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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:
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
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, 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
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
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
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.
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
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
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
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
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
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.
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.
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
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.
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
Pain in the vagina or abdomen
Bleeding from the vagina
Leaking of water (amniotic fluid) from the vagina