Whether with a first child or a fifth, there is nothing quite like seeing a pregnancy test turn positive to give your heart and mind a jolt. If you’re inclined toward skepticism, you might feel the need to repeat the test again and again but doubt not, a positive (even a faintly positive) pregnancy test is almost never wrong. Once you’ve gulped down the news yourself, you can look forward to jumping right into the exciting world of pregnancy by shouting it out on the rooftops or you can keep the news a secret close to your heart and keep the world at bay for a few weeks while you settle into the changes to come. Both options are great and you should feel free and entitled to make whatever choice suits you best.

If you’ve missed your period (assuming there is not a clear reason for missed periods like hormonal birth control) but your pregnancy test is negative, there is certainly a chance that you’ve got a “false negative” and the hormones are just not high enough to register. In this case, continue to test every few days until you either get a positive test or a period. If several weeks go by and still no answer, it is unlikely that you’re pregnant but it is a good idea to have a visit with your provider to see what else might be going on. Likewise, if you find yourself with an unintended or an unwanted pregnancy, try not to panic. You don’t need to make any decisions immediately; give yourself a few days to process the challenge at hand, find some support in your family or friends and get in to see your provider to have a comprehensive discussion of all the things you’ll need to consider.

Onward to Trimester One

The first trimester starts with your last period (LMP) and ends at the completion of the 13th week. If you are confused about those first two weeks, you’re in good company. It’s true, you’re not officially pregnant in the two weeks after the LMP but counting pregnancy dates this way proves to be the most reliable method for determining due dates and so providers, long ago, universally agreed to do so. The first trimester also holds some of the most dramatic changes of pregnancy so there is lots to think about, experience, enjoy and, sometimes, suffer through.

Just about everybody knows that nausea and vomiting are a common occurrence in these early weeks of pregnancy. About two-thirds of women will experience “morning sickness” in some form ranging from mildly annoying to quite debilitating. That means that a full 33% of women don’t get any sickness at all and this is just perfectly fine. Nausea will typically start at 6-7 weeks and start to improve at 11-13 weeks. Please see our great article on nausea and vomiting in pregnancy for tips on managing the symptoms. If you’re not feeling sick, don’t worry about it. Just consider yourself lucky and take advantage of it by eating well and getting some exercise. Many people are less familiar with the second most common early symptom of pregnancy which very significant fatigue. To be perfectly honest, you’re just going to have to suffer through this and have a good laugh at yourself for wanting to go to bed at 7pm. Your body is asking you to rest so listen up, indulge in some laziness and know that this also starts to get better at the end of the first trimester.

These 13 weeks will usher your baby through monumental changes. A microscopic bunch of cells at week one becomes a 3-inch long little boy or girl (the sex is set but we can’t see it yet) with a beating heart, spine, brain, gastrointestinal system, eyes/ears/nose/mouth, even eyelids and the beginning of fingers and toes among many other fascinating developments. For mom, the changes are constant and involve the whole body and mind but most women (particularly the first-timers) have trouble believing they’re really pregnant instead of just tired, nauseated and emotional. Many women feel like they are just about to start a period with some vague (and mild) cramping sensations and tender breasts. But it all comes together and starts to feel real when you first hear your baby’s heartbeat. We expect to hear it by 12 weeks but are often lucky and find it as early as nine or ten weeks. If ultrasound is available, a heartbeat can usually be detected by six or seven weeks.

Unless you are starting the pregnancy underweight, you really should not gain more than about five pounds during the first trimester. This can be challenging when food cravings and aversions dictate your life and nibbling constantly helps calm the nausea. But do try to keep this in mind; once the baby starts fattening up, you will be gaining about a pound a week until the end of pregnancy for a total of 25-35 lbs. You will lose 10-15 lbs on the day your baby is born and the rest of that weight is yours to work off. If you’ve indulged in an extra 20 lbs “eating for two” you will have to “exercise for two” down the road. Also, too much weight gain puts you at risk for all sorts of unpleasant complications and physical pain. We know it’s hard but do your best.

Jobs for Trimester One

There are so many things to think about with a pregnancy. Most of it is fun preparation with a few run-of-the-mill tasks. First and foremost, don’t wait to see your provider to start some prenatal vitamins. Ideally, you should have started them months ago but if not, get started today. Next priority is to get your first prenatal visit scheduled with a provider you feel comfortable with and trust. We’ve got so many great doctors and midwives here at P&MCP that we’re sure you’ll find your match. We like to see you at eight weeks but certainly no later than 12 weeks so call as soon as you get a positive pregnancy test. After scheduling your appointment, it’s a good time to figure out the details of your health insurance and get a sense of how much you will need to contribute financially to your care.

After these items are checked off, you’ve got some time (about 35 more weeks or so) to get through the many other preparations. You’ll want to stock your house with healthy foods and see if you can get a mild exercise routine going, make sure any other medical issues are being dealt with and all providers are on the same page, learn about options for prenatal testing (for birth defects), learn when you should and shouldn’t worry from your provider, buy some new bras to support your growing breasts, and have some real conversation with your partner about your visions of parenting together. Take it all on at once or take it slow but whatever your style, remember to also jot down some notes or take pictures throughout the pregnancy (even if you feel too crummy to do it, do it anyway) so you can look back on this crazy and wonderful time – your first trimester.