Woman-Centered Pregnancy and Birth - Chapter 2

Excerpt from Chapter 2 of Woman-Centered Pregnancy and Birth by Ginny Cassidy-Brinn, R.N., Francie Hornstein, and Carol Downer
Federation of Feminist Women's Health Centers
Illustrations by Suzann Gage

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Chapter 2: First, You Have To Get Pregnant

 SIGNS OF PREGNANCY

 Subjective Signs

Many women experience

• Breast tenderness
• Nausea
• Fatigue or sleepiness

Some women experience

• Breast enlargement 
• More frequent urination
• Weight gain
• Sensitivity to certain tastes or odors
• Cravings for or ability to eat only certain foods
• Changes in the appetite

Uterine Signs

•  Missed menstrual period (for most women)
•  Softer uterus 
• Enlargement of the uterus

7 weeks of pregnancy - the size of a lemon

9 weeks of pregnancy - the size of an orange

12 weeks of pregnancy - the size of a grapefruit

Cervical Signs

• Change of color to a deeper red or bluish-purplish 
• Softer cervix
• The os is more open than usual

Cervical Examination

    Looking at the cervix provides valuable information in pregnancy detection and is usually included as part of an examination by a physician or health worker.  It is even more useful for a woman to look at her own cervix if she has done self-examination before and is familiar with the appearance of her cervix when she is not pregnant.  Many women notice changes in their cervices by comparing what they see to the way it usually looks.  A darkening in color to a deeper red or bluish-purplish color is characteristic of pregnancy.  This is caused by the increased blood supply to the cervix and uterus.  This color change can occur within days after conception or, in some women, it doesn't become apparent until she is several months pregnant.  When a woman is several weeks pregnant, the cervix is softer and the os is more open than usual. 

Uterine Size Check

    Feeling an increase in the size of the uterus can be another indicator of pregnancy.  Since it is very difficult for a woman to feel her own uterus, this examination is usually done by a friend in a Self-Help group, a health worker or a physician.  A uterine size check or pelvic examination provides more specific information about the length of a pregnancy than looking at the cervix or a chemical pregnancy test does.  And experienced examiner will be able to tell with reasonable accuracy (within one to two weeks), how many weeks pregnant a woman is by the size of her uterus.  For example, the uterus is about the size of a large, unshelled walnut or a plum if a woman is not pregnant.  The uterus of a woman who is about seven weeks pregnant is about the size of a lemon; nine weeks, the size of an orange; and 12 weeks about the size of a grapefruit. Making the comparison of uterine size to fruit sizes is helpful for training women in Self-Help Clinics, health workers and physicians.  It is also valuable for graphically explaining to women about the increase in uterine size in early pregnancy. 

    If a woman has participated in a Self-Help group together to feel the size of her uterus and report if it feels softer or larger than it previously did.

    The length of time since the union of sperm and egg is usually measured from the first day of a woman's last menstrual period.  This is done for uniformity since many women do not know exactly when they became pregnant.  In fact, even when women know the exact date that they became pregnant, physicians still measure Gestation from the first day of the last normal menstrual period (LNPM).  The actual size of a woman's uterus is used less often by physicians.

    Any one subjective sign or observable characteristic of a woman's cervix and uterus is usually not enough for her to conclude that she is pregnant.  More often, it is a combination of these factors together with the knowledge that she was exposed to sperm at a time in her cycle when it was likely that she had ovulated.  However, some women have such regular menstrual periods that a matter of a few days of delay of their periods signals a sure sign of pregnancy to them.

    There are situations in which women find it difficult to determine whether or not they are pregnant.  Women who have irregular periods, who are under great stress, women who are nearing menopause, women who have recently stopped taking the Pill, or women who have signs of pregnancy often have difficulty in determining pregnancy without the help of a chemical test.  Occasionally, a woman has some bleeding around the time of her expected period when she is actually in the early part of her pregnancy.  Many a woman mistakes this for her regular period, especially if she has no other indication that she is pregnant.  Usually, this bleeding is different from a normal period; sometimes there is a lighter flow or the flow does not last as long as a regular period.  Also, having these episodes of bleeding can cause women or their physicians to think they have not been pregnant as long as they have been.  In these instances, having a uterine size check is particularly important.