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Pregnancy Calendar

Pregnancy is a special time in a woman’s life, full of joy, anticipation, but also questions and uncertainties. The pregnancy calendar then becomes an invaluable guide that, week by week, helps to understand the changes taking place in the body of the future mother and follow the fascinating development of the new life. It is a compendium of knowledge that not only informs, but also gives confidence and allows you to consciously experience each stage of this extraordinary journey. Having access to reliable information about the baby’s development, recommended tests or typical ailments transforms the waiting period into a more manageable and conscious process, giving the future mother a sense of control and influence on the course of pregnancy.

How Do We Count Pregnancy Weeks and Trimesters? Your Compass in the World of Obstetrics

Understanding how to count the weeks of pregnancy is crucial for the correct use of the calendar and effective communication with medical professionals. Normally, pregnancy is counted from the first day of the last menstrual period, not from the moment of conception, which usually takes place about two weeks later. The entire pregnancy lasts about 280 days on average, which translates into 40 weeks. However, it is worth remembering that the physiological duration of pregnancy can be up to 42 weeks.

The gestational age is given with an accuracy of the day. Each completed week is written as an integer, followed by digits from 0 to 6, indicating the following days of the current week. For example, the notation “4+3” means that 4 full weeks of pregnancy and 3 days of the fifth week have passed. In the common understanding and in many calendars of pregnancy development, a woman in this case is referred to as being in the 5th week of pregnancy. Doctors, on the other hand, often use the number of completed weeks of pregnancy, which can be calculated using a pregnancy calculator. Understanding these nuances allows you to precisely track your child’s development and properly interpret medical information.

Pregnancy is divided into three trimesters, each of which has its own specificity:

• First trimester: lasts from the first day of the last menstrual period until the end of the 13th week of pregnancy (13 weeks and 0 days, written as 13+0 t.c.).
• Second trimester: begins in the 13th week and 1st day (13+1 t.c.) and lasts until the end of the 27th week of pregnancy (27+0 t.c.).
• Third trimester: starts at the 27th week and 1st day (27+1 t.c.) and lasts until delivery.

Calculating the due date – Naegele’s rule and reality

One of the first questions a mother-to-be asks herself is about the expected date of birth of the child. Naegele’s rule is often used to calculate it. It consists of adding 7 days to the date of the first day of the last menstrual period, subtracting 3 months and adding 1 year. There is also a modified version of this rule that takes into account the individual length of a woman’s menstrual cycle.

However, it should be remembered that the due date calculated in this way is always approximate. Only a small percentage of babies are born on exactly the appointed day. This awareness allows for a more flexible approach to planning and reduces the stress of waiting for “that day” to come a little sooner or later.

The first trimester of pregnancy (1-13 weeks): the foundation of a new life

The first trimester is a time of extremely intense changes, both for the developing embryo and for the mother’s body. This is the period of organogenesis, i.e. the formation of all key organs and systems of the future human. Although the external changes in a woman’s appearance may still be minor, and the abdomen is often not visible , a real hormonal revolution takes place inside, which can manifest itself in a number of sometimes troublesome ailments. At the same time, this is the stage of the greatest sensitivity of the embryo to external factors and a key period for prevention, e.g. neural tube defects through folic acid supplementation. Self-care and a healthy lifestyle from the beginning, even when pregnancy is not yet visible, is fundamental for the proper development of the baby.

1-4 Weeks of Pregnancy: From Conception to the First Signs

Paradoxically, the first week of pregnancy in medical nomenclature is the week when the last menstrual period before conception occurs. Ovulation and fertilization usually take place at the turn of the second and third week of pregnancy. The combined egg and sperm form a zygote, which begins intensive divisions, transforming into a blastocyst. Around the fourth week of pregnancy (about a week after fertilization), the blastocyst implants in the lining of the womb – this process is called implantation. During this time, slight implantation bleeding may occur, which is sometimes mistaken for menstruation.

Three germ layers are formed from the cells of the embryo: ectoderm (from which the nervous system, skin, eyes will be formed, m.in), mesoderm (circulatory, skeletal, muscular system) and endoderm (digestive and respiratory system). The placenta is also beginning to form, which will nourish the baby throughout the pregnancy. Despite such momentous changes, the embryo itself is still microscopic, smaller than a poppy seed.

In the first four weeks, many women do not experience any specific pregnancy symptoms. The most common and first sign is the lack of expected menstruation. However, subtle signs such as fatigue, mood swings, breast tenderness or slight nausea may appear. Already at this stage, a home pregnancy test can be performed, which should confirm the suspicions. Folic acid supplementation is extremely important, preferably started at the stage of planning pregnancy.

5-8 weeks of pregnancy: heart starts beating, organs are forming

This is the period of critical organogenesis Whenthe primordia of all the most important internal organs: lungs, kidneys, liver, pancreas and spleen are formed, the due date can also be calculated. The heart and circulatory system are formed. The heart begins to beat around the 6th-7th week of pregnancy (about 22 days after fertilization), and its function can be observed during an ultrasound. A neural tube is formed, from which the brain and spinal cord will develop. The ovules of limbs, eyes, ears, nose, mouth and tongue are formed. The embryo grows very quickly – in the 6th week it is about 5 mm, and by the end of the 8th week it has already reached 1.3-1.7 cm. In the 8th week of pregnancy , the period of fetogenesis begins – the organs are already mostly formed, and further development consists in their growth and maturation of functions. However, the brain remains extremely sensitive to harmful factors, such as alcohol, which can damage already produced cells and disrupt their functioning. That is why it is so important to eliminate all toxins and take care of a healthy lifestyle.

In the future mother, the symptoms of pregnancy may intensify. Nausea and vomiting can be particularly troublesome, most often appearing between the 4th and 6th week. Fatigue, drowsiness, tenderness and enlargement of the breasts, mood swings and more frequent urination are also common. There may be slight pain in the lower abdomen, associated with the stretching of the uterus.

This is a good time for the first visit to the gynecologist, usually recommended between 5. and the 6th week of pregnancy. The doctor will confirm the pregnancy, order a package of necessary tests and give you the first tips. Up to the 10th week of pregnancy, mandatory tests should be performed, such as: blood type and Rh factor determination, test for the presence of immune antibodies (the so-called Coombs reaction), blood count, general urine test, fasting glucose concentration, tests for syphilis (VDRL), HIV, HCV, toxoplasmosis (IgG and IgM) and rubella, cytological test (if it has not been performed in the last 6 months) and TSH level determination. Ultrasound examination at this stage allows to confirm the correct implantation of the embryo in the uterus and visualize the heart function.

9-13 weeks of pregnancy: embryo becomes fetus, first movements

Around the 10th week of pregnancy (i.e. 8 weeks after fertilization), the embryo officially becomes a fetus. This is a symbolic milestone, marking the completion of the most critical phase of organ formation. From that moment on, there has been an intensive growth and improvement of the functions of the already existing structures.

The baby’s face takes on more and more human features, the eyes, although still covered by eyelids (which will remain closed for several months), gain color. Taste buds appear. Limbs, fingers and toes develop, on which nails are formed. The skeletal and muscular systems continue to develop, although the bones are still soft and gradually mineralize. The fetus begins to make its first, very delicate movements, which, however, are not yet felt by the mother. The kidneys start working and produce urine. The external genitalia differentiate, although their final determination on ultrasound will be possible later. The vocal cords develop, and the intestines, which previously partially developed in the umbilical cord, move to the abdominal cavity of the fetus. At the end of the 13th week of pregnancy, the fetus measures about 6-8 cm (parietal-sit length, CRL) and weighs about 20 grams.

For the mother-to-be, this period often brings relief – in most women, the annoying nausea and vomiting subside, and the mood generally improves. Between 11. and by the 12th week, some women may notice a slight rounding of the tummy. Due to the action of hormones, the work of the digestive tract can be slowed down, which sometimes results in bloating or constipation. Many women observe an improvement in the condition of their hair and nails. You may experience headaches or a pulling sensation in the groin, associated with the enlargement of the uterus.

The key test during this period is genetic ultrasound, performed between the 11th and 14th week of pregnancy, which can be monitored using a pregnancy calculator. It allows for a detailed assessment of the anatomy of the fetus and estimation of the risk of the most common genetic defects, m.in. by measuring nuchal translucency (NT). They are often combined with a dual test (maternal blood test for PAPP-A protein and hormone $\text{β-HCG}$), which increases the accuracy of the risk assessment. Regular general urine testing is still recommended.

Diet and Supplementation in the First Trimester: What to Eat and What to Avoid?

In the first trimester, the caloric demand of the future mother practically does not increase or increases minimally, by about 70-85 kcal per day. Much more important than the quantity is the quality of the food consumed. The diet should be varied and rich in nutrients. You should avoid thinking in terms of “eating for two” and focus on providing the body with what is best for the proper development of the child. It is recommended to eat regular meals.

What is worth including in your diet?

• Vegetables and fruits: Especially green leafy vegetables (rich in folic acid), broccoli, carrots, peppers, berries, apples. Minimum 5 servings a day.
• Whole grain cereal products: Wholemeal bread, groats, oatmeal.
• Lean meat and poultry: Always well cooked or baked.
• Fishes: Preferably oily sea fish (salmon, sardines, herring) rich in omega-3 acids (DHA), but limited to 1-2 servings per week and avoiding predatory fish with a high mercury content.
• Courage: Only well cooked (curdled yolk).
• Legumes: Beans, lentils, chickpeas.
• Dairy products: Natural yoghurts, kefir, cottage cheese – choose pasteurized products.
• Healthy fats: Olive oil, avocado, nuts (in moderate amounts).
• Fluids: About 2-2.5 liters a day, mainly still water, herbal teas (e.g. chamomile).

What should be avoided or significantly reduced?

• Raw or undercooked products: Meat (e.g. tartare, rare steaks), fish (e.g. sushi, sashimi), seafood, eggs (e.g. in homemade mayonnaise, tiramisu) – due to the risk of infection with bacteria (Listeria, Salmonella) or parasites (Toxoplasma).
• Unpasteurized milk and milk products: Soft blue cheeses (brie, camembert, roquefort), cheeses made from unpasteurized milk – risk of Listeria.
• Alcohol: Absolutely forbidden at every stage of pregnancy.
• Liver: Consume in very limited quantities due to the high content of vitamin A, the excess of which can be harmful to the fetus.
• Raw sprouts and unwashed vegetables/fruits: Risk of bacterial infections.
• Highly processed foods should be limited, especially during pregnancy and due date. Fast food, ready meals, chips, sweets, sweetened sodas – they are poor in nutritional value and rich in simple sugars, trans fats and salt.
• Caffeine: Limit to a maximum of 200-300 mg per day (equivalent to 1-2 cups of weak coffee). Keep in mind that caffeine is also found in tea, cocoa, chocolate and energy drinks (which are not recommended).
• Some herbs: Always consult the use of herbs with a doctor, some may be harmful during pregnancy.

Supplementation in the first trimester is not so much a supplement to the diet as a key element of health prevention. According to the recommendations of the Polish Society of Gynaecologists and Obstetricians (PTGiP), the following are necessary:

• Folic acid: Absolutely crucial, the recommended dose is $400-800 \text{μg}$ (micrograms) per day, preferably in the form of active folate (e.g., 5-MTHF) or in combination with traditional folic acid. Supplementation should be started at least 12 weeks before the planned conception and continued throughout the first trimester. An adequate supply of folic acid reduces the risk of neural tube defects in a child by up to 50-75%.
• Vitamin d: The recommended dose is 2000 IU (international units) per day.
• Iodine: About $200 \text{μg}$ per day.
• Omega-3 fatty acids (DHA): Especially important if the diet is poor in fatty sea fish. Consult your doctor about the dosage to see if it is appropriate for your pregnancy.
• Iron: Iron supplementation in the first trimester is recommended only in the case of diagnosed anemia or a high risk of its development, always after consulting a doctor and performing appropriate tests.

Safe Physical Activity at the Beginning of Pregnancy

Regular physical activity, unless there are medical contraindications, is recommended from the very beginning of pregnancy. It is not only a way to maintain good fitness and well-being, but also an investment in the proper course of pregnancy and childbirth. The benefits of moderate exercise include, m.in, reduced risk of gestational diabetes, pregnancy-induced hypertension, as well as better preparation of the body for the effort of childbirth.

If a woman was active before pregnancy, she can continue to exercise, but reduce its intensity, taking into account the needs of a specific trimester of pregnancy. For ladies who are just starting out, it is recommended to introduce movement gradually, e.g. from 15-minute sessions 3 times a week, gradually increasing the time to 30-45 minutes. In the first trimester, special caution should be exercised due to the slightly higher risk of miscarriage.

Recommended forms of activity in the first trimester:

• Walks: The most universal and accessible form of movement.
• Swimming: It perfectly relieves the joints and spine, minimizes the risk of injury.
• Nordic: It engages many muscle groups and relieves the joints of the lower limbs.
• Gymnastics for Pregnant Women/Prenatal Yoga: Specially selected strengthening, stretching and relaxation exercises, conducted by a qualified instructor.

What to avoid?

• Contact and trauma sports (e.g. martial arts, horse riding, skiing).
• Intense strength training, exercises that require a lot of effort and weight lifting.
• Exercises with jumps, sudden changes in the direction of movement.
• Exercises that strongly engage the abdominal muscles, causing it to tighten and strain.

Any physical activity should be consulted with the doctor in charge of the pregnancy.

Emotions in the First Trimester: How to Deal with Mood Swings?

The first trimester is not only a physical revolution, but also an emotional one. Rapid hormonal changes, especially an increase in progesterone and estrogen levels, can cause mood swings, increased irritability, tearfulness, feelings of anxiety, and even depression. These are completely normal reactions of the body to the new situation. Many women experience mixed feelings – the joy and excitement of expecting a baby, but also the fear and anxiety of pregnancy, childbirth and a new life role.

The key is to accept these emotions and understand that they are a natural part of this stage. You should not blame yourself with them or suppress them in yourself. The following may help:

• Open conversation with your partner: Sharing your feelings and concerns strengthens the bond and allows you to get support.
• Support from loved ones: Conversations with family and friends who have gone through pregnancy can be very valuable.
• Support groups for expectant mothers: Contact with other women in a similar situation gives a sense of understanding and community.
• Rest and self-care: Getting enough sleep, eating a healthy diet, relaxing activities (e.g. walking, warm bath) can improve your well-being.
• Psychological support: If mood swings are very severe, hinder daily functioning or depressive thoughts appear, it is worth seeking the help of a psychologist or psychotherapist.

Remember that taking care of your mental well-being is just as important as taking care of your physical health.

Second trimester (14-27 weeks): the golden period of waiting

The second trimester of pregnancy, lasting from 14 to 27 weeks, is often referred to as the “golden period” or “honeymoon” of pregnancy. For many women, this is the time when the troublesome ailments of the first trimester, such as nausea, vomiting and excessive fatigue, subside or significantly alleviate. There is a surge of energy and an improvement in general well-being. The belly is becoming more and more visible, which is a tangible sign of life growing in it. It is also during this period that the mother-to-be begins to feel the first movements of her baby, which is an extremely emotional and important moment that builds the bond. Feeling better creates a great opportunity to actively prepare for parenthood, e.g. by participating in antenatal classes, as well as to continue taking care of yourself through a balanced diet and safe physical activity.

14-18 Weeks of Pregnancy: First Baby Movements and Growing Tummy

During this period, the fetus continues its dynamic development. His body begins to straighten and his head no longer clings so tightly to his chest. The child intensively exercises the thumb sucking reflex and swallowing amniotic fluid, which is important for the development of the digestive and respiratory systems. At 15-16 weeks, the fetus is already about 10 cm long. A delicate fetal fuzz, called lanugo, appears on its skin, which has a protective function, and sweat glands develop. The facial muscles are already developed enough to allow for the first grimaces and facial expressions. Permanent tooth buds form under the gums.

An extremely important stage is the development of the hearing organ – the inner ear and ossicles are formed, thanks to which the child begins to hear sounds coming from the environment, including the mother’s heartbeat and her voice. Genital differentiation begins: in girls, the fallopian tubes, labia and vagina are formed, and primary ova are formed in the ovaries; In boys, the penis develops, and the testicles begin the process of descending into the scrotum. At the end of the 4th month of pregnancy (around 16-17 weeks), the fetus is about 13 cm long and weighs about 150 grams. In the 18th week, the intensive development of the nervous system continues, and the genitals are often already identifiable during an ultrasound.

In the future mother, morning sickness and vomiting usually subside, and the frequency of urination decreases compared to the first trimester. However, other ailments may appear, such as swollen ankles, gum sensitivity or more abundant, transparent vaginal discharge. The belly becomes more and more visible and weight gain is more noticeable. The most exciting event is when you feel your baby’s first movements. Women giving birth for the first time (first-timers) usually feel them around the 20th week of pregnancy, while multiparous women, i.e. women who have already given birth, can feel them earlier, even around the 16th-18th week. Initially, these are very gentle sensations, described as “tickling”, “gurgling” or “overflowing”. This moment is extremely important for building a bond with the child, being the first tangible proof of his presence and activity.

During this period, regular check-ups are continued, such as a complete blood count and a general urine test.

19-23 Weeks of Pregnancy: Mid-Term Ultrasound and Finding Out the Sex of the Baby

Around the 20th-21st week of pregnancy, the halfway point of pregnancy passes. The child is then about 16-20 cm long (measured from the top of the head to the buttocks – CRL) and weighs about 300 grams. Fat tissue begins to accumulate under his skin, which will be important for thermoregulation after birth. Meconium appears in the intestines – the baby’s first poop. The toddler may have hiccups, felt by the mother as rhythmic vibrations. The first hairs on the head begin to grow and the sleep-wake cycle becomes more regular. Interestingly, research indicates that already at this stage, the mother’s mood can affect the baby. In the 23rd week, the baby sleeps most of the day (even more than 20 hours), and milk tooth buds appear in his gums.

In the case of the future mother, the uterine fundus usually reaches slightly below the navel. A linea nigra, i.e. a dark line running from the navel down, may appear on the abdomen, as well as the first stretch marks on the skin of the abdomen, thighs or breasts. Ailments such as muscle cramps (especially calves), swelling, back pain, as well as heartburn and constipation may intensify. The skin on the growing belly can become dry and itchy.

The key examination in this period is the so-called mid-term ultrasound, usually performed between the 18th and 22nd week of pregnancy, optimally around the 20th week. Although for many parents the most exciting moment of this test is the opportunity to find out the sex of the baby, its primary purpose is a detailed assessment of the anatomy of all internal organs of the fetus (m.in. pregnancy calculator (heart, brain, kidneys, lungs), biometric measurements (size of the head, belly, femur) and assessment of the amount of amniotic fluid and the location of the placenta. It is an extremely important diagnostic test, allowing for early detection of possible developmental defects and planning further treatment. It is worth remembering that most of the results are normal, and early diagnosis of possible problems gives a chance for better care of the baby, sometimes still in the prenatal period, which can be checked using pregnancy ultrasound. As part of the recommended tests, between the 15th and 20th week, a triple test can be performed (determination of the concentration of $ \text{β-HCG} $ in the mother’s blood), which is also used to assess the risk of genetic defects.

24-27 weeks of pregnancy: intensive development of the baby’s senses

In the 24th week of pregnancy, the baby’s eyesight works intensively – the eyeballs move and the retina becomes sensitive to light, which means that the baby can react to a strong light source directed at the mother’s belly. The lungs continue to develop; The tubular period ends and the sac period begins, which is crucial for preparing for independent breathing after childbirth. The child can now consciously close his eyelids and clench his fists. It is increasingly sensitive to external stimuli, such as loud noises or sudden movements of the mother, which can cause it anxiety, especially after calculating the due date. At the end of the second trimester, around week 27, the fetus measures about 23-25 cm (CRL) and weighs close to 900 grams. His senses – hearing, sight and touch – are becoming better and better.

The expectant mother may experience or intensify ailments typical of the second trimester, such as back pain, heartburn, leg swelling or skin discoloration (e.g. chloasma). Some women may develop carpal tunnel syndrome, which manifests itself as numbness and pain in the hands due to water retention in the body and pressure on the nerves.

An extremely important screening test, routinely carried out between the 24th and 28th week of pregnancy (usually between 24 and 26th), is the oral glucose tolerance test (OGTT), commonly known as the “sugar curve”. Its aim is to early detect gestational diabetes – a carbohydrate metabolism disorder that can occur in previously healthy women under the influence of pregnancy hormones. Untreated gestational diabetes poses a risk of serious complications both for the mother (e.g. hypertension, pre-eclampsia, urinary tract infections) and for the child (e.g. excessive birth weight – macrosomia, malformations, lung immaturity, hypoglycemia after childbirth). That is why it is so important to perform this test and, if necessary, implement appropriate treatment (diet, sometimes insulin). In women who tested negative for toxoplasmosis (IgM antibodies) in the first trimester, it is recommended to repeat this test. Women with a negative Rh factor (Rh-) should have anti-D antibodies determined.

Second Trimester Nutrition: Caloric Needs and Important Ingredients

In the second trimester of pregnancy, the energy demand of the future mother increases by about 360 kcal per day compared to the pre-pregnancy requirement. This extra energy charge is necessary to cover the costs of intensive fetal growth, placental development and preparation of the mother’s body for lactation. It is important that these extra calories come from whole foods and not from so-called “empty calories”. The quality and variety of the diet, based on the principles of healthy eating discussed for the first trimester, are still crucial. Raw, unpasteurized products and alcohol should continue to be avoided.

Examples of healthy snacks or additional meal elements that can provide about 360 kcal include, for example: a fruit cocktail based on yoghurt or kefir with nuts and seeds, a sandwich made of wholemeal bread with lean cold meat or vegetable paste and lots of vegetables, a portion of porridge with fruit and dried fruits, or a tortilla with grilled chicken and vegetables.

Second Trimester Tests: What Should You Know About the Glucose Tolerance Test and Mid-Term Ultrasound?

As mentioned earlier, the two key diagnostic tests of the second trimester are the mid-term ultrasound and the glucose tolerance test.

A mid-term ultrasound (usually 18-22 weeks) is a detailed assessment of the anatomy of the fetus. The doctor carefully examines all internal organs, limbs, face, spine, measures individual parts of the child’s body, assesses the amount of amniotic fluid, the location and structure of the placenta and blood flow in the umbilical and uterine arteries. This test allows for the detection of many congenital defects and possible further diagnostic or therapeutic steps.

The glucose tolerance test (OGTT) (usually 24-28 weeks) involves taking blood three times: on an empty stomach, followed by one hour and two hours after drinking a solution containing 75g of glucose. The test allows you to diagnose gestational diabetes. Normal glycemic norms are: fasting below 92 mg/dl (5.1 mmol/l), after 1 hour below 180 mg/dl (10.0 mmol/l), and after 2 hours below 153 mg/dl (8.5 mmol/l). Exceeding any of these values results in the diagnosis of gestational diabetes.

Key Tests in Pregnancy by Trimester

Study name	Approximate week of performance	Aim of the study	Kind
I TRYMESTR
Blood type and Rh, Immune antibodies	By the 10th t.c. it is worth consulting a doctor and checking if everything is going well.	Blood type determination, prevention of serological conflict	Mandatory
Complete blood count	to 10 t.c. in the context of examinations and the course of pregnancy. (and later)	Assessment of general health, detection of anemia, infections	Mandatory
General urinalysis	to the 10th t.c. (and later)	Detection of urinary tract infections, assessment of kidney function	Mandatory
Fasting glucose	to 10. t.c.	Initial assessment of carbohydrate metabolism, diabetes risk	Mandatory
VDRL (syphilis), HIV, HCV	to 10. t.c.	Detecting infectious diseases that threaten mother and child	Mandatory
Toxoplasmosis (IgG, IgM), Rubella (IgG, IgM)	to 10. t.c.	Assessment of immunity or active infection	Mandatory
Cytology	to 10. t.c. (if it was not there)	Cervical cancer screening	Mandatory
TSH (thyroid hormone)	to 10. t.c.	Assessment of thyroid function, important for fetal development	Mandatory
Early pregnancy ultrasound	to 10 t.c. (often 6-8)	Confirmation of pregnancy, location, number of embryos, heart function	Mandatory
Genetic ultrasound (first trimester)	11th – 14th t.c.	Assessment of fetal anatomy, risk of genetic defects (e.g., hypertension)	Mandatory
The PAPP-A+$\text{β-HCG}$-test (dual test) can be included in the pregnancy calculator.	11th – 14th t.c.	Screening for genetic defects (in combination with ultrasound)	Recommended
II TRYMESTR
Mid-term ultrasound (second trimester)	18. – 22. t.c. (opt. 20)	Detailed assessment of the anatomy of all fetal organs, biometric measurements, assessment of placenta and amniotic fluid, possibility to know sex	Mandatory
Glucose Tolerance Test (OGTT, 75g)	24. – 28. t.c. (opt. 24-26)	Detecting gestational diabetes	Mandatory
Anti-D antibodies (Rh- in women)	21st – 26th t.c. (and later)	Monitoring the risk of serological conflict	Mandatory
IgM toxoplasmosis (if IgG negative in the first trim)	21st – 26th t.c.	Exclusion of fresh infection	Mandatory
Triple Test ($\text{β-HCG}$, estriol, AFP)	15. – 20. t.c.	Screening for genetic defects (alternative or complement to the dual test)	Recommended
III TRYMESTER
Third trimester ultrasound	28. – 32. t.c.	Assessment of fetal growth, anatomy, amount of amniotic fluid, fetal well-being	Mandatory
Culture for GBS (streptococci)	35. – 37. t.c.	Detection of GBS carriers, prevention of infections in the newborn	Mandatory
HBs antigen (hepatitis B)	33rd – 37th t.c.	Detection of hepatitis B infection, prophylaxis in the newborn	Mandatory
HIV, VDRL (syphilis) are tests that are worth doing to check your health during pregnancy.	33rd – 37th t.c.	Re-examination in risk groups or if it was not in the first trim.	Mandatory
CTG (cardiotocography)	from approx. 38-40 t.c., according to the indications	Monitoring fetal heart function and uterine contractions, assessing fetal well-being before delivery	Mandatory

Second Trimester Exercises: How to Actively and Safely Enjoy Pregnancy?

The second trimester, due to better mood and a surge of energy, is a great time to continue or start (after consulting a doctor) regular physical activity. Exercise not only improves your mood and fitness, but also prepares your body for childbirth and helps you manage common pregnancy complaints such as back pain or swelling.

You can continue safe forms of activity from the first trimester, such as walking, swimming, Nordic walking or special classes for pregnant women (yoga, Pilates). If you feel like it, you can increase the intensity of the exercise a bit. However, there are a few important rules to keep in mind:

• Avoid supine exercise after about 16-20 weeks of pregnancy, as the growing uterus can put pressure on large blood vessels, restricting blood supply to the heart and brain, which can be calculated using a pregnancy calculator.
• Avoid exercises that strongly engage the rectus abdominis muscle (risk of dehiscence of the linea alba).
• Continue to avoid contact sports, trauma sports, and those with a risk of falling.
• Listen to your body and stop exercising in case of pain, dizziness or other disturbing symptoms.

Of particular importance in the second trimester (and later) are exercises that strengthen the pelvic floor muscles (the so-called Kegel exercises). Regular performance helps prevent problems with urinary incontinence, prepares the perineum for childbirth and accelerates regeneration after childbirth.

Examples of safe exercises include, m.in, squats (e.g. sumo squat), lunges, abduction of legs in various planes, exercises with light dumbbells or resistance bands, focusing on strengthening the postural muscles, arms and legs.

First Preparation for Childbirth: Birthing School and Planning

The second trimester is the perfect time to start actively preparing for childbirth. Better well-being is conducive to the acquisition of knowledge and skills that can significantly reduce the fear of the unknown and increase the sense of competence.

• Birthing school: It is worth signing up for classes that will provide practical information about the course of childbirth, methods of pain relief, newborn care and breastfeeding. Often, theoretical classes are combined with gymnastics for pregnant women.
• Birth plan: You can start thinking about your preferences regarding childbirth – the choice of place (hospital, birth center), the presence of an accompanying person, methods of pain relief. Creating a birth plan and discussing it with your healthcare staff can help you feel more in control of how things unfold.
• Doula Support: If a woman is considering additional, non-medical emotional and physical support during labor and postpartum, the second trimester is a good time to seek out and connect with a doula.
• Perineal preparation: Although it is recommended to start the perineal massage itself later (around the 34th-36th week of pregnancy), you can already start gathering information on this topic and possibly consult a urogynaecological physiotherapist.

Active planning and preparation for childbirth is an investment in a positive experience of the birth of a child.

Second Trimester Supplementation: Follow-Up and Adjustment

As in the first trimester, proper supplementation of key vitamins and minerals is extremely important for the health of the mother and the proper development of the baby. You should continue to take:

• Folate: After 12 weeks of pregnancy, the recommended dose is 0.6-0.8 mg ($600-$800 \text{μg}$) per day, preferably in the form of active folate or in combination with traditional folic acid.
• Vitamin D: The recommended dose is 2000 IU per day, but optimally the dose should be adjusted based on the blood concentration of 25(OH)D.
• Iodine: About $150-200 \text{μg}$ per day. Women with thyroid disease should determine the dosage with their doctor.
• Omega-3 fatty acids (DHA): Minimum 200 mg of DHA per day. If your fish intake is low, your doctor may recommend a higher dose. In women at high risk of preterm birth, the dose may be increased to as much as 1000 mg of DHA per day.
• Iron: The need for iron increases significantly in the second trimester (the recommended intake is about 27 mg per day). Supplementation is often necessary, but should be introduced after consultation with a doctor and based on the results of a blood count to avoid excessive consumption.
• Magnesium: Supplementation may be indicated in case of calf cramps or other symptoms of deficiency, the dosage is determined by a doctor.

It should be remembered that the decision on supplementation and selection of preparations is always made by the doctor in charge of the pregnancy, taking into account the individual needs of the patient, test results and possible comorbidities. Self-modification of doses or introduction of new supplements is not recommended.

Third Trimester (28-40+ Weeks): The Great Countdown to Delivery

The third trimester, starting from the 28th week of pregnancy and lasting until birth, is the time of final preparations of the baby’s body for life outside the mother’s womb and the woman’s body for giving birth. The fetus grows intensively and gains weight, improving the functions of its organs. For the mother-to-be, it is a period of growing tension and anticipation, but often also of increasing physical ailments, such as fatigue, shortness of breath, back pain, swelling, heartburn or frequent visits to the toilet. Braxton-Hicks contractions, i.e. the so-called predictive contractions, preparing the uterus for the actual labor, may occur more and more often. This is the time when the support of loved ones, rest and conscious preparation for childbirth take on special importance.

28-32 Weeks Pregnant: The Baby Is Preparing for Life Outside the Womb

During this period, the baby gains weight dynamically – in the 28th week it already weighs over 1 kg (about 1200 g), and in the 32nd week its weight can reach 1.5-1.7 kg. The body length (CRL) at week 32 is about 28-30 cm. The brain develops extremely intensively – characteristic folds and furrows form on its surface, which indicates the maturation of the cerebral cortex and results in more and more coordinated movements and more efficient functioning of the senses. The lungs continue their development, the production of surfactant increases – a substance necessary for the proper expansion of the alveoli after birth. The eyes are already fully developed and respond to light. The child’s facial expressions are getting richer and richer. More and more fat tissue accumulates under the skin, making the skin smoother and less transparent. In the case of premature birth in the 32nd week of pregnancy, the baby already has a very good chance of survival with proper neonatal care.

For the mother-to-be, this stage may be more burdensome. A large belly and uterus reaching high above the navel press on internal organs, including the diaphragm, which can cause difficulty breathing deeper and finding a comfortable sleeping position. Heartburn, constipation, frequent urination, back pain and swelling can still bother you. Braxton-Hicks contractions occur regularly.

The key test in this period is the third trimester ultrasound, usually performed between the 28th and 32nd week of pregnancy. Its purpose is to assess the growth of the fetus (whether the baby is developing harmoniously and whether its weight is appropriate for the gestational age), re-evaluate the anatomy in search of possible defects that appear late, as well as assess the amount of amniotic fluid and the well-being of the fetus. This examination is not as “spectacular” in terms of viewing details as a mid-term ultrasound, but it is of great importance for monitoring the condition of the baby before birth. Regular blood counts and a general urine test are continued. In Rh-negative women who do not have anti-D antibodies, anti-D immunoglobulin is administered prophylactically between the 28th and 30th week of pregnancy to prevent serological conflict.

33-36 Weeks of Pregnancy: Final Preparations and Head Position

The baby continues to gain weight intensively – in the 33rd week it weighs about 1.9 kg, in the 35th week about 2.4 kg, and in the 36th week it is already over 2.5 kg. Its body length is about 44-47 cm. The bones, with the exception of the bones of the skull, which must remain flexible to allow passage through the birth canal, are already mostly hardened. By the 36th week of pregnancy, the lungs are usually fully developed , and the fetus reaches full maturity to live outside the mother’s body. The immune system is still forming, and the baby receives antibodies from the mother through the placenta that will protect it in the first months of life. The toddler regularly drinks amniotic fluid, which exercises his digestive system, and meconium accumulates in the intestines.

Most babies at this stage already take the head position, i.e. position themselves head down, preparing for birth. Due to the limited space in the uterus, the baby’s movements may feel less frequent, but they are often stronger and more decisive, sometimes even painful for the mother. The child’s hearing is becoming more and more developed and can respond to familiar voices, especially the mother’s voice.

The expectant mother may feel anxious and impatient about the upcoming birth, as well as mood swings. Physical ailments such as sleep problems, heartburn, shortness of breath, swelling, varicose veins, constipation or frequent urination can persist or worsen. The uterine fundus reaches the rib arches, pressing firmly on the diaphragm, which makes breathing difficult. Later, when the baby’s head begins to insert into the pelvis, the abdomen may lower slightly, bringing relief from breathing. Bleeding gums may occur due to increased fragility of blood vessels. An increased amount of thick, white vaginal mucus (vaginal discharge) is often observed.

Visits to the attending physician become more frequent – from the 36th week of pregnancy they usually take place every two weeks, and even more often depending on the needs. A general urine test and a complete blood count are performed regularly. An extremely important screening test is a vaginal and anal culture for group B streptococci ( GBS, Streptococcus agalactiae), performed between the 35th and 37th week of pregnancy. Detection of GBS carrier in the mother is an indication for the administration of an antibiotic during childbirth, which significantly reduces the risk of a dangerous infection in the newborn. Tests for HBs antigen (hepatitis B), HIV and VDRL (syphilis), as well as HCV are also performed in risk groups. The doctor also assesses the pH of the vaginal secretion and, if necessary, the dimensions of the pelvis.

37-40+ Weeks Pregnant: Full-term Pregnancy and Signs of Impending Labor

From the 37th week of pregnancy, we talk about a full-term pregnancy – the baby is fully mature and ready to live outside the mother’s body. At 37 weeks, she weighs an average of about 2.8-3 kg and gains about 14 grams every day. The baby’s head usually inserts deeper into the birth canal, preparing to pass through the pelvis. Due to the decreasing amount of space, the baby’s movements may feel more delicate and limited, but they should still be felt regularly. The baby already has its own circadian rhythm of sleep and wakefulness, and its eyes respond clearly to light. In male fetuses, the testicles should already be in the scrotum.

In the future mother, the abdomen may visibly lower, which often brings relief in breathing, but at the same time intensifies the pressure on the bladder and may cause more frequent visits to the toilet. Problems with hemorrhoids and constipation may intensify. Swelling of the labia and varicose veins of the lower limbs are common. Some women experience urinary incontinence, especially when exercising, coughing or laughing. Colostrum – the baby’s first food – may start to leak from the breast.

The signs of impending labor are becoming clearer:

• Departure of the mucus plug: Thick, gelatinous discharge, sometimes stained with blood, which used to close the cervical canal, protecting against infections. Her passing indicates that the cervix is beginning to prepare for childbirth (shorten and dilate). This can happen a few days or even weeks before the birth, or just before it.
• Predictive contractions (Braxton-Hicks): They may become more frequent and stronger, but they are still irregular and usually resolve when you change position or rest. The key is to distinguish them from regular labor contractions, which become more frequent, longer and more painful, not subsiding with a change in activity.
• Lowering of the abdomen: The baby’s head inserts into the pelvis.
• Change in the child’s movements: They may feel weaker or different than before, but the child should still move. A complete lack of movement is an alarm signal.
• Ailments of the digestive system: Some women may experience diarrhea, nausea or vomiting before giving birth.
• Low back pain: Often a dull, continuous pain in the lower back.
• Sudden burst of energy or fatigue: Some women feel the so-called “nesting syndrome” just before childbirth and have a lot of energy, others feel very tired.

In the last weeks of pregnancy, a CTG (cardiotocography) is regularly performed, which monitors the fetal heart function and uterine contraction activity. It is mandatory after the 40th week of pregnancy, but it is often ordered earlier, especially if there are any worrying symptoms or the pregnancy is postponed. During follow-up visits, the doctor also performs gynecological examinations, assessing the degree of preparation of the cervix for childbirth (its shortening and dilation).

Signs of Labor – When to Go to the Hospital?

Symptom	Characteristics indicating labor/need for hospital visit	What to do?
Regular uterine contractions	They occur every 5-10 minutes (or more often), last at least 30-60 seconds, become stronger and longer, and do not subside after changing position or resting.	Calmly finish packing, take a shower, contact the hospital/midwife, go to the hospital.
Drainage of amniotic fluid	Sudden splashing of fluid or constant, slow oozing. Amniotic fluid is usually colorless or slightly straw-colored, odorless.	Regardless of the occurrence of cramps, you should go to the hospital. Remember the time of departure, the color of the liquid and the date of the last menstruation.
Bleeding from the genital tract	Bright red blood in an amount greater than a small spotting (e.g. associated with the departure of the mucus plug).	Go to the hospital immediately.
Lack or significant weakness of the child’s movements	If the child does not move or his movements are much weaker than usual and does not respond to attempts to stimulate (e.g. eating something sweet, changing position).	Contact your doctor urgently or go to the emergency room for a CTG.
Green or brown amniotic fluid	It may indicate foetal hypoxia (meconium release into amniotic fluid).	Go to the hospital immediately.
Other worrying symptoms	Severe, persistent abdominal pain, high blood pressure, severe headaches, visual disturbances.	Contact a doctor urgently or go to the hospital if conception has occurred and you have worrying symptoms.

Diet at the end of pregnancy: Energy for Mom and Baby

In the third trimester, the caloric demand of the future mother increases by about 475 kcal per day compared to the pre-pregnancy requirement. This extra energy is needed for the baby’s intensive growth and for the accumulation of reserves for the period of childbirth and lactation. Regular, balanced meals, rich in protein, healthy fats, complex carbohydrates and vitamins and minerals, are still crucial. You should take care of proper hydration of the body by drinking about 2.5 liters of fluids a day, mainly water.

To minimize digestive discomfort such as heartburn or bloating, which can be exacerbated by the pressure of the growing uterus on the stomach and intestines, it is advisable to eat smaller portions, but more often. Avoid hard-to-digest, fatty, fried and spicy foods. It is also worth limiting salt intake, which can help reduce swelling. If certain products, such as cruciferous vegetables or legumes, cause discomfort, they can be temporarily limited. Raw, unpasteurized products, alcohol, excess caffeine and highly processed foods should be avoided.

Physical Activity in the Third Trimester: Preparing the Body for Childbirth

Properly selected physical activity in the third trimester can bring many benefits, both for the well-being of the future mother and for preparing her body for childbirth. It is a form of non-pharmacological support that can shorten the time of labor and potentially reduce the sensation of pain.

Moderate-intensity exercises are recommended, preferably in positions that relieve the joints and spine, e.g. exercises in water or on a stationary bike. Popular and safe forms of activity include:

• Prenatal yoga and Pilates for pregnant women: They focus on breathing, relaxation, stretching and strengthening pelvic floor and postural muscle exercises.
• Exercises with a fitness ball: Sitting on a ball, gently swaying your hips, pelvic circles can help relax your muscles, relieve back pain, and prepare your pelvis for childbirth with the right exercises. Exercising on a ball can also help to reduce the time it takes for the cervix to dilate, which can be calculated using a pregnancy calculator.
• Walking and Nordic walking: They allow you to maintain fitness, oxygenate the body and improve circulation.

Supine exercises, sudden bends, strong torso twists and any exercise that causes pressure on the abdomen or excessive fatigue should be avoided. Always listen to your body and stop your activity if you feel uncomfortable. Consultation with a doctor or physiotherapist specializing in perinatal care is advisable before starting or continuing to exercise in the third trimester.

Third Trimester Supplementation: Final Support

In the third trimester, the demand for certain nutrients is particularly high, so continuing with proper supplementation is crucial. According to the recommendations of PTGiP, attention should be paid to:

• Folic acid: The recommended dosage is $600-800 \text{μg}$ per day.
• Vitamin D: 1500-2000 IU per day, optimally the dose adjusted to the concentration in the blood.
• Iodine: Essential for the proper function of the thyroid gland of the mother and child.
• Omega-3 fatty acids (DHA): They support the development of the child’s brain and retina.
• Iron: The need for iron in the third trimester is the highest (it increases by about 7.5 mg per day compared to the first trimester). Iron deficiency can lead to anaemia in the mother and low birth weight of the child. Supplementation is often necessary, but it should always be carried out under the supervision of a doctor and based on the results of blood tests.
• Choline: Important for the development of the baby’s brain and the function of the mother’s liver.

The decision on specific preparations and doses is always made by the doctor in charge of the pregnancy.

Preparing for Birth and Postpartum: A Practical Guide

The last weeks of pregnancy are a time of intense preparations, not only physical, but also organizational and emotional for the birth of the child and the postpartum period.

Layette for a newborn: What Do You Really Need?

Completing a layette for a newborn is an exciting stage of preparation for many parents. However, it is worth approaching this task sensibly, focusing on the real needs of the baby in the first weeks of life and avoiding excessive shopping. The layette can be divided into several categories:

1. Hygiene and care products (the so-called “pharmacy” layette):

• Disposable diapers in the smallest size (for newborns).
• Cream or ointment for diaper rash (e.g. with zinc oxide, panthenol).
• Gentle bubble bath and body lotion/lotion for babies.
• Saline in ampoules (for washing the eyes, nose) is an important element in baby care, which is worth checking before birth.
• Isotonic nasal spray seawater (optional).
• Nasal aspirator (for removing secretions).
• An electronic thermometer (preferably non-contact or with a soft tip).
• Antipyretics and analgesics for infants (paracetamol in suppositories or syrup, suitable from the first days of life – always after consulting a doctor about the dosage).
• Preparation for the care of the umbilical cord stump (e.g. octenidine-based antiseptic lotion, if recommended by a midwife/doctor).
• Vitamin D3 drops (supplementation recommended from the first days of life, dosage according to doctor’s recommendations, usually 400 IU).
• Scissors with rounded ends or a special nail clippers for babies.
• Soft bath towels (2-3 pieces).
• Cotton pads, sterile gauze pads.

2. Clothes for newborns should be comfortable and adapted to the needs of a specific trimester of pregnancy.

• Bodysuit (cotton, zipped at the crotch and shoulder): 5-7 pieces in size 56 and a few in size 62.
• Rompers (one-piece, fully zipped): 5-7 pieces.
• Jackets or blouses with front zip-ups (optional, bodysuits are often more comfortable).
• Half-rompers or shorts: several pairs.
• Cotton socks (non-compression): several pairs.
• Cotton hats (thin, after bathing and for the first walks, if it is cold): 2-3 pieces.
• “Non-scratch” gloves (optional, so that the child does not scratch).
• For leaving the hospital (adapted to the season): a warmer romper, sweater, overalls, a warmer hat.

3. Sleeping textiles and accessories:

• A cot with a suitable mattress.
• Bed sheets (cotton, with an elastic band): 2-3 pieces.
• Baby swaddle wrap or swaddle: 1-2 pieces (provide a sense of security).
• Blankets (light cotton or bamboo, warmer for colder days): 2-3 pieces.
• Cloth and muslin diapers: a dozen or so pieces (for wiping, putting on, as a light cover).
• Sleeping bag (a safe alternative to a duvet for the youngest children).

4. Feeding accessories (depending on the feeding method):

• If breastfeeding is planned: nursing pads, nursing bras, possibly a breast pump (can be purchased later), nursing pillow.
• If you plan to feed with modified milk: bottles with teats for newborns, a brush for washing bottles, a sterilizer or a boiling pot, infant formula (after consultation with a doctor/midwife).

5. Equipment and additional accessories:

• Deep stroller (carrycot).
• A car seat (0-13 kg), necessary for the safe transport of the child from the hospital.
• Bathtub.
• Changing table or changing mat.
• Bag for children’s accessories (for stroller).

It is worth remembering that many things can be bought after the birth of the child, as the needs arise. Focusing on the basic, necessary elements will avoid unnecessary expenses and cluttering the space.

Hospital Bag: A List of Essentials for Mom and Baby

Packing your bag for the hospital early enough (ideally around 36-37 weeks of pregnancy) is an important part of preparation, which gives you peace of mind and avoids stress when labor begins. It is worth dividing things into those needed by the mother and those for the baby, as well as prepare a separate folder with documents.

Documents (necessary!):

• Identity card.
• Pregnancy history card.
• Original blood type and Rh factor test result (with PESEL number) and approximate date of delivery.
• Current test results: complete blood count, urine test, ultrasound (the last one, with the estimated weight of the baby), HBs, GBS, HIV, VDRL.
• Birth plan (if prepared).
• Employer’s NIP and own (to issue a sick leave after childbirth).
• Details of the person accompanying the birth (if applicable).

Things for mom:

• For the time of childbirth:
  • Comfortable, loose shirt or T-shirt (preferably cotton, zipped at the front will facilitate the first skin-to-skin contact with the child): 2 pieces (one may get dirty).
  • Bathrobe (light, cotton).
  • Warm socks (feet may freeze during childbirth).
  • Slippers or flip-flops (easy to slip on).
  • Still mineral water (small bottles with a sports spout), or light snacks (e.g. muesli bars, dried fruit – if the hospital allows).
  • Lip balm (lips often dry out during childbirth).
  • Hair elastic, headband.
  • Relaxing things: music on headphones, a book (although there may not be time for it).
  • Phone and charger.
• After childbirth (for a hospital stay, usually 2-4 days):
  • Nightgowns with front zipping (to facilitate breastfeeding): 2-3 pieces.
  • Nursing bras: 2-3 pieces.
  • Breast pads: packaging.
  • Postpartum panties (mesh, disposable or cotton, larger size): several pairs.
  • Maternity pads (large, absorbent): 2 packs.
  • Toiletries: toothbrush and toothpaste, shower gel (unscented or slightly scented), shampoo, deodorant (preferably unscented), hairbrush, or delicate face cosmetics.
  • Towels: 2 pieces (bath and smaller).
  • Flip-flops for the shower.
  • Comfortable clothing for leaving the hospital (loose, maternity or larger size).
  • Cup, cutlery (sometimes useful).
  • Medications taken on a regular basis (if applicable).

Things for a child:

• Disposable nappies for newborns (size 1): about 20-30 pieces.
• Baby wipes (fragrance-free, hypoallergenic).
• Cream for diaper rash.
• Clothes:
  • Cotton bodysuits: 3-4 pieces.
  • Cotton rompers: 3-4 pieces.
  • Socks: 2-3 pairs.
  • Cotton hat (thin): 1-2 pieces.
  • Non-scratch gloves (optional).
• Baby swaddle wrap or thin blanket to wrap.
• Cloth or muslin diapers: 2-3 pieces (for padding, wiping).
• Clothes for leaving the hospital (adapted to the season).
• Car seat (must be prepared in the car on the day of discharge).

It is worth finding out in advance what the hospital provides and what you should bring with you, as standards may vary.

Postpartum: What Is It and How to Take Care of Yourself After Childbirth?

The puerperium, often referred to as the “fourth trimester”, is the period immediately after childbirth, usually lasting until the approximate date of delivery. about 6-8 weeks. It is a time of intensive regeneration of the woman’s body, which returns to its pre-pregnancy state, and adaptation to the new role – motherhood. The puerperium is divided into three stages:

• Direct puerperium: the first 24 hours after delivery.
• Early puerperium: the first week after childbirth.
• Late puerperium: from the second to the sixth (or eighth) week after childbirth.

During this period, many changes take place in the woman’s body:

• Uterine involution: The uterus gradually shrinks to its original size. This is accompanied by cramps, often felt as menstrual pain, which can be exacerbated during breastfeeding (due to oxytocin secretion).
• Puerperal faeces: For several weeks, feces are expelled from the genital tract – initially bloody (like heavy menstruation, they may contain clots), then brownish, yellowish, and finally become scanty and whitish. This is related to the healing of the placenta site.
• Healing of the perineum or caesarean section wound: It requires proper hygiene and care.
• Initiation and stabilization of lactation: The breasts become full, and there may be a fullness of milk. It is important to properly latch the baby to the breast and empty the breast regularly.
• Hormonal changes: A sharp drop in estrogen and progesterone levels can affect physical and mental well-being.
• Changes in the circulatory and urinary systems: The volume of circulating blood decreases, diuresis (urine excretion) increases.
• Fatigue and low energy: Caring for a newborn, sleep deprivation, regeneration of the body – all this contributes to the feeling of severe fatigue.
• Mood swings: Many women experience the so-called “baby blues” – a temporary state of depressed mood, tearfulness, irritability, which usually appears between the 2nd and 5th day after childbirth and disappears spontaneously within a few days. However, if the symptoms are severe, persist for longer or there are thoughts of harming yourself or your baby, it may be a sign of postpartum depression that requires specialist help.

How to take care of yourself in the postpartum period?

• Rest: It is absolutely crucial. Try to sleep and rest whenever your baby is sleeping. Don’t hesitate to ask for help with household chores.
• Proper nutrition and hydration: The diet should be rich in nutrients and easy to digest. Drink plenty of fluids, especially if you’re breastfeeding.
• Hygiene: Regular washing (after each use of the toilet), airing the perineum, frequent change of maternity pads. In the case of a caesarean section wound – take care of it according to the doctor’s recommendations.
• Support from loved ones: Don’t be afraid to ask your partner, family, friends for help – both in caring for your child and in everyday chores (cooking, cleaning).
• Care of a community midwife: The midwife will visit you at home, assess your and your baby’s health, help you care for your newborn, and advise you on lactation.
• Taking care of mental comfort: Find time for small pleasures, a conversation with a loved one. Remember that your needs are important.
• Gradual return to physical activity: After consulting a doctor, you can start with light exercises, e.g. strengthening the pelvic floor muscles.

The postpartum period is a demanding time, but also an extraordinary time of building bonds with a new family member. Conscious preparation and support can make it much easier to get through this stage.

Common Pregnancy Complaints and Alarm Symptoms: When to Consult a Doctor?

Pregnancy is a time of many changes in the woman’s body, which can be accompanied by various ailments. Most of them are typical and harmless, but it is important to be able to recognize alarm signals that require urgent medical consultation.

How to deal with typical pregnancy ailments?

Many pregnancy ailments can be alleviated with home remedies or a change in habits. However, it is important to note that if the symptoms are very severe or cause concern, you should always consult a doctor.

• Nausea and vomiting: They often occur in the first trimester. Eating small portions can help, but often (avoiding feeling hungry and overeating), avoiding foods and smells that make you nauseous, nibbling on rusks or almonds before getting out of bed. Ginger (e.g. in the form of tea, lozenges) and vitamin B6 can alleviate symptoms. It is important to hydrate properly, especially when vomiting.
• Heartburn, which can occur during pregnancy, is a symptom that is worth reporting to your doctor to check its causes. Burning sensation in the esophagus. It is recommended to eat smaller meals, avoid fatty, spicy, sour foods, chocolate, coffee. Do not lie down immediately after eating. Sleeping with your head slightly elevated can help.
• Constipation: A common problem due to the action of progesterone slowing down intestinal peristalsis. A diet rich in fiber (vegetables, fruits, whole grains, prunes, flaxseed), drinking plenty of water (at least 2.5 liters a day) and regular, moderate physical activity help. The correct position during defecation is also important (knees higher than hips, e.g. with a footrest).
• Pain: Associated with a change in the center of gravity, relaxation of ligaments and weight gain. It helps to take care of the correct posture, avoid standing or sitting in one position for a long time, sleeping on your side with a pillow between your knees, appropriate footwear, regular exercises to strengthen the back and abdominal muscles (adapted to pregnancy), massage.
• Leg swelling: Often at the end of the day, especially in the third trimester. It helps to rest with your legs raised higher, avoid standing or sitting for long periods of time, wear comfortable shoes, avoid pressure (e.g. tight socks), drink enough water, limit salt in your diet.
• Calf cramps: They may be associated with magnesium, potassium or calcium deficiency, pressure of the uterus on blood vessels. A diet rich in these minerals (bananas, buckwheat, dairy products), proper hydration, regular stretching of the calf muscles help. In the event of severe cramps, your doctor may recommend magnesium supplementation.
• Bloating and gas: They result from the slow functioning of the intestines. Avoid bloating foods (cabbage, beans, carbonated drinks), eat slowly, chewing thoroughly. Herbal teas (e.g. fennel, chamomile, mint – after consulting a doctor) can be helpful. A safe agent is propranolol.
• Fatigue and drowsiness: Especially intensified in the first and third trimester. Rest, regular sleep, and daytime naps if possible are important. Light physical activity can paradoxically give you energy.
• Frequent urination / Urinary incontinence: Caused by the pressure of the uterus on the bladder and the action of hormones. Regular pelvic floor muscle exercises (Kegel) are helpful.

Alarming Symptoms in Pregnancy – Don’t Ignore These Signals!

Being able to recognize alarm symptoms and reacting quickly can be crucial for the health of mother and baby. The following symptoms always require urgent medical consultation or a trip to the emergency room. Early detection of potential complications, such as ectopic pregnancy, miscarriage, preeclampsia, placental abruption or premature birth, significantly improves the prognosis.

Alarm Symptoms in Pregnancy – When to Urgently See a Doctor?

Symptom	Possible cause/Risk	Recommended action
I TRYMESTR
Severe, sudden abdominal pain (especially unilateral, radiating to the arm), accompanied by weakness, dizziness, fainting	An ectopic pregnancy is a condition that can be diagnosed using a pregnancy ultrasound.	Immediate medical assistance (Emergency Room/Ambulance)
Spotting or bleeding from the genital tract (especially accompanied by abdominal/lower abdominal pain)	Threatened or ongoing miscarriage, subchorionic hematoma	Urgent contact with a doctor or Emergency Room
Fever above 38°C with pain/stinging in the lower abdomen, burning sensation when urinating	Urinary tract infection, other infection	Contact with a doctor
Persistent, severe vomiting preventing fluid and food intake (risk of dehydration)	Unrestrained vomiting of pregnancy (hyperemesis gravidarum)	Contact with a doctor, possible hospitalization
Fainting, fainting	Hypotension, anemia, other causes	Contact with a doctor
II and III TRYMESTR
Sudden, severe abdominal pain, hardening of the uterus (belly “like a plank”), bleeding or no bleeding	Premature placental abruption	Immediate medical assistance (Emergency Room/Ambulance)
Regular, painful uterine contractions before 37 weeks of pregnancy (more than every 10 minutes, getting worse)	Premature birth	Urgent contact with a doctor or Emergency Room
Drainage of amniotic fluid (sudden or oozing) before 37 weeks of pregnancy	Premature rupture of membranes (PPROM)	Urgent contact with a doctor or Emergency Room
Sudden onset of swelling (face, arms, legs), high blood pressure (e.g. >140/90 mmHg), severe headaches, visual disturbances (scotoma, flashes), upper abdominal pain	Preeclampsia	Immediate medical assistance (Emergency Room/Ambulance)
No or significant impairment of fetal movements (less than 10 movements in 2 hours of calm observation or a marked change in movement pattern)	Threat to fetal well-being, hypoxia	Urgent contact with a doctor or the Emergency Room to perform a CTG/ultrasound
Intense itching of the skin all over the body (especially hands and feet), without rash	Gestational cholestasis	Contact with a doctor
Fever, chills, pain in the lumbar region, burning sensation when urinating	Acute pyelonephritis	Urgent contact with a doctor, possible hospitalization
Bleeding from the genital tract (bright red blood)	Placenta previa, placental abruption, other causes	Urgent contact with a doctor or Emergency Room
Sharp, sudden pain in the groin or lower abdomen	Ovarian cyst torsion, appendicitis, other causes	Urgent contact with a doctor or Emergency Room

Remember that if you have any doubts about your health or the well-being of your baby, it is always better to consult your pregnancy doctor or midwife. Do not underestimate any disturbing signals.

Your Conscious Path Through Pregnancy

A pregnancy calendar is an extremely helpful tool that guides the expectant mother week after week through the fascinating but also challenging period of waiting for a baby. Being aware of the changes taking place in the body, the development of the fetus, recommended tests and ways to cope with ailments gives you confidence and allows you to enjoy every stage of this extraordinary journey.

Remember, however, that each pregnancy is an individual experience. The information in this guide is general and educational in nature. Regular visits to your doctor and midwife, who know your health situation best and can provide personalized advice and recommendations, are irreplaceable. Use the available knowledge, but above all, trust specialists and your body, and use our pregnancy calculator to better understand your condition. We wish you a peaceful and joyful pregnancy!