Baby and You

Your Pregnancy Diary

Happy doctor caring about young pregnant woman in hospital
The next nine months are all about you and your bump. Hilary Pereira explores what to expect in this month-by-month guide to pregnancy

MONTH 1

Your baby
Missed a period? It’s usually the very first sign of pregnancy. In fact, you’ll only have been pregnant for around two weeks by the end of month 1, as your estimated due date (EDD) will have been calculated from the first day of your last menstrual period (LMP), and you won’t have conceived until around a fortnight after that. Two things that are certain from the moment of conception are your baby’s eventual hair and eye colour, which are part of the genetic code.

Did you know
• The fertilized egg began as a single microscopic cell, then divided thousands of times to become an embryo.
• It travelled down one of your fallopian tubes, then embedded into the nutrient-rich lining of your uterus (the endometrium).
• By the end of this month it will still only be the size of a full stop.

You
Important changes are happening to you as well as your baby. These days it’s possible to find out if you’re pregnant just three weeks after having unprotected sex, or from the day your next period is due. Hopefully you’ll already have started taking a daily 400mcg folic acid supplement to help guard against neural tube defects such as spina bifida affecting your developing baby. If not, start straightaway and continue until the end of week 12.

Expectant mums are also advised to take a 10mcg vitamin D supplement every day throughout pregnancy as well as during breastfeeding. This will give your baby enough vitamin D for the first few months of life.

Your DIY due date calculator
Here’s a quick way to calculate your due date (with a few days’ leeway on either side). It’s so easy you can do it in your head.

1 Identify the first day of your last period

2 Add on exactly a year

3 Go back three months

4 Add one week

So if your last period started on 18 March this year:

18 March + 1 year = 18 March next year; Minus three months = 18 December this year; Plus one week = Christmas Day this year! Or you can use the NHS online due date calculator at www.nhs.uk

MONTH 2
Your baby
Your baby is about 2.5cm long. The vital organs and systems, including the brain and spinal cord, are developing quickly. All your baby’s major organs, including the heart and intestines, are starting to take shape during this month, although they’re not yet fully formed. Ovaries or testes are recognisable by week eight. Legs, arms, hands and feet are all growing, and the face is beginning to form.

Did you know
• Your baby is entirely dependent on your placenta as a life support system. It passes nutrients and oxygen from you to your baby, and carries waste products and carbon dioxide away. It does the jobs that your baby’s kidneys, lungs and digestive system will eventually take over.
• What you eat and drink is crucial right now because your baby depends on you for nutrients. Avoid alcohol, stop smoking or cut down radically; eat a well-balanced diet and take your folic acid and vitamin D supplements every day.
• Towards the end of your pregnancy, the placenta will pass antibodies from you to your baby, giving them  immunity for about three months after birth.

Common month 2 symptoms are:

  • Nausea and/or vomiting
  • Exhaustion
  • The need to urinate more often
  • A metallic taste in the mouth
  • An altered sense of smell
  • Food cravings
  • Cravings for substances normally considered inedible (such as coal or chalk). This is known as ‘pica’ and should be discussed with your midwife or doctor. Meanwhile, don’t give in to these cravings! Talk to your midwife if you can’t keep anything down at all or if you vomit frequently for more than a few days. It could be something more serious such as ‘hyperemesis gravidarum’; a severe vomiting condition that can sometimes need hospital treatment. Your baby is unlikely to suffer due to this, but you may need rehydration therapy and nutritional supplements.

You
You might have started experiencing a few niggles by now. As much of a hassle as they can be, they can be indicators of a normally progressing pregnancy, so take heart from that.

FIRST TRIMESTER STAT
At month 2, your baby is about 2.5cm long and the major organs are starting to take shape

MONTH 3
Your baby
Your baby is a fully formed little person by the end of this month and is about 9cm long. There’s a cute little face in place now but the head is out of proportion with the rest of the body. Your baby’s organs and systems are developing and maturing, and bones and muscles are growing.

Did you know?
Although not all danger has passed, the end of the third month and the first trimester is regarded as a development milestone.

You might find that:
• You feel less nauseous and, hopefully stop vomiting (although some suffer for the full nine months).
• Your energy levels and appetite are more like normal.
• You feel up and down emotionally (this is thought to be due to hormonal adjustments).
• You experience indigestion or heartburn.
• Your cravings have passed (although some women have them throughout pregnancy).

During this month
You will have your booking appointment for antenatal care and receive a portable pregnancy care book. You will have blood tests to exclude problems such as rubella, anaemia etc. You’ll also be offered an ultrasound scan, known as a dating scan, some time between weeks 11 and 14. If it’s between weeks 11 and 13, a specific skin fold at the back of your baby’s neck will also be measured to assess your risk for having a baby with Down’s syndrome. This is called a nuchal translucency scan.

Something to think about
If you’re considered high risk for having a baby with Down’s syndrome, you’ll be offered a diagnostic test that gives a definitive answer. Tests for Down’s syndrome are done at the hospital, not GP practice.

If you know that nothing will lead to you terminating your pregnancy, you might decide not to go ahead with diagnostic testing, especially as it carries a small (0.5-1%) risk of miscarriage as a result. For help making decisions around antenatal testing, get in touch with the charity Antenatal Results and Choices (ARC).

You might decide you need to know either way. For some people it is better to know and let themselves have more time to prepare themselves for having a baby with additional needs.

You
Hopefully you’ll be starting to get into the swing of pregnancy now, and your symptoms will be diminishing (although it’s not the case for all mums-to-be). You can stop taking folic acid supplements at the end of the month as your baby’s organs and systems are all in place.

MONTH 4
Your baby
Everything’s coming into proportion now and your baby looks more like a newborn.

Did you know?
• During this month, you might get the opportunity to hear your baby’s heartbeat. Often this makes pregnancy suddenly very real, and for some mums-to-be it’s the beginning of the bonding process.
• Your baby’s heartbeat will sound very fast at between 120 and 160 beats per minute.
• At this stage downy hair called ‘lanugo’, which is thought to protect your baby’s skin in the amniotic sac, starts sprouting all over their body. Unless your baby is born prematurely, this will usually have fallen out again by the time of delivery.
• Your baby’s skin is reddish and wrinkly at the moment, but it will smooth out, plump up and become pinker as your baby lays down fat stores.

During this month, you may notice:
• Your bump becoming visible and your waistbands becoming tight.
• People describing you as ‘glowing’, which is probably due to the increased blood volume that occurs during pregnancy, giving you rosier cheeks than usual.
• Your nipples becoming darker, due to an increase in melanin – the substance responsible for skin pigmentation.
• A dark stripe (the ‘linea nigra’) running lengthways down your belly, also caused by melanin.
• Moles and freckles growing darker.

You
Some women are said to ‘bloom’ around now, meaning they feel happier and less troubled by pregnancy niggles than before. If this is you, your skin, hair and nails may be in fantastic condition and you may be feeling an overwhelming sense of contentment. If it isn’t, don’t worry; everyone’s experience is different. You may be feeling a bit down as you come to terms with being pregnant and your life changing forever; you might be sporting acne reminiscent of a teenager and perhaps you’re still feeling sick. You might also have shared news of your pregnancy with family and friends so will be free to talk about your feelings.

SECOND TRIMESTER STAT
At month 5, your baby is about 25cm long and should weigh between 250g and 500g

MONTH 5
Your baby
You’ll probably have your anomaly ultrasound scan this month (between weeks 18 and 21). The purpose is to check that all your baby’s organs and systems are properly developed, and there’s a small chance that a problem may be discovered, which will be discussed with you. It’s a chance to take home some pictures of your baby.

The sex is generally reliably diagnosed from 19 weeks gestation, although whether or not your medical team will divulge this information if you do want to know will depend on hospital policy.

Did you know?
• Your baby’s now about 25cm long and should weigh between 250g and 500g.
• Eggs are already forming in the ovaries of baby girls, and in baby boys the testicles begin to descend into the scrotum.
• Your baby is sensitive to sound and may respond to loud noises or a strong light shone directly at your bump.
• If you’ve felt your baby move already, you may notice ‘wakeful’ and ‘sleepy’ patterns throughout the day as they become active then restful.

What to notice this month:
• Your baby becoming more active when you’re relaxed, such as when you’re taking a warm bath.
• A few stretch marks developing over your thighs, belly and breasts. These will eventually fade to
silvery white, but won’t actually disappear.
• A bit of discomfort down one or both sides of your belly when you bend or stretch. This is known as ‘round ligament’ pain and is a fairly common symptom of your uterus continuing to grow. Don’t worry, it’s harmless if annoying. However, if the pain becomes severe or persistent, do get yourself checked out by your midwife or GP.
• Your ankles and fingers becoming a bit puffy. This is normal water retention caused by compression of your body’s tissues. However, if your face swells or the puffiness becomes severe, get checked out as this can be a symptom of a potentially serious condition of pregnancy called pre-eclampsia, which affects around 10% of pregnancies.
• A bit of indigestion or heartburn. Eat little and often; avoid spicy or fatty foods and try to rest propped up a little against pillows.

You
If you haven’t already experienced ‘quickening’, when you feel your baby move for the first time, you probably will this month, although a few mums-to-be don’t feel their babies move until the sixth month of pregnancy. If you’re unlucky, you might be experiencing constipation, haemorrhoids (piles), varicose veins, swollen ankles and lower back pain. It’s all very normal if rather unpleasant.

MONTH 6
Your baby
Your baby’s brain is growing rapidly now and their eyes are opening on and off. It’s a time of rapid brain growth and for some babies hair is sprouting. The lungs are among the last organs to develop, and a substance called surfactant is starting to coat them to encourage them to inflate at birth.

Did you know?
• Your baby will be able to hear your voice, and will recognise it at birth.
• If you regularly watch the same TV programme, your baby might even respond to the theme tune in the early days after delivery.
• A pattern of sleeping and wakefulness is starting to emerge.

You might also notice:
•Your breasts producing colostrum – the thick, yellow, creamy substance that nourishes your baby in the first few days after birth.
• You may need to buy some bigger bras.
• You should be feeling your baby’s movements as more vigorous kicks.

You
Having passed the halfway mark in your pregnancy, it’s a good idea to read up about labour so you’ll have lots of time to explore your options. You’ll probably be unable to hide your pregnancy at this stage and might have quite a substantial bump by now.

MONTH 7
Your baby
Your baby is plumping out nicely now as fat stores increase. The brain has another development spurt at about week 28.

Did you know?
• If you gently massage or press your bump, your baby might feel your touch and respond by kicking, moving away or coming back for more.
• Your baby’s eyes can open, close and react to light during this month.
• By now your baby is considerably longer and heavier. He/she measures about 35cm and weighs about 1-1.25kg.

What to notice this month:
• Some mums-to-be can identify different parts of their baby, such as an elbow or foot, protruding from their bump. It can be a bit reminiscent of the film ‘Alien’, but can also be quite fun once you get used to it!
• Your bump may change shape.
• You may feel less of an urge to urinate as your uterus lifts away from your bladder.
• You may experience ‘Braxton Hicks’ contractions – tightenings in your uterus as your body practises for birth. These are intermittent, are at worst uncomfortable rather than painful, and will pass.
• If Braxton Hicks contractions seem to build in intensity and come more frequently and regularly, get in contact with your midwife or medical team as soon as possible as you may have started premature labour, which affects around 7% of pregnancies in the UK.

You
You’re entering your last trimester and are on the home straight. You may find this exciting, exhausting, or a bit of both. One of the most common niggles at this stage is continuing backache, as well as more indigestion and heartburn.

MONTH 8
Your baby
Some mums-to-be feel less vigorous movements from their babies but it’s not the case that they’re moving around less. The baby is still as active but just has less room for manoeuvre. Having said that, you must contact your midwife if you notice your baby is moving less than normal or have noticed a change in the pattern of movements.

Did you know?
• Your baby is plumping up rather than growing in length.
• Eyesight continues to develop and there is evidence that your baby dreams while sleeping at this point.
• A painful pelvis and difficulty walking. If so, talk to your medical team, as you might have a condition of the pelvis known as pelvic girdle pain (PGP) that needs treatment. PGP affects up to one in five of all mums-to-be.

You might also experience:
• Leg cramps and swelling – your blood pressure will be checked to exclude pre-eclampsia.
• An itchy bump as a result of over-stretching of the skin. If your hands or feet itch or itching becomes intense talk to your medical team urgently as it could indicate a potentially serious liver disease of pregnancy called obstetric cholestasis.
• In Europe, obstetric cholestasis occurs in about 0.1 to 1.5% of pregnancies and is more common in multiple pregnancies.
• Leg cramps, especially at night.
• Noticeable veins over your breasts.

You
By now you’re likely to be tiring of pregnancy. If your baby’s head does drop into a head-down position (known as ‘engaging’) you’ll probably develop a waddle rather than a walk and may be pretty uncomfortable. The up side is that once your baby’s head has dropped down into your pelvis you’ll feel less breathless and hopefully suffer less with indigestion or heartburn.

THIRD TRIMESTER STAT
At month seven, your baby measures about 35cm and weighs about 1-1.25kg

STAT
Around 7% of pregnancies in the UK are premature

MONTH 9
Your baby
Your baby’s lungs are mature enough now to function if you deliver prematurely. Your baby continues to lay down fat stores at quite a rate.

You might also experience:
• Increased pain in your lower back.
• Pressure in your pelvis.
• Contractions that could be the start of labour or might prove to be ‘false labour’.
• Tiredness.
• Leaky boobs.
• Losing your mucus plug and waters breaking, either as a trickle or a gush – although for lots of women this doesn’t happen at the beginning of labour but later on, either spontaneously or with the help of a midwife. Call your midwife or the hospital if your waters break as your baby is at risk of infection from this point.
• Overwhelming love when your baby finally arrives – but don’t worry too much if the love doesn’t come instantly. For some new mums it takes time to bond. Up to 15% of new mums experience post-natal depression (PND), so it’s a good idea to familiarise yourself with the signs – and make others around you aware – before you give birth. You can find out about PND from The Association for Post-Natal Illness at http://apni.org

You
Are you keen to deliver your baby or really anxious about labour? All feelings at this point are perfectly normal and understandable. It’s a good idea to go over your options for delivery again now: being well informed is the best preparation.

STAT
The average weight for a full-term baby is 3.5kg or 7lb 8oz

About the author
Hilary Pereira is a parenting writer with over 20 years’ experience. She has published five books, made TV appearances and writes frequently for print and online media.

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