What expectant mothers need to know

Expecting your first child can be exciting and scary. Your body changes as your baby grows, and you might not understand what’s happening or why. On top of that, there’s the stress of not getting timely appointments with a doctor when you need care. Below are some common symptoms that can develop from your first trimester to your third during a first-time pregnancy. Keep in mind that some of these may continue throughout your pregnancy or reappear in another trimester.

The good news is you’ve come to the right place to learn how to get help and what to expect throughout your pregnancy. Maple is a virtual care platform with Canadian-licensed doctors available online, 24/7. While you should always be in touch with your gynecologist or obstetrician-gynecologist (OB-GYN) throughout your pregnancy, you might be unable to reach them or your family doctor for symptoms like heartburn, constipation, and more. These can make an already challenging time even more difficult.

Whether you’re feeling unwell in the middle of the night or need to see a doctor on the weekend, you can rest easy knowing a general practitioner from our hand-picked network of doctors is available online in minutes, any time.

First trimester — week one to 13

While you may not be showing much yet, the first trimester is the most crucial part of your pregnancy. The embryo starts to form, and hormonal changes affect everything in your body. Here’s what you may experience during your first few months.

Mood changes

Pregnancy mood swings are very real. While hormones are elevated during your entire pregnancy, you’ll likely feel most of the effects of pregnancy moods and emotions during the first trimester due to increased estrogen and progesterone. Add to that pregnancy making you feel tired and emotional, and mood swings during pregnancy can be a recipe for happiness one moment and tears the next.

Worrying or feeling anxious during pregnancy isn’t uncommon, but it can hit the hardest during your first trimester. This is also the most common time for miscarriages, which may be stressful. You can always reach out to a mental health therapist for counselling to talk it out and help manage your feelings.

Morning sickness

Morning sickness is common in the early stages of pregnancy, often causing nausea and vomiting. It’s also not uncommon to experience a loss of appetite during early pregnancy because of this.

Morning sickness doesn’t cause harm to the baby, but it can be very uncomfortable. And don’t be fooled by the name — morning sickness can occur any time of day. While we don’t conclusively know what causes morning sickness, it’s believed hormonal changes are the cause.

You may also be more at risk if you are:

• Having a multiple birth
• Prone to motion sickness
• Experiencing stress
• Susceptible to migraines
• Obese
• Someone who felt sick taking contraceptive pills with estrogen
• Pregnant for the first time

Even if you feel nauseous with morning sickness, make sure you eat enough to support the baby’s development and maintain your hydration. If you aren’t keeping anything down, it’s best to check in with your healthcare provider to discuss your treatment options.

Decreased sex drive

If you’ve ever felt unsure if it’s safe to have sex during pregnancy, you’re not alone. Many women worry that sex will harm the baby or cause other symptoms. But the answer is, yes, it’s safe to have sex during pregnancy. However, it’s typical for your sex drive to decrease in the first trimester as you feel tired, nauseous, or your breasts feel tender. And, while your libido can increase in the second trimester, it may dip again in the third and continue after you give birth too.

Cravings

Between 50 and 90% of pregnant women experience cravings in their first trimester. Doctors still aren’t sure what causes cravings; like morning sickness, the most common theory is that cravings occur because of surging hormones.

From pickles and ice cream to sweets or fast food, there’s no one-size-fits-all for pregnancy cravings, and if you follow a healthy diet, indulging now and then is safe. Cravings can continue throughout your second trimester, but by the third, they usually disappear.

Metallic taste and dry mouth

It’s normal to experience a metallic taste in your mouth during pregnancy in the first trimester. Also called dysgeusia, that unpleasant sense of taste in your mouth is also attributed to changing hormone levels. Not to worry though — as your pregnancy continues, the metallic taste settles down.

You may also have dry mouth during pregnancy. This is because your body stores water to help support increased blood volume and hormonal changes. It’s a good reminder to keep hydrating to support your and the baby’s health, even though you’ll likely go to the washroom more often.

It’s also crucial to stay on top of your oral hygiene if your mouth feels dry since a lack of saliva can lead to dental problems like tooth decay and bleeding gums.

Increased urination

One of the tell-tale signs of pregnancy is more frequent urination than usual. While this can also happen in the third trimester as the baby pushes on your bladder, it starts as early as the first. This is because your body produces human chorionic gonadotropin (HCG), which increases blood flow to your kidneys. Your growing uterus also forces you to take more trips to the washroom as it takes up space.

However, there’s a difference between frequent urination and a urinary tract infection (UTI). UTIs are the most common bacterial infection in pregnancy, often due to hormonal changes. Symptoms include pain or difficulty during urination and feeling like you have to urinate constantly but only passing small amounts. You may also notice dark, cloudy, or foul-smelling urine.

UTIs can become serious if left untreated during pregnancy, so if you suspect you have one, it’s best to check in with a healthcare provider for antibiotics that are safe to use during pregnancy.

Heartburn

Heartburn often occurs during pregnancy, beginning in the first trimester. Even though it’s called “heartburn,” that acidic burn doesn’t actually come from the heart. Heartburn arises when acid in your stomach irritates your stomach lining or esophagus, which causes a burning and sometimes painful sensation. In your third trimester, heartburn is often caused by the uterus expanding to accommodate the growing baby, which can push stomach acid toward your esophagus.

Headaches

Headaches are common during pregnancy, specifically during the first trimester. Causes can include:

• Changes in pregnancy hormone levels
• Lack of quality sleep
• Change in blood circulation
• Dehydration
• Stress
• Caffeine withdrawal

To help the pain, try resting and drinking lots of fluids. If that doesn’t work, it’s safe to take acetaminophen (Tylenol) as directed by your doctor.

However, if you have severe headaches in the second or third trimesters of pregnancy, it may be another issue, like high blood pressure, or preeclampsia. If this is the case, you should see a healthcare provider right away.

Second trimester — week 14 to 27

By the second trimester, your baby’s pancreas and kidneys start functioning. The baby also moves freely in the amniotic sac in your uterus. Around week 19, you may start feeling those magical movements.

The second trimester often marks a turning point for how you feel. Many women find that nausea and fatigue start to fade. Even though your breasts are growing, which can cause pain, you’re typically more comfortable than in the third trimester. But, there are a host of other symptoms that can appear, like congestion, swelling, and more.

Pregnancy weight gain

First, it’s natural to gain weight while pregnant, as long as you do it in a healthy way. So, what exactly does that mean? Gaining a healthy amount of weight is based on your body mass index (BMI) before getting pregnant.

For example, if your BMI is between 18.5 to 24.9 before getting pregnant, healthy weight gain in your second and third trimesters would be one pound per week. Eating well and being physically active can help you achieve this.

You may also notice pregnancy stretch marks appear in your second trimester and wonder how to prevent more from popping up. The reality is that millions of women have stretch marks, and there’s no proof using creams or oils can stop them from forming. However, you’re more likely to get stretch marks if you gain more weight than average during your pregnancy (more than 22 to 28 pounds) or gain it rapidly.

Constipation

Half of all pregnant women experience the joys of constipation. But just how early does constipation start in pregnancy?

For some, it may begin in the first trimester, but constipation is most common during the second. Progesterone causes your bowel muscles to relax so that food stays in the digestive tract longer. And your ever-expanding uterus continues to take up space, making it difficult for your bowels to function normally.

Here are some home remedies that may offer immediate constipation relief during pregnancy:

• Eating more fibre
• Going for a light walk
• Drinking plenty of water (especially if you’re supplementing with fibre)
• Eating small meals throughout the day rather than fewer large ones

If nothing’s working, speak to a healthcare provider. They may recommend over-the-counter (OTC) medications that are safe during pregnancy.

Darkening of the skin

Many people talk about the “pregnancy glow” — that radiant quality pregnant women have. The truth is a beautiful glow happens because there’s an increase in blood circulation to your face, which can make your face and skin appear brighter. Not a bad little bonus!

But, skin changes like darkened nipples, areolas, freckles, moles, and more aren’t talked about as much. Caused by increased hormone levels, these skin pigmentation changes like melasma can seem alarming but are completely normal. The darkened areas may even stay the same shade after you give birth.

It’s also normal to see changes in moles during pregnancy. However, you should see a healthcare provider if you notice a mole or freckle is no longer symmetrical, has irregular edges, has gotten much darker than the rest of your moles, or is more than one colour to ensure there’s no risk of skin cancer.

You might also notice a dark line from your belly button to your pelvis. This is called the linea nigra, and it usually appears during the second trimester. It’s caused by a spike in hormones and unlike other darkened skin changes, it typically fades after the baby’s born.

Increased appetite

If you experience morning sickness, it’ll likely go away by your second trimester, and you may feel more energetic and hungry. And while you’re feeling peckish, your baby needs all the nourishment it can get.

In your second trimester, you only need to add about 340 extra calories to your regular diet each day. And, it’s best not to get these from ice cream or cookies. Use that hunger to fill up on nutritious foods like nuts, fruit, low-sugar yogurt, lean meats, or fish high in omega-3 fatty acids.

Pelvic pain

Chronic pelvic pain during pregnancy can happen in your first or second trimesters, but it’s most common in your third. It’s sometimes called pregnancy-related pelvic girdle pain (PGP), a term for symptoms caused by one or more of the three pelvic joints moving unevenly, causing instability in the pelvic girdle.

If you have a history of lower back pain, PGP, or both before becoming pregnant, you’re at greater risk of experiencing it during pregnancy.

Third trimester — week 28 to delivery

You’re getting closer! By the third trimester, your baby’s lungs are maturing, and their head starts to sit lower in your pelvis to prepare for birth. Your skin and ligaments stretch to accommodate the growing baby, and your cervix softens. You may continue experiencing heartburn among these third-trimester symptoms.

Shortness of breath

Noticeable shortness of breath in pregnancy is common in the third trimester. Your body’s doing a lot of work, and your baby’s sheer size and position — pushing your uterus against your diaphragm — is the cause. On top of that, increased levels of progesterone can cause shortness of breath. Thankfully, you’re still getting enough oxygen for you and the baby.

There are some home remedies for shortness of breath during pregnancy, such as:

• If you’re feeling out of breath, take it easy and sit down for a while
• Keeping your back and shoulders straight when you sit to allow for more airflow in your lungs
• Propping yourself up with pillows when you sleep
• Exercising. This might sound counterproductive since exercising takes a lot of energy, but it can help improve your respiratory system.

While shortness of breath during your third trimester’s normal, sudden onset of shortness of breath with chest pain, fast heartbeat, or intense chest pain could signal something more, like a blood clot. If this is the case, you’ll need medical care immediately.

Hemorrhoids

Hemorrhoids are another unpleasant surprise in the third trimester. Hemorrhoids are swollen veins around your lower anus and rectum, and they come in two forms:

• External hemorrhoids — these form under the skin around the anus. You may notice bleeding from the anus, pain or discomfort around the area, swelling, itching, or irritation.
• Internal hemorrhoids — these form inside the rectum. While there aren’t often signs of internal hemorrhoids, straining during a bowel movement can cause pain, irritation, or bleeding from the rectum.

In your third trimester, the pressure from your growing uterus increases blood flow to your pelvic region, which can cause larger veins. Constipation can be another factor. When you’re pushing to release a bowel movement, it can put pressure on your veins, causing them to swell. There are a few things you can do to help soothe hemorrhoids, such as:

• Applying a cold compress to the area
• Wearing loose-fitting clothing
• Eating high-fibre foods
• Staying hydrated
• Soaking panty liners in witch hazel and popping them in the freezer before applying to the area
• Using soothing hemorrhoid wipes

Pregnancy swelling

Swelling (edema) during pregnancy often happens in your third trimester. You might notice it in your ankles, feet, and even your fingers. This is because your body holds more fluids than usual while pregnant. By the end of the day, those fluids gather at the lowest parts of your body — especially if you’ve been standing a lot.

Your growing uterus can also affect blood flow to your legs, which can cause water to build up in your legs, ankles, and feet. While swelling can be uncomfortable, it’s not usually harmful to your baby. However, an increase in swelling can be a sign of preeclampsia. If this is the case, you should see a doctor immediately.

There are a few changes you can make to help with pregnancy swelling, including:

• Wearing comfortable footwear
• Putting your feet up as soon as you feel uncomfortable
• Doing regular light exercises, like walking or swimming
• Limiting salty foods
• Speaking to your healthcare provider about compression stockings

Leaky breasts

Your breasts begin to produce colostrum, the first form of milk that’s rich in protein, low in sugars, and contains essential antibodies to protect your baby’s health. Colostrum forms during pregnancy and lasts a few days after giving birth.

Because colostrum is forming, it’s not uncommon to leak from your breasts or to find dried-up colostrum on your nipples. However, if you’re not leaking colostrum, there’s no cause for panic since it has nothing to do with how much breast milk you’ll have when the baby arrives.

Braxton Hicks contractions

Braxton Hicks — contractions that begin before labour — can start as early as the second trimester but are most common in the third. You’ll likely feel Braxton Hicks in the afternoon or evening, especially if you’ve had an active day. While they’re your body’s way of preparing for labour, they don’t necessarily mean labour’s beginning. Think of it as “labour practice” mode.

One easy way to tell if you’re experiencing Braxton Hicks is if the contractions are irregular, intermittent, and uncomfortable rather than painful. They also tend to become more infrequent, then reappear later on. On the other hand, labour contractions occur consistently, feeling like they come in waves and have more pain that builds in intensity.

How Maple can help with pregnancy symptoms

While knowing what to expect during pregnancy won’t stop your symptoms, it can help ease your worries. So can having accessible medical care to treat pain and discomfort. Instead of waiting hours at the walk-in clinic or days for an appointment with a doctor for heartburn, hemorrhoids, constipation, and more, you can speak to a doctor in minutes on Maple. We connect you with Canadian-licensed doctors online, 24/7 for a diagnosis, health advice, prescriptions and more through secure text messaging, audio, or video chat.

And with 91% of medical issues being fully resolved within the first visit, you can feel confident turning to Maple for help. It’s easy to get started. — Simply sign up, click “Get care,” and start talking to a doctor from your phone, tablet, or computer.

This blog was developed by our team and reviewed by a medical professional.