Pregnancy and birth

Having a child is a very intense life experience. And nine months of pregnancy is an exciting time for many women and their partners, often fluctuating between joy, hope and anxiety: Will everything go well? Am I behaving correctly? What will the new life with child be like?

From conception to the birth of the child, a woman's body changes in an amazing way: It adjusts to the task of growing a new life inside of it. A new organ, the placenta, is formed to care for the baby . The body stores more fluid, and the circulatory system flows more blood than usual. Both become noticeable quite quickly in the weight. The mammary glands prepare for milk production. Connective tie, ligaments, tendons and muscles become more flexible so that the child can be born naturally. All these changes are triggered and maintained by hormones. At no time does the body produce more hormones than during pregnancy.

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At the beginning of pregnancy the physical changes are hardly visible. Due to the increased blood circulation, the skin can appear rosier. However, most pregnant women notice that their bodies are changing: Many feel tired more quickly, their appetite changes, their breasts tighten, and they often feel nauseous in the morning.

Especially in the first three months of pregnancy, the hormonal changes often affect your emotional life. Women can then, for example, react more sensitively than usual. Seeing some things differently than before. In addition, it is not always easy to adjust to the new life situation – especially if the pregnancy was unplanned.

For many women, the second trimester is the most pleasant time of pregnancy: their bodies have completely changed, but their abdominal girth and body weight do not yet interfere too much with everyday life. Mentally, most women feel back on track, some feel a special energy during this time and enjoy their bodies. The baby's movements can now usually be clearly felt.

In the last trimester of pregnancy, the baby matures rapidly, growing larger and heavier. Towards the end of pregnancy, most women experience discomfort due to the increase in the size of the abdomen, and everyday life gradually becomes more difficult. The ninth month is already marked by the birth – the anticipation grows, but also the respect for the upcoming event.

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As pregnancy progresses, everyday life also changes: preparing for the arrival of the baby takes up some of the time. Gradually, most pregnant women need more time for daily activities, and towards the end of pregnancy, maternity leave begins for working women.

Many women are more concerned with their health during pregnancy than before. This includes questions around nutrition and exercise: What should I eat, and do I need additional supplements? ? How much weight gain is normal? Can I continue to do sports, and what do I need to watch out for??

Since alcohol and nicotine can seriously harm the unborn child, the vast majority of pregnant women do not smoke. Many women take even a planned pregnancy as an opportunity to give up smoking. Smoking during pregnancy increases the risk of miscarriage, premature birth, and low birth weight, among other things.

Quitting smoking is not easy for all women; many need support. It is unclear whether nicotine replacement therapy is suitable for smoking cessation during pregnancy. Other weaning programs are likely to be just as effective.

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Some women feel completely well during their pregnancy, some even better than ever before. However, many have typical complaints that change over the months: At the beginning, nausea is a common problem, later and with increasing weight it can be, for example, back pain , heartburn , water retention, varicose veins , urinary urgency or sleep disturbances.

Since such complaints are often experienced as accompanying symptoms of a positive condition and disappear by themselves, most pregnant women cope well with them. And there are several ways to alleviate pregnancy symptoms.

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If a woman becomes seriously ill during pregnancy, she is usually also worried about her child. In fact, caution is often needed when treating with medications. This also applies to certain infectious diseases that could harm the unborn child.

There are diseases that only occur during pregnancy, such as preeclampsia. One risk factor is the development of gestational diabetes . Some pregnant women with a chronic condition, such as asthma or diabetes, wonder if they can continue taking their medications. The answer is yes. As a rule, this is even necessary – for example, a lack of oxygen supply due to an asthma attack would endanger the child more than possible medication side effects.

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Pregnant women today receive intensive medical care. Regular check-ups to make sure that the baby is developing normally and that the mother-to-be remains healthy. For this purpose, women who have no particular risk factors are offered three ultrasound exams. More may be needed to clarify abnormalities. In addition to ultrasound examinations. Blood tests are also done urine tests. In addition, a test for gestational diabetes is offered. In Germany, the maternity guideline specifies what is examined and how pregnant women with statutory health insurance are examined.

Pregnancy check-ups also include a test for HIV infection (AIDS test). Because if a pregnant woman is infected and finds out in time, her child can almost always be protected from infection.

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Often, even healthy pregnant women without any particular risk are offered additional prenatal diagnostic examinations. They are used to find certain abnormalities or malformations in the unborn child. Although such indications can also be found during normal ultrasound examinations, they are not specifically searched for during them.

It is important to remember: prenatal examinations can have far-reaching consequences – they can help, but they can also be unsettling. In certain situations, prenatal diagnostic tests can be used for clarification if other tests have revealed abnormalities. Some are then covered by health insurance: These include certain non-invasive prenatal tests (NIPT) , further ultrasound examinations, amniocentesis and chorionic villus sampling. Doctors are obliged to inform about the aims, significance and possible consequences of these examinations.

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All prenatal examinations are voluntary – that is, a woman can refuse an offered examination at any time without justification.

Women and couples can get information and advice about these examinations in a gynecological practice or institute, for prenatal diagnostics or human genetics . In addition, psychosocial counseling at a pregnancy counseling center can be an important help.

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The birth is longed for by most at the end, but also expected with mixed feelings. Even though many women prepare intensively for it, the event remains a big unknown. All pregnant women feel at least a certain amount of respect – because there is only so much you can plan for the birth: how long it will take, how painful it will be, whether it will be free of complications – a woman doesn't know all that until she finally holds her child in her arms.

Today, there are several ways to relieve birth pain. If they become too heavy, medication can help. The most effective drugs are those used for local anesthesia. Some are also suitable if a cesarean section becomes necessary. The active substances are not dangerous for the child.

When the expected delivery date has passed, waiting for the birth can be a test of patience. A transfer of one to two weeks is usually not a cause for concern. However, the risk of harm to the child increases somewhat after this time. After two weeks at the latest, the birth is usually induced.

If a child is born much too early, it usually needs special support. If a premature birth is imminent, the chances of a healthy start to life can be improved, for example with medication to speed up lung maturation.

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As soon as a child is born, it is examined whether it is well and everything is in order. During this first medical examination, called "U1," a baby's heart sounds and pulse rate are also checked. However, most babies are born healthy.

Within the first two days after birth, clinics and practices offer an examination that is free of charge for those with statutory health insurance, called "pulse oximetry". It is designed to detect rare, serious heart defects, allowing for early treatment.

After the birth the mother's body gradually recovers. However, it takes a while for everything to heal and for the uterus to recede. If all goes well, the first weeks with the child, the so-called postpartum, can be a special phase of peace and happiness. Today, fathers also usually plan a break from work to get to know the newborn and support their partner.

Until the child is two months old, people with statutory health insurance are entitled to postpartum care from a midwife. In the first ten days after the birth, a midwife even makes daily home visits. Their advice and active support are an important help for many mothers and their families.

Many women weigh more than before for some time after pregnancy. For most of them it takes half a year to get back to their original weight. But even if it doesn't work out: extra weight is usually a health problem only for women who became very overweight during pregnancy. Immediately after childbirth is not a good time to lose weight in a targeted way. In the long run, a combination of dietary changes and plenty of exercise often helps.

The renewed hormonal changes after childbirth and the completely new life situation can also cause women psychological problems, despite all the joy about their child: Happiness and stress are usually close together. Without sufficient support, a feeling of being overwhelmed easily sets in. The phenomenon of "baby blues", a short phase of severe mood swings and inexplicable sadness after birth, is well known. If sadness lasts longer, it may be a sign of postpartum depression. In most cases, outside help is then needed.

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In the first year of a child's life, much of the focus is on ensuring that it thrives well and without problems. A key ie is often nutrition – breastfeeding or proper bottle feeding in the early months, complementary feeding later on. Babies gain weight very quickly. Need a lot of food for this. Because their stomachs aren't quite fully developed, many babies regurgitate some milk or porridge more often – this can sometimes be annoying, but is usually no reason to worry.

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The German Federal Center for Health Education (BZgA) provides comprehensive information on pregnancy, birth and the time thereafter on its Family Planning website.en ready. Under the heading "Pregnancy", mothers and fathers can find answers to many questions about the course of pregnancy and child development, preventive examinations, birth and the puerperium.

Beckermann M, Perl FM. Gynecology and Obstetrics: Integrating evidence-based medicine into women-centered gynecology. Basel: Schwabe; 2004.

Rath W, Gembruch U, Schmidt S (Ed). Obstetrics and perinatology: prenatal diagnosis – diseases – delivery. Stuttgart: Thieme; 2010.

Updated on 11. October 2021 Next planned update: 2022

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