In talking to several people considering pregnancy, two questions come up a lot:
- How much will my work be affected?
- How much will pregnancy suck?
There are occasional people who feel better than usual during pregnancy, and some who are hospitalized for large portions of it. Most of us are somewhere in the middle.
Obviously no one can know in advance how things will go for them personally; the best we have is statistics. So let’s look at those!
I’m just looking at pregnancy here, not pre-conception fertility treatments, actual birth, or postpartum recovery.
Missing work
Aside from how you’ll feel, you might also want to know how your work will be affected.
Even during a healthy pregnancy, you will lose time to routine prenatal appointments. During a normal 40-week pregnancy in the US, you might go for 16 total visits and ultrasounds. (These days you might have some of those appointments virtually.) If you have a complication like gestational diabetes, there might be more appointments.
What about decreased ability to work due to fatigue, nausea, poor sleep, back pain, etc? Measuring how much sick leave people take is not the same thing — you might not be as productive even if you’re able to show up every day. This matters more the more you care about how useful your time at work will be, and not just whether you can clock the hours. I couldn’t find much on this, so I did an informal poll of parents who went to the same college as me on how much their work was affected during their first full pregnancy. Among 53 people, the range went from “barely affected” to “extreme exhaustion” to “had to quit my job.”
So in this group, the most common experience was not losing much productive time at work. But almost a quarter of the sample lost 6 weeks or more.
(I expect this is somewhat overstating the risk of bad experiences because of sampling bias. Three people who answered mentioned they had hyperemesis gravidarum, which is about three times the number you’d expect in a group this size. People who have experienced a problem are probably more interested in answering about it.)
Health and quality of life
Causes of lower quality of life during pregnancy include fatigue, pelvic pain, back pain, poor sleep, nausea and vomiting, and anxiety. Pre-pregnancy anxiety, higher body weight, chronic health conditions, older age, low income, low partner support, and low social support are predictors of worse health-related quality of life during pregnancy. (source, source)
Planned, wanted pregnancies are associated with better health-related quality of life during pregnancy. (source)
Here’s a look at the health of Wisconsin women during normal pregnancy. Note that 25% of the original sample is not included because they developed some problem (mostly preterm labor, more rarely things like gestational diabetes.) That plummeting “vitality” figure during first trimester is the result of questions like “did you feel worn out” and “did you feel full of pep” (which is definitely not how I would describe early pregnancy).
A Dutch study: During some part of the first trimester, 44% of women experienced daily fatigue, 34% for nausea, and 10% for vomiting. (source)
Another Dutch study divided women into groups based on whether their health-related quality of life stayed fairly high, stayed low, declined, or improved during pregnancy. (source) The good news is that nearly two thirds of the women were in the “healthy” category, but the bad news is that late pregnancy is still physically hard.
Nausea and vomiting
AKA morning sickness. For some people it is actually in the morning (I know someone who pulled over to vomit at the same spot of her morning commute each day) and for others it’s at other times or all day.
Nausea and vomiting during pregnancy is probably under-treated. If you’re having a bad time you should definitely ask your care provider about it.
One Australian study asked women at 9-16 weeks of pregnancy about nausea and vomiting during pregnancy (NVP). “Of 116 participants, 72% had NVP, with no baseline (including mental health) differences between women with or without NVP. As classified by modified Pregnancy-Unique-Quantified-Emesis (PUQE) survey, 42% had mild symptoms, 55% moderate and 1% severe. . . . Despite this, we found low treatment utilisation, even in those with moderate/severe symptoms. Women should be encouraged to seek assistance for NVP.”
(Yes, the scale is called PUQE!)
In bad cases, it can be really bad. From a Norwegian study: “Over one fourth of the women with severe NVP considered terminating the pregnancy due to NVP, and three in four considered not to get pregnant again.”
Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, happening in about .5 to 2% of pregnancies. It often requires hospitalization to treat dehydration because you can’t keep anything down. Some people with hyperemesis describe labor as comparatively easy because you know you will finally feel better once it is done.
How much do you bounce back?
In terms of physical function, pretty well. Energy wise, not so much because now you have a baby keeping you up.
A San Francisco study before, during, and after pregnancy:
But for the most part, birth and postpartum will be a topic for another time.