First Trimester Basics

Learn about the common conditions, changes, and pregnancy side effects a women in her first trimester of pregnancy may encounter.
What to Expect in the First Trimester of Pregnancy

First Trimester Basics

by Dr. Peter J. D'Adamo with Catherine Whitney

The first trimester is the most critical time in your pregnancy. Although the fetus at the end of three months is only about 4 inches long and weighs less than 1 ounce, all of its functions have begun to form — major organs and nervous system, heartbeat, arms, fingers, legs, toes, hair, and buds for future teeth.

This is not a time to skimp on food or count calories. You're not quite eating for two people, but you do need extra nutrients for your growing fetus. The general recommendation is to eat about 300 extra calories a day. You'll need to gain 25 to 35 pounds during your pregnancy. This will allow you to nourish your fetus and store nutrients for breast-feeding. Expect to gain at least 3 to 4 pounds during the first trimester.

For many women, the first trimester is also the period when you experience the most profound changes. Although you may not appear pregnant, you'll certainly feel all of the differences.

Common First Trimester Conditions
Morning Sickness and Nausea
The nausea — "morning sickness" — that many women experience during the first trimester of pregnancy is the result of hormonal changes. Morning sickness (which isn't necessarily limited to mornings) may actually be a positive thing — though you may not feel particularly grateful. Some scientists believe that morning sickness evolved as a natural way of protecting women against foods that might contain dangerous microorganisms or parasites, or foods whose chemical compositions might prove harmful to a developing fetus, by expelling those foods. Also, increasing levels of the hormone beta-hcg have been linked to nausea. Since high levels of beta-hcg tend to protect against miscarriage, look on the bright side: Your morning sickness may well be an early sign that your pregnancy is off to a good start. Morning sickness usually disappears after the first trimester.

Mood Swings
Women are often surprised that they don't feel more buoyant at the start of pregnancy — especially when it is a long-awaited result. The stresses of the first trimester can produce many emotional ups and downs. Although you may be delighted that you're pregnant, the hormonal adjustments you're experiencing can make you feel anything but joyous. You may experience mood swings, fatigue and insomnia, anxiety about your ability to experience a successful pregnancy, and fear about what will happen.

Constipation is a fact of life for most pregnant women. Hormonal changes are largely responsible, signaling food to move more slowly through your system as it nourishes your fetus.

Your entire system is fully engaged in creating a healthy environment for your fetus — producing the placenta, a process that is completed at the end of the third month, as well as providing sufficient nutrients. Every organ is engaged in a vast reorganization. No wonder you're tired.

Food Aversions and Cravings
The food cravings and aversions that many women experience during pregnancy are something of a mystery. While you may crave what's good for you and be repelled by foods that are harmful, it doesn't always work that way. Your best strategy is to eat what's right for you and try to find replacements within your diet for the harmful foods you may crave.

Prenatal Supplements
Vitamins are very important to the developing fetus. However, you should be aware that overdoing supplements can cause grave problems in the baby, so consult your physician before taking any vitamins or supplements.

Virtually any of the commercial prenatal multivitamins will be effective. But many are made with synthetic components rather than the preferred whole food ingredients. Choose a blend of the B vitamins, along with antioxidants. Look for quality, not quantity. Not all formulations release the specified amount of nutrients on the label. When researchers at the University of Maryland tested nine prescription prenatal vitamin tablets to see whether the folate contained would dissolve, only three passed the muster. Two failed so miserably that they released less than 25 percent of the folate specified on the label. That means that if swallowed by someone, more than 75 percent of the folate in those pills could possibly travel right through the body with very little chance of being absorbed by the blood and transported to various tissues, including tissues belonging to the fetus. If possible, use powder-in-capsule versus compacted pills: Evidence suggests that dissolvability is a big problem with many prenatals. Encapsulated ingredients do not need to dissolve.

Your daily prenatal vitamin/mineral supplement probably doesn't give you enough calcium. Most of the daily prenatal formulas only contain about 200 to 300 milligrams of calcium — about 1,000 milligrams less than you and your baby need every day. So check the label on your bottle or talk to your doctor. You'll want to make sure that you are getting at least 1,200 milligrams of calcium every day from natural food sources and supplements.

If you wish to take a prenatal supplement specifically formulated for your blood type, see appendix B for information about "Healthy Start ABO."

Special Note: DHA Supplementation
A natural nutrient for humans of all ages, DHA, an omega-3 long-chain polyunsaturated fatty acid, is one of the essential building blocks of human brain tissue. Found naturally in breast milk, DHA is also present in egg yolk and oily fish, such as salmon and sardines. What does having enough DHA mean for you and your baby? Whether you're a baby or an adult, DHA is important for signal transmission in the brain, eye, and nervous system. Your developing baby receives the DHA through the blood, via the placenta and umbilical cord. Seventy percent of the brain cells are formed before birth. These cells are mainly composed of essential fatty acids, with DHA being the most important because it gives great flexibility to the cell membranes. Flexibility is essential for fast and accurate message transfer in the brain. During pregnancy, the recommended intake of DHA is 300 milligrams per day, in food and supplements. Studies have shown that mothers' diets deficient in DHA are often linked with low head circumference, low placental weight, and low birth weight in their babies.

Exercise Guidelines
There are tremendous benefits to maintaining your exercise program throughout your pregnancy. Regular exercise improves your condition and reduces the risk factors associated with pregnancy. It can also alleviate many of the uncomfortable side effects of early pregnancy, such as fatigue and morning sickness.

One of the most important functions of exercise is its ability to reduce stress and improve your mental condition. Pregnancy itself can be stressful. Throughout your pregnancy, you are also grappling with the effects this new reality will have on your relationship to the world. Your feelings, fears, and expectations about yourself, your family, and the impending arrival of your baby are important, too. To make matters a bit more complicated, your emotions can be affected by the dramatic hormonal changes you're experiencing. This is especially true during the first trimester.

Exercising three to four times a week, according to the blood type recommendations contained in chapters 3 to 6, will help you reduce stress, fight fatigue, and stabilize your emotions.

Exercise is good for your baby, too. Studies show that babies born to moms who exercise during pregnancy may benefit from better stress tolerance and advanced neurobehavioral maturity. These children are leaner at five years of age and have better early neurodevelopment. The new findings are added to the already-known benefits of exercise during pregnancy, including improved cardiovascular function, improved attitude and mood, easier and less complicated labor, quicker recovery, and improved fitness.

In addition to individual blood type guidelines, all blood types should bear in mind the following:

  • All aerobic exercise is not of equal value. If your regular workout involves contact sports or in-line skating, I'd suggest you forgo them during pregnancy, to avoid any potential injury to the abdominal area.
  • Make your aerobic exercises the low-impact variety. If you are taking dance or movement classes, keep your feet on the floor. No jumping or bouncing. Or choose exercises such as cycling, swimming, or brisk walking that have little or no impact risks.
  • Take extra time to warm up and properly stretch your muscles before exercising.
  • Wear a good support bra to protect your breasts and limit discomfort, especially if they are feeling tender.
  • Drink plenty of water throughout the workout.
  • Don't exercise on an empty stomach. Eat a snack 30 minutes before exercising.

Exercise Caution
Though exercise in pregnancy is generally safe, moms-to-be embarking on an exercise program should be aware of warning signs. If any of these symptoms occur, stop exercising and contact your practitioner: sudden and severe abdominal pain; uterine contractions lasting 30 minutes once exercising stops; dizziness; and vaginal bleeding. Other signs to watch for are decreased fetal activity, visual disturbances, or numbness in any part of the body.

For some women, such as those with heart disease, blood clots, recent pulmonary embolism, or for those who have a "high-risk" pregnancy, exercise may not be recommended. In taking the complete medical history, your practitioner will determine if maternal conditions limit, or exclude, an exercise program.

  • Eat Right for Your Baby
    Eat Right for Your Baby
    Eat Right for Your Baby