My first pregnancy: what I wish I had known back then | Pregnancy

About expecting my first baby, where I felt lost and what would have helped me then.

I remember sitting in the gynaecologist's waiting room with my new pregnancy card in my hand, feeling huge joy and, at the same time, fear that I would get something wrong. I wanted to do everything right. I took the classic route. I paid my gynaecologist extra for an above-standard care package and went to every test they recommended.

It never occurred to me that these tests were recommended, not compulsory. That I could decide about them myself. I simply went to all of them. I thought that was what a good mum did.

I prepared for the birth conscientiously. I read books about natural birth and paid for an online birth-preparation course. I felt ready.

Then our daughter was born. And I found out that I was not ready for so many things. I was completely at the end of my tether and didn't know which way was up.

This article is for you if you are expecting your first baby. I am writing it the way I would have wanted to read it back then. Take from it whatever makes sense to you.

How the body changes

Your body changes from the very first weeks right up to the birth. Every woman experiences it differently, so take this overview as a map, not as a list of things you have to go through. Some of the changes surprised me back then, and I didn't know whether they were normal.

First trimester: invisible work

Nothing shows on the outside yet, but a lot is happening inside. The hormone hCG from the placenta helps keep oestrogen and progesterone levels high, and these protect the pregnancy. So you may:

feel very tired, even after a completely ordinary day,
feel sick or vomit, at any time of day,
have bigger, tender breasts,
need the toilet more often,
have moods that change quickly.

At the same time, the amount of blood in your body starts to grow. By the end of pregnancy there will be almost half as much again.

Second trimester: the bump grows

Nausea and tiredness often ease and your appetite comes back. Your womb grows and by around week 20 it reaches roughly your belly button.

You will usually feel your baby's first movements between weeks 16 and 24, with a first baby often only after week 20. At first they feel like a gentle fluttering, later like kicks.

A dark line (linea nigra) may appear down the middle of your bump, the skin around your nipples may darken and brown patches may appear on your face.
The skin on your bump stretches, may itch, and stretch marks may appear. It helps to moisturise your body every day.
A sharp pain on one side of your lower tummy is often from the ligaments stretching to support your growing womb.
Your breasts keep preparing for breastfeeding.

Third trimester: the body gets ready for birth

Your womb now reaches up under your ribs. You may find it harder to breathe and get heartburn more often. Your body holds on to more water, so your ankles and feet may swell, especially in the evening.

The ligaments and joints in your pelvis loosen to make room for the baby. Together with the growing bump, this can cause back pain.
Now and then you may feel your bump tighten and relax. These are practice contractions (Braxton Hicks). They are irregular, short and usually painless.
Sleep often gets harder, tiredness comes back and you wake more often at night needing the toilet.
A little colostrum, your baby's first milk, may leak from your breasts.
Towards the end, your baby may drop lower, head first, into your pelvis. Then you will need the toilet even more often.

What would have helped me to know: Many of these changes are normal and go away after the birth. But don't be afraid to contact your midwife or doctor whenever you are unsure. Call straight away if:

you have vaginal bleeding,
you have a severe headache, blurred vision, or sudden swelling of your face, hands or feet,
later in pregnancy your baby is moving less than usual or the pattern of movements has changed (don't wait until the morning),
fluid is leaking from your vagina.

Better to call once for nothing. That is not overreacting, it is taking care of yourself and your baby.

Tests: I went to all of them

Every check-up felt a bit like an exam. I waited for the results and only breathed out once everything was fine. I never asked what each test was for or whether I really wanted it.

I don't want to say it was wrong. Many tests make good sense and bring many women peace of mind or timely help. I just wish I had known back then that I had a choice.

Overview of tests

This overview is based on the recommended practice of the Czech Gynaecological and Obstetrical Society (ČGPS ČLS JEP, 2021) and information from VZP, the largest Czech health insurer. It applies to pregnancies without particular risks, and your doctor may adjust it.

✓ = covered by insurance · 💳 = you pay yourself (VZP contributes, see below)

At every check-up

✓ weight, blood pressure, urine, signs that the baby is well
check-ups roughly every 4–6 weeks, from week 34 every 1–2 weeks, from week 40 at least twice a week

1st trimester (up to week 14)

✓ booking appointment and pregnancy card
✓ blood: blood group and RhD, antibodies, blood count, HIV, hepatitis B, syphilis, fasting blood sugar
✓ ultrasound by week 14
✓ / 💳 combined screening (weeks 11–13): the blood part is covered, you pay for the ultrasound part
💳 NIPT (test from the mother's blood)

2nd trimester

✓ ultrasound at weeks 20–22
💳 detailed assessment of fetal anatomy
✓ gestational diabetes test (oGTT) at weeks 24–28
if you are RhD negative: anti-D prevention from week 28

3rd trimester

✓ blood count at weeks 28–34
✓ ultrasound at weeks 30–32
✓ group B strep swab at weeks 35–37
💳 ultrasound screening of the baby's growth at weeks 36–37
check-in at the maternity hospital at weeks 36–37, often booked as early as weeks 32–35 (see below)
CTG (baby's heart monitor) from week 40, at the doctor's discretion

Extra: during pregnancy you are entitled to two preventive dental check-ups.

Maternity hospital: If you decide to give birth in a hospital, because that is a choice too, it pays to look at its website in good time. I will write about home birth in future articles.

The big Prague maternity hospitals no longer require compulsory birth registration (as of October 2026):

Podolí (ÚPMD): registration not needed since 15 March 2024. One visit to the prenatal clinic after completed week 36 for paperwork.
U Apolináře (VFN): no registration needed. They recommend a "first visit" around week 20 (booked through their online diary) and a check-in at weeks 36–37, booked after completed week 34.
Motol (FNMH): registration not required.
Bulovka (FNB): registration is not a condition, but you can register online from 14+0 to help them plan capacity.
Thomayer Hospital (FTN): check-in between 36+0 and 37+6, book at weeks 32–34.
Vinohrady (FNKV): compulsory registration abolished; you can register voluntarily between weeks 12 and 34. Check-in at weeks 36–37, book at weeks 34–35.

What would have helped me to know: The rules change and every hospital does it differently. Look at the website of the hospital you are considering by mid-pregnancy, and note the booking dates so nothing catches you off guard.

Paediatrician: It is good to have chosen your child's GP (praktický lékař pro děti a dorost) before the birth. The first visit should take place within 48 hours of leaving the maternity hospital, and hospitals often ask for the paediatrician's name. In some places practices are full.

What would have helped me to know: Start looking for a paediatrician early, ideally in the first or at the latest the second trimester. Check that the practice is taking new patients and has a contract with your insurer. If you can't find anyone, your health insurer should help you.

Contribution: With VZP you can claim up to CZK 5,000 per pregnancy and the 6 months after birth. It can go towards tests that are not covered (up to CZK 1,500 each for combined screening, the detailed anatomy scan and growth screening, and up to the full amount for NIPT), a birth-preparation course, lactation consultant services or breastfeeding aids. Other insurers have their own programmes, so check the terms with yours.

Remember: screening is a risk estimate, not a diagnosis.

Preparation: books and a course

Books about natural birth gave me courage. In the evenings I read other women's birth stories and told myself that I could do it too. On top of that I paid for an online birth-preparation course.

What I didn't prepare for was breastfeeding. I had no idea there was such a thing as an antenatal breastfeeding course. I assumed breastfeeding would just come.

Birth: accepting the pain

I prepared for a painless birth. It didn't work out. It hurt like nothing before. I fought the pain for many hours, I panicked, and suddenly I was refusing to become a mother.

When I couldn't go on any more, strapped to the birthing chair with the baby monitor on, my husband was holding my hand, which I was crushing through every contraction. And he said: "Try to accept the pain." I tried. And within about an hour our daughter was born.

After the birth: nobody told me this

I thought that once the baby was born, it was over. It wasn't. This is exactly where I was at the end of my tether.

The placenta still has to be born

Many of my friends had no idea that after the baby, the placenta has to be born too. I was lying with my daughter on my chest and suddenly I had to give birth again.

What would have helped me to know: After the baby is born, the womb keeps contracting and pushes out the placenta. This is called the third stage of labour, and it can take a while. It's not a good idea to pull on the umbilical cord. When the baby latches on to the breast, oxytocin is released, which helps the placenta come sooner. It should be born within one to two hours.

Afterpains can hurt

The contractions after birth hurt me. I didn't expect it.

What would have helped me to know: After birth the womb shrinks, helped by contractions. Some women hardly notice them after a first birth; after later births they are usually stronger. They get stronger during breastfeeding, because breastfeeding releases oxytocin.

Babies cry too

I imagined that a newborn mostly sleeps and feeds. But my daughter cried too. And I didn't know what I was doing wrong.

What would have helped me to know: Crying is normal in newborns and doesn't mean you are doing something wrong. What can help:

skin-to-skin contact – your naked baby on your chest. According to the Czech Neonatology Society, among other things it calms the baby, shortens crying and helps breastfeeding get going;
feeding on demand – following what your baby shows you, not the clock. In the first days babies feed often, at night too;
carrying – in your arms, a sling or a carrier, with gentle rocking, talking, singing.

Breastfeeding didn't come by itself

The start of breastfeeding with my daughter was very hard. For a while we had to supplement. I felt like a mother who had failed.

MAMILA's videos and support helped me. Step by step we managed it, and in the end I breastfed my daughter until halfway through my next pregnancy, when my milk supply dropped sharply. I tell the whole story in Breastfeeding: a miracle we sometimes have to learn.

What would have helped me to know: If breastfeeding isn't working, it is not your failure. Help exists, and a lactation consultant can come to you at home or even in the maternity hospital.

A woman becomes a mother

With a first child, it isn't only a baby who is born. A mother is born too. It is a huge transformation. Back then I lived it mainly as confusion. I only understood it with hindsight.

What came next

In my next pregnancies I did things differently. I chose my care more consciously and prepared very practically for a calmer birth.

That is what my next article will be about.

Books that helped me (Czech editions)

Michel Odent – Znovuzrozený porod (Birth Reborn; Argo). The experience of an obstetrician who let birth unfold as naturally as possible.
Marie F. Mongan – Hypnoporod (HypnoBirthing; Triton). On deep relaxation, breath and trust in the body.
Jana Doležalová, Ivana Königsmarková – Hovory s porodní bábou (Argo). A conversation with a Czech midwife, from conception to the postnatal weeks.
Ina May Gaskin – Zázrak porodu (One Woman Press). Birth stories and a midwife's view of physiological birth.

Where to find courses

Birth-preparation course: offered by maternity hospitals and midwives. VZP may contribute to a course run by a maternity hospital or a provider on VZP's list.
Antenatal breastfeeding course:
- MAMILA – the list notes when a consultant offers breastfeeding preparation for pregnant women,
- Laktační liga – certified lactation consultants by region,
You will find more contacts in Where to turn for breastfeeding help.

This content is for information only and does not replace individual care from a midwife, doctor or lactation consultant. If you have any problems, always seek professional care.

Sources

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