The 10 Most Important Questions for the First TrimesterCeridwen Morris
You missed your period and now your home pregnancy test shows “2 lines” (either 2 pink or a pink and a blue). A zillion things may start running through your mind: “What do I do now?” “Who do I call?” “Is everything going to be okay?” “Should I be doing something different?” “I don’t even know what questions to ask or how to get started”.
The unique stresses of an early pregnancy overwhelm most women. The mental fog caused by the natural hormone changes can complicate your ability to stay focused on the most necessary details and responsibilities. Early on, as the newness and excitement permeates every aspect of your life, it’s quite easy to spin your wheels as you try gathering information.
To help you get through this whirlwind of hormonally charged mental confusion, we’ve created a simple checklist. Hopefully this list helps you cut through the mental fog and will give you a productive focus for your energy.
So here they are, for simplicity we’ve narrowed it down to the 10 most important questions (or topics) to ask your care provider (and yourself) during these first few days, weeks, and months of pregnancy. Obviously you will have more questions than these, but using this list will get you started on the road to an empowered and knowledgeable pregnancy.
When should I schedule my first prenatal visit? What will they do at that visit? 1 of 10Most OB providers like to see you sometime between 7 and 12 weeks of pregnancy. If you have any chronic health issues (high blood pressure, diabetes, etc.) you should be seen as soon as possible after finding out you are pregnant. At a typical first visit your provider or the nurse talks with you and your partner about your health history and any risk factors that may affect your pregnancy. Routine blood tests may also be taken. At this visit (or the next) you will get a physical and pelvic exam. The first visit usually takes longer than your follow-up appointments. Make sure to take adequate time off from work. Since blood tests are taken, make sure you have eaten a meal. It is also helpful to drink an extra glass of water an hour or so prior to your appointment time.
Photo credit: 4Neus.
What can I do for nausea, vomiting, dehydration, and constipation? 2 of 10About 75% of pregnant women experience these symptoms. About 2%-5% actually become dehydrated (with weight loss and other complications from the more severe form called hyperemesis gravidarum). Your OB care provider may recommend natural remedies (crackers, ginger, etc.). They may suggest some over-the-counter medications (Vitamin B6, Diphenhydramine, or doxylamine). If you are particularly miserable, your provider may actually prescribe anti-nausea medications. Constipation tends to be worse during this time thanks again to the affect on your intestines from the high levels of hormones. It puts them into slow motion. Stool softeners, high fiber foods or fiber supplements, and hydration may help. If these don't work, or you go less than once every four to five days, you may need additional help.
Photo credit: lifeography®/Flickr .
What is my due date and how is it calculated? 3 of 10Due dates are strange things … only about 5% of women actually deliver on their calculated due date. Although we stress that you should deliver sometime during a "due date range", most women want to know or feel better with an exact date. A full term "normal" pregnancy lasts about 40 weeks (start counting from your last period) or 38 weeks from conception. That's 280 days or 266 days depending on when you start counting. If you don't know when your last period was, or you have irregular cycles, or you don't have a clue when you conceived, the sooner you can get an appointment and get checked (with a pelvic exam, blood tests, and/or early ultrasound), the more accurate your due date will be. It is ideal to know your due date as soon as possible because several optional blood tests need this date for the testing to be done. Also … you won't be one of those women who says, "I think I've been given 2 or 3 or 4 different due dates". Plus…you can have friends start planning your baby shower â˜º
Photo credit: Amberlane/Flickr.
What are the signs of a miscarriage or an ectopic pregnancy? When should I be worried? When should I go to the emergency room? 4 of 10Contact your OB provider if you have any vaginal bleeding, severe cramps, or pain on one side or the other of your lower belly. Let them decide what you should do. Heavy bleeding like a period may be a sign of a miscarriage. If you do not have an OB care provider, you should be evaluated in an emergency room.
Photo credit: Torrie/Flickr .
What foods, drinks, or other environmental things should I avoid? 5 of 10You could really freak yourself out and want to wrap yourself in plastic wrap if you read every little thing about how various foods in our society may cause potential harm. This brief list will get your started…if you can heed these recommendations; you are a step ahead of the average person.
1) Stop smoking
2) Avoid alcohol
3) Wash fruits and vegetables before eating
4) Cook (microwave steam) pre-sliced deli meats or hot dogs
5) Don't eat raw or undercooked meats or eggs
6) Don't eat fish with high mercury levels limit other fish/seafood to 3-4 servings per week
7) Avoid unpasteurized dairy (fresh milk or cheeses)
8) Avoid caffeine
9) Very loud noises (jet engines, firing guns, front row rock concerts)
10) Avoid handling potentially infections animals or reptiles without gloves.
Photo credit: Termie/Flcikr.
When should I start taking vitamins or other supplements? 6 of 10If you planned your pregnancy, you should have already started taking a daily prenatal vitamin. In most situations, for those who haven't started yet, there is no need for a prescription type of vitamin. Choose an over-the-counter type that has 300mg of DHA (omega-3 fatty acid), at least 400mcg of folic acid (folate), and no more than 5,000 units of Vitamin A.
If you aren't a good milk or dairy consumer, you may also want to take calcium with Vitamin D as a supplement. A dose of 500 mg to 600 mg per day is a good starting dose.
Photo credit: BradleyJ/Flickr.
Do I stop or should I continue taking any previously prescribed medications? 7 of 10Some women take prescription medications for a variety of health issues (migraine headaches, high blood pressure, depression, anxiety, etc.). Certain medications are totally safe for the growing fetus while others (especially during the first 14 weeks) may cause problems. Your OB provider must coordinate and make the decisions to stop, change, or continue your medications. Don't try to make this decision alone. Call your prescribing provider right away.
Photo credit: Sojn/Flickr.
What things would make this pregnancy a “high-risk” pregnancy? 8 of 10If you are a healthy woman and take no regular medications, your pregnancy will typically progress as a low-risk experience. The following examples may put you in a high-risk category:
1) Being over age 35 at the time of your delivery
2) You are having twins or triplets or ???
3) Having had more than three miscarriages
4) Have a history of an ectopic pregnancy
5) Your pregnancy is the result of infertility and required assisted reproductive technology for your conception.
6) Chronic/consistent vaginal bleeding
7) You have a chronic health condition (diabetes, high blood pressure, etc.).
8) You develop a serious condition during pregnancy (placenta previa, preeclampsia, fetal birth defect, gestational diabetes, etc)
Photo credit: Daquellamanera/Flickr.
Can I continue to have sex? 9 of 10Your sex drive and your partner's will typically change throughout your pregnancy experience. During the first 14 weeks many women are very tired, and may have various degrees of nausea and vomiting. This makes it more difficult to get in the mood. Most women are safe continuing with their pre-conception love life. There are several reasons why your OB provider would not let you have sex. These include (not limited to): 1) Sexually transmitted diseases 2) Unexplained vaginal bleeding 3) Placenta previa 4) Previous premature birth (or labor) 5) Incompetent or dilated cervix
Photo credit: GraceL.
If I don’t have health insurance, what can I do to get started with my prenatal care as soon as possible? 10 of 10If you become pregnant and you have no health insurance, contact your local Health Department or Department of Social Services. Assistance programs may be available that will help pay for all or part of the cost of the care you need. Try not to delay care because you don't have insurance. Private practice medical offices, public clinics, and hospitals may offer discounts to get you started.
Here are some helpful hints to get the "ball rolling" for public assistance:
1) Find your birth certificate. You will need a certified copy of it to apply for any state medical assistance. This is one of the hardest things for many women to do. It is a huge reason why care gets delayed. Get on it!!
2) Get an official urine pregnancy test. This can be at a medical office, clinic, health department, etc. Ask for your "proof of pregnancy" documentation. You need this proof to get registered and started with your prenatal care.
3) Gather your financial papers. You will need proof of income. This can be tax forms, pay stubs, etc. Usually the past 3 months are sufficient proof.
4) If you are not married, write down your baby's father's name, date of birth, and social security number. If you don't know it, find out. This is vital information for establishing paternity and receiving child support.
Photo credit: Warreno.
Camilla Bicknell (RNC, WHNP) is the co-author, with Dr. James S. Betoni, of The Pregnancy Power Workbook, an incredibly informative new book that helps women navigate pregnancy by understanding the topics and questions most relevant to their prenatal care.
Above are a few specifics regarding the checklist topics. This is not a substitution for the care and relationship you have with your OB care provider. This just gets you started on that road.
Ceridwen Morris (CCE) is a certified childbirth educator– follow her pregnancy and birth blogging on Facebook.