First Trimester Overview — Conception through week 13
What's going to happen during physician visits?
First signs of pregnancy Pregnancy — in all its accompanying signs, symptoms, and surprises — is different for every woman, especially in the first trimester. Some women feel physically out of sorts, while others experience emotional upsets (as if they were premenstrual). For the more fortunate, the only sign of having conceived is the absence of menstruation.
If you think you may be pregnant, be on the lookout for any or all of these telltale signs:
tender, swollen breasts
cravings for certain food
darkening of the skin around the nipples (areolas)
On the emotional end, you may feel weepy, unstable, irrational, and all-around irritable. If you're more prone to mood swings, you may feel joy and elation on a good day and, on a less-than-cheery one, misgivings or fear. These feelings may set in as early as the first month of pregnancy, or they may develop sometime in the second. If you're really lucky, they may not affect you at all.
Note: If you have any bleeding, pelvic pain, non-stop vomiting (unable to even tolerate liquids), painful urination, or sudden swelling of your hands, feet, or face, you should call your doctor immediately.
How old is your baby? When conception takes place, it happens midway in your menstrual cycle or at approximately 2 weeks after your last period. When you calculate your due date, that 2 weeks is counted in the calculation, therefore your estimated due date will span 40 weeks (dating back to your last period), instead of the 38 weeks since conception. *
Once you know your due date, sign up for our free Oh Baby! weekly parenting email to receive information tailored to your week of pregnancy and subsequently to the age of your newborn from the Texas Health hospital of your choice.
Visiting your medical caregiver You may have already had your first obstetric appointment to confirm your pregnancy. If you arrived full of questions about your pregnancy and then thought of more on your way home, don't worry. Your caregiver will be seeing you again soon enough. You'll need to be seen:
about once a month now through the fifth month of pregnancy
every three weeks in the sixth and seventh months
every two weeks in the eighth month
weekly in the ninth month until your baby is born
At your first visit, your caregiver will give you a physical exam, ask you about your medical history and your family's, and perform blood tests. These tests will identify your blood type and check for anemia and sexually transmitted diseases. Your doctor will want to know if you are immune to rubella (German measles) and mumps, have been exposed to tuberculosis, or have had chicken pox, among other potential risks to your baby. You will be asked for a urine sample to check your levels of sugar and protein. A pelvic exam will tell the size of your uterus, which helps to estimate your due date. A Pap smear may also be done at this time.
Future appointments will require less testing. Your caregiver will want to:
take a urine sample to monitor your sugar and protein levels
take your blood pressure
measure your uterine growth
check your baby's heartbeat and activity level
answer any questions and discuss any concerns you may have**
Tips for the first trimester
Find a health care provider. Now is the time to find a health care provider to put you on a healthy path throughout your pregnancy. Will you see an obstetrician? An obstetrician (OB) is a medical doctor who specializes in the care of women during pregnancy, childbirth, and recuperation from delivery. Or will you see a certified nurse-midwife? A certified nurse-midwife is a registered nurse with advanced, specialized training and experience in taking care of healthy pregnant women and delivering babies. Family physicians also care for pregnant women as well as their newborns. Need help finding a physician? Use Texas Health's physician finder.
If you're not already, start taking a prenatal vitamin ASAP. Ideally you should start taking a prenatal vitamin at least 3 months before you plan to conceive. Choose a vitamin with at least 400 mcg of folic acid, a B vitamin that's been shown to reduce the risk of severe birth defects.
The telltale sign of pregnancy -- morning sickness -- may set in by week six. To ease your queasy tummy, try keeping it full at all times. Eat small, simple meals every two to three hours, drink lots of water, and never leave home without a healthy snack in your bag. Some mothers' favorite snacks include power bars, graham crackers, plain crackers, and dried fruits and nuts.*
Be sure to avoid all alcohol during your pregnancy. Even small amounts of alcohol can affect your baby, potentially leading to low birth weight, behavior issues, or cognitive delays.
Eat wisely and well. Especially lots of the leafy dark green and yellow vegetables that are your best source of folic acid, a key nutrient before and in early pregnancy for healthy fetal development. Avoid foods made from unpasteurized milk (including many soft cheeses) and raw or undercooked meats and seafood. We also recommend that you drink at least eight glasses of water a day. Be sure to take your daily prenatal multivitamin, which contains the folic acid that is so important for your baby's early development. Research suggests that the quality of a mother's nutrition during her pregnancy may have a lifelong impact on her baby's overall health.
Consider the sources of the food in your meals. A recent study found that the sons of women who ate a lot of red meat during pregnancy had, as adults, lower sperm counts. It is possible, suggested the researchers, that the growth hormones fed to most cattle raised in North America may affect fetal development. While more research must be done, it may be wise during the next nine months to try to choose food raised, grown, and produced without chemical fertilizers, hormones, and other additives not yet tested for their effect on developing fetuses.
Tell your dentist and any other healthcare providers you see that you are pregnant, so that they can help you make informed decisions about your care. If you are taking prescription medications for asthma, high blood pressure, depression, or other chronic conditions, talk to your doctors about how to manage your medications and your health, as well as that of your developing baby.
Do you have pets at home? If you have a cat, arrange for someone else to clean the litter box, as the germs carried by the waste can be dangerous. You may also need to use precautions with other kinds of pets-particularly reptiles and birds.
If you exercise regularly, you can continue your routine throughout your pregnancy as long as you are comfortable doing so. In early pregnancy, continue with your activities, adjusting to your comfort level, and seek out a qualified prenatal fitness program.**
Yes, vaccinations are the best way to protect yourself from the flu. This year, you will need to get two flu vaccinations — a seasonal flu vaccine and an H1N1 vaccine. This will protect you from the different types of the flu that are around this year.