Great expectations

Not sure about the next nine months? Emily Dunn gives a rundown what to expect as new life looms.

The initial excitement of becoming pregnant can give way to trepidation and feeling overwhelmed, but never is the saying ''Knowledge is power'' truer. S Well guides mums-to-be through what to expect in each trimester.

WEEKS 1-12

Regardless of whether a pregnancy is a surprise or planned, by the time a woman takes her first pregnancy test, her body is already working overtime to grow and nurture a baby.

A missed period is often the first red flag of early pregnancy but within the first week of conception a woman might notice subtle symptoms such as fatigue, sore breasts, a heightened sense of smell and what feels like a constant need to use the bathroom.

Sick and tired

''The tiredness of early pregnancy is not like anything you have ever felt before; you will feel like you need to go and lie down,'' says a midwife and spokeswoman for the Australian College of Midwives, Hannah Dahlen. ''Even once you know you are pregnant, you may not be ready to tell other people, so if you are working this can be difficult. You need to make sure you go to bed early and catch up on sleep on the weekend.''

Many women experience morning sickness - which can actually strike at any time of the day - ranging from mild nausea to vomiting. For those unlucky enough to suffer it, the good news is that for most people this disappears by week 14. Maintaining a healthy diet and adequate rest are the first means of coping. Supplements such as ginger and vitamin B6 can also help. For severe vomiting, medication is also available.

A Sydney obstetrician, Stephen Morris, says as long as a woman is hydrated, morning sickness is unlikely to have long-term health effects on mother or baby.

''The time to go to hospital is when you are clinically dehydrated and no longer passing urine,'' Morris says. ''Prior to that, the standardised regime is to snack frequently and increase hydration.''



You might feel as though all you want to do is lie down but the first trimester is the time to make some important decisions, such as how and where you want to have your baby.

For most women, a GP is the first port of call to discuss options such as pregnancy management with an obstetrician and delivery at a private hospital, or management by a GP or a midwife, then delivery at a public hospital. For women who want to know the risk of Down syndrome for their baby, an ultrasound is usually done between weeks 11 to 13.

Most importantly, the first trimester is the time to make some significant lifestyle changes.

Avoid toxins such as alcohol and cigarette smoke, take a pregnancy multivitamin that contains essential nutrients such as folic acid and iodine and make yourself aware of the foods that could pose a risk for infections such as listeriosis and salmonella.

''All the really important developments of the baby are happening in the first eight weeks; for a planned pregnancy you should really start taking a prenatal multivitamin before conception,'' Dahlen says.


The second trimester is often considered the best and, by now, most pregnant women have reason to celebrate. Many of the side effects of the first trimester start to disappear and the risk of miscarriage drops to less than 3 per cent, which means many now feel confident to shout their good news from the rooftops.

An ultrasound will be carried out about 18 to 19 weeks, giving you a chance to see your baby developing and to check for possible abnormalities but, meanwhile, your body continues to undergo fascinating changes.

Glow and behold

A bloated stomach that might have previously been mistaken for too many doughnuts turns into a proper ''bump'', you feel the first fluttery movements of your baby and might notice increased pigmentation of the skin. For some, this can be a dark line down the centre of your stomach while others look as if they have spent a week on a tropical island. This, combined with thicker, lustrous locks and improved skin condition, gives the famed pregnancy ''glow''.

Less attractive perhaps is that the second trimester can also be a time of rapid weight gain. However, Dahlen and Morris point out that how much weight a woman gains depends on the individual.

''Some women gain weight straight away; others don't gain much until the third trimester,'' Morris says.

''The most important thing in managing weight gain is to maintain a healthy diet and remain active.''

''This is not a time to let yourself go,'' Dahlen says. ''Not only can it add to complications with birth but it is jolly hard to get off afterwards. There is the common advice to put your feet up, which is also important, but going for a good walk can also be a very healthy thing.''


The excitement is building but so is your impatience, as the increasing weight of the baby starts to make things uncomfortable again. Your basketball-size bump grows to resemble a beach ball and this can lead to shortness of breath and difficulty sleeping.

In the final weeks, you may have to trade walking for waddling as the baby drops deeper into the pelvis.


Other unsavoury, cosmetic symptoms may also emerge such as itchy skin, stretch marks on the breasts, stomach and hips and varicose veins on your legs.

While there is little to be done about stretch marks - and most disappear after the birth - keeping skin well moisturised can help minimise the effects and also alleviate itching. Varicose veins also usually disappear after the birth but can be minimised by regular movement, exercise and avoiding crossing your legs.

Many women experience a nesting instinct in the third trimester, which is not only an important time to prepare for labour but also a time to prepare for the arrival of a baby. Birth classes can help you and your partner prepare for the labour but, as Dahlen points out, this is also the time to think beyond the birth to issues such as breastfeeding, parenting and ensuring someone will be there to look after you in the first, hazy weeks of motherhood.

''There is often an obsession with the 12 hours you are in labour but not much preparation for the weeks beyond,'' Dahlen says. ''Think ahead, prepare meals and make sure you have support.''

What happens for men?

Pregnancy is no big deal for a man. At least, that's the stereotype; the reality is somewhat more complex.

As his partner experiences all the ups and downs of pregnancy, the dad-to-be may be experiencing similarly intense emotions, ranging from anxiety and irritability to excitement and elation.

Studies have found men undergo significant hormonal changes during pregnancy that complement those of their partners. Moreover, there is the sheer magnitude of the impending change. This is what makes the prospect of fatherhood so daunting. It's a big change and it's permanent; you can't try before you buy.

''Fatherhood is an unpredictable experience,'' Melbourne columnist Ross Campbell wrote in the 1950s. ''You cannot tell whether you will like it until you've tried it.''

The first piece of advice to note is, don't worry about worrying. It's important to recognise your apprehension is natural and surprisingly common. It may help to compare notes with other dads and dads-to-be. If your darker emotions are getting too much, seek professional help.

The second thing to note is that denying the reality of the impending change doesn't help. Become involved as much as possible. Help choose the pram and decorate the nursery. If you find this hard, articulate why with your partner.

The third thing is to support your partner as much as possible. Let's be blunt: pregnancy isn't primarily about you. Your issues are the sideshow. On the main stage are your partner and your unborn child and they need to be nurtured and supported. That means everything from giving foot rubs to stepping up with domestic chores.

That said, many men experience pregnancy as a time of profound delight; it's a time when you and your partner can take your relationship much deeper, in emotion and intimacy. And at the end of it, there's the likelihood of joy. That's certainly how it turned out for Campbell, who wrote: ''As soon as I saw my small daughter, who had wisps of red hair, I knew I was glad to be a father.''


Sacha Molitorisz is the author of From Here To Paternity (Pan Macmillan).