THE ‘PERFECT PREGNANCY’ MYTH

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

If you feel like pregnancy has changed everything about you, you’re not wrong! Changes aren’t just happening to your growing baby – they’re also happening to you, both physically and emotionally.

The popular media image of glowing, relaxed mothers can add undue stress to women facing challenging pregnancies. These idealised pregnancies can lead to unrealistic expectations, and cause feelings of inadequacy when things don’t go as planned. In reality, there’s no such thing as a ‘perfect pregnancy’.

You’re definitely not the only expectant mother feeling this way, and knowing about the most common changes experienced during pregnancy can help you understand and prepare for them. No woman should feel isolated and alone during pregnancy, and high levels of stress for a prolonged period can hurt your baby and cause you health problems, like high blood pressure and heart disease. If you are feeling overwhelmed, seek help.

Coming to terms with all the changes taking place in your body requires self-compassion, open communication with loved ones, and getting support when you need it, whether this is through family and friends, healthcare providers or pregnancy support groups.

Remember to be kind to yourself! You’re doing your best, and it’s okay to ask for help when you need it.

COMMON PHYSICAL CHANGES DURING PREGNANCY

1. Weight gain

While you may expect to gain weight during your pregnancy, you may not expect it to be so much. Most women should gain 12 to 16 kilogrammes during pregnancy. Gaining the right amount of weight is crucial for the health and development of your baby. Too little, and your risk of complications increases. Too much, and your risk of gestational diabetes increases. Focus on healthy eating and exercise in consultation with your healthcare provider, including to determine how much weight you should be gaining throughout your pregnancy.
2. Heart growth

Your body is supporting two people during pregnancy, and your blood volume increases by up to 50% to meet this need. As a result, your heart has to beat faster and more strongly to make sure your baby gets the food and oxygen it needs, and this process makes your heart increase in size. Typically, your heart will gradually return to its pre-pregnancy size after delivery.
3. Skin changes
Your pregnancy-induced increase in blood volume provides extra blood flow to the uterus and other organs, especially the kidneys. It also affects your skin:

increases in oil gland secretion: your skin becomes oilier, often referred to as ‘pregnancy glow’. Unfortunately, this also makes acne common during pregnancy.

increases in pigment production: you may notice brownish patches on your skin, or a dark line down the middle of your abdomen. The skin around your nipples and genitals may become darker, and any mole or freckles you have may get bigger and darker too. While this can’t be prevented, wearing sunscreen and avoiding UV light can minimise the effects.

Your skin will also stretch as your abdomen swells, which can lead to itchiness, flaking, and stretch marks. Your healthcare provider can recommend soothing creams to use.

Most skin changes improve after delivery, although some stretch marks may never disappear completely.
4. Nail and hair changes

You are likely to notice faster nail and hair growth during your pregnancy due to hormonal fluctuations.

Many women have changes in hair texture, but these changes are not usually permanent. You may find yourself losing some hair after delivery or after you stop breastfeeding. The changes in hair texture can make your hair drier or oilier – and you might even find your hair changing colour.

Some women find that they grow hair in unwanted places, such as on the face or belly or around the nipples. This extra hair usually fades away within six months of delivery.

Like hair, nails are also affected by hormonal changes, and you may find they’re growing faster and becoming stronger. Unfortunately, some women find their nails splitting and breaking more easily. These changes are not permanent. If your nails start to split and tear more easily, it helps to keep them trimmed and to avoid the chemicals in nail polish and nail polish remover.
5. Changes in shoe size

It is common for feet to grow during pregnancy, sometimes by up to one shoe size. Your body retains extra fluid which causes swollen feet. Also, your joints tend to be looser during pregnancy. The extra weight pushing down on loose joints causes your feet to get flatter, longer, and wider. You may need to wear a larger shoe size while pregnant – and sometimes even after childbirth. Slip-on shoes are often the most comfortable, especially during hotter months.
6. The 'pink toothbrush' effect

It’s called the ‘pink toothbrush effect’ as hormonal changes in your body increase blood flow to your gums, making them more sensitive and prone to bleeding during brushing.

This increased blood flow also affects the nasal passages and can cause nosebleeds.
7. Sciatica and round ligament pain
Sciatica: As your centre of gravity changes during pregnancy and your muscles and ligaments stretch, pressure is often put on the sciatic nerve. This causes pain in your lower back, which can even radiate down your legs. Massage, heat pads, and warm showers may help reduce your pain.

Round ligament pain: Some women experience pain on one or both sides of their abdomen during pregnancy. This pain can come on suddenly and is especially common if you sit or stand up quickly, but can also occur during exercise and while shifting positions during sleep.
8. Joint mobility

During pregnancy, your body makes the hormone relaxin to help prepare your pubic area and cervix for birth. Relaxin loosens the ligaments in your body, making you less stable and more at risk for injury. It’s easy to overstretch or strain yourself, especially the joints in your pelvis, lower back, and knees. When exercising or lifting objects, go slowly and avoid sudden, jerking movements.
9. Varicose veins and haemorrhoids
Varicose veins are usually found in the legs and genital area. They’re caused when blood pools in the veins, which have been enlarged by pregnancy hormones. Varicose veins often go away after pregnancy. To help prevent them:

avoid standing or sitting for extended periods

wear loose-fitting clothing

wear support stockings

sit with your feet raised

Haemorrhoids are varicose veins in the rectum. These are also common during pregnancy due to increased blood volume and your uterus putting pressure on your pelvis. These veins may enlarge into grape-like clusters, which can be very painful and can bleed, itch, or sting, especially during or after a bowel movement.

There are creams and ointments that can shrink haemorrhoids, but the best way to deal with them is to prevent them in the first place:

eat a diet rich in fibre

make sure you are well hydrated every day

exercise regularly to help keep your bowel movements regular
10. Constipation
Constipation is caused by pregnancy hormones slowing the passing of food through your gut. During the later stages of pregnancy, your uterus may push against your large intestine, making it hard for you to have a bowel movement.

Constipation can contribute to haemorrhoids because straining to pass a stool may enlarge the veins of the rectum. As with haemorrhoids, prevention is your best course of action:

eat a diet rich in fibre

make sure you are well hydrated every day

exercise regularly to help keep your bowel movements regular

If you become constipated, talk to your healthcare provider about using stool softeners or laxatives.
11. Lightning crotch

Lightning crotch is exactly what the name implies – a sudden shooting pain in your pelvic area that feels like you’ve been zapped by lightning. While intense, the pain usually comes and goes and doesn’t last for very long. It’s most probably caused by pressure on your pelvic area, but as long as you are not experiencing other concerning symptoms, like bleeding or contractions, it’s usually nothing to worry about.
12. Unexplained bleeding

Bleeding during pregnancy is always worrying and it is ESSENTIAL that you mention it to your healthcare provider whenever you experience it.

Sometimes, especially in early pregnancy, light bleeding happens with no clear reason and with no reason to worry, especially after sex or a pelvic exam. Light bleeding may also be harmless in later pregnancy, though any instance of heavy bleeding, especially with cramping, should be taken seriously.
13. Shortness of breath

Hormonal changes can affect the lungs, as can your growing uterus as it puts pressure on your diaphragm, making it harder to take deep breaths. Although this is a common pregnancy symptom, you should mention it to your healthcare provider when you experience it.
14. Fatigue

Extreme tiredness is very common during pregnancy, especially in the first and third trimesters. It is often caused by hormonal changes, increased blood volume, and the physical demands of carrying a growing baby. You should prioritise rest, even if it means taking naps during the day.
15. Morning sickness

Nausea and vomiting, commonly known as ‘morning sickness,’ can occur at any time of day during pregnancy. Fortunately, nausea starts to subside after week 14 and usually stops around week 20.

You can manage your nausea by eating smaller, more frequent meals, avoiding triggering foods and smells, and adding more rest to your days. Your pharmacist may be able to prescribe anti-nausea and vomiting medication without you having to wait for your next medical appointment.

However, if your nausea is so extreme that you are not able to eat, your vomiting is very frequent, and weight and fluid loss become concerns, you may be experiencing a condition called Hyperemesis gravidarum, and it is essential that you contact your healthcare provider immediately.
16. Bra size

An increase in breast size is one of the first signs of pregnancy, and although breast growth is highest in your first trimester, your breasts can continue to grow throughout your pregnancy.

Your bra size is also affected by your ribcage. When you’re pregnant, your lung capacity increases so you can take in extra oxygen, which may increase the size of your chest. You may need to replace your bras several times during your pregnancy.
17. Breast tenderness

Along with an increase in size, breast tenderness is often one of the earliest symptoms of pregnancy. Your breasts may become sore, heavy, or tingly as early as 1–2 weeks after conception. The nipples may also feel sensitive or even painful to touch.

These changes occur because of rising hormone levels in the body and increased blood flow to the breast tissue. Breast discomfort often subsides after a few weeks, although it may return in the later stages of pregnancy.
18. Cravings

Experience food cravings during pregnancy – most often for sweet, salty, or sour foods – can be a sign of nutrient deficiencies or simply a hormonal shift. While most cravings are harmless, it is important not to over-indulge and to maintain a balanced diet. Consult your healthcare provider if you have concerns.
19. Indigestion

Indigestion, or heartburn, is common during pregnancy due to the growing baby putting pressure on the stomach, causing stomach acid to reflux into the oesophagus (the tube connecting the throat to the stomach). You can often manage it with lifestyle and dietary changes, but it’s important to talk to your healthcare provider before taking any medications.
20. Frequent urination

COMMON EMOTIONAL AND PSYCHOLOGICAL ASPECTS OF PREGNANCY

1. Body image

Women often face body image challenges during pregnancy. The physical changes like weight gain and stretch marks, along with hormonal shifts, can lead to negative self-perception. It is important to acknowledge that your body is changing to accommodate a growing baby and try to focus on the positive work your body is doing. If you’re struggling with body image, it is essential that you talk to someone – your partner, a family member, or a healthcare professional.
2. The nesting instinct

The nesting instinct is thought to be a natural, adaptive behaviour to prepare for and protect the unborn baby, potentially linked to hormonal changes during pregnancy. Nesting can manifest as cleaning, organising, decorating, or even finishing home projects. While it can occur at any point during pregnancy, it’s most common in the final weeks before delivery, often starting in the third trimester.

It is important to note that not all women experience nesting, and the intensity and timing can vary. If you don’t experience nesting during pregnancy, it’s perfectly normal and doesn’t indicate anything about your parenting abilities or the health of your pregnancy.
3. Problems with concentration

During pregnancy, many women experience what’s often called ‘pregnancy brain’ or ‘baby brain,’ characterised by memory lapses, brain fog, and forgetfulness. This is caused by the combination of hormonal changes, poor sleep, and the emotional and physical changes of pregnancy. This is normal, and generally temporary, and tends to improve if not completely subside in the months following childbirth.
4. Mood swings

Hormonal changes are also responsible for mood swings during pregnancy, which is a common experience. They can range from heightened emotions to irritability, and while normal, if they are persistent or severe, you should discuss them with your healthcare provider.
5. Prenatal depression and anxiety

Depression and anxiety are common during pregnancy, and it’s important to seek help if you are struggling with these emotions. Persistent feelings of sadness, anxiety, and fatigue can make it difficult to carry out daily tasks and care for yourself or others. If untreated, you are at increased risk of postnatal depression.
6. Postnatal depression

Many women experience mild, short-lived mood changes, often called the ‘baby blues’ in the first few days after childbirth, but if symptoms are severe or last longer than two weeks, it could be a sign of postnatal depression. Postnatal depression is a serious mood disorder characterised by overwhelming sadness, anxiety, and fatigue, impacting your ability to care for yourself and your baby. It’s crucial to seek professional help for postnatal depression. You can read more about postnatal depression here.

MANAGING THESE CHALLENGES

1. Accept that every pregnancy is unique
2. Accept that not everything is under your control

Did you know that only 5% of babies arrive on their due date? The majority of babies are born before or after their due date, with only a small percentage arriving exactly on schedule. Accepting that not everything is under your control is crucial for managing stress and embracing your unique journey, as both your body and your situation can be unpredictable. Focus on what you can control, like your health and wellbeing.
3. Seek support

Having support during your pregnancy is crucial for both your and your baby’s wellbeing. It helps reduce stress and improve mental health, contributing towards a healthier pregnancy and a stronger foundation for motherhood. Open communication and shared experiences can also strengthen the relationship between partners during pregnancy.

Talk to your partner, family, and friends about how you’re feeling. Join a moms’ support group to connect with other pregnant or new mothers. Some of the websites listing support groups include:

Pregnancy Help Network: this network connects pregnant women with life-affirming pregnancy help and community organisations across South Africa.

Expectant Mothers Guide: this website lists various support groups and organisations, including those focused on pregnancy, adoption, and crisis pregnancy.

The Mom Archive: this website provides a directory of maternal support groups and services.
4. Practice self-care
Prioritising self-care is crucial for you and your child’s health. This involves:

Maintaining a healthy diet to support your body and your baby’s development. Eat a balanced diet, and supplement with prenatal vitamins like folic acid. Drink plenty of fluids to stay hydrated.

Making time for activities that you enjoy and that help you relax and de-stress. Exercise plays an important role in managing stress; stay active with the guidance of your healthcare provider.

Getting enough sleep to help manage fatigue and improve mood. Take breaks and rest when needed, especially during the first and third trimesters.

Make sure you attend all your prenatal visits. To ensure a healthy pregnancy and baby, it’s crucial to attend all scheduled prenatal visits, as they allow healthcare providers to monitor your and your baby’s health, identify potential problems early, and provide guidance for a safe pregnancy and delivery. This is also valuable time for you to discuss any concerns you may have with your healthcare provider.
5. Practice putting in boundaries
When you’re pregnant, you will find that everyone—from your in-laws to complete strangers—has an opinion about your pregnancy and is eager to offer advice, even when not requested. Some people may even feel entitled to come up to you and touch your belly! While some of these comments won’t be too bad, others can be upsetting, especially if they are about the changes your body is going through, insensitive comments about your family, medical history, or your ability to be a ‘good’ mom, etc.

It’s okay to tell people that their comments are insensitive or hurtful, and it’s okay to distance yourself from people who make these sorts of comments. Preparing a few standard responses can save you reacting in shock and then being angry with yourself later for not standing up for yourself. It can also save you from saying something horrible to someone who really just meant well. Some options to practice:

“I’d really rather not talk about that.”

“It’s personal.”

“My doctor is happy with my progress.”

Chat with the other moms in your support group – you’ll find you’re not the only one experiencing this, and may learn some new techniques on how best to handle these unwelcome comments!

WHERE TO GO IF YOU STILL HAVE QUESTIONS

“When will my baby start kicking?” “Can I drink coffee while I’m pregnant?” “Can I drive during my last trimester?” “Is it safe to eat sushi?”

It’s normal to have lots questions like these. Finding the answers will help you enjoy your pregnancy and avoid unnecessary stress. Write down your questions and bring them up with your healthcare provider at your next appointment. Prenatal classes, books about pregnancy, and pregnancy reference websites are also good resources. And remember, the Bonitas Maternity Programme offers you a 24/7 Maternity Health Advice Line: 0860 999 121

THE ‘PERFECT PREGNANCY’ MYTH

THE ‘PERFECT PREGNANCY’ MYTH

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.

OVERVIEW

COMMON PHYSICAL CHANGES DURING PREGNANCY

COMMON EMOTIONAL AND PSYCHOLOGICAL ASPECTS OF PREGNANCY

MANAGING THESE CHALLENGES

WHERE TO GO IF YOU STILL HAVE QUESTIONS

FURTHER READING