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Pregnancy refers to the time period, usually lasting 40 weeks, during which the fetus develops in a woman’s womb or uterus. The beginning of pregnancy occurs when the egg, released by a woman’s ovaries, gets fertilized by a man’s sperm in the uterus. Once implantation (the process through which the fertilized egg adheres to the wall of the uterus to get nutrition and grow) is achieved, the gestation period, also known as pregnancy, starts. 

Since it’s difficult to pinpoint the exact time when an egg is fertilized, the period of pregnancy is calculated from the first day of a woman’s last menstrual period. Gynecologists add 40 weeks or 280 days from this date to calculate when the baby is to be expected. 

Once a pregnancy is confirmed, proper prenatal care should be taken to avoid any complications, like miscarriage, placental abruption, etc. Every pregnant woman has to undergo routine check-ups during pregnancy to understand how the foetus is developing and if special care is needed. There are a number of vaccinations that pregnant women are supposed to take during the period of their pregnancy, and all women are also supposed to take vitamin and mineral supplements during pregnancy.

It’s also important to follow a proper pregnancy diet and exercise routine during the gestation period to ensure that the mother is healthy, and that the baby is getting enough nutrition to grow properly. If there are no complications during pregnancy then women are able to have a normal vaginal delivery. In case of premature labour or complications, the baby is delivered through caesarean or c-section. Here’s everything you need to know about pregnancy.

  1. How to get pregnant
  2. Symptoms of pregnancy
  3. How to confirm your pregnancy
  4. First trimester of pregnancy
  5. Second trimester of pregnancy
  6. Third trimester of pregnancy
  7. Complications of pregnancy
  8. High blood pressure
  9. Gestational diabetes
  10. Infections
  11. Miscarriage
  12. Ectopic pregnancy
  13. Premature labour
  14. Stillbirth
  15. Check-ups during pregnancy
  16. Vaccinations during pregnancy
  17. Diet and supplements during pregnancy
  18. Labour and birth of your baby

How to get pregnant

The first thing you need to know about how to get pregnant is ovulation. Of course, you need to have sexual intercourse to get pregnant, but the right time and method matters - and that’s why understanding ovulation is important. 

Ovulation is the time period when a woman’s ovaries release eggs every month. The eggs then travel to the uterus via the fallopian tubes, where they are fertilized by sperm. To facilitate this fertilization, a woman’s body also releases hormones called estrogen and progesterone, which build up a lining in the uterine wall to create a conducive environment. 

If fertilization happens, then the build-up in the uterine wall helps the egg attach to the womb. If fertilization does not happen, then the egg is naturally destroyed, and the uterine lining also breaks down - leading to bleeding or menstruation. This entire process is repeated every month.

Since ovulation happens for just five to six days every month, it’s important to increase the frequency of sex during this time to ensure pregnancy. Sperms can remain active in a woman’s body for upto seven days, so if you have sex before ovulation, the sperm might “wait” to fertilize the egg. Here are a few things you should remember if you want to get pregnant:

  • Stop taking contraceptive pills, painkillers, antidepressants and other medications that might interfere with ovulation.
  • Avoid taking excess sugar and salt, and make sure to stay away from foods that have high mercury content.
  • Have sex in missionary (man on top) and doggie (man behind woman) positions to maximise chances of pregnancy.
  • Do not stand up or wash your vagina after sex. Raising your legs up can also help.
  • If you do need a lubricant, consult a doctor about the safest one to ensure pregnancy.

Symptoms of pregnancy

A lot of women, especially those who are not actively trying to get pregnant, are taken by surprise when they do get pregnant. This is why it’s important to pay attention to changes in your body, which are the first symptoms of pregnancy. The following symptoms usually manifest if you are pregnant:

  • Missing your period is one of the classic symptoms of pregnancy. However, missed periods can also signify health issues like polycystic ovary syndrome (PCOS) and uterine fibroids, so it’s best to consult a gynecologist if you miss a period.
  • Vomiting or morning sickness is another classic symptom of pregnancy, and are caused by increased hormone levels in the body.
  • Breast changes are the first noticeable symptoms of pregnancy. If your breasts feel tender, swollen or fuller, it might be that you’re pregnant and your body is getting ready for lactation.
  • There might be some light bleeding or spotting when implantation happens, and if you’re experiencing this, do consult a doctor or get a home pregnancy test.
  • Headaches are a common symptom of early pregnancy and happen because of changes in hormones and increased volume of blood.
  • Gaining weight is a way for the body to prepare to support a pregnancy, so if you’ve added a few kilos without doing anything to gain weight, it’s time for a pregnancy test.
  • Heartburn and constipation are also common symptoms of early pregnancy because changes in hormones can affect the digestive system.
  • Many women have acne outbreaks during early pregnancy. Increased hormone levels can make the skin oily, which leads to clogged pores and acne.
  • Pain in the back and hip are also common, and are caused by weight gain and expansion of the uterus to accommodate the growing foetus.

How to confirm your pregnancy

If you suspect that you are pregnant - due to a missed period or other symptoms - the best way to confirm it is through a pregnancy test. You can go to a doctor and ask them to administer the test, or opt to take a pregnancy test in the comfort and security of your home with a home pregnancy test kit.

Home pregnancy test kits are easily available in the market, they are cheap and also easy to use. All pregnancy tests measure the hormone called human gonadotropin (hCG), which the body starts producing within six days of a successful fertilization of the egg. 

All you need to do during a home pregnancy test is to pee on a stick and wait for the result. The result notifier of home pregnancy tests differ from one manufacturer to another, so it’s important to read the instructions thoroughly. Positive results are usually correct, but if you got a negative result it’s best to confirm it by taking another test too. 

If the second test also shows up as negative and you still don’t get your period, consult your doctor or a gynecologist immediately.

First trimester of pregnancy

The first trimester of pregnancy consists of weeks one to 12. Although most women don’t realise they are pregnant until they are already five-seven weeks into the pregnancy, the actual calculation starts from the first day of the last period. The chances of miscarriage are high during this trimester, so extra care should be taken.

A woman’s body prepares for the entire gestation period during the first trimester. The uterus expands to house the foetus, the placenta develops to provide it with nutrition, the hormones and blood volume doubles, and there is inevitable weight gain too.

The baby develops rapidly during the first trimester. The spinal cord, brain and organs of the baby form during this phase, and by the end of it you will be able to hear the heartbeat of the baby in an ultrasound.

Second trimester of pregnancy

The second trimester of pregnancy consists of weeks 13 to 27. Women start to feel the baby move inside the uterus during this trimester. This means that the baby is growing well in the womb. Prenatal care should be continued properly during this trimester, especially if you are going through a multiple or twin pregnancy.

An ultrasound is conducted in the second trimester to track the growth of the baby between weeks 18 and 20. It’s best if deficiencies and risks of birth defects like spina bifida are discovered early in the second trimester, since this would give the mother more chances of taking the right course of action and also help doctors understand how to treat complications, if any.

It’s also important to remember that even though babies are considered to be in utero (or capable of surviving outside the uterus) after week 23, the longer the baby lives in the uterus, the better its chances of survival and lesser the number of its medical issues.

Third trimester of pregnancy

The third trimester of pregnancy consists of weeks 28 to 40. During these weeks, your weight gain will increase and you will feel more tired than before. It’s important to take plenty of rest during this trimester to ensure the safe delivery of your baby.

The baby’s bones, even though soft, are fully formed by this trimester. The baby can also sense light as well as open and shut his or her eyes. The baby and the mother’s body will start preparing for vaginal delivery towards the end of this trimester if everything goes right.

It’s important to note that babies born before 37 weeks are termed premature, and they are more likely to be at risk of developmental delays and weaker immune systems. Babies born in weeks 39 and 40 are considered to be full term, and have better health outcomes.

Complications of pregnancy

There are many women who sail through their pregnancies without any serious health issues, and these women are indeed lucky. There are, however, many women who do have a more difficult pregnancy due to complications in their own health, their baby’s health, or both. While taking proper precautions before getting pregnant (like not smoking or drinking, and sticking to a balanced diet) reduce the chances of these complications, women who were absolutely healthy before their pregnancy can also get these complications. 

These pregnancies are known as high-risk pregnancies, and extra prenatal care, medical treatments and even surgical interventions might be necessary to help these pregnancies sustain without harming the mother irrevocably. The following are the major complications that mothers-to-be may face during their pregnancy.

High blood pressure

High blood pressure, also known as hypertension, is a condition that can severely affect the baby’s health. Having a high blood pressure can reduce the flow of blood to the placenta, which provides the baby with oxygen and nutrition. Reduced blood flow to the placenta can slow the development of the baby. What’s more, it can induce premature labour in the mother and can also cause preeclampsia.

Women who suffer from hypertension before getting pregnant need to constantly monitor their condition during pregnancy. If the high blood pressure occurs after a woman gets pregnant, it’s known as gestational high blood pressure. This latter form of hypertension usually manifests in the second or third trimesters, and usually goes away naturally after the baby is delivered.

Gestational diabetes

Gestational diabetes occurs when a woman who did not have diabetes or blood sugar issues before develops the condition during pregnancy. The pancreas releases a hormone called insulin, which breaks down glucose and delivers it to all the cells for energy. Hormonal changes during pregnancy can cause the body to not produce enough insulin or not use it normally. This can lead to the build-up of glucose in the bloodstream, increase blood sugar levels and lead to gestational diabetes.

If you are diagnosed with gestational diabetes, it’s best to follow the medication treatment suggested by the doctor. Following this treatment is important, as it can lead to complications that can cause premature birth.

Infections

If a mother contracts infections during pregnancy - whether they are bacterial infections, viral infections, fungal infections or sexually transmitted infections (STIs) - they can be passed onto the foetus, which can affect the health of both the mother and the child after birth. Many of these infections can be treated before and during pregnancy, and might require appropriate follow-up care. 

Getting yourself checked for infections and taking ample precautions against them is important because these can lead to complications like miscarriage, ectopic pregnancy, premature delivery, birth defects and death of the newborn. You should talk to your doctor about these infections and take vaccinations or treatments if you are at risk.

Miscarriage

Miscarriage refers to the natural loss of the foetus within the first 20 weeks of pregnancy. It can happen due to a number of reasons, including infections, immune system responses and uterine abnormalities. The chances of a miscarriage occurring are increased if you smoke or drink alcohol, if your pregnancy occurs at an older age, or if you have a history of miscarriages. Lack of exercise, stress and excessive caffeine consumption can also lead to a miscarriage.

Symptoms of miscarriage include vaginal bleeding, cramping, vaginal discharge, etc. Once started, the process of miscarriage cannot be reversed. A miscarriage can be quite traumatic, and can be caused if you have a history of miscarriages or have lifestyle habits like smoking or drinking. This does not mean that you cannot get pregnant again, so it’s best to not lose heart and get ample support from family, friends and healthcare professionals.

Ectopic pregnancy

Usually, the embryo gets fertilised in your womb, but if this fertilisation happens in the fallopian tubes instead, then what you experience is called an ectopic or tubal pregnancy. Symptoms of ectopic pregnancy therefore need to be recognised immediately. These symptoms include pelvic or abdominal pain, bleeding, nausea and the urge to make a bowel movement.

It is impossible for an ectopic pregnancy to proceed normally, so you will have to get it treated medically or surgically. If not detected on time, an ectopic pregnancy can lead to the bursting of the fallopian tubes in some cases, which can be life-threatening. So, if you see any of the symptoms of an ectopic pregnancy, as mentioned below, contact your doctor and visit the hospital immediately.

Premature labour

If labour starts before week 37 of pregnancy then it’s called premature labour. Babies born due to premature labour usually have health issues and slow development post birth. This happens because the brain and the lungs finish their development in the final weeks of pregnancy. 

Premature pregnancy is often caused by lifestyle issues with the mother, including poor prenatal nutrition, smoking, alcohol abuse, use of illegal drugs, uterine abnormalities, and infections. Lower levels of the hormone progesterone can also cause premature labour, which is why women at risk are treated with this hormone to delay labour until delivery is deemed safe.

Stillbirth

The loss of pregnancy after 20 weeks is known as stillbirth. The term is also used to refer to babies who died during delivery. Quite a large number of stillbirths are caused by unknown factors, and are called unexplained stillbirth. The number of stillbirths in India is the highest in the world with an estimated 592,100 deaths per year, which translates to 22 deaths per 1000 births, according to the World Health Organisation (WHO). 

Smoking, alcohol abuse, late age pregnancies, and medical conditions like diabetes and obesity increase the risk of stillbirth, along with poor socio-economic conditions in developing countries. Stillbirth can be very traumatic for parents, especially the mother, which is why proper counselling should be given to couples who go through this.

Check-ups during pregnancy

A comprehensive health assessment of both the mother and the father is vital during the first trimester of pregnancy. Not only does your baby derive nutrition from the mother during pregnancy, but the parents’ genes are also passed down to the newborn baby. Since this plays a role in the long-term development of the baby, getting routine tests and screenings done is very important.

These tests and screenings include a comprehensive blood count, urinalysis, tests for hepatitis, STIs and HIV/AIDS. Tests like pregnancy-associated plasma protein and human gonadotropin are also done to make sure that there are no chromosomal abnormalities in the baby. Ultrasounds and Nuchal Translucency scans are also done to track the development of the foetus and to ensure no abnormalities exist.

Read more: Check ups during pregnancy: Tests and ultrasound in all three trimesters

Vaccinations during pregnancy

The immune system of the mother plays a huge role during pregnancy because your baby’s health depends on it. The mother’s immune system protects the baby during the gestation period, and after birth it is maintained through breastfeeding until the baby receives all his or her own vaccinations.

This is why it’s important that the mother has received all the vaccinations she should. You should get all the recommended check-ups and screenings, and based on the results of those, the doctor will let you know which vaccines you need. It’s important to note that the influenza vaccine and the vaccine for tetanus, diphtheria and whooping cough (TDaP) is given to all pregnant women.

Read more: Vaccination during pregnancy

Diet and supplements during pregnancy

A healthy diet is important to maintain adequate nutrition during pregnancy, because the mother needs nutrition to sustain herself and for the growing baby. This is why maintaining a balanced pregnancy diet, which includes adequate amounts of carbohydrates, proteins, vitamins and minerals, is vital.

Read more: Foods to eat and avoid during pregnancy

Water is underrated when it comes to nutrition during pregnancy, but dehydration can cause serious complications. So, drinking enough water is very important. There are also a number of vitamins and minerals your body needs during pregnancy - including folate and iron, which are compulsorily recommended to all pregnant women.

Read more: Vitamins and minerals you need during pregnancy

Labour and birth of your baby

The fact that your body is ready for labour and the delivery of your baby is announced through contractions. After the fourth month of pregnancy, you may even experience some contractions which do not increase in intensity and do not occur at frequent intervals. These contractions are known as Braxton-Hicks contractions or false labour. 

If you experience contractions that are frequent and increasing in intensity before 37 weeks of your pregnancy, it can be a sign of premature labour. If these signs show up, you should consult your doctor immediately and head to the nearest hospital.

Labour contractions are of two types: early labour contractions (which are five minutes apart) and active labour contractions (which are more frequent and intense in pain). The cervix starts opening up during contractions, and when this happens you might see a blood-tinged discharge. 

Once your cervix is dilated enough, your body is ready for vaginal delivery. If this dilation does not happen, or if there are any complications, then you might have to go for a c-section or caesarean delivery. 

Pain management during delivery is important, because the pain becomes intense during active labour. Most women are given analgesics and anesthetics like epidural to manage this pain, but a lot of women are now opting for meditation, yoga and music therapy instead of medications that interfere with their birthing experience.

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