Pregnancy- 1 st Trimester

Welcome to your first trimester! This guide walks you through what's happening in your body, how to ease common symptoms, and how to find the care you need from the very beginning.

What is the first trimester?

The first trimester runs from the first day of your last period through the end of week 13. It's a time of rapid change: around weeks 5 to 6, your baby's major organs begin to form, and early heart activity can often be seen on ultrasound.

Common symptoms in the first trimester include:

• Nausea, sometimes with vomiting

• Fatigue

• Mild abdominal cramping

• Tender or swollen breasts

• Frequent urination

• Constipation

• Heartburn

• Nasal congestion

• Mild shortness of breath

• Sore or bleeding gums, due to hormonal changes

Every pregnancy is different. You may feel many of these, or very few.

Why does nausea happen?

About 75% of pregnant women experience some nausea, often called morning sickness, even though it can happen at any time of day. Rising levels of the pregnancy hormones hCG and estrogen are thought to play a role, and they can make you more sensitive to certain smells and tastes. For most women, it eases after the first trimester.

Remedies that may help

• Eat small meals often. Several small meals through the day are easier on your stomach than three large ones. Going too long without eating can make nausea worse.

• Keep a snack by your bed. Eating a few crackers before you get up in the morning can help.

• Try protein before bed. Many women find a protein-rich snack at night, like yogurt, eggs, or chicken, helps them feel better the next morning.

• Ginger. Ginger tea or ginger chews have been studied for pregnancy nausea and are a common first remedy.

• Vitamin B6. Vitamin B6 can ease nausea for many women. Ask your provider about the right dose for you.

• Sparkling water. Some women find small sips of sparkling water or a non-caffeinated soda settling.

• Crackers and cheese. Cheese adds protein and crackers add easy carbs. Choose pasteurized cheese.

If your nausea is severe, talk with your provider. There are safe prescription options, such as a combination of vitamin B6 and doxylamine, and other medications if needed.

What should I be doing in the first trimester?

• Rest. Your body is working hard to support your growing baby, and fatigue is one of the most common early symptoms. Sleep and nap when you can.

• Take a prenatal vitamin. Look for one with at least 400 micrograms of folic acid, which helps prevent certain birth defects. Prenatal vitamins also provide iron, calcium, and iodine.

• Book your first prenatal visit. Many first visits happen around 8 to 10 weeks. This is a good time to start thinking about what kind of care you want.

• Stay hydrated. ACOG recommends 8 to 12 cups of water a day, or 64 to 96 ounces. Hydration also helps with constipation.

• Eat protein-rich meals. Protein in the morning and at night can help steady your energy and may ease nausea.

• Know what's normal for weight. You don't need extra calories in the first trimester. Some women gain a few pounds, and some lose a little because of nausea. Your provider will guide you on what's healthy for you.

What should I avoid in the first trimester?

• Raw or undercooked foods. Skip raw fish (like sushi), undercooked meat, and runny eggs.

• High-mercury fish. Cooked fish is a healthy choice in pregnancy. The FDA recommends 2 to 3 servings a week of low-mercury fish like salmon, shrimp, cod, tilapia, and canned light tuna. Avoid shark, swordfish, king mackerel, marlin, orange roughy, bigeye tuna, and tilefish from the Gulf of Mexico.

• Unpasteurized cheese and milk. Soft cheeses like queso fresco can carry Listeria, a bacteria that can cause miscarriage, stillbirth, or serious infection in newborns. Only buy soft cheeses labeled "pasteurized," and choose trusted brands, since cheese made in unclean conditions can still be contaminated.

• Alcohol, smoking, and vaping. There is no known safe amount of alcohol during pregnancy.

• Too much caffeine. Keep it under 200 mg a day, about one 12-ounce cup of coffee.

• Overheating. Avoid hot tubs and saunas.

Gentle suggestions for your first trimester

• Rest without guilt. Your body is doing important work.

• Explore your care options. Research hospitals and birth centers near you, and ask yourself: do I want an OB-GYN, a midwife, or both?

• Plan for movement. Look into prenatal yoga or gentle walks as you head toward your second trimester. Check with your provider before starting something new.

• Make time for self-care. Dancing, journaling, scrapbooking, meditating, painting, or a slow evening ritual can help you feel grounded through all the changes.

When to call your provider

Call your provider right away if you have:

• Any vaginal bleeding

• Severe abdominal pain or cramping, especially on one side, or shoulder pain

• Fever or chills

• Vomiting so severe you can't keep fluids down, or signs of dehydration

• Dizziness or fainting

Go to the emergency room if bleeding is heavy, such as soaking through a pad in an hour or passing large clots, or if it comes with severe pain, weakness, or dizziness.

This article is for education only and is not medical advice. Always talk with your healthcare provider about your own pregnancy. If you need help finding a provider or birth center, Wombline Care can help you explore your options.

References

• American College of Obstetricians and Gynecologists. How much water should I drink during pregnancy?

• American College of Obstetricians and Gynecologists. Nutrition during pregnancy.

• Centers for Disease Control and Prevention. While pregnant, be careful with queso fresco.

• U.S. Food and Drug Administration and Environmental Protection Agency. Advice about eating fish.

• UT Southwestern Medical Center. Understanding and managing morning sickness.

• Mayo Clinic. Bleeding during the 1st trimester of pregnancy.