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Muscles and joints shift and jostle.
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The heart's pounding rhythm speeds up. Blood roars through arteries and veins.
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Over the course of a pregnancy, every organ in the body changes.
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Ignited by a range of hormones,
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these changes begin as soon as pregnancy begins.
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Just days after fertilization, the embryo implants in the lining of the uterus.
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Because its DNA doesn't exactly match the mother's,
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the immune system should theoretically recognize it as an invader,
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attack, and destroy it, like it would bacteria or other harmful microbes.
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That's the challenge: the mother's immune system
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needs to protect both her and the fetus, but can't act as it usually does.
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What happens is not as simple as decreasing the immune response.
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Instead, it's a complex interaction we're just beginning to understand,
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involving many different types of immune cells—
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some of which seem to protect the fetus from attack by other immune cells.
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The body also creates an antibacterial plug made of mucus on the cervix,
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which keeps germs away and stays sealed until labor.
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As a pregnancy progresses,
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the uterus expands upward and outward with the growing fetus.
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To make room, hormones called progesterone and relaxin
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signal muscles to loosen.
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The muscles that propel food and waste through the digestive tract also loosen,
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which makes them sluggish,
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causing constipation as passage through the tract slows down.
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Loosened muscles at the top of the stomach
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might allow acid to escape into the esophagus and throat,
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causing heartburn and reflux.
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These changes can worsen morning sickness,
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which is caused in part by hormone HCG— and can also happen at other times of day.
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As the uterus grows, it pushes on the diaphragm,
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the muscle that expands and contracts the chest with each breath.
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This limits the diaphragm's range.
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To compensate, the hormone progesterone acts as a respiratory stimulant,
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making the pregnant woman breathe faster so both she and the baby
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can both get enough oxygen with less lung capacity.
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This all may leave the pregnant woman feeling short of breath.
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Meanwhile, the kidneys make more erythropoietin,
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a hormone that increases red blood cell production.
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The kidneys also keep extra water and salt rather than filtering it out into urine
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to build up the volume of the blood.
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A pregnant woman's blood volume increases by 50% or more.
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But it's also a bit diluted,
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because it only has 25% more red blood cells.
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Usually, the body makes blood cells using iron from our food.
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But during pregnancy, the fetus is also building its own blood supply
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from nutrients in the mother's food—
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leaving less iron and other nutrients for the mother.
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The heart has to work extra hard to pump all this blood
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through the body and placenta.
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A pregnant woman's heart rate increases,
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but we don't fully understand how blood pressure changes in a healthy pregnancy—
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an important area of research,
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because some of the most serious complications
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are related to the heart and blood pressure.
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The expanding uterus may press on veins—
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causing fluid buildup in the legs and feet.
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If it presses on a large vein called the inferior vena cava,
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it might interfere with blood returning to the heart,
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causing a dizzying drop in blood pressure after standing for too long.
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Some of these changes start to reverse even before birth.
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Shortly before delivery, the fetus drops down,
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decreasing the pressure on the diaphragm
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and allowing the pregnant woman to take deeper breaths.
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During labor and birth,
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much of the extra fluid in the body is lost when the water breaks.
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The uterus shrinks back down in the weeks after birth.
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Like the rest of the body, pregnancy affects the brain—
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but its effects here are some of the least understood.
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Recent studies show differences in brain scans
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after pregnancy and early parenting,
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and suggest that these changes are adaptive.
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That means they could help with parenting skills,
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such as an increased ability to read facial cues since babies can't talk.
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The lack of information about pregnancy's effects on the brain
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highlights a general truth: historically, almost all the research around pregnancy
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has focused on the fetus, rather than pregnant women.
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Experiences of pregnancy vary widely,
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both within the range of healthy pregnancies
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and due to complicating health conditions— new research will help us understand why,
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and develop effective treatments where necessary.
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In the meantime, every pregnancy is different,
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and it's important to consult a doctor with any specific questions.
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Today, we're turning an exciting corner,
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as more research is devoted to the astounding biology of pregnancy.