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What to expect in your first trimester – a four-part series

June 11, 2018

How to care for baby and you during each stage of pregnancy and beyond

So you’ve taken an at-home pregnancy test, and it came back positive. Congratulations! Now what happens? Lorraine S. Novas, M.D., an OB/GYN who delivers at Northwest Community Healthcare (NCH), has the answers to questions about the first trimester, which runs from the first missed period through about the end of the 12th week.

Women may notice breast tenderness and frequent urination, but the big question is, “Why am I so tired?”

“It could be that the added metabolic needs of the pregnancy cause it,” Dr. Novas says. “The reality of it is that it’s very common, not unusual or bad.”

She recommends getting nine or 10 hours of sleep each night and if you’re working, try to avoid the night shift. “It can cause anxiety and depression,” she says.

Most commonly, women in their first trimester want to know about eating, exercising and hair products, Dr. Novas says. “Usually, I tell them that it’s fine to dye or perm your hair and get your nails done. And you can use cleaning products.”

Dr. Lorraine Novas

The no nos

Soon enough, you’ll be telling your toddler no. But first you have to tell yourself no to certain things while pregnant. Dr. Novas’ list includes:

  • Sugary soda
  • Caffeine
  • Alcohol (due to the risk of Fetal Alcohol Syndrome)
  • Cigarettes
  • Marijuana
  • Hot tubs
  • Changing the litter box (due to toxoplasmosis)
  • Large meals (due to nausea)
  • High fructose corn syrup
  • Raw, uncooked meats including deli meats
  • Certain seafood with high mercury levels (shark, mackerel, etc.)

Diet and dealing with morning sickness

Dr. Novas’ advice includes eating small meals several times a day and keeping hydrated. Steer clear of strong smells. Don’t cook with heavy spices. Eat a variety of foods that include fruits, vegetables, meats, nuts and dairy. Avoid sugar.

“Sugar in general is not good for baby,” Dr. Novas says. “This is going to encourage weight gain, nausea, vomiting, gestational diabetes – all things you want to avoid.”

Various medications can help with morning sickness and are considered safe. You can try an antihistamine like Unisom, available over the counter. Vitamin B pyridoxine is considered safe and effective at lowering nausea, but marijuana is not recommended.

“There’s a big buzz going around that using marijuana helps with nausea and vomiting, but it probably makes it worse, especially with the edible marijuana,” Dr. Novas says.

Realize that morning sickness will pass. Expect some nausea to begin around week eight and end around week 12.

“Morning sickness is actually a sign of a healthy pregnancy because there’s a hormone associated with the pregnancy and when it goes up sharply, that’s when the nausea really hits,” Dr. Novas explains. “Those tend to be the healthy pregnancies.”

In your first trimester and beyond, consuming a good variety of healthy foods will provide enough folic acid, which is important for baby’s development. It’s also great to begin taking prenatal vitamins. Either purchase an over-the-counter brand or get a prescription from your obstetrician. You can take them one month before the pregnancy and during the pregnancy to reduce birth defects,” Dr. Novas says.


If you’ve already made reservations for a trip or you want to plan one during your first trimester, it’s okay. “Airplane travel is not intrinsically dangerous but sitting for many hours may encourage blood clots in the legs,” says Dr. Novas says, who recommends getting up frequently, especially on long cross-country trips.

Speaking of getting up and moving around, exercise is encouraged during all stages of pregnancy. “Even fairly vigorous exercise makes you stronger and it’s easier to push baby out,” she says.

What happens at the first OB visit?

Dr. Novas collects health history information from both families. A pap smear is done and state laws mandate testing for gonorrhea and chlamydia. The second visit is between six and eight weeks (if they’re not already at that stage at the first visit) at which point an ultrasound is performed.

“Once we’ve seen the embryo, we go ahead with blood tests because we want the blood type, the blood count and we check the thyroid,” Dr. Novas says. “We test for hepatitis, AIDS and syphilis, and make sure that there is immunity to rubella and German measles.”

Prenatal testing for birth defects also is offered at this point, although it is optional.


“Before you’ve missed your second period, we can see the heartbeat on ultrasound,” Dr. Novas explains. “Even if you’re two or three weeks late, we can probably see a heartbeat on ultrasound.”

Much can be detected at the eight-week ultrasound, Dr. Novas says, including the size of the embryo which helps to establish a due date.

Stay tuned for our next article, “What to Expect in the Second Trimester.”

Dr. Novas is part of Gynecological & Obstetric Associates, SC.

Learn more about the NCH Women’s Center.