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Staying Healthy during Each Pregnancy Trimester

Staying fit and healthy throughout your pregnancy should be your goal. Pregnancy is divided into three stages called trimesters, each lasting three months. The 40 weeks of gestation thus get divided into smaller, distinct phases of development for both the mother and baby.

The first trimester is the stage of pregnancy that begins on the first day of your last menstrual period and ends at 13 weeks. Human gestation is actually only 38 weeks, but the date of conception can be a tough one to nail down because many people don’t keep track of intercourse (especially if it is an unplanned pregnancy) and conception can actually occur a few hours to a few days after the intercourse. It is therefore easier to use the date of the last period as the start of pregnancy and simply add two weeks to the length of expected gestation. By the time you take a pregnancy test and find out that you are indeed pregnant, you are already about four weeks along (what a deal!)

During the first trimester, the basis for all of your baby’s organs will form. Your hormone levels are also rising rapidly. The concentration of hCG (human chorionic gonadotropin) typically doubles every 48-72 hours in the early weeks. This rapid increase along with changes in estrogen and progesterone levels and the increased work-load of your body to make new organs result in typical first trimester symptoms, which may include: nausea, vomiting, fatigue, emotional sensitivity, food aversions and cravings, heartburn, indigestion, tender or swollen breasts, changes in complexion, frequent urination, constipation, and dizziness.

Because of these symptoms, many women do not have the desire, energy, or motivation to exercise. However, there is no medical reason that you should not be able to continue your pre-pregnancy fitness routine (unless it included contact sports, horseback riding, gymnastics, or other activities where the risk for trauma and falls is high.) If you enjoyed jogging, swimming, cycling, weightlifting, yoga, or walking prior to pregnancy, it is likely safe to continue at your previous intensity levels, though it is always a good idea to discuss this with your doctor and listen to your body. If you were not active prior to pregnancy, it is a good idea to start a simple walking program. Walking helps maintain or promote cardiovascular fitness and stamina, helps tone muscles, and contributes to a positive outlook and mood.

In addition to safe and regular exercise, you should be taking a prenatal vitamin with folic acid daily. This is especially important in the first trimester when the neural tube is forming and closing. Smaller and more frequent meals can ease symptoms of nausea and heartburn. Drinking plenty of water can help with fatigue, headaches, constipation, and dizziness. Increased sleep and rest will help combat fatigue. It is also important to not smoke or drink alcohol. Studies have shown that mothers who smoke are at greater risk for spontaneous pregnancy losses, preterm delivery, low birth weight, premature rupture of membranes, placenta previa, and stillbirth. Alcohol also has negative effects throughout pregnancy; it can cause growth impairment, facial dysmorphia, neurologic problems, and low cognitive function for the baby.

The second trimester covers weeks 13 through 26. Your hormone levels begin to stabilize, which allows the nausea, fatigue, and other first trimester discomforts to decrease or disappear altogether. You are likely beginning to look and feel pregnant; your bump might even be noticeable enough to attract attention from strangers. Nasal congestion, constipation, and mild swelling in the ankles are common second trimester symptoms, though not all women will have them. The baby is busy fine-tuning his/her organs, which will be moving to their correct locations. He/she also begins to practice sucking and swallowing. Reflexes are developing, and he/she is beginning to gain weight. Sometime between 16 and 22 weeks, you will begin to feel his/her movements.

Your increase in energy will possibly increase your motivation to exercise, and most pre-pregnancy and first trimester activities continue to be safe. However, it is important to remember that your abdomen is growing, which changes your center of gravity and affectsyour balance. Some yoga and weightlifting exercises may need to be modified to accomadate your growing belly. You should avoid laying flat on your back for long periods of time, as it can put pressure on important blood vessels that supply the uterus. Jogging, swimming, cycling, and walking continue to be safe, though modification may be necessary. Many women run, swim, bike, or walk shorter distances at a slower pace. It might also be a good idea to switch to a stationary bike in order to avoid falls.

In addition to exercise, you should continue to take a prenatal vitamin, eat a wide variety of nutritious foods, drink plenty of water, get adequate rest, and see your health care provider regularly. Smoking and drinking alcohol continue to be detrimental to both you and the baby.

The third trimester is the final stretch that includes week 26 through the birth of your baby. The baby’s main job in the third trimester is to get bigger and increase fat stores, which will help regulate body temperature after birth. Because the baby is getting bigger, so are you! This can make you feel quite uncomfortable and put pressure on your bladder causing increased urination, pressure on your colon causing constipation, pressure on your diaphragm causing breathlessness, and pressure on your stomach causing heartburn. You may also feel fatigued from carrying around the extra weight.

Exercise may begin to feel more uncomfortable because of your increased weight, the pressure on your bladder and pelvic bones, and the dramatic change in your center of gravity. It may be beneficial to switch to light walking or to swimming or another form of water exercise (where you are essentially weightless), though if you are not uncomfortable, other forms of exercise (even jogging) are okay. It is also important to strengthen the pelvic floor muscles through simple kegel exercises. This will aid in delivery and recovery and may help prevent you from having urinary incontinence in the postpartum period.

You should also get as much rest as possible, continue to eat a healthy diet, drink plenty of water, and do your best to prepare emotionally for both the baby’s delivery and motherhood.

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