First Trimester

05/20/19 ·CompEAP

Congratulations! Your journey to motherhood is underway.

Changes in Your Body

During the first three months of pregnancy, known as 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. Most of these discomforts 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:

Fatigue

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. Fatigue will pass over time and be replaced with a feeling of well-being and more energy. 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 relieves 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.
  • Try drinking carbonated drinks like ginger ale or seltzer in between meals. Sometimes, sniffing a cut lemon will clear your head from strong cooking smells.
  • Ask your health care provider if you should stop taking your prenatal vitamin for a while if it adds to your morning sickness.
If you are vomiting a lot, you may be at risk for dehydration (by losing too much fluid in your body). Contact your health provider about taking vitamin B6 or other treatments.

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 may feel constipated. Headaches can be one symptom of constipation. To prevent constipation, try to eat fresh or dried fruit, raw vegetables, and whole grain cereals or breads every day. Also, try to drink eight to ten glasses of water every day. Some of these servings can be substituted with fruit or vegetable juice. Try to avoid caffeinated drinks, such as coffee, tea, colas, and some other sodas, since caffeine makes your body lose fluid and won’t help with constipation. Walking is good exercise to get your systems moving.

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. To keep your blood flow circulating, 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 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, try propping your feet up on a footstool, box or several books. When relaxing at home, keep your feet up on a footstool, some pillows on the couch, or another chair.

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 low-fat milk and other calcium-rich foods. You also get 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 before 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 by 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 congestion. 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 a half ounce. The eyes and the ears are moving into position. The liver and the kidneys are functioning. 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 early months of pregnancy, 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 – they are all 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 your family health history as it impacts your pregnancy. Factors include diseases, operations, and other pregnancies. You will have a complete physical exam and lab tests. 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 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. If you smoke, quit immediately because 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 or drinking large amounts of alcohol once in a while has 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. Over-the-counter medicines can also have dangerous effects on a pregnancy. 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 work 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.

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, are good choices.

Yoga can be beneficial, but let your leader know you are pregnant since some poses are not advised. 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, 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 infection, or bacterial infection that needs treatment.

Caring for Your Mouth and Teeth

A pregnant woman’s teeth and gums need special care. Pregnant women with gum disease problems have been found 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 that 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 as well as 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.

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:

  • Pain in the vagina or abdomen
  • Bleeding from the vagina
  • Leaking of water (amniotic fluid) from the vagina