An A to Z list of what you’re likely to encounter over the next nine months, courtesy of Easy Parenting Magazine

Joy of joys, you are pregnant! You have nine months of planning and preparing ahead of you, plenty of time to adjust to welcoming a new life. As delighted as you may be about bringing a life into the world, there are a few things you should know in advance. Pregnancy brings with it all sorts of weird and sometimes wonderful (often uncomfortable) symptoms. Be prepared for what you will need and what your body will go through with our A-Z of pregnancy guide.

ACNE

You may have thought that you left acne behind in your teenage years, but unfortunately pregnancy hormones can trigger it, or if you have adult acne, make it worse. Hormones called androgens are partly responsible as they prompt the sebaceous glands in your skin to get bigger and also boost production of oil called sebum. This sebum gets blocked in your pores and combined with hair follicles, shed skin cells and bacteria on your skin can multiply, causing spots.

There is no way to know if you’ll have mild, moderate or severe acne, or none at all. Every woman is different. Pregnancy acne can come and go or can last throughout the entire pregnancy. You can minimise the outbreaks by keeping skin clean, washing it with mild soap or face wash. Some washes have salicylic acid, which reduces outbreaks, however this is not recommended for use when pregnant. Be sure to consult your doctor before you start any acne treatment.

BREASTS

One of the first signs you are pregnant is breast tenderness. The hormonal changes that occur during pregnancy cause increased blood flow and changes to the breast tissue. This makes breasts feel swollen, sore and sensitive to touch. Some women even report tingles. The sensitivity usually starts around four to six weeks and lasts for the first trimester. After that, you will notice your breasts getting bigger and they will continue to grow through pregnancy. You may want to apply moisturiser or stretch mark cream as the skin stretches and expands and may even become itchy.

You may notice your areolas (pigmented circles around your nipples), will be bigger and darker. After your third month of pregnancy, your breasts may produce the special milk your baby will start nursing on, called colostrum. This may start leaking some yellow substance in the last few months of pregnancy, but not every woman will get this.

It is important to wear supportive bras during pregnancy to reduce backache and even breastache. Maternity bras are made of soft material with no seams at the nipple to provide comfort. You can also buy bra extenders for the first few months of pregnancy to make your normal bras continue to fit. In the third trimester you may prefer a nursing bra, which you can then use for breastfeeding when your baby is born. Whatever bras you wear, ensure you are fitted by a bra specialist in store.

CRAVINGS

Once you are pregnant you may start to have insatiable cravings for foods you may never have been interested in before. While there is no scientific evidence to explain food cravings, some researchers believe it stems from a nutrient deficiency. For most women, pregnancy food cravings fall into just a few categories: sweet, spicy, salty, or occasionally sour. Surveys show only a scant 10% of pregnant women crave fruits and veggies during pregnancy.

While some pregnancy cravings can certainly seem a bit odd, in most instances, they don’t represent any real threat to mother or the baby. This, however, can change dramatically, when the craving is for a nonfood item. The condition, known as pica, can lead to an overwhelming desire to consume any number of substances, some of which can be extremely harmful to both mother and baby. During pregnancy a woman can crave and eat things like dirt, laundry starch, crayons, ground up clay pots, ice scraped from the freezer. As bizarre as it seems, the desire can be overwhelming. If you do find yourself craving any nonfood item, see your doctor immediately and be tested for iron deficiency anemia or other nutritional deficiencies such as zinc, which has also been linked to pica. Some women even experience an aversion to certain foods, which is perhaps the body’s way of keeping her away from harmful foods e.g. soft drinks, coffee, alcohol. If however, you begin to crave something odd and harmful to you or your baby, consult your GP immediately.

DISCHARGE

It is normal to experience an increase in vaginal discharge when pregnant. This is called leucorrhoea, (an odourless or mild smelling milky discharge), which all women get, pregnant or not. However, when pregnant, this discharge will increase due to oestrogen production and greater blood flow to the vaginal area. Leucorrhoea is made of secretions from the vagina and cervix, old cells from the vaginal wall and normal bacterial flora from the vagina. You may find that wearing panty liners will make you feel more comfortable. If, however, you notice that the discharge is excessive, or runny and clear, consult your doctor, as this could be leaking amniotic fluid.

EMOTIONS

You may find that you are on an emotional rollercoaster while pregnant. One moment you’re going about your day, the next you’re blubbing into the tablecloth. Even if you and your partner are delighted to be pregnant, you are almost certain to feel utterly all over the place emotionally throughout the pregnancy. These emotions can range from fear of your body’s changes, to fear of not making a good mother, to absolutely nothing significant at all making you cry.

Ask your partner and family for hugs and support while you manage each stage. If it helps, explain your changing moods to your nearest and dearest, including any other children, and ask them not to take it personally if you do lose your cool or end up sobbing over a piece of toast dropped on the floor. When you feel overwhelmed, take a deep breath and try to relax. If you feel like crying, let it out. These feelings are a normal part of pregnancy and have no reflection on how you’ll be as a parent. Be kind to yourself.

FOLIC ACID

Folic acid is important for pregnancy as it can help prevent birth defects known as neural tube defects, such as spina bifida. You should take a 400 microgram folic acid tablet every day while you are trying to get pregnant and until you are 12 weeks pregnant. If you didn’t take folic acid before you conceived, you should start as soon as you find out that you are pregnant. You should also eat foods that contain folate (the natural form of folic acid), such as green leafy vegetables and brown rice. Some breakfast cereals, breads and margarines have folic acid added to them. Some women have an increased risk of having a pregnancy affected by a neural tube defect, and are advised to take a higher dose each day until they are 12 weeks pregnant. Discuss your requirements with your doctor.

Women have an increased risk if they:

• or their partner have a neural tube defect
• have had a previous pregnancy affected by a neural tube defect.
• or their partner have a family history of neural tube defects.

You should always seek advice from your doctor or public health nurse before taking any supplements.

GAS

One of the big symptoms of pregnancy is the increase in bodily gas that you will expel, to the detriment of yourself and your loved ones! The average person will produce 1-4 pints of gas a day and will pass this gas 14-23 times a day. Once pregnant, this number significantly increases, and you may find yourself feeling bloated and passing gas and burping more often.

The reason for the gas increase is due to the higher levels of progesterone. This relaxes smooth muscle tissue in your body, including in the gastrointestinal tract, which slows your digestion leading to gas, burping, bloating and flatulence. Later in your pregnancy you may feel even more bloated due to your growing uterus and its demands on your abdominal cavity.

HICCUPS

Many pregnant women report feeling fetal hiccupping – when your baby hiccups inside your tummy. This usually occurs in the late first trimester or early in the second trimester, although you may not feel this until your third trimester. Fetal hiccupping feels like small rhythmic movements in your tummy, and is caused by your baby’s reflex development process. It is completely normal and can happen intermittently with some babies getting them daily.

Fetal hiccups are actually a good sign. Towards the end of your third trimester your doctor may ask you to keep note of your baby’s movements. If you notice little movement or none at all for a prolonged period, contact your doctor immediately.

INDIGESTION & HEARTBURN

Indigestion (dyspepsia) and heartburn in pregnancy are caused partly by hormonal changes, and in late stages of pregnancy by your womb pressing on your stomach. It is extremely common, with eight out of 10 women experiencing it at some stage. Indigestion can cause you to feel nauseous, sick or gassy and symptoms are often felt after eating. Heartburn causes a strong, burning pain in the chest and is due to stomach acid passing from your stomach into your oesophagus.

Indigestion and heartburn occur more frequently at the late stages of pregnancy and are unfortunately unavoidable, although you can ease the symptoms by adjusting your diet and lifestyle. If you feel symptoms are extreme and causing you severe discomfort, discuss it with your GP and they may suggest medication to ease it. However, check the antacids are suitable to take during pregnancy.

JOINT PAIN

It is common to feel pressure on your joints while pregnant. Often pregnant women will feel stiffness or pain in the bending parts of the body i.e. elbows, fingers, knees, hips and ankles. While a lot of this discomfort can be attributed to the weight gain, joint pain can also be caused by fluid retention. Carpal tunnel syndrome is also extremely common in pregnancy, causing pain in the hands and wrists.

Try to get a full eight hours of sleep a night and if pressure on your joints is uncomfortable, take a rest and put your feet up. Massage can also assist with the symptoms of joint pain. Your partner can help you with this by rubbing the sore areas to alleviate pressure. While light exercise can help keep you keep limber, excessive exercise can actually cause pressure on joints, so go easy on yourself.

KICKING

Feeling your baby kicking is one of the most exciting stages of pregnancy, as you feel connected with your baby as they move about your womb. While your baby starts to move at about seven or eight weeks, you probably won’t feel anything until 16 to 22 weeks.

Some women report the feeling of their baby kicking akin to popcorn popping, butterflies fluttering or a goldfish swimming around in their tummy! Often kicking will feel like hunger pangs, so it can be difficult to discern for first-time mums. Veteran mums often notice the feelings earlier in their pregnancies, as they know what to look out for.

It is easier to feel your baby kicking if you are sitting or lying still. At first you may find the kicks are few and far between, but as you progress in your pregnancy, you may feel them getting more regular and jerkier. From the second trimester on, these kicks will be livelier and are a great sign that your baby is well. It’s important to take notice of the regularity of your baby’s kicking and contact your doctor if you feel a decrease in activity.

LABOUR

Chances are you a dying to meet your new baby, but not looking forward to the labour ordeal in order to do so. There are numerous ways to alleviate the discomfort of labour. Deciding before labour on where you will give birth – at home or in hospital, and what pain relief you are willing to have can take some of the uncertainty out of the process.

There is no certain length of how long a labour will last, but most fall between 10 and 20 hours. Some women have shorter labours than this and likewise some have longer labours than 20 hours. Women who have given birth before generally find labour goes faster.

There are three stages to labour:

• First stage: Contractions begin and the cervix gradually thins out and dilates.
• Second stage: The cervix is fully dilated and you will begin to push your baby out through the vaginal passage.
• Third stage: The placenta is pushed out after your baby has been born.

Some women swear they forget the pain after birth, and are more engrossed in their new babies than thinking about the difficulty or pain of childbirth. This can be attributed to the hormone oxytocin, the ‘love’ chemical released during labour and breastfeeding to assist bonding between you and your baby.

MORNING SICKNESS

Morning sickness is a misleading term. Most women who experience this will actually feel symptoms all day as opposed to just morning. Although the term refers to how symptoms can worsen after a long break without food, like after sleeping overnight, thus causing illness in the morning. The symptoms include nausea, vomiting and fatigue and the intensity is different for every woman.

Morning sickness affects about three quarters of pregnant women during the first trimester and some feel relief after about 14 weeks, although some will experience it for another month. About half of all women experience both vomiting and nausea, which can kick in anywhere between four and six weeks. A small percentage of women will unfortunately experience morning sickness symptoms throughout their entire pregnancy. Try eating little and often to keep your blood sugar levels up. Dry crackers can assist with nausea. Alternatively, your doctor can advise you of the best way to manage your symptoms.

NESTING INSTINCT

Many pregnant women experience the nesting instinct, a powerful urge to prepare their home for the baby by cleaning and decorating. Or perhaps you’ll want to tackle projects you haven’t had time to do, like organising your garage or wardrobes. As your due date draws closer, you may find yourself cleaning cupboards or washing walls – things you never would have imagined doing in your ninth month of pregnancy! This desire to prepare your home can be useful because it will give you more time to recover and nurture your baby after the birth. But be careful not to overdo it.

OXYTOCIN

This is known as the hormone of love because it is present in the body during sex, fertility, labour, birth and breastfeeding. The hormone triggers loving feelings, and helps us with bonding and attachment with a partner or child.

Oxytocin is released after orgasm and is often referred to as the ‘cuddle hormone’ as the feelings of wellbeing can make you feel closer to your partner. This hormone is also present in breast milk, assisting mother and baby in the bonding process. This same hormone is released gradually in pregnancy, and then sharply in labour. It stimulates powerful contractions and helps thin out and dilate the cervix, push the baby and placenta out, and limit bleeding at the site of the placenta.

The baby also produces oxytocin during labour, and after the birth, mother and baby are enveloped in these hormones when they meet. The bonding process is enhanced by skin and eye contact, as well as breastfeeding.

PERINEUM

This is the area between the vagina and anus that can be stretched and even tear during labour. It stretches to allow the baby’s head through the vagina, but sometimes will need to be cut by the doctor (episiotomy). There are things you can do to prepare and prevent tearing during labour. Perineum massage three times a week in the month coming up to birth can make it more flexible. You or your partner can do this massage. Using clean hands, insert a thumb into the vagina and press down towards the anus until a tingling is felt. Then massage this area in a U shape and around the outer vaginal entrance for a few minutes.

QUENCH YOUR THIRST

It’s hugely important to hydrate yourself during pregnancy. The entire body requires water to function normally, and when you are pregnant your body needs more to cope with the demands of the changes it’s going through.

Drinking water at its most basic function prevents dehydration – which causes nausea, headaches, cramps and dizziness, as well as preterm labour in the third trimester. Drinking plenty of water can also assist with feelings of morning sickness, heartburn and indigestion. The best way to monitor your hydration levels is by checking your urine colour. If it is dark, you need to drink more water. Pale, yellow-coloured urine indicates good hydration levels.

Some women find drinking water can help prevent urinary tract infections, , and ease constipation, haemorrhoids and water retention. The more you drink, the less water your body will retain.

RH FACTOR

When you have your blood tested in the first trimester, it will be checked for the Rh factor. This is a protein in the blood. When a mother has Rh-negative blood and the father has Rh-positive blood, there is a potential for their baby to have a health problem. The Rh incompatibility isn’t problematic if it’s a mother’s first pregnancy, as the fetus’s blood won’t usually enter the mother’s circulatory system. However, the blood can intermingle in labour.

If this happens, the mother’s body recognises the Rh protein as a foreign substance and can begin producing antibodies (protein molecules in the immune system that recognise, and work to destroy, foreign substances) against the Rh proteins introduced into her blood.

If a mother hasn’t started to produce Rh antibodies, she’ll need an injection of a blood product called Rh immune globulin. The immune globulin prevents the body from producing Rh antibodies during the pregnancy. If the baby is born Rh negative, no additional treatment is needed.

If the baby is born Rh positive, the mother will need another injection shortly after delivery. She’ll likely need injections during any subsequent pregnancies and after the delivery of each Rh-positive baby as well.

STRETCH MARKS

During pregnancy, everything grows to accommodate your new baby, especially your skin. As skin grows, you can be left with stretch marks. These are small, indented lines or streaks on the skin. They usually fade to faint, silvery lines over time but moisturising regularly can help prevent these marks. They are often found on the breasts, stomach, bottom and thighs during pregnancy and start out red, pink, purple or dark brown, depending on your skin colour. Moisturising three or four times a day with products that contain cocoa butter or shea butter as a prime ingredient can help to reduce stretch marks.

TIREDNESS

A general feeling of tiredness is common during all stages of pregnancy, however, it appears to be worse in the first trimester and just before birth. While some women won’t report any fatigue at all, the majority of women will find it difficult to stay up past 8pm for the first trimester.

While there is no particular cause for pregnancy tiredness, the increase in hormones in the body including a huge rise in progesterone could be to blame. Also coupled with morning sickness symptoms like vomiting and nausea – you are likely to feel drained and worn out. Tiredness can also be a sign of iron deficiency anaemia, which is common during pregnancy. You will be tested for this during your prenatal doctor visits. Take it easy, get plenty of rest and ask for help during this time. If you can, take a nap during the day to refresh yourself and go to bed earlier in the evenings. The good news is the tiredness recedes marginally in the second trimester and doesn’t resurface until about seven/eight months.

UTERUS

The uterus is a small organ, about 7cm long and 5cm wide. However, during pregnancy it expands dramatically. By 36 weeks, it has grown to reach the lower edge of the rib cage. It also increases in weight from 25g to 50g. The uterus is able to stretch due to its anchoring to the pelvis with ligaments, which stretch as the uterus grows. After the birth of your baby, your uterus will return to its original size and weight.

VITAMIN D

Vitamin D helps maintain proper levels of calcium and phosphorus, which help you and your baby’s bones and teeth. Because the body makes vitamin D from sunshine, Irish people can be deficient. Lack of this vitamin can lead to growth retardation and skeletal deformities, and even impact on birth weight.

If you are deficient in this vitamin, your baby will be too. This can cause your baby to have rickets, abnormal bone growth and delayed physical development. It is recommended that pregnant women take a supplement of vitamin 5 mg daily. Once your baby is born, it is also recommended that you continue to give her a vitamin D3 supplement of 5 mg daily. Vitamin D can come from food sources too; fish liver oil, oil-rich fish, fortified milk, egg, and cereal.

WEIGHT GAIN

When pregnant, you are recommended to eat an extra 300 calories a day – such as an extra yoghurt and a bagel. Expect to gain between one and a half to two and a half stone by the end of your pregnancy. You may find the changes in your body unsettling at first, but these changes are necessary for your baby’s development. Weight usually starts to increase around the 12-week mark, and only marginally. From the 20th week until the 30th week, there will be the most weight gain. Breastfeeding can assist with post-birth weight loss – losing the baby weight can take upwards of a year. Ideally, you should take the weight off gradually, aiming for one to two pounds per week.

X-RAYS

X-rays should be avoided while pregnant if possible. The issue is contentious as to whether x-ray can cause problems for the fetus and has yet to be confirmed. If you need to have dental work or diagnostic tests, tell your dentist or doctor that you are pregnant so that extra care can be taken.

YOGA

It is important to maintain some form of light exercise throughout pregnancy to keep you fit and healthy. Yoga helps alleviate some pregnancy complaints such as back pain and sciatica, assists breathing processes and helps build up strength and endurance that will be needed in the delivery. Generally, pregnant mums who do yoga exercises appear healthier, both in mind and body. Their bodies are more flexible, which enables them to adapt to various positions when in labour and the ligaments are more elastic, which in turn can help to reduce labour pain.

If you have never tried yoga before, you should start by taking classes to learn the poses under supervision.

ZINC

Zinc is important throughout the development of the baby for cell growth and for the immune system of mum and baby.

Zinc is important throughout pregnancy because this mineral plays an important role in cell growth and replication. Because the baby is experiencing rapid cell growth in all stages of pregnancy, this nutrient is important for the entire nine months. The recommendation for zinc during pregnancy is between 12 mg and 15 mg, which is the amount contained in most prenatal vitamins. So, if you are taking a daily prenatal vitamin and eating a fairly balanced diet, zinc deficiency should not be a problem.