Chapter 10

Psychological & Physiological Changes of Pregnancy

What will we learn in this chapter?

• Presumptive, Probable, and Positive Signs
of Pregnancy
• Psychological Changes of Pregnancy
• Psychological Tasks of Pregnancy
• Physiologic Changes of Pregnancy
 Psychological Changes of Pregnancy
that are normal

• Grief
Grief may arise from the realization that one’s roles would be
changed permanently.

• Mood Swings
Also known as emotional lability, this psychological reaction can be
caused by two factors: hormonal changes or narcissism.
 Psychological Changes of Pregnancy
that are normal

Changes in Sexual Desire

• Women who are on the first trimester of pregnancy experience a
decrease in libido mainly because of breast tenderness, nausea,
and fatigue.
• On the second trimester, sexual libido may rise because of
increased blood flow to the pelvic area that supplies the placenta.
• The third trimester might bring an increase or decrease in sexual
libido due to an increase in the abdominal size or difficulty in
finding a comfortable position.
• Estrogen increase may also affect sexual libido as it may bring a
loss of desire.
 Psychological Changes of Pregnancy
that are normal

Stress

• Pregnancy is a major change in roles that could cause stress.

• The discomforts that she may feel could also add up to the stress
she is experiencing.
• Assess whether the woman is in an abusive relationship as it may
contribute further to the stress.
 Psychological Changes of Pregnancy
that are normal

Introversion/Extroversion

• Introversion refers to someone who focuses entirely on her own

body and a common manifestation during pregnancy.
• Some pregnant women also manifest extroversion, or acting more
active, healthier and more outgoing than before their pregnancy.
• Extroversion commonly happens to women who had a hard time
conceiving and finally hit jackpot.
 Psychological Tasks of Pregnancy
https://nurseslabs.com/psychological-changes-pregnancy/
First Trimester: Accepting the Pregnancy

• The shock of learning about a new pregnancy is sometimes too

heavy for a couple, so they need to spend some time
recovering from this life-altering situation and avoid
overwhelming themselves.

• One of the most common reactions of a couple who would be

having a baby for the first time is ambivalence, or feeling both
pleased and unhappy about the pregnancy.
 Psychological Tasks of Pregnancy

Second Trimester: Accepting the Baby

• The woman and her partner will start to merge into the role
of new parents as second trimester closes in.
• Emotions such as narcissism and introversion are commonly
present at this stage.
• Role playing and increased dreaming are activities that help
the couple embrace their roles as parents.
• At this stage, the woman and her partner must start to
concentrate on what it will feel like to be parents.
 Psychological Tasks of Pregnancy

Third Trimester: Preparing for the Baby

• The couple starts to grow impatient as birth nears.

• Preparations for the baby, both small and big, takes place
during this stage.
• The baby’s clothing and sleeping arrangements are set
and the couple is excited for his arrival.
Presumptive Signs
Presumptive signs are signs that are least indicative of a pregnancy. 
These changes can only be felt by the woman but cannot be documented by the healthcare
provider.

• Swollen breasts
•  Nausea & vomiting
• Amenorrhea
• Frequent urination, 
• Fatigue
• Uterine enlargement
•  Quickening
• linea nigra,
• melasma,
• striae gravidarum
• However, these signs
may also denote
other conditions that
the body is
undergoing.
Probable Signs
Probable signs of pregnancy are objective and can be seen primarily by the
healthcare provider. 
These can be taken through laboratory tests and home pregnancy tests to detect the
presence of human chorionic gonadotropin in the blood or in the urine.

• Ballottement is described as the rise of the fetus felt

through the abdominal wall when the uterine segment is
tapped on a bimanual examination.
• The fetal outline can also be now palpated by the examiner
through the abdomen.
• Braxton-Hicks contractions are periodic uterine tightening
and contractions.
Probable Signs
• Chadwick’s sign or a change in the
color of the vagina from pink to
violet is a probable sign.

• Goodell’s sign is a probable sign

that depicts a softening of the
cervix.

• Hegar’s sign is the softening of the

lower uterus.
Positive Signs
There are only three positive
signs of pregnancy that are
documented by the health care
providers.

• Evidence of a fetal outline on

ultrasound.
• With the use of a Doppler
which can auscultate fetal
heart at 12th week.
• The last is fetal movement
felt by the healthcare
provider.
https://nurseslabs.com/physiological-changes-pregnancy/
Thank You for
Listening