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What’s going on in there? Pregnancy from the body and baby’s perspective By Lara C. Hanlon, MD
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Pregnancy is an incredibly exciting time. It can also be an intimidating and stressful time when suddenly you realize that you don’t have the
control over your body that you used to have. It can feel at times as if you are being “Invaded by the Body Snatchers.” Of course, they are
adorable, lovable and quite innocent body snatchers, yet demanding nonetheless.
It’s helpful to know exactly what is happening inside in order to appreciate why we feel the way we do when we are pregnant. So many changes
occur that are necessary for our bodies to be able to support a pregnancy. Almost immediately, the cardiac output, or the amount of blood that is
pumped from your heart into your body, significantly increases, as does your heart rate. Despite this increase, the pressure from your growing
uterus can make it difficult for the blood to get up to your heart and brain, leaving you feeling dizzy and faint at times, especially when lying on
your back. There is more swelling of the legs for the same reason; the fluid has a harder time getting pumped upward through the body.
In the beginning of pregnancy, the walls of the blood vessels relax and your blood pressure will usually drop below your normal pressure. Toward
the end of pregnancy, the blood pressure usually returns to normal. Some people will experience elevated blood pressures beyond their normal.
This can be a relatively benign condition called gestational hypertension, or can develop into a more serious condition called pre-eclampsia,
sometimes referred to as toxemia. This is one of the reasons why we see people more frequently toward the end of their pregnancy.
The increased hormones of pregnancy also lead to changes in the nasal passages and the lungs, causing more stuffiness and an increased rate
of breathing. This can lead to the sensation of being short of breath. Furthermore, the pressure of the expanding uterus on the stomach, in
addition to the relaxation of the muscle that normally keeps acid within the stomach, can lead to increased heartburn in pregnancy. This typically
resolves almost immediately after delivery. Your kidneys are working overtime in pregnancy too. Because of this, along with the body’s increased
fluid volume, you will be going to the bathroom much more frequently when you are pregnant.
Your number of red blood cells, which carry oxygen, will overall decrease. This will lead to a temporary state of “anemia” in pregnancy. This is why
increased iron (usually obtained from prenatal vitamins) is recommended in pregnancy.
Lastly, the body’s ability to process sugar is altered in pregnancy. Some women will develop a temporary condition called gestational diabetes,
which usually resolves after delivery. However, if you are diagnosed with gestational diabetes, you will have an increased chance of gestational
diabetes in future pregnancies as well as a risk of being diagnosed with diabetes later in life.
Of course, one of the biggest concerns for most women is their weight gain in pregnancy. Again, this is at least partially out of your hands. Calorie
requirements do increase during pregnancy and weight gain will occur, and should occur, for most women. The goal should be to focus on eating
the right kinds of food rather than focusing on the scale. Go easy on yourself. Of course, it is not the time to overeat “just because you are
pregnant.” Regular, moderate level exercise is encouraged for most pregnant women, with care to avoid activities that carry a high risk of falling
or trauma to the abdomen.
From the baby’s perspective, he or she is hanging on for the ride and experiencing major transformations him or herself. The first 3 to 8 weeks
after conception are the “biggies” as far as development and the formation of the major organ systems. During this time, the heart, arms, and
legs have formed and all of the other organs, including the nervous system, eyes, ears and genitals have undergone major growth. During the
remainder of the pregnancy, the nervous system continues to grow and mature and the finishing touches are added to your masterpiece. The
pulmonary system, or lungs, is one of the last organ systems to mature.
Very important to the nervous system development is the role of folic acid. However, the role of folic acid is primarily important before you even
find out you are pregnant. That is why it is important to take a supplement of at least 400 micrograms per day of folate if you are planning on
getting pregnant. This requirement increases to 4 milligrams for women who are at increased risk for neural tube defects, such as a prior history
of a neural tube defect or women taking certain medications for a seizure disorder.
Important food groups to avoid while the baby is on board are fish high in mercury, such as shark, swordfish and mackerel, which can affect the
baby’s nervous system. Other fish, including light tuna, should be limited to 12 ounces per week and white (albacore) tuna should be limited to 6
ounces per week. Caffeine should be limited to one to two cups per day. Soft and/or unpasteurized cheeses, such as Brie, should be avoided, as
should all other unpasteurized foods. Cold cut delicatessen meats should also be avoided, as these can carry bacteria called Listeria, which can
be harmful to the baby. Artificial sweeteners are considered fine in pregnancy. Lastly, as probably goes without saying, alcohol and tobacco
should be avoided in pregnancy, as these can adversely affect the baby’s development throughout the pregnancy.
It is hard to believe all that the body and baby go through during this process in order to come up with the final product. Ultimately, at the end of
this major construction project, there is a big present waiting for you in the form of your baby (or babies), which makes all the hard work and
changes you go through worthwhile.