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First Trimester Questions

Updated: May 1, 2023

Once the reality of pregnancy starts to sink in, you realize that there is a lot you need to know! Some people have been planning and thinking about their pregnancy for years, while others found themselves surprised by a state that they didn't expect to be in. For me, my first pregnancy was actually a combination of the two, but I still had questions! Here are some of the things I worried and wondered about, along with several other items that pregnant women and partners of pregnant women frequently ask about in the first trimester.


**Disclaimer: I am not a medical professional and the following information is not meant to replace the advice or information provided by a medical professional. Please note the sources of information provided, and seek medical advice from your primary doctor or OB/GYN if you have questions.**


When Should I go to the Doctor?

Most doctors or midwives will schedule you for an appointment 6-8 weeks after your last menstrual period to confirm your pregnancy and check your hormone levels. I was surprised to find that I couldn't just walk in the door the day after my positive pregnancy test, though some of you may experience that. Since the risk of miscarriage remains high (10-20%) at six weeks, many doctors choose to wait until eight weeks, when the risk of miscarriage decreases to around 2-5% (Mayo Clinic, 2021). A little depressing, I know, but to be honest I was impressed my odds improved so dramatically from six weeks to eight.


If you are past the eight week mark, make an appointment as soon as you can to get started on your prenatal care with a provider.


What Vitamins or Supplements Should I be Taking?


Prenatal Vitamins

Prenatal vitamins are extremely important to ensure that the baby is getting the nutrients it needs to develop. It is also important for the person carrying the baby! If the baby is not getting what it needs from diet, the body will take it from the mothers stores (for example, not enough calcium leads to leaching from the mother's bones, teeth, etc.). Here are things to look for in your prenatal vitamins (sources linked below):

  1. Folic acid: Folic acid is important for the development of the neural tube, which eventually becomes the brain and spinal cord of the fetus. It's recommended that women take 400-800 micrograms of folic acid daily, ideally starting at least one month before getting pregnant and continuing throughout the pregnancy.

  2. Iron: Iron is essential for the production of hemoglobin, which carries oxygen to the fetus. Pregnant women need about 27 milligrams of iron daily, which is more than the average woman. Iron supplements may be recommended if a woman is not getting enough iron from her diet.

  3. Calcium: Calcium is important for the development of the fetal skeleton and teeth, as well as for the maintenance of the mother's bone health. Pregnant women need about 1,000-1,300 milligrams of calcium daily, which can be obtained through a combination of diet and supplements.

  4. Vitamin D: Vitamin D is important for the absorption of calcium and for the development of the fetal skeleton. Pregnant women need about 600-800 international units (IU) of vitamin D daily, which can be obtained through sun exposure, diet, and supplements.

  5. Omega-3 fatty acids: Omega-3 fatty acids are important for the development of the fetal brain and eyes. Pregnant women are advised to consume at least 200-300 milligrams of omega-3 fatty acids daily, which can be obtained through fatty fish or supplements. DHA is especially important for fetal brain and eye development, and it can be difficult to get enough through diet alone. Prenatal vitamins that contain DHA usually indicate it on the label.

What Should I NOT be consuming or doing?



  1. Alcohol, tobacco, other forms of nicotine, and illicit drugs.

  2. Certain acne medication (talk with your doctor).

  3. Raw or undercooked meat, eggs, and fish: These foods can harbor harmful bacteria or parasites that can cause foodborne illnesses like salmonella, listeria, or toxoplasmosis.

  4. Unpasteurized dairy products: These products can also contain harmful bacteria like listeria that can cause foodborne illnesses.

  5. Cold deli meat, since deli meat may cause a foodborne illness called listeriosis. To reduce the risk of listeriosis, the Centers for Disease Control and Prevention (CDC) recommends that pregnant women heat deli meats to steaming hot before eating them. This can be done by heating the meat in the microwave, on the stovetop, or in the oven.

  6. Certain types of fish: Some fish contain high levels of mercury, which can be harmful to the developing baby's nervous system. Pregnant women should limit their intake of fish that are high in mercury, such as shark, swordfish, king mackerel, and tilefish. Limit intake of tuna to one can a week.

  7. Changing the cat litter. Cat feces can contain a parasite called Toxoplasma gondii, which can cause toxoplasmosis, a disease that can be harmful to a developing fetus. If you have to change cat litter, wear gloves and a mask, and wash your hands thoroughly afterward.

  8. Contact sports. It is generally not recommended for pregnant women to engage in contact sports due to the risk of injury to both the mother and the developing fetus. Physical trauma from contact sports can result in premature labor, placental abruption, and other complications. Talk to your doctor if you aren't sure about the safety of a sport you engage in.

What Medications or Supplements are Safe to Treat Symptoms?


Something that I discovered quickly was that pretty much no one wants to recommend that you take medications while you are pregnant, but especially during the first trimester. It seems like most everything has the potential to impact the baby, and since the first trimester is the "riskiest" trimester in terms of potential miscarriage, no one wants to recommend something that might increase that risk. That being said, here are some of the common ailments, and the most commonly recommended remedies.


Coughs & Colds

Got a little sniffle you need to take care of? No one knew something so seemingly innocuous could get so complicated! Unfortunately, since the immune system shifts to a more suppressed state during pregnancy, it is not uncommon to find yourself picking up the common cold and other infections more easily. Additionally, the increased blood volume and hormonal changes during pregnancy can lead to swelling and inflammation of the nasal passages, making it easier for viruses to infect the respiratory system (sources below).


The American Pregnancy Association and the American College of Obstetricians and Gynecologists say some safe options that are generally recommended for pregnant women to relieve cold symptoms include:

  1. Acetaminophen (Tylenol): This pain reliever and fever reducer is considered safe during pregnancy when taken as directed.

  2. Saline nasal spray: This can help to relieve congestion and dry nasal passages without medication.

  3. Honey and lemon: This can help to soothe a sore throat and cough.

  4. Steam inhalation: Breathing in steam from a hot shower or humidifier can help to relieve nasal congestion.

The use of decongestants and other cold medications should be avoided in the first trimester of pregnancy, though some doctor's will provide you with alternative medications that are considered "worth the risk" since the risk appears to be so minimal. I will leave it to your doctor to tell you which medications those are.


Some natural alternatives and over the counter medications appear safe but will contain ingredients that are not considered safe during pregnancy. Here are a few of the top ingredients to look for (and avoid):

  • NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen, and naproxen, which can increase the risk of bleeding and harm the developing baby. According to the American College of Obstetricians and Gynecologists (ACOG) and the March of Dimes, pregnant women should avoid NSAIDs during pregnancy (source: https://www.acog.org/womens-health/faqs/pain-relievers-and-pregnancy).

  • Decongestants such as pseudoephedrine and phenylephrine, which can cause blood vessel constriction and reduce blood flow to the placenta. According to the Centers for Disease Control and Prevention (CDC), pregnant women should avoid decongestants in the first trimester and use them with caution in the second and third trimesters (source: https://www.cdc.gov/pregnancy/meds/treatingfortwo/features/painreliever.html)

  • Antihistamines such as diphenhydramine, chlorpheniramine, and cetirizine, which are generally considered safe during pregnancy, but should be used with caution in the first trimester and in high doses (source: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/antihistamines-and-pregnancy/art-20046965)

  • Belladonna is an herb that contains atropine and scopolamine alkaloids, which can have antispasmodic and analgesic effects. However, there is limited information available on the safety of belladonna during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) advises against the use of belladonna during pregnancy due to concerns about its potential effects on fetal development and its potential to cause adverse reactions in both the mother and fetus (source: https://www.acog.org/womens-health/faqs/herbal-products-and-pregnancy).

Nausea


Some women have nausea that is so extreme that it needs to be treated in order for them to maintain their daily lives. I was lucky enough to get by with some drops to suck on, gum, and tea (more on my first trimester experience here). Other remedies include citrus smells (think lemon essential oils), small frequent meals, lots of hydration, and motion sickness bands like this one from Frida Mom (one of my FAVORITE mom and baby brands):




However, if you find yourself throwing up regularly and unable to do the things that are necessary to carry on at your work or home, there are several medications that are commonly used to treat nausea and vomiting during pregnancy. However, it's important to note that not all of these medications are safe for everyone or in every situation, and if you are being impacted to this degree, you really should be talking to your OB about it. Most likely, they will prescribe one of the following medications for nausea and vomiting during pregnancy:

  1. Vitamin B6 (pyridoxine): This is a safe and effective treatment for mild to moderate nausea and vomiting in pregnancy.

  2. Antihistamines: Some antihistamines, such as doxylamine, are commonly used to treat nausea and vomiting during pregnancy.

  3. Diclegis: This is a combination of vitamin B6 and doxylamine that is specifically formulated for use during pregnancy to treat nausea and vomiting.

  4. Ondansetron (Zofran): This is a prescription medication that is commonly used to treat nausea and vomiting in pregnancy, particularly in cases where other treatments have not been effective. It's important to note that there have been some concerns raised about the safety of ondansetron during pregnancy, so it should only be used under the close supervision of a healthcare provider.

Fatigue



I don't think there is a soul that passes through the first trimester without suffering from fatigue. Of course the first remedy for this is to simply rest. Get all the rest you can mama, because your body is working hard, and rest will be much harder to come by in a few short months!


Other advice is the typical eat healthy, drink lots of water, stick to a regular sleep schedule, and perhaps not so obvious: exercise! Exercise has loads of benefits for you and baby, and will help you to maintain all of the aforementioned recommendations around healthy eating, hydration, and sleep. In fact, exercise is so important and so beneficial, I wrote an additional blog post on that topic alone here.


Many pregnant women choose to abstain from caffeine once they discover they are pregnant. I am not one of them! I continued to drink a cup of coffee every morning until coffee didn't sound good to me for a couple of months, then I picked it back up when my mood shifted again. There have been a lot of mixed studies on the topic. The American College of Obstetricians and Gynecologists recommends that pregnant women limit their caffeine intake to no more than 200 mg per day, which is roughly the amount in one 12-ounce cup of coffee. That being said, I decided to stick with my cup of coffee and haven't regretted it.


Back Pain

Back pain is a common complaint during pregnancy, and there are several things that can be done to help alleviate it. Here are some options:

  1. Exercise (again!): Regular exercise can help strengthen the muscles in the back and abdomen, which can help reduce back pain during pregnancy. Low-impact exercises such as walking, swimming, and prenatal yoga are good options.

  2. Good posture: Maintaining good posture can help alleviate back pain during pregnancy. This includes sitting up straight, keeping the shoulders back, and not slouching. Your posture will play an even more important role of positioning of baby in your third trimester, so it's best to get into good habits now.

  3. Heat and cold therapy: Applying heat or cold to the affected area can help reduce inflammation and alleviate back pain. A warm bath or heating pad can help relax the muscles, while an ice pack can help reduce inflammation. There is some question floating around about the risk of heating pads, but no evidence has been found that the use of heating pads causes harm to the baby. Harm comes to the baby when the core body temperature rises and stays elevated (which requires more than localized heating from a hot pad). If you are concerned, stick with 20 minutes of heat exposure on low-medium heat.

  4. Massage therapy: Massage therapy can help reduce muscle tension and alleviate back pain during pregnancy. It's important to find a massage therapist who is trained in prenatal massage.

  5. Acupuncture: Acupuncture may also be effective in reducing back pain during pregnancy, but it's important to find a licensed acupuncturist who is trained in treating pregnant women.

  6. Pregnancy support belts or clothing: Pregnancy support belts can help support the lower back and abdomen, which can help alleviate back pain during pregnancy. Clothing that is built for pregnant women with support in mind can be game changing. I personally lived in my Blanqi and Kindred Bravely (my two FAVORITE maternity and postpartum clothing brands) support tank tops during my pregnancy and did the same with their postpartum tank tops after birth.




It's always a good idea to talk to your healthcare provider before trying any new treatments for back pain during pregnancy.


Cramps

Cramps can be scary in the first trimester, but they are very common and usually harmless. As mentioned earlier, Acetaminophin is safe to take, as are heating pads and warm baths.


However, if you experience severe or persistent cramping, or if the cramping is accompanied by other symptoms such as vaginal bleeding or fever, it's important to talk to your doctor right away. Additionally, if you have a history of miscarriage, ectopic pregnancy, or other reproductive health issues, it's important to let your doctor know if you experience any cramping, even if it is mild or temporary. Your doctor can perform an exam and run any necessary tests to determine the cause of the cramping and ensure that your pregnancy is progressing normally. Peace of mind is worth the visit if you have concerns!


Heartburn & Indigestion


This got SO much worse for me in my third trimester, but other women may begin to experience this right off the bat. There are several safe remedies that can help alleviate discomfort:

  1. Eating smaller, more frequent meals: This can help prevent overloading your digestive system and minimize acid reflux.

  2. Avoiding trigger foods: Certain foods such as spicy or fatty foods, caffeine, and citrus fruits can aggravate heartburn and indigestion. Avoiding them can help reduce symptoms.

  3. Drinking plenty of fluids: Staying hydrated can help reduce symptoms of indigestion.

  4. Taking antacids: Antacids are safe to take during pregnancy and can help neutralize stomach acid.

  5. Using ginger: Ginger has natural anti-inflammatory properties and can help relieve nausea and indigestion. Ginger tea or ginger supplements can be effective.

Constipation

Constipation is a common complaint during pregnancy, and it can be caused by several factors including hormonal changes, increased pressure on the rectum and intestines from the growing uterus, and changes in diet and physical activity levels. Here are some remedies that may help relieve constipation in the first trimester of pregnancy:

  1. Increase your fiber intake: Eating more fiber-rich foods like fruits, vegetables, whole grains, and beans can help add bulk to your stool and promote bowel regularity.

  2. Drink plenty of fluids: Staying well-hydrated is important for preventing constipation. Aim to drink at least 8-10 glasses of water each day, and consider adding other fluids like fruit juice or herbal tea to your diet.

  3. Stay active: Regular physical activity can help keep your digestive system moving and prevent constipation. Try going for a brisk walk or doing light exercise each day.

  4. Try a stool softener: Some over-the-counter stool softeners like docusate sodium (Colace) can help make it easier to pass stools. Be sure to talk to your healthcare provider before taking any new medications during pregnancy.

  5. Use laxatives only under medical supervision: Some laxatives can be harmful during pregnancy, so it's important to check with your healthcare provider before using them.


Sources not already cited above:


Disclaimer: This post may contain affiliate links from Amazon. Amazon has not influenced our choice in items, however, when a product we recommend is also available on Amazon, we will link it to our website. If you choose to purchase on Amazon through our links, we receive a percentage of their profit.

 
 
 

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