You're excited, elated and just plain thrilled about being pregnant. At your first prenatal check-up, your doctor assures you that everything is coming along well. But now you've noticed that your breasts are very tender to the touch, and there's heavier vaginal discharge than before. Also, your best friend says you should be gaining weight by now. Is all of this cause to be concerned? Just what exactly makes a pregnancy normal?
Normal is a very broad term and every woman will have a different experience while pregnant. Still, certain changes in the body are part of the process and should be expected, while others may indicate a potential problem. For a new mom-to-be, it is sometimes difficult to differentiate the two.
Breasts: Changes in the breasts are normal and are one of the first symptoms of pregnancy that most women experience. It might be as early as the second week following conception that you will begin to feel breast or nipple tenderness. As pregnancy progresses, your breasts will increase in size and the area around the nipple may become darker in color. Blood vessels will also become more prominent.
What may not be normal is if only one breast becomes tender, says Jeffrey L. Ecker, MD, an obstetrician and clinical faculty member of the Vincent Memorial Obstetrics and Gynecology Service at Massachusetts General Hospital in Boston. "In fact," he says, "All symptoms that are asymmetrical -- if applicable -- should be reported, such as if a woman has just one tender breast, or swelling in one leg".
Morning Sickness: While some women have their worst nausea in the morning, it can occur all day long, at night, or not at all. This common symptom varies tremendously among women, as do the tricks in alleviating it. Morning sickness changes from normal to concerning if you are vomiting everything you eat, including fluids. You are then at risk for dehydration, and you are depriving your body of needed, essential nutrients.
Weight Gain: Gaining weight, of course, is part of being pregnant, although women no longer follow the old adage that one must 'eat for two'. Ideally, a woman should be neither over- nor underweight before becoming pregnant. Normal weight gain for women beginning pregnancy at their ideal weight is between 25 and 30 pounds. However, some women may gain weight slowly, or even lose weight if they are having severe morning sickness.
"There is no concern at less than 20 weeks if weight gain is slow or even if there is weight loss, as long as it is not extreme, " says Dr. Ecker. "Following and monitoring weight gain is, of course, one reason women should seek regular prenatal care".
Fetal Movement: Every new mom-to-be is thrilled at the first sign of her baby's movement. But it is quite normal not to feel this until well into the second trimester. Expect the first movement between 18 to 22 weeks, but even then, it is not cause to panic if you still don't feel the baby. Some women may not begin to experience their baby's kicking and turning until 24 weeks. However, if you don't feel any anything by weeks 24 to 26, then it should be reported to your health care provider.
Food Cravings: You may not dream of pickles and ice cream, but food cravings are normal. This happens because the sense of smell, and therefore taste, changes in pregnancy. Just make sure you eat a healthy and balanced diet. Cravings for non-food items could indicate some type of deficiency, and should be discussed with a healthcare provider.
Cramps and Discharge: A slight amount of brownish-tinged discharge very early in your pregnancy is normal, and due to the implantation of the blastocyst into your uterine lining. Regular discharge may be heavier than before you became pregnant, but vaginal discharge that is copious, yellow or greenish colored and foul smelling usually indicates that there is some type of infection. Bloody discharge later on in the pregnancy may also indicate a problem.
"Bleeding in pregnancy that is more than quarter sized on a pad and not associated with intercourse should always be reported," says Dr. Ecker. "But such bleeding, however, does not always herald a complication and so women should not necessarily be alarmed".
You may also feel occasional contractions, especially as you enter the third trimester. These are normal as well, especially if they are irregular and last only a few seconds. Not drinking enough fluids and becoming dehydrated can also make your uterus irritable, and lying on your left side and upping your fluid intake usually alleviates that. But cramping may be a concern if it lasts longer than 30 to 60 seconds and continues for more than four hours despite lying down and/or is associated with bleeding, says Dr. Ecker. "That should be reported".