Mayo Clinic Guide to a Healthy Pregnancy: From Doctors Who Are Parents, Too!

CHAPTER 6. Month 3: Weeks 9 to 12

I feel like my body is preparing me for motherhood by reminding me what it’s like to be a child. I eat every three hours, want things I don’t need, cry because I’m tired, and I’ve become a bit of a narcissist. — Yumna

Hang in there, girl — you will start to feel and behave better! As you enter the last month of your first trimester, the signs and symptoms of early pregnancy — fatigue, hunger, nausea, increased urination — are at their peak, and they may be getting the best of you. Things should start to improve in a few weeks. For many women, the first is the worst. Once they get past the first trimester, the remainder of their pregnancy is fairly comfortable.

BABY’S GROWTH

Your baby is still very small at this point in time — only about an inch long — but changing rapidly. During the third month, he or she begins to take on a much more human shape.

Week 9 This week your baby is looking less like a tadpole and more like a person. The embryonic tail at the bottom of the spinal cord is shrinking and disappearing, and the face is more rounded. Compared with the rest of the body, your baby’s head is quite large and is tucked down onto the chest. The hands and feet are continuing to form fingers and toes, and elbows are more pronounced. Nipples and hair follicles are forming.

Your baby’s pancreas, bile ducts, gallbladder and anus have formed, and the intestines are growing longer. Internal reproductive organs, such as testes or ovaries, start to develop this week, but the external genitals don’t yet have noticeable male or female characteristics.

Your baby may start making some movements this week, but you won’t be able to feel them for several more weeks. At nine weeks into your pregnancy, seven weeks since conception, your baby still weighs only about ⅛ of an ounce.

Week 10 By week 10, all of your baby’s vital organs have begun to form. The embryonic tail has disappeared completely, and baby’s fingers and toes are fully separated. The bones of the skeleton are now forming. Your baby’s eyelids are more developed, and the eyes look closed. The outer ears are starting to assume their final form. Your baby is also starting to develop buds for teeth. His or her brain is now growing more quickly. This week almost 250,000 new neurons are being produced every minute. If your baby is a boy, his testes will start producing the male hormone testosterone.

Week 11 From now until the time your baby is full term, he or she is officially described as a fetus. With all organ systems in place, growth becomes more rapid. From week 11 until week 20 of pregnancy — the halfway mark — your baby will increase his or her weight thirtyfold and will about triple in length. To accommodate all this growth, blood vessels in your placenta are growing larger and more numerous to keep up the supply of nutrients to your baby. His or her ears are moving up and to the side of the head this week, and his or her reproductive organs are developing quickly, too. What was a tiny tissue bud of external genitalia has begun to develop into either a penis or a clitoris and labia majora, which will soon be recognizable.

Week 12 Your baby’s face takes on further definition this week, as the chin and nose become more refined. This week also marks the arrival of fingernails and toenails. Your baby’s heart rate may speed up a few beats per minute. By the 12th week of your pregnancy, your baby is nearing 3 inches long and weighs about  of an ounce. The end of this week marks the end of your first trimester.

YOUR BODY CHANGES

The third month of pregnancy is the last month of your first trimester. Some of the discomforts and annoyances of early pregnancy, such as morning sickness, fatigue and frequent urination, may be particularly troublesome this month. But the end is in sight — at least for a while. For most women, the side effects of early pregnancy greatly diminish in the second trimester.

What’s happening and where Hormone production continues to increase this month, but a shift is taking place. By the end of your 12th week of pregnancy, your baby and placenta will be producing more of the hormones estrogen and progesterone than your ovaries do.

This continued increase in hormone production may continue to cause you to experience unpleasant signs and symptoms, such as nausea and vomiting, breast soreness, headaches, dizziness, increased urination, insomnia, and vivid dreams. Nausea and vomiting may be especially bothersome. If you have morning sickness, it may last this entire month. For many women, though, morning sickness begins to subside midway into the next month.

Heart and circulatory system Increased blood production will continue throughout your pregnancy, but at the end of this month it will slow. To accommodate this change, your heart is continuing to pump harder. It’s also pumping faster. These changes in your circulatory system may be continuing to cause unwelcome physical signs and symptoms, such as fatigue, dizziness and headaches.

Eyes While you’re pregnant, your body retains extra fluid, which causes the outer layer of your eye (cornea) to thicken. This change often becomes obvious by about the 10th week of your pregnancy, lasting until about six weeks after your baby is born. At the same time, the pressure of fluid within your eyes, called intraocular pressure, decreases about 10 percent during pregnancy. Because of these two events, your may notice slightly blurred vision. Your eyes will return to normal after you give birth.

Breasts Your breasts and the milk-producing glands inside them continue to grow, stimulated by increased production of estrogen and progesterone. The areolas, the rings of brown or reddish-brown skin around your nipples, may become larger and darker. Your breasts may continue to feel tender or sore, though the soreness is probably easing a bit. Your breasts may also feel fuller and heavier.

Uterus Up to your 12th week of pregnancy, your uterus fits inside your pelvis. It’s probably hard for anyone to tell you’re pregnant just by looking at you. Even so, you’ll likely have pregnancy-related signs and symptoms. Throughout this month, due to your uterus’ increasing size and proximity to your bladder, you’ll probably continue to feel the need to urinate more often. By the end of the month, your uterus will have expanded out of your pelvic cavity, so the pressure on your bladder won’t be as great.

Bones, muscles and joints You may continue to feel some twinges, cramps or pulling in your lower abdomen. The ligaments supporting your uterus are stretching to accommodate its growth. Early in the second trimester, it’s common to have sharp pain on one side or the other, usually provoked by a sudden movement. This pain results from stretching of the round ligament that tethers the uterus to the abdominal wall. It isn’t harmful, but it can hurt.

Weight When you add everything up — your baby’s weight, the placenta, the amniotic fluid, the increased amount of blood your body has produced, the fluid that’s accumulated in your body tissues, and your bigger uterus and breasts — you’ll probably have gained about 2 pounds by the end of your 12th week of pregnancy. Most of your weight gain will occur in the second half of your pregnancy, especially after your 33rd week. At that point in time, you may gain about a pound a week.

SEX DURING PREGNANCY

Has pregnancy spiked your interest in sex? Or is sex the last thing on your mind? Either way, here’s what you need to know about sex during pregnancy.

Is sex OK during pregnancy? As long as your pregnancy is proceeding normally, you can have sex as often as you like — but you may not always want to. At first, hormonal fluctuations, fatigue and nausea may sap your sexual desire. During the second trimester, increased blood flow to your sexual organs and breasts may rekindle your desire for sex. But by the third trimester, weight gain, back pain and other symptoms may once again dampen your enthusiasm for sex.

Can sex during pregnancy cause a miscarriage? Many couples worry that sex during pregnancy will cause a miscarriage, especially in the first trimester. But sex isn’t a concern. Early miscarriages are usually related to chromosomal abnormalities or other problems in the developing baby — not to anything you do or don’t do.

Does sex during pregnancy harm the baby? Your developing baby is protected by the amniotic fluid in your uterus, as well as the mucous plug that blocks the cervix throughout most of your pregnancy. Sexual activity won’t affect your baby.

What are the best sexual positions during pregnancy? As long as you’re comfortable, most sexual positions are OK during pregnancy. As your pregnancy progresses, experiment to find what works best. Rather than lying on your back, you might want to lie next to your partner sideways or position yourself on top of your partner or in front of your partner.

Can orgasms trigger premature labor? Orgasms can cause uterine contractions, but these contractions are different from the contractions you’ll feel during labor. If you have a normal pregnancy, orgasms — with or without intercourse — don’t seem to increase the risk of premature labor or premature birth. Likewise, sex isn’t likely to trigger labor even as your due date approaches.

Are there times when sex should be avoided? Although most women can safely have sex throughout pregnancy, sometimes it’s best to be cautious. Your health care provider may recommend avoiding sex if:

 You’re at risk of preterm labor

 You have unexplained vaginal bleeding

 You’re leaking amniotic fluid

 Your cervix begins to open prematurely (cervical incompetence)

 Your placenta partly or completely covers your cervical opening (placenta previa)

THAT PREGNANCY GLOW

Not all things happening this month are necessarily “bad.” Your increased blood volume and increased production of the hormone human chorionic gonadotropin (HCG) are working together to give you that pregnancy glow. Greater blood volume is bringing more blood to your blood vessels, resulting in skin that looks slightly flushed and plump. In addition, the hormones HCG and progesterone, which are causing the skin glands on your face to secrete more oil, are helping make your skin look smoother and slightly shinier. However, if you commonly experienced acne breakouts during your menstrual period before you were pregnant, this extra oil may be making you more prone to acne.

YOUR EMOTIONS

For the past couple of months, your emotions have centered around news of your pregnancy and all of the changes in store. Now that reality has sunk in — at least somewhat — your emotions may change course a bit. This month, as you start developing a small potbelly, you may become more focused on how your own body is changing in shape. While some women love the physical changes of pregnancy, others struggle with them.

Dealing with body image Changes in your body’s shape and function can affect the way you feel. During the first trimester, your body forms fat stores, most of it below the waist. In addition, your breasts will put on almost a pound a piece. During this time, your body may not look and feel like your own. If this is your first pregnancy, you may be especially bothered by changes in your body image. Given the emphasis our culture puts on being slim, you may not like what’s happening to you. Simply put, you may feel fat and unattractive.

If you don’t care for the changes taking place within your body, you may be having trouble enjoying or even wanting to have sex with your partner. If you’re feeling this way, keep a couple of things in mind. For most women, while interest in intercourse continues during pregnancy, it may decrease a bit. This is normal. Also, though it may be hard for you to believe, you partner may be excited about the changes to your body that come with pregnancy. Ask him about it.

PRENATAL CHECKUP

You’ll likely have your second prenatal visit with your care provider this month. This visit may include many of the same things that occurred at your first visit, but it should be shorter.

If your second visit occurs around the 12th week of your pregnancy, your care provider may try to listen for your baby’s heartbeat. If a heartbeat isn’t there, don’t panic. It may still be too soon.

Prenatal tests: Yes, no, not sure? At this month’s prenatal checkup, your care provider may talk with you about prenatal testing for fetal abnormalities. Prenatal tests are performed to assess the health of your baby, generally by way of a blood test or ultrasound exam. Some prenatal tests are optional while others are highly recommended or required. In certain states, some tests are mandated by state law, such as tests for HIV or other sexually transmitted infections.

Many women have questions about prenatal testing, and that’s perfectly normal. Your prenatal checkup is a good time to discuss your concerns with your care provider, so that when the time comes to make decisions about prenatal testing, you can make informed ones. Prenatal tests are generally performed between the 10th and 20th weeks of pregnancy, depending on the tests. Some tests need to be performed at a very specific time.

Some women want to have all of the tests performed, and others opt for just some, mainly those tests that are required or recommended. To help you learn more about prenatal tests, see Chapter 21. If your care provider doesn’t discuss the risks and benefits with you, don’t be afraid to ask.

Boy or girl: Do you want to know? In the coming weeks, you’ll likely undergo an ultrasound exam. This is exciting because it’s the first time you’re able to see that precious little one growing inside of you. Depending on your care provider and the tests you have, you may receive an ultrasound anywhere between your 11th and 20th week. If you have your ultrasound closer to your 20th week, the person administering the exam may be able to determine the sex of your baby. The question is, Do you want to know?

Before you have an ultrasound, discuss with your partner if you want to know the sex of your child right now, or if you’d prefer to wait until the baby is born. There is no right or wrong when it comes to this decision. Some parents want to know right away for practical reasons — it will make getting rooms ready or other arrangements at home easier — or they simply can’t stand the suspense. Others prefer the excitement of not knowing whether it’s a boy or girl until the child is born.

If you want to keep the sex a secret, let your health team know so that they don’t let the information slip during your exam. If you do decide to find out early, remember that determining baby’s sex by way of an ultrasound exam isn’t foolproof, especially if the exam is performed early in the pregnancy. Occasionally, mistakes are made, and Ethan turns out be Emma!