The first trimester: Weeks 0-13
It’s a very exciting time! You are pregnant…. and huddled over the toilet, willing yourself not to revisit your breakfast. The first trimester of pregnancy is tough. The fetus and uterus are only about the size of a plum, but they can cause major drama. Your body is going through some crazy hormonal changes, you are taking what seems like horse vitamins that make you queasy, your normal diet, exercise, your whole routine has to adapt to this plum sized terror that is wreaking absolute havoc on you. The first trimester is especially challenging because most women don’t discuss their pregnancy until after 14 weeks, so there is hardly any company for your misery. I also believe second time moms do not get enough credit. Going through the first trimester can be extremely challenging enough, but now there’s a little mini-me who doesn’t get why you are sleeping/ passing gas/ cranky/ nauseous all the time.
Here are some very frequently asked questions that might help ease you through this 12-14 week period. First of all, know that it does get better for the overwhelming majority of women. Most of the first trimester pregnancy symptoms happen because there is a sudden surge of estrogen and progesterone that helps to support the growing terror—er, I mean, fetus. By week 12 or so, they taper and plateau causing the symptoms to also subside.
What are some things that may help get through this first trimester?
Feeling nauseous: Some simple lifestyle modifications can really help with nausea. Small and frequent meals are best (think a handful of food every 2-2.5 hours). The reason it is called “morning sickness” is because commonly, waking up and having an empty stomach is going to trigger the waves of nausea. Ginger based products, as well as slightly salty foods (think of the pregnant woman drinking ginger ale and eating crackers for weeks) can also help reduce nausea. In general, it is best to maintain a diet that is slightly bland in consistency and taste to minimize gastrointestinal upset. If these do not help, chat with your doctor about medicinal therapy. Nausea and vomiting can become a serious health concern if a woman cannot stay hydrated, and this should definitely be addressed with your physician.
Getting a cold: Every single remedy says “If pregnant, discuss with your physician.” Medicines go through a rigorous evaluation before they are approved by the FDA and sold to the public. Because it is extremely unethical to perform experiments on pregnant women (Ma’am, we don’t know what side effects this medicine will cause on your unborn fetus, however, we appreciate you taking one for the team….), obstetricians don’t always have exact rules to follow. This is why we say things like “it is generally safe” or “the risks are almost nothing with this medication.” So what is safe to use in pr
egnancy if you don’t feel good? Acetaminophen, in the appropriate adult dosage is safe to use occasionally for pain, headaches, etc. You should never use Ibuprofen, or other anti-inflammatory
medications, ever, unless directly prescribed by your physician! Benadryl is also safe to help sleep at night for the occasional tossing and turning that may occur. For the women who complain of congestion at night, I am a huge fan of nasal strips to help open the nose. Of course, staying hydrated is also a great way to reduce congestion. I generally recommend that pregnant women give themselves about 5-6 days to notice an improvement. If they do not, they should see a primary care doctor for a course of antibiotics. Pregnancy makes it harder to fight infections, and you do not want to be miserable!
Exercise: I tend to be a bit conservative when it comes to exercise in the first trimester. The general rule of thumb is your heart rate should not exceed 160bpm for more than 20 minutes. This means you may have to modify your normal routine. Fatigue and dehydration will be more severe in the first trimester, and it is important not to push yourself. Brisk walking is a great way to stay active, without putting extra stress on your body. If you experience any cramping or spotting, you should rest immediately.
The body and uterus are pretty amazing at nurturing a pregnancy. It can be nerve wracking and confusing with all the information out there. I always recommend discussing all questions and concerns with your physician, as everybody is different.