Pregnancy is a mentally and physically transforming stage in a woman’s life. Although generally portrayed as one of the most beautiful experiences, it is also a period of transition in which some women can present concerns when experiencing body changes that are not commonly discussed.
In some cases, several pregnancy-related changes can continue during the postpartum stage [1]. These body changes are specific for each woman, eliciting a diversity of experiences associated with them. Some women, for example, experience a feeling of increased confidence, attractiveness, and femininity during pregnancy [2]; while others present a sense of dissatisfaction, and discomfort. These experiences are not limited to emotional changes, but also to the rapid and physical transformations that the human body goes through [3].
Monitoring body changes during the stages of pregnancy and understanding that they are a natural and temporary part of this event are key elements of a healthy pregnancy.
In this article, we will explore the changes that women’s bodies go through during pregnancy, including the most common and the not-so-common symptoms. So, let’s discuss the great variety of symptoms (or lack thereof) to comprehend why they occur, at what stage they are more likely to develop; and, if applicable, how to treat or alleviate them.
Common changes during pregnancy
Let’s start with the most common symptoms that pregnant women frequently experience throughout the stages of pregnancy:
First trimester
During the first trimester, pregnancy-related physical symptoms are very common. Women generally exhibit nausea, vomiting, back pain, frequent urination, and breast tenderness [4, 5]. In fact, around 80% of women experience nausea, while vomiting occurs in about 40% of pregnancies in the first trimester [4].
Second trimester
Symptoms tend to diminish when entering the second trimester. However, keep in mind that the body is still adjusting to pregnancy and that each body reacts differently. The most common symptoms are bloating, fatigue, and sometimes an increase in appetite. Frequent urination continues to be a common symptom since there is an increase in blood volume and, as your uterus becomes larger, it presses on your bladder [5]. Your baby is bigger by now, so it is completely normal to feel heavier and experience swelling around your ankles due to water retention. Due to the physical stretching of the skin, stretch marks are very likely to appear at this stage, making them one of the most common skin-related changes during pregnancy [6].
Additionally, pulse rate can increase since blood needs to be pumped more frequently to deliver enough oxygen to the baby, so you might feel dizzy and light-headed [7]. Do not get alarmed and try to lie down once in a while!
Third trimester
You’re almost there! Some of the symptoms experienced during the first and second trimesters continue to be present at this stage; for example, frequent urination, fatigue, and swelling. Other symptoms, such as nausea, usually subside when entering the third trimester; however, some women continue to experience it until the end of the pregnancy [8]. Additionally, it is common to experience insomnia and vaginal discharges in the third trimester [9].
Less common changes during pregnancy
Now, let’s explore the not-so-common changes that may take place during pregnancy:
Hair changes
During pregnancy, some women exhibit changes in the hair follicle cycle, including alterations in hair growth, thickness, etc. This happens because there is a significant increase in the levels of various hormones, such as progesterone and estrogen, that are associated with hair growth. Surprisingly, the month in which birth takes place also plays an important role in hair changes. This is because hair tends to grow faster during the warmest months as naturally, we lose hair during the winter. So, for example, if you give birth during August, it is more likely for your hair to grow back faster as there is no other natural shedding taking place [10].
The hair follicle cycle generally goes back to normal without any treatment, as progesterone and estrogen levels return to normal only two to four days after giving birth. However, in some cases, it takes longer for hormone levels to go back to normal [10]. Nonetheless, even though hair changes can be stressful and distressing, especially when there are other body alterations taking place, it is a normal and temporary process during this important life event.
Skin changes
Skin changes are also reported by some pregnant women. These changes can occur during the early stages of pregnancy. Skin changes generally happen due to hormonal, metabolic, and immunologic changes. And, similar to hair changes, estrogen and progesterone are the main hormones to blame because they stimulate the production of melanin in the body [11].
The most common skin change is hyperpigmentation or darkening of the skin. This generally affects areas that are naturally darker, such as nipples, areolas, neck, armpits, inner thighs, genitalia, etc. Hyperpigmentation generally starts in the first trimester of the pregnancy and tends to fade away after giving birth [6]. Other skin-related changes are varicose veins and acne (less frequent) during the third trimester. All of these changes are treatable, but they should usually go away on their own [6]. However, it is important to attend a dermatologist to make sure the products are ‘pregnancy-safe’ and, most importantly, try to remain patient during the process.
Vaginal changes
In some cases, women may exhibit vaginal changes such as swelling, infections, and discharge during pregnancy. This is often associated with changes in the vaginal microbiota (the wide diversity of microorganisms that live in your vagina) during the first trimester. These alterations, often caused by hormonal changes and an increase in amino acid concentrations, play a major role in maternal-fetal health. For example, research studies show that low levels of microbial diversity may lead to healthier pregnancies, while infections by pathogenic bacteria are often associated with pregnancy complications. Although the vaginal microbiota tends to recover its balance towards the end of the pregnancy [12].
Breast changes and colostrum
Several changes can occur in the breasts during pregnancy and nursing. During pregnancy, breast size can increase in some women as the breast tissue expands and the nipples and areolas tend to become darker and more sensitive. However, excessive breast growth, potentially caused by an abnormal response to female sex hormones, is an uncommon change that may lead to infections and pain. Additionally, blood discharge from the nipple is also an unusual change that occurs in the third trimester. This occurs because of an increase in breast vascularity and generally ceases with the onset of breastfeeding [13].
Colostrum, also known as the ‘first milk’, can start being produced after the second trimester. This can lead to recurrent fluid discharges that, although maybe uncomfortable, are completely natural [14].
Digestive issues
It is well known that nausea and vomiting are symptoms that affect 50-80% of pregnant women. However, there are other less common gastrointestinal symptoms during pregnancy, such as heartburn and constipation. Recent studies suggest that changes in the intestinal microflora (the diverse communities of microbes that live in your gut) could play a major role in gastrointestinal disorders. Therefore, professionals suggest that making diet changes, such as cutting caffeine and fatty foods and increasing fibre and water intake, can contribute to the improvement of symptoms during pregnancy [15].
Anxiety and depression
Anxiety is a completely natural reaction to potential danger and a fundamental part of human behaviour. However, it can become a mental health issue if it affects the daily life of an individual. Pregnancy is a transforming and eventful stage in a woman’s life. Therefore, women are more likely to face high levels of anxiety and depression during this stage [16], especially in the second trimester of their pregnancy [17]. When anxiety and depression occur together in a pregnant woman, they can lead to high cortisol levels in the mother’s body [18].
This topic has received more attention in recent years since research studies show that these high levels of cortisol during pregnancy can affect the cognitive and social development of the child [18]. For this reason, it is fundamental to visit a healthcare professional to obtain the best treatments and coping techniques to improve your well-being during and after your pregnancy.
Absence of pregnancy symptoms
Some women experience few or no symptoms during pregnancy, especially at the early stages. While this sounds like great news for some, it is a reason for concern for others. Although it is not as common as having recurring symptoms, such as nausea and dizziness, research studies indicate that it can happen to some women but, unfortunately, it remains an underexplored topic.
It is also important to consider that some women tend to expect the most common symptoms of pregnancy, such as morning sickness, swollen breasts, or a need to urinate frequently, disregarding the less-common symptoms, such as constipation, hair loss, and sometimes even back pain and recurrent headaches [9]. Although some pregnancies can be asymptomatic, it is important to have regular check-ups and monitor body changes throughout all pregnancy stages.
When to visit a healthcare professional?
Each body responds differently to pregnancy. There are other uncommon symptoms not included in this article that can be experienced individually or together throughout pregnancy. Regardless of the nature of your symptoms (common or uncommon), setting up recurrent medical appointments as early as possible is an essential part of a healthy pregnancy.
It is fundamental to immediately contact your healthcare provider if you are experiencing physical symptoms including but not limited to fever, excessive pain, unusual vaginal discharge, symptoms of urinary tract infection [19], persistent vomiting and/or bleeding, severe headaches, blurred/altered vision, sudden swelling of hands, feet or face, sudden belly pain [20] or emotional symptoms, such as severe anxiety or depressive symptoms. Although the appearance of new symptoms can be a completely normal part of pregnancy, asking your healthcare provider for guidance will always be the right thing to do. Healthcare professionals will make sure to do an extensive checkout and provide treatment, guidance, and reassurance by answering all your questions.
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