When it comes to pregnancy, we frequently hear about a certain handful of side effects. There are the weird cravings and bouts of morning sickness. Then there's frequent urination, swollen feet, and mood swings.
But what about the lesser-known surprises that come with carrying a baby? What should you expect to happen to your body during those nine months of pregnancy?
We asked Eva Martin, MD, an OB/GYN with Main Line Health, to weigh in on everything you need to know about pregnancy.
Although vaginal bleeding can be scary and nerve-racking, it's actually quite common. In fact, approximately 40 percent of pregnant women will experience some degree of bleeding in the first trimester.
Just because you have a bit of vaginal bleeding does not mean you will miscarry or have issues with delivery. However, it's important to tell your physician if you do spot some blood.
"If you haven't had an ultrasound to evaluate the pregnancy, your doctor will want to make sure you do not have an ectopic pregnancy, which is a pregnancy outside of the uterus," Dr. Martin explains.
Ectopic pregnancies, while rare, can put you at risk for heavy internal bleeding. An ultrasound can confirm that the pregnancy is taking place in the uterus and that you are not having a miscarriage. There are several other causes for bleeding, such as vaginal or cervical irritation or a subchorionic hematoma, which can all be identified via ultrasound as well.
Let's be frank: One thing you absolutely need to know if you're pregnant is that you're likely going to be exhausted.
"Every pregnant person I've ever talked to is exhausted, especially during the first trimester. This is likely from one of the hormones of the pregnancy called progesterone," Dr. Martin says. "In addition, many women experience nausea and vomiting, which takes a toll on the body and your energy."
If you feel overly tired and lethargic, don't worry. It's completely normal to feel exhausted, and as you cruise into your second and third trimesters, you'll start to feel more like yourself.
Ultrasounds, ultrasounds, ultrasounds
You can expect to go through a few rounds of ultrasounds throughout the course of your pregnancy. There's the infamous first ultrasound, which will confirm the fact that you're pregnant and determine your expected due date. Then, there's an ultrasound at around 11 to 14 weeks to examine the thickness behind the baby's neck, which can help detect chromosomal abnormalities like Down syndrome.
At about 20 weeks, women should get an anatomy scan to assess the baby from head to toe. You can also choose to find out the gender at this time.
Other than that, most women will not get additional ultrasounds unless there is a concern for the development of the baby or a pregnancy complication such as high blood pressure, diabetes, or another pre-existing condition.
What's that line on my belly?
A large number of pregnant women will develop increased pigmentation (or darkening of the skin) during pregnancy. According to Dr. Martin, many doctors relate this trend to the hormones associated with pregnancy. The most common area for this pigmentation to occur is the line from the pubic bone up to your chest called the linea nigra.
Other areas of the body that can develop darkening of the skin are the nipples, armpits, genitalia, face, perineum, anus, inner thighs, and neck. If your skin darkens in these areas, don't fret—it's normal! Your skin will likely go back to normal following delivery.
Restless leg syndrome
One out of five women will experience restless leg syndrome during pregnancy, so if one or both of your legs starts throbbing or aching, don't panic. Symptoms range from mild discomfort to extreme pain. For most pregnant women, symptoms worsen in the third trimester but disappear shortly after delivery.
Doctors don't know what causes this, but they believe it's influenced by family factors or possibly iron deficiency. If you do suffer from restless leg syndrome, avoid Benadryl, as this will make symptoms worse, and try to make time for some moderate exercise, yoga, or a prenatal massage.
Exercising will not only alleviate pain in your legs, but it'll help you build strength in your back and core, which are two areas that undergo a lot of strain during pregnancy.
Comments and advice
From the moment you share the news that you are expecting, people will be quick to comment on how far along you are and offer their best advice, regardless of whether or not you asked for it.
"When you are pregnant, many people feel comfortable telling you how big (or little) you look according to how far along you are. Women are all different; our bodies grow differently," Dr. Martin notes.
Try not to let comments from others bother you. Your doctor will track your weight and size of the baby and tell you everything you need to know about pregnancy.
Delivery and post-delivery
Ta-da! You're ready to have your baby. Be aware that there are a few different possibilities for how you will go into labor.
Your body might enter into labor naturally, which usually starts with painful uterine contractions. Generally speaking, these contractions will last 30 to 70 seconds and start in your back before moving to your front. They'll come at regular intervals, but they'll also increase in strength over time. Once you feel these contractions every five minutes for a full hour, you should call your OB/GYN. They will likely bring you into the hospital to check your cervix and confirm you are in labor.
There is also the possibility of your water breaking at home. Usually this comes as a large gush of fluid, but it can also be a continued trickle of fluid that soaks through your underwear and leaks down your legs. About 10 percent of women will have their water break prior to contracting. If your water breaks at home, call your OB/GYN—they will likely have you come into the hospital or the office to confirm.
If you don't start contracting on your own, many doctors will induce labor with medication in order to decrease risk of infection for you and your baby. There are several other reasons for inducing labor with medication, including high blood pressure or preeclampsia, diabetes, problems with the baby's growth or function of the placenta, or not going into labor naturally more than a week past your due date. Remember that every patient and pregnancy is an individual situation, so speak with your doctor about their plans and expectations for you.
Additionally, women can expect a generous amount of vaginal discharge and bleeding after delivery. Dr. Martin assures us that this is completely normal and that your nurses will monitor your pads closely to make sure the bleeding remains at a safe level. The bleeding and discharge will likely begin red, turn to a pinkish color for two to three weeks, and then change to yellow.
Although it's inconvenient, this discharge, called lochia, is the result of your uterus shedding the lining of the pregnancy. Most women will not have any further vaginal bleeding or discharge by the six-week mark.
Pregnant women should also be aware of the possibility of postpartum depression and emotional changes after delivery. New mothers should never be ashamed to ask for help when it comes to dealing with the overwhelming changes in both emotions and lifestyle that come with welcoming a new baby.
Remember: Every person's pregnancy looks and feels different. While no one can predict exactly what your pregnancy will be like, these things you need to know when you are pregnant will help you prepare to welcome the newest member of your family.
The more informed and prepared you are, the less overwhelming and unpredictable your pregnancy journey will be.
Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.