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First Trimester FAQs

Pregnancy is a life-altering event that results in many changes for the expectant mother, both physically and mentally. Especially for first-time mothers, pregnancy is accompanied by many questions and concerns.

Dr. Radha Rani Padhy of Keystone Women’s Care addresses some frequently asked questions about the first trimester of pregnancy in today’s Take Care article.

What kind of changes start to happen to a mother’s body during the first trimester of pregnancy?

An enormous transformation takes place this trimester, both psychologically and physically. Many women start to experience nausea, heartburn, fatigue, insomnia, constipation and frequent urination due to hormonal and physiological changes. Breasts many enlarge and start to become tender, tingly and sore.

Nausea and vomiting, most commonly referred to as morning sickness, may be the most significant change experienced this trimester and most often those symptoms lessen by the second trimester. Some tips for easing discomfort include avoiding greasy, spicy and fatty foods, eating small meals frequently, drinking plenty of fluids and including Gatorade or G2 in your daily fluid intake, incorporating ginger-enriched foods into your diet and paying attention to triggers such as certain foods and smells.

What are common concerns that mothers have during this time, and what emotional changes will take place?

Naturally, many expectant mothers worry about the baby’s health. They also may have concerns about adjustment to parenthood – both emotionally and financially, maintaining a work-life balance after the baby is born and the effect of concurrent medical conditions and medications on the pregnancy.

Moods can change considerably over the course of a single day, and emotions may range from exhilaration to exhaustion, delight to depression. This occurs due to the pregnancy-related physical stresses and hormonal changes in your body, and this emotional whirlpool can be overwhelming. The best way to cope is to discuss your emotions with your partner, family or healthcare provider.

What are common tests that will be run during this time?

A detailed health history will be taken and a full physical exam will be performed at the first prenatal visit. Prenatal tests will include testing for: blood type, HIV and STDs, a complete blood count to check for anemia or low platelets, immunity to certain diseases from previous vaccinations such as rubella, hepatitis B and chickenpox and a urine analysis to check for bladder or kidney infections.

Additionally, an ultrasound will be performed to determine the baby’s gestational age and estimated due date. Genetic screening will be offered to assess risk of chromosomal abnormalities (Down syndrome, Trisomy 13 and Trisomy 18). Be aware that screening tests only evaluate the risk. If they come back abnormal, additional testing will be needed to confirm whether the abnormality truly exists.

If the mother has certain health conditions, her pregnancy may be deemed as high-risk. In that case, additional tests may be ordered and a referral to a specialist in maternal-fetal-medicine may also be given.

My advice for prenatal appointments is to be as honest as possible with your health history so that you can get the best care tailored specifically to you. Ask many questions and educate yourself about all the tests that are being ordered and why, and discuss your fears and concerns about pregnancy and childbirth with your healthcare provider. Your relationship with your provider should be one of honesty and transparency, which is a two-way street.

What do doctors generally recommend when it comes to over the counter medications, diet and physical activity during this trimester?

A daily prenatal vitamin with at least 400 mcg of folic acid is recommended. Adequate folic acid will reduce the risk of developing defects in the neural tube, which gives rise to the brain, spinal cord and spinal nerves.  Some over the counter medications are allowed during pregnancy, and others are not. A list will be given to you at your first prenatal visit. If you are unsure about any medications, always ask your provider before use.

30 minutes or more of moderate exercise per day is recommended in the absence of other medical or obstetric complications. Stop smoking and do not drink alcohol while pregnant. Always ask for help as quitting is not easy. Other things to avoid include hot tubs and saunas and recreational activities with a high risk of falling or a high risk of abdominal trauma.

What warning signs should the expectant mom be concerned about and when should she call a doctor?

During this trimester the placenta starts to grow and secure its attachment to the uterus. Sometimes this results in minor bleeding which usually is normal.  However, if you experience heavy bleeding or bleeding that lasts longer than a day contact your provider immediately.

Other reasons to call your doctor immediately are: severe abdominal or pelvic pain (especially if accompanied by a fever or bleeding), nausea and vomiting with inability to eat or drink, a fever greater than 102 degrees F,  a severe and persistent headache (especially with dizziness, faintness or visual disturbances), severe shortness of breath or chest pain, inability to urinate or painful urination, leg pain with redness or swelling, heavy and steady watery vaginal discharge and a low mood, loss of pleasure and thoughts of harming yourself or others.

Pregnancy can be an amazing and frightening experience at the same time. Remember to always ask questions and address your fears and concerns as they arise. Planning ahead for and maintaining regular prenatal appointments helps to ensure the pregnancy is continuing in a healthy manner and to detect any problems as soon as possible.

Most of all, enjoy this precious experience and always maintain a positive outlook. Pregnancy is a matter of mental health as much as physical well-being. Never hesitate to ask for help, no matter how small you may think that the problem might be; don’t think you are alone. It is not only our job as your provider to take care of you, but it is our utmost pleasure to do so. We all have the same goal: a healthy baby and a healthy mom.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.