CHANGES IN MOTHER'S BODY

While a woman enters the phase of pregnancy, her body prepares to bear and deliver the child. This means that during the entire process, she experiences numerous bodily changes. These changes are physical, emotional and mental in nature. Being aware of these changes allows the mother to handle the pregnancy with ease.

 

HORMONAL CHANGES

Hormones play a very important role throughout the pregnancy/gestation period. Main Pregnancy hormones are:

  • Estrogen

  • Progesterone

  • HCG (Human Chorionic Gonadotropin) or BHCG (Beta HCG)

  • HPL (Human Placental Lactogen) 

Estrogen, progesterone and HCG hormone levels across all the months of pregnancy

Effects of these hormones on the mother's body:

  • Extreme mood swings

  • Significant help in development of the foetus (baby)

  • Delivery of the baby from the uterus

  • Helps in the postpartum period or the phase after childbirth with breastfeeding

  • Brings in the pregnancy glow

Estrogen and Progesterone  

Estrogen and progesterone are known as the chief pregnancy hormones. They are part of a routine menstrual cycle but their production rises dramatically when you become pregnant.

Women produce more estrogen during pregnancy than throughout the rest of their lives.

At first, estrogen and progesterone are secreted by the corpus luteum of the ovary, and later, by the placenta. Their levels rise consistently during the full-term of pregnancy while they reach their peak in the third trimester.

However, right before parturition or childbirth, the estrogen and progesterone level drops for labour.

Role of Estrogen 

  • Supports uterus and placenta to carry out functions required for the development of foetus

  • Enlargement of the uterus and expansion of the pelvic area to facilitate delivery 

  • Enlargement of the breasts and increased growth of the milk ducts

  • Maintains uterus lining to prevent the foetus from any physical shock/hurt
     

Role of Progesterone 

  • Works as a smooth muscle relaxant while maintaining the thick uterine lining which sustains the growth of the foetus

  • Helps with balanced nutrition of the embryo

  • Prepares the breast for lactation, after childbirth, along with estrogen
     

HCG | BHCG

HCG (Human Chorionic Gonadotropin)​ is a protein hormone. It is released by the cells that surround a growing embryo, that eventually forms the placenta after the stage of implantation during pregnancy.  The secretion of HCG helps in increased secretion of Progesterone by Corpus Luteum (present in ovaries) during early stage of pregnancy. 

Role of HCG

  • HCG becomes detectable in the second week of pregnancy

  • It is during this second week of pregnancy that home pregnancy tests determine HCG levels in the urine of the woman, in order to confirm pregnancy

  • HCG levels increase and reach a peak in the 8th week of pregnancy and it reaches its lowest level in the 16th week of pregnancy. Thereafter, the levels remain low until the pregnancy ends

  • HCG serves as a replacement for progesterone once the placenta is fully formed

  • It promotes the formation of new blood vessels in the uterus to support the growth and nutrition of the child

  • It also promotes the growth of uterine tissue to support the growth of the child and the growth of the umbilical tissue which makes up the umbilical cord

  • HCG levels have also been indicated to cause nausea and vomiting which the pregnant mother experiences in the initial stages of pregnancy

  • The level of HCG also helps in determining critical conditions like trophoblastic disease and ectopic pregnancies

  • Trophoblastic disease (the fertilised egg grows into a tumor/cancer cell within the uterus) is indicated by a very high level of HCG (3-100 times higher than normal)

  • Ectopic pregnancy (the fertilised egg implants and starts growing in fallopian tubes instead of uterus) is indicated by lower level of HCG than normal

HPL (Human Placental Lactogen) 

HPL is also a protein hormone, released by the placenta during the pregnancy.

Role of HPL

  • HPL can be detected in the blood from 6th week of pregnancy and the level of this hormone peaks on the 34th week of pregnancy, usually when the HCG levels begin to decrease.

  • High levels of HPL indicate a healthy and growing placenta. 

  • Its function is similar to that of growth hormone. 

  • It provides energy to the foetus by breaking down fats from the mother.

  • It causes resistance to the insulin hormone in mother, which benefits the growing child in the womb. 

  • The glucose which is available in the blood is not completely absorbed in the mother’s body, due to insulin resistance. This makes the glucose available for the child which requires it for nutrition. 

  • As glucose levels increase in the mother's body, it may lead to a common complication of gestational diabetes.

  • HPL also promotes the growth of breast tissue before pregnancy, along with the hormone prolactin to make the breasts ready for breastfeeding. This happens in the last trimester of pregnancy

The Thyroid Hormone

The thyroid hormone is extremely critical for the baby's brain and nervous system development.

  • During the first 12 weeks of pregnancy, the placenta provides (absorbs from the mother's blood) for the foetus requirement of thyroid hormone

  • Post 12 weeks, foetus' thyroid glands become active but only after 20th week of pregnancy is the production of thyroid is enough to meet the demand of the baby's growing body

  • HCG and estrogen help in the increased production of thyroid hormone in mother during the first trimester. The thyroid gland grows larger in size in mother during this phase.

  • Excess of thyroid hormone in mother can cause hyperthyroidism, which can lead to multiple pregnancy complications like: miscarriage, premature birth, low birth weight of child, preeclampsia—a dangerous rise in blood pressure during late pregnancy.

  • Hyperthyroidism may also lead to the following complications in a newborn child: very high heart rate (causing heart failure), early closing of the soft spot in the baby’s skull, lower weight gain, and irritability. Sometimes the enlarged thyroid gland may also choke the windpipe. 

  • Continuous check of the thyroid hormone is very important during the pregnancy

RESPIRATORY AND METABOLIC CHANGES

Mother's body undergoes increased metabolism to provide for the nourishment of the growing foetus and also ​to accommodate the physical changes happening in her body, which further leads to rapid breathing. 

  • Pregnancy leads to the increased flow of oxygen throughout the body usually due to increase in metabolic rate  

  • During pregnancy, the size of the uterus enlarges, which increases the pressure inside the abdominal cavity. This increased abdominal cavity pressure leads to diaphragmatic breathing by the mother. Hence, the mother seems to be breathing rapidly

  • Metabolic rates speed up significantly around the 14th-15th week of pregnancy, reaching its peak by the third trimester. This sudden increase in metabolic rate might put the pregnant women at a elevated risk of hypoglycaemia (also known as low blood sugar)

  • However, the metabolic rate could drop marginally as she reaches the completion of the pregnancy term

  • Nevertheless, the metabolic rate will remain elevated even during several weeks of postpartum or until breast feeding takes place

     

CIRCULATORY SYSTEM CHANGES

Changes in heart and blood pressure of the mother:

  • Primarily, there is an increase in the amount of blood the heart pumps out, throughout the body, due to greater flow of blood to the placenta (Placenta provides nutrition to the foetus)

  • This increase in cardiac output leads to increase in the heart rate, the number of heart beats per minute

  • This leads to an increase in the volume of blood pumped out of the heart

  • Along with a few vascular changes, this increases the blood pressure of the woman

  • Increase in the blood pressure is a common complication in pregnancy which is a result of many factors, mostly Preeclampsia, a complication of having high BP around 20th weeks of pregnancy

  • This can result in a critical situation of high BP in the mother, which in turn results in a fatal condition known as Eclampsia

CHANGES IN THE BLOOD

 
 
Changes in the blood volume during pregnancy
 
 
 
 
  • There is an increase in the volume of blood by 40%

  • The increase in the plasma volume leads to Edema (a condition which leads to swelling due to excess fluids in the body), also known as fluid retention. This leads to swelling in the hands, feet, arms, ankles, and legs. This is quite common and normal

  • There is an increase in RBCs, the red blood cells by 25%

  • The above two changes in the blood cause anaemia, a condition in which the blood does not have enough healthy RBCs which leads to pale skin or yellowing of the skin in the body. Anaemia can be critical to the life of child as well as mother

  • The women’s body also observes coagulation, an abnormally increased tendency of blood clotting

  • A major, and common, complication of blood clotting is Deep Vein Thrombosis, a blood clot in a deep vein, usually in the leg causing it to swell
     

MUSCULOSKELETAL CHANGES

 During pregnancy, there is enlargement of the uterus which leads to increased size of the abdominal cavity which contributes to several other changes, such as  

  • Increase in the body mass index (BMI), the ratio of the weight and the height of an individual

  • Increase in the weight of the mother by 10-15 kgs, leading to stretch marks on the belly, upper thighs and breast

  • There is appearance of a curve in the spine due to the increase in the curve of the baby bump

  • Condition of sciatica is also observed, which is a pain experienced due to compression of nerves at the buttock around the upper thigh

  • Muscle cramp is also a frequent problem experienced by women during pregnancy

DERMATOLOGICAL CHANGES

  • The most familiar changes seen in a pregnant woman is the pregnancy glow or the rose glow, due to increase in blood volume, estrogen and progesterone that leads to cleansing of the face

  • Skin pigmentation is another common change observed by majority of women. This is the process of darkening of skin tone in various body parts such as the areolas, genitals, scars, and the linea alba, the midline of the abdomen

  • Certain other changes are spider angioma (an abnormal collection of blood vessels near the surface of the skin) and stretch marks in the belly, upper thigh and breast

  • PUPPP or pruritic urticarial papules and plaques of pregnancy, is a normal skin condition during pregnancy , that basically consists of rashes and stretch marks on the abdomen

  • Alterations in the growth tendency of hair is witnessed, i.e., the growth is either increased or decreased

  • Hair fall is also pretty evident, especially during the postpartum period

  • Growth of the nails, during pregnancy, seems to be faster than usual but the nails also turn more brittle than usual during the phase of pregnancy
     

FEMALE REPRODUCTIVE SYSTEM CHANGES

During the term of pregnancy, there are a lot of obvious changes in the female gynaecological system, such as,

  • Enlargement of the breasts for breastfeeding. Estrogen increases the size of the lactiferous duct in the breast while progesterone leads to an enlargement of the lobules, the cells that produce the milk. The milk is then secreted out from the nipple of the breast

  • Soreness in the breasts

  • The darkening of areolar tissue which is around the nipples in the breast

  • Uterine hypertrophy, which means the size of the uterus increases by 10 times

  • Enlargement or hypertrophy of the cervical gland which leads to an increase in mucus secretion at the cervix leading to formation of mucus plug at the cervix due to the secretion of progesterone

  • Estrogen also leads to the formation of vaginal lactobacillus proliferation which increases the lactic acid and decreases the pH level of the vagina making sure that no foreign microorganism or bacteria enters the vagina

 UROLOGICAL CHANGES

Urological changes (changes in urinary system) during pregnancy
 
 
  • Blood flow to the kidneys increases by 40%. Also, the increase in weight of the baby puts pressure on stomach, intestines and urinary bladder. This, in turn, increases the frequency of urination in pregnant women 

  • The size of the kidneys increases as well to compensate for the increase of the GFR, glomerular filtration rate

  • Progesterone tends to relax uterine muscles, whereas, the estrogen tends to increase uterine contractility

  • Therefore, an increase in estrogen to progesterone ratio results in an overall increased contraction of the uterine muscles 

  • Furthermore, a hormone released from the pituitary gland called oxytocin, also acts to increase uterine contractility

  • The enlargement of the uterine musculature due to the development of the foetus also contributes to the increased stimulation of the uterine wall which helps in smooth muscle contraction

  • The stretch of the cervix due to the growth of the foetus also contributes to the increased contractility of the uterus

     

 SENSORY CHANGES

  • The pregnant women develop sensitivity to smell and taste

  • This may also lead to lack of desire to eat

  • The cravings for a variety of food is frequent and it changes rapidly

  • Most women experience changes in their sense of taste during pregnancy. Therefore, she may crave for food that she would have never preferred before pregnancy

  • Some women also experience a metallic taste in the mouth during pregnancy. This can aggravate nausea and may indicate a nutrient imbalance

  • She shall typically prefer saltier and sweeter foods than a non-pregnant woman

  • She could also have a greater tolerance for strong sour, salty, and sweet tastes 

  • Dysgeusia, a decrease in the ability to taste, is most experienced during the first trimester of pregnancy

  • The mother may experience a dulled sense of taste for a short time during the postpartum period, they naturally regain full taste capability after pregnancy

  • Yet another common change during this phase is with vision or eyesight, which includes blurriness, short-sightedness or discomfort with lens, if using

OTHER CHANGES

  • Hyperthermia, a condition where the body temperature of the pregnant women increases majorly due to weather conditions, exercise or stress.

  • Dehydration, a condition where the body loses more fluid than consumed.  

 

Both the above conditions can be taken care of with small measures such as, 

  • Avoiding exercising in hot and humid environment

  • Avoiding excessive sweating

  • Avoiding activity leading to shortness of breath

  • Frequent consumption of water and other fluids

  • Having a prescribed balanced diet
     

EMOTIONAL CHANGES 

Change in mood

  • One of the common side effects of pregnancy is the constant change in the emotional state

  • Many external and internal factors may contribute to the emotional stress of the mother and there should be absolutely no guilt or shame in admitting this and seeking help if necessary. These changes in emotions are known as pregnancy emotions, which is very common

  • The hormones involved in the change of the emotional state are estrogen and progesterone. These hormones have an impact on the emotions or the brain's ability to handle the emotions or changes

  • The woman may get moody, cranky and frustrated or happy and joyous or angry and rebellious within minutes

Change in stress level 

  • Some women also undergo a lot of stress as compared to usual

  • The stress may be due to the concern of a safe and healthy pregnancy, upcoming financial needs, health and education of the child, the household or even the desire to accomplish best ways of parenting

Increase in discomforts 

  • The woman experiences an immense transformation in her body, both internally and externally. It may take some time for the mother to accept these changes and feel normal about it

  • There is an increase in morning sickness during the first trimester

  • There is also an increase in sleeping discomfort with changes in sleeping patterns as the mother can no longer sleep on her tummy or back

  • Many women tend to feel less attractive

No one but the pregnant woman herself can experience and understand the intensity of the changes during her pregnancy, others may relate to her. Family and close friends can make efforts in comforting and supporting her emotionally and physically throughout her journey of pregnancy, parturition and postpartum.

Support, care and comfort can be provided to the pregnant women by,

  • Helping her get adequate rest

  • Reduction of the workload to necessary minimum

  • Feeding her a balanced and nutrition rich diet that is prescribed by her doctor

  • Making sure that she meditates and exercises persistently

  • Reminding her to stay hydrated

  • The person closest to her should make sure to spend quality time and hear her out while she vents out her stress and worries, etc 

  • Most importantly, any teratogens or substances like drugs, alcohol or tobacco must be strictly restricted as this may put the life of the mother and the baby at risk

  • Avoiding any such act that might put her through additional sadness, anger, stress or worries 

  • Keeping the room of her presence well ventilated and aromatic to soothe her anxiety

  • Lastly, by making sure that the mother is happy and is surrounded by positivity