Pregnancy guide: Key physical changes that occur during each trimester and expert tips on how to manage them

Trimester by trimester guide for expecting moms: Doctor-backed handbook you didn’t know you needed to navigate changes in your body during pregnancy.

Pregnancy is a time of remarkable transformation — physically, emotionally and mentally. As your body adapts to support and nurture new life, you may notice a host of changes—some expected, others surprising. For many women, these changes can bring a mix of awe, confusion, joy and sometimes discomfort.

Your pregnancy survival guide: Doctor-approved tips for every body change.(Image by Gustavo Fring on Pexels)

In an interview with HT Lifestyle, Dr Neha Khandelwal, director of the department of obstetrics and gynecology at Cloudnine Group of Hospitals in New Delhi's Kailash Colony, walked us through the key physical changes that occur during each trimester, offer expert tips on how to manage them and most importantly and help embrace our evolving body with knowledge and confidence.

The first trimester (weeks 1–12): A time of subtle yet significant change

 

Around 25% of pregnant women suffer a miscarriage during the first trimester of pregnancy.(Istock)

 

Dr Khandelwal shared, “Even before you ‘show’, your body is working hard behind the scenes to create a healthy environment for your growing baby.” 

She explained:

1. Fatigue and Hormonal Shifts

Rising levels of progesterone can make you feel unusually tired. This hormone helps maintain your pregnancy but also slows down your metabolism, making rest crucial.

What helps:

• Prioritise sleep and short naps.
• Eat small, energy-boosting snacks like nuts or fruits.
• Stay hydrated.

2. Breast Changes

Hormonal changes prepare your breasts for breastfeeding. They may feel fuller, more tender, or even itchy as the skin stretches.

What helps:

• Wear a supportive bra, even at night if needed.
• Use gentle moisturizers to relieve dryness or itchiness.

3. Morning Sickness

Despite the name, nausea can occur at any time of day. It’s linked to rising hCG (human chorionic gonadotropin) levels.

What helps:

• Eat small, bland meals more frequently.
• Ginger tea or vitamin B6 supplements (consult your doctor) can ease symptoms.

4. Digestive Changes

Hormones relax your digestive tract, which can lead to bloating, gas, and constipation.

What helps:

• Increase fiber intake with fruits, vegetables, and whole grains.
• Drink plenty of water and engage in light movement.

The second trimester (Weeks 13–26): A period of growth and relief

 

Pregnant women often suffer gestational diabetes, a condition which usually occurs in the second or third trimester.(Shutterstock)

For many women, Dr Neha Khandelwal pointed out that the second trimester brings a sense of relief. Energy returns, nausea subsides and the body begins to visibly change. She elaborated -

1. Weight Gain and Body Shape

You’ll likely begin gaining weight steadily. Your abdomen expands to accommodate your growing uterus, and you may feel the first flutters of fetal movement by week 18–20.

What helps:

• Focus on nutritious foods to support healthy weight gain.
• Start gentle prenatal exercises (like walking, stretching, or prenatal yoga) to stay active and manage weight.

2. Skin Changes

You might notice a dark line (linea nigra) down your abdomen, pigmentation on your face (melasma), or stretch marks as your skin stretches.

What helps:

• Use fragrance-free moisturizers to reduce dryness and itchiness.
• Wear sunscreen to protect against melasma.
• Understand that stretch marks are common and fade over time.

3. Back Pain and Postural Changes

Your growing belly shifts your center of gravity, and the hormone relaxin loosens ligaments, which may cause backaches or balance issues.

What helps:

• Practice good posture.
• Wear supportive footwear.
• Try prenatal massages or see a physiotherapist for tailored exercises.

The third trimester (weeks 27–40): Preparing for baby’s arrival

Tips for pregnant women to manage common pregnancy symptoms, stay comfortable in your third trimester (Photo by Mauricio Gutiérrez on Unsplash)

 

According to Dr Neha Khandelwal, this is when your body reaches its peak transformation, preparing itself for labor, delivery, and breastfeeding.

1. Breathlessness and Pressure

As the uterus expands, it can press against your lungs and diaphragm, making it harder to breathe deeply. The growing baby also puts pressure on your bladder and pelvic floor.

What helps:

• Sit and sleep with supportive pillows to elevate your upper body.
• Practice pelvic floor exercises (Kegels) to strengthen muscles for delivery and postpartum recovery.

2. Swelling and Circulation Issues

It’s common to experience swelling in your feet, ankles, and hands due to increased blood volume and fluid retention.

What helps:

• Elevate your feet when sitting.
• Wear loose clothing and compression socks if needed.
• Stay hydrated and avoid excessive salt.

3. Braxton Hicks Contractions

These are “practice contractions” that prepare your uterus for labor. They are irregular and usually painless but can be startling.

What helps:

• Rest, hydrate, and change positions if you feel discomfort.
• Contact your doctor if contractions become regular or painful.

4. Leaking and Tender Breasts

Your breasts may begin leaking colostrum (the first milk), and nipples may become more sensitive.

What helps:

• Use nursing pads in your bra to absorb leaks.
• Clean gently and avoid harsh soaps on the nipples.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.