First Trimester

Pregnancy - First Trimester

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1-13.6 Weeks

During sexual intercourse, millions of sperm go into the vagina. Only 1 sperm will penetrate and fertilize the female egg while it is in the Fallopian tube. One week later, the fertilized egg implants into the wall of the uterus. An embryo begins to develop into a baby. The amniotic sac, which is a water tight sac that forms around the fertilized egg, helps cushion the growing embryo throughout the pregnancy. The placenta also develops during the first trimester. It is a round, flat organ that transfers nutrients from the mother to the growing baby. By the end of the first month of pregnancy your baby is 6-7 mm (1/4 inch) long which is the size of a grain of rice. At 6 to 8 weeks, the eyes and face are formed and the heartbeat can be seen on ultrasound.

During the second month of pregnancy development continues with the ears, tiny buds that will become arms and legs and the neural tube system (brain, spinal cord, and central nervous system) is well formed. By the end of the second month your baby is now called a fetus and is about 1 inch long and weighs about 1/3 ounce. The head makes up about 1/3 of the baby.

By the end of the third month of pregnancy, your baby is fully formed. Your baby has arms, hands, fingers, feet, and toes. It can open and close its mouth and fists. The teeth and nails are starting to form. The reproductive organs are beginning to develop although will not be distinguishable on ultrasound for many more weeks. The circulatory and urinary systems are working and the liver is producing bile. At the end of the third month your baby is about 3-4 inches long and weighs about 1 ounce.

At the end of 12 weeks ( first trimester), all the baby's organs are formed. Now that you are pregnant, you will want to do everything you can to have a healthy baby. Two of the most important things are to get good prenatal care and follow your caregiver's instructions. Prenatal care is all the medical care you receive before the baby's birth. It is given to prevent, find and treat problems during the pregnancy and childbirth.

PRENATAL EXAMS:

During prenatal visits, your weight, blood pressure and urine are checked. This is done to make sure you are healthy and progressing normally during the pregnancy.
A pregnant woman should gain 25 to 35 pounds during the pregnancy. However, if you are over weight or underweight, your caregiver will advise you regarding your weight.
Your caregiver will ask and answer questions for you.
Blood work, cervical cultures, other necessary tests and a Pap test are done during your prenatal exams. These tests are done to check on your health and the probable health of your baby. Tests are strongly recommended and done for HIV with your permission. This is the virus that causes AIDS. These tests are done because medications can be given to help prevent your baby from being born with this infection should you have been infected without knowing it. Blood work is also used to find out your blood type, previous infections and follow your blood levels ( hemoglobin).
Low hemoglobin ( anemia) is common during pregnancy. Iron and vitamins are given to help prevent this. Later in the pregnancy, blood tests for diabetes will be done along with any other tests if any problems develop. You may need tests to make sure you and the baby are doing well.
You may need other tests to make sure you and the baby are doing well.

CHANGES DURING THE FIRST TRIMESTER (THE FIRST 3 MONTHS OF PREGNANCY)

Your body goes through many changes during pregnancy. They vary from person to person. Talk to your caregiver about changes you notice and are concerned about. Changes can include:

Your menstrual period stops.
The egg and sperm carry the genes that determine what you look like. Genes from you and your partner are forming a baby. The male genes determine whether the baby is a boy or a girl.
Your body increases in girth and you may feel bloated.
Feeling sick to your stomach ( nauseous) and throwing up ( vomiting). If the vomiting is uncontrollable, call your caregiver.
Your breasts will begin to enlarge and become tender.
Your nipples may stick out more and become darker.
The need to urinate more. Painful urination may mean you have a bladder infection.
Tiring easily.
Loss of appetite.
Cravings for certain kinds of food.
At first, you may gain or lose a couple of pounds.
You may have changes in your emotions from day to day (excited to be pregnant or concerned something may go wrong with the pregnancy and baby).
You may have more vivid and strange dreams.

HOME CARE INSTRUCTIONS

It is very important to avoid all smoking, alcohol and un-prescribed drugs during your pregnancy. These affect the formation and growth of the baby. Avoid chemicals while pregnant to ensure the delivery of a healthy infant.
Start your prenatal visits by the 12th week of pregnancy. They are usually scheduled monthly at first, then more often in the last 2 months before delivery. Keep your caregiver's appointments. Follow your caregiver's instructions regarding medication use, blood and lab tests, exercise, and diet.
During pregnancy, you are providing food for you and your baby. Eat regular, well-balanced meals. Choose foods such as meat, fish, milk and other low fat dairy products, vegetables, fruits, and whole-grain breads and cereals. Your caregiver will tell you of the ideal weight gain.
You can help morning sickness by keeping soda crackers (saltines) at the bedside. Eat a couple before arising in the morning. You may want to use the crackers without salt on them.
Eating 4 to 5 small meals rather than 3 large meals a day also may help the nausea and vomiting.
Drinking liquids between meals instead of during meals also seems to help nausea and vomiting.
A physical sexual relationship may be continued throughout pregnancy if there are no other problems. Problems may be early ( premature) leaking of amniotic fluid from the membranes, vaginal bleeding, or belly ( abdominal) pain.
Exercise regularly if there are no restrictions. Check with your caregiver or physical therapist if you are unsure of the safety of some of your exercises. Greater weight gain will occur in the last 2 trimesters of pregnancy. Exercising will help:
Control your weight.
Keep you in shape.
Prepare you for labor and delivery.
Help you lose your pregnancy weight after you deliver your baby.
Wear a good support or jogging bra for breast tenderness during pregnancy. This may help if worn during sleep too.
Ask when prenatal classes are available. Begin classes when they are offered.
Do not use hot tubs, steam rooms or saunas.
Wear your seat belt when driving. This protects you and your baby if you are in an accident.
Avoid raw meat, uncooked cheese, cat litter boxes and soil used by cats throughout the pregnancy. These carry germs that can cause birth defects in the baby.
The first trimester is a good time to visit your dentist for your dental health. Getting your teeth cleaned is OK. Use a softer toothbrush and brush gently during pregnancy.
Ask for help if you have financial, counseling or nutritional needs during pregnancy. Your caregiver will be able to offer counseling for these needs as well as refer you for other special needs.
Do not take any medications or herbs unless told by your caregiver.
Inform your caregiver if there is any mental or physical domestic violence.
Make a list of emergency phone numbers of family, friends, hospital, police and fire department.
Write down your questions. Take them to your prenatal visit.
Do not douche.
Do not cross your legs.
If you have to stand for long periods of time, rotate you feet or take small steps in a circle.
You may have more vaginal secretions that may require a sanitary pad. Do not use tampons or cented sanitary pads.

MEDICATIONS AND DRUG USE IN PREGNANCY

Take prenatal vitamins as directed. The vitamin should contain 1 milligram of folic acid. Keep all vitamins out of reach of children. Only a couple vitamins or tablets containing iron may be fatal to a baby or young child when ingested.
Avoid use of all medications, including herbs, over-the-counter medications, not prescribed or suggested by your caregiver. Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. Do not use aspirin, ibuprofen (Motrin ®, Advil ®, Nuprin ®) or naproxen (Aleve ®) unless OK'd by your caregiver.
Let your caregiver also know about herbs you may be using.
Alcohol is related to a number of birth defects. This includes fetal alcohol syndrome. All alcohol, in any form, should be avoided completely. Smoking will cause low birth rate and premature babies.
Street/illegal drugs are very harmful to the baby. They are absolutely forbidden. A baby born to an addicted mother will be addicted at birth. The baby will go through the same withdrawal an adult does.
Let your caregiver know about any medications that you have to take and for what reason you take them.

MISCARRIAGE IS COMMON DURING PREGNANCY

A miscarriage does not mean you did something wrong. It is not a reason to worry about getting pregnant again. Your caregiver will help you with questions you may have. If you have a miscarriage, you may need minor surgery (a D & C).

SEEK MEDICAL CARE IF:

You have any concerns or worries during your pregnancy. It is better to call with your questions if you feel they cannot wait, rather than worry about them.

SEEK IMMEDIATE MEDICAL CARE IF:

An unexplained oral temperature above 100° F (37.8° C) develops, or as your caregiver suggests.
You have leaking of fluid from the vagina ( birth canal). If leaking membranes are suspected, take your temperature and inform your caregiver of this when you call.
There is vaginal spotting or bleeding. Notify your caregiver of the amount and how many pads are used.
You develop a bad smelling vaginal discharge with a change in the color.
You continue to feel sick to your stomach ( nauseated) and have no relief from remedies suggested. You vomit blood or coffee ground like materials.
You lose more than 2 pounds of weight in one week.
You gain more than 2 pounds of weight in a week and you notice swelling of your face, hands, feet or legs.
You gain 5 pounds or more in 1 week (even if you do not have swelling of your hands, face, legs or feet).
You get exposed to German measles and have never had them.
You are exposed to fifth disease or chicken pox.
You develop belly ( abdominal) pain. Round ligament discomfort is a common non-cancerous ( benign) cause of abdominal pain in pregnancy. Your caregiver still must evaluate this.
You develop headache, fever, diarrhea, pain with urination, or shortness of breath.
You fall, are in a car accident or have any kind of trauma.
There is mental or physical violence in your home.

Document Released: 04/07/2004 Document Re-Released: 10/15/2010

1st Trimester counseling