
This is the first stage in pregnancy which you will possibly be unaware of.
Fertilisation occurs around the time of ovulation which is approximately two weeks before the date of the expected period. The fertilized egg starts to quickly divide and a ball of quickly multiplying cells( called blastocyst ) embeds itself in the lining of the uterus. This is the stage of fertilisation and implantation. The lining of the womb is already thickened with appropriate hormonal support to support the growing embryo.
In order to date any pregnancy we take the first day of the last menstrual period as Day 1 and add 240 days which is approximately nine month and 7 days to estimate the expected date of confinement (EDC).
Exercising in pregnancy is very important. In order to enjoy your pregnancy with minimum pain and discomfort on should have a small routine of regular exercise which could just be a 10 minute walk. Vigorous exercise should be avoided.
Healthy diet is very important as well and you should try to increase your intake of fresh fruit, vegetables and high fire foods and try to cut out highly refined starchy foods.
At this stage the first sign of being pregnant will be identified by most women which is usually a missed period.
The fertilized ball of cells is rapidly dividing to form the embryo. The embryo is gently floating in the amniotic fluid, attached by the umbilical cord and is easily seen with the naked eye.
Pregnancy could be confirmed by Urine pregnancy test kits bought off the counter at home or by a test done at your GP’s surgery. If the test is negative and you still do not see any period (possible due to late ovulation in a particular cycle subsequently leading to delayed fertilisation ) – the test could be repeated in a few days time.
The embryo now matures to form the foetus. It is about the size of a baked bean. The spinal column starts to develop and the foundations of the brain and spinal cord begin to appear.
Folic acid is very important for the proper development the spinal cord and nervous system so it is very important that you are taking Folic acid supplements (usually 400microgram ). It is also important that any woman who is contemplating to get pregnant should taking Folic acid pre-conception.
The foetus already has its own blood system at this point in time and may be a different blood group from its mother. Blood vessels are forming in what will become the umbilical cord. Tiny buds appear which will eventually form the upper and lower limbs ( the hands and feet )
By week seven baby´s heart is beginning to develop. Morning sickness and other side effects of early pregnancy may start.
Around this time many women start experiencing the minor side-effects of early pregnancy. This includes nausea and vomiting, increased frequency of urination and feeling a bit weepy and irritable. You might be feeling exhausted because of all the hormonal changes in your body. If you are suffering from morning sickness try eating ginger biscuits first thing.
All medication including supplements need to be carefully checked as the foetus is undergoing vital development in the first 12 weeks.
This is the appropriate time to inform your community midwife and register with your GP. You should make an appointment with your GP to have your pregnancy confirmed and arrange your booking appointment the hospital.
The embryo becomes known as a foetus (Latin for ‘young one’). The foetus is beginning to look more human. The spine can now move and the genital organs are now visible.
Your baby is about 25mm long
An ultrasound scan may be done at this stage if there are any concerns like abdominal pain or vaginal bleeding. It may also be done as a reassurance scan in cases with any history of previous miscarriages or ectopic pregnancy.
An early scan is often done through the vaginal route and is used to check that the pregnancy is not an ectopic pregnancy and it also confirms viability of the pregnancy (picks up the baby’s heartbeat) .It may be used as an early dating scan especially in women with very irregular periods (e.g. Polycystic ovaries ). It also identifies multiple pregnancy . This vaginal scan causes no harm to the pregnancy though it may cause slight discomfort and embarrassment to the pregnant mum.
The nervous system is rapidly developing by this stage especially the brain. The foetal head gets bigger and eyes start form under the skin of the face. The foetus’ limbs are growing and look more like arms and legs. All the internal organ system start developing and becoming more complex.
Booking blood tests are organised by the community midwife which include Full blood count ,Blood group and infection screen ( HIV ,Hepatitis B )
Sickle cell anaemia and thalassaemia are rare but serious inherited blood disorders. They are more common in people of certain ethnic backgrounds including African, Caribbean and some Asian and Mediterranean communities.
Women who may be at higher risk should be offered a blood test before 10 weeks.
If the mother is found to carry the gene for either condition, the father is offered a test. If both parents are found to be carriers then they are offered the option of testing the foetus in the womb.
You may start to feel your clothes tighten round your waist and your breasts may feel bigger.
The first scan also called the early dating scan is planned between now and 14th week of pregnancy. This helps us to calculate the accurate estimated date of confinement (EDC). Women who are above 37 yrs of age may be counselled about additional scan to rule out any chromosomal problems.
The external parts of the ears are beginning to grow and the eyes have now formed. The fingers and toes are distinguishable though they are still joined by webs of skin.
Your baby’s head is still large in comparison to the rest of the body and its development is pronounced. Length is about 4.5cm and weight is roughly 5g.
The umbilical cord is fully formed and functional now providing nourishment and removing waste products. The foetus looks like a human being now.
Additional scans can be performed between now and 13th week to measure the Nuchal Translucency (NT) (It is actually the measurement of the thickness of the skin fold and fluid at the back of the foetus’s neck).
This value along with first trimester Blood tests results (for Hcg ,PAPP & Estradiol) may be combined to give a risk value for chromosomal problems like Down’s and Edward Syndrome which could be compared to the age related risk. The pregnant mother thus can be appropriately counselled and reassured.
The risks of a possible miscarriage is much reduced beyond this stage in pregnancy if there has been no concerns so far.
The foetus is grows in length much more quickly by now it is about eight cm long and weighs about 60 grams. The placenta is now well formed and starts supporting the pregnancy. The mother is likely to have her first scan this week.
The woman’s uterus becomes bigger and is starting to rise out of the pelvis. The uterus may be felt through the tummy. The first foetal heart sounds may be heard using sonicaid.
The foetus can move its head quite easily.
Most symptoms of first trimester are alleviated now. The pregnant mum feels much happier and reassured at this stage.
Second trimester screening for Downs syndrome is offered about now. A simple blood test is carried out first then further tests may be offered depending on the results which gives us a risk rather than an absolute value. This test is 60-70% sensitive.
On the basis of the blood test results if it showing a higher risk the woman may opt for a Chorionic Villus sample or an amniocentesis which would diagnose Down’s syndrome or other chromosomal abnormalities.
However these diagnostic tests have a small risk of subsequent miscarriage. (usually around 0.5 – 1%)
At this stage in your pregnancy the foetus developes skin appendages like the toe and finger nails, eyebrows and eyelashes. It is also covered with downy hair.
The Lanugo or the fine hair starts to form . This hair is very fine more like down and it probably serves as some form of insulation and protection for the skin. This lasts through pregnancy and is present at birth.
The external parts of the ears are beginning to grow and the eyes have now formed. The fingers and toes are distinguishable though they are still joined by webs of skin.
Your baby’s head is still large in comparison to the rest of the body and its development is pronounced. Length is about 4.5cm and weight is roughly 5g.
By this stage pregnant mums feel hungrier than usual, and breasts might be getting larger and more tender as they prepare to feed your baby.
You might notice some bleeding in you gums when you brush your teeth, if so it’s a good idea to see a dentist as gingivitis (gum disease) can be quite common in pregnant women. Dental care is free throughout pregnancy and for the first year of your baby’s life.
The ears of the foetus becomes functional and they can can hear noises from the outside world. By this stage most mothers are noticeably pregnant and the uterus is rising higher.
Your baby will begin to practice breathing by inhaling and exhaling amniotic fluid. He is moving about, turning and kicking enthusiastically though it may only feel like tiny bubbles bursting or a tummy rumble to you.
Some mums can easily feel the movements especially if it is the second pregnancy or more. Some others may feel flutter like movements.
The foetus now weighs about 300gan is about 15-20cm long. Milk teeth have formed in the gums.
Your baby’s movements are stronger as his nervous system becomes more sophisticated and if you haven’t felt them already you may now. Most first time mothers feel their baby’s move between weeks 17 and 20. Usually 16-18 weeks in subsequent pregnancies.
You may experience some light breathlessness caused but the hormones circulating, this is nothing to worry about but if you find that you are severely out of breath then you should speak to your doctor.
This is the end of the first half of pregnancy. Almost all mothers are offered a routine scan called the Midtrimester or Anomaly scan to have a detailed look at all the major organ structure and rule out any structural abnormality.
Vernix, which is a wax like coating forms all over the skin.
As mentioned earlier the scan can show the foetus in fine detail and can often tell if the baby is a boy or a girl. Most hospitals have a policy of not telling the sex as there is a possibility of a wrong identification of sex. On the other hand some parents wish this to be a surprise anyway.
You might want to think about booking in to antenatal classes if you haven’t already done so. These can be invaluable at preparing you for labour and delivery and helping you think about what kind of birth you would like to have by discussing all the options in detail.
The pregnant uterus is growing upwards fast in the abdomen.
Sometimes the mother may be offered another ultrasound scan around this time if it was not possible to see all the organ structure at the 20 week scan due to awkward foetal position or maternal habitus. This scan can check the baby´s spine and internal organs and further ensure that all is normal.
Sensations of taste and touch start developing at this stage.
Some mums feel quite tired at this stage so it is important to make sure you are getting enough iron and protein in your diet. Your shoes and rings may start to feel a little tight – this is normal due to fluid retention in pregnancy.
The skeleton continues to develop and bones that form the skull begin to harden – but not fully.
You will be gaining weight steadily and may have put on between 2-3kg already. You may be experiencing some backache. Good posture will prevent most pregnancy aches and pains.
Antenatal checkup is done by the midwife and all results uptil now are updated.
This is the first age of viability. A baby born at this stage may survive after intensive support but lot of morbidity may co exist ( especially breathing problems and susceptibility to infection )
Further scans may be planned at this stage if there are concerns like history of cardiac defects or in the case of multiple pregnancy.
High risk cases attend consultant clinics at the Maternity unit whereas low risk cases are followed up by the midwife.
The foetus is fully formed now and the remainder of the pregnancy is for growth.
You might have some difficulty sleeping, lying on your side with a pillow between your legs and under your bump might help. ‘Pregnancy pillows’ (like a regular pillow but about twice as long) can be very useful for taking the weight off your bump. You may have a glucose tolerance test around this time to check for diabetes.
Preeclampsia could be a risk from now onwards. This is a condition which could be potentially fatal. Pre eclampsia is characterised by high blood pressure ,protein in the urine and swelling caused by fluid retention. The causes are unclear but research suggests it may be linked to an immune reaction to the foetus or the placenta. If the blood pressure is high women may be advised to take drugs to lower their blood pressure. Monitoring is by doing blood tests , Ultrsound for estimation of foetal well being and measuring protein loss in the urine . The treatment is delivery either by Caesaren section or inducing labour as appropriate.
Growth continues and the foetus skin is gradually becoming more opaque than transparent.
You should try to keep a mental note of the frequency of fetal movements. If there are less than 10 movements in 10 hours you should get in touch with the midwife. She may send you to the maternity unit for assessment.
The estimated fetal weight now is 800gm and it measures about 34 cm long.
If this is a high risk pregnancy growth scans will be organised.
Most Mums find that that they are almost always hungry. They sould try to avoid unhealthy snacks. Try to eat plenty of fruit and veg especially those with lots of fibre as constipation could become a problem. It is also important to drink lots of water.
Routine checkup to rule out preeclampsia.
Women with Rhesus negative blood will also be tested for antibodies.
In Rhesus negative pregnancy a prophylactic dose of Anti-D will be given to avoid development of antibodies to her baby´s blood during labour. This can happen if the mother has Rh negative blood but the baby is Rh positive. This is not a problem in the first birth but can affect subsequent pregnancies and result in stillbirth.
Some women develope tingling and numbness in the feet or legs which may be associated with cramps. This happens more commonly at night. This is called restless leg syndrome. It is commonly noticed in the third trimester.
No-one knows what causes this harmless but irritating condition.
Some studies have shown that by this gestation your baby can open his eyes and will even turn towards a bright light. He may weigh around 3lbs and 26cm long from head to bottom – 38cm from head to toe.
Shortness of breath is a common ailment noticed now because the growing uterus is pushing up towards the rib cage. The breasts may increase by up to a third over the next few weeks.
The pregnant mum may start to feel Braxton Hicks contractions around now. They are practice contractions which don’t usually hurt.
These are irregular, painless contractions which feel like a squeezing sensation near the top of the uterus. If contractions become painful or occur four times an hour or more, the woman should call a doctor as she may be in early labour (preterm labour).
Heart burn and acid reflux may become a common problem as the growing baby puts pressure on the internal organs especially stomach. Discuss the problem with your midwife about which remedies are safe and try drinking cold milk. Watch what you are eating as spicy food and fatty food can cause this to happen more frequently.
The foetus is growing fast and can see now… It can distinguish kight from dark.
The mother´s breasts start to produce colostrum about now.
This high calorie milk is produced by the mother to feed the baby for the first few days after birth before normal milk starts.
Another antenatal appointment. The foetus is about 42cm and weighs 2.2kg. A baby born after this stage has a very good chance of survival and risk of morbidity from prematurity is minimal.
From now the baby should become settled in a head downwards position in case of cephalic presentation. Malpresentation from earlier tend to spontaneously correct by now.
You may be feeling uncomfortable as your bump gets bigger and the baby’s kicks become less pleasant. You might need to think about slowing down and taking more rest to cope with the extra weight.
The pregnant mum is now feeling a little distressed due to the enlarged uterus and it is usually difficult to sleep at night. Occasionally breathing tends to be difficult and some may complain of pelvic and back pain.
It is perfectly normal to be worried about the approaching birth, especially for first time mothers. It is important that you discuss your fears and anxieties with your midwife, or your antenatal class instructor who will hopefully be able to allay any anxiety and put your mind at rest.
If the mother has been told she may need a planned caesarean, now is a good time to discuss it further.
The baby’s eyes are now coloured and his nails have grown to the ends of his fingers and toes.
Hair on his head may be up to 2.5-5cm long.
This is the time for rapid growth and weight gain for the baby –it may will put on about 1oz a day for the next four weeks and in most first pregnancies the head will move down into the pelvis now.
The baby´s head may engage in the pelvis any time now.You may notice your baby ‘dropping’ down in your abdomen this is called lightening and some women find it uncomfortable when they walk. You may need to urinate more often as the baby puts pressure on your bladder.
The baby´s lungs are practically mature now and it can survive unaided. The final weeks in the womb are to put on weight.
You may find breathing becomes less restricted and there is less pressure on your chest and stomach as the baby moves further down in your pelvis. Walking may be uncomfortable if the baby’s head is pressing on your pelvic floor.
This is considered to be term gestation. Babies born after this are unlikely to suffer from problems of prematurity.
You may be feeling a little impatient, heavy and clumsy. You might be looking forward to the labour and birth willing it to happen now or you might be scared and anxious, quite happy to wait another couple of weeks.
Midwife will usually check the pregnant mum and measure Blood pressure and check urine. She will make sure of the presentation.
Your baby’s growth rate is slowing down as he is fully developed but he will continue to put on some weight – laying down fat that will help regulate his body temperature after he is born.
You might notice some spotting of blood or a mucus plug, some women have a ‘show’ a week before they actually go in to labour. Your Braxton Hicks contractions may feel stronger and you may mistake them for the real thing, call your midwife if you think you might be in labour she should be able to tell the difference. Remember that ‘real’ contractions are usually more regular.
Theoretically the baby should be born this week (only 3% ). The mother´s cervix prepares for the birth by softening. Increased vaginal discharge may be noted. (this blood stained mucosy discharge is called show) Niggling pain may start – this is prelabour stage.
A bout 10 % of pregnancy can go past the due date. Labour is usually induced at 12 days past the due date if there are no other obstetric complications or concern.