Take These Steps when You Are Newly Pregnant

The first twelve weeks of your pregnancy are known as the first trimester. During this time, the fetus begins to develop a brain, spinal cord, and organs. Before the end of your first trimester, your baby will have a heartbeat, fingers, toes, and sex organs. The first trimester is vital for your baby’s development, so it’s important you take care of yourself and stay on top of your prenatal care.

At Physicians for Women in Madison, Wisconsin, our team of women’s health specialists, including board-certified obstetricians and certified nurse midwives, help navigate each trimester of your pregnancy and manage your prenatal care. 

What to do during your first trimester 

Many women commonly experience symptoms such as: 

• Nausea and vomiting (morning sickness) 
• Upset stomach and constipation 
• Tender breasts 
• Headaches 
• Heartburn
• Fatigue 
• Mood swings
• Increased urination 

Eating smaller, frequent meals and ensuring proper hydration often help ameliorate GI symptoms common in pregnancy and combat fatigue, which can be challenging if napping during the day isn’t an option.

Make sure to take your prenatal vitamins, and follow your obstetrician’s instructions on maintaining a healthy diet. Often your diet must be modified in the first trimester, secondary to food aversions or nausea. Sometimes a brief discontinuance of your prenatal vitamin helps calm your stomach and allows you to eat more normally. Stopping your prenatal vitamin for a week or so does not cause harm to your growing baby. The vitamin is really targeted to help replace your vitamin stores that are naturally utilized by your baby.

If you liked to exercise before becoming pregnant, there is no reason to stop unless complications, such as bleeding, arise. We counsel our patients to use the “talk test” and therein remain aerobic while exercising and pregnant. If you can talk or sing a song while exercising, you are doing so while remaining aerobic. When your speech is halting, secondary to effort, you are approaching anaerobic levels and we encourage you to reduce your efforts.

We also recommend that you begin doing Kegel exercises throughout your pregnancy and postpartum. These will strengthen your pelvic floor, and may help you in labor and in particular, help restore normal bladder function postpartum.

What to avoid 

It’s common knowledge that you should avoid alcohol, cigarettes, and drugs during pregnancy, but they aren’t the only things you should avoid or modify your intake. 

• Caffeine- it is recommended you limit consumption of caffeine to <200 mg per day. That’s equivalent to a 12 oz cup of black coffee.
• Beginning an exercise regimen once pregnant is ill-advised with an increased risk of injury. If you haven't been exercising prior to pregnancy, we recommend prenatal yoga, swimming or walking over taking up running, cycling or weight training. If these are things you want to do, wait until you are postpartum to begin and only after receiving clearance by us.
• Steak-like fish (Tuna, Mackerel, Cod, Swordfish and Salmon) contain higher levels of mercury and other toxins as they are predator fish and higher up on the food chain, eating smaller fish). Stick to one serving per month of fish like this. Other types of fish, e.g. flounder and trout have lower levels and can be eaten as you like in pregnancy.
• Raw fish (including sushi) and raw sprouts- both are healthy and delicious but not in pregnancy. Secondary to a naturally weakened immune system in pregnancy, women are at risk for becoming infected with certain parasites or bacteria in these foods.
  https://www.foodsafety.gov/sites/default/files/2019-05/food-safety-infographic-pregnant-women.jpg

• Unpasteurized dairy- this includes cheeses and milk
• Processed, cured meats e.g. hotdogs, deli meats and sausages may contain Listeria. Heating these foods to 165F or higher improves their safety.
• Changing the kitty litter box. This is only if you have outdoor cats they may inadvertently eat animals that have become infected with Toxoplasmosis; a parasite. If your cats are indoor only, changing the kitty litter is not a risk 

What to expect from prenatal care 

If you’ve never had a baby before, you might not know what prenatal care includes. You can expect a number of standard tests, including: 

• Urinalysis 
• Blood count 
• Thyroid tests 
• Rubella immunity
• Blood type and antibody screen
• STI tests (chlamydia, gonorrhea, HIV, Hepatitis B, and syphilis) 

You can also expect some specific lab tests or procedures throughout your pregnancy, such as: 

• MsAFP testing- a blood test drawn around 16 weeks gestation as a screening tool to detect neural tube defects, e.g. spina bifida
• Tdap booster shot - received at the beginning of your third trimester to allow antibodies to develop and cross into breast milk and help protect your baby primarily from Pertussis (Whooping Cough)
• Gestational diabetes screening and reassessment for anemia at the beginning of your third trimester
• Nuchal translucency (NT) scan and cfDNA testing as screens for Trisomy 21 (Down’s Syndrome)
• Ultrasounds -typically around 8 weeks gestation and again at 12 weeks for NT testing. We also perform an ultrasound at 20 weeks gestation to confirm all is well with your baby and placenta and look for abnormalities that might warrant additional imaging
• Weight checks 
• Blood pressure checks 
• Uterine growth checks. These are called fundal checks. Measuring in centimeters from the pubic symphysis to the top of your growing uterus (fundus) roughly correlates the weeks gestation starting at about 20 weeks.
• Fetal heart tone checks at every visit

Regular prenatal care is a crucial part of monitoring your pregnancy and making sure you and your baby remain healthy. Whether you’re a first-time mother or you’ve been through this process before, it’s important to find an OB/GYN that understands your needs and knows how to address your concerns. 

Is your new pregnancy making you second guess your current OB/GYN? Do you want a more experienced doctor on your side? Get in touch with the team at Physicians for Women by calling 608-218-4835, or book an appointment online.