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First trimester guide: getting the hang of things

Woohoo, you’re pregnant! The first trimester of your pregnancy will be filled with lots of evaluations to make sure you and Baby are doing well. It can be a very exciting yet nerve-wracking time, so make sure you know what to expect in order to stay calm and on schedule.


First trimester symptoms are perhaps the most well known and include:

  • Morning sickness: Though the exact cause is unclear, an increase in pregnancy hormone chorionic gonadotropin has been known to make you queasy. Try eating smaller meals throughout the day or taking in ginger or vitamin B6 to combat bouts of nausea.
  • Food cravings or aversions: Strong likes or dislikes for various foods are often connected to morning sickness and are similarly unpredictable. Try not to give in to too many unhealthy cravings and substitute healthy alternatives for the foods that you can’t stand.
  • Frequent urination: Attributed mainly to the increasing size of your uterus and pressure on your bladder. Empty your bladder often to prevent a urinary tract infection.
  • A heightened sense of smell: This one is very closely intertwined with morning sickness.
  • Fatigue: One of the most common symptoms of pregnancy, overall tiredness is a result of all the new processes your body goes through to nourish Baby and help them grow. The increase in progesterone is also associated with a sedative effect.

Additionally, the beginning stages of pregnancy can leave you feeling overly emotional due to the whirlwind of new concerns and pressures on your body. There are many solutions to make this time more comfortable for you, and you can ask your healthcare provider to suggest the best one for you. The majority of your experiences are common to millions of women around the world, and it’s best to take one day at a time and treat your symptoms as they come.

However, certain symptoms should never be ignored, such as heavy vaginal bleeding, persistent vomiting, or severe cramps. These should be addressed immediately as they could be associated with a miscarriage.

Health care provider appointments

Your healthcare provider is the best resource you have throughout the course of your pregnancy, and he or she can easily resolve your concerns and give you the best personalized advice to ensure as healthy a pregnancy as possible.

The first visit should be scheduled as soon as you think you’re pregnant, and it would be a good idea to bring your partner along since you will receive a lot of important information regarding your future lifestyle. At this appointment, your provoder will ask about your medical history, including your typical menstrual cycle and medication use. Additionally, they can establish an estimated due date, which is important to monitor Baby’s growth and schedule certain tests or procedures accordingly.

Your provider will also perform a physical exam that encompasses weight, height and blood pressure to assess your overall health and a vaginal exam to check for infections. This appointment also includes the blood tests, urine tests and screening procedures mentioned above relating to fetal abnormalities.

Subsequent prenatal visits are usually scheduled every four weeks in the first trimester and won’t be quite as thorough as the first appointment. Rather, you’ll meet with your healthcare provider, who will check your weight and blood pressure and use it as a time to discuss any signs and symptoms.

At an appointment toward the end of the first trimester, around 9-12 weeks, you may be able to hear Baby’s heartbeat, one of the most exciting developments for any new mom.


The first trimester is a critical time to test for various diseases or conditions that could affect Baby, particularly if they are common in your racial, ethnic, or family background. Most issues are detected through:

  • Blood tests screen for conditions like anemia, Hepatitis B, and HIV in addition to providing your blood type and Rh-factor. All of these can be assessed with a single blood draw, which is performed on almost every new mom at her first appointment.
  • Urine tests look for signs of kidney infection and evaluate glucose and protein levels. You will probably provide a urine sample at every prenatal appointment to track these, since abnormal levels can indicate serious pregnancy-related issues.
  • Chorionic Villus Sampling (CVS): tests for chromosomal defects like Down syndrome and muscular dystrophy. This test is optional and very invasive, usually reserved for women over 35. The procedure requires a tissue sample from the placenta obtained by threading a small catheter through the cervix or inserting a needle into your abdomen. It is 98% accurate in ruling out some chromosomal birth defects, but does not detect neural tube disorders, such as spina bifida and anencephaly.
  • First Trimester Combined Screen: Performed between weeks 11 and 14, the First Trimester Combined Screen is a testing option that consists of a Maternal Serum Screening Test (MSS) and a Nuchal Translucency ultrasound (NT). The MSS tests for pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (hCG), irregular levels of both of which can indicate a chromosomal disorder. In addition, the nuchal translucency ultrasound is performed to determine the size of clear space (fluid) in the back of the neck, which can also indicate a risk of Trisomy-21 (Down Syndrome). The First Trimester Combined Screen is not diagnostic, it merely screens for an increased likelihood of having certain chromosomal disorders. Although it identifies 85% of the babies with Down Syndrome, 5% of women tested will also register a false positive, and because Down Syndrome is relatively rare, even most babies of most women who are notified that their baby has a heightened risk for the condition will not actually have the condition. The First Trimester Combined Screen is highly effective at screening for chromosomal disorders, but cannot give conclusive results for the genetic disorders, nor can it show any indication of neural tube defects, so an amniocentesis may be recommended during the second trimester if there is a positive indication during this screen.

Genetic diseases like cystic fibrosis and sickle cell anemia will be tested for only if you are likely to develop them based on your family history. Some women have their hCG and progesterone levels checked often as well.

Read more
  • Mayo Clinic Staff. “Symptoms of pregnancy – What happens right away.” Mayo Clinic. Mayo Clinic, 7/12/2013. Web.
  • Healthline Editorial Team. “What Bodily Changes Can You Expect During Pregnancy?” Healthline. Healthline, 3/5/2012. Web.
  • Mayo Clinic Staff. “Prenatal care: 1st trimester visits.” Mayo Clinic. Mayo Clinic, 7/31/2015. Web.
  • “Prenatal care in your first trimester.” U.S National Library of Medicine. MedlinePlus, 6/11/2014. Web.
  • “The Rh Factor: How It Can Affect Your Pregnancy: FAQ027.” ACOG. American College of Obstetricians and Gynecologists, 9/13/2015. Web.
  • Mayo Clinic Staff. “Chorionic Villus Sampling.” Mayo Clinic. Mayo Clinic, 10/17/2015. Web.
  • “Prenatal Tests.” March of Dimes. March of Dimes, 6/03/2016. Web.
  • “Carrier Testing for CF.” CFF. Cystic Fibrosis Foundation, n.d. Web.

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