Pregnancy is a weird thing. Changes are sudden and some of them really took me by surprise. Here are the top 5 things that surprised me and why they happen.

1. Respiratory Rate

Heavier breathing was one of the first symptoms that I noticed and it turns out that this occurs for multiple reasons.

o The first is Hormones. Increased progesterone, oestrogen and prostoglandins, leads to an increased sensitivity to CO2, alters smooth muscle tone in airways and increases resistance in airways.

o The second reason is that the enlarged uterus displaces the diaphragm upward. Therefore there airways close sooner and lung volume actually changes during pregnancy.

o Another reason for increased respiratory rate is that O2 consumption actually increases during pregnancy (by about 20%). The O2 demand increases even more during exercise, which explains why I’m so out of breath at the top of every hill!

2. Nosebleed

Total blood volume doubles throughout pregnancy. This coupled with increased respiratory rate and heavier breathing to dry out the small blood vessels in the nose leads to an increase in nosebleeds.

20% of women get nosebleeds during pregnancy, compared to 6% while not pregnant.

3. Weight gain/clothing

The fact that you gain weight in pregnancy isn’t surprising. What I didn’t expect about it was how self-conscious I would be about gaining weight and how quickly my normal clothes would start to feel uncomfortable - even before I started showing!

I am lucky in the fact that since I stopped growing, I really haven’t outgrown clothes so it was really surprising and mentally challenging for me to stop fitting pants and to watch the number on the scale increase. I found that once I got some maternity clothing I started to feel much better about the changes in my body. I needed maternity clothing around wk11-12 which I think is earlier than most women. Even before I was actually showing, normal clothes were really uncomfortable. Potentially due to bloating or general tenderness because even early on the uterus is growing to accommodate the baby and pushing other organs out of the way. Either way, I mainly wore sweatpants even in those early weeks.

4. The eating - nausea cycle

Morning sickness doesn’t just happen in the morning. I had flu-like symptoms for about a month and a half and they were all day long. I also haven’t had specific cravings (yet) but I was adverse to pretty much everything. Now (around 15-16w) I am back to mostly normal eating but I am still very opposed to dairy and beef.

The aversions made it really difficult to eat and not eating made me feel sicker. It was really a tough loop to break out of. I found quinoa chips to be great because they were super mild but still had a bit of protein.

Approximately 70% of pregnant women experience morning sickness so again, not really that surprising but I really couldn’t believe how sick I felt and how foods I love could sound so terrible (I wasn’t even in the mood for my morning coffee!!)

5. Eye changes

Eye changes are what caught me most off guard! The most noticeable change so far has been that I cannot wear my contacts all and sometimes they don’t seem to fit correctly in my eyes.

Most ocular changes in pregnancy are harmless and will go back to normal during the postpartum period. These typical changes include changes in both shape and thickness of the cornea due to increased fluid retention. Contact lens intolerance has been reported in pregnant women, likely due to those changes. It has also been shown that Intraocular pressure decreases which can lead to blurry vision, cornea swelling or cataracts. Around 14% of women have a changed prescription during pregnancy.

(1) LoMauro A, Aliverti A. Respiratory physiology of pregnancy: Physiology masterclass. Breathe (Sheff). 2015;11(4):297-301. doi:10.1183/20734735.008615

(2) https://www.pregnancybirthbaby.org.au/nosebleeds-during-pregnancy

(3) https://my.clevelandclinic.org/health/diseases/16566-morning-sickness-nausea-and-vomiting-of-pregnancy

(4) Naderan M. Ocular changes during pregnancy. J Curr Ophthalmol. 2018;30(3):202-210. Published 2018 Jan 3. doi:10.1016/j.joco.2017.11.012