Pregnancy: The First Trimester
Congratulations! You are pregnant. Alhamdulillah.
Pregnancy can be one of the most joyous periods in your life, Masha Allah. Yet the accompanying hormonal, chemical and physical changes can equally make it one of the most overwhelming.
Knowing what physical and emotional changes to expect during each trimester can significantly ease your months ahead, not to mention your husband’s.
Allah (SWT) in His infinite wisdom created each of us to be unique, so too will be each woman’s pregnancy experience. Some are blessed to breeze through pregnancy. Other mums will also attest that each of their pregnancies were very different.
Let us consider the physical changes than commonly occur in the first trimester of pregnancy.
Nausea is one of the most universal symptoms of pregnancy and affecting up to 85% of pregnant mums. Morning sickness or nausea can hit you even before you perform a pregnancy test and may last throughout the 1st trimester or more. Rapidly rising levels of hormones, estrogen and progesterone, cause a relaxation of smooth muscles, thereby slowing down stomach emptying. Again, the severity of nausea differs between women. Some are fortunate to only experience mild nausea, others can’t start their day without vomiting, yet other unfortunate ladies will vomit throughout the day.
How to alleviate it: by eating small frequent meals throughout the day. Choose foods that are high in protein, low fat (crackers), and drink more fluids. Avoid smells or food that will aggravate symptoms.
When to seek help: when you can’t keep anything, even fluids down. When your urine is in very small amounts or very dark in color and when you feel faint or lightheaded.
Heartburn & Constipation
The same hormone progesterone that relaxes smooth muscles of the stomach also affects the smooth muscle of the esophagus. A relaxed lower esophagus will cause acid re-flux or heartburn, as acid which is normally in the stomach flows back to the esophagus. This is another reason to have small frequent meals and to avoid greasy, spicy food.
Progesterone also slows down intestinal contractions. Iron supplementation further aggravates this problem. Hence a diet high in fiber is encouraged. As well as increasing fluids.
Talk to your doctor if any of the above symptoms are bothering you. They may prescribe medications such as laxatives or stool softeners that are safe during pregnancy.
I would cut back on tea and coffee as these are diuretics and make you lose more water.
About 25% of pregnant women may experience slight bleeding during the 1st trimester. This could be physiological (normal) as a positive sign of implantation of the fertilized embryo. However if the bleeding is significant or associated with abdominal cramps or sharp pains in the abdomen, please seek medical attention. These could be signs of a miscarriage or an ectopic pregnancy (pregnancy outside the womb).
Hormonal changes are also behind the sensation of breast tenderness. Accompanying the changes in the womb, the breast is undergoing changes to supply milk for the baby. Consider getting support bras.
The growing uterus exerts increased pressure on the bladder, resulting in an increased sensation to empty the bladder. You may also suffer from urine leakage when sneezing, coughing or laughing. Avoid or reduce caffeine intake, especially before bedtime or after dinner, as these are diuretics that stimulate bladder emptying. Do not, however reduce fluid intake.
Fatigue is a common complaint during the 1st trimester as the lower blood pressure and sugar levels sap your energy. Hence the need for iron supplements and high protein intake. Do not neglect to continue in physical activity such as brisk walking and ensuring adequate rest.
Although blood volume per se increases during pregnancy, to meet demands of a growing fetus, the blood vessels themselves dilate, thereby causing an overall drop in blood pressure. It is thus common to feel lightheaded or dizzy during pregnancy. This can be prevented or reduced by rising slowly after lying or sitting and also avoiding prolonged standing.
Food cravings and aversions
Again these are common and attributable to drastic hormonal changes. A roller coaster of emotions like those that have never been experienced before may accompany these physical and hormonal changes in the body. Bouts of weepy-ness and mood swings are also common, but if these symptoms are prolonged or intense, do talk to your doctor, friend or spouse.
What to expect at your antenatal visits
Your initial visit will be focused on your personal health, medical history (including your biological mother’s history), identifying health risks and estimating the baby’s gestational age based on your last menstrual period (LMP) and expected delivery date (EDD). Screening for chromosomal abnormalities such as Downs Syndrome will also be discussed. Subsequent visits in the 1st trimester will usually be 4 weeks apart.
Remember to discuss any problems or concerns that you have with your health care provider and last but not least, try to complete reading the Holy Quran during the pregnancy for ease of delivery.