Things to Expect During Your Pregnancy: A Week-by-Week Guide to Symptoms and Changes 

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Headshot of Robb McKeown, MD, OB-GYN, who shares information about pregnancy symptoms and changes
Robb McKeown, MD

Pregnancy is a beautiful, transformative experience, but it also comes with its share of surprises. From the moment you find out you’re expecting to the birth of your baby, your body will undergo many changes. Understanding what’s happening at each stage can help you feel more prepared and confident during this exciting journey.  Robb McKeown, MD, an OB-GYN at Fort Sanders Women’s Specialists shares what to expect during each trimester and the common pregnancy symptoms and changes you might experience along the way. 

First Trimester (Weeks 1-12): Early Changes and Adjustments 

Many women experience the most dramatic symptoms and changes in their bodies during the first trimester. Although you may not yet be showing, this is when your baby is developing rapidly. Your body starts adjusting to support your growing baby. 

Common Pregnancy Symptoms: 

Morning Sickness – Nausea and vomiting, often referred to as “morning sickness,” can occur at any time of the day, not just in the morning. It can last until the end of the first trimester, but may extend longer for some women. 

Fatigue – You might feel more tired than usual during the first trimester. Your body is working hard to support your pregnancy, which can drain your energy levels. 

Breast Tenderness – Hormonal changes may cause your breasts to become swollen, tender or sore. You may also notice changes in your nipples and areolas, which can darken during pregnancy. 

Frequent Urination – The increased blood flow to your kidneys and the growing uterus can put pressure on your bladder, leading to more frequent trips to the bathroom. 

Mood Swings – Pregnancy hormones can cause emotional ups and downs. You may feel more sensitive, irritable, or even overwhelmed at times. 

Second Trimester (Weeks 13-26): A Time of Growth and Energy Boost 

The second trimester is often considered the “honeymoon phase” of pregnancy. Many women find that pregnancy symptoms like nausea and fatigue subside, and they experience a boost in energy. It’s also the stage where your baby’s growth accelerates, and you may begin to “show” more. 

Common Pregnancy Symptoms: 

Visible Baby Bump – As your baby grows, you may begin to notice a small bump. For first-time mothers, this usually becomes more prominent around weeks 16-20. 

Increased Energy – With morning sickness behind you, you may feel more energetic during the second trimester. This is a great time to enjoy some physical activity, but always check with your healthcare provider before starting a new exercise routine. 

Stretch Marks – As your baby and uterus grow, you may notice stretch marks on your belly, hips, or thighs. These are normal and a natural part of pregnancy. 

Heartburn and Indigestion – Your baby’s growth and expansion of your uterus can put pressure on your stomach, leading to acid reflux and heartburn. Eating smaller meals more frequently can help alleviate this symptom. 

Braxton Hicks Contractions – These are mild, irregular contractions that help prepare your body for labor. They are not usually painful, but can feel like a tightening of the abdomen. 

Preparing for Labor 

As your pregnancy nears its end, your focus will likely shift toward preparing for labor and the arrival of your little one. Consider taking childbirth education classes, creating a birth plan, and having everything ready for your baby’s arrival. Be sure to communicate with your healthcare provider about any questions or concerns you may have. 

Third Trimester (Weeks 27-40): Preparing for Birth 

During the third trimester, you’ll see the most dramatic growth in both your baby and your body. Your baby is getting ready for the outside world, and your body is preparing for labor and delivery. 

Common Pregnancy Symptoms: 

Back and Pelvic Pain – As your baby grows, you may experience back pain and pelvic pressure due to the extra weight. Your center of gravity shifts, which can strain your back muscles. 

Swelling – It’s common to experience swelling in your feet, ankles, and hands. This is due to extra fluids retained in your body during pregnancy. 

Shortness of Breath – As your uterus expands, it may press up against your diaphragm, making it harder to breathe deeply. Take breaks when needed and try to keep yourself as comfortable as possible. 

Frequent Urination (Again) – As your baby drops lower into the pelvis in preparation for birth, you may feel the need to urinate more often. You might also experience urinary incontinence because of pressure on the bladder. 

Trouble Sleeping – With your growing belly, finding a comfortable sleep position can be challenging. Try using pillows to support your back and belly. Avoid caffeine late in the day to help improve sleep quality. 

Nesting Instinct – Many women experience a strong desire to organize and prepare their home for the baby. This “nesting” instinct is completely normal and can be a great way to channel your energy before delivery. 

Labor Signs – As you near the end of your pregnancy, you might notice signs that labor is approaching, including the loss of your mucus plug, light cramping, or your water breaking. If you have any questions or concerns, always reach out to your healthcare provider. 

When to Call Your Healthcare Provider 

While many pregnancy symptoms and changes are normal, it’s important to know when to seek help. Always contact your provider if you experience: 

  • Severe abdominal pain or cramping 
  • Vaginal bleeding 
  • Sudden or severe headaches 
  • Sudden swelling of the hands, feet or face 
  • Decreased fetal movement (especially in the third trimester) 
  • Signs of preterm labor (contractions before 37 weeks) 
  • A sudden increase in weight gain or swelling 

Support for Every Stage of Pregnancy 

Pregnancy is an incredible journey filled with unique experiences at each stage. While a variety of pregnancy symptoms and changes occur with each trimester, it’s important to remember that every pregnancy is different. If you have concerns or questions, don’t hesitate to reach out to your healthcare provider. We are here to support you through every step of your pregnancy! 

Our OB/GYN team of board-certified physicians and advanced practitioners are extensively trained in women’s health and provide comprehensive gynecology and obstetric services. Please call us at 865-331-1122 if we can help you.

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About the Author

Covenant Health

Headquartered in Knoxville, Tennessee, Covenant Health is a not-for-profit, community-owned, healthcare enterprise committed to providing the right care at the right time and place. Covenant Health is the area’s largest employer and has more than 11,000 compassionate caregivers, expert clinicians, and dedicated employees and volunteers.