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Pregnancy:
What to Expect in Your Three Trimesters
Tim Blevins
Head of International Network & Medical Management
Aetna Global Benefits
Pregnancy can be a combination of both pure delight and concern for most women. Here are some helpful tips to help women and their families plan for a healthy pregnancy and prepare for the journey ahead:
Prenatal Care — What to Expect
Being pregnant, you will likely visit the doctor's office more often than you ever have before. But what happens at your prenatal doctor visits? Every doctor may be different, but here is what you can generally expect at your doctor visits now that you are expecting:
First Trimester
Your first pregnancy visit to the doctor is one of the most complete physical examinations a healthy person will ever have. Here are some things you can expect at your first visit (although this may vary from country to country and doctor to doctor):
• The doctor or nurse will record your height, weight, blood pressure and pulse rate.
• Be prepared to give the date of your last period in order to find out your baby's approximate due date.
• The doctor will want to know about your past pregnancies, miscarriages or abortions, any inherited disorders (which might be passed on to your child), and any current and past illnesses.
• At your first visit, the doctor will give you a general physical examination, as well as pay close attention to the heart, lungs, abdomen and pelvis, and
• The doctor also will either take or send you elsewhere for a blood sample and a urine sample to run some tests.
After your first visit, you will probably need to see your doctor every month during your first trimester, unless your doctor advises you otherwise.
During your 12th-week visit, your doctor will likely place an electronic device on your abdomen and you will be able to hear your baby's heartbeat! The heartbeat cannot be heard with a regular stethoscope until approximately 20 weeks, but with this instrument you will be able to hear the tiny heartbeat of your little one.
Second Trimester
Throughout your second trimester, you will probably continue to visit your doctor once a month, as long as your pregnancy is progressing normally.
Each appointment will likely begin with your stepping on the scale. By tracking your weight, your doctor can estimate your baby's growth. Aiming for a healthy 25- to 35-pound weight gain is just what the doctor ordered. Straying too far from this guideline can lead to problems.
Here are some tests that you can expect during your second trimester:
• Urinalysis – This test, which might be performed at each doctor's visit, measures the protein and sugar in your urine. It will identify excess protein, which can be a warning sign of preeclampsia. Urinalysis also may be used to identify the presence of drugs or bladder infection.
• Triple marker test – Part of this blood screening test measures a specific protein, alpha-fetoprotein or AFP, in your blood. If the AFP levels are high it may identify a neural tube defect; if AFP levels are low (combined with abnormalities found in two other tests) this may identify Down Syndrome.
• Rhesus (Rh)-antibody-level test (a blood test for rhesus negative women) – Most people have a protein in their blood called the Rh factor. Those who do not are Rh-negative. If a woman tests Rh-negative, the father of the child also must be tested for his Rh factor because problems arise when a Rh-negative woman conceives a baby with a Rh-positive man. Fortunately, a substance called Rh- immune globulin can protect the baby.
• Ultrasound – This test uses high-frequency sound waves to visualise the unborn baby. The doctor will cover your abdomen with mineral oil or gel to decrease the loss of ultrasound waves where the transducer meets the skin. Then the doctor will move the transducer gently and smoothly over your stomach, allowing the sound waves to pass through into your abdominal cavity. The waves will bounce back to the transducer, forming an image that is displayed as a picture on a monitor. With a vaginal ultrasound, the transducer is placed in the vagina to let the doctor see the early pregnancy sac and detect any abnormalities.
• Amniocentesis – This test of the fluid that surrounds your baby detects chromosomal and other genetic disorders, such as Down Syndrome, hemophilia and sickle-cell anemia. It usually is performed on women over 35 and on women who have an abnormal triple-screen result. The procedure is done by inserting a long, thin needle through the abdominal wall to take a sample of amniotic fluid, which is then studied in the laboratory.
Third Trimester
In your third trimester, your visits to your health care provider will likely increase from once a month to once every other week. Your health care provider will:
• Keep track of your weight gain. During your third trimester, you should be gaining three- quarters to one pound a week.
• Monitor your blood pressure.
• Screen for diabetes.
• Check your urine sample for sugar and protein.
• Listen to the baby's heartbeat.
• Check the size and position of the baby, by feeling your abdomen, and
• Look at your feet, ankles and hands for signs of swelling.
It can be very hard to tell when labour begins, particularly if this is your first child. Here are some warning signs that labour will begin within a few days:
• You see an increased and thickened vaginal discharge.
• The mucus plug that has sealed off the opening of the uterus is expelled.
• You feel an intensification of Braxton-Hicks contractions, which are those contractions you may have been feeling in your lower abdomen.
It is time to call the doctor when:
• You see a "show" or blood-tinged mucus discharge from your vagina.
• Your water breaks, either in a gush or a trickle.
• You feel contractions at regular intervals, and the intervals gradually shorten.
• The intensity of the contractions gradually increases, and/or
• You feel discomfort in your back and abdomen.
Sometimes, the contractions you feel may not be a sign of true labour. Showing up at the hospital with false labour is fairly common for first time mothers, so do not be embarrassed if you make the trip and then get sent home – just consider it practice!
Best wishes for the birth of your healthy baby!
June 2009
This has been a quick overview of what to expect during your three pregnancy trimesters. A wealth of information of this nature is available free-of-charge to Aetna Global Benefits (AGB) policyholders as part of the European Large Corporate Offering.
Aetna Global Benefits, the international business segment of Aetna, is a provider of comprehensive health benefits solutions and health management services for multinational employers, high-net-worth individuals and government entities. Aetna Global Benefits, an Aetna Company, is a gold sponsor of ExpatWomen.com.
Visit for more information.
Sources:
Deveraux, Julianne. First Trimester Doctor Visits. Your Baby Today.
Retrieved March 10, 2008 at
Deveraux, Julianne. Second Trimester Doctor Visits. Your Baby Today.
Retrieved March 10, 2008 at
Deveraux, Julianne. Third Trimester Doctor Visits. Your Baby Today.
Retrieved March 10, 2008 at
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