1 00:00:08,119 --> 00:00:11,229 Muscles and joints shift and jostle. 2 00:00:11,229 --> 00:00:16,658 The heart’s pounding rhythm speeds up. Blood roars through arteries and veins. 3 00:00:16,658 --> 00:00:21,028 Over the course of a pregnancy, every organ in the body changes. 4 00:00:21,028 --> 00:00:23,514 Ignited by a range of hormones, 5 00:00:23,514 --> 00:00:26,937 these changes begin as soon as pregnancy begins. 6 00:00:30,384 --> 00:00:36,238 Just days after fertilization, the embryo implants in the lining of the uterus. 7 00:00:36,238 --> 00:00:39,608 Because its DNA doesn’t exactly match the mother’s, 8 00:00:39,608 --> 00:00:43,510 the immune system should theoretically recognize it as an invader, 9 00:00:43,510 --> 00:00:48,417 attack, and destroy it, like it would bacteria or other harmful microbes. 10 00:00:48,417 --> 00:00:51,577 That’s the challenge: the mother’s immune system 11 00:00:51,577 --> 00:00:57,083 needs to protect both her and the fetus, but can’t act as it usually does. 12 00:00:57,083 --> 00:01:01,053 What happens is not as simple as decreasing the immune response. 13 00:01:01,053 --> 00:01:06,144 Instead, it’s a complex interaction we’re just beginning to understand, 14 00:01:06,144 --> 00:01:08,984 involving many different types of immune cells— 15 00:01:08,984 --> 00:01:13,523 some of which seem to protect the fetus from attack by other immune cells. 16 00:01:15,977 --> 00:01:20,537 The body also creates an antibacterial plug made of mucus on the cervix, 17 00:01:20,537 --> 00:01:24,512 which keeps germs away and stays sealed until labor. 18 00:01:24,512 --> 00:01:26,096 As a pregnancy progresses, 19 00:01:26,096 --> 00:01:30,076 the uterus expands upward and outward with the growing fetus. 20 00:01:30,076 --> 00:01:33,806 To make room, hormones called progesterone and relaxin 21 00:01:33,806 --> 00:01:36,347 signal muscles to loosen. 22 00:01:36,347 --> 00:01:41,208 The muscles that propel food and waste through the digestive tract also loosen, 23 00:01:41,208 --> 00:01:42,638 which makes them sluggish, 24 00:01:42,638 --> 00:01:46,777 causing constipation as passage through the tract slows down. 25 00:01:46,777 --> 00:01:48,826 Loosened muscles at the top of the stomach 26 00:01:48,826 --> 00:01:52,147 might allow acid to escape into the esophagus and throat, 27 00:01:52,147 --> 00:01:54,347 causing heartburn and reflux. 28 00:01:54,347 --> 00:01:56,607 These changes can worsen morning sickness, 29 00:01:56,607 --> 00:02:03,121 which is caused in part by hormone HCG— and can also happen at other times of day. 30 00:02:03,121 --> 00:02:06,091 As the uterus grows, it pushes on the diaphragm, 31 00:02:06,091 --> 00:02:10,487 the muscle that expands and contracts the chest with each breath. 32 00:02:10,487 --> 00:02:12,917 This limits the diaphragm’s range. 33 00:02:12,917 --> 00:02:17,592 To compensate, the hormone progesterone acts as a respiratory stimulant, 34 00:02:17,592 --> 00:02:21,317 making the pregnant woman breathe faster so both she and the baby 35 00:02:21,317 --> 00:02:25,122 can both get enough oxygen with less lung capacity. 36 00:02:25,122 --> 00:02:29,222 This all may leave the pregnant woman feeling short of breath. 37 00:02:29,222 --> 00:02:32,702 Meanwhile, the kidneys make more erythropoietin, 38 00:02:32,702 --> 00:02:35,812 a hormone that increases red blood cell production. 39 00:02:38,901 --> 00:02:43,690 The kidneys also keep extra water and salt rather than filtering it out into urine 40 00:02:43,690 --> 00:02:46,420 to build up the volume of the blood. 41 00:02:46,420 --> 00:02:50,892 A pregnant woman’s blood volume increases by 50% or more. 42 00:02:50,892 --> 00:02:52,399 But it’s also a bit diluted, 43 00:02:52,399 --> 00:02:56,384 because it only has 25% more red blood cells. 44 00:02:56,384 --> 00:03:00,214 Usually, the body makes blood cells using iron from our food. 45 00:03:00,214 --> 00:03:04,154 But during pregnancy, the fetus is also building its own blood supply 46 00:03:04,154 --> 00:03:06,014 from nutrients in the mother’s food— 47 00:03:06,014 --> 00:03:09,284 leaving less iron and other nutrients for the mother. 48 00:03:09,284 --> 00:03:12,304 The heart has to work extra hard to pump all this blood 49 00:03:12,304 --> 00:03:14,444 through the body and placenta. 50 00:03:14,444 --> 00:03:16,834 A pregnant woman’s heart rate increases, 51 00:03:16,834 --> 00:03:21,334 but we don’t fully understand how blood pressure changes in a healthy pregnancy— 52 00:03:21,334 --> 00:03:23,401 an important area of research, 53 00:03:23,401 --> 00:03:25,904 because some of the most serious complications 54 00:03:25,904 --> 00:03:29,274 are related to the heart and blood pressure. 55 00:03:29,274 --> 00:03:31,921 The expanding uterus may press on veins— 56 00:03:31,921 --> 00:03:35,191 causing fluid buildup in the legs and feet. 57 00:03:35,191 --> 00:03:38,851 If it presses on a large vein called the inferior vena cava, 58 00:03:38,851 --> 00:03:41,949 it might interfere with blood returning to the heart, 59 00:03:41,949 --> 00:03:46,608 causing a dizzying drop in blood pressure after standing for too long. 60 00:03:46,608 --> 00:03:51,220 Some of these changes start to reverse even before birth. 61 00:03:51,220 --> 00:03:54,670 Shortly before delivery, the fetus drops down, 62 00:03:54,670 --> 00:03:56,941 decreasing the pressure on the diaphragm 63 00:03:56,941 --> 00:04:00,911 and allowing the pregnant woman to take deeper breaths. 64 00:04:00,911 --> 00:04:02,491 During labor and birth, 65 00:04:02,491 --> 00:04:05,721 much of the extra fluid in the body is lost when the water breaks. 66 00:04:08,612 --> 00:04:13,232 The uterus shrinks back down in the weeks after birth. 67 00:04:13,232 --> 00:04:16,545 Like the rest of the body, pregnancy affects the brain— 68 00:04:16,545 --> 00:04:20,246 but its effects here are some of the least understood. 69 00:04:20,246 --> 00:04:23,096 Recent studies show differences in brain scans 70 00:04:23,096 --> 00:04:25,606 after pregnancy and early parenting, 71 00:04:25,606 --> 00:04:28,706 and suggest that these changes are adaptive. 72 00:04:28,706 --> 00:04:31,736 That means they could help with parenting skills, 73 00:04:31,736 --> 00:04:37,505 such as an increased ability to read facial cues since babies can’t talk. 74 00:04:37,505 --> 00:04:41,085 The lack of information about pregnancy’s effects on the brain 75 00:04:41,085 --> 00:04:47,174 highlights a general truth: historically, almost all the research around pregnancy 76 00:04:47,174 --> 00:04:51,044 has focused on the fetus, rather than pregnant women. 77 00:04:51,044 --> 00:04:53,775 Experiences of pregnancy vary widely, 78 00:04:53,775 --> 00:04:56,245 both within the range of healthy pregnancies 79 00:04:56,245 --> 00:05:01,711 and due to complicating health conditions— new research will help us understand why, 80 00:05:01,711 --> 00:05:05,271 and develop effective treatments where necessary. 81 00:05:05,271 --> 00:05:08,545 In the meantime, every pregnancy is different, 82 00:05:08,545 --> 00:05:12,269 and it’s important to consult a doctor with any specific questions. 83 00:05:13,189 --> 00:05:16,779 Today, we’re turning an exciting corner, 84 00:05:16,779 --> 00:05:21,723 as more research is devoted to the astounding biology of pregnancy.