PHYSIOLOGICAL AND EMOTIONAL CHANGES DURING PREGNANCY OBG SYN. 10
📚🤰 Physiological Changes During Pregnancy
📘 Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Midwifery/Obstetric Nursing Exams
✅ 1. Introduction / Definition:
Pregnancy induces systemic physiological changes in a woman’s body to support the growth and development of the fetus and to prepare the body for labor and delivery.
“Physiological changes during pregnancy are adaptations in organ systems that help maintain pregnancy, nurture the fetus, and prepare for childbirth.”
✅ 2. Endocrine System Changes:
hCG: Maintains corpus luteum till placenta takes over
Estrogen: Promotes uterine growth, breast development, increased blood flow
Breasts: Enlarge, tenderness, Montgomery glands visible, colostrum secretion begins in late pregnancy
✅ 10. Psychological Changes:
1st trimester: Ambivalence, emotional swings
2nd trimester: Acceptance, attachment to fetus
3rd trimester: Anxiety about labor, childbirth, and motherhood
✅ 11. Golden One-Liners for Quick Revision:
Blood volume increases by ~50%
Progesterone relaxes smooth muscles → GI & urinary symptoms
Estrogen increases vascularity and pigmentation
Linea nigra and striae gravidarum are normal skin changes
Uterus reaches the level of the umbilicus by 20 weeks
Physiological anemia is due to hemodilution
Frequent urination is normal in early and late pregnancy
✅ 12. MCQs for Practice:
Q1. Which hormone maintains the corpus luteum during early pregnancy? a) Estrogen b) Progesterone ✅ c) hCG d) Oxytocin
Q2. The increased blood volume during pregnancy leads to: a) Polycythemia ✅ b) Physiological anemia c) Hypovolemia d) Hemophilia
Q3. Lordosis in pregnancy is due to: a) Estrogen increase ✅ b) Uterine weight and center of gravity shift c) Reduced calcium d) Fetal pressure on diaphragm
Q4. Linea nigra and chloasma are examples of: a) Digestive changes ✅ b) Skin changes c) Endocrine changes d) Psychological changes
Q5. Which of the following is a respiratory change during pregnancy? a) Decreased tidal volume b) Decreased respiratory rate ✅ c) Increased tidal volume d) Increased oxygen saturation
📚🧠 Emotional Changes During Pregnancy
📘 Highly Important for GNM/BSc Nursing, NHM, AIIMS, NORCET, GPSC & Midwifery/Psychiatric Nursing Exams
✅ 1. Introduction / Definition:
Emotional changes during pregnancy refer to the psychological and mood variations experienced by a woman as a result of hormonal shifts, physical changes, and life adjustments during gestation.
“Emotional changes are common in pregnancy and range from mood swings to anxiety and maternal attachment, influenced by hormonal and psychosocial factors.”
✅ 2. Causes of Emotional Changes:
Hormonal fluctuations: Increased estrogen and progesterone levels
Physical discomforts: Nausea, fatigue, body image changes
Fear and anxiety: Related to labor, delivery, and parenthood
Social and family stress
Previous miscarriage or trauma
Sleep disturbances and fatigue
✅ 3. Trimester-Wise Emotional Changes:
Trimester
Emotional Features
1st Trimester
Ambivalence, irritability, frequent mood swings, fear of miscarriage, self-focus
2nd Trimester
Acceptance of pregnancy, bonding with fetus, more stable mood, increased energy
3rd Trimester
Anxiety about labor/delivery, sleep issues, fear of parenting, impatience to deliver
✅ 4. Common Emotional Reactions:
Excitement and joy – Looking forward to becoming a mother
Anxiety and worry – About health, fetal development, financial readiness
Depressed mood – Often from hormonal imbalance or previous history
Irritability or tearfulness – Common and usually temporary
Body image concerns – Related to weight gain or stretch marks
Fear of pain or cesarean section
✅ 5. Maternal Role Adaptation Stages (Reva Rubin’s Theory):
Stage
Description
Taking-in phase
Passive; mother focuses on self (early pregnancy)
Taking-hold phase
Begins to focus on baby; seeks information (middle)
Letting-go phase
Fully accepts maternal role (late pregnancy/postpartum)
✅ 6. Nursing Responsibilities:
Provide emotional support and reassurance
Allow patient to express fears, thoughts, and concerns
Screen for depression or mood disorders
Educate on normal emotional fluctuations
Encourage partner and family involvement
Refer to mental health professional if signs of clinical depression, anxiety, or psychosis are observed
Excessive worry, panic attacks, or obsessive thoughts
✅ 8. Golden One-Liners for Quick Revision:
Mood swings are common in the first trimester
Bonding with fetus usually begins in the second trimester
Anxiety about labor increases during third trimester
Support and reassurance are key nursing roles
Persistent sadness or fear needs mental health referral
✅ 9. MCQs for Practice:
Q1. Emotional ambivalence is most commonly seen in: a) Second trimester ✅ b) First trimester c) Third trimester d) Postpartum period
Q2. Which hormone is primarily responsible for mood swings in early pregnancy? a) Oxytocin ✅ b) Progesterone c) Insulin d) Relaxin
Q3. In which trimester do most women begin to bond with the fetus? a) First ✅ b) Second c) Third d) Postpartum
Q4. A common emotional concern in the third trimester is: a) Ambivalence ✅ b) Fear of labor and delivery c) Denial of pregnancy d) Morning sickness
Q5. Which of the following is a red flag for referral to a mental health professional? a) Occasional crying b) Anxiety about delivery ✅ c) Thoughts of self-harm d) Body image concerns