Maybe you’ve been trying to have a baby for months and have grown accustomed to squinting at negative pregnancy tests, hoping to see that elusive second line. Maybe pregnancy was the farthest thing from your mind, until you got queasy brushing your teeth last week. Either way, you’re expecting! Now the only trouble is, you have absolutely no idea what comes next—and it’s starting to make you panic.
The earliest days of pregnancy are a rollercoaster of emotion—thrill and joy at the thought of your soon-to-arrive little one, and fear and doubt over all of the changes your body is going through. For first-timers, that uncertainty can be especially hard to handle. Every woman, and every pregnancy, is unique, but knowing what to expect beforehand can make those first eight weeks a lot easier, and give you the peace of mind you’ll need to start planning for the next chapter of your life.
Visiting the Doctor
Once the reality of a positive home pregnancy test has started to settle in, your first thought will probably be, “Call the doctor!” It’s easy to be impatient in those early days, but getting in to see your doctor immediately may not be in the cards. Many newly pregnant women are surprised to discover that a first prenatal visit is commonly scheduled at eight weeks or later. (If there is reason for your pregnancy to be considered high risk, you can expect to see your doctor around the six-week mark.) The reason for this is simple: There just isn’t much to see before then.
“The earliest you could expect to see a heartbeat on an ultrasound is six weeks,” explains Dr. Robin Kalish, MD, an OB-GYN who practices at Weill Cornell Medical College in New York, New York. “Still, a pregnancy can be perfectly healthy and not have a visible heartbeat at six weeks. Many doctors are hesitant to bring a patient in that early, because if no heartbeat can be found it can worry her unnecessarily. By eight weeks though, there should definitely be a nice, strong heartbeat. So [this is] the optimal time for a first appointment by many doctors.”
It’s also worth noting that while a heartbeat should be visible on an ultrasound by eight weeks, the heartbeat won’t be audible until farther along in the pregnancy. Some doctors opt not to do an early ultrasound at all, waiting until around 12 weeks to listen for the heartbeat with a device called a Doppler, and doing an ultrasound around 18 weeks to check on the overall development of the fetus. If this is the case at your doctor’s office, you may not get an initial appointment until you’re closer to 12 weeks along. If an early ultrasound is done, your doctor will be looking for confirmation that the pregnancy is developing in the uterus—not in the fallopian tubes, as it would in an ectopic pregnancy—and checking to see if you’re carrying one baby or multiples.
If you haven’t seen your doctor in a while and are due for a Pap smear, your doctor will perform one as well as a pelvic exam and a breast exam. Blood will be drawn to look for things like anemia, and in some cases an STD screen may be done. (State law may mandate tests for HIV and other diseases.) Says Dr. Kalish, “At this first appointment, I’ll ask the patient about her family background to see if she should have any genetic testing done; for example, if she is from an Eastern European or Ashkenazi Jewish background I may test for Tay-Sachs disease. I’ll also do some initial counseling—what to expect during pregnancy, how my office works, how often she can reach me.”
Managing Early Symptoms
We’ve all heard the horror stories of nausea, vomiting, and bone-crushing fatigue from women who have been there, and this creates a lot of preconceived notions about what to expect when we’re expecting. The truth is, every woman is different, and the symptoms that accompany the first few months of pregnancy can be surprising.
Headaches: Dr. Kalish says that headaches are one of the most common symptoms in early pregnancy. “It is believed that the body’s increased production of estrogen during this time causes the headaches,” she says. “Tylenol is safe to take, but stay away from aspirin or products like Advil and Motrin.”
Heartburn: “One thing I was totally unprepared for is how debilitating heartburn can be during the first trimester,” says Kate Galloway, 31, from Minneapolis, Minnesota. “Sure, you expect a woman in her third trimester to have it; her stomach is basically in her chest at that point! But no one talks about how bad it can be early on.” Galloway, who is now in the second trimester of her first pregnancy, was able to reduce her heartburn by drastically changing her diet. When it flares up, she takes over-the-counter medications like Zantac. “Rolaids and Tums really didn’t help me,” she says. “And they’re awful to eat!” Over-the-counter antacids are generally considered safe to take during pregnancy, but it is advisable to speak with your doctor before you choose to take any kind of medication.
Nausea: Most women go into pregnancy prepared for the prospect of morning sickness. What they may not be prepared for is the all-day, low-grade nausea that is so common during these early months. “I find that reassurance really goes a long way in helping women to deal with nausea,” says Dr. Kalish. “They might be nauseated all the time, but never actually get sick, and this worries them. But it’s normal.” Also normal are food aversions and extreme sensitivity to smells. “Coffee is one of my favorite things in the world—something I thought I could hardly go a day without having—and right away it was one of the first things that made me nauseated,” says Galloway.
Eating more frequently is one way to head off nausea, which can often be caused by an empty stomach. Saltine crackers and ginger (ginger ale and ginger-flavored candies) are helpful as well, but Galloway warns that salty foods and carbonated drinks can trigger heartburn. Dr. Kalish recommends making an effort to avoid any foods or smells that may make you queasy, and says taking vitamin B6 may be one of the easiest ways to feel better quickly. “Studies have shown that B6 can be very effective in treating pregnancy-related nausea,” she says. “There are also over-the-counter acupressure remedies like Seabands, a product that is worn around the wrist to treat motion sickness. There is a lot of controversy surrounding the efficacy of Seabands, but they certainly can’t hurt. There’s nothing dangerous about them.”
Cramping: Menstrual-like cramping and other PMS-like symptoms in the weeks immediately following a positive test result can send a woman into a tailspin of worry. But cramping is actually a fairly common pregnancy symptom. “No one knows exactly why it happens,” Dr. Kalish says. “It may be because the uterus is starting to stretch and prepare itself for a growing baby. As long as there is no bleeding, there is usually nothing to be concerned about.” She recommends relaxing, and if the cramping becomes more severe or lasts for more than an hour, calling your doctor.
So what if you’re having no symptoms at all? It doesn’t necessarily mean that something is wrong. Some women simply have an easier time of it than others. However, if you’ve been experiencing the full range of symptoms—nausea, fatigue, sore breasts—and all of that suddenly comes to a stop, it would be worthwhile to check in with your doctor. A sudden loss of symptoms could be an indicator of a lost pregnancy.
Getting a Healthy Start
Women who are trying to conceive should start eating healthfully, getting exercise, and taking prenatal vitamins, but even if your pregnancy was a surprise, there is still plenty of time to get your body ready for Baby. If you’re not already taking a prenatal vitamin, start. The vitamin you choose should be high in folic acid, which has been shown to greatly reduce the risk of neural tube and other birth defects when taken in early pregnancy. Exercise is also a must. It’s important not to gain too much weight during your pregnancy, as this can put you at risk for gestational diabetes and other complications.
If you’ve been working out regularly before your pregnancy, you can continue to do the same routine. “Just use common sense,” says Dr. Kalish. “If you’re feeling overly tired or cramping, then that’s your body’s way of saying you’re overdoing it.” If you’ve been a couch potato up to now, start slowly. “Try to get in 30 minutes of brisk walking four times a week,” she says. “Yoga and other low-impact exercises can be a good way to strengthen muscles and avoid things like back strain as the pregnancy progresses.”
Says Galloway, “I’m learning to listen to my body more and know when it’s time to take a break. It’s really difficult to eat nutritiously when you’re nauseated and have heartburn, so I’ve learned to be happy for the small victories in my diet!”
Bonding with Your Baby
Perhaps the most difficult part of early pregnancy is finding a way to bond with your baby. You can’t feel your baby’s movements yet, and your body is showing no outward signs of impending motherhood. Dr. Kalish suggests talking to your baby. Even though the baby won’t be able to hear you until farther along in the pregnancy, studies have shown that newborns recognize the voices they heard in the womb after they’re born. Talking to your baby now will make you feel like he or she is already a part of the family, and will get you into the habit for later on.
Reading about the week-by-week development of your baby will make you feel more connected to the changes taking place within you, and talking about the baby’s arrival with your partner will help you get used to the idea of having a baby in the house.
Finally, if your doctor does not initially offer you an early ultrasound, ask for one. “One of the greatest things an early ultrasound does is to help a woman bond with her baby,” says Dr. Kalish. “A pregnancy test can tell you that you’re pregnant, but actually seeing your baby up there on the monitor makes it real. Seeing is believing.”