First Trimester

Am I pregnant?

Aside from the obvious (a missed period and a positive pregnancy test) here are some signs and symptoms of early pregnancy that you can expect to start from around the 6th week of pregnancy (or about 2 weeks after your period is due):

Bloating and cramping

Bloating is caused by the increase of a hormone called progesterone.  This hormone is responsible for relaxing smooth muscle in the body which means that when you eat, your food takes longer to pass through your gastrointestinal tract, causing you to feel bloated and windy.  To help with this, you can try to eat several smaller meals a day rather than 3 large ones.  Ensure that you are eating a well balanced diet with plenty of fibre and water to help avoid constipation.  Try to avoid foods that cause you to be windy and try to take your time eating meals and chew your food well as this will aid in your digestion.

Feeling extra sleepy

Fatigue can be one of the earliest symptoms that you are pregnant and tends to be worst in the first trimester.  The good news is that fatigue generally eases off in the 2nd trimester and but will reappear again in the 3rd trimester but isn’t usually as bad. Progesterone is the hormone that can be blamed for this.  Additionally your body is working hard to build up its own blood volume and this causes increased work for the heart and other organs.  In order to combat fatigue, it is best to limit caffeine, eat a balanced diet including meat and iron rich foods, get as much rest as you can and also try to enjoy light exercise such as walking.

Increased frequency of urination

Increased levels of the pregnancy hormone hCG cause increased blood flow to the kidneys and pelvis organs, thus increasing the need to pee.  Additionally, the growing uterus begins to press on your bladder also giving that feeling that you need to visit the loo regularly.  As your body begins to increase blood volume, this too causes you to pee more often.  To help with this symptom, continue to drink lots of water during the day, but you may wish to limit your fluid intake in the evening before bed.  You may find it helpful to limit drinks with caffeine in them as caffeine can make you pee more.  Make sure you fully empty your bladder when you go to the toilet.  Try leaning forward when you pee or, when you think you have finished, try to pee again.  Do alert your midwife you feel burning or stinging while passing urine, you have a fever or abdominal pain as these could be signs of a urinary tract infection (UTI).

Breast changes

Some changes that may be experienced are tenderness of the breasts, growth in size of the breasts or feelings of fullness, darkening of the areola (area around the nipples), or you may not notice any change. By the end of the first trimester, you may even notice that your breasts look very veiny as well.   Pregnancy hormones are responsible for some of these changes.

Food cravings or aversions

Good old pregnancy hormones are responsible for causing you to suddenly “go off” a food item you used to love or start eating something more often than you used to.  Generally, cravings and aversions will stop by around the end of the fourth month, so in the meanwhile, here are a few tips to help you deal with cravings and aversions:

Cravings

-try to feed your cravings but in moderation.  Instead of eating a huge bowl of ice cream, perhaps a small scoop in a cone would be sufficient

-when a craving strikes, especially if it is one that isn’t so healthy, try some light exercise to distract you

-enjoy your cravings in moderation.  You can eat one bad meal once in awhile as long as you are having a balanced diet the rest of the time

-Pica is a craving for dirt, ash, chalk or clay and may indicate a deficiency of iron in your body. If you experience intense cravings to eat non-food items such as those listed here, contact your care provider as you may need to have a blood test taken.

Aversions

Aversions can be very hard to cope with, especially if you are suffering from morning sickness.  It can sometimes seem that there is simply nothing that you want to eat or can even imagine putting in your mouth.  If you are suffering from strong aversions to foods, don’t worry too much.  Just eat what you can knowing that this symptom of pregnancy should pass once you hit the second trimester.

Increased salivation

It is quite normal for some women to experience an increase in the amount of saliva, or spit, they produce.  Increased salivation can be very unpleasant and can contribute to feelings of nausea and heartburn.  To help with this, you can try to increase your fluids, brush your teeth often and suck on lozenges or chew some gum.  Fortunately, this symptom tends to disappear by the 2nd trimester.

Nausea/vomiting

As many as 80% of women will experience some form of nausea and vomiting in pregnancy.  Some women experience these symptoms much more strongly than others.  The term “morning sickness” can be a bit deceptive as some women feel worse later in the day, or they feel terrible all day long.  In some cases, vomiting is extreme and occurs several times a day, or a woman may be so nauseated that she cannot eat or drink. This is known as Hyperemesis Gravidarum (HG).

Although it is miserable, in most cases, nausea and vomiting are a good sign that your baby is well implanted in your womb and may be less likely to experience a miscarriage.

Fortunately, most women experience a decrease in these symptoms as they enter the second trimester.

If your sickness symptoms are causing you problems with sleeping and your ability to work, talk to your midwife as she can provide some information on ways to cope and failing that, there are some medications we can use to help you feel better.

Here are some websites with some tips to cope with nausea and vomiting in pregnancy and also a great site about HG.

http://www.babycentre.co.uk/pregnancy/antenatalhealth/morningsicknesswhy/

http://www.bpac.org.nz/magazine/2011/november/docs/bpj_40_pregnancy_pages_24-29.pdf

http://www.helpher.org

A period that is lighter or shorter than normal, or comes earlier or later than it should

It is not unusual for a woman to have a bit of bleeding or spotting around the time her period is due.  This” period” might be much lighter than normal and could also be very short, lasting only a day or two.  This could be implantation bleeding as the embryo begins to bury itself into the wall of your uterus.  You may also feel crampy and “like your period is coming”.  Spotting can also be triggered by sexual activity.  If spotting is brown or light pink, this is fairly normal, however, if the blood is very red and heavy, you may be having a miscarriage and should contact your LMC.

http://www.babymed.com/implantation-bleeding-or-menstrual-period-bleeding-cycle

Headaches

Headaches are a very common symptom experienced in early pregnancy, again, due to large amounts of hormones circulating in your system. It is important to stay well hydrated by drinking water, eating a well balanced diet, avoiding stress, getting plenty of rest, and if you need to, you can take some Panadol.

Increased sense of smell

It is very usual for women to notice that their sense of smell becomes much more sensitive during pregnancy.  Sometimes, this can be quite overwhelming, especially if you are dealing with other symptoms like nausea and headaches.

If your sense of smell is causing you problems, especially with day to day activities such as cooking, then here are a few ways to help:

– Cook things that you can tolerate the smell of (or better yet, get your partner to cook for you while you relax in another room)

– Get plenty of fresh air, leave the windows open a bit to keep clean air coming into your home or office

– reduce the amount of scented products you use for personal hygiene and when cleaning the house

– stay away from smoking areas

– you can always use a few drops of mint or lavender on a handkerchief and keep this in your purse for times when your senses are assaulted by smell (for example you can breathe into the handkerchief when passing through the mall food court area)

Much of the information above was found on the following websites which are rich in information about the different stages of pregnancy.  Take a look!

Refs:

http://www.americanpregnancy.org

http://pregnancy.about.com

http://www.whattoexpect.com

http://www.countdowntopregnancy.com

http://www.marchofdimes.com

http://www.webwomb.com

How pregnant are you?

Confused about how far along you are or need help understanding if you are pregnant for 9 months or ten?  Take a look here for some explanations about dating your pregnancy…

http://www.baby2see.com/pregnancylength.html

Pregnancy Tests

Am I pregnant? A quiz

http://pregnancy.about.com/library/quiz/amipreg/blamipregquiz.htm

Some info about pregnancy tests:

There are 2 types of pregnancy tests, a urine(pee)  test or a blood test.  Both test for the same hormone, human chorionic gonadotropin or hCG.  Once the fertilized egg has implanted in the uterus (usually around 7-10 days after you ovulate but it can happen much later), hCG is then produced and levels rise rapidly.  The blood test can be ordered by your GP or midwife and is very accurate and can detect levels of hCG very early.  The urine test can be purchased from the local grocery store or chemist and can be done at home.  Occasionally, the home pregnancy test can give a false negative if you test too early(and false negatives are more likely to occur than false positives), however, a positive is usually a sign that you are pregnant! Tests that claim to provide early results  tend to be more sensitive, that is, they can detect a positive pregnancy with lower levels of hCG in your urine.  If you do a home pregnancy test and it is negative and you do not start your period after a few days, it might be worthwhile to test again.

Here is a link to some information about pregnancy tests:

http://womenshealth.gov/publications/our-publications/fact-sheet/pregnancy-tests.cfm

Now that you know you are pregnant, when are you due?

Check out this due date calculator to find out when your baby might arrive:

http://www.kidspot.co.nz/due-date-calculator-kidspot.asp?gclid=CPLK7tLX6rACFQZ5hwodwlKwtw

Gender predictor?

Feel like having some fun and want to know what you are having?

http://www.babygenderprediction.com/

http://www.childbirth.org/articles/boyorgirl.html

http://www.babygenderprediction.com/category/gender-prediction-myths

Interested in the changes you can expect to see in your body and also how your baby is growing?

Check out these pregnancy calendars which give lots of great information:

This one gives you information day by day.

http://www.justmommies.com/pregnancy_calendar.php

Dietary Information for Pregnancy

A good diet is an important part of your pregnancy.  The food you eat helps to provide your body with the energy to grow your baby but it also has an impact on how your baby develops.

Following are some links to websites with great information related to eating in pregnancy.

http://www.kiwifamilies.co.nz/articles/nutrition-in-pregnancy/

http://www.whattoexpect.com/pregnancy/eating-well/pregnancy-diet.aspx

This website has excellent information related to all sorts of eating issues including eating while travelling, food safety and handling, a guide to eating right in pregnancy

http://www.foodsmart.govt.nz/information-for/pregnant-women/

Are you vegetarian and wondering what to eat during your pregnancy?

http://www.health.qld.gov.au/nutrition/resources/antenatal_veget.pdf

http://www.vegsoc.org/document.doc?id=9

Vegan?

http://www.vrg.org/nutrition/veganpregnancy.htm

http://www.vegan-momma.com/vegan-pregnancy.html

http://www.health.qld.gov.au/nutrition/resources/antenatal_vegan.pdf

Supplements

There are all kinds of ideas out there about supplements and things that you need to take in pregnancy.  Iodine and folic acid are two such supplements that are highly recommended in New Zealand (and across the world) for the health of your baby.

Iodine

Why do we need to take iodine in pregnancy?  Find the answers here…

http://www.health.govt.nz/our-work/preventative-health-wellness/nutrition/iodine

http://www.foodsmart.govt.nz/whats-in-our-food/chemicals-nutrients-additives-toxins/food-additives/iodine/

Folic Acid

Information about the importance of folic acid supplementation in the first trimester can be found here:

http://www.health.govt.nz/our-work/preventative-health-wellness/nutrition/folate-folic-acid

http://www.foodsmart.govt.nz/whats-in-our-food/chemicals-nutrients-additives-toxins/food-additives/folate/

Multivitamins

Do I need to take a multivitamin?

The Ministry of Health currently recommends that women who are pregnant take folic acid from one more before conceiving up until the end of the 12th week of pregnancy and iodine from when you become pregnant until you stop breastfeeding.  If your diet is well rounded and you eat from all of the food groups, you are unlikely to need further supplementation than the folic acid and iodine.

Alcohol in Pregnancy

It is unknown if there is any safe amount of alcohol in pregnancy despite a recent research article published by some Danish researchers.  While one woman may have many drinks in her pregnancy and have a baby who is unaffected by Fetal Alcohol Syndrome (FAS), another woman may only have a few and have a child who has FAS.  The best way to ensure the safety of your baby is to abstain from alcohol completely during pregnancy.  The links below provide some excellent information on alcohol use in pregnancy, as well as some information on Fetal Alcohol Syndrome. If you feel that you have a problem with alcohol, please talk to your midwife who can help you access help.

http://alcoholism.about.com/cs/preg/a/aa070997.htm

https://www.healthed.govt.nz/resource/alcohol-and-pregnancy-when-you-drink-alcohol-so-does-your-baby

http://www.marchofdimes.com/pregnancy/alcohol_indepth.html

Some information on Fetal Alcohol Syndrome

http://www.fan.org.nz/home

Smoking

It is well known that smoking is harmful to a person’s health, however, it also a problem for your baby as well.  Each time you smoke while pregnant, your baby is deprived of oxygen and nutrients and its heart rate rises to try and move more oxygen around its body.  It is directly exposed to nicotine and carbon monoxide.   Smoking in pregnancy increases your risk of a miscarriage.  Babies of smoking mothers tend to be smaller because the chemicals in cigarette smoke cause constriction of the blood vessels in the placenta, reducing flow of nutrients and oxygen to the baby.  Once the baby is born, it may suffer withdrawal from the nicotine.

Here is some information on how smoking affects mum and baby:

http://www.helpwithsmoking.com/smoking-and-pregnancy/effects-on-foetus-pregnancy.php

http://www.everybody.co.nz/page-9ed182c5-be8d-4661-adb3-d92ea256efe7.aspx

A baby is also at risk after it is born, it its parents continue to smoke.  The risk of cot death (or Sudden Unexplained Death in Infants or SUDI for short) is very high in infants whose parents smoke.

Quitting smoking

Pregnancy is a wonderful time to quit smoking as the health benefits not only affect you, but also your baby.

Smoke change is a free service for pregnant women and their partners to assist them in changing their lives by quitting smoking.

http://www.changeforourchildren.co.nz/our_kites/smokechange

http://www.quit.org.nz/46/staying-quit/tips-for-quitting

Drugs in Pregnancy

Use of illegal drugs in pregnancy (such as marijuana and pills as examples) can have long lasting effects on your baby.  Read here for more information:

http://www.mamamaternity.co.nz/mama-maternity-abc/planning-your-pregnancy-care/tobacco-alcohol-and-drugs/

Need help to stop using?

http://www.drughelp.org.nz/?gclid=COWGgqrU_LACFWaXpgody01VQA

http://www.drugfoundation.org.nz/

Screening in Early Pregnancy

In the first trimester of pregnancy, it is likely that you will be offered some tests.  You may be offered a blood test to check the levels of the pregnancy hormone hCG.  This test is helpful if you are uncertain of when you may have conceived or it seems that you might be at risk of miscarriage.

Additionally, you will likely be asked to have a blood test that looks at a variety of aspects of your health, including your blood type, a complete blood count and your immunity to some diseases such as hepatitis b and syphilis.

Click on this link for more information about what is tested for: http://www.everybody.co.nz/page-0b755006-b9db-4151-99b9-966d7c2e23c6.aspx

http://www.mamamaternity.co.nz/mama-maternity-abc/planning-your-pregnancy-care/antenatal-screening-and-diagnostic-tests/

At the end of the first trimester, you will be offered the opportunity to have an ultrasound scan and blood test which will help to determine the chances of your baby having a chromosomal disorder such as Down Syndrome (Trisomy 21), Edwards Syndrome (Trisomy 18) and Patau Syndrome (Trisomy 13).

This website provides excellent descriptions of the testing that is carried out and what may happen next if your baby is found to be at increased risk for a chromosomal issue. http://nsu.govt.nz/current-nsu-programmes/antenatal-screening.aspx?gclid=CLnjiI3S_rACFWaXpgody01VQA

http://www.lpch.org/diseasehealthinfo/healthlibrary/genetics/trisomy.html

Trisomy 13

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002625/

Trisomy 18

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002626/

http://www.trisomy18.org/site/PageServer

Trisomy 21 Down Syndrome

http://www.mosaicdownsyndrome.com/

http://www.nzdsa.org.nz/

Finding a midwife

You can contact one of our midwives either by phone or email or through our Contact Us page.

It can also be useful to talk to friends and family about the midwives they had.

You can call the Midwifery Resource Centre, 365-2789 or you can peruse the listings on the New Zealand College of Midwives website by following this link: http://www.midwife.org.nz/index.cfm/1,155,html or http://www.midwiferycouncil.health.nz/how-to-find-a-midwife/

Antenatal Classes

Now is a wonderful time to start thinking about Antenatal classes.  Some places offer an early class in the first trimester to discuss common pregnancy issues and diet and exercise.

Places you can contact are:

Christchurch Womens Hospital, 03 364-4421

http://www.cdhb.health.nz/Hospitals-Services/Maternity/Birthing-Locations-Postnatal-Care/Christchurch-Birthing-Suite/Pages/default.aspx

Burwood Birthing Unit, 03 383-7579

http://www.cdhb.health.nz/Hospitals-Services/Maternity/Birthing-Locations-Postnatal-Care/Burwood-Birthing-Unit/Pages/default.aspx

Rangiora Hospital, 03 313-7682

http://www.cdhb.health.nz/Hospitals-Services/Maternity/Birthing-Locations-Postnatal-Care/Rangiora-Birthing-Unit/Pages/default.aspx

Lincoln Maternity Hospital, 03 325-2802

http://www.cdhb.health.nz/Hospitals-Services/Maternity/Birthing-Locations-Postnatal-Care/Lincoln-Birthing-Unit/Pages/default.aspx

Parents Centre, 03 383-9009 (these classes fill up quickly so it is best to book early!)

http://www.parentscentre.org.nz/