7 Key Changes Every Pregnant Person Should Understand

You’re pregnant and lying awake at 2 AM, Googling or social media scrolling yet another “feeling”. Your body feels like a stranger. Is this normal? Should you call your doctor? The pregnancy app says one thing, your mother says another, and social media has seventeen different opinions.

Meanwhile, you’re preparing for a big presentation at work, and you can’t remember if you already responded to that critical email.

Sound familiar? You’re not alone.

On paper, you’re prepared. And honestly, you feel completely overwhelmed. You’re terrified because you  don’t know what you don’t know. But your challenge isn’t lack of information, it’s lack of clarity for understanding your own transformation.

Why understanding your pregnancy changes reduces anxiety

Research consistently shows that childbirth education lowers anxiety levels and increases confidence. It’s not about memorizing every possible complication, but developing a roadmap for understanding what your body is communicating. When you understand the “why” behind your changes, everything shifts. 

That brain fog making you second-guess yourself? It’s your brain rewiring for heightened emotional attunement and protective vigilance. These are enhanced capabilities that will serve you as both a mother and a leader. Knowledge transforms uncertainty into confidence. 

Understanding terminology enables better discussions. You can ask informed questions, understand your options, and make decisions aligned with your values. You develop shared language with your care team. 

You recognize what’s normal versus what needs attention. This discernment alone can eliminate hours of anxious Googling or social media scrolling and help you distinguish between normal adaptation and genuine red flags. 

When you understand what’s happening physiologically, you can request specific accommodations at work, communicate needs to your partner, and discuss preferences with your provider from informed clarity. You advocate with confidence. 

Here’s what you should know

1. Your hormones are orchestrating everything

Specific hormones guide your entire pregnancy and birth process:

• Oxytocin (the “love hormone”) influences your emotional state and prepares your body for bonding and breastfeeding—this is why you might feel more emotionally connected or tearful at unexpected moments
• Relaxin promotes cervical softening and pelvic ligament flexibility, which is why you might feel less stable or experience new hip and back aches
• Progesterone maintains pregnancy but also slows digestion (hello, heartburn) and increases fatigue
• Prolactin prepares your body for breastfeeding and contributes to that famous “nesting instinct”

Your emotional fluctuations aren’t character flaws—they’re chemically influenced adaptations serving a purpose.

2. Your brain is restructuring

“Pregnancy brain” is real, and it’s not a deficit, it’s an adaptation. Your brain is rewiring for enhanced emotional attunement, improved risk assessment, and heightened protective instincts. Yes, you might forget your keys more often. But you’re also developing enhanced capabilities valuable in leadership: reading emotional cues, assessing risk quickly, and maintaining vigilant awareness.

3. Your pelvis is more adaptable than you think

Your pelvis contains joints that can move and flex. The sacrum and coccyx can rotate to increase the birth passage. Ligaments and muscles work together to support these adaptations. This is why certain movements feel dramatically different during pregnancy, your body is adapting purposefully to allow your baby to move through the birth path in the right manner and timing.

4. Your uterus utilizes its muscle layers

The uterus expands from pear-sized to watermelon-sized, with three distinct muscle layers that build for use during labor. These layers work in coordinated patterns: the upper contracts to create pressure, the middle provides strength, and the lower thins and opens to create the birth path.

5. Your cardiovascular system works overtime

Your blood volume increases 30-50% to support your growing baby. This is why you might feel your heart racing more easily, feel warmer than usual, experience swelling, and tire more quickly. Your body is working incredibly hard to support two lives simultaneously!

6. Your pelvic floor supports and prepares

Your pelvic floor muscles support your growing baby while preparing for birth. They need both strength AND flexibility, not just strengthening. This is why prenatal yoga and specific pelvic floor exercises matter.

7. Your body creates an entire support system

Beyond your baby, your body creates the placenta (an entire organ), amniotic fluid for protection, complex blood vessel systems, and shifts all your organs to accommodate growth. This is why you might experience round ligament pain, pressure in unexpected places, or notice your breathing feels different.

How can you integrate all this knowledge? 

In Daily Life

Distinguish between normal adaptation and red flags. Communicate needs clearly to your partner, friends and loved ones. Practice self-compassion: emotional fluctuations are hormonally influenced, not character failures. Set appropriate activity levels based on understanding cardiovascular changes.

At Work

Understanding hormonal shifts helps you reframe conversations with your manager. Instead of apologizing for forgetting details or needing to be late for a meeting, highlight your enhanced strategic thinking and emotional intelligence. Request accommodations based on physiological reality, not weakness.

With Your Care Team

Ask informed questions. Instead of “Is this normal?” ask “How does this relate to [specific change]?” Advocate for specific care based on understanding, not just anxiety. Make values-aligned decisions rather than defaulting to “whatever the doctor says”.

Knowledge As Portal, Not Pressure

Advancing your knowledge about pregnancy isn’t about becoming an expert on everything that could possibly happen. It’s about developing a framework that turns uncertainty into confidence.

Work on distinguishing between clinical knowledge and embodied understanding. You don’t need a perfect birth, you need to trust in your body’s wisdom so that you can feel empowered through every decision because you understand what your body is doing at each stage.

Ready to deepen your understanding? Get my free Prepared Pregnancy video series specifically designed for those who value evidence-based information and practical frameworks for navigating their pregnancy with confidence. Click here to access.

By mastering the basics, you’ll master your birth.

Dr. Michelle El Khoury

Perinatal Educator & Doula, Founder of Yogamazia

Further Reading

1. American College of Obstetricians and Gynecologists (ACOG). (2022). Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion No. 804. Obstetrics & Gynecology, 139(6), e228–e239. Retrieved from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period
2. Hoekzema E, Barba-Müller E, Pozzobon C, et al. (2017). Pregnancy leads to long-lasting changes in human brain structure. Nat Neurosci, 20(2):287-296. Retrieved https://pubmed.ncbi.nlm.nih.gov/27991897/
3. Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016 Mar-Apr;27(2):89-94. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC4928162/