Normal Pregnancy

The First Trimester

From the very beginning of your pregnancy, your baby alters your body and the way you live. During the first three months of your pregnancy, known as the first trimester, you will feel many physical changes as your baby begins to grow and develop.

Although the symptoms of early pregnancy vary tremendously from woman to woman - and even from pregnancy to pregnancy - most women can expect to experience one or more of these signs of early pregnancy:

• No period
• Larger, more tender breasts
• Nipples may stick out more
• More frequent urination
• Feeling very tired
• Nausea or vomiting
• Craving certain foods or loss of appetite
• Heartburn or indigestion
• Constipation
• Feeling bloated or heavy
• Gain or loss of a few pounds

You can eliminate many of the most common complaints of early pregnancy by eating properly, keeping your stress level down, and getting enough rest.

When To Call The Doctor

While most women have few problems during their first trimester, you should call your doctor if you experience any of the following:

• Heavy vaginal bleeding or clotting
• Lighter bleeding that lasts for more than one day
• The passage of grayish or pinkish tissue
• Any amount of bleeding that is accompanied by cramps, fever, chills, or dizziness
• Severe pain in abdomen or in your shoulder area
• Dehydration
• A fever of more than 101°F
• Painful urination
• A watery discharge from the vagina

How Your Baby Grows

During the first month of your pregnancy, your baby, officially called a fetus at this point, is 1/2 inch long and weighs less than one ounce. However, by the 14th week of your pregnancy, all of your baby's major organs are developed. 


During the first month you are pregnant, your baby’s:

• Arms and legs begin to form
• Brain and spinal chord begin to form
• Heart and lungs begin to develop
• Heart begins to beat near the end of the month

At the end of the second month, your baby is one inch long and still weighs less than one ounce. Other developments include:

• Eyelids form, but remain closed
• Inner ear begins to develop
• Bones appear
• Ankles, wrists, and toes form
• Genitals begin to develop

By the third month, your baby is most likely now 3-1/2 inches long and weighs just over an ounce. Other changes occurring during the third month include:

• Twenty buds for future teeth appear
• All internal parts are formed, but not fully developed
• Fingers and toes continue to grow and soft nails begin to form
• Intestines begin to form
• Backbone is soft and can flex
• Skin is almost transparent
• Hands are more developed than feet
• Arms are longer than legs

The Second Trimester of Your Pregnancy

The second trimester is the time many women begin to make important decisions concerning the birth of their baby, such as when to begin their maternity leave, whether to hire a doula, and whether to write a birthing plan.

Often referred to as the Golden Age of Pregnancy, the second trimester is typically the time when many women experience increased energy levels. The risk of miscarriage also declines significantly at this point in your pregnancy.

Sometime between weeks 16 and 20 of the second trimester is also when you get to experience those exciting first feelings of your baby. Be sure to note the date on which you first feel fetal movement. This can help your doctor more accurately date your pregnancy.

Although you'll likely lose a few of the more bothersome symptoms of the first trimester, such as nausea and extreme fatigue, the second trimester has some physical feelings all its own. While every pregnancy is unique, here are some of the changes you may see during weeks 15 through 27 of your pregnancy:

• Increased appetite and easing of nausea and fatigue
• Abdomen beginning to expand - by the end of this trimester, the top of your uterus will be near the rib cage
• Abdominal and breast skin stretching and may feel tight and itchy, possibly with stretch marks
• Abdomen aches on one side or the other as the ligaments that support the uterus are stretched
• A dark line, known as the linea nigra, may appear down the middle of the abdomen, from navel to pubic bone
• Brown patches of skin on the face, known as the "mask of pregnancy"
• The darker skin around the nipples (areolas) may darken
• Swelling of feet and ankles
• Hip and back pain
• Feeling the uterus in the lower abdomen

When To Call The Doctor

While your body undergoes many changes during your second trimester, there are some things that warrant a call to your doctor:

• Heavy vaginal bleeding or clotting
• Lighter bleeding that lasts for more than one day
• Any amount of bleeding that is accompanied by pain, fever, or chills
• Severe abdominal or shoulder pain
• A severe or persistent headache, particularly one that is accompanied by dizziness, faintness, or visual disturbances
• Dehydration
• A fever of more than 101°F
• Painful urination
• A watery discharge from the vagina
• Sudden swelling of the face, hands, or feet
• The signs of premature labor, including regular uterine contractions, lower back pain, a feeling of heaviness in the lower pelvis or abdomen, diarrhea, slight spotting, or bleeding, or a watery fluid or mucus discharge
• A significant decrease in fetal movement after the 24th week of pregnancy

Screening Tests

Your doctor will explain each of the screening tests and advise you of the precautions you must take if any of the test results are positive. Some of the more common tests during this period include:

• Gestational diabetes: Caused by the hormonal and metabolic changes of pregnancy, between two and 10 percent of women are affected by gestational diabetes with no warning signs. If you test positive for gestational diabetes, the doctor will closely monitor your pregnancy.
• Anemia: Pregnancy can cause some women to develop an iron deficiency. Many doctors will test for anemia at the same time you are screened for gestational diabetes. If positive, the doctor will provide steps to take to ensure you and your baby are receiving adequate supplies of iron.
• Genetic Disorders: If you are 35 years or older, doctors often recommend that you undergo amniocentesis, a test used to detect Down's syndrome and other serious genetic disorders that are more common among babies born to older moms.

How Your Baby Grows

During the fourth month of your pregnancy, development includes:

• Eyebrows, eyelashes, and fingernails form
• Arms and legs can flex
• External sex organs are formed
• Skin is wrinkled and the body is covered with a waxy coating and fine hair
• The placenta is fully formed
• The outer ear begins to develop
• Your baby can swallow and hear
• The neck is formed
• Kidneys are functioning and begin to produce urine

At the end of the fourth month, your baby will be six to seven inches long and weigh five ounces.

• During your fifth month, development includes:
• Develops the sucking reflex. If the hand floats to the mouth, the baby may suck his or her thumb.
• Is more active and you may be able to feel the baby move
• Sleeps and wakes regularly
• Nails grow to the tips of the fingers
• Gall bladder begins producing bile, which is needed to digest nutrients
• In girls, all her eggs have formed in the ovaries
• In boys, the testicles begin to descend from the abdomen into the scrotum

At the end of the fifth month, your baby will be nearly 10 inches long and weigh 1/2 to one pound.

At the end of the sixth month, your baby is 12 inches long and weighs between one and a half and two pounds. Other developments include:

• Real hair begins to grow
• The brain is rapidly developing
• The eyes begin to open
• Finger and toe prints can be seen
• The lungs are fully formed, but not yet functioning

The Third Trimester of Your Pregnancy

Weeks 26 through the birth of your baby make up the third trimester of your pregnancy. During this final trimester, your baby grows larger, the organs mature, and the baby moves frequently. Your uterus is large and hard and you may experience false labor.

The baby's increasing size and the many changes your body goes through to prepare for labor and delivery may cause the following to occur:

• Feeling the baby's movements strongly
• Shortness of breath because the top of your uterus now rests under your rib cage
• Need to urinate more often as the baby drops and puts more pressure on your bladder
• Colostrum (a yellow, watery pre-milk) may leak from your nipples
• Navel sticking out
• You may have contractions, either false or real

At the end of the third trimester, your baby will most often settle into a head-down position in your uterus, preparing for birth. This position will likely cause you some discomfort as you get close to delivery.

Although your due date marks the end of your 40th week, a full-term pregnancy can deliver between the 37th and 42nd weeks of pregnancy. Prior to pregnancy, your uterus weighed two ounces and was capable of holding half an ounce of liquid. By the time you deliver, it will weigh over two pounds and hold a quart of amniotic fluid.

When To Call The Doctor

Many physical changes occur during your third trimester. While most of these changes are to be expected, you should call your doctor if you experience any of the following symptoms:

• Heavy vaginal bleeding or clotting
• Lighter bleeding that lasts for more than one day
• Any amount of bleeding that is accompanied by pain, fever, chills, or severe abdominal or shoulder pain
• A severe or persistent headache, particularly one that is accompanied by dizziness, faintness, or visual disturbances
• Dehydration
• By the start of the third trimester, your uterus is large and hard, your baby's movements are visible, and you may be experiencing false labor.
• A fever of more than 101°F
• Painful urination
• A watery discharge from the vagina
• Sudden swelling of the face, hands, or feet
• The signs of premature labor, including regular uterine contractions, lower back pain, a feeling of heaviness in the lower pelvis or abdomen, diarrhea, slight spotting or bleeding, or a watery fluid or mucus discharge
• A significant decrease in fetal movement

Screening Tests

The American Academy of Pediatrics recommends that all pregnant women be screened for group B strep bacteria between 35 and 37 weeks of pregnancy. This bacteria is carried by 10 to 30% of pregnant women and is found most often in the vagina and the rectum.

You should be screened for this type of bacteria because:

• Women with group B strep bacteria may experience no complications at all or develop bladder, uterine, or other infections.
• You can pass the group B strep bacteria to your baby during pregnancy, delivery, or after birth.
• A baby infected with group B strep may end up with blood, lung, brain, and spinal-cord infections.

The group B strep test involves taking a culture from your vagina, perineum, and rectum during pregnancy. The results of the culture are available within two days. If your test comes back positive, your doctor will recommend that you take antibiotics during your labor to minimize the risk of passing group B strep to your baby.

How Your Baby Grows

Your baby continues to gain about 1% of its weight each day during the third trimester of pregnancy and will more than double in size. Males tend to be slightly heavier than females.

During the seventh month, your baby can:

• Open and close eyes
• Sense light changes
• Kick and stretch
• Grasp motions
• Respond to sound

By the end of this month, your baby will be 14 inches long and weigh two to two and a half pounds.

At the end of the eighth month, your baby is 18 inches long and weighs approximately five pounds. Other developments include:

• Rapid weight gain
• Bones hardening, but the skull remains soft and flexible for the delivery.
• The different regions of the brain are forming.
• Taste buds develop and the baby can now taste sweet and sour.
• Your baby may now hiccup.

Here's what your baby is doing the ninth and final month of your pregnancy:

• Your baby usually turns into a heads-down position for birth.
• The skin is less wrinkled.
• The lungs mature and are ready to function on their own.
• Sleeping patterns develop.
• Your baby will gain about a half pound per week.

By the end of your pregnancy, your baby will be approximately 20 inches long and weigh between six and nine pounds.

Although you might feel a little odd interviewing caregivers for your baby before he or she arrives, this is one task that needs to be handled before the birth.