My wife is physically fit and super athletic. No smoking, alcohol or drugs before or during pregnancy (as well as zero junk food before or during). And, unsurprisingly, her pregnancy was basically ideal. She had an easier time than any of her friends, but it still kicked her ass - especially the final trimester (fatigue, poor sleep, hormonal swings, etc). She joked it felt like birthing a face hugger from the movie Aliens. Her friends who already had underlying conditions or overall weaker health generally also had the roughest pregnancies, and many of them had various medical complications. They also had higher incidence, severity and duration of post-partum depression which can be a big issue (fortunately, my wife had virtually none). Plus my wife only worked minimally and entirely by choice while having great medical care that was local and which she knew how to fully utilize.