What to Expect in Pregnancy

When you are pregnant you go through many physical and emotional changes. We have broken these changes down into stages, with specific health information for each stage of your pregnancy.

First 7 months

Changes to Expect in the first 7 months

First 12 weeks

You may:

feel tired and need to rest. When you first feel this you may not even know you are pregnant
feel sick to your stomach and may vomit
have headaches or feel light headed
notice changes in your breasts. They may feel tender and tingle, get bigger and the dark part around the nipple, called the areola, gets darker
gain or loose weight at the beginning.
feel short of breath
feel you need to pee more. Even though the baby is very tiny, your little one is putting pressure on your bladder because he/she is low down in your pelvis.

Feeling sick

Feeling sick or experiencing morning sickness is common. About 80% of women feel some degree of sickness during the first 7-12 weeks and 20% of women will feel this for longer than the 12 weeks.

For more information, talk to your midwife or doctor or visit HealthlinkBC for ways to manage morning sickness

Gaining weight

After 12 weeks, the recommended weight gain is from 1 to 3.5 lbs per week depending what your weight was when you became pregnant.

If you have any questions about what you are eating or drinking, talk with your care provider or call 8-1-1. You can contact the Prenatal Dietitian here at BC Women's Hospital or you can speak to a Dietitian 9 am – 5 pm Monday to Friday. You can leave a message after hours or email a HealthLink Dietitian

12-18 weeks

Physical Changes

You may notice:

changes in your skin colour. For example, the skin around your eyes may darken (this is called cholasma), or you may develop a dark line (called linea nigra) that goes from your pelvis up to your belly button.
more breast changes, such as small bumps on the areola (the dark part around your nipples), or a liquid (called colostrums) may begin to leak from your breasts.
increased secretions from your vagina. They do not smell, and are a milky colour.
feeling movements like butterflies or bubbles. It's your baby!

Emotional Changes

Becoming a mom is a process and takes time. It takes until your baby is a year old for you to fully understand your new self and role as a mom. If you already have children, you will go through this process again.

It is normal:

to feel uncertain about the pregnancy and becoming a mom.
to start being a mom.
to have vivid dreams.
to feel close to your partner sometimes and farther away other times.

Remember

The changes you feel in the first 18 weeks are dramatic. You may feel very different but look the same. Many of these changes are chemical and hormonal.
The physical changes of pregnancy can cause a wide range of discomfort. What affects you may not be the same for your friend.
Get help with symptoms if you feel they are causing a great deal of discomfort and difficulty in your daily life.
You will start to feel closer to your baby on your own time table. There are many variations on what “normal” is.

Feeling uncertain

Feelings of uncertainty are often the first emotion of pregnancy. It is typical to feel introverted, more passive, experience mood swings and feel a change in how you look at yourself. Your changing hormones affect how you are feeling and the changes of pregnancy can cause stress.

remember a degree of uncertainty is normal. Give yourself some time to grow into the idea of becoming a mom.
tell your story about your pregnancy to a good listener.
talk about what you want and need during the pregnancy, what kind of care you want, and your ideas about motherhood.

Start being a mom

It is normal to begin to develop an image of your baby. What is she doing? What does she look like? Your image of your baby changes as your little one grows and you learn more about her.

Hear your baby’s heart beat. Your baby’s heart beat can usually be heard between 10 to 12 weeks but sometimes earlier.
Feel your baby’s movements. For first-time moms this is around 18 to 19 weeks. For experienced moms you often recognize these movements earlier, around 16 or 17 weeks.

Vivid dreams

Dreaming is a way to test new ideas, find ways to mother and rework relationships. It is common for either you or your or partner to have vivid and sometimes disturbing dreams. It does not mean that the dream will happen.

Close to your partner

Sometimes you will feel you are in tune with your partner, other times you may feel you are on a very different journey and sometimes at odds with each other. These are typical feelings. The support you give each other influences how you respond to your new identity as a mom or dad and as you develop your new roles.

talk about who your role models are for moms and dads
what the pregnancy is like for both of you
it takes time to become used to the idea of being a mom or dad. Becoming moms and dads are different processes.

19-28 weeks

Physical Changes

You may notice:

you have more energy
you have a stuffed up nose
that your gums bleed More about bleeding gums
that your voice sounds different because of hormone changes
mild swelling of your hands, feet, ankles and face
lower back pain first, and then upper back pain later
pain in your side. As your baby grows and your womb (uterus) gets bigger, the ligaments that support your uterus may feel sore.
that your pelvis is beginning to feel loose when you are walking. Pregnancy hormones make your joints relax more.
you have hard, dry stools (constipation)
leg cramps, especially at night
more of your baby’s movements

Emotional Changes

You may notice that you are thinking more about your body image. This is normal. Now that you are further along and your baby is growing, your body image is changing. Changing body image can be one of the main things that stresses many pregnant women.

Remember:

increases in your weight are normal and important for you and your baby.
exercise can help you feel better about yourself. Go for a walk everyday.
you are not alone in feeling like this. Talk it over with your midwife or doctor. You can also make an appointment to see a Dietician (dial 8-1-1)

You may notice:

you focus more on becoming a parent. You may find yourself thinking more about who your role model are.
You protect both you and your baby.
You want more information about concerns. You want to know what is safe and unsafe for you and your baby.

You may ask:

Who will support you as a parent and increase your confidence?
What does your family and culture expect from mothers?

Bleeding gums

This can happen because of changes in your hormones, or because you have plaque left on your teeth. Floss and brush everyday, and see your dentist for a checkup. Remember to tell her you are pregnant.

Swelling

Mild swelling is common and normal for 50-80% of women. You may have it in only one area or in all those areas mentioned. It does not necessarily mean you have any other condition. The swelling happens over time. If all of a sudden you have swelling or are concerned about it, talk to your midwife or doctor.

Back Pain

This is because there is extra stress on your body. Many women experience back pain during the later stages of pregnancy. To alleviate the pain, it may help to:

keep good body posture when standing and sitting.
try heat or cold packs.
get a massage from your partner or a certified massage therapist who knows how to work with pregnant women.
use a pillow under your upper leg for support when you are lying down on your side.
do exercises to stretch and strengthen your back. The Antepartum physiotherapy class at BC Women's can help with this. Call (604-875-2126) to make a time to see the physiotherapist.

Constipation

If you have had this before you were pregnant, you usually have it more so during pregnancy.

To alleviate constipation try to:

increase the fibre in your diet (add a bit of bran to your cereal)
increase the amount of water you drink, at least 8-10 glasses a day.
Exercise. It's safe and helps with many discomforts.

Before you take any medicine, talk to your doctor or midwife. You can also make an appointment to see a Dietician (dial 8-1-1).

Check the next tab entitled, The last few weeks for information on what to expect as your due date approaches.

The last few weeks

As your due date approaches

You are almost there! You and your family will likely be excited and nervous about the birth of your baby. Physical discomfort can make daily activities challenging in the late third trimester. It is important to have realistic hopes for yourself as your due date approaches.

It is normal for your labour to start anytime from 37 to 42 weeks of pregnancy. Natural labour is the best way to know your baby is ready to be born. Here are some things you might experience as your due date approaches.

Baby's movement

At this point in your pregnancy, you are likely familiar with your baby's pattern of movements. Some people notice their baby is less active in the last few weeks of pregnancy. If you are concerned by the lack of movement, have something to eat or drink and then sit down. Place your hands on your belly, pay close attention, and count how many times your baby moves in 2 hours. Your baby should have at least six movements (kicks, flutters, rolls) in 2 hours. If you do not feel 6 movements during the 2-hour period, call your doctor or midwife or go to the hospital to see why your baby is moving less than usual.

Shortness of breath

You may feel out of breath more easily in the final weeks of pregnancy. As your uterus expands beneath your diaphragm, your lungs are limited in their ability to fully expand at each breath. Pregnancy hormones help with this by stimulating you to breathe more often and more efficiently. To relieve breathlessness, slow down, try lying on your side or move around until you find a position that helps you breathe easier.

Sleep disturbances

Getting a good night's sleep can be more challenging at this point. Your baby's movements, the frequent need to urinate, leg cramping and an increase in your body's metabolism can all disturb your sleep. Tuck a pillow between your knees for extra support when sleeping on your side. Short daytime naps help with getting extra rest. Drink more fluids earlier in the day rather than before bed to reduce the need to urinate in the night.

Backache

Aches and pains in your back are common as your uterus expands and pregnancy hormones relax the joints in your pelvis. The pain can sometimes run from your lower back down the back of one leg to your knee or foot. This is sciatica and occurs when your growing baby puts pressure on your sciatic nerve.

Ease back pain by lying down, resting and applying heat (heat pack or pad) and pressure to the painful area. Sit in chairs with good back support. Talk to your doctor or midwife if your back pain is severe or does not get better. You can also see a physiotherapist at BC Women's Hospital.

Pelvic Pain and Pressure

Pressure in your pelvis as your baby drops lower and pushes on your bladder and pelvic floor muscles is common. This may cause you to urinate more often and experience bladder control problems. You might leak urine when you cough, sneeze or laugh. You might also feel pain near your pubic bone as the bones in your pelvis loosen up in preparation for labour.

Braxton Hicks Contractions

Irregular, not painful, Braxton Hicks contractions are more common as your due date approaches. This is when your uterus tightens and relaxes. Braxton Hicks are random, infrequent, and do not increase in intensity. Some women experience these from as early as 6 weeks' gestation but may have more of them in the lead up to labour. True labor contractions get longer, stronger, closer together and are painful. Call your doctor or midwife if you experience contractions that are painful or regular prior to 37 weeks of pregnancy.

Swollen Ankles, Feet and Fingers

As your growing baby puts pressure on your veins it is common for your legs, hands, and feet to swell. Tingling or numbness in your hands and feet due to pressure on your nerves are also common. Rest and elevate your feet on a stool or pillows. Try not to sit with your legs crossed. Move around often if you have to stand for long periods of time. Cold compresses to your legs and ankles reduce swelling and improves comfort.

Bleeding

Beginning around 36 weeks of pregnancy, your cervix will prepare for labour and it is common to have "bloody show" (light bleeding: a mix of blood and mucous) from your vagina. If you have bright red blood on your sanitary pad or underwear that is bigger than the size of a Toonie coin call your care provider.

These are general guidelines. Your care provider will talk to you about when to contact them regarding your pregnancy, labour and delivery.

Preparing for labour

Many people worry they won’t know when their labour starts. Usually, labour starts gradually and builds over hours. Knowing what the normal progress of labour looks like will help you prepare for labour and recognise the signs of labour when the time comes.

Early labour

Early labour is when your body prepares for birth. You may notice some bleeding or a sticky discharge (mucous plug). You may begin to have labour pain (contractions) as your cervix prepares for birth.

Other signs:

mild to moderate irregular contractions, usually a few seconds to one minute long;
cramping or backache;
loose bowel movements or stomach upset.

Early labour can last from a few hours to a few days; this is normal. During this time, your contraction pains will become stronger and more uncomfortable. Most people can still walk and talk during contractions. It is recommended that you stay home during this time. Try to sleep or get rest and keep your energy up for later.

When Labour Starts: Early labour is a normal part of the birth process (PDF)

When Labour Starts (ENG) is a quick reference for people in labour and their support people. This handout is also available in the following languages:

Simplified Chinese
Traditional Chinese
Punjabi
Spanish
Vietnamese

When your water breaks

It is normal for your water to break before or after contractions start. For most people, the water bag breaks after contractions begin. There may be a sudden gush of fluid which soaks your underwear, clothes or bed sheets or a slow, ongoing leak of fluid, much more than vaginal discharge. Both are normal. Unlike urine, the fluid is odourless. The fluid should be clear or slightly pink.

Call your care provider if:

your maternity care provider asked you to call them when your water breaks;
the fluid is a green colour;
the fluid is foul smelling.

Managing labour at home

Walk and rest during labour. Relax at home and ease your discomfort with these measures:

Eat light meals if you are hungry and drink plenty of fluids.
Breathe slowly through contractions.
Have a warm shower or bath (do not have a bath if your water has broken).
Change positions often, try standing and leaning forward during contractions.
Rock or kneel over a birthing ball.
Apply a warm heating pack to your lower back.
Ask a support person to massage your lower back.
Distract yourself with an activity you enjoy.

Eating and drinking in labour

When you are in labour it is important to know what to eat and drink. In many cases you will be able to drink during labour and eat a light snack. Check with your care provider about the best nutrition plan for you.

If your care provider recommends eating during labour, starches are easily digested and give a slow release of energy.

Some examples are:

Bread, naan, chapati, plain buns, bannock
White rice
Noodles or pasta
Soft fruit such as bananas, melon, plums, peach, papaya, watermelon
Cooked vegetables without skin or seeds
Plain biscuits or crackers

When you want to drink, clear fluids are best:

Clear soup
Clear tea
Black coffee
Clear juice without pulp
Sport or energy drinks
Clear gelatin
Clear frozen pops

Food to avoid in labour:

High fibre and protein food (nutrition bars with nuts)
High-fat food (desserts, pastries)
Protein (meat, fish, beans)
Dairy (cheese, yogurt, milk)

You may be advised to only drink clear fluids, or to stop eating and drinking altogether. Check with your care provider as your labour progresses.

Download a printable PDF of Eating and drinking in labour.

Role of support people

Having a doula, your partner, a family member or close friend with you during labour can offer support. It is helpful if these people learn about labour and talk with you about what would be useful for you during labour and birth. This can include things like giving you a back massage, preparing a bath or going for a walk.

Labour can last a long time. It is important your support team take care of themselves by eating and drinking regularly so they can continue to assist you.

Active labour

You are in active labour when your contractions are consistently 3 to 5 minutes apart lasting 45-60 seconds each. Usually at this point, it is too painful to walk or talk when you have a contraction. To time the frequency of contractions, you should time from the start of one contraction to the start of the next contraction. Talk to your maternity care provider about when to contact them.

When to call your care provider during labour

For most people, you can labour at home for as long as you feel comfortable even when you are in active labour.

Contact your maternity care provider for any of the following:

your contractions are 5 minutes apart, lasting at least 45 seconds, and this goes on for one complete hour;
your water breaks;
you have bright red vaginal bleeding that is larger than a toonie or soaking a pad;
you feel less than 6 baby movements in 2 hours;
you have fever or chills;
you have any concerns or questions.

What to Pack

Use our checklist of what to bring to the hospital.

Your Maternity Care Provider

Write down your maternity care provider’s contact number and keep it posted in a visible spot.

Tab Heading