Pregnancy & risks
Pregnancy is used to describe when a fetus develops inside a woman’s womb or uterus that lasts around 9 months (40 weeks). Your body will change, and it might require you to change your daily routine (sleeping earlier or eating frequent, small meals).
What is it?
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Pregnancy is used to describe when a fetus develops inside a woman’s womb or uterus that lasts around 9 months (40 weeks). Your body will change, and it might require you to change your daily routine (sleeping earlier or eating frequent, small meals). As your pregnancy progresses, a lot of the uncomfortable changes will stop. But some women might not feel any discomfort at all. Being pregnant before could make it easier/different when you get pregnant again. Every pregnancy is different. Pregnancy is split into three stages called trimesters. The significant events in each trimester are:
First trimester (Week 1- 12)
This stage starts when the sperm penetrates an egg and fertilizes it. The fertilized egg (a zygote) then goes through the fallopian tube to the uterus, where it implants itself in the uterine wall. The zygote comprises a cluster of cells that later form the fetus and the placenta. The placenta connects the mother to the fetus and provides nutrients and oxygen.
Your body goes through several changes, and hormonal changes affect most of your organ systems. The clear sign of pregnancy is when your period stops. Additional changes can include:
- Extreme exhaustion
- Tender, swollen breasts (nipples might stick out)
- Morning sickness (Upset stomach with or without vomiting)
- Cravings or disgust for some foods
- Mood swings
- Constipation (difficult bowel movements)
- Frequent urination (more than usual)
- Headache
- Heartburn
- Weight gain or loss
Second trimester (Week 13 - 28)
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This is the stage where your doctor will look for birth defects and can determine the sex of your baby. Movement can be felt at week 20 of the pregnancy. Footprints and fingerprints are formed, and the fetus wakes up and sleeps at 24 weeks. Babies born at 28 weeks will experience serious health complications such as respiratory and neurologic problems and have a 92% survival rate, according to research made by the NICHD Neonatal Research Network.
Several women experience less discomfort during this stage compared to the first trimester. There are noticeable changes like the abdomen expanding and feeling your baby move before the trimester ends. Your body will make the necessary changes to accommodate your growing baby. You might experience:Â
- Aching body (back, abdomen, thigh, or groin (area between the abdomen and the upper thighs)
- Stretch marks (stomach, breasts, thighs, or buttocks)
- Skin around the nipples darken
- Noticeable line on the skin from the belly button to the pubic hairline
- Mask of pregnancy (patches of darker skin on cheeks, forehead, nose, or upper lip that matches on both sides of the face)
- Carpal tunnel syndrome (hands numb or tingle)
- Itching (stomach, palms, and soles of the feet). Call your doctor if you see signs of a serious liver problem (Nausea, loss of appetite, vomiting, jaundice (yellowing of skin or whitening of eyes), or fatigue combined with itching)
- Swelling (ankles, fingers, and face). Call your doctor if you see signs of preeclampsia (sudden or major swelling or gaining weight too quickly)
Third trimester (Week 29 - 40)
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This is the stage where your doctor will look for birth defects and can determine the sex of your baby. Movement can be felt at week 20 of the pregnancy. Footprints and fingerprints are formed, and the fetus wakes up and sleeps at 24 weeks. Babies born at 28 weeks will experience serious health complications such as respiratory and neurologic problems and have a 92% survival rate, according to research made by the NICHD Neonatal Research Network.
Several women experience less discomfort during this stage compared to the first trimester. There are noticeable changes like the abdomen expanding and feeling your baby move before the trimester ends. Your body will make the necessary changes to accommodate your growing baby. You might experience:Â
- Aching body (back, abdomen, thigh, or groin (area between the abdomen and the upper thighs)
- Stretch marks (stomach, breasts, thighs, or buttocks)
- Skin around the nipples darken
- Noticeable line on the skin from the belly button to the pubic hairline
- Mask of pregnancy (patches of darker skin on cheeks, forehead, nose, or upper lip that matches on both sides of the face)
- Carpal tunnel syndrome (hands numb or tingle)
- Itching (stomach, palms, and soles of the feet). Call your doctor if you see signs of a serious liver problem (Nausea, loss of appetite, vomiting, jaundice (yellowing of skin or whitening of eyes), or fatigue combined with itching)
- Swelling (ankles, fingers, and face). Call your doctor if you see signs of preeclampsia (sudden or major swelling or gaining weight too quickly)
Antenatal Care
It is a care you receive when you are pregnant to check on your baby. Your doctor or midwife will check both you and your baby’s health, give you helpful information for a healthy pregnancy (healthy eating and exercise), discuss choices for your care during pregnancy, labor, and birth.
You will go through several tests like urine tests, blood pressure checks, pregnancy scans every time you go to the hospital, and screening for sickle cell and thalassemia at 10 weeks of pregnancy. It is normal to have 10 antenatal appointments during your first pregnancy. If you’ve previously given birth, you’ll have about 7 appointments that can be more if you develop a medical condition.Â
Your doctor or midwife will give you a schedule (after discussing with you) for your appointments. These appointments should be in an environment where you can easily talk about difficult issues such as mental health issues, drugs, domestic or sexual abuse. You will be asked about your family’s health or any support you might need to get the best of your pregnancy care. You must go to every appointment since it may influence your choice later in pregnancy.
Postnatal care
The riskiest time for the death of an infant or mother is the first few hours or days after giving birth. This is why postnatal care is necessary to help ensure the survival of mother and baby. Both infant and mother are kept in the hospital for the first 24 hours during postnatal care. Your baby needs constant care and attention. Your nurse or doctor will prioritize giving you information on exclusive breastfeeding, cleaning your baby’s skin, umbilical cord care, and keeping your baby warm. You will be getting counseling and education before leaving the hospital on signs of any danger to your baby and the steps you can take immediately.
This care is even more important for infants who are born too early, too small, suffer from different kinds of infections, or suffocate during delivery to keep you and your infant healthy. Counseling is given to the mother, partner, and available family. Postnatal exams allow doctors to look for anything odd with the mother or baby.
Danger signs of pregnancy and what to do when she gets these signs
Almost all women feel pain or discomfort throughout their pregnancy, but some are worse than others and may require them to get immediate medical care. Signs to look out for that are dangerous to your pregnancy are;
- Unusual discharge or bleeding from your vagina
- Your water breaking before labor starts or the liquid is greenish or brown color (doesn’t look healthy or clean)
- Your baby moves less than usual or not at all
- Cramps or pain in your stomach during the first few weeks of pregnancy
- Sudden swelling of your hands, feet, or face
- Pain or burning while urinating combined with a sore back and fever is terrible
- Painful area behind your calf or knee which is reddened and too warm to the touch
- Intense headaches that last more than a few hours
- Blurry or double vision or seeing white flashes or spots
- Fever above 38° C that lasts more than a day
- Injury to your stomach
- 5 or more uterine contractions in one hour before 36 weeks
- Unable to pee but get very thirsty
- During late pregnancy, frequent throwing up and getting sick even more so if you have pain and fever
- Diarrhea nausea, or vomiting for more than a day
If you get any of these signs, you have to immediately call or visit your doctor to make sure everything is alright and to take the necessary steps for treatment if needed.
Abnormal pregnancies
There are several causes for abnormal pregnancies, terrible like issues with the placenta that can be deadly for the fetus. The different types of abnormal pregnancies include pregnancy failure (miscarriage), ectopic pregnancy, and molar pregnancy.
Pregnancy failure (miscarriage)
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also known as early pregnancy loss or spontaneous abortion and occurs in the 1st trimester (20th weeks) of pregnancy. Several factors contribute to this, but fetal abnormalities are the most common. Other causes can be a woman who has already experienced miscarriage and older women. The most common symptoms are bleeding from the vagina and uterine cramping.Â
Causes:
There are different causes for miscarriages, such as genetic issues and a mother’s health conditions. Genetic problems include intrauterine fetus death (embryo formation stops), blighted ovum (embryo doesn’t form at all), problems with the placenta (the organ that joins the mother’s blood supply to the baby’s), molar pregnancy (no development of the fetus but there’s an abnormal growth of placenta), & partial molar pregnancy (abnormal placenta and abnormal fetus growth). The mother’s long-term health conditions include uncontrolled diabetes, infections, uterus and cervix problems, thyroid disease, health disease, immune system disorders, kidney disease, antiphospholipid syndrome (the immune system wrongly produces antibodies that attack the embryo/fetus), Polycystic ovary syndrome (PCOS) (ovaries are larger than usual that can lower egg production and is the leading cause for infertility), and more.Â
Risk factors:
Multiple risk factors raise the chances of miscarriage, such as a woman who is 35 or above, being overweight, smoking, alcohol, drugs, excess caffeine, food poisoning, physical trauma, and certain medications.Â
Prevention:
Since many causes of miscarriage are unknown, you wouldn’t be able to prevent it, but you can lower your chances by:
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Quitting smoking, alcohol, drugs
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Limit caffeine intake (less than 200 mg per day) and herbal teas (maximum 4 cups)
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Eating a balanced healthy diet and being a healthy weight before getting pregnant
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Clean fruits and vegetables thoroughly
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Avoid infections
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Avoid certain foods like unpasteurized milk/cheese, raw or undercooked meat or eggs, liver,
Ectopic pregnancy
occurs when the embryo attaches outside the womb and is fatal to the fetus. This abnormality in pregnancy mainly occurs in the fallopian tube but can also happen in the abdomen, cervix, or ovary. It may cause bleeding and pain in your pelvis. Some women may not have any symptoms unless the site the egg attaches itself to breaks. A ruptured ectopic pregnancy has symptoms such as hemorrhaging (excessive release of blood from blood vessels) and extreme pain, which can cause maternal death; however, if treatment is provided before the rupture, maternal death can be avoided.Â
Treatment:
- Medical treatment: is used to treat an early ectopic pregnancy without heavy bleeding. It is injected into your body, prevents growth cells, and breaks down existing cells. After being injected, your doctor will examine you to check if the treatment has been effective.Â
- Laparoscopic surgery: a small cut is made in the stomach (around or in the belly button) for a thin camera tube to view the area and remove the ectopic pregnancy. There are two types of laparoscopic surgery, and the amount of bleeding and damage will determine the type of procedure.Â
Emergency surgery: this is necessary if you have heavy bleeding where you will get an abdominal cut to remove the torn tube, but in some cases, the fallopian tube is saved.
Molar pregnancy
occurs when an undeveloped egg gets fertilized, causing the tissue that was supposed to become a fetus turns into a large mole that can grow and fill the uterus. Another way is when two sperms fertilize one egg causing the placenta (organ providing nourishment to the fetus) to turn into a mole. Fetal tissue that is available will have serious defects. Symptoms can be the same as a normal pregnancy but can also have unusual ones like discomfort in the pelvis and vaginal discharge that look like grapes. To treat this pregnancy, the abnormal tissue needs to be removed.
Treatment:
Surgical treatment is effective for most women called dilatation and auction evacuation (D&E), where a thin tube is used to suck the molar tissue. Another method called dilation and curettage (D&C) is when a sharp object cuts the tissue from the womb’s lining.
Medical treatment: this is effective for women with partial molar pregnancy and is referred to as medical management or medical evacuation. The drug will make the womb shrink to remove the abnormal cells.
Placental abruption
occurs when the placenta separates from the uterus before the baby is born, causing a reduction or prevention of oxygen and nutrient supply to the baby and can cause heavy bleeding in the mother. It happens without warning and is dangerous to the mother and baby. In the worst-case scenario, a placental break might cause fetal death.
Treatment:
Mild: if you are less than 37 weeks into your pregnancy and your baby’s heart rate is normal, you will be hospitalized to be monitored closely. If your bleeding stops and your baby’s condition is stable, then you could be able to go home.
Moderate or Severe: if you are after 37 weeks of your pregnancy and the placenta abruption seems very little, you can have a vagina delivery with close observation. However, an immediate C-section will be performed if the abruption gets worse or endangers you or your baby.
Suppose you get any symptoms, you need to visit your doctor immediately for proper diagnosis and treatment. If you had any of these abnormalities in your previous pregnancy, you should talk to your doctor when you think of conceiving again. This will reduce your chances of going through this painful experience again. In addition to this, you might suffer from negative thoughts about the loss of your baby. Please talk to trusted friends, family, or mental health experts if you have difficulty copying.
Postpartum Depression
A new mother suffers severe depression (feels empty and sad) after giving birth that lasts longer than 2 weeks. It is a serious condition that affects your brain, behavior, physical health, and overall day-to-day life. Hormonal changes might trigger these symptoms where some mothers go through anxiety disorders. Some mothers might not feel connected to their baby, feel like they aren’t the baby’s mother, or might not love their baby.
Symptoms
- Depression gets more and more intense
- Difficult to work or get things done at home
- Pulling back from family and friends
- Lack of care for yourself or your baby (eating, sleeping, washing)
- Thoughts about hurting yourself or your baby
- Intense crying, irritability, anger
- Insomnia or sleeping too much
- Overwhelming fatigue
- Feeling shame, guilt, worthlessness, or inadequacy
Treatment
Therapy: you talk to your therapist to help you figure out ways to cope with your depression and change your thoughts.
Medicine: If your therapist believes your depression is severe, she/he will refer you to a doctor to prescribe you antidepressants (the most common medication for depression) to help relieve symptoms of depression. However, it will take several weeks to work.
Electroconvulsive therapy (ECT): is used for extreme cases of postpartum depression.
Your doctor might recommend you to take the treatments together or alone after discussing the benefits and concerns of treatment. Treatment is essential for you and your baby. Getting help is necessary for your overall health.Â
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