Pregnancy care through the trimesters
Congratulations, you’re expecting a baby. The sheer joy of starting a family and sharing the news is a wonderful part of the pregnancy journey. It’s ideal that you see your regular GP or Doctor before you think about starting a family. They can help give you advice that improves the chances of you having a safe and healthy pregnancy. Your pregnancy doctor will give you advice on healthy eating, vitamin supplements (including folic acid) and exercise plans. They will also inform you to avoid smoking and drinking alcohol. Before you become pregnant, your doctor will also ensure you’re up to date with vaccinations. The influenza vaccine is very important to have if you are pregnant or planning to get pregnant.
Normal, full-term pregnancies are 40 weeks and can range from 37-42 weeks. It’s divided into three trimesters. Each pregnancy trimester lasts between 12 and 14 weeks or about three months. During your pregnancy, each trimester has different hormonal and physiological changes. When you’re aware of what happens during each trimester, you will be better prepared. It’s also important to know about specific risk factors during each trimester. These risk factors have medical tests you may need to undergo.
What happens during the first trimester?
The first appointment with your pregnancy doctor should occur 6 to 8 weeks after your last period. At the pregnancy clinic, your doctor will confirm your pregnancy with a urine or blood test. During your initial pregnancy care appointment, your doctor will also discuss the important tests you’ll need to have. These include general blood tests and an ultrasound. They will also discuss testing for Down’s syndrome and other congenital conditions.
The first trimester of your pregnancy is from week 1 to week 12. In week 1 the implantation of the fertilised egg into the womb occurs. By the end of the first trimester your baby will have grown to about the size of a lemon. During the first trimester even though you may not look pregnant, your body is changing a lot. During week 5 your baby’s heart will start to beat. By week 6 your baby will have legs and arms. By week 11 your baby will have formed nails and hair.
During the first trimester, physical symptoms are common. They include:
- Vomiting and nausea. This is common in the morning but for some women can last all day.
- Constipation. If this happens to you, inform your doctor so they can help treat it.
- Tender breasts. By 6 weeks your breasts will become larger and more tender. By the end of the first trimester, breast tenderness can settle down.
- Feeling tired and/or fatigued. This is a result of the high levels of progesterone in your body. Regular exercise and plenty of sleep can reduce these feelings.
- Swings in your mood. As your hormones change, your emotions and mood may be up and down. If this happens to you, inform your doctor so they can help treat this.
- Developing heartburn or indigestion.
What happens during the second trimester?
The second trimester is from weeks 13-28 of your pregnancy. For many women, the second trimester is the most comfortable time of their pregnancy. With some of the early pregnancy symptoms disappearing, your energy may have improved. You may also feel less nausea. During the second trimester, you will begin to look and feel pregnant. This is the time many women start to wear maternity clothes. By the end of the second trimester your baby will be the size of an eggplant.
During the second trimester you will start to feel your baby move. This varies between women but is usually between 16 and 25 weeks into your pregnancy. Your physical symptoms during the second trimester will usually improve. During the second trimester you may develop:
- Braxton Hicks contractions. These upper abdominal contractions sporadic and mild. They are usually more noticeable after physical activity or sex. If you have these contractions lower down, and they’re more rhythmic or painful, it’s very important to see your doctor
- A stuffy nose and/or nose bleeds
- Increased size of belly and breasts
- Cramps in your legs
- Vaginal discharge. This is usually white and clear, without an odour. If your vaginal discharge is bleeding and/or smelly, you must see your doctor.
During your second trimester, your pregnancy doctor will check your blood pressure and weight. They may also refer you to an obstetrician. At 20 weeks, you will have a scan to ensure your baby is developing well. At this morphology scan your baby’s body will be measured and assessed. These body parts include their heart, lungs, kidneys and brain. During this scan, you’ll be able to find out the sex of your baby.
What happens during the third trimester?
The third trimester is from 29 weeks until the birth of your baby. During your third trimester, your baby will keep growing. By week 37, your baby will be fully developed. Most pregnant women will give birth at around 40 weeks. Only about 4% of women will give birth on their due date.
Common physical symptoms during your third trimester include:
- Braxton Hicks contractions
- Feeling short of breath
- An increasing urge to urinate with increased frequency of urination
- Back aches and pains
Some women can develop varicose veins, spider veins and/or haemorrhoids during the third trimester. This is due to an increase in blood supply during this stage of pregnancy. During your third trimester, you’ll start to visit your pregnancy doctor more frequently.
Common checks your doctor will perform include:
- Testing your urine for protein
- Checking your blood pressure
- Measuring your fundal height (the approximate length of your uterus)
- Listening to the foetal heart rate
- Checking your hands and legs for any swelling
Your pregnancy doctor will also check for gestational diabetes during your third trimester. Pregnant women can develop diabetes during pregnancy when their body can’t cope with the extra demands for insulin. According to Diabetes Australia, “Gestational diabetes is managed by monitoring blood glucose levels, adopting a healthy eating plan and performing regular physical activity. Medication is not usually required.
If your blood group is negative, you may need to have an anti-body injection. Anti-D (RH (D) immunoglobulin) helps prevent potential harm to your baby during pregnancy, by preventing your body from developing antibodies to your baby’s blood.
During your third trimester you and your partner will need to have a whooping cough vaccination (Boostrix). It’s also recommended any friends or family who will be in close contact with your baby during their first 8 weeks of life have a whooping cough vaccination, and they should have this at least 2 weeks before your child is born.
During your third trimester, your pregnancy doctor will give you information about childbirth classes. These classes can be invaluable in helping you and your partner prepare for labour and delivery.
Where to get the best pregnancy care in Melbourne
Access Health & Community team of experienced pregnancy doctors have decades of experience offering pregnancy care and advice at our Richmond and Hawthorn pregnancy clinics. As a community health provider, we offer bulk billing appointments for patients who want to access quality health care but can’t afford it. Pregnant patients may be bulk billed if they have a valid Medicare card and are:
- Health Care Card Holders
- Pension Card Holders
- DVA Card Holders
- Children under 16 years
- Students under 25 years with a Student card
- NDIS clients