• The First Trimester

  • Congratulations! You're pregnant! And while you may be thrilled to be having a baby, the first trimester, or the first three months of pregnancy, is also a period of adjustment. Your body is changing in new ways, and you're probably changing your lifestyle and learning what's "normal."

    Follow the links below to learn more about having a healthy first trimester.

    Skip to a topic on this page:

    Seven Important First Steps
    Danger Signs to Watch For
    Understanding Gestational Diabetes

    Seven Important First Steps

    Start your pregnancy off right. Here are seven important steps you can take.

    1. Call your doctor. When you think you might be pregnant, take an at-home pregnancy test. If it's positive, call your doctor and schedule your first prenatal appointment. Starting prenatal care as early as possible will help increase your chances of having a healthy pregnancy and a healthy baby.
    2. Stop drinking, smoking or using illicit drugs. If you drink, smoke or use illicit drugs, stop immediately. These substances are harmful to your baby (and you). If you need help quitting, talk to your doctor about finding professional support.
    3. Continue folic acid. Make sure you're taking a prenatal vitamin with folic acid, which helps your baby's healthy brain development.
    4. Drink plenty of water. Staying hydrated can help minimize constipation and nausea during pregnancy.
    5. Monitor reactions to food. If you notice your nausea comes at certain times of the day or after you eat certain foods, make a note. The sooner you can learn how to minimize nausea in the early months, the more comfortable you'll be. Learn more about nutrition during pregnancy.  
    6. Eat frequently. Eating small meals or snacks six to eight times a day can help keep nausea at bay.
    7. Study up. Now is a good time to pick up books or magazines or to review various Web sites on pregnancy and childbirth. Learn what to expect as well as make decisions about what's important to you during labor and delivery.
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    Danger Signs to Watch For

    While most women will likely have healthy pregnancies and healthy babies, it's important to make sure you know the potential first-trimester threats. If you believe you are experiencing any of these symptoms, you should call your doctor or go to a hospital right away.

    Hyperemesis gravidarum (HG). "Morning sickness" may be normal. But severe, persistent nausea and vomiting during pregnancy should be treated to ensure the mother and baby are getting the nutrients and fluids they need. If your nausea won't go away, you're losing weight, feeling dehydrated or feeling faint, talk to your doctor about medications or other treatments.

    Ectopic pregnancy. This occurs when the fertilized egg implants itself outside of the uterus. They often develop in a fallopian tube but may develop in other places. You might notice abdominal pain, shoulder pain, vaginal bleeding and dizziness. This condition can be life threatening. With an ectopic pregnancy, the egg cannot develop, and your doctor will discuss treatment options - medication or surgery - with you.

    Miscarriage. Miscarriage, which ends as many as 20 percent of pregnancies, is the loss of the fetus from natural causes before 20 weeks. The causes vary and often are unknown. The chances of miscarriage can range from 10 percent to 25 percent, making it very common. Generally it cannot be prevented. If you experience the following symptoms, call your doctor right away:

    • Mild to severe back pain
    • White-pink mucus
    • Contractions (which are often painful and happen every five to 20 minutes)
    • Brown or bright red bleeding (with or without cramps)
    • Tissue with clot-like material passing from the vagina

    Vaginal spotting may not indicate a miscarriage, but to be sure, call your doctor if you are experiencing any bleeding.

    After a miscarriage, a physician needs to make sure the bleeding has stopped and prevent infection. If the body doesn't expel all the tissue from the uterus, a medical procedure may be necessary.

    A miscarriage is often no one's fault, which can add confusion to this emotional and difficult time. If you've had a miscarriage and are coping with depression, talk to you doctor. He or she can put you in touch with women who've been through what you have, counselors or support groups.

    Source: WomensHealth.gov, americanpregnancy.org

    When to call your doctor. In addition to the conditions above, you should call your doctor if you experience any of the following symptoms:

    • Bleeding or leaking fluid from the vagina
    • Sudden or severe swelling in the face, hands or fingers
    • Severe or long-lasting headaches
    • Discomfort, pain or cramping in the lower abdomen
    • Fever or chills
    • Discomfort, pain or burning with urination
    • Problems seeing or blurred vision
    • Dizziness
    • Persistent vomiting with the inability to keep down fluids
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    Understanding Gestational Diabetes

    Women who have diabetes before they get pregnant need to work with their physicians to monitor glucose levels and control the disease. But women who've never had diabetes can develop gestational diabetes, which means they have high blood sugar (glucose) levels during pregnancy. This condition affects about 4 percent of all pregnant women, according to the American Diabetes Association.

    For these women, hormones from the placenta may block the insulin in their bodies. If your body cannot make and use the insulin it needs for pregnancy, glucose cannot leave the blood and be used as energy.

    Gestational diabetes typically affects the mother late in the pregnancy. Poorly controlled or untreated gestational diabetes can harm the baby. Extra blood glucose can go through the placenta, giving the baby high blood glucose levels. Because the baby is getting more energy than he or she needs, that extra energy is stored as fat. The baby may have an increased risk for obesity and for type 2 diabetes later in life. A mother who experiences gestational diabetes also is at increased risk for developing type 2 diabetes after her pregnancy. Controlling blood sugar levels can also reduce the risk of birth defects.

    Treatment, which includes diet modification and physical activity, is designed to keep blood glucose levels equal to those of pregnant women who don't have gestational diabetes. Treatment also may include daily blood glucose testing and insulin injections.

    Visit the American Diabetes Association to learn more about gestational diabetes.
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