“ When a woman comes into the office and tells me that she has quite a bit of morning sickness, I actually tell her that's a very good thing. ”
Frequently Asked Questions About Pregnancy
Sandra Abraham-Hebert, M.D., a gynecologist and obstetrician practicing in suburban Washington D.C., is featured in Ultimate Guide: Pregnancy on Discovery Health Channel.
Q: What are the first changes that happen to a woman when she becomes pregnant, even before she realizes she's pregnant?
A: Dr. Abraham-Hebert: Even before she knows she's pregnant, she'll notice breast changes. Her breasts become tender. Her nipples become tender. Her breasts enlarge ever so slightly and increase during the entire pregnancy. Some other changes are generalized gas production, so constipation as well as gas bloating of the belly occur. These are some of the changes that people come into the office complaining of when they don't even know they're pregnant.
Other early changes occur in the skin. There are some ever-so-slight pigment changes in the face or all over the body. Some women can get increased oil production and acne as well in early pregnancy.
Q: What's the tip-off for a woman that she's pregnant?
A: Dr. Abraham-Hebert: Some of the tip-offs that you're pregnant could include generalized bloating or difficulty in digestion. That's a big one. Many women begin to feel like they have to urinate very often.
Q: You mentioned that one of the first changes is breast swelling. What happens to the breasts during pregnancy?
A: Dr. Abraham-Hebert: Some of the changes in the breast that occur include increased growth of the actual cells of the breast. Initially they increase in number. This is very early. Then what happens during the rest of the pregnancy is that the glandular and ductal cells grow in number and actually expand, getting ready to fill with milk, which will happen right after delivery.
Q: What causes morning sickness and what does it actually indicate?
A: Dr. Abraham-Hebert: The causes of morning sickness are not always clear. There is some thought that hormone changes — increases in progesterone and estrogen — cause morning sickness. Usually about 70 to 80 percent of women suffer from morning sickness during early pregnancy; some even begin noticing nausea as early as four to eight weeks.
Morning sickness occurs not just in the morning but actually all through the day. It usually ends at about 14 to 16 weeks. One thing that triggers morning sickness is an empty stomach. One way to battle that would be to actually keep food in the belly every two to three hours. There have also been reports showing that vitamin B-6 and calcium can help as well.
Q: What does morning sickness indicate?
A: Dr. Abraham-Hebert: Morning sickness is a signal that the progesterone hormones are actually increasing normally. When a woman comes into the office and tells me that she has quite a bit of morning sickness, I actually tell her that's a very good thing. That usually shows that the progesterone hormones are increasing normally and her pregnancy is most likely very protected.
Q: What changes occur to the uterus during pregnancy?
A: Dr. Abraham-Hebert: The uterus is made of muscle cells. Throughout pregnancy, many changes occur in the uterus. First, these muscle cells start increasing in size and number. They increase in size all the way through to the delivery.
During pregnancy, the uterus grows from about the size of my fist and even smaller in some people, to the size of a large orange or grapefruit, then to the size of a cantaloupe, and then, of course, to the size of a small watermelon at the end.
Around nine to 12 weeks the uterus actually goes from being a pelvic organ to being an abdominal organ. We can feel it in the abdominal exam after about 12 weeks or a little bit earlier.
