First Trimester Pregnancy Guide

Congrats You’re Pregnant! Now What?

Maybe you’re feeling thrilled and have been waiting for this moment for a long time, maybe you’re feeling a little overwhelmed at the thought of becoming a parent, or maybe you’re somewhere in the middle with your emotions, but no matter how you’re feeling, know that you are not alone.

Now is definitely the time to reach out to others you trust for support, especially if you’ve decided to keep the news of your pregnancy quiet for a while. If you have ever experienced a loss, the first trimester can be a difficult time, so finding support in ways that matter for you is so important. Some people might find it helpful to tell a friend about their pregnancy or join an online message board, while others may need to avoid pregnancy content for a while—it’s all about what helps you during this time.

And in the meantime, to help you stay physically comfortable, it might be useful to pick up some first trimester essentials, such as:

• A comfortable, bigger bra
• Peppermint if you’re experiencing nausea—hard candies, gum, or just breathing in a drop of essential oil can all help
• A pregnancy app, if you want, to follow along with your baby’s development
• Prenatal vitamins (be sure it has at least 400 mcg of folic acid)
• Plastic bags, if you’re out and about a lot and have severe morning sickness (don’t ask how we know this, but just trust us)
• A ponytail holder can help you loosen your waistband cheaply—just wrap one end around your button, pull the other through the opening, and fasten
• Acetaminophen (Tylenol) for mild pain. Tylenol is usually recommended over ibuprofen/Motrin for mild pain relief or headaches (some women are more prone to migraines during the first trimester) but always check with your doctor.

What Happens to A Woman’s Body During the First Trimester?

The first trimester of pregnancy will be different for every woman—some women will spend all of their time running to the bathroom to puke (pro tip: always scout out the nearest trash can when going to new places if this is your experience), while others will sail through with nary a nauseous moment in sight.

Physically, some women will also show signs of pregnancy earlier than others. Especially if you’re pregnant for the first time, you may not “show” until well into your second trimester. No matter what the outside looks like, however, there is a lot going on inside your body as your little one grows:

• Your blood volume increases—by almost double, and even more in your later trimesters.
• Your heart is working harder—even by as early as 8 weeks, your heart workload has increased by 20%, which may explain why you’re so darn exhausted.
• Massive hormone changes—hCG, commonly known as the “pregnancy hormone,” peaks at the end of your first trimester.
• Your metabolic rate increases by 15%–bring on the extra calories!
• You use more oxygen—your oxygen consumption goes up by 20%, primarily because you literally are breathing in more air every time you breathe.
• Your breast size will increase, as a result of both blood volume, water retention, and hormonal changes.
• Nearly every single organ and system in your body is affected.
• Your hair shedding cycle changes, so you lose less hair, resulting in that lustrous hair everyone talks about.
• You will have to go to the bathroom more—thanks again to those extra fluids, and hormones doing double filtration duty.

Being Pregnant for the First Time: Symptoms, Hunger and Everything Else

Early pregnancy exhaustion? Insatiable appetite?  Here are some of the symptoms you might experience in your first trimester of pregnancy:

Upset Stomach in First Trimester

Somewhere between 50% and 90% of women experience some form of nausea and vomiting during the first trimester. Doctors aren’t even totally sure why that is, but it’s thought to be due to the hormones that are produced and altered by pregnancy. In most cases, nausea goes away by 20 weeks of pregnancy.

Some women also experience other symptoms of an upset stomach in the first trimester, including diarrhea, constipation, and heartburn. If you can, try to stay hydrated and eat well to balance digestive symptoms.

Cramping in the First Trimester

Many women will experience cramping in the first trimester, as your body adjusts to being pregnant. Often times, the cramping is due to ligaments stretching too, but if you experience any regular cramping, or sudden, severe pain, especially on one side, you should contact your doctor right away.

Spotting during the First Trimester

Bleeding occurs in about 15-25% in the first trimester of all pregnancies, according to the American College of Obstetricians and Gynecologists (ACOG). You could experience light spotting during implantation, which would occur right before your period was due, and in some cases, spotting occurs for different reasons during the first trimester.

The most important thing you should know that is that bleeding does not always mean that a miscarriage is going to happen. However, if you experience bleeding and especially if it is accompanied by any other symptoms, such as cramping, pain, feeling lightheaded, or a fever, you need to call your doctor.

Chills in First Trimester

Some women have reported feeling “chills” during their first trimester, similar to an involuntary shudder, or momentarily cold, even in warm air. And while we will say that hormones can do weird things to you, if your chills during pregnancy are ever accompanied by an actual fever, or any other symptoms such as feeling lightheaded, pain, or bleeding, you need to call your doctor right away.

Fetal Development in the First Trimester

What’s so interesting about the first trimester of pregnancy is that even though it might feel like the time when you look the least pregnant, it’s actually when the most crucial fetal development happens.

While you might feel like you’re spending all your time feeling exhausted or scrounging for a snack that doesn’t make you want to throw up, your baby is actually incredibly busy working on some massive growth and development.

Weeks 1-8

During these weeks, the foundation of all major body parts and systems are set into place:

• The placenta, which provides essential nutrients and hormones to sustain the pregnancy, develops.
• The brain and spinal cord begin to form.
• Fetal heart tissue forms and a heartbeat can be detected by ultrasound as early as 5-6 weeks.
• Limb “buds” appear, so the fetus appears to have hand and feet paddles.
• Eyes, ears, and nose start to develop.
• Eyelids form, but your baby’s eyes will stay closed.
• Genitals start to form.
• All major organs and body systems have been started by 8 weeks.

Weeks 9-12

With the major parts into place, all of the smaller details of fetal development start:

• Teeth begin to form.
• Fingers, toes, and nails start to form.
• Bones and muscles grow.
• Intestines begin development.
• The fetus has a soft backbone that can flex.
• Thin, transparent skin is present.
• Hands are well developed.
• Arms are longer than the legs.

When Should You Go See Your Doctor If You Are Pregnant?

You should call your pregnancy care provider to schedule your first prenatal appointment as soon as you find out you are pregnant.

Every provider will have different policies on when they will see you during your first trimester, but you may have two different types of appointments during your first trimester:

• An initial education visit—during this visit, you may not see your pregnancy care provider, but instead, you will get the bulk of your pregnancy education done, along with preliminary lab work. A nurse or other health professional may go over first trimester education, including advice on things like exercise, nutrition, what symptoms you will be experiencing, and how the rest of your pregnancy care will progress. You will most likely have all of your initial basic bloodwork done during this visit, your weight and urine testing done, and be given a prescription for prenatal vitamins if you haven’t yet.
• Your first doctor’s visit—after your first educational visit, you will see your doctor for the first time. During that first visit, your doctor will perform a pelvic exam, a Pap smear if you are due, and a vaginal ultrasound, depending on their policy, or if you have any complications that warrant it. A vaginal ultrasound provides the most accurate look at fetal development, especially early in the first trimester, since the fetus is so small (only about the size of a blueberry by 8 weeks!).

Your doctor may also offer you a first trimester screening that can be done between 10 and 13 weeks of pregnancy. The first trimester screening is a combination of a blood test that screens for markers of certain chromosomal abnormalities, such as Down Syndrome, and an ultrasound that looks at physical indicators, specifically the thickness of the space the back of the fetal neck, called nuchal translucency.

There is no right or wrong decision about choosing a first trimester screening test—you should discuss that decision with your doctor and your partner. However, you should be aware that not all insurance plans cover first trimester screening, so be sure to check with your own insurance company if finances are a consideration for you.

You should also call your doctor if you experience any of the following symptoms in your first trimester of pregnancy:

• Bleeding
• Regular cramping or back pain
• Sudden pain
• Leaking of any fluids
• Fever
• Nausea and vomiting that is debilitating (it could be a sign of hyperemesis gravidarum, which could leave you at risk for dehydration)