The first trimester of pregnancy is marked by an invisible — yet amazing — transformation. And it happens quickly. Hormones trigger your body to begin nourishing the baby even before tests and a physical exam can confirm the pregnancy.
Knowing what physical and emotional changes to expect during the first trimester can help you face the months ahead with confidence:
Pregnancy is different for every woman. Some women glow with good health and vitality during those first three months; others feel absolutely miserable. Here are some of the changes you might experience, what they mean, and which signs warrant a call to your doctor.
The first trimester begins on the first day of your last period and lasts until the end of week 12. This means that by the time you know for sure you’re pregnant, you might already be five or six weeks pregnant!
A lot happens during these first three months. The fertilised egg rapidly divides into layers of cells and implants in the wall of your womb where it carries on growing. These layers of cells become an embryo, which is what the baby is called at this stage.
During this trimester, your baby grows faster than at any other time. By six weeks, a heartbeat can usually be heard and by the end of week 12, your baby’s bones, muscles and all the organs of the body have formed. At this point, your baby looks like a tiny human being and is now called a fetus. He or she will even be practising swallowing!
First Trimester of Pregnancy: Changes in Your Body
Bleeding. About 25% of pregnant women experience slight bleeding during their first trimester. Early in the pregnancy, light spotting may be a sign that the fertilized embryo has implanted in the uterus. However, if you have significant bleeding, cramping, or sharp pain in your abdomen, call your doctor. These could be signs of a miscarriage or ectopic pregnancy (a pregnancy in which the embryo implants outside of the uterus).
Breast tenderness. Sore breasts are one of the earliest signs of pregnancy. They’re triggered by hormonal changes, which are preparing your milk ducts to feed your baby, and will probably last through the first trimester. Going up a bra size (or more) and wearing a support bra can make you feel more comfortable; you can go back to the lacy bras after your baby is finished nursing.
Constipation. During pregnancy, the muscle contractions that normally move food through your intestines slow down because of higher levels of the hormone progesterone. Add to that the extra iron you’re getting from your prenatal vitamin, and the result is uncomfortable constipation and gas that can keep you feeling bloated throughout your pregnancy. Increase your fiber intake and drink extra fluids to keep things moving more smoothly. Physical activity can also help.
If your constipation is really bothering you, talk to your doctor about what mild laxative or stool softeners are safe to use during pregnancy.
Discharge. It’s normal to see a thin, milky white discharge (called leukorrhea) early in your pregnancy. You can wear a panty liner if it makes you feel more comfortable, but don’t use a tampon because it can introduce germs into the vagina. If the discharge is foul-smelling, green, or yellow, or if there’s a lot of clear discharge, call your doctor.
Fatigue. Your body is working hard to support a growing fetus, which can wear you out more easily than usual. Take naps or rest when you need to throughout the day. Also make sure you’re getting enough iron (too little can lead to anemia, which can cause excess fatigue).
Food cravings and aversions. Although you may not want a bowl of mint chip ice cream topped with dill pickles, as the old stereotype goes, your tastes can change while you’re pregnant. More than 60% of pregnant women experience food cravings, and more than half have food aversions, according to research. Giving in to cravings from time to time is OK, provided you are generally eating healthy, low-calorie foods. The exception is pica — a craving for non-foods like clay, dirt, and laundry starch, which can be dangerous for you and your baby. If you experience this kind of craving, report it to your doctor right away.
Frequent urination. Your baby is still pretty small, but your uterus is growing and it’s putting pressure on your bladder. As a result, you may feel like you constantly have to go to the bathroom. Don’t stop drinking fluids — your body needs them — but do cut down on caffeine (which stimulates the bladder), especially before bedtime. When nature calls, answer it as soon as you can. Don’t hold it in.
Heartburn. During pregnancy, your body produces more of the progesterone hormone which relaxes smooth muscles — including the ring of muscle in your lower esophagus that normally keeps food and acids down in your stomach. This muscle relaxation can lead to acid reflux, otherwise known as heartburn. To avoid the burn, eat frequent, smaller meals throughout the day; don’t lie down right after eating; and avoid greasy, spicy, and acidic foods (like citrus fruits). You can also try raising your pillows when you sleep.
Mood swings. Increased fatigue and changing hormones can put you on an emotional roller coaster that makes you feel alternately elated and miserable, cranky and terrified. It’s OK to cry, but if you’re feeling overwhelmed, try to find an understanding ear — if not from your partner, then from a friend or family member.
Morning sickness. Nausea is one of the most universal pregnancy symptoms, affecting up to 85% of pregnant women. It’s the result of hormone changes in the body, and it can last through the entire first trimester. For some pregnant women, nausea is mild; others can’t start their day without vomiting. Nausea is usually worst in the morning (hence the name, “morning sickness”). To calm your nausea, try eating small, bland, or high-protein snacks (crackers, meat, or cheese) and sipping water, clear fruit juice (apple juice), or ginger ale. You may want to do even do this before getting out of bed. Avoid any foods that make you sick to your stomach. Nausea itself isn’t anything to worry about, but if it persists or is severe, it can affect the amount of nutrition getting to your baby, so call your doctor if you can’t stop vomiting or can’t keep down any food.
Weight gain. Pregnancy is one of the few times in a woman’s life when weight gain is considered a good thing, but don’t overdo it. During the first trimester, you should gain about 3 to 6 pounds (your doctor may recommend that you adjust your weight gain up or down if you started your pregnancy underweight or overweight). Although you’re carrying an extra person, don’t go by the adage of “eating for two.” You only need about an extra 150 calories a day during your first trimester. Get those calories the healthy way, by adding extra fruits and vegetables, milk, whole-grain bread, and lean meat to your diet.
Any of these symptoms could be a sign that something is seriously wrong with your pregnancy. Don’t wait for your prenatal visit to talk about it. Call your doctor right away if you experience:
- Severe abdominal pain
- Significant bleeding
- Severe dizziness
- Rapid weight gain or too little weight gain
First Trimester: To-Do List
Start a prenatal vitamin. If you haven’t already, start taking a prenatal vitamin immediately — doing so in the first trimester has been shown to greatly reduce the risk of neural tube defects (like spina bifida).
Choose your practitioner. There are a number of different practitioners you can choose for your pregnancy, from OB-GYN to midwife to family physician. So take time to consider your options and pick the right practitioner for your needs.
Book your first ob-gyn visit. Your doctor will review your medical history and perform a thorough physical exam. You’ll likely undergo a battery of tests, including a Pap smear, urinalysis and blood work to determine your blood type and Rh status, hCG levels and the presence of any infections. You’ll likely have an initial ultrasound to confirm a heartbeat, date your pregnancy and be sure things are progressing as they should. You might also be screened for genetic illnesses or diabetes, depending on your family history. While your practitioner will ask lots of questions, be prepared to ask plenty of your own: Now’s the time to inquire about the safety of any medications you’re currently taking, help for quitting smoking or anything else that’s on your mind.
Consider genetic tests. You’ll likely have a nuchal translucency screening (between weeks 11 and 14 of pregnancy) to look for
Down syndrome and congenital heart defects, based on your risks, your practitioner may also recommend NIPT around week 9 (a noninvasive blood screening that looks for chromosomal abnormalities) and/or invasive but more definitive prenatal tests (chorionic villus sampling or amniocentesis).
Look into health insurance options. The cost of pregnancy varies based on a number of factors (and it’s a whole lot more expensive if you don’t have health insurance). So now’s the time to sign up for a plan or review the terms of your policy, focusing on your premiums and co-insurance to keep your overall costs as low as possible. The good news: You can still take steps to reduce your prenatal insurance costs.
Make a budget. Growing your family is an excellent — and necessary — time to reevaluate your monthly expenses. So learn the cost of having a baby, then set up your monthly budget.
Eat right. Now’s the time to cut down on caffeine, as well as to learn which foods to avoid and which to feature in your pregnancy diet so you can stock your kitchen accordingly.
Carve out time for fitness. There are lots of benefits of exercise during pregnancy for you and baby — which can be good motivation to get your 30 minutes of physical activity most days of the week. Not sure where to start? Try these pregnancy-friendly workouts.
Start thinking about baby names. If you don’t have a baby name in mind, it’s never too early to start tossing around ideas.
Plan to announce your pregnancy. Think about how and when you want to tell your friends and family the good news, and if and when you’ll announce on social media. Most women wait until the end of the first trimester to do so, when risk of miscarriage is lower. And if you’re employed, start thinking about when to tell your boss your pregnant and what to say; do your research in advance to understand your company’s maternity leave policies.