Pregnancy is a life-transforming journey and while there is so much changes that happens during this time, you cannot always be prepared for everything. Here are 10 surprising facts that you did not know were true during pregnancy.

The Nesting Instinct

If you have seen animals look for paper scraps, or take fur out of their own body or collect small twigs and stem to build a nest for their upcoming babies, even if the animals are domesticated, humans do the name. Humans do not take fur or hair out of their body, but we too experience a powerful urge to prepare our home for the baby. We clean it, decorate it and thanks to modern homes, we can now baby proof it do!

Mommy Brain

This happens in the first trimester, when tiredness, morning sickness and other symptoms can make the mother feel worn out and mentally fuzzy, often called the mommy brain. The National Institutes of Health also notes that cognitive function decline in the third trimester of pregnancy, leading to memory problems.

Mood Swings

Premenstrual syndrome (PMS) and pregnancy share several symptoms, such as breast swelling and tenderness, hormonal fluctuations, and mood swings. If you’ve experienced severe mood swings due to PMS, you may notice an intensification of these emotions during pregnancy. It's common to feel joyful one moment and tearful the next as your body adjusts to hormonal changes.

Breast Growth

An increase in breast size is one of the earliest signs of pregnancy apart from your missed period. It happens in the first trimester due to the higher levels of hormones like estrogen and progesterone. The growth continues throughout pregnancy.

Skin Changes

Have you heard about pregnancy glow? This happens because pregnancy women have an increased blood volume, this happens to provide extra blood flow to the uterus and other organs, especially the kidneys. This greater volume brings more blood to the vessels and increases oil gland secretion.

Hair and Nails

During pregnancy, many women notice changes in their hair texture and growth. Hormonal shifts can make hair grow faster and reduce hair loss. However, these changes are typically temporary, and many women experience some hair loss during the postpartum period or after they stop breastfeeding. In some cases, hair growth may also occur in unexpected areas like the face, belly, or around the nipples. Additionally, hair texture can shift, becoming drier or oilier, and some women even notice a change in hair color.

Nails can also undergo changes during pregnancy. Increased hormone levels may cause nails to grow faster and become stronger, but for some women, nails may become more brittle, splitting and breaking more easily. Like hair changes, these nail changes are usually temporary. If your nails are more prone to splitting or tearing, it’s helpful to keep them trimmed and avoid exposure to chemicals in nail polish and nail polish remover.

Your Feet Grow

If you have heard about it, then you already know that it is not just the clothes that do not fit you, it is your shoes too. Extra fluid in the pregnant body also leads to swollen feet. The joints also tend to be looser during pregnancy.

Joint Mobility

Your body also releases hormones like relaxin that prepares your body, especially the cervix for the birth. This loosens the ligament in your body, which may make you less stable .

Varicose veins, constipation, and hemorrhoids

Varicose veins, common in the legs and genital area during pregnancy, result from blood pooling in veins enlarged by pregnancy hormones. They often disappear after delivery. To prevent them, avoid prolonged sitting or standing, wear loose clothing and support hose, and elevate your feet when seated.

Hemorrhoids, which are varicose veins in the rectum, may develop due to increased blood volume and uterine pressure. They can cause pain, itching, bleeding, or stinging, especially during bowel movements. Constipation, caused by hormonal changes and uterine pressure on the large intestine, can worsen hemorrhoids by straining during bowel movements.

Prevent constipation and hemorrhoids by eating a fiber-rich diet, staying hydrated, and exercising regularly. If needed, consult your doctor about stool softeners, laxatives, or creams for relief.

Labor and what goes out of your body

When you are in labor, your amniotic sac, that has fluid that surrounds the baby, breaks or ruptures, which is what is also known as water breaking. For most women contractions start before their water breaks, if not, then the doctor may have to rupture the amniotic sac, in case the cervix is already dilated. Some women may feel the urge to pee, while for some it may feel a trickling their leg.

A new study published in The Lancet Obstetrics, Gynaecology, & Women's Health has revealed an alarming rise in infertility rates among women aged 35 years and older.

The analysis, based on the Global Burden of Disease Study 2023, found that global female infertility could affect nearly 80 million women aged 35–49 by 2036 if current trends continue.

In 2023, an estimated 53.60 million women aged 35–49 were affected by infertility. Nearly 54 million women in this age group sought fertility care, including fertility testing and assisted reproductive technologies such as in vitro fertilization (IVF).

Asia Bears Highest Burden

According to the study, Asia has the highest need for fertility care particularly East Asia reported the highest regional burden, while Australasia has the lowest. At country level, the Central African Republic had the highest reported burden, while Nepal had the lowest.

Although disparities between low- and high-income regions have narrowed, the burden is shifting toward high-income settings, where women are more likely to delay pregnancy and seek fertility testing and treatment.

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The researchers said, "This shift reflects broader social and economic changes, including delayed family planning and greater access to fertility services in some affluent regions".

"Advanced-age female infertility represents a growing global health challenge. Despite improved regional equity, low-SDI countries continue to face significant burdens. This necessitates implementing tailored public health strategies and prioritizing resource allocation to mitigate future burdens," said the researchers from China, Hong Kong, and Singapore in the paper.

To address the rising demand, the authors called for

• expanding and integrating fertility services into primary health care, reducing financial barriers to treatment,
• using innovative delivery methods,
• mobile health tools,
• improve equitable access to fertility care.

Infertility A Growing Global Health Concern

The World Health Organization defines infertility as the failure to achieve a clinical pregnancy after 12 months of regular unprotected intercourse.

Approximately 8–12 per cent of reproductive-aged couples worldwide experience infertility, with the burden disproportionately affecting women aged 35–49 years.

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The study noted that this higher risk is largely biological, driven by age-related declines in ovarian reserve and oocyte quality, which reduce natural fertility, increase miscarriage risk, and lower the success rates of assisted reproductive technologies (ART).

As populations age and socioeconomic transitions continue, the number of women exposed to advanced-age infertility risk is increasing, making it an increasingly important public health issue.

How Was The Study Conducted?

The researchers analyzed data from the Global Burden of Disease (GBD) 2023 study to provide what they describe as the first comprehensive assessment of infertility among women aged 35–49 across 204 countries and territories.

Since 1990, both the age-standardized prevalence rate and disability-adjusted life years (DALYs) attributable to infertility have risen steadily, by 0.45 per cent and 0.47 per cent every year, respectively.

The study projects that infertility cases in women aged 35–49 will continue to rise, reaching nearly 80 million by 2036 in the absence of targeted interventions.

The researchers also found a 23.10% reduction in the relative disparity in infertility-related DALYs between low- and high-Socio-demographic Index (SDI) regions since 1990, indicating progress in equity while highlighting persistent structural gaps in access to care.

A 20-month-old toddler from West Bengal who suffered from recurring urinary tract infections (UTIs) for six months was eventually diagnosed with cystinuria, a rare inherited metabolic disorder that causes recurrent kidney stone formation.

About The Case

The diagnosis came after the toddler experienced persistent UTIs over a period of six months. After multiple episodes of infection couldn’t be solved despite treatment, the doctors discovered the rare condition.

Initially, the doctors believed that it could be vesicoureteral reflux, a condition in which urine flows backward from the bladder towards the kidneys.

However, more investigations revealed an unusual kidney stone caused by cystinuria, an inherited disorder that leads to excessive amounts of the amino acid cystine in urine.

As cystine dissolves poorly in urine, it can crystallise and form stones, which may block urine flow, trigger recurrent UTIs, and damage the kidneys if left untreated for a long time. Doctors at a Bengaluru hospital treated the child using a minimally invasive procedure to remove the stone.

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What Is Cystinuria?

Usually, the kidneys reabsorb cystine after filtering blood. In individuals with cystinuria, this process does not work well.

Large amounts of cystine pass into the urine. As cystine does not dissolve in urine, it forms crystals and eventually stones in the kidneys.

The condition is caused when the child inherits one faulty gene from each parent. Parents who carry one altered gene usually have no symptoms themselves.

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Symptoms & Treatment

Unlike most kidney stones, which are more common in adults, cystinuria presents during childhood or adolescence. Parents must look out for the following symptoms in their children:

• Recurrent urinary tract infections

• Pain while passing urine

• Blood in urine

• Abdominal or flank pain

• Kidney stones at an unusually young age

• Difficulty passing urine if stones obstruct the urinary tract

Although cystinuria has no cure, effective treatment and management can reduce stone formation and protect kidney function. It includes:

• Drinking large amounts of water to dilute urine and reduce the formation of stones

• Reducing salt intake

• Limiting consumption of excessive animal protein

• Medications that make urine less acidic (urine alkalinisation)

• Drugs that reduce cystine stone formation in severe cases

• Surgical or minimally invasive procedures to remove stones when necessary

Parents must seek medical attention when the child faces the following:

• Two or more UTIs within six months or repeated infections over a year

• Recurrent fever without an obvious cause

• Intense pain during urination

• Blood in the urine

• Difficulty in gaining weight

• Persistent irritability

• Recurrent abdominal or back pain

While most recurrent UTIs are caused by common anatomical or behavioural factors, persistent or unusual infections can occasionally point to rare inherited disorders like cystinuria that warrant medical attention.

Early diagnosis and timely treatment can help prevent permanent kidney damage and significantly reduce the frequency of stone formations.

Hypertension or high blood pressure is an increasingly common problem among children and adolescents; many children may not have any obvious signs or symptoms in the early phase. It is said that hypertension in children is a “silent condition,” and therefore, it is of paramount importance that doctors, parents, and teachers are aware of it to detect the condition early.

Symptoms Of High Blood Pressure In Children

While some kids might not have any symptoms at all, there are some signs that shouldn't be overlooked. Recurrent headaches or morning headaches, especially headaches in the back of the head, may occasionally be a sign of high blood pressure. Symptoms can be dizziness, blurred vision, flashers, loss of energy for no known reason, nausea, vomiting, difficulty breathing during exercise, chest pain, palpitations, or frequent nosebleeds for no obvious reason.

There can also be changes in a child's behaviour or physical appearance in the school environment that teachers might observe. Children with high blood pressure often experience headaches, frequent visits to the sick room for weak or dizzy spells and ask to go out of class to rest. Sometimes, symptoms such as difficulty in concentration, sudden drop in school performance, irritability, changes in mood or appearing unusually withdrawn are associated with underlying health problems, such as hypertension.

Some children may be more tired, winded or unwell from sports or physical activity than others and avoid it. These symptoms can be missed and dismissed as stress, poor sleep or lack of interest in studies or sports. Such symptoms may be overlooked and blamed on stress, sleep deprivation or low interest in studies or sports.

Leading Causes & Prevention

Doctors think obesity, poor diet, excessive salt intake, poor sleep, low exercise, and watching too much screen time are all factors that are driving up hypertension rates in kids and teens. Other kidney disease, heart disease, hormone imbalances, or family history can also contribute in some children.

Regular blood pressure checks on children's routine visits are very significant because many children with hypertension may be asymptomatic, experts say. Prompt diagnosis and treatment can prevent complications with the heart, kidneys, brain and eyes in the long term.

It is important that parents and teachers do not shrug off repeated complaints of headaches, fatigue, dizziness or vision problems as insignificant. Early medical assessment can be important in safeguarding a child's long-term health.

By Dr Vaibhav Meshram, Paediatrician, Ruby Hall Clinic