First Trimester of Pregnancy

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.

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 1200 to 1500 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.

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:

Pain in the vagina or abdomen

Bleeding from the vagina