Congratulations!
Your journey to motherhood is underway.
View the printable version of The First
Trimester
Changes in Your Body
During the first 3 months of pregnancy, or the first trimester, your body is undergoing
many changes. As your body adjusts to the growing baby, you may have nausea, fatigue,
backaches, mood swings, and stress. Just remember that these things are normal during
pregnancy, as your body changes. Most of these discomforts will go away as your pregnancy
progresses. And some women might not have any discomforts! If you have been pregnant
before, you might feel differently with this pregnancy. Just as each woman is different,
so is each pregnancy. And, as your body changes, you might need to make changes to your
normal, everyday routine. Here are some of the most common changes or symptoms you might
experience in your first trimester:
Tiredness
During your pregnancy, you might feel tired even when you've had a lot of sleep at
night. Many women find they're exhausted in the first trimester. Don't worry, this is
normal! This is your body's way of telling you that you need more rest. After all, your
body is working very hard to develop a whole new life. Tiredness will pass over time and
be replaced with a feeling of well being and more energy. When you are tired, get some
rest. Try to get eight hours of sleep every night, and a nap during the day if you can. If
you feel stressed, try to find a way to relax. You might want to start sleeping on your
left side, if you find it more comfortable. This will relieve pressure on major blood
vessels that supply oxygen and nutrients to the fetus. If you have high blood pressure
during pregnancy, it is even more important to be on your left side when you are lying
down.
Nausea and Vomiting
Usually called "morning sickness," nausea and vomiting are common during
early pregnancy. For many women, though, it isn't limited to just the morning. Although it
can seem like it will last forever, nausea and vomiting usually go away after the first
trimester. Try some of these tips to help your nausea:
Eat frequent, small meals (6 to 8 small meals a day, rather than 3 large
meals).
Avoid fatty, fried, or spicy foods.
Try starchy foods, like toast, saltines, cheerios, or other dry cereals.
Keep some by your bed and eat them before you get out of bed in the morning and when you
get up in the middle of the night. Also keep some with you at all times, in case you feel
nauseous.
Try drinking carbonated drinks like ginger ale or seltzer in between
meals.
Ask your health care provider if you should stop taking your prenatal
vitamin for a while if it adds to your morning sickness.
Ask your health care provider if you should take vitamin B6 treatments
for severe nausea and vomiting that doesn't get better with the dietary changes listed
above.
If you are vomiting a lot, you might want to call your health care provider to make
sure you don't get dehydrated (lose too much fluid in your body). When the nausea and
vomiting begins to go away, try to resume a healthy eating plan, and take your prenatal
vitamins.
Frequency of Urination
Running to the bathroom all the time? Frequent urination is common during pregnancy.
Early in pregnancy, the growing uterus presses on your bladder. If you notice pain,
burning, pus or blood in your urine see your health care provider right away. You might
have a urinary tract infection that needs treatment.
Constipation
As your uterus begins to expand, you might notice you're constipated. To prevent
constipation, try to eat fresh or dried fruit, raw vegetables, and whole grain cereals or
breads everyday. Also, try to drink eight to ten glasses of water everyday. Some of these
servings can be substituted with fruit or vegetable juice. Try to avoid caffeinated drinks
(coffee, tea, colas, and some other sodas), since caffeine makes your body lose fluid and
won't help with constipation.
Dizziness
Dizziness, feeling lightheaded, and even fainting can occur at any stage of pregnancy,
since there now is extra blood going down towards your uterus and legs. You can help
relieve these symptoms by lying down on your left side. Or to help prevent them, try
moving around more instead of sitting or standing in one position for a long time.
Varicose Veins and Hemorrhoids
During pregnancy, pressure on the large veins behind the uterus causes the blood to
slow in its return to the heart. This can lead to varicose veins in the legs and hemorrhoids (varicose veins in the vagina or
around the anus). Varicose veins look like swollen veins raised above the surface of the
skin. They can be twisted or bulging, and are dark purple or blue in color. They are found
most often on the backs of the calves or on the inside of the leg, anywhere from the groin
to the ankle. You can try to prevent varicose veins during pregnancy by:
Avoiding tight knee-highs or garters.
Sitting with your legs and feet raised when possible. If you work at a
desk, you can prop your feet up on a footstool, box or several books. Or when relaxing at
home, keep your feet up on a footstool, some pillows on the couch, or another chair.
Click here for more information on varicose veins.
Leg Cramps
At different times during your pregnancy, you might have cramps in your legs or feet.
This is due to a change in the way your body processes, or metabolizes, calcium. One way
to prevent these cramps is to make sure to get enough calcium through nonfat or lowfat
milk, and calcium-rich foods. You also get some calcium in your prenatal vitamin, but you
might need to take a calcium supplement if you don't get enough through your diet. Talk
with your health care provider first about taking calcium supplements.
You can relieve leg and foot cramps by gently stretching the muscle. If you have a
sudden leg cramp, flex your foot towards your body. If you point your foot to stretch your
leg, the cramp could worsen. Wrapping a warm heating pad or warm, moist towel around the
muscle also can help the muscle to relax.
Nosebleeds, Nasal Stuffiness, Bleeding Gums
These little discomforts are the result of hormonal effects on the tissues of your
throat, mouth, and nose. They usually are not serious, and you might not even notice them.
When you blow your nose, you might see a small amount of blood in the tissue. Blow gently,
and stop a nosebleed by just squeezing your nose between your thumb and finger for a few
minutes. See your health care provider, though, if you have nosebleeds that do not stop in
a few minutes or happen often. Any nasal stuffiness that you have during pregnancy should
not be extreme and can be helped by drinking extra water, or with using a cool mist
humidifier in your bedroom. Talk with your health care provider before taking any
over-the-counter or prescription medicines for colds or nasal stuffiness. You can help
bleeding gums by brushing with a soft-bristled toothbrush and flossing daily.
Changes in Your Baby
By the end of this trimester, your baby is about three inches long and weighs about
half an ounce. The eyes move closer together into their positions, and the ears also are
in position. The liver is making bile, and the
kidneys are secreting urine into the bladder. Even though you can't feel your baby move
yet, your baby will move inside you in response to pushing on your abdomen.
Prenatal Care
Visits and Tests
During these special months of pregnancy, especially the early ones, visiting your
health care provider is very important. Your provider will schedule you for regular
check-ups throughout the next nine months to keep your baby healthy and avoid problems
with delivery. Become a partner with your health care provider to manage your care. Keep
all of your appointments - every one is important! Pregnancy typically lasts 40 weeks,
counting from the first day of your last menstrual period. The first trimester lasts 12
weeks, the second from 13 to the end of 27 weeks, and the third from 28 to 40 weeks. Your
health care provider will refer to your pregnancy by the age of the fetus in weeks.
During the first prenatal visit, your health care provider will discuss important parts
of your health history that may have some impact on your pregnancy. These include
diseases, operations, and other pregnancies. There also will be questions about your
family's health history. You will have a complete physical exam, lab tests, and a Pap
test. From now on, your blood pressure, urine, and weight will be checked at every visit.
For special genetic or medical reasons, you may need other lab tests, like blood or urine
tests, cultures for infections, or ultrasound exams. Your health care provider will
discuss them with you during your visits. Your health care provider also will figure out
your expected delivery date and answer questions about any concerns you might have.
Caring For Yourself
Smoking, Alcohol, and Drugs
By taking good care of yourself during pregnancy, you're also nurturing the new life
inside of you. Quit smoking if you smoke, since smoking during pregnancy passes nicotine
and cancer-causing drugs to the fetus. Smoke also keeps your baby from getting needed
nourishment while in your uterus, and raises the risk of fetal death and premature birth
(a low-birth weight baby born too early). Quit drinking if you drink alcohol. The amount
of alcohol needed to cause problems in your baby is not known. But, drinking every day,
drinking large amounts of alcohol once in a while but not all the time, or drinking with
when you are out with friends or at a party, all have been shown to have harmful effects.
Tell your health care provider if you are taking any medications or drugs, since some can
be harmful to your baby's development. Only take drugs or medicines prescribed or approved
by your health care provider. You should never take illegal drugs like marijuana, cocaine,
heroin, speed (amphetamines), barbiturates, LSD, and others. Talk with your health care
provider right away if you need help with quitting smoking or drinking, or a drug habit.
You can also get help with alcohol and drugs by talking with a member of your faith
community, a counselor, or a trusted friend.
Work
Many women continue working through pregnancy. Staying active might help you stay
healthier. If you have a question about the safety of your particular job, talk with your
health care provider.
Nutrition and Weight Gain
What you eat isn't only important for your own health anymore, but for the current and
future health of your baby. Healthy foods are the building blocks for your growing baby
since pregnancy is a complex time of developing new tissues and organs. Throughout
pregnancy, try to make most of your food choices healthy ones. Eating junk food during
pregnancy leads to too much weight gain without meeting your increased need for nutrients.
Folic acid: Folic acid is the most vital nutrient pregnant women need.
Folic acid is a B vitamin that helps prevent neural tube defects (defects of the spine,
brain, or their coverings) and other birth defects like cleft lip and congenital heart
disease. By making sure you consume at least .4 milligrams (mg) of folic acid every day
before getting pregnant and during the first three months of pregnancy, you can help
reduce the risk of these defects. Folic acid is found in dark-green leafy vegetables (like
spinach or kale), beans and citrus fruits, and in fortified cereals and bread. But to make
sure you consume enough folic acid, it is best to take a daily vitamin that contains it.
At your first prenatal visit, your health care provider will talk with you about taking
prenatal vitamins with folic acid and iron. Click here for more information on folic acid.
Iron: Iron is needed to fuel hemoglobin (a type of protein in red
blood cells that helps take oxygen to body tissues for energy and growth) production for
you and your baby. Iron also helps build bones and teeth. A shortage of iron can cause a
condition called anemia. Most women do not have symptoms of anemia, but some might have
extreme fatigue. Your health care provider can check for signs of anemia through the
routine blood tests that are taken in different stages of your pregnancy. If you have
anemia, your health care provider will give you iron supplements to take once or twice a
day. You can help prevent anemia by eating more iron-rich foods like potatoes, raisins,
broccoli, leafy green vegetables, whole-grain breads and iron-fortified cereals.
Key Food Groups: Always remember that you are eating to nourish your
baby, and choose a variety of foods from the daily Food Guide Pyramid. Also, women who are
pregnant or breastfeeding should have at least three servings of milk, yogurt, or cheese
to meet their calcium needs. They should also eat more breads and cereals, fruits,
vegetables, and meat and meat alternatives - up to a total of 2,200 or 2,800 calories. Try
to have three meals every day, or six smaller meals if you have problems with nausea or
heartburn.
Protein-rich foods build muscle, tissue, enzymes,
hormones and antibodies for you and your baby. They also have B vitamins and iron, which
is important for your red blood cells.
Carbohydrates (breads and cereals) give you energy,
iron, B vitamins, some protein, and other minerals. Try to eat whole grains (like whole
wheat bread) because they have more vitamins and fiber.
Milk and other dairy products have calcium, which you
and your baby need for strong bones and teeth. Milk and diary products also have vitamin A
and D, protein, and B vitamins. Vitamin A helps growth, resistance to infection, and
vision. Pregnant women need 1000 milligrams (mg) of calcium each day. Try to have nonfat
milk and milk products to lower your fat intake. Other sources of calcium include dark
green leafy vegetables, dried beans and peas, nuts and seeds, salmon and sardines (with
bones), and tofu.
Fruits and vegetables with vitamin C help you and your
baby to have healthy gums and other tissues, and help your body to heal wounds and to
absorb iron. Examples of fruits and vegetables with vitamin C include strawberries,
melons, oranges, papaya, tomatoes, peppers, greens, cabbage, and broccoli. A variety of
fruits and vegetables also add fiber and other minerals to your diet, and give you energy.
Plus, dark green vegetables also have vitamin A, iron, and folic acid.
Water: Water plays a key role in your diet during pregnancy. It
carries the nutrients from the foods you eat to your baby, and also helps prevent
constipation, hemorrhoids, excessive
swelling, and urinary tract or bladder infections. Most importantly, drinking enough
water, especially in your last trimester, prevents you from becoming dehydrated which can
then lead you to have contractions and premature, or early labor. Pregnant women should
drink at least six to eight ounce glasses of water per day, and another glass for each
hour of activity. You can drink juices for fluid, but they also have a lot of calories and
can cause you to gain extra weight. Coffee, soft drinks, and teas that have caffeine
actually reduce the amount of fluid in your body, so they cannot count towards the total
amount of fluid you need.
Click here for more information on pregnancy and
nutrition
Weight gain: Weight gain during your pregnancy depends on your height
and how much you weighed before you became pregnant. All weight gain during pregnancy
should be gradual, with most of the weight gained in the last trimester.
During the first trimester, it is normal to gain only a small amount of weight, about
one pound per month. According to the American College of Obstetricians and Gynecologists
(ACOG): if you were underweight before becoming pregnant, you should gain between 28 and
40 pounds; if you were overweight, between 15 and 25 pounds. Recent research shows that
women who gain more than the recommended amount during pregnancy and who fail to lose this
weight within six months after giving birth are at much higher risk of being obese nearly
10 years later. Check with your health care provider to find out how much weight gain
during pregnancy is healthy for you.
Exercise
If you have no medical problems with your pregnancy, regular physical activity (30
minutes per day, most days of the week), can help you have a more comfortable pregnancy
and labor. It also helps to lower your risk for having pregnancy problems like high blood
pressure and gestational diabetes. And you will have an easier time getting back into a
healthy body shape and weight after the birth. Normal, low-impact activities, like walking
and swimming, that don't involve a lot of bouncing, stretching your muscles to their
greatest extent, or deeply bending your joints, are good for you. Because your connective
tissues stretch much more easily during pregnancy, high impact or high resistance
exercises that involve a lot of bouncing and extreme muscle stretching can increase your
risk of joint injury. If you haven't exercised regularly before becoming pregnant, you can
still begin an exercise program. Just start slowly and progress gradually. Talk with your
health care provider first about what types of exercise or activities are best for you.
One type of exercise that can help your muscles prepare for delivery, help support your
uterus during pregnancy, and help you to control your urine are pelvic floor exercises
(also called Kegel exercises). Pelvic muscles are the same ones you use to stop and start
your flow of urine. You can do this exercise standing, sitting, or lying down. To do this
exercise: tighten the pelvic floor muscles for five seconds, then relax. Repeat 10 times.
You can also talk with your health care provider about how to do this exercise.
Bathing
Both baths and showers are fine to take during pregnancy, but very hot baths, hot tubs,
and saunas can be harmful to the fetus, or cause you to faint. You also might want to
avoid taking frequent bubble baths or baths with perfumed products that might irritate
your vaginal area, and increase your risk of a urinary tract infection or yeast infection.
Do not use douches, even vinegar-based douches, without first talking with your health
care provider. Although vaginal discharge tends to be heavier during pregnancy, you should
see your health care provider if you have vaginal itching, burning or a heavy discharge.
You could have a urinary tract infection, yeast infection, viral or bacterial infection
that needs treatment.
Caring for Your Mouth and Teeth
A pregnant woman's teeth and gums need special care. We know that pregnant women with
gum disease problems are much more likely to have premature babies with low-birth weight.
This may result from the transfer of bacterial microbes in the mother's mouth to the baby
during the third trimester of pregnancy. The microbes can reach the baby through the
placenta (a temporary organ joining the mother and fetus which supplies the fetus with
blood and nutrients), through the amniotic
fluid (fluid around the fetus), and through the layer of tissues in the mother's
stomach.
Every expectant mother should have a complete oral exam prior to or very early in
pregnancy. All needed dental work should be managed early, because having urgent treatment
during pregnancy, while possible, can present risks. Interventions can be started to
control risks for gum inflammation and disease. This also is the best time to change
habits that may affect the health of teeth and gums, and the health of the baby. Remember
to tell your dentist that you are pregnant! Brush with a soft toothbrush and floss gently
at least twice a day. Click here for more information on oral health for women.
Sexual Relations
It is fine to have sexual intercourse throughout your pregnancy unless your health care
provider tells you not to. Some women who have had miscarriages have to avoid sexual
intercourse during the first three months. You should contact your health care provider if
you have any of the following symptoms during sexual intercourse:
The following resources also can help you with the first trimester of your
pregnancy:
This page last updated: June 2003 |