Hesperian Health Guides

The 9 months of pregnancy

Every day 20,000 people visit the HealthWiki for lifesaving health information. A gift of just $5 helps make this possible!

Make a giftMake a gift to support this essential health information people depend on.


HealthWiki > A Health Handbook for Women with Disabilities > Chapter 10: Pregnancy > The 9 months of pregnancy


A pregnancy usually lasts for 9 months and is divided into 3 parts that each last about 3 months. During each of these 3-month parts, a woman’s body goes through many changes.

Months 1 to 3

When you first become pregnant, and the baby starts to grow, your breasts begin to swell and may be tender. You may feel more tired than usual and also have nausea and some vomiting. (In some places, this is called ‘morning sickness’).

Months 4 to 6

Many women enjoy the 4th, 5th, and 6th months of a pregnancy. Usually they stop feeling sick in the stomach, stop feeling tired, and have a lot more energy. This is also the time when the belly gets bigger, the baby starts to move, and you can hear the baby’s heartbeat.

Months 7 to 9

This is an exciting time during your pregnancy. You will feel the baby move every day. At the same time, your belly is getting bigger and bigger and, depending on your disability, you may be having more difficulties or problems getting through the day. If you experienced difficulties during the first 6 months, these may continue and may even get worse.

During the last month, about 2 weeks before birth, the baby often drops lower in the belly, especially first babies, and you may find it easier to breathe.

What to expect

Feeling the baby move
WWD Ch10 Page 218-1.png

For most women, feeling the baby move inside the belly is the most exciting part of being pregnant. And most women, regardless of their disability, seem to be able to notice the movement, although the sensation can be difficult to recognize at first. Many women describe it as a fluttering movement, and others compare it to gas in the stomach or intestines. Some notice a feeling of pressure inside the belly and then use their hands to feel the movement.

When the baby starts to move in the 4th month, the movements will be very soft and you may not feel them every day. But by the 5th month, you should feel them every day (not all day long--there will be periods of rest in between movements). If you are concerned because you have not felt the baby move for several hours, eat or drink something and then lie on your side in a quiet place for about 30 minutes. During that time you should feel the baby move at least 3 times. If you do not feel or notice any movement, talk with a midwife or health worker.

Hearing the baby's heartbeat

This can be done after about 5 months and gets easier to do as the pregnancy gets more advanced. A baby's heartbeat is very quick and quiet. It is not an easy thing to hear, even for someone with better-than-average hearing, and it is even harder to feel. A birth attendant or health worker can use a fetoscope to listen to the baby's heartbeat. It is difficult for the mother herself to do unless she has a stethoscope (like the one used for taking blood pressure).

WWD Ch10 Page 218-2.png WWD Ch10 Page 218-3.png WWD Ch10 Page 218-4.png
Fetoscopes
A one-ear fetoscope
can be used to hear
the baby's heartbeat.
The baby's heartbeat is quiet and quick. It may sound like a watch ticking under a pillow, only faster.The baby's heartbeat is about twice as fast as a healthy adult heartbeat. You can listen to it yourself with a stethoscope.

Losing a pregnancy (miscarriage)

Women with disabilities are no more likely to have a miscarriage than women who are not disabled. Losing a pregnancy is hard for anyone who wants to have a baby, but it can be especially hard for a woman with a disability. Many people may not think she should get pregnant anyway, and when she does, she will face disapproval in her community. If she has a miscarriage, people assume it is because of her disability. She may think that too.

Miscarriages most often happen during the first 3 months of pregnancy. A miscarriage can happen for many reasons, such as:

a man comforting a blind woman.
Losing a pregnancy is common. If it happens to you, it does not mean you cannot have a healthy pregnancy the next time.
  • unhealthy eggs or sperm
  • a problem with the shape of the womb
  • growths (fibroids) in the womb
  • infection in the womb or vagina
  • an illness, such as malaria
  • heavy work or accidents
  • poisons
  • malnutrition
  • emotional stress or trauma

If you have a miscarriage, take good care of yourself for a few days. This can help prevent you from getting an infection and will help your body heal faster. Try to:

  • Drink plenty of fluids and eat nutritious food.
  • Rest often.
  • Avoid heavy work for 7 days.
  • Bathe regularly, but do not wash out your vagina (douche), or sit in a tub of water until a few days after your bleeding stops.
  • Use clean cloths or pads to catch any blood, and change them often.
  • Do not put anything inside your vagina, and do not have sexual intercourse, for at least 2 weeks, and not until a few days after you stop bleeding.
  • Wait until you have had your monthly bleeding 3 times before trying to get pregnant again. If you wait, there is less chance of having another miscarriage.

Having a miscarriage, whether early or later in a pregnancy, can cause enormous emotional pain and sadness. It can be worse because the people around you may expect that when the pains in your body have gone, you will be fine again. They may not realize how sad you may feel.

Give yourself time to feel sad and cry. Spend time with friends who understand how you feel and don’t force yourself to ‘be happy.’ Some people may suggest you try to get pregnant again right away. Take time to feel ready for another pregnancy.

Pain in the lower belly (abdomen)

Strong, constant pain in the first 3 months may be caused by a pregnancy growing outside the womb in the tube (a tubal, or ectopic, pregnancy). As the tube stretches, it causes pain. If the pregnancy grows large enough, the tube will burst and bleed. This is very dangerous. You will bleed inside your abdomen and may die.

Signs of tubal pregnancy:
a disabled woman holding one side of her abdomen in pain.
  • missed monthly bleeding
  • pain in the lower abdomen on one side
  • slight bleeding from the vagina
  • feeling dizzy, weak, or faint
a woman's womb, ovaries, and tubes.
a pregnancy growing in
the tube

If you have some of these signs, go to the nearest hospital.

Bleeding during pregnancy

Do not worry if you spot or bleed a little during the first 3 months. This is not unusual, especially if there is no pain or cramps.

But you must go to a hospital for medical help right away if you have:

  • bleeding as much as monthly bleeding at any time during your pregnancy.
  • bleeding with pain at any time during your pregnancy.
  • bleeding with no pain after the first 3 months.