Bodily Changes During Pregnancy

From carrying her baby for as long as 9 months, the routine doctor visits accompanied with blood tests and ultrasound checks, to going through an array of emotional ups and downs and subtle to obvious bodily changes by the 9th month, pregnant mothers are so very admirable and deserve all the recognition they can get.
 

Have you ever wondered what bodily changes pregnant mothers face during pregnancy besides the change in appearance that is visible such as expanding belly and weight gain? Let’s find out! 

1. Hormonal changes during pregnancy
   The first thing that most pregnant mothers would experience upon being pregnant is the symptoms exhibited due to hormonal fluctuations from time to time. In early pregnancy, especially for those who are pregnant for the first time, these symptoms can be pretty overwhelming. For example, some mothers may feel particularly emotional, moody and drained in energy than pre-pregnancy and this can be explained by the dramatic increase in the number of hormones during pregnancy. However, do not frown as these changes don’t just affect the mood but can also create pregnancy “glow”, significantly enhance the development of the fetus and at the same time change the physical impact of exercise and physical activity on the body. Keep reading! 
   
   Essentially, human chorionic gonadotropin (HCG), human placental lactogen (hPL), estrogen, and progesterone are the main hormones that predominate during pregnancy and they’re also known as the “culprit” behind the mood swings of most pregnant mothers.
   
   HCG: A hormone produced by the placenta that helps prepare and support the body for implantation and gestation. It decreases after the first trimester, and may be responsible for the nauseous feeling experienced by most during the first trimester. 
   hPL: A hormone produced by the placenta whose role is to stimulate the growth of milk glands in the breasts for the preparation of breastfeeding
   Estrogen: A hormone produced in large amounts in the placenta that is thought to play an important role in helping the fetus develop and mature.
   Progesterone: A hormone that increases substantially during pregnancy and helps with implantation. It contributes to the loosening of your joints so that your body can accommodate the growing uterus from the size of a small pear to a uterus that can accommodate a full-term baby.

2. Weight Gain and Fluid Retention
   Weight gain is undoubtedly the most apparent and common bodily changes most women would experience at some point in their pregnancy journey. It usually happens from the second to third trimester due to multifactorial reasons such as: a growing baby, your body storing more fats to produce breast milk once the baby is born and fluid retention as hormone level changes. Hence, it is common to see pregnant women with swelling hands, feet and ankles, especially in the third trimester.
   Like everything else, this change will pass and your weight will return to normal once you deliver but if we may suggest some tips to ease swelling, it would be to:
   - Rest adequately
   - Avoid long periods of standing
   - Try to avoid taking high amount of caffeine and sodium
   - Increase dietary intake of potassium such as bananas, green leafy vegetables etc

3. Taste and Smell Changes
   Attributing back to the hormonal changes, pregnant women may complain of sensory changes especially in terms of their taste and smell. Don’t be surprised if foods that once were your favorite do not appeal to you during pregnancy and food that you may not particularly like or tasted before would be something you crave for. 
   And it doesn’t help when nausea and vomiting are one of the hallmark symptoms experienced by pregnant mothers. This condition is also known as morning sickness since it usually is the worst in the mornings. They are thought to be caused by the elevated levels of estrogen and human chorionic gonadotropin (hCG).  Some women have also reported of a “metallic” taste during the first trimester.
   
   While these may sound terrifying and weird to some, experts have explained that these changes may have a protective effect as the senses are more fine-tuned than before, thus protecting us from ingesting anything that may cause us to be sick or harm our fetus.

4. Breast and Uterus Changes
   Another most obvious change that almost all pregnant women undergo is the change in breast size. This usually happens to prepare the body for breastfeeding when the baby is eventually given birth. The mammary glands that produce milk will increase gradually in number in order to produce sufficient milk later on. As the breasts continue to grow, pregnant women may feel tender and swollen on their breasts. Hence, wearing a bra that fits like a glove and can provide excellent support is very important. Besides, some women may also notice stretch marks shown as prominent veins on the breasts, especially if they undergo rapid growth.
   On the other hand, pregnant mothers would also observe significant change in their uterus size and weight. As you are further along your pregnancy, your uterus may expand up to the size of a watermelon which indicates you are ready to give birth. However, fret not as this is only temporary and your uterus will shrink back to its original size just within a few weeks of delivery.

5. Digestion
   Aside from the hormonal changes that we’ve discussed that may result in morning sickness, food aversions and random cravings, the digestive system may also experience major changes not due to the shift in hormone levels. For example, pregnant mothers may complain of constipation in part to the added weight of her growing belly and uterus possibly due to the slowing down of the digestion process. At the same time, heartburn is also one of the common symptoms experienced by pregnant mothers especially when they are entering the third trimester.
   
   A pro tip to overcome this is to eat smaller, frequent meals at different intervals to ease digestion and to take antacids according to your doctor’s recommendation and instruction.

6. Circulatory System Changes
   Needless to say, pregnant women would also go through circulatory system changes as blood volume will be increased substantially to support the growth and development of the growing fetus. This increase in blood volume can cause vein enlargement and therefore increases the risk of varicose veins as well as hemorrhoids. Moreover, changes in the circulatory system and subsequently blood pressure can also result in the feeling of dizziness and in some cases, loss of consciousness. This is because the expanding uterus that is exerting pressure on the blood vessels, as well as appetite and metabolism changes.
   To overcome this, do ensure to stay off your feet when needed, to stay out of heat whenever possible, get up slowly from sitting and to wear loose-fitting clothes as much as possible as to not restrict blood flow.

7. Back Aches and Leg Cramps
   Backache in varying degrees and pain are very common in pregnancy. This is because the spine curves more to balance the weight of the enlarging uterus. To avoid this, you can:
   - use a maternity support belt to help distribute the abdominal weight more evenly which will ease off the back pain
   - Go for a gentle massage every now and then 
   - Do some light aerobic exercise catered for pregnant women
   - Maintain a good posture when sitting
   - Avoid lifting heavy items; if you must, it is highly encouraged to bend with the knees and not the waist to not exert additional pressure
   - Wearing flat shoes with good support or a lightweight maternity girdle to reduce back strain
   Additionally, leg cramps are also one of the common phenomena seen during pregnancy. They can be really painful (like an intense spasm in your leg muscles) and often experienced first thing upon waking or at night. These cramps can be explained due to the way our body processes calcium during pregnancy and relief can be made with gentle massaging, rest, elevation, heat and increasing your dietary calcium intake.

8. Skin changes
   Pregnant mothers can also expect skin changes such as the famous “rosy pregnancy glow” that most, if not all experience. This is likely due to the increased blood circulation and pregnancy hormones.
   On the downside of things, stretch marks are perhaps the most well-known skin changes during pregnancy as the abdomen and breasts grow. Stretch marks are usually found at the belly, abdomen, breasts, thighs or buttocks. They are thought to be caused by a combination of physical stretching of the skin and the effects of hormone changes on the skin elasticity.
   Stretch marks would start out as red, pink or brown and within a few months. Though stretch marks may never fully disappear, good news is they will eventually fade to a light pink or silver shade and shrink in size after pregnancy. Stretch marks may itch, so applying cocoa butter or anti-itch creams may help.
   

9. Hair and nail changes
   Many women experience rapid hair and nail growth changes during pregnancy and again, this is due to the changes in their hormonal levels. For instance, estrogen is thought to increase the length of the growing phase of hair follicles, which in return result in a thicker and healthier looking hair. While this sounds enticing and desirable, the hair growth is not just at the head but they may also grow and thicken in unwanted places such as on the face, upper lips, arms, legs or the back. Do not worry as most changes in hair growth will return to normal after the baby is born.
   On the contrary, as estrogen levels decrease after delivery, women may experience hair loss as seen by clumps of hair falling out after a shower or brushing. This is a totally normal occurrence and you have nothing to worry about.
   Meanwhile, many women also notice that their nails grow faster during pregnancy. Although some may find the change favorable, some may notice nail brittleness (break more easily), breakage (split more easily) or presence of grooves which can be painful and disturbing. This can however be overcomed by incorporating healthy dietary changes and taking prenatal vitamins that add to the growth hormones needed during pregnancy. Most women are also not encouraged to get manicures or pedicures for this very reason. Usually, most women would find their hair and nails return to its normal growth and texture within 4-6 months postpartum.

10. Things to Consider
    Although the word “common” is brought up a few times in this article, we would like to remind you that everyone is different and each pregnancy experience is unique to different individuals. Even the same person may experience different changes in their multiple pregnancies.
    With that, we hope that after reading this brief explanation on some of the bodily changes most women go through, mothers who are planning to be pregnant or are going through pregnancy are more well informed on what to expect during pregnancy.

    

    This article is written by Janelle Leong, Bpharm(Hons) (DOC2US), 
    reviewed by Dr. Syamim Asyraf Shahidan, MBBCh​ (DOC2US)

    References
    1. What Bodily Changes Can You Expect During Pregnancy? - Healthline. Available at: https://www.healthline.com/health/pregnancy/bodily-changes-during#hormonal-changes Accessed on 26th November 2022
    2. How Your Body Changes During Pregnancy - VeryWellFamily. Available at: https://www.verywellfamily.com/body-changes-during-pregnancy-5069922#toc-skin. Accessed on 26th November 2022
    3. Body Changes During Pregnancy - Cari Nierenberg 2021. Available at: https://www.livescience.com/50877-regnancy-body-changes.html. Accessed on 26th November 2022
    4. Medical Care During Pregnancy - MSD. Available at:  https://www.msdmanuals.com/en-gb/home/women-s-health-issues/normal-pregnancy/medical-care-during-pregnancy. Accessed on 26th November 2022 
    5. Changes in Your Body During Pregnancy: First Trimester - familydoctor.org. Available at: https://familydoctor.org/changes-in-your-body-during-pregnancy-first-trimester/. Accessed on 26th November 2022 

Written by

Janelle Leong, Bpharm(Hons)