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Pregnancy month-by-month: 1st Trimester

What to expect and what to plan for in the first trimester

Posted: 28 March 2009
by Maria Muennich

The First Month | Month Two | Month Three

The First Month
Women often spend the first few weeks of their pregnancy completely unaware that they they are pregnant. Those not using contraception and actively trying to conceive may be more sensitive to early symptoms of a potential pregnancy, but a pregnancy isn't usually confirmed until at least a couple of weeks after conception has taken place (usually following a missed period and/or positive home pregnancy test). What's more, doctors date a pregnancy from the first day of the last menstrual period, rather than conception, so by the time you realise you are pregnant you may well officially be over four weeks into pregnancy. But there is still plenty happening in this first month of pregnancy and plenty that you can do to protect the health of your baby if think you might be pregnant, even before your suspicions are confirmed.

Getting off to a healthy start
If you suspect you may be pregnant you may get an accurate test result with a home pregnancy test once your period is several days late. Or you can book an appointment with your doctor for a pregnancy test. Meanwhile, it makes sense to behave as if you were pregnant until you can confirm otherwise, so read up on our essential pregnancy dos and don'ts to get a potential pregnancy off to a healthy start. Besides being careful to avoid harmful substances, such as drugs, cigarettes and alcohol, do make sure you're taking a folic acid supplement of 400mcg daily to assist the healthy development of the fetus.

If you've already got a positive test then congratulations! Have a read here about what happens inside your body in the first weeks of pregnancy. If you've ben feeling a little emotionally out-of-kilter in these first few weeks then be assured that this is normal for the early stages of pregnancy as pregnancy hormones begin to flood your body, throwing off your usual balance. You might also already be feeling tired and experiencing some other early early symptoms of pregnancy, such as sore breast, abdominal cramps and needing to urinate frequently.

If this isn't your first pregnancy then you may be wondering how pregnancy will be different second time around. Of course everybody's experiences are different, but there are some common themes in second pregnancies for which you might want to prepare. If you're still breastfeeding your first baby then you may be wondering whether it's safe to continue breastfeeding while pregnant.

Month Two
Confirming your pregnancy & booking in
Sometime around the start of this month is when most pregnant women notice they have missed a period and test for pregnancy and are finding out what lifestyle changes pregnancy brings. Now's the time to make an appointment with your GP to confirm your pregnancy and get your antenatal care started by booking in with the midwife. Take the opportunity to talk to your doctor about any medication you are currently taking as well as any herbal or homeopathic treatments so you're sure you're not taking anything that may harm your developing child.

Your doctor may want to discuss your gynaecological history with you and should give you some pointers for getting your pregnancy off to a healthy start, avoiding certain foods while pregnant and good pregnancy nutrition. During your pregnancy you'll need to be more careful than ever when it comes to kitchen hygiene and be particularly careful when handling pets (or vegetables that may have soil on them) to avoid toxoplasmosis. If you're struggling to reduce your alcohol intake then bear in mind that weeks 6-12 are the most critical for your baby's development and it's wise to avoid alcohol completely at this time - have a read of our tips for cutting out the booze to help.

When at your booking-in appointment with your midwife (or GP), hopefully sometime this month, but possibly next month, be prepared that you will need to face the needle for blood tests.

Planning antenatal screening
During this month you may also want to think about whether to undergo antenatal screening, including blood tests to check for abnormalities, particularly if you are in your late thirties or have a family history of genetically transferred illness. If you're over 35 then you may be offered a Nuchal Translucency or Nuchal Fold scan (sometimes alongside the 12-week scan) to check your baby's risk of developing Down's Syndrome. This is a non-invasive risk-assessment, carrying no risks to mother or baby, unlike CVS or amniocentesis, but it isn't routinely offered to expecting mothers and coverage across the UK can be patchy. If you'd like the scan then do make sure to ask your GP or midwife about it early this month - if you wait for your booking-in appointment with your midwife it may be too late to arrange the scan which needs to be done between weeks 10 and 13.

If you enjoy exercise and you're worried about how your exercise regime might affect your developing baby then be reassured that plenty of exercise during pregnancy is great for your baby and for you. You may well, however, need to change the type and intensity of the exercise you do. It's a good idea to talk to your doctor about this (particularly if you're now starting an exercise regime), read up on what exercise is safe in each trimester and to be aware of signs that you are overdoing it.

Pregnancy discomforts
If you're one of the 7 in 10 women who are affected by morning sickness then you'll probably find that it kicks in sometime this month, often by week six. Nausea can range from mild discomfort to daily disruption and vomiting and in the worst cases can make it difficult to eat or drink much at all. A small number of women will suffer a more extreme form of morning sickness, hyperemesis Gravida requiring medical treatment. Most women, though, will find that they can get some relief through the careful managing of their diet, scents or one of the increasing number of products designed to help.

Even more common than nausea in these early weeks is pregnancy tiredness - making a baby is hard work so don't be too surprised if you suddenly find you're wanting to nap during the day and hit the sack by nine-thirty. If you're affected then try our tips for boosting your energy levels during pregnancy. Early pregnancy aches and pains are also quite common - whether that's headache, backache, sore sinuses, abdominal cramps, wind or constipation. Make sure you know what medicines are safe to take during pregnancy, and always check with your doctor or chemist before taking anything. You may also be experiencing mixed emotions about your pregnancy, swinging between euphoria and the blues and perhaps find yourself feeling a bit weepy. If you are suffering then try to focus on the positive.

Bleeding during early pregnancy is relatively common, but it can be alarming. Although many causes of early pregnancy bleeding are benign, it may also be a sign of threatened miscarriage, so if you are experiencing any spotting, bleeding and/or severe abdominal cramps then it's best to inform your doctor or midwife straight away to see if they can determine the cause and give you specific advice relating to your circumstances.

If you're not experiencing any of these pregnancy discomforts at this stage then don't worry that your pregnancy isn't 'normal', just get on and make the most of it being plain sailing!

Your partner's role
Your partner may not have quite the same thirst for knowledge about all things pregnancy as you do at the moment, but he can support you better through any pregnancy difficulties if he has at least some idea of what's happening, so do encourage him to find out how he can help in early pregnancy.

Month Three
By now you should have been given an appointment for your 12-week development scan (if this is offered on the NHS in your area). If you haven't yet got your appointment early this month then do chase up with your midwife or hospital concerned. A few areas of the NHS do not offer this scan, in which case you should still be offered the chance to hear your baby's heartbeat with a doppler at around 12 weeks. You also have the option of paying privately for a scan if you feel you can't wait until the 20-week scan to see your baby.

Physical changes
In this third month you may well still be adjusting to the fact of being pregnant and to the thought of becoming a mother in a few months' time. Partly for this reason, but also because of various pregnancy discomforts, difficulties sleeping are common even now, before you develop a jiggling bump. If you're affected then find out about ways you can improve your chances of a good night's sleep. While you're likely familiar with the notion of pregnant women 'blooming', pregnancy hormones and discomforts may adversely affect your skin and hair condition right now, leaving you dry, spotty, itchy and generally bloom-less. If you're suffering with oily, spotty skin then treat your skin gently to avoid worsening the problem and keep dry, itchy skin well moisturised.

The extra blood being pumped around your body can make your teeth more susceptible than usual to tooth decay from quite early on in pregnancy, so good dental hygiene is particularly important at this time. You are entitled to free dental health care on the NHS during pregnancy, so do make the most of it, but make sure that your dentist knows you are pregnant right away, as some procedures will need to be modified for pregnancy or put on hold until after the birth.

During this month you may start to notice your body shape changing, with changes to your breasts, your waistbands becoming tighter and perhaps even a hint of a bump. You may already feel that you need to invest in a few new bras, particularly if your breasts have also become very sensitive. Some women change shape more quickly than others and it's usual to grow faster the second (or third etc.) time around.

Image of 12-week fetus courtesy of Babybond
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Your 12-week scan
As this trimester draws to a close, most women will have the excitement of the 12-week developmental scan, usually done between weeks 12 and 14. This is usually the first chance that you will have have to see your baby and hear his or her heartbeat (it's still too soon to discern the gender).

This scan will usually be an external scan and you'll probably be asked to drink plenty of water beforehand to fill your bladder and so move the uterus higher to give a clearer picture. An NHS scan is usually two- or three-dimensional, unlike the 4-D scan pictured here, but you should still be able to see that your baby is already a mini-human being with arms, legs, head and defined spine. You may be allowed to take stills from the scan home with you, so it's definitely worth asking. Find out more about what happens at antenatal scans here.

If you are expecting twins then this scan might well be the first time that you realise it's a multiple pregnancy. So you might want to find out more about any special circumstances of a twin pregnancy, find out how fetal development differs for twins and make doubly sure that you eat well.

Fetal development in the first trimester

These articles contain information on how your baby is growing in the womb week-by-week, advice on what to expect at your current stage of pregnancy and top tips on how to combat common problems such as morning sickness.

Fetal development week-by-week: 1-4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13

When you become a member of ThinkBaby you are given the chance to receive these weekly Fetal Development updates as newsletters. Two easy steps are all it takes to sign up for the Fetal Development e-mails. After you have joined ThinkBaby visit the 'My Newsletter' page in your profile. Simply click on the box next to 'Fetal Development newsletters' and then visit the 'My Baby' page and select the date your baby is due.

Alternatively, if you don't want to receive this information straight to your inbox, you can read them all here at your own leisure.

Once your baby is born you can choose to receive monthly Baby Development newsletters in the same way.

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