Pregnancy

1. Pregnancy briefly explained

Every human life begins with a pregnancy, but not every pregnancy is the same. Most pregnancies last 40 weeks from the last menstrual period. This means that the actual duration of pregnancy from fertilization is about 38 weeks, as the first two weeks of the 40-week cycle cover the time before ovulation and fertilization.

At the end of a birth lasting about 3 to 12 hours, there is a baby weighing 3 to 3.5 kilograms. A small miracle of nature. However, the lightest healthy newborn weighed only 244 grams and the heaviest 10.2 kilograms. So there is a wide range.

2. The signs of pregnancy at a glance

Some couples have wanted to get pregnant for a long time, while others were convinced that they were using effective contraception - and are then surprised to discover that a child is on the way. Being pregnant simply means that a woman's egg has been successfully fertilized by a male sperm after ovulation. The first signs of pregnancy can appear soon. However, only a pregnancy test or ultrasound can confirm the diagnosis.

A distinction is made between uncertain and certain signs of pregnancy.

2.1. Uncertain signs of pregnancy

The uncertain signs of pregnancy include:

• Absence of menstruation – Pregnancy can be the reason for the absence of monthly menstruation. If the egg is fertilized, menstruation will stop for the duration of the pregnancy.
• Physical symptoms – Pregnancy can cause nausea, vomiting or a feeling of tension in the breasts. But there can be other causes. Increased urination and tiredness can also be signs.
• Darkening of skin areas – The skin around the nipples can turn dark. A dark line can also appear that runs vertically from the pubic bone through the belly button to the breastbone (linea fusca or nigra). The vaginal opening can also change color slightly.
• Various tactile signs – In the past, there were examinations in which pregnancy was detected with the hands. These no longer play a role since the development of ultrasound examinations.

2.2. Reliable signs of pregnancy

Reliable signs of pregnancy include:

• Pregnancy test – The hormone β-HCG can be detected in the blood during pregnancy – from the 6th to 9th day after fertilization – and in the urine – from the 14th day.
• Ultrasound detection – An embryo can be detected using sonography, which creates a 2D image using ultrasound waves.
• Perception of fetal movements – From the 18th to 20th week of pregnancy, pregnant women can feel their baby moving in their stomach.

Good to know: An embryo can be detected using vaginal ultrasound from the 5th to 6th week of pregnancy. From the 7th week, a heartbeat can be detected using this examination method.

2.3. How to calculate the due date

The due date can be estimated either by ultrasound or using the so-called Naegele rule. The latter is calculated as follows:

3. Milestones of pregnancy

As soon as the pregnancy test is positive, couples calculate the expected due date. This is because many other considerations and plans are tied to this: Will you push the stroller through the park in the sweltering summer? Can your friend lend you baby clothes? In any case, the following phases are involved:

3.1. Pregnancy duration: 40 weeks over 3 trimesters

A normal pregnancy lasts 40 weeks and consists of three so-called trimesters or trimenons. This corresponds to about nine months and one week. The count starts from the first day of the last menstrual period (“p.m.” or “post menstruationem”). So, for example, if five weeks of pregnancy have been completed, the expectant mother is in the sixth week of pregnancy.

In medicine, the elapsed pregnancy duration is indicated with an abbreviation. For example, if the pregnant woman is on the first day of the sixth week of pregnancy, this is referred to as “5+0 weeks”. A premature birth is a birth before the 37th week of pregnancy has been completed (“36+6 weeks”). Gynecologists speak of a post-term birth when the 42nd week of pregnancy has been completed (“42+0 weeks”).

Up to the eighth week of pregnancy, the baby is an embryo. During this time, the organs form - from the brain to the heart. The beginnings of body parts develop from a few dividing cells. From the ninth week of pregnancy, the unborn child is called a fetus. During this phase, the various organs can slowly mature. The transition from embryo to fetus takes place in the first trimester.

3.2 Body changes during pregnancy

A variety of physical changes occur during pregnancy and are completely normal. Most of these changes begin during the first trimester and disappear again after the birth. 

The following table provides an overview:

4. Diet and exercise during pregnancy

If a woman changes her eating and drinking habits, suddenly toasts with orange juice at events and turns down invitations to eat sushi, family, friends and acquaintances will suspect that pregnancy is behind it. Because even before the belly grows noticeably, many things change in a pregnant woman's diet. Find out below what you should pay attention to in terms of diet and exercise.

4.1 What can pregnant women eat and what not?

When it comes to nutrition, there are three rules of thumb for pregnant women: Firstly, certain nutrients are needed more as a result of growth. Secondly, what was already harmful before is often even more harmful during pregnancy. Thirdly, anything that may contain pathogens should be avoided.

In general, animal products such as meat, fish or eggs should be cooked for a long time before consumption in order to kill bacteria. Wash fruit and vegetables carefully and avoid sprouts and certain types of cheese such as Brie, feta and blue cheese. Drinks containing caffeine should only be consumed in moderation, while alcohol and nicotine should be avoided altogether. The intake of folic acid is recommended. The Federal Institute for Risk Assessment (BfR) also advises pregnant women to make sure they have a sufficient intake of iodine.

Pregnant women can clarify individual questions with their gynecologist.

4.2 How much weight do pregnant women gain?

A newborn baby usually weighs 3 to 3.5 kilograms at birth; women gain an average of 10 to 12 kilograms during pregnancy. Weight gain also depends on how much the woman weighed before pregnancy. The following table provides a guide:

4.3 What sport can pregnant women do?

Regular physical activity is extremely healthy for everyone, whether pregnant or not. Too little exercise is more of a problem than too much - even during pregnancy.

For pregnant women, exercise has a positive effect on circulation, endurance, mobility, general pain relief, metabolism, the risk of gestational diabetes and much more.

To prevent injuries and damage to the baby, a balanced mix of light endurance and strength training is recommended. The former includes walking, aerobic dancing, cycling on the exercise bike, jogging for previously active runners and swimming. Strengthening training can consist of exercises with Therabands, your own weight or light dumbbells as well as pelvic floor exercises. According to new studies, yoga is particularly recommended for reducing stress and relieving back pain.

Peak loads, long distances, overheating, falls, collisions and strong pressure build-up in the abdominal cavity should be avoided. If you have a high-risk pregnancy or are interested in more demanding sports, it is important to consult your gynecologist.

5. Complaints during pregnancy

The path to birth is an impressive feat of strength. Over the course of nine months, the pregnant woman lets new life grow inside her and ends up carrying a being weighing several kilos. And the extra weight is by no means the only challenge: there are also potential complaints such as nausea, back pain and skin changes. They affect the majority of all pregnant women. Below you will find an overview.

5.1 Gastrointestinal complaints during pregnancy

Around four out of five pregnant women suffer from morning sickness. Vomiting also occurs in every third pregnancy. These symptoms mainly occur between the 8th and 12th week of pregnancy, but can also occur throughout the entire pregnancy. As a rule, the symptoms are harmless. However, if vomiting occurs very frequently - more than five times a day - it can lead to weight loss and even metabolic disorders. Immediate medical attention is then required.

Heartburn and constipation are also common pregnancy complaints. As with persistent nausea, adjusting your eating habits can help. This includes eating more small, high-fiber meals instead of large, fatty and acidic ones and drinking plenty of water or tea. Physical exercise, sitting upright while eating, stress reduction and relaxation techniques can also help. If your symptoms persist or are particularly severe, it is advisable to talk to your gynecologist.

5.2 Typical pain during pregnancy

Various types of pain can occur during pregnancy. Around half of all pregnant women suffer from back pain. This is usually due to the extra weight and the change in the body's center of gravity. Physiotherapy, heat treatments and massages can help with mild pain. But if the pain becomes more severe, medical advice should be sought.

Headaches are also not uncommon during pregnancy. However, types of headaches such as migraines can occur even less frequently during pregnancy due to hormonal changes. Many pregnant women also suffer from abdominal and pelvic pain. The causes are varied and can also occur independently of pregnancy.

Examples include cramps or stretching pains in the growing uterus, premature labor and urinary retention in the case of a large uterus. In most cases, abdominal pain is not a cause for concern. But especially in combination with nausea after the 20th week of pregnancy, fever, diarrhea, headaches and if the pain is persistent or severe, a gynecologist should be consulted.

5.3 Skin changes during pregnancy

Pregnancy can cause a number of skin changes. These include acne, stretch marks, darkening of the skin and itching. Acne can occur from the 3rd month and mainly affects the face. It usually disappears again after the birth. Acne that already existed before pregnancy can improve or worsen. Some women also develop acne for the first time after giving birth. The majority of pregnant women are affected by reddish stretch marks. These stretch marks usually appear on the stomach, breasts or hips and fade as the pregnancy progresses.

The skin can become darker in certain areas during pregnancy. This typically affects the skin around the nipples, but can also occur on the face. For some, a dark line runs vertically from the pubic bone to the belly button to the breastbone. The vaginal opening can also become slightly discolored. Itching is another common symptom during pregnancy. In most cases, the cause is not clear, but the itching is harmless. If itching is severe or other symptoms are present at the same time, you should consult your gynecologist.

6. Preventive check-ups

Regular, free check-ups help to monitor the health of mother and child. Check-ups can be carried out by both midwives and gynecologists. Only ultrasound examinations are reserved for doctors. At every check-up, the pregnant woman is weighed, her blood pressure is measured and her urine is tested for germs, protein and sugar. If no ultrasound is performed, the abdominal circumference can be measured and the height of the uterus palpated to ensure that the child is developing on time. If necessary, the cervical length (the length of the neck of the uterus) and the cervix are checked. The length of the cervix is of great importance during pregnancy, as a shortened cervix increases the risk of premature birth.

Examination calendar for pregnancy:

From gestational week 5: Initial examination with blood test, maternity passport

Week 9 to 12: check-up, first ultrasound

From gestational week 12 to 14: for rhesus-negative women, determination of the child's rhesus factor from the mother's blood, DNA blood test for trisomies (from gestational week 10)

Week 13 to 16: Screening examination

Week 17 to 20: Preventive check-up, second, large organ ultrasound

Week 21 to 24: Screening examination

Week 24 to 28: Antibody test, glucose tolerance test (oGTT)

Week 25 to 28: Preventive check-up

Week 29 to 32: Preventive check-up, third ultrasound

From gestational week 32: check-ups every two weeks

From gestational week 40: check-ups every two days, determination of amniotic fluid volume

7. Important before birth

The birth marks the end of one special phase of life and the beginning of another. It is worth remembering a few things in preparation. Before a planned pregnancy and at the latest before the birth, certain vaccinations should be checked and refreshed if necessary. These include the flu vaccination and COVID-19 vaccination, both of which are also recommended during pregnancy according to the STIKO to protect mother and child. You can find more information on this in our articles Vaccinations during pregnancy and Whooping cough vaccination during pregnancy.

A midwife is a valuable companion during this time. It makes sense to find a midwife as early as possible for the time before and after the birth. She will help with check-ups, birth preparation and questions after the birth - in dealing with the newborn. And where do you want to give birth? There are a number of options - whether it's a clinic, birth center or home birth, the important thing is to take care of it in good time.

Every pregnancy has its own special features. You should therefore seek advice: Under what circumstances may a caesarean section be necessary? What pain treatments and anesthetic procedures are available? And, of course, it makes sense to pack your hospital bag in advance.

It is also important to think about whose help you can ask for and who should be contacted by whom and when. And last but not least: Keep your nerve at the beginning of the opening contractions. There are now on average 3-12 hours left until the rupture of the membranes. And then the baby can come!

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