What to Expect For Your Body to Change During Pregnancy

Changes to a woman’s body begin very early in pregnancy. In fact, it seems that just about everything changes. Understanding these changes is important, as they will help you realize what is normal or abnormal. Only if you understand the normal are you able to understand and recognize an abnormal change that might happen. This article will not cover all the changes that occur during pregnancy, but will concentrate on those that are most visible or most often asked about.

Change in Appetite

Most women experience an increase in appetite beginning early in the first trimester. This increase in appetite usually persists throughout pregnancy. The recommended dietary allowance calls for an additional 300 calories per day. Obviously, the amount of exercise and activity a woman gets also plays a big role. Some women experience changes in their sense of taste or have cravings for particular foods (pica). These cravings are different depending on which part of the country or part of the world a woman lives in. For example, in the United Kingdom, the most common craving is for coal, while in the rural south the most common pica is for clay or starch.

Saliva Changes

Ptyalism is an unusual complication of pregnancy and most often occurs in women suffering from nausea and vomiting. It is possible to lose up to one to two liters of saliva per day. Most research shows that ptyalism actually represents an inability of the nauseated woman to swallow normal amounts of saliva rather than an increase in the production of saliva.

Changes to Gums

During pregnancy gums usually become swollen and soft. Therefore, they may bleed after tooth brushing. A less common condition is called epulis gravidarum. This is a condition in which pedunculated lesions form at the gum line. These lesions can bleed profusely. They usually disappear one to two months after delivery. However, if they do not, or if they bleed excessively during pregnancy, they should be removed. There is no evidence of increased cavity formation during pregnancy.

Constipation

Constipation is a common problem during pregnancy for several reasons. First, the enlarged uterus causes compression of the colon. In addition there is reduced motility of the colon because of a hormone produced during pregnancy that relaxes smooth muscle, and there is increased water absorption from the colon. To combat these changes, you should increase your water intake and the amount of fiber in your diet (fruits, vegetables and grains).

Respiratory System

Because of the increased estrogen levels during pregnancy the lining (mucosa) of the nose becomes swollen (edema) and there is increased production of mucus. These changes lead to nasal stuffiness. There is also an increase in the number of blood vessels in the mucosa which can lead to nose bleeds. Small polyps can develop in the nose and sinuses during pregnancy. But, these usually regress during the postpartum period.

As the ribs expand the overall chest diameter will increase by about 2 cm. The respiratory rate is unchanged, but the amount of air with each breath increases by 30% to 40%. Overall, oxygen consumption increases only about 15% to 25%. Shortness of breath (dyspnea) is common during pregnancy. The reason for this is not really known.

Skin

Increased estrogen levels also causes skin changes. Vascular spiders (red elevations with tiny vessels branching out) occur in approximately 67% of white women and approximately 10% of black women. They almost always regress after delivery. Palmar erythema (redness of the palms) develops in about 60% of pregnant women.

Striae gravidarum (stretch marks) develop in about 50% of all pregnant women. They are initially pink or purple in color, but eventually become white or silvery in appearance. Development of stretch marks does not appear to be related to the amount of weight gain. There is no proven effective way to prevent their formation.

Women may also experience pigmentary changes during pregnancy. Many pregnant women have hyperpigmentation (darkening of the skin). Most commonly this occurs on the nipples and areolae, in the axillae, perineum and in the middle of the lower abdomen. Many people have heard of the mask of pregnancy, which is the formation of blotchy, irregular darkening of the forehead, cheeks, nose, and upper lip. This change is also commonly seen in women who are taking birth control pills.

Hair Growth

Hair grows in three phases. There is a growth phase (anagen) and a telogen (resting) phase that is affected by pregnancy. Following the telogen phase, the hair falls out and is replaced by a new hair. About 15% to 20% of hair is in the telogen phase at any one time. Late in pregnancy, only about 10% of hair is in the telogen phase. Therefore, after delivery, the amount of hair entering the telogen phase increases, which leads to increased hair loss around 2 to 3 months after delivery.

Heart Changes

The amount of work that your heart does is increased during pregnancy by about 30% to 50%. As pregnancy progresses, there is a gradual increase in your heart rate so that by the beginning of the third trimester, it has risen 15 to 20 beats per minute. Blood pressure falls progressively during the first 24 weeks of pregnancy. The systolic pressure (top number) falls by 5 to 10 points, and the diastolic (bottom number) falls on average about 10 to 15 points. After 24 weeks, blood pressure rises gradually so that it returns to a non-pregnant level by term.

Ankle Edema

Edema of the ankles is an almost universal finding in late pregnancy because of the reduced venous blood flow that occurs, the reduced flow of fluid from the legs, and the increased compression on the larger veins in the lower abdomen by the growing uterus and baby. To improve blood flow, women are advised to sit or lie with feet elevated above the level of the heart. Circulation is also improved if you lie on your left side when doing this, so that the weight of the uterus and baby are shifted off the pelvic veins.

Breast Changes

Early in pregnancy the breasts begin to change. They become tender, have tingling sensations, and a feeling of heaviness begins to occur within four weeks of the last menstrual period. Over the next four weeks, the breasts continue to enlarge as a result of vascular engorgement. During the reminder of pregnancy, the breasts continue to enlarge as a result of estrogen and progesterone stimulation. Other changes in the breasts include nipple enlargement and increased nipple mobility. The areolae enlarge ad become more darkly pigmented. In the later half of pregnancy, colostrum, a thick yellow fluid, may leak or be expressed from the nipples. This normal finding is more common after the first pregnancy.

Postural Changes

During pregnancy, there is increased convexity of the lower spine. This “bending backwards” helps to keep the woman’s center of gravity over the legs, because the enlarging uterus would otherwise shift the center of gravity forward. This change in position is the cause of back pain during pregnancy. A hormone produced by the placenta, relaxin, causes increased mobility of the pelvic joints. These changes may result in joint discomfort or pain.

Eyes

During pregnancy, there is increased thickness of the cornea and a decrease in the pressure within the eye. These changes may result in an intolerance to contact lenses.

Diastasis Recti

Some women experience diastasis recti – a condition caused when the stomach muscles separate due to pressure from the growing fetus. A long ridge running down the midline of the abdomen from the xiphoid (breastbone) to the navel appears when the infant strains or attempts to sit up. This condition is also common in women who have poor abdominal muscle tone.

Changes to Your Body During Your Pregnancy