Physiologic and

Psychological Changes
during Pregnancy

Cherry Joyce G. Basco, RN, LPT

 Physiologic and Psychological Changes during Pregnancy

• Patients are often interested in learning more about the physical or psychological
changes that pregnancy brings because these changes both verify the reality and mark
the progress of pregnancy.
• Physiologic changes of pregnancy occur gradually but eventually affect all of a woman’s
organ systems.
• They are necessary changes because they allow a woman’s body to be able to provide
oxygen and nutrients for her growing fetus as well as extra nutrients for her own
increased metabolism.
• They also ready her body for labor and birth and for lactation (breastfeeding) once her
baby is born (Bernstein & VanBuren, 2013).
• Despite the magnitude of these changes, such as a woman’s blood volume doubling in
amount, they are all extensions of normal physiology.
• At the end of pregnancy, her body will virtually return to its prepregnant state.
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 Physiologic and Psychological Changes during Pregnancy

• Psychological changes of pregnancy occur in response not only to the

physiologic alterations happening but also to the increased
responsibility associated with welcoming a new and completely
dependent person to a family.
• Because pregnancy changes are extensions of normal psychological
and physiologic baselines, pregnancy represents a time of wellness, not of
illness.
• A major responsibility for nurses caring for pregnant women and their
families is to help the family maintain a feeling of wellness throughout
the pregnancy and into early parenthood (Rogers & Worley, 2016).

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 Psychological Changes of Pregnancy
• Pregnancy is such a huge change in a woman’s life; it brings about more psychological
changes than any other life event besides puberty (Fletcher & Russo, 2015).
• How a woman adjusts to a pregnancy depends a great deal on psychological aspects,
such as the environment in which she was raised, the messages about pregnancy her
family communicated to her as a child, the society and culture in which she lives as an
adult, and whether the pregnancy has come at a good time in her life (Silveira, Ertel,
Dole, et al., 2015).
• For many women, a prenatal visit is the first time they have seen a healthcare
provider since childhood. Guidance given during this time can be instrumental in not
only guiding a woman safely through a pregnancy but also connecting her back with
ongoing health care.

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▪ Although the average woman is happy to be pregnant,
don’t underestimate the effect the emotional and physical
upheavals brought about by the hormonal changes of
pregnancy can cause.
▪ These can be so tremendous that they can influence
whether a pregnancy is carried to term, which may not
only lead to poor acceptance of the child but also to
postpartum depression or, in rare instances, psychosis
(Biaggi, Conroy, Pawlby, et al., 2016; Lilliecreutz, Larén,
Sydsjö, et al., 2016).
FIRST TRIMESTER: ACCEPTING THE PREGNANCY
The Woman

The task of women during the first trimester of pregnancy is to accept

the reality of the pregnancy; later will come the task of accepting the
baby.

✓ Receiving confirmation of pregnancy, at her health care provider’s

office, makes the mother feel “more pregnant.
✓ Fortunately, most women are able to change their attitude toward
the pregnancy by the time they feel the child move inside them.
✓ At this stage, the unborn child is incorporated as part of woman's
body image or as part of herself
✓ “ I AM PREGNANT”
✓ For partners, accepting the pregnancy means not only accepting
the certainty of the pregnancy and the reality of the child to come
but also accepting the woman in her changed state.
 • In reality, as many as 49% of pregnancies are still unintended, unwanted,
or mistimed (centers for disease control and prevention [CDC], 2015).
Because no woman can be absolutely confident in advance that she will be
able to conceive until it happens, even planned pregnancies are a surprise to
some extent because a woman can be amazed it either happened so
quickly or took so long.
• Following their initial surprise, women often experience feelings less than
pleasure and closer to anxiety or a feeling of ambivalence. Ambivalence
doesn’t mean positive feelings counteract negative feelings and a woman is
left feeling nothing. Instead, it refers to the interwoven feelings of wanting and
not wanting, feelings which can be confusing to an ordinarily organized woman.

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 FIRST TRIMESTER: ACCEPTING THE PREGNANCY
The Partner
• In the past, partners were forgotten persons in the childbearing
process. Unwed fathers were dismissed as not interested in either the
pregnancy or the woman’s health. A female partner was completely
ignored.
• In actuality, all partners are important and should be encouraged to
play a continuing emotional and supportive role in a pregnancy.
• Accepting the pregnancy for a partner means not only accepting the
certainty of the pregnancy and the reality of the child to come but also
accepting the woman in her changed state.
• Like women, partners may also experience a feeling of ambivalence. A
partner may feel proud and happy at the beginning of pregnancy, for
example.

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 FIRST TRIMESTER: ACCEPTING THE PREGNANCY

• Soon, however, it’s easy to begin to feel both overwhelmed with what
the loss of a salary will mean to the family if the woman has to quit
work, and a feeling close to jealousy of the growing baby who, although
not yet physically apparent, seems to be taking up a great deal of the
woman’s time and thought (Da Costa, Zelkowitz, Dasgupta, et al.,
2015).
• To help both male and female partners resolve these feelings, be
certain to make partners feel welcome at prenatal visits or during fetal
testing, provide an outlet for them to discuss concerns, and offer
parenting information as necessary.

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 SECOND TRIMESTER: ACCEPTING THE BABY
As soon as fetal movements can be felt, psychological responses of
both partners usually begin to change.
The Woman
• During the second trimester, the psychological task of a woman is
to accept she is having a baby, a step up from accepting the
pregnancy.
• This change usually happens at quickening, or the first moment a
woman feels fetal movement.
• Until a woman experiences for herself this proof of the child’s
existence and although she ate to meet nutritional needs and
took special vitamins to help the fetus grow, it seemed more like
just another part of her body.
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 SECOND TRIMESTER: ACCEPTING THE BABY
The Woman

• With quickening, the fetus becomes a separate identity. She then

may imagine herself as a mother, teaching her child the alphabet or
how to ride a bicycle. This anticipatory role-playing is an
important activity for mid-pregnancy as it leads her to a greater
concept of her condition and helps her realize she is more than
just pregnant—there is a separate human being inside her.

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✓ “I am going to have a baby”

QUICKENING at 20 weeks--- there's a baby

separate from her.

Fantasize about the gender/ it’s a BOY, or GIRL

A good way to measure the level of a woman’s

acceptance of her coming baby is to measure how
well she follows prenatal instructions.
 The Partner

• As a woman begins to actively prepare for the coming baby, a partner

increasingly may feel as if he or she is left standing in the wings, waiting to
be asked to take part in the event.
• To compensate for this feeling, a partner may become overly absorbed in
work.
• This preoccupation with work may limit the amount of time a partner
spends with family or is available for prenatal visits, just when the
pregnant woman most needs emotional support.
• Some men may have difficulty enjoying the pregnancy because they have
been misinformed about sexuality, pregnancy, and women’s health. A
man might believe, for example, that breastfeeding will make his wife’s
breasts no longer attractive or that after birth, sexual relations will no
longer be enjoyable.
• Such a man needs education to correct misinformation. Read the
pamphlets supplied by your prenatal healthcare setting and ask.

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 THIRD TRIMESTER: PREPARING FOR PARENTHOOD
• During the third trimester, couples usually begin “nest-building” activities, such as planning the
infant’s sleeping arrangements, choosing a name for the infant, and “ensuring safe passage” by
learning about birth. (These preparations are evidence the couple is completing the third trimester
task of pregnancy or preparing for parenthood.)
• Couples at this point are usually interested in attending prenatal classes and/or classes on preparing
for childbirth. It’s helpful to ask a couple what specifically they are doing to get ready for birth to
see if they are interested in taking such a class and to document how well prepared they will be for
the baby’s arrival.
• Attending a childbirth education class or one on preparing for parenthood can not only help a
couple accept the fact they are about to become parents but also expose them to other parents as
role models who can provide practical information about pregnancy and child care (Jones, Feinberg,
& Hostetler, 2014).

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 • Although pregnancy is a happy time for most women, certain external life
contingencies such as an unwanted pregnancy, financial difficulties, lack of
emotional support, or high levels of stress can slow the psychological work of
pregnancy or attachment to the child (Biaggi et al., 2016).
• I am GOING TO BE A MOTHER
• Prepares the NURSERY ROOM
• Choosing name/s

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 ADDITIONAL PREPARATION WORK TO COMPLETE IN PREGNANCY
• In addition to the three main tasks of pregnancy, more subtle emotions also surface or need to be
worked through.
Reworking Developmental Tasks
• An important task to complete during pregnancy is working through previous life experiences or
Erikson’s developmental tasks of autonomy, industry, and identity (Erikson, 1993).
• Needs and wishes that have been repressed for years may surface to be studied and reworked,
often to an extreme extent along these lines. Fear of being separated from family or fear of dying
are common preschool fears that can be revived during pregnancy.
• A clue that might signal a woman’s distress over this could be “Am I ever going to make it through
this?” Such an expression might simply mean she is tired of her backache, but it also might be a
plea for reassurance she will survive this event in her life.
• Part of gaining a sense of identity is establishing a working relationship with parents, which may
still be an awkward one since adolescence. For the first time in her life, a woman during
pregnancy can begin to empathize with the way her mother used to worry because she’s already
begun to worry about her child when she feels no movement for a few hours. This can make her
own mother become more important to her and a new, more equal relationship may develop.
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 ADDITIONAL PREPARATION WORK TO COMPLETE IN PREGNANCY
Reworking Developmental Tasks
• Teenagers who are pregnant need to resolve the double conflict of still establishing a
sense of identity (teenagers are still children developmentally) at the same time they are
planning to be a mother. Unless these feelings are examined and resolved, teenagers can
have a difficult time thinking about enjoying their pregnancy or becoming a mother.
• A partner needs to do the same reworking of old values and forgotten developmental
tasks. A man has to rethink his relationship with his father, for example, to understand
better what kind of father he will be. Some men may have had emotionally distant
fathers and wish to be more emotionally available to their own children. Support from
healthcare providers and exposure to caring role models can be instrumental in helping a
man achieve this goal.

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 ADDITIONAL PREPARATION WORK TO COMPLETE IN PREGNANCY

Role-Playing and Fantasizing

• Another step in preparing for parenthood is role-playing, or fantasizing
about what it will be like to be a parent.
• As a part of this role-playing process, women’s dreams tend to focus on
the pregnancy and concerns about keeping themselves and their coming
child safe.
• There is concern that a young adolescent will have inadequate role
models for motherhood; they are either other teens her age, who
typically are not interested in a commitment to mothering, or possibly
her own mother, who may have struggled with poverty or her own
lack of support.
• Try to locate good role models (e.g., in classes for mothers, at the
healthcare agency, or in a social agency) for adolescents so they can
find a good maternal role model to copy and modify their own
behavior.
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• A woman’s partner also has the same role-playing to do during pregnancy, to imagine
himself or herself as the parent of a boy or a girl. A partner who is becoming a parent
for the first time may have to change a view of being a carefree individual to being a
significant member of a family unit.
• If the partner already is a parent from a former relationship, he or she has to cast
aside the parent-of-one identity to accept a parent-of-two image, and so forth. Other
support persons who will have an active role in raising the child, such as grandparents,
close friends, or an ex-spouse, also have to work out their roles with regard to the
pregnancy and impending parenthood.
• This may be particularly difficult because the roles for these support persons may not
be clearly defined, and no role model may be apparent (Hayslip, Blumenthal, & Garner,
2015).

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EMOTIONAL RESPONSES THAT CAN CAUSE CONCERN IN
PREGNANCY
• Because of all the tasks that need to be worked
through during a pregnancy, emotional responses can
vary greatly, but common reactions include grief,
narcissism, introversion or extroversion, body image
and boundary concerns, couvade syndrome, stress,
mood swings, and changes in sexual desire.
• These are all normal, so it is helpful to caution a
pregnant woman and her partner that these common
changes may occur so they’re not alarmed if they
appear.
• Otherwise, a partner can misinterpret the woman’s
mood swings, decreased sexual interest, introversion,
or narcissism not as changes from pregnancy but as a
loss of interest in their relationship.
 EMOTIONAL CHANGES DURING PREGNANCY

✓ Grief- to give up or alter her present roles

✓ Narcissism- self love and self care
✓ Introversion vs Extroversion (Introversion, or turning inward to
concentrate on oneself and one’s body, is a common finding during
pregnancy.. Some women, however, react in an entirely opposite fashion
and become more extroverted)
✓ Body Image and Boundary: Body image (the way your body appears to
yourself) and body boundary (a zone of separation you perceive between
yourself and objects or other people) change during pregnancy as a
woman begins to envision herself as a mother
✓ Stress

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 EMOTIONAL CHANGES DURING PREGNANCY

✓Emotional Lability- Mood swings due to hormones.

✓Changes in Sexual Desire
✓Changes in the Expectant Family- Most parents are aware that
their older children need preparation when a new baby is on
the way; however, knowing that preparation is needed and
being prepared to do this are two different things
✓Couvade syndrome - somatic experiences of father during
pregnancy simulating those of the pregnant mother

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CONGRATULATIONS
on YOUR
PREGNANCY!
 The Confirmation of Pregnancy
• A medical diagnosis of pregnancy serves to date when the birth will occur and
also helps predict the existence of a high-risk status.
• Most women who come to a healthcare facility for a diagnosis of pregnancy
have already guessed they are pregnant based on a multitude of subjective
symptoms as well as having completed a home pregnancy test, so a healthcare
visit is more a confirmation of pregnancy than a diagnosis.
• If a pregnancy was planned, this official confirmation of pregnancy produces a
feeling of intense fulfillment and achievement.
• If the pregnancy was not planned (remember almost half of pregnancies are
unintended), it can result in an equally extreme crisis state.

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 The Confirmation of Pregnancy
• From the day a pregnancy is officially confirmed, most women try to eat a more
nutritious diet, give up cigarette smoking and alcohol ingestion, and stop taking
nonessential medications. Because a woman may not take these measures before
confirmation of her pregnancy, this makes early confirmation of pregnancy
important.
• If a woman does not wish to continue the pregnancy, early confirmation is also
imperative; therapeutic termination of pregnancy should be carried out at the
earliest stage possible for the safest outcome (Gerdts, Dobkin, Foster, et al.,
2016).
• Before there were sonograms and maternal serum pregnancy tests, pregnancy
was diagnosed on symptoms reported by the woman and the signs elicited by a
healthcare provider.

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Presumptive (Subjective) Signs of Pregnancy

• Presumptive signs of pregnancy are those that are

least indicative of pregnancy; taken as single entities,
they could easily indicate other conditions. These
findings, discussed in connection with the body system
in which they occur, are experienced by the woman
but cannot be documented by an examiner.

• Ex: amenorrhea, breast changes, urinary frequency,

quickening, easy fatigability, leukorrhea, nausea and
vomiting, skin changes (striae gravidarum).

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• Probable Signs of Pregnancy

• In contrast to presumptive signs, probable

signs of pregnancy are objective so can be
documented by an examiner.
• Although they are more reliable than
presumptive signs, they still are not positive or
true diagnostic findings. They are also
discussed in connection with the body system
in which they occur.

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 Probable Signs of Pregnancy
• Laboratory Tests- + pregnancy test - presence of human chorionic
gonadotropin (hCG)
• Hegar’s sign: softening of the uterine segment felt at 6-8 wks after LMP
• Uterine Growth
• Ballotement- rebound that occurs when the examiner`s fingers tap the
floating fetus
• Uterine suffle - swishing sound
• Goodels sign - softening of the cervix
• Braxton-hicks contractions - painless palpable contraction
• Fetal outline - palpable at 24 weeks

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 POSITIVE SIGNS OF PREGNANCY

• There are only three documented or positive signs

of pregnancy:
1. Demonstration of a fetal heart separate from the
mother’s
2. Fetal movements felt by an examiner
3. Visualization of the fetus by ultrasound

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 PHYSIOLOGIC CHANGES IN PREGNANCY
REPRODUCTIVE SYSTEM CHANGES
• Reproductive tract changes are those involving the uterus, ovaries, vagina, and breasts.

Uterine Changes
• The most obvious alteration in a woman’s body during pregnancy is the increase in size
of the uterus to accommodate the growing fetus. Over the 10 lunar months of
pregnancy, the uterus increases in length, depth, width, weight, wall thickness, and
volume.
• Length grows from approximately 6.5 cm to 32 cm.
• Depth increases from 2.5 cm to 22 cm.
• Width expands from 4 cm to 24 cm.
• Weight increases from 50 g to 1000 g.
• Early in pregnancy, the uterine wall thickens from about 1 cm to about 2 cm; toward the end of
pregnancy, the wall thins to become supple and only about 0.5-cm thick.
• The volume of the uterus increases from about 2 ml to more than 1,000 ml. This makes it possible for
a uterus to hold a 7-lb (3,175-g) fetus plus 1,000 ml of amniotic fluid for a total of about 4,000 g.

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Uterine Changes

• By the end of the 12th week of pregnancy, the uterus is

large enough that it can be palpated as a firm globe
under the abdominal wall, just above the symphysis pubis.
An important factor to assess regarding uterine growth is
its constant, steady, and predictable increase in size.
• By the 20th or 22nd week of pregnancy, it typically
reaches the level of the umbilicus.
• By the 36th week, it usually touches the xiphoid process
and can make breathing difficult.
• About 2 weeks before term (the 38th week) for a
primigravida, a woman in her first pregnancy, the fetal
head settles into the pelvis and the uterus returns to the
height it was at 36 weeks.

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 • During the 16th to 20th week of pregnancy, when the fetus is still small in relation to
the amount of amniotic fluid present, during a pelvic exam, the fetus can be felt to
bounce or rise in the amniotic fluid up against a hand placed on the abdomen. This
phenomenon, termed ballottement (from the French word ballotter, meaning “to
quake”)
• These “practice” contractions (uterine contractions), termed Braxton Hicks
contractions, serve as warm-up exercises for labor and also increase placental perfusion.
• Amenorrhea (absence of menstruation) occurs with pregnancy because of the
suppression of follicle-stimulating hormone (FSH) by rising estrogen levels
• Cervical Changes- In response to the increased level of circulating estrogen from the
placenta during pregnancy, the cervix of the uterus becomes more vascular and
edematous. Increased fluid between cells causes it to soften in consistency, and
increased vascularity causes it to darken from a pale pink to a violet hue (Goodell’s
sign)
• Vaginal Changes- An increase in the vascularity of the vagina parallels the vascular
changes in the uterus. The resulting increase in circulation changes the color of the
vaginal walls from the normal light pink to a deep violet (Chadwick’s sign).

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• Ovarian Changes- Ovulation stops with pregnancy
because of the active feedback mechanism of
estrogen and progesterone produced by the
corpus luteum early in pregnancy and by the
placenta later in pregnancy.

• Changes in the Breasts- Early in pregnancy, the

breasts begin readying themselves for the secretion
of milk. By the 16th week, colostrum, the thin,
watery, high-protein fluid that is the precursor of
breastmilk, can be expelled from the nipples.
• As vascularity of the breasts increases, blue veins
may become prominent over the surface of the
breasts. The sebaceous e glands of the areola
(Montgomery’s tubercles), which keep the nipple
supple and help to prevent nipples from cracking
and drying during lactation, enlarge and become
protuberant.
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 Systemic Changes
• Respiratory System

• A local change that often occurs in the

respiratory system is marked congestion,
or “stuffiness,” of the nasopharynx, a
response to increased estrogen levels.
• Shortness of breath
• To keep the mother’s pH level from
becoming acid because of the load of
CO2 being shifted to her by the fetus,
increased ventilation (mild hyperventilation)
to blow off excess CO2 begins early in
pregnancy.
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 Systemic Changes
Integumentary System
• This leads to pink or reddish streaks (striae gravidarum) the abdominal wall has
difficulty stretching enough to accommodate the growing fetus, causing the rectus
muscles to actually separate, a condition known as diastasis.
• A narrow, brown line (linea nigra) may form, running from the umbilicus to the symphysis
pubis and separating the abdomen into right and left hemispheres. This is known as
melasma (chloasma), or the “mask of pregnancy.”
• Vascular spiders or telangiectases (small, fiery-red branching spots) are sometimes
seen on the skin of pregnant women, particularly on the thighs.
• Palmar erythema (redness and itching) may occur on the hands from the increased
estrogen level.

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 Systemic Changes
• Temperature

✓Early in pregnancy, body temperature increases slightly because of the secretion of

progesterone from the corpus luteum (the temperature, which increased at
ovulation, remains elevated).

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 Systemic Changes
Cardiovascular System

• Blood Volume. circulatory blood volume of a woman’s body increases by at least 30% (and
possibly as much as 50%) during pregnancy. Blood loss at a normal vaginal birth is about
300 to 400 mL; blood loss from a cesarean birth can be as high as 800 to 1000 mL
• Because the plasma volume increases faster than red blood cell production, the
concentration of hemoglobin and erythrocytes may decline, giving a woman a
pseudoanemia.
• Heart-To handle the increase in blood volume in the circulatory system, a woman’s
cardiac output increases significantly, by 25% to 50%; the heart rate increases by 10 beats
per minute.
• the heart is shifted to a more transverse position in the chest cavity
• Palpitations in the early months of pregnancy are probably caused by sympathetic nervous
system stimulation; in later months, they may result from increased thoracic pressure caused
by the pressure of the uterus against the diaphragm.
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 Systemic Changes
• Blood Pressure.
• Peripheral Blood Flow.-
• During the third trimester of pregnancy, blood flow to the lower extremities is
impaired by the pressure of the expanding uterus on veins and arteries
• Supine Hypotension Syndrome.
• When a pregnant woman lies supine, the weight of the growing uterus presses the
vena cava against the vertebrae, obstructing blood flow from the lower extremities.
This causes a decrease in blood return to the heart and, consequently, decreased
cardiac output and hypotension
• Blood Constitution.
• The level of circulating fibrinogen, a constituent of the blood that is necessary for
clotting, increases as much as 50% during pregnancy, probably because of the
increased level of estrogen. Other clotting factors, such as factors VII, VIII, IX, and X,
and the platelet count also increase.
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 Systemic Changes
Gastrointestinal System
• Because of the gradual slowing of the gastrointestinal tract, decreased
emptying of bile from the gallbladder may result This can lead to reabsorption
of bilirubin into the maternal bloodstream, giving rise to a symptom of generalized
itching (subclinical jaundice).
• Pressure from the uterus on veins returning from the lower extremities can
lead to hemorrhoids.
• Some pregnant women notice hypertrophy at their gumlines and bleeding of
gingival tissue when they brush their teeth.
• There may be increased saliva formation (hyperptyalism), probably as a local
response to increased levels of estrogen.

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 Systemic Changes
• Urinary System
• Like other systems, the urinary system
undergoes many physiologic changes
during pregnancy. These include
alterations in fluid retention and renal,
ureter, and bladder function. These
changes result from:
• Effects of high estrogen and
progesterone levels
• Compression of the bladder and ureters
by the growing uterus
• Increased blood volume
• Postural influences

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 Systemic Changes
Renal Function

• During pregnancy, a woman’s kidneys must excrete not only the waste products
from her body but also those of the growing fetus
• During pregnancy, urinary output gradually increases (by about 60% to 80%). The
specific gravity of urine decreases. The glomerular filtration rate (GFR) and renal
plasma flow begin to increase in early pregnancy to meet the increased needs of
the circulatory system. By the second trimester, both the GFR and the renal
plasma flow have increased by 30% to 50%, and they remain at these levels for
the duration of the pregnancy.
• Ureter and Bladder Function.
• A pregnant woman may notice an increase in urinary frequency during the
first 3 months of pregnancy, until the uterus rises out of the pelvis and
relieves pressure on the bladder.
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 Systemic Changes
Muscolo-Skeletal System

• Calcium and phosphorus needs are increased during pregnancy, because the
fetal skeleton must be built. As pregnancy advances, there is a gradual
softening of a woman’s pelvic ligaments and joints to create pliability and to
facilitate passage of the baby through the pelvis at birth. This softening is
probably caused by the influence of both the ovarian hormone relaxin and
placental progesterone.
• Pride of pregnancy.- Standing this way, with the shoulders back and the
abdomen forward, creates a lordosis

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 Systemic Changes
Endocrine System

• Estrogen causes breast and uterine enlargement. Palmar erythema during early pregnancy may
also be a response to the high circulating estrogen levels.
• Progesterone has a major role in maintaining the endometrium, inhibiting uterine contractility,
and aiding in the development of the breasts for lactation.
• Relaxin, secreted primarily by the corpus luteum, is responsible for helping to inhibit uterine
activity and to soften the cervix and the collagen in joints.
• hCG is secreted by the trophoblast cells of the placenta in early pregnancy. It stimulates
progesterone and estrogen synthesis in the ovaries until the placenta can assume this role
• hPL, HUMAN PLACENTAL LACTOGEN_also known as human chorionic
somatomammotropin, is also produced by the placenta. It serves as an antagonist to insulin,
making insulin less effective, which allows more glucose to become available for fetal growth. In
addition to these changes, prostaglandins are found in high concentrations in the female
reproductive tract and the decidua during pregnancy.
• Prostaglandins affect smooth muscle contractility to such an extent they may be the trigger that
initiates labor at term.
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 Systemic Changes

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 Systemic Changes
Immune System
• Immunologic competency during pregnancy apparently decreases,
probably to prevent a woman’s body from rejecting the fetus as if it
were a transplanted organ. Immunoglobulin G (IgG) production is
particularly decreased, which can make a woman more prone to
infection during pregnancy. A simultaneous increase in the white
blood cell count may help to counteract the decrease in IgG
response.

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Thank you!
SEE YOU NEXT MEETING.