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Pregnancy


What to expect in the first trimester

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Real mum's tip


"I am more aware of what I’m eating now that I am pregnant: I’m older, and so while carrying a baby I really want to do this right."
Mums’ Choice member Mariangela Balsama, 42

Month 1, weeks 0-4: discovering you're pregnant

Pregnancy is usually dated by doctors from the first day of your last period – often before your baby has even been conceived! Most women conceive around two weeks after this, but you may know the exact date of conception. You will be asked for this date if you know it, or for the first day of your last period at your first midwife's appointment (See Month 3, weeks 9-12), so they can calculate your baby's due date.

At this early stage, there's the possibility you will feel no different at all, and until a missed period you could remain completely unaware of your pregnancy. However, even before that missed period, many women start to "feel" pregnant. You might notice that your boobs feel heavy and your nipples are a bit sore, you could be experiencing extreme tiredness and find yourself nipping to the toilet every 20 minutes! Some women also feel quite emotional at this stage; so if you find yourself welling up at television adverts, just blame the hormones buzzing around your body.

If you haven't already been taking folic acid, start taking 400 micrograms a day as soon as possible – it can help reduce the likelihood of conditions such as spina bifida in your baby. Your body is more efficient at absorbing nutrients when you're pregnant, so make sure you eat a balanced, healthy diet and take a multi-vitamin specifically formulated for pregnancy that includes 10 micrograms of vitamin D – and it shouldn't contain vitamin A, which can harm your baby – find out more at NHS Choices.

Your baby

Although he's only the size of a grain of rice, your baby has multiplied to more than 150 cells, and over the coming weeks, layers of cells will form different parts of the body. For example, the outer layer will become your baby's nervous system, skin and hair, while the inner layer will become breathing and digestive organs. The middle layer will become the skeleton, cartilage, muscles, circulatory system, kidneys and sex organs.

This period of rapid change is when your baby's most susceptible to damage from alcohol, drugs or illness so cutting out alcohol and reducing caffeine intake is recommended.  If you want to find out more, check out the full government guidelines on pregnancy and alcohol.

Month 2, weeks 5-8: managing morning sickness

By now a missed period will have probably let you know for sure that you're pregnant. See your GP or a midwife as soon as possible and they can set the wheels in motion for your antenatal care. You may be getting morning sickness, which despite its name can strike at any time of day. Eating small, regular snacks can help and try not to skip meals – an empty tummy can trigger that queasy feeling. Many mums swear by ginger, so keep a stash of ginger biscuits or ginger tea bags to hand. Steer clear of spicy foods, as strong smells and flavours can also trigger feelings of nausea. Tiredness plays a big part in setting it off, so rest well, take naps and try to get at least eight hours' sleep at night.

Some women are fortunate enough to avoid morning sickness completely, but if you're not one of the lucky ones, don't worry – it will pass. By your second trimester, it should have got significantly better or stopped completely. In the meantime, if you're finding it hard to keep food down, talk to your GP or midwife for advice or ask other mothers for their personal tips – after all, they've had first-hand experience and this is a perfect time to share your worries.

Your baby

Your little one is less than 2.5cm long. His face is forming, his arms and legs are moving and his brain is developing further. By the end of week six, your baby is about the size of a small bean, but if you could look inside at what's happening you'd see a large head and dark spots where the eyes and nostrils are beginning to form. Other features, like ears, are also beginning to emerge. His hands and feet are shaped like little paddles at this stage, and even tiny fingers are beginning to form. Your baby's heart has divided into two chambers and is beating around 150 times a minute – if you had an ultrasound now, the heartbeat would show up. The neural tube (brain, spinal cord and other neural tissue of the central nervous system) is also well formed.

Month 3, weeks 9-12: understanding pregnancy hormones

As pregnancy hormones flood your system, you may find your emotions go haywire and you feel very tired. Go to bed early if you want to and if you feel like having a good cry, go right ahead! For many women, this can be one of the hardest stages of pregnancy, no matter how overjoyed you may be at being pregnant. If you've decided not to tell many people until after three months, it's difficult to explain why you're not quite yourself. The journey into work may feel more of a strain. So if you need to and you can, take time off work. Listen to your body if it's telling you to take it easy – and don't worry, the tiredness will ease in your second trimester.

Between 8 and 12 weeks, you should have a booking appointment with your midwife. To build up a picture of you and your pregnancy, they'll ask you some questions and it's also a chance for you to ask them any questions you might have. If you are at risk of having a child with an inherited genetic disorder such as cystic fibrosis or sickle cell, you may be offered chorionic villus sampling (CVS) from around 11 weeks. This test may also be used if you have a higher risk result when tested for Down's Syndrome (see What happens at your first scan? below) and involves taking a sample of cells from the placenta. To find out more about CVS, visit NHS Choices.

As you near the end of your first three months of pregnancy, your uterus is about the size of a grapefruit and you may have started to develop a small but distinct bump.

Your baby

Weighing around 28g, your baby now has wiggling fingers and toes and even tiny fingerprints. From week 10, your baby will more than double in size over the next few weeks, and he's now swallowing and kicking too. All of his major organs are fully developed, even though by the end of week 12 he's still only the size of a satsuma!

What happens at your first scan?

Between 8-14 weeks, you'll go for a first dating scan. If you haven't got one already, the hospital will recommend a midwife. Different hospitals offer different types of scan, but the most common is an ultrasound to check whether you're carrying one baby or twins, triplets or more. At your first scan, don't forget to ask for a picture before they finish – it will be his first portrait! You may be offered a separate nuchal scan between 11 weeks 2 days and 14 weeks and 1 day. This measures fluid at the back of your baby's neck to help assess the risk of Down's Syndrome or other chromosomal conditions (screening for Down's and other genetic disorders is offered to all pregnant women). It's not a diagnostic test, but estimates the likelihood of occurance, combined with a blood test that measures two blood chemicals associated with pregnancy. Ask your GP or midwife for more details. Your dating scan and nuchal scans may be combined. Your next scan, at around the 20-week stage, will be more in depth and will check that your baby is developing normally.

At your first scan, don't forget to ask for a picture before they finish - it will be his first portrait!

In your first trimester you might need...