PNEI of the first trimester of pregnancy

The first trimester of pregnancy, from a PNEI point of view, is defined as the trimester “of chaos”, as is destabilizes and urges the woman to adapt. Hormones induce the woman to become receptive, therefore passive. In order to do so, these hormones slow down the person, overturn daily rhythms, increase sleep, make it impossible to eat at certain times. Progesterone and the baby’s hormones, B-hcgs, are asking the woman to become earth. Stress hormones increase, too. If kept at normal levels, stress hormones make the baby’s implantation into the uterus faster. Cortisol, above all, inducing the syntesis of prostaglandines in the endometrium, makes the uterine soil dewier, richer, even more sensitive. This is why during the first trimester of pregnancy you can feel “sparkles” in your belly: it is due to the prostaglandines that turn the uterus on, like a string of fairy lights being turned on on a Christmas tree. Such sensations can also be like small cramps and come along pinkish discharge, all signs of good implantation.

The first trimester, even of a much desired and sought after pregnancy may put the mother’s psychophysical adaptability to the test and the ups-and-downs might make the woman strangely little enthusiastic about the pregnancy. It is good to know that alternating ambivalence and states of discomfort are completely physiological during this trimester.

The midwife can help the woman and the family accept the adaptation process of the first trimester and accept it for what it is, legitimising ambivalences, thus eliminating the taboo and the stigma that hits a pregnant person facing a crisis. The midwife can also help the woman to orient towards resources, lifestyles, and strategies, in order to better cooperate with the adaptation of the third trimester and can propose antistress- or reharmonising manual treatments. Often, in women who have experienced losses, abortions, or traumas, the first trimester of a pregnancy, although desired, triggers a state of anxiety that makes adaptation more difficult. Also in this case the midwife can help, through touch, visualisations, listening, and presence.

The first interview

Certain care attitudes, if they are not in line with the woman’s real needs at the time of the first interview, may grant prescriptions and projections in a patronizing manner, which trigger anxiety and the feeling that pregnancy is a disease. The belief that you should see a doctor as soon as you learn about the pregnancy, or receiving the information about prenatal diagnostics without having asked for it, being presented the scenario of an ill child and therefore the idea of a voluntary termination of a much-sought pregnancy, may be very damaging for the woman, their image of the baby, and the way they will experience their first trimester of pregnancy. For some women and couple, the sanitary dazzle retards prenatal bonding: the baby constantly undergoes tests, so the parents will only let themselves grow fond of them once they have passed all the tests (bi-test, amniocentesis, morphological ultrasound).

The first interview with a midwife is an imprinting. Healthcare professionals must create culture, demedicalise maternity, and make sure it is not experienced as a disease.

We can call this “slow midwifery”: opposing to the rush of the modern world, the SEAO midwife slows down and prolongs the time devoted to interviews during pregnancy to offer a safe space, where biopsychosocial- and individual aspects are recognised, to value the prenatal bonding process if present, and to embrace ambivalences and fears. This way, the midwife understands when it is the right moment to propose the sanitary care offer (the pregnancy agenda, the proposed tests and so on) and when to propose reharmonising treatments. This approach allows not to overlook the actual needs of the family during the first interview, needs that are rarely just medical.