions abound. What can you do to build a healthy baby? Is it normal to have all these different feelings? What does your little guy look like growing in there? Here is a guide to your pregnancy, one trimester at a time.

So you’re going to be a mom. The first 13 weeks are all about adjustment: you’re getting used to the idea of that little being developing inside you, while your body is adapting to the demands of building that baby. No wonder you’re so tired!

MOOD SWINGS
Mood swings are completely normal. Not only are your hormones going crazy, but the prospect of parenthood may be a bit overwhelming. You’re also probably worried about birth defects and other problems. Reality check: you’ve got a 97 per cent chance of having a healthy baby. Then there’s the humbling experience of watching your brain fly right out of the window. Whether it’s due to those pesky hormones or to a preoccupation with your growing baby, “pregnancy brain” is common. So don’t be surprised if you put your car keys in the microwave and a cup of tea in your handbag.

WHAT TO AVOID

• Acne medication
  Steer clear of all oral and topical treatments that contain vitamin A or its derivatives, such as Accutane, Retin-A and Renova. High doses of this vitamin can cause severe birth defects in your developing baby.
  
  
• Alcohol
  Since no amount of alcohol has been proven safe during pregnancy, it is recommended that pregnant women totally abstain.
  
  
• Caffeine
  Excessive amounts have been linked to an increased risk of miscarriage and birth defects; moderate amounts – up to 300mg per day – seem to be safe – that’s about two filter coffees.
  
  
• Cigarette smoke
  Smoking is, of course, off-limits throughout pregnancy. Also, beware of exposure to second-hand smoke – it’s been linked to an increased risk of miscarriage, low birth weight and other pregnancy complications.
  
  
• Risky foods
  To avoid listeriosis, a serious food poisoning that can cause major problems with the baby, don’t eat cold-cut meats – including packaged items and those from the deli counter. Also forgo unpasteurised milk and soft, blue-veined cheeses, such as feta, Brie, Roquefort and Camembert. Hard, processed, cream and cottage cheeses are safe. Steer clear, too, of pâtés and meat spreads, as well as smoked seafood unless thoroughly cooked.
  
  Do not eat large predatory fish such as shark, swordfish or mackerel, as these types typically have the highest mercury content. But do eat up to 340g a week of fish and shellfish that are lower in mercury: shrimp, canned light tuna and salmon. Limit your intake of albacore, or “white”, tuna to 170g per week.
  
  
• Toxoplasmosis
  This parasitic disease can be contracted by coming into contact with the faeces of infected cats or, more commonly, by eating undercooked meat. It can cause lifelong problems with the baby’s brain, eyes, heart and other organs. Make sure any meat you eat is well cooked. And delegate the litter-box duties, or wear gloves while cleaning the box.
  

BODY BUMMERS

• Constipation
  Increased progesterone, which slows intestinal movement, is the culprit. Drink at least eight large glasses of water a day; eat plenty of high-fibre foods (fruits, vegetables, whole grains); and exercise safely. If you’re really blocked up, talk to your doctor about taking a fibre supplement or laxative.
  
  
• Fatigue
  You may experience mind-numbing fatigue from the moment you wake up until the minute you hit the sheets – it’s no surprise, considering all the work your body is doing. Master the art of napping; even 20 minutes can give you an energy boost. And remember, the sleepies usually ease after the first trimester.
  
  
• Headaches
  Hormonal havoc is at play here. While it’s best to avoid using non-essential medications throughout pregnancy, if you’re really in pain, talk to your doctor.
  
  
• Nausea
  Morning sickness can last all day. The good news: it usually disappears by the second trimester. In the meantime, eat several small meals throughout the day, and try eating foods that contain ginger or lemon and wearing seasickness wristbands.
  
  
• Tender breasts
  These are often the first sign of pregnancy. Find a supportive bra – many women say maternity bras work best. Consider investing in a sleep bra as well.
  

TESTING
Chorionic villus sampling (CVS) is usually performed between 10 and 12 weeks. While it cannot detect neural-tube defects such as spina bifida, it can diagnose chromosomal abnormalities such as Down’s syndrome. It poses a 1-in-370 risk of miscarriage. Nuchal translucency is a relatively new screening test for Down’s syndrome and other chromosomal abnormalities. It must be done between 11 and 14 weeks. Combined with a test of the mother’s blood, the procedure uses ultrasound to measure the fold at the back of a baby’s neck.

MISCARRIAGE
Unfortunately, miscarriages do happen – about 15 per cent of women under the age of 35 will have one. The majority are due to chromosomal problems with the embryo or foetus and cannot be prevented. In fact, many miscarriages occur so early in pregnancy that the woman isn’t aware she has conceived.

But here’s the good news: once you pass the eight- to 12-week mark and your doctor can see the foetus’s heartbeat by ultrasound, you have a 98 per cent chance of giving birth to a full-term, healthy baby.

Trimester Two

During the “honeymoon trimester”, many of the annoyances of the first three months will disappear and you’ll really be able to start enjoying your pregnancy. If you want to go on a “babymoon”, the end of this trimester is a good time.

WHAT'S ON YOUR MIND
The nausea and fatigue that marred the first three months have been replaced with energy and a feeling of wellbeing. Plus, you’re not huge yet. Still, you may be plagued by underlying fears: everything from how healthy your baby is to what might happen during labour to whether you’ll be a good mother.

Talking with your doctor or midwife, childbirth educator and other new moms during this time can help ease anxieties. But if you find yourself worrying excessively, you may want to seek professional help: high levels of anxiety and stress may be linked to low birth weight and premature delivery and may have other negative effects on the baby’s health.

PESKY PROBLEMS

• Wind
  Just as increased progesterone is at the root of constipation, its slowing effect on intestinal movement can cause wind to build up. Common culprits include cauliflower, broccoli, beans and fried/fatty foods.
  
  
• Heartburn
  Make friends with Tums. They won’t harm your baby, and they work wonders on the burning in your throat and chest. (Just to be safe, talk to your gynae before taking them.)
  
  
• Leg cramps
  These are most common at night. To help prevent them, stretch your legs, especially your calves, before going to bed. Also avoid standing or sitting in any one position for too long. Load up on fluids, particularly water, throughout the day; dehydration can be a contributing factor. If you do get a cramp, straighten your leg, heel first, and wiggle your toes. Leg massages also can help.
  
  
• Sleep problems
  As your baby grows, you may find yourself becoming uncomfortable at night. If so, invest in a good body pillow. To prevent your growing uterus from putting too much pressure on a major vein called the vena cava, try to avoid sleeping flat on your back. Don’t worry if you do – you’ll roll over or wake up if your circulation is affected.
  

EXERCISE SAFELY
Try to exercise for 30 minutes every day throughout pregnancy, even if you just take a walk. Be sure to pay attention to your heart rate: if you can carry on a normal conversation, you’re exercising in the right range. Also, steer clear of any activities that pose the risk of a fall or abdominal trauma. (Scuba diving is out, too, in case you were wondering.) And from now, avoid doing any exercises that require you to lie flat on your back for more than a few seconds.

If you experience any of the following symptoms while working out, stop immediately and call your doctor: calf pain or swelling; chest pain; decreased foetal movement; difficult or laboured breathing; dizziness; headache; leakage of amniotic fluid; muscle weakness; uterine contractions; vaginal bleeding.

TESTING 1 2 3
The triple test is a blood test done between 15 and 20 weeks that screens for chromosomal abnormalities as well as neural-tube and other defects. If you receive an abnormal result (don’t panic – the test is notorious for its high number of false-positives), your doctor will recommend a detailed ultrasound and/or amniocentesis.

Amniocentesis can diagnose chromosomal abnormalities and other defects. Typically performed between weeks 15 and 20, the procedure involves inserting a thin needle through your abdomen into your uterus and withdrawing a small amount of amniotic fluid, which is then analysed in a lab. Amnio poses a 1-in-370 risk of miscarriage, depending on the skills of the practitioner.

A glucose screen checks for gestational diabetes. Conducted between the 24th and 28th week of pregnancy, this test involves drinking a sugary concoction and then having your blood analysed for excessive amounts of glucose. The procedure can be unpleasant, but poses no risks to you or the baby.

PRACTICE CONTRACTIONS
Sometime during the second trimester, you may start experiencing Braxton Hicks, or “practice” contractions as your uterus gears up for actual labour. They are completely normal and typically feel like a tightening throughout the abdomen that occurs at irregular intervals; they happen more often when you are active or the baby moves. If the contractions become closer together, stronger or more regular, call your doctor.

WHAT ABOUT SEX?!
For most women, sex is perfectly safe throughout pregnancy. In fact, many find that hormonal changes and increased blood flow to the genitals make for a heightened experience. However, intercourse may not be safe if you have had preterm-labour symptoms during this or a previous pregnancy, if your waters have broken or if you’ve had problems with bleeding.

Trimester Three

As the big day approaches, you’ll probably find yourself thinking – OK, obsessing – about the looming prospect of labour and parenthood. Excitement abounds, but you may be feeling anxious and fearful as well. It’s normal. Many women also find themselves fully in the throes of the “nesting” syndrome at this point: redecorating your home, organising the garage, decorating the nursery – nothing is beyond the watchful eye of the third-trimester mom.

BODY BUMMERS

• Frequent urination
  As your uterus grows, pressure on your bladder increases. Continue to drink plenty of fluids during the day, but limit them towards bedtime. Also, cut back on coffee and tea, as they can act as diuretics.
  
  
• Haemorrhoids
  Constipation is a major cause, as is extra weight. Keep downing fluids, and load up on fibre-rich foods. Talk to your doctor about using haemorrhoid products if they are really bothering you.
  
  
• Squished stomach
  As your baby grows, something’s gotta give – namely, extra space in your abdominal area. Try to maximise room by standing and sitting as upright as possible, and eat several small meals throughout the day.
  
  
• Swollen legs
  Elevate your legs whenever possible, avoid salty food, and wear support stockings. Ask your partner for nightly leg massages; they help with swelling and snoozing.
  

RED FLAGS TO WATCH OUT FOR

• Constant abdominal pain.
  
• Decreased foetal movement. Fewer and/or weaker kicks are common as your baby’s quarters become increasingly cramped, but be sure to notify your doctor if you notice a dramatic decrease in movement.
  
• Leakage of fluid from your vagina.
  
• Vaginal bleeding.
  
• Marked increase in swelling.
  
• Severe headaches.
  
• More than five uterine contractions per hour, if you’re fewer than 37 weeks along in your pregnancy.
  

GET READY FOR LABOUR

• Sign up for a yoga or Pilates class or join a gym that offers classes tailored to pregnant women. These classes are a great way to meet other expectant moms.
  
• Look into childbirth-education classes; ask at your hospital. Make sure it will be finished by about week 36.
  
• Do your Kegels. These exercises are a great way to strengthen and prepare your pelvic-floor muscles for labour and delivery. They also help reduce embarrassing “leakage” when you cough, sneeze, laugh, breathe, etc.
  
  To do them, contract the muscles around your vagina as if stopping the flow of urine. Hold for a few seconds, release and repeat. Aim to do 10 to 15 of these at a time, several times per day.
  

SIGNS OF LABOUR

• Contractions that occur at regular intervals (say, every 15 minutes) and slowly increase in frequency.
  
• Contractions that gradually become stronger. You may feel them in your back as well as your abdomen.
  
• Contractions that do not abate with movement.
  
• Contractions that are so strong, you have difficulty speaking.
  
• “Bloody show” (brown- or pink-tinged vaginal discharge). This is actually the mucus plug that has been sealing your cervix.
  
• Increased pelvic pressure, which means your baby’s head has dropped in place.
  
• An increase in vaginal secretions. As the cervix softens, white, or sometimes pink discharge may be seen.
  
• Experiencing shivering or trembling for no reason. This early sign of labour might happen without any sensation of cold or weakness, and can be the result of stress hormones or an alteration in the level of progesterone in your body.
  
  Note: call your doctor or head to the hospital when your contractions occur every five to 10 minutes or if your waters break. You’re about to become a mom!