Week 11
Ask your midwife or doctor about online antenatal classes – they may be able to recommend one. The charity Tommy’s has lots of useful information on antenatal classes and preparing you for birth.
Placental abruption
The placenta attaches to the wall of the uterus (womb) and supplies the baby with food and oxygen through the umbilical cord.
Placental abruption is a serious condition in which the placenta separates from the wall of the uterus before birth. It can separate partially or completely. If this happens, your baby may not get enough oxygen and nutrients in the womb. You also may have pain and serious bleeding.
Normally, the placenta grows onto the upper part of the uterus and stays there until your baby is born. During the last stage of labor, after the baby is born, the placenta separates from the uterus, and your contractions help push it into the vagina (birth canal). This is also called the afterbirth.
About 1 in 100 pregnant people (1 percent) have placental abruption. It usually happens in the third trimester but it can happen any time after 20 weeks of pregnancy. Mild cases may cause few problems. An abruption is mild if only a very small part of the placenta separates from the uterus wall. A mild abruption usually isn’t dangerous but needs to be followed closely because it can lead to complete separation.
If you have a placental abruption (greater separation between the placenta and the uterus), your baby is at higher risk for:
- Growth problems, called intrauterine growth restriction; identified by ultrasound
- Preterm birth (birth that happens too early, before 37 weeks of pregnancy). An early delivery can be done to save you and your baby
- Stillbirth (when a baby dies in the womb after 20 weeks of pregnancy) if the separation of the placenta is sudden and severe.
Placental abruption is related to about 1 in 10 premature births (10 percent). Premature babies (born before 37 weeks of pregnancy) are more likely than babies born later to have health problems during the first weeks of life, lasting disabilities, and even death.
Placental abruption can cause anemia and life threatening complications for a pregnant person. If it’s not diagnosed and treated immediately there can be hemorrhage and blood clotting complications for both the baby and the pregnant person. Delivery by cesarean birth (c-section) section may be required.
What are the symptoms of placental abruption?
The main symptom of placental abruption is vaginal bleeding. You also may have pain, contractions, discomfort and tenderness or sudden, ongoing belly or back pain. Sometimes, these symptoms may happen without vaginal bleeding because the blood is trapped behind the placenta. If you have any of these symptoms, call your health care provider and go to the hospital right away.
How is placental abruption diagnosed?
If your provider thinks you are having an abruption, you may need to get checked at the hospital. Your provider can look for abruption by doing a physical exam and an ultrasound. An ultrasound can find many, but not all, abruptions. Your provider will also monitor your baby’s heartbeat.
How is placental abruption treated?
Treatment depends on how serious the abruption is and how far along you are in your pregnancy.
Your provider may simply monitor you and your baby. But sometimes you may need to give birth right away.
If you need to give birth right away and if there is time, your provider may give you medicines called corticosteroids. These medicines help speed up the development of your baby’s lungs and other organs.
Mild placental abruption
If you have a mild abruption at 24 to 34 weeks of pregnancy, you need careful monitoring in the hospital. If tests show that you and your baby are doing well, your provider may give you treatment to try to keep you pregnant for as long as possible. Your provider may want you to stay in the hospital until you give birth. If the bleeding stops, you may be able to go home.
If you have a mild abruption at or near full term, your provider may recommend inducing labor or c-section. You may need to give birth right away if:
- The abruption gets worse and you are having increased pain.
- You are bleeding heavily or show signs in your blood tests of severe anemia.
- Your baby has heart rate changes that indicate it is having problems.
Moderate or severe placental abruption
If you have a moderate to severe abruption, you are in a medical emergency and usually need to give birth right away. Needing to give birth quickly may increase your chances of having a c-section.
If you lose a lot of blood due to the abruption, you may need a blood transfusion. An emergency c-section may be needed to save you and your baby. It’s very rare, but if you have heavy bleeding that can’t be controlled, you may need to have your uterus removed by surgery (hysterectomy). A hysterectomy can prevent deadly bleeding and other problems in your body. But it also means that you can’t get pregnant again in the future.
What causes placental abruption?
We don’t really know what causes placental abruption. You may be at higher risk for placental abruption if:
- You had an abruption in a previous pregnancy.
- You have high blood pressure.
- You smoke cigarettes.
- You use cocaine.
- Your belly is harmed from a car accident or physical abuse.
- You’re a person who is 35 or older.
- You have an infection in your uterus.
- You are in preterm labor.
- Your water breaks before 37 weeks.
- You have problems with the uterus or umbilical cord.
- You have more fluid around the baby than is normal.
- You’re pregnant with twins, triplets or more.
- You have asthma.
- You have a sibling who had placental abruption.
- You’ve had a cesarean section in a previous pregnancy.
- You’ve been exposed to air pollution.
- Your sonogram shows evidence of mild separation of the placenta
If I’ve had a placental abruption before, what are my chances of having it again?
If you’ve had a placental abruption in a past pregnancy, you have about a 1 in 10 (10 percent) chance of it happening again in a later pregnancy.
How can you reduce your risk for abruption?
In most cases, you can’t prevent abruption. But you may be able to reduce your risk by getting closely monitored and treated for high blood pressure, not smoking or using street drugs, and always wearing a seatbelt when riding in a car. Your health care provider may also recommend that you take prenatal vitamins, including folic acid.
Last reviewed: September 2021
Week 11
You only have 2 weeks until you start your 2nd trimester. This is when many women start to “glow” and regain their energy as their hormones settle down.
You’ll be offered a range of tests around now that will look at your blood, urine and blood pressure. These tests provide an opportunity to have yours and your baby’s health checked.
What’s happening in my body?
As you start to bulge out a bit, your muscles and ligaments will stretch, and this could give you pains around your stomach. If it hurts a lot, see your midwife or doctor as soon as possible.
Your body is now pumping around up to 50% more blood than usual. The blood feeds your womb, but it can also make you feel hot, sweaty and dizzy. That’s your baby’s way of telling you to rest.
Your baby has previously been fed by a yolk sac, but a new organ called the placenta is about to take over. The placenta will nourish the baby and remove waste. While the switchover happens, the hormones involved could make you feel tired and emotional.
Early pregnancy symptoms (at 11 weeks)
You may be feeling very tired at the moment, but gentle exercise such as walking could help you feel better.
Your early signs of pregnancy could also include:
- aches and pains around your bump
- nausea
- mood swings
- a metallic taste in your mouth
- sore breasts
- indigestion and heartburn
- headaches
- dizziness
- new likes and dislikes for food and drink
- a heightened sense of smell
- a white milky pregnancy discharge from your vagina
- light spotting (see your doctor if you get bleeding in pregnancy)
- cramping, a bit like period pains
- darkened skin on your face or brown patches – this is known as chloasma or the “mask of pregnancy”
- greasier, spotty skin
- thicker and shinier hair
- bloating and the feeling of being bloated (read ways to cope with bloating on week 10’s page)
What to expect from your first scan
Hospitals in England usually offer 2 ultrasound scans during pregnancy. The first is a dating scan between 8 and 14 weeks.
The sonographer (who takes the test) uses harmless invisible waves to build up a detailed picture of the inside of your womb.
The test can include a nuchal translucency test (NT) that measures the fluid at the back of the baby’s neck, as part of a screening process for Down’s syndrome.
What does my baby look like?
Your baby, or foetus, is now around 41mm long from head to bottom, which is about the size of a fig. The head is still supersized, but the body is growing quickly.
The fingers and toes are separating out. There are tiny fingernails and miniature ears.
Although your baby is kicking around inside your womb, you probably won’t feel anything for several weeks.
Your baby is about the size of a fig.
Action stations
See your midwife or GP
Share the news with your GP or ask for an appointment with a midwife at your doctors’ surgery. Alternatively you can refer yourself to your local hospital – look for contact details on their website.
You’ll need to arrange a booking appointment. This usually takes place between weeks 8 and 12, and takes around an hour.
You can talk about the options for your pregnancy and the birth. Plus you’ll be offered screening tests for infectious diseases, and conditions such as Down’s syndrome. You could ask about the Maternity Transformation Programme and how it could benefit you.
You will get your first dating scan at 8 to 14 weeks.
If it’s your first pregnancy you will probably have around 10 appointments and 2 scans in total. Ask if it’s possible to see the same carer for your entire pregnancy, to give you continuity.
Antenatal classes
Ask your midwife or doctor about online antenatal classes – they may be able to recommend one. The charity Tommy’s has lots of useful information on antenatal classes and preparing you for birth.
Antenatal classes will give you the chance to meet other people and prepare you for parenthood. The NCT offers online antenatal classes with small groups of people that live locally to you.
Smoking, drinking and caffeine in pregnancy
Ask your midwife or GP for support.
Vitamins in pregnancy
Take prenatal vitamins. You’re advised to take 400mcg of folic acid every day, until at least week 12. This helps to form your baby’s nervous system and offers some protection from conditions such as spina bifida.
To keep bones and muscles healthy, we need vitamin D. From late March/early April to the end of September, most people make enough vitamin D from sunlight on their skin.
However, between October and early March, consider taking a daily vitamin D supplement because we cannot make enough from sunlight.
Some people should take a vitamin D supplement all year round – find out if this applies to you on the NHS website.
You just need 10 micrograms (it’s the same for grown-ups and kids). Check if you’re entitled to free vitamins.
Exercising in pregnancy
You could start off with just 10 minutes of daily exercise – perhaps take a brisk walk outside. Check out Sport England’s #StayInWorkOut online exercises (scroll to the pregnancy section).
Listen to your body and do what feels right for you.
Healthy eating
There’s no need to eat for 2. You just need to eat a healthy balanced diet, with a variety of different foods every day, including plenty of fruit and veg. Have a look at our guide to healthy eating in pregnancy.
You may be able to get free milk, fruit and veg through the Healthy Start scheme.
Emotional and mental wellbeing
How are you today? If you’re feeling anxious or low, then talk to your midwife or doctor. They can point you in the right direction to get all the support that you need. You could also discuss your worries with your partner, friends and family.
You may be worried about your relationship, or money, or having somewhere permanent to live.
Don’t keep it to yourself. It’s important that you ask for help if you need it.
Sexually transmitted infections (STIs)
Do you think you or your partner could have an STI? If so, get checked out, as this could affect your baby’s development. Talk to your midwife or GP, or visit a sexual health clinic.
Long-term conditions
If you have a long-term health condition, then let your specialist or GP know you’re pregnant as soon as possible.
Don’t stop taking any regular medication without discussing it with your doctor first.
Want to know when the baby’s due?
Use the NHS’s pregnancy due date calculator. You’ll get a more accurate date from your doctor or midwife when you have a dating scan (usually at 8 to 14 weeks).
More in week-by-week
Week 12
There’s a good chance that the placenta is now feeding your baby, having taken over from the yolk sac, and once this happens your hormones will calm down a bit.
