As soon as the feelings of excitement, anticipation and joy (or, perhaps, shock and ambivalence) that accompanied your positive pregnancy test recede. You may begin to experience specific concerns about the pregnancy and the enormity of what it means to become a mother.
Rest assured you're perfectly normal: worry, it seems, goes hand in hand with impending parenthood.
But some concerns loom larger than others, depending on where a woman is in her pregnancy. To help you handle the issues you may be wrestling with right now and anticipate which ones might be lurking on the horizon, here's a trimester-by-trimester look at some of the most pressing concerns pregnant women face - and expert advice on how to put them into perspective.
Your journey to mother-hood should be just as joyful as what comes after.
The concern
- Doing all the right things
"Am I exercising too hard? Am I eating the right (or wrong) foods? What if I eat three servings of fish a week, rather than the recommended two?" Tracy Whitton, Pretoria, mother of Finn, two.
We live in an information society - or, as some people believe, a too-much-information society. The result can be anxiety. "There's a certain fear that comes from reading and hearing reports of medical studies that are not put into proper context," says Dr Michael Broder, author of
The Panic-Free Pregnancy (Penguin Books). "It's important that pregnant women put this information into perspective."
Yes, you should follow a few common-sense rules to help keep you - and your baby - healthy. Get regular prenatal care; eat a healthy, balanced diet; exercise regularly; avoid dangerous chemicals, cigarette smoke, alcohol and illicit drugs. But you don't need to drive yourself crazy.
"The same healthy guidelines that people should be following for a lifetime is what they should do while pregnant," Dr Broder says. "If all women did this, they would have a much greater impact on the outcome of their pregnancy than by avoiding nail polish and limiting their fish intake."
- Reality check Consider Dr Broder's words: "Reproduction is the most important function from an evolutionary standpoint, and pregnancy is extremely well protected."
- The concern
Not feeling connected to the baby
"Between morning sickness and disappointment over gender, I just couldn't bond with my baby. I didn't care that I was pregnant, I didn't want to be pregnant (and it was planned), and I worried that I'd never get over it and really love my child." Emily de Villiers, Margate, mother of Charl, three-and-a-half, and Danie, five months
Thoughts like these are often tied to physical discomforts (it's hard to feel the love when you're hanging over the toilet), fears (a self-protective mechanism can kick in if you're worried about miscarriage) or, sometimes, disappointment (such as over gender). Yet, in most cases, there is no cause for concern.
"Bonding isn't instant; it happens in degrees," says Dr Gayle Peterson, author of Making Healthy Families (Penguin Books). If a woman isn't feeling a connection with her budding babe early on, the maternal juices usually start flowing as the pregnancy progresses.
"When she has her first ultrasound or begins to feel her baby move, a woman typically feels more reassured that the baby is real, that the baby is safe," she explains. "At that point, the bonding process begins."
Dr Peterson adds that if a woman is feeling extremely ambivalent or unattached to her baby at any point in her pregnancy, she should seek professional help.
- Reality check Some women tend to be more emotionally cautious than others. Even if you're not convinced that you're bonding properly with your baby throughout pregnancy, as you get to know your child, the love will grow over time.
- the concern
Having a miscarriage
"I was constantly terrified of losing the
pregnancy, especially since I'd had two miscarriages." Lisa Cohen, Cape Town, mother of twins Benjamin and Isaac, 9nine months
Even women who've never suffered a pregnancy loss worry about the possibility. Unfortunately, about one in five pregnancies do end in miscarriage. But the vast majority of the time, these losses are caused by chromosomal "errors" at the time of conception. What's more, many occur so early the woman doesn't even realise she's pregnant.
And just as you can't prevent a miscarriage, neither is there much you can do - apart from such extreme situations as heavy drug or alcohol use or suffering a violent blow to your abdomen - to cause one. "An average car accident or fall won't trigger a miscarriage," says Dr Henry Lerner, the author of Miscarriage: Why It Happens and How Best to Reduce Your Risks (Perseus Books). "Neither will exercise, sex or physical labour," he adds.
- Reality check
"Once you're pregnant, your chances of having a successful pregnancy are very good: roughly 80 percent," says Dr Lerner. "By about 10 weeks from conception, if we can see the baby's heartbeat by ultrasound, the risk of miscarriage drops to one to two percent."
- the concern
Screening tests and birth defects
"We did the triple test, which yielded funny results, so we worried about heart defects until week 18, when an ultrasound showed that everything was fine." Zolisa Miotta, Johannesburg, mother of Luca, 11 months
Screening tests can be a double-edged sword: they often help put a woman's mind at ease if they show that her foetus is at low risk for having a disorder; on the flip side, they can cause unnecessary anxiety if they show an elevated risk. But it's important to keep this point in mind: a positive screening test doesn't mean that a child actually has a disorder. Screening tests don't give a definitive answer, says clinical geneticist Dr Karen Filkins. "Rather, they usually assess the risk - such as a one-in-10 or one-in-100 risk - of a foetus having a disorder."
If a woman's screening test is positive, she can then choose to undergo others, such as an ultrasound, or move on to a definitive diagnostic test, such as chorionic villus sampling or amniocentesis. While some women might be hesitant to do so because they feel that even if a disorder was detected they would not terminate a pregnancy,
Dr Filkins points out that termination is not the only possible outcome. "A woman might choose to continue the pregnancy and find support early on so that she's prepared to care for that child when it's born," she says. Still, try to keep the risk in perspective. "Most times the results of a diagnostic test will be perfectly normal, even if a screening is positive."
- Reality check
"A full 97 percent of babies are born without a major defect," Dr Filkins says.
- the concern
Getting it all done
"During my second trimester, I started worrying about all the little details: registering for my shower, furnishing the nursery, making sure I had all the gear I needed before the baby came." Lauren Bender, 30, Port Elizabeth, mother of Skye, three
Sometime during pregnancy, many, if not most, women get struck with an almost irresistible urge to feather their nests. "There's a natural desire to get things ready for the baby," says paediatrician Dr Jennifer Shu, co-author of Heading Home With Your Newborn: From Birth to Reality (American Academy of Pediatrics). "Women are so excited that they want everything to be exactly the way they imagine it. They want it to be perfect."
Yet perfection is a mirage, as any seasoned mom will tell you. "I don't think it's possible to get everything done - there's always something else," Dr Shu says. "Women should rest easy in knowing that they can't get it all done perfectly because there's no such thing. Just do what you can."
That said, you do need a few basics on hand when you bring your newborn home: an infant car seat, a safe place for the baby to sleep, nappy and feeding supplies and a basic layette.
Convenience items, such as a baby bathtub and changing table, aren't crucial.
"You could just as easily change the baby on a bed, in the cot or on the floor and bathe him in the sink, as long as you're careful about it," Dr Shu says. She also points out that you won't need certain items until the baby is older - a highchair and jogging pram, for example.
- Reality check
"Remember that your baby's health is what's important - not how pretty the nursery looks or whether everything matches," Dr Shu says.