Body Changes During Pregnancy

The first definite sign that a woman is pregnant is that she fails to have a menstrual period when one is normally due. At about the same time as the period is missed, the woman may feel unwell, unduly tired, and her breasts may change.

Very early, the breasts will start to prepare for the task of feeding the baby, and one of the first things the pregnant woman notices is enlarged and tender breasts and a tingling in the nipples. With a first pregnancy, the skin around the nipple (the areola) will darken, and the small lubricating glands may become more prominent to create small bumps. This darkening may also occur with the oral contracep­tive pill.

Hormonal changes in early pregnancy cause the woman to want to urinate more frequently. This settles down after the twelfth week, but later in pregnancy the size of the womb puts pressure on the bladder, and frequent urination is again necess­ary.

Some women find that they develop dark patches on the fore­head and cheeks. Called chloasma, these patches are caused by hormonal changes affecting the pigment cells in the skin. Such changes can also be a side effect of the contraceptive pill. The navel and a line down the centre of the woman's belly may also darken. These pigment changes fade somewhat after the preg­nancy but will always remain darker than before.

As the skin of the belly stretches to accommodate the growing baby, and in other areas where fat may be found in the skin (such as breasts and buttocks), stretch marks in the form of reddish/purple streaks may develop. These will fade to a white/silver colour after the baby is born, but they will not normally disap­pear completely, much to the chagrin of many women. There is unfortunately nothing that can be done to prevent or treat stretch marks.

About the fourth or fifth month, the thickening waistline will turn into a bulge, and by the sixth month, the swollen belly is unmistakable. The increased bulk will change the woman's sense of balance, and this can cause muscles to become fatigued unless she can 'carry her burden with pride' and make a conscious effort to maintain an upright posture. Care of the back is vitally important in later pregnancy, as the ligaments become slightly softer and slacker with the hormonal changes, and movement between the vertebrae in the back can lead to severe and dis­abling pain if a nerve is pinched.

During pregnancy, the mother must supply all the food and oxygen for the developing baby and eliminate its waste materials. Because of these demands, the mother's metabolism changes, and increasing demands are made on several organs. In particular, the heart has to pump harder, and the lungs have more work to do, to supply the needs of the enlarged uterus and the placenta. Circu­lation to the breasts, kidneys, skin and even gums also increases. Towards the end of the pregnancy, the mother's heart is working 40% harder than normal. The lungs must keep the increased blood circulation adequately supplied with oxygen.

In the month or so before delivery, it will be difficult for the mother to get comfortable in any position, sleeplessness will be common, and the pressure of the baby's head will make passing urine a far too regular event. Aches and pains will develop in unusual areas as muscles that are not normally used are called into play to support the extra weight, normally between 7 and 12 kg (baby + fluid + placenta + enlarged uterus + enlarged breasts), that the mother is carrying around.

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