The process of pregnancy to delivery is a chain of one unit from conception, nidation, introduction of adaptation, maintenance of pregnancy, endocrine changes in preparation for the birth of the baby, and delivery with readiness to care for the baby (Sitanggang et al, 2012). 1. Ovulation Ovulation is the process of releasing ovum which is influenced by a complex hormonal system. During the fertile period, which lasts 20-35 years, only 420 ovum can participate in the maturation process and ovulation occurs (Manuaba, 2012). Every month a woman releases one to two eggs from the ovaries (ovulation) which are captured by the fimbriae and enter the egg (Dewi et al, 2014). The release of an egg (ovum) only occurs once per month, around the 14th day of a normal 28-day menstrual cycle. 2. Spermatozoa Sperm looks like a tadpole consisting of a slightly flattened oval-shaped head filled with a nucleus (nucleus). The neck that connects the head to the middle and the tail can vibrate so that the sperm can move quickly. The length of the tail is about ten times the head.

Uterus The uterus will enlarge in the first months of pregnancy due to increased levels of estrogen and progesterone so that the uterus will increase following the growing size of the fetus in the womb. The normal weight of the uterus is 30 grams, but at the end of 40 weeks of gestation the uterus weighs 1000 grams with a length of 20 cm and a wall of 2.5 cm. At the early gestational age, the shape of the uterus will form like an avocado, slightly flattened. 2. Cervical uteri The cervical uteri in the first trimester of pregnancy undergoes changes due to the influence of estrogen levels. If the uterine carpus contains more muscle then the cervix contains more connective tissue, only 10% muscle tissue. The glands in the cervix will secrete more secretions so that in the first trimester pregnant women secrete a lot of fluid, this is still considered normal. 3. Vagina and vulva The vagina and vulva also experience changes due to the hormone estrogen, the Chadwick's sign will cause the vulva to appear reddish.

a) Severe headaches Headaches that persist and do not go away with rest. You will find that your vision becomes blurred. b) Vision problems Visual changes that identify life-threatening conditions are sudden visual changes. Visual changes such as blurry or ghosted vision and the mother will have a severe headache and may be a sign of preeclampsia. c) Swelling of the face and hands A serious problem if swelling appears on the feet, hands and face, does not go away after rest, and is accompanied by other physical complaints. Is a sign of anemia, heart failure or preeclampsia. d) Severe abdominal pain A life-threatening problem is severe pain that persists and does not go away after rest. e) Reduced fetal movements Fetal movements are felt by the mother at 10 weeks of pregnancy. The baby must move at least 3 times in 3 hours.