Emotional and Physical Changes During Pregnancy

What changes during pregnancy? The Rochester Regional Health obstetrics and gynecology team offers an in-depth view of the emotional and physical changes to expect.

You’re pregnant! This exciting time is filled with all sorts of wonderful celebrations, as well as more than a few physical and emotional changes. Pregnancy differs for each and every person, but understanding common changes helps many expecting moms feel more prepared.

Rochester Regional Health obstetrics and gynecology physician assistant Emily DeBadts provides in-depth descriptions on what to expect as well as tips to help you navigate the weeks and months to come.

The first trimester

Your body goes through a lot, both emotionally and physically, during your first trimester (weeks 0 - 13). Some may be very obvious, like your period stopping and your breasts becoming tender. Other changes–internal and external–may be unexpected.

First trimester emotional changes

Mood changes are very common. Regular meals, staying physically active, and sharing your feelings with your support system (family, friends, partner) are a great way to regulate and ensure you aren’t holding things in.

Mothers and fathers-to-be often experience feelings of uncertainty, excitement, and fear about parenthood. These are all normal feelings, and many other parents-to-be have them. In addition to speaking with your provider about these feelings, you may consider connecting with local support networks as a way to speak to other expectant parents going through the same thing.

However, if you are no longer finding joy where you once did, or have been feeling down for more than one week, it may be time to talk to your OBGYN or midwife about perinatal depression. This too, is common, and your provider will help you find ways to cope.

First trimester physical changes

Morning sickness

Morning sickness–nausea and vomiting–is one of the most expected side effects of pregnancy. It varies, person by person, and can range from not occurring at all, to being mild or extreme, and can happen any time throughout the day. It may also continue beyond your first trimester, but 85% of nausea and vomiting resolves by the second trimester. If you find that your morning sickness makes it difficult to get through the day, speak to your provider about ways to ease your symptoms.

Fatigue

Some people experience tiredness; some do not. If you are feeling sleepy and more tired than usual, rest whenever you can. Small pauses and breaks can go a long way towards making you feel refreshed. Whenever you’re feeling overtired, stop and take a break. Your body is working hard!

Eating several small meals throughout the day and drinking plenty of water will help replenish your nutrients and keep your body balanced. Do your best to eat a diet high in iron (red meat, dark green vegetables, and dried fruit), and take iron supplements as recommended by your provider.

Frequent urination

You may find that you need to urinate more often than usual when pregnant. You’ll be drinking more water, but avoiding coffee, tea, or soda is also a great way to make sure you aren’t peeing out essential vitamins and nutrients your body and baby need.

It should never be uncomfortable to urinate while pregnant. If you experience this, blood in the urine, or sudden onset of urgency, please call your provider’s office.

Headaches

Pregnancy comes with hormonal changes, which can and do lead to headaches. Practicing good posture, eating several small meals, drinking plenty of water, and avoiding activities that cause eye strain can help. That may be tough if you sit in front of a computer all day, but small breaks are beneficial for your eyes and your brain.

Getting plenty of sleep and rest during the day will also help with headaches. If your head is bothering you, drinking water and taking acetaminophen (Tylenol) can help alleviate the pain, as can a cool or warm washcloth on your forehead or the back of your neck. A small dose of caffeine (8 ounces of coffee or tea) can help as well, especially if you have recently cut way back on caffeine consumption.

Vaginal secretions

Most women experience regular discharge, and that will continue during pregnancy because of your elevated hormone levels. Thin and milky vaginal secretions are normal, and small pads, cotton underwear, and loose pants can help. You may also want to shower or bathe often.

Contact your provider if you’re experiencing colored, frothy, smelly, itchy discharge, vaginal pain, or bleeding.

Light-headedness and shortness of breath are also quite normal during your first trimester. Be sure to stand up slowly and eat regularly and often. You and your body are working hard to grow a baby. Periods of happiness, sadness, and fear are perfectly normal, as are physical changes. Taking it easy, understanding your new limits, and making sure you’re getting enough good food and sleep will help you as you enter the second trimester. 

The second trimester

During weeks 13-27, your second trimester, you’ll reach the halfway point in your pregnancy. For some, the time will have flown by, and others will be glad they’re over the first trimester. We all experience different pregnancies, and you may experience some of the following physical and emotional changes during your second trimester.

Second trimester emotional changes

For many, your emotions are more stable during the second trimester. Often, mothers-to-be have an increased sense that the pregnancy is real, and will find little times to celebrate the pregnancy and connect with their baby. Find time to talk with your baby and if you have a partner, involve them too. Some find it fun to keep a pregnancy diary and pregnancy photo album, but each pregnancy is personal, so do what makes you happiest.

Second trimester physical changes

Swelling, especially in your feet and ankles is normal throughout your pregnancy. Avoiding added salt and high sodium foods should help keep swelling down. Most swelling should be gone by the time you get up in the morning, but if it continues, make sure to mention it to your OBGYN or midwife at your next prenatal appointment.

For some, nausea lessens during the second trimester, but is replaced with consistent nasal congestion, almost as if you have a cold. Using saline nasal gel can help with your symptoms, and this will go away after you give birth.

Constipation

Drinking more water, eating high fiber foods, and engaging in physical activity will help with constipation. If you need to have a bowel movement, go when you have the urge and try not to hold back or force it. Unless recommended by your provider, do not use suppositories, laxatives, or enemas.

If you’re worried about your constipation, be sure to mention it at your next prenatal visit.

Inflamed gums

Increased blood flow from estrogen stimulation leads to plaque build-up, which in turn causes red, inflamed gums. Nausea during pregnancy may lead to poor dental hygiene, so be sure to brush your teeth and floss regularly, and tell your dentist that you are pregnant when you go in for your bi-annual visit.

Lower back pain

Your lower back may ache because your back is curving to balance the increasing weight of the uterus. Maintaining good posture and pulling in your stomach muscles, tightening your buttocks, and tucking in your seat to flatten your lower back can all help. Prenatal yoga and gentle stretching are great ways to strengthen and stabilize your back and improve symptoms. Be sure to heat and/or ice, sleep on a firm mattress, massage problem areas, and rest when your back is bothering you.

Nasal congestion and nose bleeds

Higher than usual estrogen levels cause increased blood flow to your mucus membranes, which can lead to nose bleeds and congestion. Using a humidifier and normal saline nose drops can go a long way towards easing these symptoms. 

Sore legs and varicose veins

Compression of the nerves that go to your legs and feet occur because of your enlarging uterus, which can lead to leg cramps and sore legs. Flexing your toes toward your head, gently massaging, and maintaining good hydration and an adequate diet will help with your cramps. 

Varicose veins are a hereditary predisposition, but occur during pregnancy because of your hormones. They’re also aggravated by your enlarging uterus and gravity. The best way to combat varicose veins is to wear maternity support pantyhose, avoid prolonged sitting or standing, and avoid crossing your legs.

Stretch marks

Purple, pink, and red marks may appear on your breasts, abdomen, and thighs, and very little can be done to prevent them. You may be at a higher risk if you have a family history of stretch marks, are Caucasian, and if you gain a lot of weight during pregnancy. After giving birth, your stretch marks will gradually change to tan or white, and will become less visible. 

Some of these changes will continue in your third trimester, especially as your uterus continues enlarging.

The Third Trimester

The final weeks of your pregnancy are finally before you! Some experience increased forgetfulness during their third trimester, and are a little more tired and uncomfortable than they have been before. Listen to your doctor and your body as you reach weeks 28-40.

Third Trimester Emotional Changes

Your baby is almost here, and things are coming together. You may be feeling excited or impatient to finally meet your baby, and you may experience stress as you finish up your preparations. Remember that people–family, friends, and your partner–are eager to help. Voicing your feelings, sharing what you need help with, and leaning on those you love can all help with anxiety and stress.

It is common for you to experience feelings of doubt or fear before you go into labor. Your provider, who has been by your side for the last twenty-eight weeks, is here to help! Talk to them about your plans for labor, work on a birth plan, and attend prenatal classes so you have a better idea of what lies ahead. 

Third trimester physical changes

The final weeks of your pregnancy are filled with some incredible physical changes, and you may need to take extra time to tend to your body. Some of the changes you may experience include itchy skin, increased fatigue, hemorrhoids, and heartburn.

Braxton Hicks contractions

As your body prepares for labor, your uterus will contract to soften and thin your cervix. These contractions, called Braxton Hicks contractions, are normal.

Difficulty sleeping

Caffeine, overexertion before bedtime, and lots of fluids before sleep can all contribute to insomnia, as can your little one – who at this point you can likely feel moving around in your belly. A regular schedule with regular exercise, fresh air, warm milk, and chamomile tea can all help promote better rest. It’s also a good idea to avoid long naps during the day so you’re ready to sleep at night.

Dry, itchy skin

Dry, itchy skin is normal during pregnancy, and can be made worse by cold,dry weather or long, hot baths. Oils and lotions can keep your skin moisturized, and calamine lotion may help relieve any itching. It’s also a good idea to search for a soap made with glycerin because it helps lock in your skin’s natural moisture.

If you are experiencing severe itching, mention it to your provider, and try to remember when it occurs.

Heartburn

The progesterone found in your body during pregnancy slows digestion and delays the emptying time of your stomach. Your enlarging uterus also compresses the stomach and displaces it upward. All of this combined can lead to heartburn, which feels like a burning sensation in the lower portion of your chest or upper abdomen, and sometimes includes burping and raising of a sour-tasting fluid.

To prevent heartburn, avoid gas-forming, greasy, and spicy foods. Try to avoid large meals, especially before lying down. Milk, hot tea, gum, chewable antacids and liquid antacids (Pepcid-AC, Mylanta, Maalox, and TUMs) may offer relief. Do not take Pepto-Bismol, as it contains aspirin. If you have persistent symptoms, please call your OBGYN or midwife.

Hemorrhoids

Your enlarging uterus, gravity, and bearing down for bowel movements can all cause hemorrhoids. If you can, try to avoid prolonged standing, sitting, and constipation. Kegel exercises, warm baths, ice, and over-the-counter topical preparations (like Preparation H) can all provide comfort. If you are experiencing severe pain or bleeding, speak with your provider about other options.

And just like that, you’re ready to welcome your new arrival! Rest assured that your care team will be by your side every step of the way. No question is too big or too small, and we look forward to caring for you and your growing family!