DEFINITION

Pregnancy is the growth and development within a woman of a baby. Pregnancy is measured in weeks from the first day of your last menstrual period.

DESCRIPTION

CONCEPTION (the fertilisation of of an egg by a sperm)
During the monthly menstrual cycle, one egg is released from the ovaries approximately 14 days before the next menstrual period. This is known as ovulation. The egg moves to one of the fallopian tubes, where it may be fertilised by a sperm and then transported to the uterus. There it grows into an embryo - the beginning of a baby. A pregnancy is divided into 3 sections or trimesters. Each trimester has particular events and developmental markers.

FIRST TRIMESTER
Your baby is called an embryo from the time of conception to the end of the first 12 weeks (first trimester). Rapid development occurs during this time according to a very predictable timetable. At day 28 or 29, for example, the neural tube closes and it is necessary for adequate folic acid to be present to prevent spina bifida.

By the end of the first trimester all of your baby's body systems have developed in a very basic form. Limbs are present, the heart is pumping blood and the early stages of facial features are forming.

SECOND TRIMESTER
At the start of the second trimester the embryo is now called a foetus. The second trimester of pregnancy is from 13 to 27 weeks after your last menstrual period. By 16 weeks, the top of the uterus (fundus) is approximately halfway between the pubic bone and your navel. By 27 weeks, the fundus is slightly above the navel and this is the time when most begin to look pregnant and begin to wear maternity clothes. By the end of the second trimester your baby is approximately 25.4 cm long and weighs in the vicinity of 680.39 gms.

As the uterus grows up and out of the pelvis, pressure on the bladder may lessen. Symptoms of breast tenderness, morning sickness and fatigue may being to improve. The first movements of your baby may be felt between weeks 16 and 22. At approximately week 18 or 19 the sex of the baby can be determined by ultrasound. Symptoms such as stretch marks and other skin changes, haemorrhoids and constipation, breast changes, heart burn, bleeding gums, nose bleeds, leg cramps and vaginal yeast infections may develop in the second trimester.

By the end of the second trimester the head and body of your baby are in proportion. Blinking of the eyes and sucking motions of the lips occur in preparation for feeding. Tastebuds, hair, fingernails and toenails develop and the skeleton is maturing. Your baby can recognise the sound of your voice. Fat is developing beneath the skin. All of your baby's senses are developing and though small and fragile your baby is growing rapidly and may survive if born at this stage.

THIRD TRIMESTER
At start of the third trimester your baby has a regular sleeping cycle and the organs and brain are growing very rapidly. The lungs and digestive tract are nearly mature and the baby's weight gain will exceed growth in length. There may be a decrease in your baby's movements due to the increasing size of your baby and the limited space in the uterus. You may feel like your baby is gradually dropping. This is called lightening. The feeling comes from increased pressure in the lower abdomen as your baby prepares to move down the birth canal. Between 38 and 42 weeks your baby is considered to be 'full term'.

SIGNS AND SYMPTOMS

Some typical signs and symptoms of Pregnancy include:
- Missing a period.
- Nausea and/or vomiting.
- Need to urinate often.
- Extreme fatigue.
- Breast tenderness.

TREATMENT OPTIONS

PRE-CONCEPTION
If you are planning to have a baby, visit your Doctor, who can provide preconception counselling.
PREGNANCY
If you think you might be pregnant, see your Doctor immediately. Your Doctor can explain what you can do to maximise your chances of having a healthy pregnancy (e.g. avoid alcohol, smoking and recreational drugs) and how to minimise the risk for birth defects and complications (e.g. taking folic acid supplements to help prevent spina bifida and other neural tube defects).

YOUR FIRST VISIT TO YOUR DOCTOR
You will have a physical examination and tests for sexually transmitted diseases. If you are uncertain of your menstrual cycle, you may need to have an ultrasound.

AFTER THE FIRST VISIT
Generally, you will visit your Doctor every 4 weeks in the first trimester and early second trimester. This generally increases to every 2 weeks after the second trimester and weekly in the third trimester.

PHARMACIST'S ADVICE

Ask your Pharmacist for advice.
1) Ask your Pharmacist about Home Pregnancy Tests. Confirm your Pregnancy with your Doctor as soon as possible.
2) See the Pregnancy Diet available on the Healthpoint.
3) Avoid alcohol, smoking and street drugs. See the Pregnancy and Alcohol and Pregnancy and Smoking topics on the Healthpoint.
4) It is recommended that women considering becoming pregnant and those in the early stages of pregnancy take folic acid supplements to help prevent spina bifida and other neural tube defects. Ask your Pharmacist for advice.
5) Some prescription drugs and over-the-counter drugs and products should not be taken by women who are pregnant. See the Pregnancy and Drugs topic and ask your Pharmacist for advice.
6) Ask your Pharmacist for a special oil or cream to apply to your stomach to help avoid stretch marks.
7) A nipple cream is available to help relieve cracked nipples although simply smearing in some breast milk is usually sufficient.
8) There are nipple shells available which may help with inverted nipples. Wearing nipple shells for a short time each day may increase your confidence in your nipple's ability to stretch enough for your baby to latch onto. Ask your Pharmacist for advice. (See the topic on Breastfeeding for further information).
9) See the other topics in the Pregnancy topic group on the Healthpoint.

DIET HINTS

See the Pregnancy Diet on the Healthpoint.

VITAMINS/MINERALS/HERBS

Please see the Pregnancy/Breastfeeding and Vitamins/Minerals topic on the Healthpoint.

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