Pregnancy is a transformative experience that marks the beginning of one of life's most remarkable journeys. It is a period of great anticipation and over the course of approximately nine months or forty weeks, expectant mothers and their families embark on a path filled with wonder and challenges.
Planning a pregnancy
If you are planning a pregnancy, it is recommended that you take a 400 microgram daily supplement of folic acid three months before conception and continue to take this until the end of the first trimester at 12 weeks. This is to help reduce the chances of your baby developing birth defects such as spina bifida. Some individuals will need a higher dose due to their medical history. Speak with your doctor if you are concerned.
You should be offered the influenza vaccine and a whooping cough booster vaccine during your pregnancy. Both vaccines are safe and effective at protecting you and your newborn baby as they will be born with antibodies passed from you.
Don’t worry if you get pregnant unexpectedly: just start taking the supplements as soon as you find out.
Other ways to look after you and your baby include stopping smoking, cutting out alcohol and maintaining a healthy diet and weight. Take advice from your doctor if you are on any medication.
First trimester: 1-12 weeks
Pregnancy is dated from the first day of your last period – so for approximately the first two weeks you aren’t technically pregnant. Adjusting to pregnancy can be an exciting time but includes a range of physical and emotional changes. What will you be experiencing during the first 12 weeks?
- Your periods have stopped.
- You may feel nauseated or vomit – the term “morning sickness” is sadly misleading as the symptoms can happen at any time of the day or night. Some people have no symptoms, but an unlucky few can develop hyperemesis gravidarum, which results in severe vomiting and will require medical treatment.
- Feeling tired or sometimes exhausted.
- Feeling exhilarated and/or up and down due to hormonal changes.
- Tender breasts.
- Increased sensitivity to smells, changes in taste.
Baby
- Just after 12 weeks the foetus is fully formed. Organs, muscles, limbs, bone and sex organs are in place.
- You will usually have your first scan around the 12-week mark and can see the developing baby.
Second trimester: 13-27 weeks
During the second trimester at around 20 weeks, you will usually be offered a detailed ultrasound scan. The scan checks on the development of the baby and can help to identify any potential problems. At this scan the sonographer may be able to tell you the sex of the baby. However, some hospitals may refuse. You should check your local hospital’s policy.
For most individuals, the sickness and exhaustion improve during the second trimester. You will notice your bump starting to grow and you may see skin changes. You may develop a dark line down the middle of your stomach. These changes will gradually fade after the baby is born.
You will also start to feel the baby moving. This is usually between 16 and 24 weeks. If it is your first baby, you might not notice movements until 20 weeks.
Third trimester: 28-40+ weeks
This is the home stretch. During this trimester, you baby is continuing to grow and its lungs and central nervous system are maturing. Towards the end of the trimester (depending on the position of your baby), the head will often 'drop' into your pelvis.
As the baby grows, some individuals experience additional symptoms:
- heartburn and shortness of breath;
- excessive tiredness;
- swollen feet or hands (if the swelling develops suddenly or gets a lot worse, contact your midwife to check for a condition called pre-eclampsia);
- difficulty sleeping;
- increased urinating especially at night;
- Braxton-Hicks contractions, or “practice contractions” from 30+ weeks. These are caused by the womb starting to contract;
- varicose veins due to expansion of blood volume and changes in the vessel walls;
- leaking a milky fluid called colostrum from your breasts.
You will see your midwife more frequently as the pregnancy reaches term, and you may have bloods taken at around 28 weeks to ensure you are not becoming anaemic.
Most babies do not arrive on the due date, and many individuals go past their expected delivery date. This is common and usually not something to be concerned about.
In most cases labour will have started naturally by 41-42 weeks. If not, you will be offered an induction to start your labour as there is a higher risk of stillbirth beyond 42 weeks.
Labour
The experience of labour can be different from one person to another, but generally everyone giving birth will experience:
- contractions or 'tightenings' – as labour progresses, these increase in intensity and frequency;
- a 'show' when the plug of mucus at the entrance to your womb has come away;
- back pain;
- waters breaking – labour will normally start within 24 hours of your waters breaking; if not, you will be offered an induction, because without the amniotic fluid there is an increased risk of infection for your baby.
Stages of labour
- 1st stage: contractions are gradually dilating (opening) the cervix, and for most women this is the longest stage of labour and can take many hours, particularly if it is your first baby. You are not in 'established labour' until you are at least 4cm dilated.
- 2nd stage: now you are fully dilated (to 10cm) and your body is ready to push and deliver your baby.
- 3rd stage: delivery of the placenta – this can happen naturally or actively if you have treatment to make it happen faster. Your midwife will discuss your options with you.
Pregnancy and work
Most people can safely continue to work during their pregnancy. Speak to your employer about carrying out a pregnant worker’s risk assessment.
Pregnancy is a protected characteristic under the Equality Act 2010.
You will need a MAT B1 form which is usually completed by your doctor or midwife. This confirms the pregnancy and expected week of confinement (EWC) and is issued after your 20th week of pregnancy.
You should inform your employer of the date you plan to start maternity leave no later than 15 weeks before your baby is due.
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