Gestational age can be confusing. A full-term pregnancy is usually about 40 weeks from the first day of your last menstrual period. Newsflash: This makes pregnancy 10 months long. Forget about the nine-month myth, people — you’re actually growing a tiny human in your uterus for longer than that. But by the time you find out you’re pregnant, you may already have one month in the bag because your hCG hormone level has to be high enough to confirm you’re expecting and turn a pregnancy test positive.
With so much information out there about pregnancy, it can be overwhelming — particularly if it’s your first baby. It can be an incredibly exciting time, but it can also be stressful and overwhelming. To make it a little easier, here’s what you really need to know about pregnancy, month by month.
Month 1: Early days
At this stage, you might not even know you’re pregnant. The pregnancy calendar counts your first week of pregnancy as the last day of your period even though the egg and sperm haven’t met yet. If you’ve been trying to conceive and have a regular menstrual cycle, the first sign of pregnancy is likely to be a missed period. Today’s home-pregnancy tests are sensitive and sophisticated — many of them can detect pregnancy from the first day you’ve missed your period. For the most reliable results, the U.S. Food and Drug Administration advises testing one to two weeks after you miss your period. If you have an irregular cycle, the Office on Women’s Health recommends taking a test four weeks after the last time you had unprotected sex.
Whether you find out you’re pregnant at this stage or a little later, make a prenatal appointment with your doctor as soon as you get that positive result.
Month 2: Nausea & vomiting
You might not be noticeably pregnant just yet, but there’s a lot going on during the second month of pregnancy. Around halfway through the second month, the ball of cells in your uterus is turning into an embryo and starting to develop all its major internal organs. This is when many women notice early signs of pregnancy. While everyone is different, the most common symptoms are frequent urination, sore or tender breasts, fatigue, nausea, bloating and mood swings, says Planned Parenthood.
“If nausea and vomiting are unremitting or you cannot ingest any food, get yourself to the hospital to be evaluated and treated,” Dr. Anat Zelmanovich, gynecologist and female pelvic medicine and reconstructive surgeon at Manhattan Specialty Care, tells SheKnows.
Month 3: Screening tests
When you’re three months pregnant, your embryo becomes a fetus and is connected to your placenta and uterine wall via the umbilical cord. The changes going on inside you are fascinating — bones harden, skin and fingernails start to grow, early sweat glands appear and external sex organs begin to appear — but all you can probably think of is those darned side effects. Pregnancy symptoms, particularly nausea, sometimes worsen during the third month. You might also be amazed at how your breasts are changing — getting bigger and darkening around the nipple area. You might be offered some tests, such as the nuchal translucency and the cell-free fetal DNA test, during the third month of pregnancy. “These screening tests are utilized to screen for the trisomies — chromosomal disorders — and in the case of the cell-free fetal DNA test, can be used to identify the gender of the baby. You no longer have to wait until that 20-week anatomy scan,” Dr. Angela Jones, an OB-GYN and Astroglide’s resident sexual health advisor, tells SheKnows.
Month 4: Changing pregnancy symptoms
You might be able to say good riddance to some pregnancy symptoms, such as nausea, during the fourth month, but other problems might take over, like heartburn, constipation, shortness of breath, bleeding gums and nasal stuffiness. On the plus side, you should get a welcome energy boost that will hopefully help you power through the next few months. You might also experience round ligament pain, sharp shooting pains on the sides of the abdomen, says Zelmanovich. While this is a normal effect of a rapidly growing uterus, Zelmanovich recommends letting your doctor know just so they can make sure it’s not something more serious.
Month 5: Baby’s moving (maybe)
The fifth month is exciting — you might start to feel your baby’s movements! Don’t expect huge kicks, though — the first movements are more like flutters or “butterflies” in your belly — and don’t panic if you don’t feel anything at all. Some moms don’t feel fetal movement until much later in pregnancy. “This may take up to 22 weeks in some pregnancies,” says Jones. “There is so much that goes on during the course of a pregnancy. If you aren’t sure of what is and isn’t normal; please ask your OB-GYN.”
Expect more tests during this month: the AFP test, which screens for neural tube defects such as spina bifida, and the anatomy scan. “This is a very thorough ultrasound that looks at the major organ systems of the baby to detect any obvious structural/anatomical defects,” explains Jones. “It also determines (or confirms) the sex of the baby.”
Month 6: Goodbye energy, hello insomnia
The high energy levels you may have been enjoying for the last couple of months might start to drop around the sixth month, and the heavier weight of your ever-growing uterus might affect how you walk and put extra pressure on your bladder. (Yes, that means more trips to the bathroom throughout the day and night — but try to see it as preparing you for sleepless nights with a newborn.) If you’re experiencing insomnia, WebMD suggests trying some natural sleep remedies, such as meditation, hot milk before bed or, with your doctor’s approval, more daytime exercise.
By this stage, your baby will probably be wriggling, kicking, pushing and doing all sorts of other cool things inside you — such as hiccuping!
Month 7: Counting kicks
Jones recommends starting to count kicks around this stage of pregnancy. Remember, what’s “normal” for you will be different from what’s normal for another mom. Recognize your baby’s unique patterns of movement to help you identify any changes. In most cases, Baby’s movements are most noticeable at night and after meals. Ashlyn Biedebach, women’s health RN and doula, tells SheKnows setting aside a time during the day to focus on your baby’s movements, making notes on paper or your phone to give you a baseline. If you have any concerns about your baby’s lack of movement, check in with your doula, midwife or doctor to be on the safe side. If your baby is born prematurely, they have a very good chance of survival from the seventh month onward, says BabyCenter.
Month 8: Peeing when you sneeze
By this stage, most moms-to-be are really feeling the full effects of pregnancy. Prepare yourself for extremely unglamorous side effects, such as increased breathlessness (your uterus is growing upward), varicose veins, hemorrhoids, stretch marks where your skin has expanded, Braxton-Hicks (false) contractions, heartburn and constipation. You might even pee a little when you laugh or sneeze (your uterus is also pressing on your bladder). Don’t panic — it’s all perfectly normal, and on the plus side, those rampant hormones might make your hair, nails and skin look amazing.
This is also the time when many women feel the need to “nest” and get their homes ready for the new life that’s about to enter the world, says Zelmanovich. (FYI, lying on the sofa watching Netflix totally counts as nesting.)
Month 9: Pack your bag
By the ninth month of pregnancy, your uterus has grown to about 1,000 times its original size, and your increasing bump and continued symptoms serve as a reminder that you don’t have long to go. This is a good time to familiarize yourself with the early signs of labor (your water breaking or painful or regular contractions) and get your hospital bag ready.
You’ll get another test around this time — the group-B strep test, which involves a vaginal and rectal swab to test for group-B strep bacteria. While this is a common bacteria that won’t make you sick, it could be harmful to your baby if they are exposed to it at birth, so knowing whether you have it is important. If you do, all you need are antibiotics during the birth to prevent exposure.
Month 10: Final prep
During the final month of pregnancy, your baby’s head may become engaged — it settles into the pelvic cavity in preparation to enter the world at last. When the fetus “drops” like this, it often signals an end to breathlessness, heartburn and constipation, but the low position may ramp your need to pee up a notch (something you probably didn’t think was possible). A few weeks before you give birth, your cervix may begin to dilate (open). Typically, this is accompanied by sharp pains in your vagina. At this point, all you can do is trust the medical professionals looking after you and go with the flow. You’ll have your baby in your arms before you know it.