The First Trimester of Pregnancy

(Setting the Stages of Your Pregnancy)

Pregnancy is divided into trimesters. The first trimester ends at 12 weeks, the second at 24 weeks and the third at delivery. Many changes occur to the developing fetus and mother during each trimester. After the initial excitement of a positive pregnancy test many women wonder why they just don’t feel well during the early part of pregnancy. Although every pregnancy is different and women all report different experiences during early pregnancy, most women will report some symptoms of nausea and fatigue.

Fatigue or an almost overwhelming tiredness is very common in early pregnancy. I have found (both personally and professionally) that the fatigue tends to be worse in second pregnancies than first. Perhaps because the expectant mother is unable to devote as much time to resting when she has other children to care for. There is no easy solution for the fatigue, most physicians will check for anemia and a prenatal vitamin is recommended. The best solution is to try and get extra sleep at night and ideally a nap in the afternoon. Excessive amounts of caffeine or other stimulants are not recommended during pregnancy. Fortunately the fatigue usually goes away by the second trimester.

Along with fatigue, nausea is almost universal in early pregnancy. Although called morning sickness, symptoms can occur at any time during the day. A better name would be "empty stomach sickness" as this tends to make the nausea worse. I have found that once you can get some food into your stomach you tend to feel better. Nausea can be mild or quite severe and accompanied by vomiting. Common sense remedies can often be helpful. Avoid smells that provoke nausea. If a particular food makes you feel sick, don’t eat it; conversely if something sounds appealing try to eat that. Frequent small meals are usually more tolerable than the typical 3 meals a day. Some women tend to "graze" during this time with constant small snacks. Sometimes the act of preparing food can make nausea worse; enlist the aid of your family and friends in preparing meals or make only very simple meals.

Avoiding dehydration is important. Dehydration will make nausea worse and may require a trip to the emergency room. Constant small sips of fluids (water or juice) can help avoid fluid depletion. Sucking on popsicles or ice chips will also help. In severe cases (called hyperemesis gravidarium) intravenous fluids may be required.

Other morning sickness remedies include eating as soon as you wake up in the morning; toast, crackers or rice cakes. Ginger and peppermint teas may also help. Flat ginger ale or cola drinks may help. Sucking on pieces of lemon has also been suggested. Accupressure bands (used for seasickness) will help some women. Vitamin B6 supplements (50 mg) are also used for morning sickness. Dried fruit such as apricots or raisins may be tolerable. Although we would rather avoid any medications early in pregnancy there are drugs that can be used for women with severe nausea that doesn’t respond to other remedies. Any pregnant woman who hasn’t been able to keep any thing in her stomach for 24 hours should contact her obstetrician.

Many women (myself included) feel that the first trimester is the most difficult in regard to just not feeling well. However, these feelings pass and most women have much more energy in the second trimester.