Behavioral Changes in Pregnancy

Assessment/Characteristics	Nursing Care Plan/Implementation
First Trimester Emotional lability (mood swings) Displeasure with subjective symptoms of early pregnancy (nausea, fatigue, etc.) Feelings of ambivalence	Encourage verbalization of feelings, concerns Health teaching: diet, rest, relaxation, diversion Validate normalcy of feelings, behaviors
Second Trimester Accepts pregnancy (usually coincides with awareness of fetal movement, i.e., “quickening”) Becomes introspective: resolves old conflicts (feelings toward mother, sexual intimacy, masturbation) Reevaluates self, lifestyle, marriage Daydreams, fantasizes self as “mother” Seeks out other pregnant women and new mothers	Encourage exploration of feelings of dependency, introspection, mood swings Discuss childbirth preparation and preparation-for-parenthood classes; refer, as necessary
Third Trimester Altered body image Fears body mutilation (stretching of body tissues, episiotomy, cesarean birth) Distress over loss of control over body functions (ptyalism, colostrum leakage, leukorrhea, urinary frequency, constipation, stress incontinence Anxiety for baby (deformity, death) Fears pain, loss of control in labor Acceptance of impending labor during last 2 wk (ready to “move on”)	Encourage verbalization of concerns, discomforts of late pregnancy Help meet dependency needs; offer reassurance, as possible Health teaching: Kegel exercises; preparation for labor. Anticipatory guidance and planning for needs of self, baby, and family in early postpartum