The First Trimester of Pregnancy: An Overview

Most couples expect to get pregnant at some point. When it's the first time, they suddenly realize what a gamble pregnancy is. However, be reassured. Most pregnancies—whether it is a woman's first or fifth—usually go without a hitch.

The first 12 weeks are a wonderful, exciting, and sometimes scary time. Let's talk about the most common concerns during this time—and, hopefully, reassure you.

Why Would I Suspect I'm Pregnant?

Besides missed menstrual periods, several symptoms can indicate that you're pregnant:

• Breast tenderness, because estrogen stimulates breast tissue
• Constipation, because progesterone slows down the intestinal tract
• Cravings, although doctors don't really know why
• Mood swings, also from fluctuations in hormonal levels
• Queasiness and nausea, possibly caused by the rise in the hormone hCG, which resembles elevated thyroid hormone, a cause of nausea

Prenatal Care Checklist

OK, now you're sure you're pregnant. Congratulations! Your next step is to make an appointment with your obstetrician or nurse midwife for an initial prenatal visit. Allow at least an hour for the visit, or longer if you need an ultrasound or if the blood laboratory is located elsewhere.

What will routinely happen during that first appointment? Your care provider will do the following:

• Take a history or get a history update.
  
  
• Give you a thorough physical exam.
  
  
• Confirm the pregnancy and estimate your due date (your baby's gestational age).
  
  
• Arrange for initial blood work. This includes getting a blood count, determining your blood type for Rh, and screening for syphilis and rubella (German measles) immunity. Depending on your family history, your blood may be screened for sickle cell anemia, Tay-Sachs disease, and cystic fibrosis.
  
  
• Get standard cultures for the sexually transmitted diseases (STDs) gonorrhea and chlamydia.
  
  
• Get a Pap smear, unless you've had one recently.
  
  
• Listen for fetal heart tones if you are more than 12 or 13 weeks pregnant.