Articles

Key takeaways

• Pregnancy is divided into three trimesters.
• Your baby grows rapidly, developing vital organs and movements throughout.
• Common symptoms like morning sickness and back pain often change across trimesters.
• Labour has three stages, followed by a fourth trimester of recovery and bonding.

The first trimester: The beginning of your journey

The first trimester begins on the first day of your last menstrual period. It lasts until the end of week 12.

By the time you find out you are pregnant, you might already be 5 or 6 weeks pregnant.

Early signs of pregnancy

A missed period is often the most reliable early sign of pregnancy. In the first few weeks, you may have a bleed similar to a very light period. This light spotting or small amount of blood is called implantation bleeding.

Other early signs of pregnancy can include:

• Feeling sick (nauseous) or being sick – this is often called morning sickness but can happen at any time of the day.
• Tiredness and feeling emotional.
• Sore breasts – they may become larger, tender, or tingle.
• Needing to wee more often.
• Constipation.
• More vaginal discharge than usual.
• A metallic taste in your mouth.
• Loss of interest in certain foods or craving others.
• Sensitivity to common smells.
• Cramping – similar to period pains.
• Darker patches of skin on your face, sometimes called the 'mask of pregnancy'.
• Thicker and shinier hair.
• Bloating.

Symptoms usually start when you are around 4 to 6 weeks pregnant.

Foetal development in the first trimester

The fertilised egg rapidly divides into layers of cells. It implants in the wall of your womb and continues to grow.

These layers of cells become an embryo—what your baby is called at this stage.

By week 5, all the building blocks for your baby's vital organs are in place. Blood vessels and other organs also start to form.

By week 7, their heart has started to beat. Tiny buds are developing that will become their arms and legs. By the end of week 8, your baby has tiny hands and feet with webbed fingers and toes. Their lungs have also started to grow. By week 9, all major internal organs are developing, and bones are starting to form. Around week 10 to 11, their arms and legs are getting longer, and their elbows bend. Their fingers and toes are beginning to lose their webbing. Their heart is fully developed and beating. By week 12, they are about 5.4 cm long from head to bottom.

Maternal symptoms and changes

It is common to experience symptoms such as pregnancy sickness, tiredness, and sore breasts. Hormones are natural chemicals that help your body manage your pregnancy.

They prepare it for birth and produce milk for your baby. The hormones oestrogen and progesterone flood your body in the first 12 weeks. These hormones can make you feel more emotional than normal.

If you are sick all the time and cannot keep anything down, see a GP. You may have a condition that causes severe vomiting and needs treatment (hyperemesis gravidarum).

Many people start to feel better after the first trimester. Most people stop feeling sick around this time, but not everyone.

The second trimester: Finding your stride

The second trimester runs from week 13 to the end of week 27. Many early pregnancy symptoms often disappear or reduce during this time.

Your breasts may not feel as tender, nausea or sickness often stops, and the deep tiredness usually goes away. This can leave you with more energy than before.

Feeling your baby move

You should start to feel your baby move between 16 to 24 weeks of pregnancy. If this is your first baby, you might not feel movements until after 20 weeks.

The movements can feel like a gentle swirling or fluttering at first. As your pregnancy progresses, you may feel kicks and jerky movements.

Feeling your baby move is a sign that your baby is well. If you have not felt your baby move by 24 weeks, tell your midwife.

Significant foetal growth

Early in the second trimester, your baby is about 7 cm from head to bottom. Their ears have developed, but they cannot hear yet.

Their liver, kidneys, and digestive system are all developing. Their lungs are also forming. They now get all the energy and nutrients they need from you through the placenta.

Your baby's body grows fast to catch up with the size of their head. They have fine, downy hair called lanugo on their body, which will go before they are born.

They can suck their thumb and move all their arms, legs, and joints.

By week 20, your baby is about 25.5 cm from head to toe and very active. They can grasp with their hands. Their body starts to be covered with a white sticky substance called vernix, which forms a greasy waterproof layer on their skin.

Maternal physical changes

As you go through the second trimester, you will gradually see your bump grow. You may have that "pregnancy glow" by week 15 and 16. Your hair may look thicker, and your skin may be more plumped out. Your usual clothes will start to feel tight.

You may experience some aches and pains as your bump gets bigger.

Your midwife will measure your bump at regular appointments from 24 weeks. This measurement, from your pubic bone to the top of your womb (fundal height), helps to check your baby's growth. It indicates if your baby is growing at a normal rate. The measurement in centimetres is usually about the same as the number of weeks you are pregnant. Don't worry if your measurement is a little different. Every pregnancy is unique, and your midwife will let you know if they have any concerns.

The third trimester: Preparing for arrival

The third trimester of your pregnancy is from the start of week 28 to week 40. You may start to feel a bit more uncomfortable and tired during this time.

Rapid foetal growth and development

Each week, your baby gets stronger and more ready for life outside the womb. They are developing fat and muscle.

They might begin to open and close their eyes. They can turn their head towards a bright light. They can also smell, taste, and hear more as their brain grows quickly.

They are making breathing movements more regularly and may have hiccups.

The fine hair (lanugo) covering them may be starting to fall out. Their lungs have formed and are developing.

They can feel you touching them when you rub your tummy. They might be lying head down now, getting ready for birth.

Common maternal discomforts

You may experience heartburn and indigestion due to your growing baby and hormones. Your back will also be under strain from the extra weight you are carrying. Your joints and ligaments will be looser than usual.

Your ankles, feet, and face could be puffing out a bit, especially when it is hot. This is likely due to water retention.

Get this checked out, as it could be a sign of pre-eclampsia. This is a blood pressure condition in pregnancy.

Managing back pain

To help manage back pain, you can try the following:

• Heat packs – It is safe to use a heating pad or hot water bottle on your back. Do not use these on your bump.
• Posture – Avoid standing in the same position for long. Stand tall with your bottom gently tucked under. Keep your head lifted and shoulders relaxed.
• Sitting – Use cushions to support your back and rest your feet on the floor. Lying on your side or using a birthing ball may also help.
• Sleeping – Avoid lying flat for long periods. After 28 weeks, it is better for your back and baby to lie on your side. Use a pillow under your bump or between your knees for support.

Call your GP or midwife urgently if severe back pain occurs during the second or third trimester. This is especially important if you also have a fever, pain when urinating, or pain under the ribs on one or both sides. You should also contact them if you experience bleeding from the vagina. Call 999 if you have back pain and also lose feeling in your legs, bottom, or genitals. Alternatively, go to A&E (Accident & Emergency).

Managing swelling

To help with swelling, you can try the following:

• Avoid standing for long periods.
• Regularly rest with your feet raised up.
• Wear comfortable clothes and footwear.
• Foot exercises can improve circulation.

If swelling happens suddenly, contact your midwife or maternity unit immediately. This could be a sign of a blood pressure condition in pregnancy (pre-eclampsia).

Preparing for labour

As you near the end of your pregnancy, your body begins to prepare for labour.

Signs that your baby will arrive soon include:

• Braxton Hicks contractions – These are irregular and short practice contractions where your tummy tightens for a few seconds. They do not mean you are in labour.
• Baby settling into position – Your baby will move into position for birth.

In your third trimester, you will have more antenatal checks with your midwife. They will check your blood pressure, urine, and baby's growth.

Most antenatal classes start around 8 to 10 weeks before your due date. They are a great way to prepare for birth and learn about looking after your new baby.

It is a good idea to start thinking about your birth plan. Your midwife can help you with this. Consider:

• How and where you would like to give birth
• Who your birth partner will be
• What pain relief you would like

You might also feel the urge to sort out and clean everything in your home. This is called the nesting instinct.

Early signs of labour

Labour may be starting if:

• You have a show – This is when the mucus plug that seals your cervix comes out. It can be a single blob or smaller pieces. These are sometimes reddish-brown and blood-tinged.
• Your waters break – The amniotic sac (bag of fluid around your baby) breaks. This can be a sudden gush or a trickle of fluid.
• You start to have contractions – Unlike Braxton Hicks, labour contractions are different. They get longer, stronger, and more regular.

Labour, birth, and the fourth trimester

If you are having a vaginal birth, your labour will have three stages. Knowing what happens can help you feel calmer.

The stages of labour

1. The first stage of labour – This is usually the longest stage. During this time, your cervix softens and opens (dilates). Contractions also become stronger and more regular.
2. The second stage of labour – This stage begins when your cervix is fully open and concludes with the birth of your baby.
3. The third stage of labour – This happens after your baby is born. Your womb contracts and the placenta comes out through your vagina. Your midwife will discuss management options with you.

During the second stage, you will feel an urge to push as your womb muscles tighten and loosen. Your midwife may guide you on pushing.

Sometimes, they may ask you to stop and take short breaths as your baby's head is born to allow the perineum time to stretch. An episiotomy (a small cut) might be suggested to avoid a tear or speed up delivery. A local anaesthetic is given first.

The fourth trimester

The first few days after your baby is born can be tough. You are likely to be tired, sore, and uncomfortable.

It takes time for your body to recover and adjust. Try to take it easy and do not push yourself too hard.

Physical recovery

Your body will be recovering from labour and birth. It will start to return to how it was before you were pregnant.

Your tummy will look saggy and soft immediately after birth. For some, it tones up. However, this does not happen for everyone.

Your muscles and joints might ache or be painful from the effort during labour. Your breasts may also feel uncomfortable, even if you are not breastfeeding. You might also experience:

• Afterpains – Cramping pains in your tummy as your womb shrinks back to size.
• Constipation – Difficulty passing stools after birth.
• Piles – Swollen veins in and around your bottom (also known as haemorrhoids).
• Perineal pain – Discomfort in the area between your vagina and anus.
• Vaginal discharge after birth – Also known as lochia.
• Leaking urine when you cough or sneeze – Also known as stress incontinence.

Emotional changes and bonding

Becoming a parent changes your life in many ways. Getting to know your baby and having a new routine takes time.

Be kind to yourself and take things at your own pace. You may have mixed feelings, such as joy, pride, and love.

These can be mixed with anxiety, tearfulness, and stress. These feelings are normal.

The baby blues are very common after giving birth. They usually start in the week after birth and stop by the time your baby is around ten days old. Symptoms can include:

• Feeling emotional and irrational.
• Bursting into tears for no clear reason.
• Feeling touchy.
• Feeling depressed or very anxious.

These are normal feelings caused by hormone changes as your body adjusts to no longer being pregnant. Being very tired can also make you feel worse.

The baby blues are not the same as postnatal depression or anxiety. If your symptoms do not get better after a couple of weeks, talk to your health visitor or GP.

Some people expect new parents to bond naturally with their baby. This is not always the case. Bonding with your new baby is a journey, and it will take time to get to know one another.