Physical and emotional changes in pregnancy

Physical and emotional changes For the newly pregnant woman, months of physical and emotional change are ahead. The three distinct stages in pregnancy are described as trimesters. The first trimester runs from conception to about 12 weeks’ gestation, before any foetal movement is felt. The second trimester is from the end of the fourth to about the eighth month—most growth occurs during this time and foetal movement can be felt. During the third trimester the parents have a physical and emotional orientation towards the baby’s birth and arrival in the world. The first trimester For many women the first trimester is associated with fatigue and nausea as their body adjusts to carrying and nurturing another life. In this early stage of pregnancy a range of emotions are common, including excitement and anxiety, elation and fear. I very much wanted to be pregnant, but I hadn’t expected how up and down I would feel. Sometimes I felt so tired and sick. I woke up at night, so anxious about the changes ahead. Other times, I couldn’t be happier. (Celia, 37.) The range of normal transient emotions, driven by hormonal and psychological changes, affects thoughts and feelings about the pregnancy. Parents may feel ambivalent, even with a wanted pregnancy, and may have difficulty accepting that these feelings are a common experience. Prolonged or
intense mood disturbance indicates the need for mental health assessment.
The second trimester
For most women, the second trimester is associated with an increase in energy levels without the physical discomfort that occurs in the later stages of pregnancy. Feeling the baby’s movements occurs around fourteenth to sixteenth
week. Tests to determine foetal health and well-being are usually completed in the early months of this trimester and bring reassurance to most parents.
Inconclusive or abnormal test results can herald a difficult period of uncertainty
as the process of clarification occurs. Concerns about maternal or foetal health,
or issues such as previous obstetric loss, may have a negative effect on the usual enjoyment of this phase of the pregnancy.
I felt so well once I got to about 15 weeks, I felt fantastic, physically and mentally,
really full of life! I loved feeling the baby move and my husband and I both shared a lot of excitement then. During the second trimester the foetus gains about 285 grams in weight and
12.5 centimetres in length. The mother feels the first flutter, called ‘quickening’,
in her abdomen and by the fifth and sixth months a pregnant woman and her
partner can feel her baby kicking and moving about.
The third trimester
In the last trimester expectant parents, especially the woman, begin to think and worry about how the baby is going to be delivered. The realities of parenting an infant are often hard to anticipate as energy goes into planning and preparing
for delivery. As the reality of the birth approaches, it is common for fears of
foetal abnormality or illness to resurface. The mother to be may also experience
a conscious or unconscious anxiety that she or her infant may not survive the
labour intact. This state of emotional confusion gives the impetus to and
prepares for a woman’s emotional birth as a mother when her baby is born.
I got very physically uncomfortable towards the end, and focused on the delivery.
I also felt very happy and complete at times, the baby and I felt so close and
connected. I also felt more dependent and needy—vulnerable really. I needed
reassurance. It was a time of contradictions again—happiness a powerful feeling, but lots of worries too.
Women, including those with a previous difficult or complex labour, may
become very anxious and fearful about labour and delivery. A clear discussion of options for pain and obstetric management during labour can be very helpful, allowing the woman and her partner to anticipate and make choices about how
labour and delivery will be managed. Few women want to repeat an experience of pain, powerlessness and anxiety, and discussion of interventions that enable
parents to make informed choices (including for example, elective caesarean
delivery) is often appropriate.
Labour and birth
The experiences of labour and birth contribute to the development of the
relationship between parents and infant, and to the meaning of this particular
infant to this family. For example, what may be considered a medically successful
outcome of a healthy infant and mother may have been experienced by the
woman as a frightening, painful loss of control, something that didn’t go the way she had imagined. For another woman, the same sequence of events would have
different connotations, depending on her expectations of herself and her partner,
the medical personnel and the labour process.
Birth can feel like a shared experience or an ordeal for the woman and those
with her at the time. She may feel closely connected to the baby during stages of
the labour but it is also common for women at times to feel alone, surviving each contraction, focused only on getting through the next few moments.
At the start I knew Andrew and Talia (birth support people) were with me, I
could talk to them, tell them what I needed. Later, as it got more intense I was shouting at them sometimes I think. I didn’t care about anything except surviving,
me and Sam (the baby). The labour went on and on and I got so tired. I had an epidural and got a bit of sleep. Afterwards I thought about Sam, he didn’t get a break like I did. I wondered if I had let him down. That didn’t last, once I held
him and got to know him a bit, I didn’t care how hard it had been or how it hadn’t gone the way we had planned, I was just happy that he had arrived, and I kept thinking, ‘he’s so beautiful’, even though he was all squashed and funny looking at first.