NurseAsk Nurse Lisa

Pregnancy

“Have patience – some things cannot be rushed.”

– Universal Alaska Native Value16

Last updated April 2021

What is pregnancy?

Pregnancy is the term used to describe the period of time when a fetus develops inside the uterus of a person with female reproductive organs. Pregnancy usually lasts about 40 weeks, or nine months, and is measured from the first day of the last menstrual period to delivery. Each person is unique and may not experience the same symptoms as another person. There are three segments of pregnancy, called trimesters.

The first trimester is from week one to week 12. There are several changes that take place in the body during the first trimester, many triggered by hormones. The changes can cause multiple symptoms with some of them being:8

  • Missed period
  • Extreme tiredness
  • Tender and swollen breasts
  • Upset stomach (morning sickness)
  • Mood swings
  • Constipation

The second trimester is from week 13 to week 28. A lot of people find that the second trimester is easier than the first, but there are new symptoms and changes to the body that may occur during this time. As the stomach begins to expand to make room for the growing fetus, some people may also experience:

  • Body aches (back, abdomen, groin or thigh pain)
  • Stretch marks on the stomach, breasts, thighs, or buttocks
  • Darkening of the skin around the nipples
  • Swelling of the ankles, fingers, and face
  • A dark line on the skin that runs from the belly button to pubic area8

During the second trimester, it is recommended to have an ultrasound to check the growth of the baby for birth defects.15 This is also the time when people may even be able to find out the sex of the baby! Also during this trimester, there are some routine screenings to check for things like gestational diabetes or the Tdap vaccine, which will help protect the baby from whooping cough. 7 At around 20 weeks, movements of the baby inside the uterus may be felt.

The third trimester is from week 29 to week 40. During this time, the same symptoms from trimesters one and two may be present, but as the body gets ready to deliver the baby, there may also be 8:

  • Frequent urination
  • Shortness of breath
  • Backaches
  • Braxton Hicks contractions
  • Heartburn

Regular doctor visits will increase during the third trimester. Between 36 and 37 weeks the doctor will test the pregnant person for Group B Strep (GBS). Giving IV antibiotics during labor can prevent most early-onset GBS disease in newborns. 3 As the due date gets closer, the doctor may do a cervical check to see how much it has dilated.

There are other topics to consider related to pregnancy, such as:

How does someone become pregnant?

Pregnancy occurs when sperm enters the vagina and fertilizes an egg that implants in the uterus. The fertilization process may take up to two to three weeks to happen.

There are multiple ways someone can become pregnant:

  • Vaginal intercourse is the most common way people become pregnant.10 This occurs when a person with a penis ejaculates inside the other person’s vagina.
  • Although less common, sex without penetration can also result in pregnancy. This occurs when ejaculate or pre-ejaculate comes in contact with the vagina.
  • It is also possible to become pregnant without sex. Medical procedures, like in vitro fertilization (IVF) and intrauterine insemination (IUI), are the two most common fertility treatments to assist with becoming pregnant.9

At home pregnancy tests are available at most drug stores and clinics at either a low-cost or sliding scale fee. Click here to find a family planning clinic for more information.

How do I reduce my risk for pregnancy?

Everyone has the power to reduce their risk for pregnancy, whether they are sexually active or not. The most effective way to prevent an unplanned pregnancy is abstinence, the decision to not have sex.12 However, if a person does decide to have sex, using safer sex supplies, like condoms and birth control, are recommended.

For those who are sexually active, using a condom and another form of birth control is the best way to prevent pregnancy.11 When used correctly, external condoms are 98% effective at preventing pregnancy while offering protection against STDs. In addition to condoms, there are several types of birth control available including intrauterine devices (IUDs), the implant, the pill, ring, patch, and shot. Each of these options have pros and cons for each individual. For more information on each and to decide what option is best for you, visit the Birth Control page and speak with your health care provider to discuss what makes most sense for you.

Emergency contraception are methods used to prevent pregnancy when there is an immediate risk for a person to become pregnant. Some of these methods include progestin-only pills, ulipristal, birth control pills taken in specific amounts, or copper intrauterine device.13 The pills or IUD must be taken or inserted within five days of unprotected sex to reduce the risk of pregnancy. 13 Emergency contraception typically is less effective than regularly used birth control methods.

What happens if my partner or I get pregnant?

Pregnancy can be a difficult experience, but whether it was planned or unplanned, it is an opportunity to be extra supportive of one another. Anyone can seek guidance and support from a trusted adult or health care provider. While supporting each other, it is an important time to consider all options regarding the future of the pregnancy.

There are three options when considering how to proceed with pregnancy:

  • Parenthood – Giving birth to the child and raising them.
  • Adoption – Giving birth and placing the child with another person or family permanently.  
  • Abortion – Taking a medication or having a procedure to end the pregnancy.

As these options are considered, it is important to consult your local health care provider. The provider will help provide an overview of the options and help guide important healthcare decisions, like discussing the use of prenatal vitamins or stopping any alcohol, tobacco, or other drug use. The provider will also be able to provide any unique recommendations for the health of the pregnant person and the fetus, but also will be able to connect any persons interested in adoption services to the right place.

In the meantime, as these options are being considered, it is recommended to:

  • Stop any current use of tobacco, alcohol or illicit drugs. Consuming these while pregnant have been linked to birth defects, decreased oxygen to the baby, preterm birth and other complications.4 For more information, visit your local health care provider, or search the Alaska 211 database for a resource available to you in your community.
  • Exercise! Exercise is important for general health and can help reduce stress, improve circulation, and sleep better! Pilates, yoga, swimming, and walking are great activities for most pregnant women, but always check with your doctor before starting a new exercise program. It is recommended to aim for 30 minutes of exercise for five days a week.14

Pregnancy loss

Miscarriage is the spontaneous loss of a pregnancy before the 20th week of gestation. About 10-20% of known pregnancies end in miscarriage.6 While miscarriage is relatively common, it doesn’t make experiencing it any easier. After a pregnancy loss, a person might feel several emotions, including postpartum depression, denial, guilt, anger, envy and yearning. A pregnancy loss may also result in physical trauma.

For people who have experienced pregnancy loss, there are people and resources to help. Talking to someone who is trained to help with grief is recommended. These trained professionals may include trusted adults like providers, social worker, grief counselor, and spiritual leaders.

Online support resources include:

Where can I go for more information on pregnancy?

WeRNative

A comprehensive health resource for Native youth, by Native youth. They promote holistic health and positive growth of their local and national communities.

  • Text 4 Sex Ed (scroll to bottom) can deliver sex and relationship information privately to your phone.
  • Check out their resources related to pregnancy here.

Healthy Native Youth

A resource for tribal health educators, teachers and parents.

[1]Centers for Disease Control and Prevention [CDC]. (2019a). Reproductive Health: Teen Pregnancy. The Importance of Prevention. Reference: https://www.cdc.gov/teenpregnancy/about/index.htm#:~:text=In%202017%2C%20a%20total%20of,drop%20of%207%25%20from%202016.

[2]CDC. (2019b). Social Determinants and Eliminating Disparities in Teen Pregnancy. Disparities by Race and Ethnicity. Reference: https://www.cdc.gov/teenpregnancy/about/social-determinants-disparities-teen-pregnancy.htm

[3]CDC. (2020a). Group B Strep (GBS). Pregnant Women. Reference: https://www.cdc.gov/groupbstrep/about/fast-facts.html#:~:text=Doctors%20should%20test%20pregnant%20woman,onset%20GBS%20disease%20in%20newborns.

[4]CDC (2020b). Maternal and Infant Health. Substance use during pregnancy. Reference: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/substance-abuse/substance-abuse-during-pregnancy.htm#:~:text=Top%20of%20Page-,Tobacco,infant%20death%20syndrome%20(SIDS).

[5]Department of Health and Social Services. (2020). Complete Health Indicator Report of Teen Birth Rate. Why Is This Important? Reference: http://ibis.dhss.alaska.gov/indicator/complete_profile/AdoBrth.html#:~:text=The%20teen%20birth%20rate%20of,(10.5%20per%201%2C000)%20youth.&text=In%202019%2C%2015.0%25%20of%20births%20to%20teens%20were%20repeat%20births.

[6]Mayo Clinic. (2019). Miscarriage. Overview. Reference: https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes/syc-20354298

[7]Mayo Clinic. (2020). 3rd Trimester Pregnancy: What to Expect. In-Depth. Reference: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20046767

[8]Office of Women’s Health. (2019). Stages of Pregnancy. You’re pregnant: Now what? Reference: https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/stages-pregnancy

[9]Planned Parenthood. (2021a). Fertility Treatments. What are the different types of fertility treatments? Reference: https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments

[10]Planned Parenthood. (2021b). What are some tips for getting pregnant? What are the different ways I can get pregnant? Reference: https://www.plannedparenthood.org/learn/pregnancy/how-pregnancy-happens/what-are-some-tips-getting-pregnant

[11]Planned Parenthood. (2021c). What’s the Best Kind of Birth Control? STDs, birth control, and pregnancy. Reference: https://www.plannedparenthood.org/learn/teens/stds-birth-control-pregnancy/whats-best-kind-birth-control

[12]TeensHealth. (2016). Birth Control Methods: How Well Do They Work? Some methods work better than others. Reference: https://kidshealth.org/en/teens/bc-chart.html

[13]The American College of Obstetricians and Gynecologists [TACOG]. (2018). Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap. How effective are barrier methods of birth control in prevention pregnancy? Reference: https://www.acog.org/womens-health/faqs/barrier-methods-of-birth-control-spermicide-condom-sponge-diaphragm-and-cervical-cap

[14]TACOG. (2019). Exercise During Pregnancy. How much should I exercise during pregnancy? Reference: https://www.acog.org/womens-health/faqs/exercise-during-pregnancy#:~:text=How%20much%20should%20I%20exercise,arms)%20in%20a%20rhythmic%20way.

[15]TACOG. (2020). Ultrasound Exams. Frequently asked questions. Reference: https://www.acog.org/womens-health/faqs/ultrasound-exams

[16] UAF. (2021). Alaska Native Values for Curriculum. Alaska Native cultures. Reference: http://ankn.uaf.edu/ancr/Values/index.html

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