Pregnancy: First Trimester Pregnancy: Second Trimester Pregnancy: Third Trimester

Weeks 1-13 Weeks 14-27 Weeks 28-40

Weight 2-4 lbs 1 lb/week (11 lbs) 1 lb/week (11 lbs)
BP Normal (90-139/60-89 mm Hg) Lower Normal
Pulse May increase, 10-15 bpm (normal: 60-90 bpm)
Behavior Tired, ambivalent Introspective, energetic Restless, preparing for baby, labile moods
Emotional Surprised, excited, happy, relieved Excited, mixed emotions Excited, can't wait to meet my baby
Shocked, scared, unsure Forgetful and vague Scared or anxious
Anxious or concerned Healthy and 'glowing' Feeling teary, mood swings
Teary, mood swings I hate being pregnant! Body image and sexuality
Worried about miscarriage Wondering who the baby will look like and Sensitive to what I watch and who I'm
Relationship reactions which sex with
Fantastic or scary dreams Will my baby be OK?
Body image and sexuality Concerns about relationship changes
Thinking about relationship with own Parenting, can I do this?
mother Feeling fed up
Feeling depressed Concerns of dying in labor
Mood swings, forgetfulness and
excitement
Pregnant Absent Waistline thickens, pregnancy becomes Increased fetal movement; Protrusion of
Look more obvious navel; Large belly
Breast enlargement
Eating Morning sickness, increased salivation 15% of women will continue to feel Good appetite, cravings
(ptyalism) nauseous or vomit
Appetite returns, food cravings
Skin Mild cramping, tugging and pulling Heat and hormonal rashes, oily or dry skin, Linea nigra, straie gravidarum, chloasma,
Straie gravidarum, spider nevi stretch marks, a darkening (or spider nevi
pigmentation) of the skin in various areas,
skin tags and red spider veins
Linea nigra, straie gravidarum, chloasma,
spider nevi
Physical: Increased blood flow to skin (↑ sweating Feel warmer and sweat more Aches and pains
General and warmer extremities), 'bloated' and Bleeding gums; Nose bleeds Backache and sciatica
 possibly experiencing cramping and/or
pelvic discomfort, slight backache
Morning sickness
Dizziness, fainting
PMS-type symptoms: Swollen tender
breasts, feeling tired, 'bloated' and
possibly experiencing cramping and/or
pelvic discomfort
Breasts and Swollen tender breasts, dark coloring
Vagina around areola
Skin of the nipple and areola may start
to darken or 'pigment'
Goodell's sign
Chadwick's sign
Hegar's sign
GI ↑ urination, constipation, gas
Sexuality Extra blood flow to the breasts and
genitals can increase sensitivity, sexual
arousal and the desire for sex
-OR-
Continual tiredness, nausea and/or
vomiting, making sex the furthest thing
from their mind
Constipation
Longer colds and sinus infections
Heightened sense of smell
Heartburn
Hemorrhoids
Indigestion
Metallic taste
Restless legs; swelling, fluid retention
Pain-'stretching and burning' to very mild
cramping, to low, heavy aching and
'dragging' or stitch-like pains with tugging
and pulling
Braxton-Hicks contractions
Breast tenderness, slight increase in breast
size; nipples often become very sensitive
and the veins under the skin more
noticeable
Some colostrum expression (nipple
secretions)
Increased risk of vaginal infections-thrush,
gardnerella
Normal
Extra blood supply to the vagina and
clitoris increase sensation, genitals softer
and more full; nipples can be extremely
sensitive to touch, being either more
sensuous or perhaps uncomfortable;
breasts are larger and sometimes tender
Breathlessness
Carpal tunnel/numb and tingling hands
Constipation
Frequent urination
Hemorrhoids
Heartburn
Insomnia
Leg cramps
Nausea/vomiting during late pregnancy
Palpitations
Restless legs
Swelling, fluid retention
Symphysis pubis pain
Tiredness and insomnia
Increased vaginal discharge
Varicose veins of the legs
Varicose veins of the vulva
Increased breast size, tenderness
Vagina soft, mucous lining swells to
produce more secretions; discharge is
usually milky white (known as
'leucorrhoea') or clear and mucous-like
(no smell)
Vagina and genitals look very purplish or
blue in color
Heightened sexual sensations
Cervix thins, softens and ripens in
preparation for labor
↑ urination, constipation
woman may start to feel tired, heavy and
large. There are often other discomforts
such as heartburn, sore hips or back pain,
frequent toilet trips, cramps, restless legs
or strong Braxton Hicks contractions. All
these can contribute to reducing the
woman's interest in sex.
Use Naegele's rule to calculate baby's due date: 9 months + 7 days after the first day of your last NORMAL menstrual period
The 'average' weight gain of around 12 to14 kg can be physically The 4 or 5 digit system is used to notate a woman's pregnancies:
attributed to:
baby = 3 to 4 kg TPAL (4) or GTPAL (5)
placenta = 0.5 kg G: gravity, pregnancy
amniotic fluid = 1 kg T: term births, born after week 38 to 42
uterus = 1 kg P: preterm births, born between 20-37 weeks
blood volume = 1.5 kg A: abortions, miscarriage or elective termination
breasts = 0.5 kg L: living children
Fat stores for breastfeeding = 3.5 kg
Fluid retention = 1.5 kg

Common Indicators for Problems

Your entire system is readjusted when you're pregnant. The heart pumps more blood and the lungs work more efficiently, as does the digestive
system. With these and more changes occurring, it is no wonder that pregnancy can be uncomfortable. Minor aches and pains can be dealt with;
however, you should never ignore pain or extreme fatigue, which can be warning signs of trouble. Always consult your health care provider if you
experience any of these changes:

Pain or burning during urination

Vaginal spotting or bleeding; Leaking or gushing from vagina; Blister or sore in vaginal area
Uterine contractions
Severe nausea or vomiting; Severe abdominal pain
Chills and fever over 100 degrees
Dizziness or lightheadedness; Severe headache
Swelling of the face, eyes, fingers or toes
Sudden weight gain
Visual problems
Noticeably reduced fetal movement
Absence of fetal movement for 24 hours
A hot, reddened painful area behind your knee or calf
And just when you think you can't take it another day, the biggest changes of all: labor and delivery!
First Trimester 1 - 3 Months
Physical and emotional changes that may be happening during this trimester include:

Physical & Emotional Changes Relief Measures/Feelings

Fatigue • rest when possible

• usually decreases by mid-second trimester

Morning Sickness • small, frequent meals

• dry crackers
• drink after eating, not at meals
• never become hungry

Second Trimester 4 - 6 Months

You will be feeling less tired. Often women feel a sense of physical well-being during this trimester. This is a great time for vacations and
projects.

Physical & Emotional Changes Relief Measures/Feelings

Fetal Movement • excitement

Steady Weight Gain • affirms the growth of the fetus

• feels good knowing that eating a balanced diet takes good care
of both mother and baby

Third Trimester 7 - 9 Months

You will be getting more tired as the baby and your body continue to change, which requires lots of energy. You are becoming more
uncomfortable, and your nighttime sleep may be interrupted and not very restful. Naps are helpful midday, if possible.

Physical & Emotional Changes Relief Measures/Feelings

Braxton-Hicks Contractions • body preparing for labor

• if frequent, consult MD

Shortness of Breath • avoid rushing and crowded areas

• sleep with extra pillows