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Setting Expectations for a Healthy Pregnancy

by Autumn Hill, CNM

Welcoming a baby into the world is a special lifetime moment. A full-term pregnancy is divided into three trimesters of baby development in the mother’s womb. Each trimester comes with its own hormonal and physiological changes. As a new mom, the education about each trimester prepares you for how the baby affects your body and allows you to prepare for those changes.

Being aware of the ways that your growing baby is affecting your body will help you better prepare yourself for these changes as they happen. It’s also helpful to be aware of the specific risk factors and associated medical tests for each of the trimesters so you can set expectations and make the best choices for you and your baby.

First Trimester

The first few weeks of pregnancy are crucial in a child's development. However, many women don't realize they're pregnant until several weeks after conception. Once a blood pregnancy test comes back positive, you should schedule your first appointment with your obstetrician or midwife and maternity care team at about eight weeks into your pregnancy. 

The first appointment may be overwhelming in the beginning, but it's a fairly simple process. You will meet with a nurse who will ask you to provide a thorough personal and family medical history. This includes your own past pregnancies, gynecological history, medical conditions, medications, and previous surgeries. This background information helps your provider develop your pregnancy plan. The care team will provide you with a lot of information, but don’t worry, they will be with you to help ease your fears and guide you step by step through the journey.

Your second appointment will be scheduled around the 12-week mark, and it will involve a series of screenings that include a vaginal exam and blood tests. These procedures and tests help to determine proper development and the risk, if any, of your child having a birth defect. 

Second Trimester

The second trimester, weeks 13 to 27, is typically a more comfortable period for most pregnant women as most of the early pregnancy symptoms will gradually disappear. Women often also will feel their baby move for the first time. Your abdomen will start to look pregnant, as the uterus will grow rapidly in size. Baby is developing quickly during the second trimester and an anatomy ultrasound will be performed to measure and assess the functioning of parts of the baby’s body like the heart, kidney, and brain. This anatomy scan is also a time when you can learn the sex of your baby. Baby can also start to hear and recognize your voice at this time.

In addition to the ultrasound, another common test at this time is the glucose test, which is typically performed between 24 to 28 weeks. This is a routine test to measure the level of sugar in your blood for pregnancy-induced diabetes, which can result in overly large babies, difficult deliveries, and health problems.

Third Trimester

The third trimester lasts from week 28 until the birth of your baby. During the third trimester, you’ll start seeing your health care provider more frequently, about every two weeks up until 36 weeks, and weekly checkups after 36 weeks until you give birth.

Your provider will regularly test your urine, check your blood pressure, listen to the fetal heart rate, measure your fundal height, check your hands and legs for any swelling, determine the baby’s position, and possibly check your cervix in order to monitor how your body is preparing for childbirth.

During this time frame, your provider may also perform the following tests:

  • Group B Streptococcus Screening: Group B strep, also called GBS, is common and not dangerous to you, but can pose a serious threat to newborns if it’s passed to them during delivery. If you’re GBS positive, you’ll receive antibiotics in labor to prevent the baby from getting it.
  • Nonstress Test: Measures your baby’s heart rate as they move around.
  • Biophysical Profile: Ultrasound that evaluates your baby’s movement, breathing, and the fluid around baby to determine well-being.

Delivery and the Fourth Trimester

Welcoming a new baby can be a very exciting and confusing time for both mom and baby. The baby has been in the warm womb for nine months and is now exposed to new sights, sounds, and the world. Your provider will perform exams on you and the pediatrician will assess baby. These exams help ensure you’re both healthy and ready to head home. Your provider will also discuss follow-up care for you and your baby.

The fourth trimester, first 12 weeks following birth, can be a vulnerable time for new mothers and should be viewed as a continuation of prenatal care. The American College of Obstetrics and Gynecology (ACOG) is now recommending that doctors view postpartum care as a part of maternal health. This new focus means that everyone is starting to recognize a healthy pregnancy goes beyond the birth of the child. Talk with your provider about your fourth trimester plan of care.

Knowing that you’re going to have a baby can be a magical time in your life –– but it can also be stressful, especially if it’s your first time. You’re not alone on the journey to parenthood and your providers encourage you be actively involved in your pregnancy. Don’t be afraid to ask questions and ask for help.

Learn more about maternity care at UPMC in the Susquehanna region.