First trimester (week 1-week 12)
During the first trimester your body undergoes many changes. Hormonal changes affect almost every organ system in your body. These changes can trigger symptoms even in the very first weeks of pregnancy. Your period stopping is a clear sign that you are pregnant. Other changes may include:
- Extreme tiredness
- Tender, swollen breasts. Your nipples might also stick out.
- Upset stomach with or without throwing up (morning sickness)
- Cravings or distaste for certain foods
- Mood swings
- Constipation (trouble having bowel movements)
- Need to pass urine more often
- Weight gain or loss
As your body changes, you might need to make changes to your daily routine, such as going to bed earlier or eating frequent, small meals. Fortunately, most of these discomforts will go away as your pregnancy progresses. And some women might not feel any discomfort at all! If you have been pregnant before, you might feel differently this time around. Just as each woman is different, so is each pregnancy.
Second trimester (week 13-week 28)
Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months.
You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move!
As your body changes to make room for your growing baby, you may have:
- Body aches, such as back, abdomen, groin, or thigh pain
- Stretch marks on your abdomen, breasts, thighs, or buttocks
- Darkening of the skin around your nipples
- A line on the skin running from belly button to pubic hairline
- Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. Patches often match on both sides of the face. This is sometimes called the mask of pregnancy.
- Numb or tingling hands, called carpal tunnel syndrome
- Itching on the abdomen, palms, and soles of the feet. (Call your doctor if you have nausea, loss of appetite, vomiting, jaundice or fatigue combined with itching. These can be signs of a serious liver problem.)
- Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.)
Third trimester (week 29-week 40)
You’re in the home stretch! Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Don’t worry, your baby is fine and these problems will lessen once you give birth.
Some new body changes you might notice in the third trimester include:
- Shortness of breath
- Swelling of the ankles, fingers, and face.
- Tender breasts, which may leak a watery pre-milk called colostrum (kuh-LOSS-struhm) Hemorrhoids
- Your belly button may stick out
- Trouble sleeping
- The baby “dropping”, or moving lower in your abdomen
- Contractions, which can be a sign of real or false labor
- As you near your due date, your cervix becomes thinner and softer (called effacing). This is a normal, natural process that helps the birth canal (vagina) to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited — the final countdown has begun!
How your baby develops in the womb
Three weeks after the first day of your last menstrual period, your fertilised egg moves slowly along the fallopian tube towards the womb. Find out what happens next. You might start to notice the first signs and symptoms of pregnancy.
By now the face is slowly forming, and the eyes are more obvious and have some colour in them. You might still be feeling tired and sick, but this should clear up soon. Find out what else happens in the third month of pregnancy.
At 14 weeks, the baby is about 85mm long from head to bottom. If you have been feeling sick and tired, you will probably start to feel better when you are around 13 or 14 weeks pregnant.
Your baby’s body grows bigger so that the head and body are more in proportion and the baby doesn’t look so top heavy.
When you are 24 weeks pregnant, the baby has a chance of survival if it is born. Most babies born before this time cannot live because their lungs and other vital organs are not developed enough.
Your baby may begin to follow a pattern for waking and sleeping. Very often this is a different pattern from yours, so when you go to bed at night, the baby may wake up and start kicking.
By about 32 weeks the baby is usually lying with its head pointing downwards, ready for birth.
Your baby’s bones are starting to harden now, even though the skull bones will stay soft and separated to make the journey through the birth canal easier.
The amniotic fluid now turns into waste, called meconium, in the baby’s intestines, and the soft hair (lanugo) that covered your baby’s body is now almost all gone.
Hallucinations are where someone sees, hears, smells, tastes or feels things that don’t exist outside their mind.
They’re common in people with schizophrenia, and are usually experienced as hearing voices.
Hallucinations can be frightening, but there’s usually an identifiable cause. For example, they can occur as a result of:
- Taking illegal drugs or alcohol
- A mental illness, such as schizophrenia or dementia
- A progressive neurological condition, such as Alzheimer’s disease or Parkinson’s disease
- Loss of vision caused by a condition such as macular degeneration – this is known as Charles Bonnet syndrome
Hallucinations can make you feel nervous, paranoid and frightened, so it’s important to be with someone you can trust.
Hallucinations can also occur as a result of extreme tiredness or recent bereavement. However, these and other rarer causes aren’t covered here.
The typical types of hallucinations and why they occur:
Hearing voices in the mind is the most common type of hallucination in people with mental health conditions such as schizophrenia. The voices can be critical, complimentary or neutral, and may make potentially harmful commands or engage the person in conversation. They may give a running commentary on the person’s actions.
Hearing voices is a well-recognised symptom of schizophrenia, dementia or bipolar disorder, but can be unrelated to mental illness.
The experience is usually very distressing, but it’s not always negative. Some people who hear voices are able to live with them and get used to them, or may consider them a part of their life.
It’s not uncommon for recently bereaved people to hear voices, and this may sometimes be the voice of their loved one.
Illegal drugs and alcohol
People can experience hallucinations when they’re high on illegal drugs such as amphetamines, cocaine, LSD or ecstasy. They can also occur during withdrawal from alcohol or drugs if you suddenly stop taking them.
Drug-induced hallucinations are usually visual, but they may affect other senses. They can include flashes of light or abstract shapes, or they may take the form of an animal or person. More often, visual distortions occur that alter the person’s perception of the world around them.
The hallucinations can occur on their own or as a part of drug-induced psychosis. After long-term drug use, they may cause schizophrenia.
Some people take cannabis to “calm themselves” and relieve their psychotic symptoms, without realising that in the longer term, the cannabis makes the psychosis worse.
Heavy alcohol use can also lead to psychotic states, hallucinations and dementia.
Various prescription medicines can occasionally cause hallucinations. Elderly people may be at particular risk.
Hallucinations caused by medication can be dose-related and they usually stop when you stop taking the medicine. However, never stop taking a medication without speaking to your doctor first and, if necessary, after being assessed by a psychiatrist.
Hallucinations and sleep
It’s relatively common for people to experience hallucinations just as they’re falling asleep (hypnagogic), or as they start to wake up (hypnopompic).
The hallucination may take the form of sounds, or the person may see things that don’t exist, such as moving objects, or a formed image, such as a person (the person may think they’ve seen a ghost).
Hypnagogic and hypnopompic hallucinations are particularly common in people with narcolepsy. However, they can also occur in people without narcolepsy or any disorder. They’re essentially like dreams, and in themselves are nothing to worry about.
Hallucinations in children with a fever
Hallucinations can sometimes occur in children who are ill with a fever.
Charles Bonnet syndrome
It’s estimated that around 60% of people with visual impairment may experience temporary visual hallucinations.
This is known as Charles Bonnet syndrome and it tends to affect older people who have started to lose their sight, although it can affect people of any age.
The hallucinations usually last for about 12 to 18 months and can take the form of simple, repeated patterns or complex images of people, objects or landscapes.
Some of the most common causes of visual impairment include:
- Age-related macular degeneration (AMD) – where the central part of the back of the eye (the macula, which plays an important role in central vision) stops working properly
- Cataracts – when changes in the lens of the eye cause it to become less transparent (clear)
- Glaucoma – where fluid builds up inside the eye, damaging the optic nerve (which relays information from the eye to the brain)
- Diabetic retinopathy – where blood vessels that supply the eye become damaged from a build-up of glucose
In the UK, around 100,000 people are thought to be affected by Charles Bonnet syndrome.
Hallucinations in older people with delirium
Hallucinations can sometimes occur in frail older people who are ill. The hallucinations may start before other signs that the person is unwell. They may be caused by a chest infection or urine infection, for example.
Common ways of suicide
Suicide is the act of intentionally ending your life.
Many people who have had suicidal thoughts say they were so overwhelmed by negative feelings they felt they had no other option. However, with support and treatment they were able to allow the negative feelings to pass.
- Plastic bag and drugs
- Drug poisoning
- Plastic bag and gas
- Carbon monoxide (CO) poisoning
- Jumping off a high building
- Jumping under a train
- Chemical poisoning
- Cyanide and potassium chloride
- Euthanasia and assisted suicide
Most lethal methods of suicide study
Two hundred ninety-one lay persons and 10 forensic pathologists rated the lethality, time, and agony for 28 methods of suicide for 4117 cases of completed suicide in Los Angeles County in the period 1988-1991. Whereas pathologists provided consistent ratings, lay persons demonstrated extreme variability and a tendency to inflate ratings of all three dimensions. Significant gender differences emerged, with females rating frequently used suicide methods more similarly to pathologists than the males did. Males who committed suicide used the most lethal and quickest methods whereas females selected methods varying in lethality, duration, and agony. African Americans were overrepresented in the use of the most lethal and quickest methods.
|Rank||Method Name||Lethality (%)||Time (min)||Agony|
|1||Shotgun to head||99.0%||1.7||5.5|
|3||Gunshot of head||97.0%||2.5||13|
|4||Shotgun to chest||96.4%||1.4||16|
|6||Hit by train||96.2%||17.92||7.08|
|7||Jump from height||93.4%||4.56||17.78|
|8||Gunshot of chest||89.5%||7||21.7|
|12||Set fire to self||76.5%||57||95|
|15||Hit by truck/auto||70.0%||19||63|
|17||Gunshot of abdomen||65.0%||69||74|
|19||Stab of chest||58.5%||96||76|
|21||Overdose illegal drugs||49.4%||116.25||5.25|
|22||Plastic bag over head||23.0%||7||23|
|24||Drowning swimming pool||21.5%||18.5||79|
|25||Stab of abdomen||12.5%||252||78|
|26||Overdose prescription drugs||12.3%||129||8.5|
|27||Overdose non-prescription drugs||6.0%||456||22.5|
Suicide Life Threat Behav. 1995 Fall; 25(3):373-80.
Dimensions of suicide: perceptions of lethality, time, and agony.
15 common causes of suicide:
- Mental illness
- Traumatic experience
- Personality disorders
- Drug addiction / substance abuse
- Eating disorders
- Social isolation/ loneliness
- Relationship problems
- Genetics/ family history
- Philosophical desire/ existential crisis
- Terminal illness
- Chronic pain
- Financial problems
- Prescription drugs
Reasons for domestic abuse
Some immediate causes that can set off a bout of domestic abuse are:
- provocation by the intimate partner
- economic hardship, such as prolonged unemployment
Domestic abuse may start when one partner feels the need to control and dominate the other. Abusers may feel this need to control their partner because of low self-esteem, extreme jealousy, difficulties in regulating anger and other strong emotions, or when they feel inferior to the other partner in education and socioeconomic background.
Some people with very traditional beliefs may think they have the right to control their partner, and that women aren’t equal to men. Others may have an undiagnosed personality disorder or psychological disorder. Still others may have learned this behavior from growing up in a household where domestic violence was accepted as a normal part of being raised in their family.
A partner’s domination may take the form of emotional, physical or sexual abuse. Studies suggest that violent behavior often is caused by an interaction of situational and individual factors. That means that abusers learn violent behavior from their family, people in their community and other cultural influences as they grow up. They may have seen violence often or they may have been victims themselves. Some abusers acknowledge growing up having been abused as a child.
Children who witness or are the victims of violence may learn to believe that violence is a reasonable way to resolve conflict between people. Boys who learn that women are not to be valued or respected and who see violence directed against women are more likely to abuse women when they grow up. Girls who witness domestic violence in their families of origin are more likely to be victimized by their own husbands. Although women are most often the victim of domestic violence, the gender roles can and are reversed sometimes.
Alcohol and drugs may contribute to violent behavior. A drunk or high person will be less likely to control his or her violent impulses toward their partner, so keeping such drinking or drug use episodes to a minimum may be valuable for a person living in a domestic violence situation.
What causes domestic violence?
There is no single cause of domestic violence. It comes from a combination of factors, including society’s attitudes, community responses, and the individual psychology experiences of the abuser and the abused.
Domestic violence is the result of an abuser’s desire for power and control. Many in our society consider women less important and this creates an imbalance of power between the sexes.
As a result male abusers are too often allowed to get away with their actions.
An abortion is the medical process of ending a pregnancy so it doesn’t result in the birth of a baby. It’s also sometimes known as a termination.
The pregnancy is ended either by taking medications or having a minor surgical procedure. One in three women will have an abortion in their lifetime.
How to get an abortion
Abortions can only be carried out in an NHS hospital or a licensed clinic, and are usually available free of charge on the NHS.
There are three main ways to get an abortion on the NHS:
- Contact an abortion provider directly – the British Pregnancy Advisory Service (BPAS), Marie Stopes UK and the National Unplanned Pregnancy Advisory Service (NUPAS) can tell you about eligibility and services in your area
- Speak to your GP and ask for a referral to an abortion service – your GP should refer you to another doctor if he or she has any objections to abortion
- Visit a contraception clinic, family planning clinic, sexual health clinic or genitourinary medicine (GUM) clinic and ask for a referral to an abortion service
When an abortion can be carried out
Most abortions in England, Wales and Scotland are carried out before 24 weeks of pregnancy.
They can be carried out after 24 weeks in certain circumstances – for example, if the mother’s life is at risk or the child would be born with a severe disability.
The length of your pregnancy is calculated from the first day of your last period. If you’re not sure how long you’ve been pregnant, you may need an ultrasound scan to check. Abortions are simpler and safer the earlier they’re carried out. Getting advice early on will give you more time to make a decision if you’re unsure.
What happens during an abortion
Before having an abortion, you’ll attend an appointment to talk about your decision and what happens next.
Whenever possible, you should be given a choice of how you would like the abortion to be carried out.
There are two options:
- Medical abortion (the “abortion pill”) – you take two medications, usually 24 to 48 hours apart, to induce a miscarriage
- Surgical abortion – you have a minor procedure to remove the pregnancy and normally go home soon afterwards
- After an abortion, you’ll probably need to take things easy for a few days. It’s likely you’ll experience some discomfort and vaginal bleeding for up to two weeks.
Risks of an abortion
Abortions are safest if they’re carried out as early as possible in pregnancy.
Most women won’t experience any problems, but there is a small risk of complications, such as:
- Infection of the womb – occurs in up to 1 in every 10 abortions
- Some of the pregnancy remaining in the womb – occurs in up to 1 in every 20 abortions
- Excessive bleeding – occurs in about 1 in every 1,000 abortions
- Damage to the entrance of the womb (cervix) – occurs in up to 1 in every 100 surgical abortions
- Damage to the womb – occurs in 1 in every 250 to 1,000 surgical abortions and less than 1 in 1,000 medical abortions carried out at 12 to 24 weeks
If complications do occur, further treatment – including surgery – may be required.
Having an abortion won’t affect your chances of becoming pregnant again and having normal pregnancies in the future.
Types of Abortion
There are two types of abortion treatment, ‘Medical’ and ‘Surgical’ abortion.
- Medical abortion: The abortion pill
Some women feel that a medical abortion is a more natural process. There are two types of medical abortion:
Abortion pill (also known as early medical abortion) up to 10 weeks
- Involves taking medication to cause an early miscarriage (women experience cramping, pain and heavy bleeding).
- After 9 weeks gestation 2 visits to the clinic will be needed (the visits may be on the same day or up to 3 days apart). Check the details when you book.
- No surgery or anaesthetic.
Abortion pill from 10 weeks up to 24 weeks
- Involves taking medication to cause the womb to contract and push out the pregnancy.
- 2 visits to the clinic are needed.
- Sometimes an overnight stay is needed on the 2nd visit – check when you book.
- Surgical abortion
Surgical abortion involves a quick, minor operation. There are two types of surgical abortion:
Vacuum aspiration up to 15 weeks
- Removes the pregnancy by gentle suction.
- Up to 14 weeks of pregnancy this can be done with local anaesthetic. The quicker recovery time for this option means you can leave the clinic unattended and drive sooner.
- Up to 15 weeks it can be done with sedation (relaxed and sleepy).
- One visit to the clinic and you go home the same day.
Dilatation and evacuation between 15 and 24 weeks
- Carried out with general anaesthetic.
- The pregnancy is removed using narrow forceps passed through the neck of the womb and some gentle suction.
- One visit to the clinic and you go home the same day.
What causes muteness?
According to Robert Cooper, a Professor of Neurobiology at the University of Kentucky, a mute is defined as a person who cannot speak. Dr. Cooper states that the causes of muteness range from brain damage as a result of a low Iodine diet during the baby’s formation, to brain injuries, substance abuse, strokes, Selective Mutism and various other causes. In many cases, the causes of an individual’s muteness can remain undetermined during an entire lifetime.
The University of California at San Francisco (UCSF) released an Intensive Care Nursery House Staff Manual focusing its last pages in Perinatal Substance Abuse. They determined that approximately 11 per cent of infants are exposed to alcohol and/or illicit drugs before delivery. Opiates, cocaine, amphetamines, alcohol and tobacco are the most abused substances by expecting mothers. These substances, according to the UCSF, can have serious adverse neonatal and long-term effects. Muteness has been attributed to prolonged substance abuse that resulted in fetal brain damage, and in both auditory and speech impairments.
One of the most common causes of a person’s muteness is being born deaf. “Hearing is critical to the development of speech and language skills, as it is through listening to others that children learn how to pronounce sounds and words, how to pace their verbal speech, and how to use correct tone, pitch and cadence in their speech,” according to Speech Disorder. Another common denominator among individuals suffering from muteness is Autism. Neurological disorders such as Aphasia, Apraxia of Speech/Dyspraxia and Friedreich’s Ataxia, also play an important role in causing muteness in people suffering from any of these conditions.
https://www.youtube.com/watch?v=MDTifGn_bGU – Video on being a mute
Types of Mutism
Mutism is most commonly found in children and can be traced to one of three commonly seen categories. Akinetic, elective and selective mutism are the three major sub-categories of the disorder. Akinetic mutism is another type of mutism that deals with frontal lobe injuries and usually causes a sufferer to lose the ability to both move and speak. This may also be caused by a treatment of psychosis in which glands in the brain are halted by medicines in order to treat a more severe mental condition.
Elective mutism is a complete lack of speech, to any and everyone, usually resulting from a personal choice of the patient. This may be a reaction to a traumatic event that has caused a mental change in the person or a serious injury that has been sustained to the mouth or throat. Selective mutism is when someone who has the ability to speak chooses not to. While those suffering from this disorder may speak to close family or friends they are usually silent around strangers.
Mutism can be a confusing disease and should be a cause of concern if seen in a child. Underlying factors usually point back to anxiety disorders, even if the mutism cannot be traced back to a medical reason. Doing some early research using the Internet will help you determine which type of mutism a loved one may be affected by and will help find the best treatment options available.
https://digest.bps.org.uk/2015/07/08/the-experiences-of-adults-with-selective-mutism-in-their-own-words/ – The experiences of adults with “selective mutism” in their own words (Research Digest)
Films told by diaries:
Bridget Jones Diary (2001) http://www.imdb.com/title/tt0243155/
The motorcycle Diaries (2004) http://www.imdb.com/title/tt0318462/
The Princess Diaries (2001) http://www.imdb.com/title/tt0247638/
Chernobyl (2012) http://www.imdb.com/title/tt1991245/
Diary of the Dead (2007) http://www.imdb.com/title/tt0848557/