Pregnancy

First Trimester

The first trimester is the first 12 weeks of your pregnancy, starting from the first day of your last menstrual period. By the time you realise you are pregnant, you may already be in your 5th or 6th week of pregnancy!

The first trimester is often a time of great joy and anticipation for couples, and you’ll discover a lot of changes in yourself and your baby. As your baby grows from a fertilised egg into a foetus, an ultrasound around the 6th week of pregnancy will allow you to listen to its heartbeat. By the 12th week, your baby is almost as big as a lime, with all the vital organs of the body formed.

The first trimester experience is different for every woman. Some women sail through this period with few symptoms, while others struggle with nausea and fatigue. Nausea, often called morning sickness, is one of the most common symptoms in the first trimester. It is usually worst in the morning, but some women may have nausea throughout the entire day. Other symptoms that may be experienced in the first trimester include soreness of breasts, vaginal discharge, and mood swings.

Second Trimester

The second trimester spans the 13th – 28th week of your pregnancy. This is often called the “honeymoon” period of your pregnancy, where you likely feel better both physically and emotionally. By now, the raging hormones that had caused the bothersome symptoms during the first trimester have finally settled. As the symptoms subside, you may start to notice a surge in your energy levels.

This is an exciting time for couples as you can feel your baby move for the first time at around the 20th week of your pregnancy. You can also learn the sex of your baby through an ultrasound. As your baby continues to grow bigger in the second trimester, your belly will also expand and your baby bump will become noticeable.

Some women may experience minor, irregular cramping in the lower abdomen, especially after physical activity or sex. You may also develop leg cramps, stretch marks, and darkening of the skin especially over the face and abdomen.

Third Trimester

The third trimester is the last stretch of your pregnancy. By now, you are probably eagerly preparing for your baby’s arrival and nervously anticipating the childbirth process. Most women find the third trimester the most challenging phase of pregnancy.

By the third trimester, your baby can weigh somewhere around 2 – 4 kg. With a growing and active baby occupying most of your belly, you may face struggles such as heartburn, a frequent need to urinate, backaches, varicose veins and haemorrhoids. As your due date approaches, your doctor will advise you to come in more frequently for check-ups.

Changes to the Breasts

Due to increased levels of the hormones oestrogen and progesterone, the expectant mother’s breasts may become tender and increase in size, in preparation for breastfeeding during delivery. Her nipples may protrude more. By the 3^rd trimester, a yellow, watery pre-milk known as colostrum may start leaking from the nipples.

Hormonal Changes

By weeks 10 – 12, the placenta acts as a temporary gland to produce large amounts of oestrogen and progesterone, hormones that are vital in creating and maintaining the conditions required for pregnancy. The increased hormonal levels may cause pregnant women to have an increased basal metabolic rate, feel warmer and experience ‘hot flushes’. Some women will also experience changes in hair and nail texture and growth during pregnancy. Nearing the end of the 3^rd trimester, the posterior pituitary, which is a gland in the brain, will start secreting the hormone that kick-starts the birthing process via contraction of muscles in the uterus. During delivery, the posterior pituitary will start secreting a hormone that stimulates the production of breast milk.

Changes to the Heart & Cardiovascular System

During pregnancy, more blood vessels grow and blood volume increases within the cardiovascular system. The pressure of the expanding uterus on large veins also causes the blood to slow in its return to the heart. This leads to increased cardiac output, elevated resting heart rate, and a decrease in blood pressure during the 2^nd trimester.

Changes to the Stomach & Digestive System

Pregnancy may bring about increased gastric reflux and heartburn, and increase in constipation symptoms, due to the womb rising to the upper abdomen. By the end of the 2^nd trimester, the top of the womb will be near the rib cage. This action pushes the intestines and stomach upwards resulting in changes to your regular bowel movement. The stretching of the abdominal wall and ligaments supporting the uterus may also cause abdominal discomfort and pulling pains.

Changes to the Urinary System

Pregnancy increases the workload for both kidneys due to extra waste from fetus. The expanding uterus also places pressure on the urethra, bladder, and pelvic floor muscles. This may lead to temporary bladder control problems and frequent urination.

Changes to the Musculoskeletal System

During pregnancy, the spinal curvatures realign to maintain balance, which results in a posture shift usually seen in women later into their pregnancy. The ligaments that hold the pelvic bones together also gradually loosen during pregnancy to prepare the mother for labour and birth.

The changes to the expectant mother’s body are in sync with the development of fetus. In the following illustration, we look at the monthly development of the baby within the mother’s womb.

(Click to view enlarged image in a new tab)

• Having negative thoughts about yourself and baby
• Feeling sad and hopeless
• Being unable to sleep well
• Loss of appetite
• A lack of interest in life
• Crying for no reason

Women who are pregnant should take their feelings seriously, as negative emotions experienced during pregnancy may lead to more severe illnesses post-delivery. It is important to realise that changes to the body during pregnancy are temporary, and part of the miracle of life.

Depression after giving birth may be a sign of postnatal depression. This can develop during the first 6 months after birth, and can last for over a year if left untreated. Early diagnosis helps with prompt treatment and care. If you do not feel right, or notice yourself feeling worried or sad, seek help by talking to your family physician, obstetrician or therapist.

Prenatal Tests & Scans

As you go through the pregnancy journey, your doctor will advise you to undergo certain prenatal tests and scans to ensure that you and your baby are doing well. Prenatal ultrasound scans are safe and useful in evaluating your baby’s growth and health. The first scan is usually performed in the first trimester so that your doctor can visualise the growing foetus in the pregnancy sac inside your womb. An ultrasound scan can also assess your baby’s risk of having a genetic condition called Down Syndrome.

In the second trimester, a detailed foetal anomaly scan can be performed to check for any structural abnormalities affecting your baby, such as issues with the heart, brain, kidneys, and other organs. By the third trimester, ultrasound scans are performed to monitor the growth of your baby and to examine if the amniotic fluid surrounding your baby is adequate.

Aside from prenatal scans, your doctor may also request for several prenatal tests. These tests include blood tests to check your blood count and to check for infections such as hepatitis, rubella, and other sexually transmitted infections. You will also be asked to have an oral glucose tolerance test to screen for gestational diabetes. Some women may also be advised to undergo invasive or non-invasive prenatal testing to analyse foetal DNA and determine the baby’s risk of having certain genetic conditions.

Certain medical conditions may also lead to higher risk of pregnancy complications. Some examples include diabetes, high blood pressure, cancer, anaemia, or sexually transmitted diseases. Other risk factors for pregnancy complications include:

• Eating disorders like anorexia
• Pregnancy at age 35 or older
• Smoking or alcohol intake
• History of pregnancy loss or preterm birth

If you have a chronic condition or illness, talk to your obstetrician to understand how you can minimise your complications before and during pregnancy. Even with complications, early detection and proper prenatal care can help to reduce the risk for both the expectant mother and baby.

Miscarriage

A miscarriage refers to the spontaneous end of a pregnancy. It is a very difficult and emotional experience for anyone to go through. Our specialists will be able to provide support, appropriate medical care, and advice to help you through this difficult time.

Miscarriage symptoms

Symptoms of a miscarriage include vaginal bleeding, abdominal pain or cramps, and pain in the lower back. The amount of vaginal bleeding progresses from an initial light bleeding to heavier bleeding. Some women may also pass foetal tissue from the vagina.

Miscarriage facts

Miscarriages may be more common than you think. About 10 – 20 percent of women who know they are pregnant will experience a miscarriage. Some women have a miscarriage even before they miss a period and realise they are pregnant.

Miscarriages are most likely to occur during the first 3 months of pregnancy. The most common cause of miscarriage is an abnormality in the chromosome of the foetus. These chromosomal abnormalities usually occur by chance and are not affected by the health of the mother or the father. Other factors that can increase a risk of miscarriage include:

• abnormalities in the uterus
• alcohol consumption
• exposure to radiation or toxic agents
• infection
• smoking
• use of illicit drugs
• maternal medical illnesses such as uncontrolled diabetes, thyroid disease, malnutrition, and autoimmune diseases

Some people falsely believe that exercising, working, or having sexual intercourse may cause a miscarriage. This is untrue.

Most women who experience a miscarriage have subsequently had normal pregnancies and births.

Physical and emotional healing are very important for couples who had a miscarriage. If you’ve experience a miscarriage, take your time to work through the grief and sadness. There are also support groups and counselling that may help you with recovery.

References:

1. Pregnancy complications (2015, September 29). Retrieved from http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregcomplications.htm
2. What are some common complications of pregnancy? (2013, July 12). Retrieved from http://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/Pages/complications.aspx

Delivery and Pain Relief

Normal labour and delivery usually stretches the vagina and cervix – fortunately, both areas contain a rich blood supply and heal quickly.

Various pain relief methods are available for both labour and delivery, such as the administration of an epidural.

During the birth process, contractions in the body enable the baby to descend into the birth canal, before entry into the vaginal area. When required, your doctor may perform an episiotomy to allow baby’s head to emerge. The birthing process ends with the delivery of the placenta.

Speak to your obstetrician to understand more about the available pain relief options and what to expect during labour and delivery.

Childbirth is a wonderful experience like no other for you and your family. As you step into this journey of parenthood, Gleneagles Hospital has a team of healthcare professionals, services and facilities to give you support, knowledge, and peace of mind. Read on to learn more about preparing for baby’s arrival, things to pack when going to the hospital for delivery, our maternity wards and packages, and how you may seek help when it comes to healthcare costs.

Preparing for Your Baby’s Arrival

Before your baby arrives, it is important to seek a healthcare institution that addresses your concerns and professional needs. At Gleneagles Hospital, maternity tours are conducted to help you and your partner learn more about our facilities and services so that you will be better prepared for delivery upon admission. To make an enquiry or a reservation, please call the Gleneagles Hospital Customer Service Team at +65 6470 5615 during Monday to Friday, 9am – 5pm.

Learn more about our maternity rooms and maternity packages.

What to Bring for Your Hospital Stay

We encourage you to bring the following items upon admission:

• Documents including your NRIC/ Passport, doctor's referral letter, maternity bed reservation form, insurance card / LOG (if any)
• Personal sleepwear (front-open types for easier breastfeeding)
• Nursing bra
• Cardigan
• Bedroom slippers
• Your preferred brand of sanitary napkins
• Undergarments
• A set of clothing each for mother and baby for discharge
• Nipple cream
• Camera and camera charger

It is advisable to pack your bag to be ready for admission about 2 – 3 weeks before your baby’s Estimated Date of Delivery (EDD).

ParentCraft Services

Gleneagles ParentCraft Centre has a team of dedicated and trained personnel to prepare you for childbirth and provide advice on confinement/postnatal care and caring for your newborn in areas such as bathing and breastfeeding. Individual (English & Mandarin) classes on childbirth preparation are available.

For enquiries on ParentCraft services,
Please call: +65 6470 5852
Monday to Friday, 9am – 5pm
Saturday, 9am – 12pm

Bills & Insurance

Gleneagles Hospital is an integrated tertiary private healthcare provider and we work with many insurance partners for coverage on hospitalisation bills. Gleneagles Hospital accepts bill financing from local and international private hospitalisation insurance and MediSave-approved Medishield, also known as ‘Integrated Shield Plans’.

For enquiries on estimated hospital bill size, please call the Gleneagles Bill Advisor at +65 6653 7566 or read more.