Congratulations on your pregnancy! This can be such an exhilarating time, although many first-time expectant moms are initially overwhelmed and uncertain about what to expect. Our advice: Take it one month at a time. Here’s a brief guide to each month of pregnancy to help you along the way.
The First Trimester
Month 1: Weeks 4-8
This is the time to establish healthy habits:
• Maintain a balanced and nutritious diet.
• Begin taking a prenatal vitamin if you are not already doing so.
• Keep up a low-to-moderate-intensity exercise regimen.
While you may want to shout your news to the world, many women choose to wait until the second or third month, when the risk of miscarriage is not as high. Ask around or call your local medical center to find a healthcare provider and make a prenatal appointment. Typically, the first visit is around eight weeks.
Month 2: Weeks 8-12
You should have your first prenatal visit early in the second month if you haven’t had it already. Depending on your history and menstrual cycles, your provider may order an ultrasound. She will recommend a panel of blood work and urine tests, including tests for current or past infections. A flu shot is recommended at this time during non-summer months. You will have the option to do testing for Down syndrome and other abnormalities, which is done as early as 10 to 12 weeks.
Your provider should be able to hear your baby’s heartbeat around this time as well! Although it can be a very happy time, it can also be quite difficult for those experiencing morning sickness. Hang in there, and make sure to talk to your provider, especially if your symptoms are severe. From month two through month seven she will likely see you once per month, so make sure to write down any non-urgent questions and concerns between appointments to jog your memory when you see her.
Month 3: Weeks 12-16
You may start to show as your enter your second trimester. Your morning sickness may be getting better and you should start to see the first few pounds of the recommended 25-to 35-pound weight gain for a normal pregnancy, if you haven’t announced your good news yet to friends and family (and to your employer), now may be a good time since the risk of miscarriage is much lower.
The Second Trimester
Month 4: Weeks 16-20
Some providers recommend a blood test during this month for spinal cord, brain and abdominal wall defects. The recommendation for almost all pregnant women is to have an ultrasound at around 20 weeks to examine the baby’s anatomy head-to-toe. This is also when you may find out your baby’s sex, so be sure to bring a support person! If you weren’t showing before, you probably are now —and you can start to transition to comfortable maternity clothing.
Month 5: Weeks 20-24
Although you can no longer wear your favorite jeans, this is a time when many expectant moms are feeling pretty good. Go ahead and plan some pampering around town or even a “babymoon”. Keep up with your healthy diet and exercise regimen. You’ll keeping seeing your provider once a month.
Month 6: Weeks 24-28
During month six your provider will recommend a test for gestational diabetes and anemia, and often a tetanus and whooping cough booster shot to protect your baby after birth. Women with certain blood types will need an extra immunization to protect future pregnancies from complications. You can start to ask friends and neighbors for pediatrician recommendations — call to ask if the providers are accepting new patients and get on the list.
The Third Trimester
Month 7: Weeks 28-32
Welcome to your third trimester! Some women like to do hospital tours, breastfeeding classes and “infant care 101” or CPR courses. This is also a good time to have a baby shower. You may find your energy starting to fall, so make sure to get plenty of rest and hydration to keep you and your growing baby healthy.
Month 8: Weeks 32-36
If you haven’t already, you’ll likely start seeing your provider at least every two weeks at this point. She will review signs of preterm labor or ruptured membranes and she will begin teaching you how to count your baby’s kicks. Your provider will check your baby’s position to ensure that he or she is setting down in your pelvis headfirst.
Like many women before you, you may be increasingly uncomfortable allover. Lower back pain is very common at the end of pregnancy as you center of gravity and alignment shift.
At around 35 weeks or so, you will have a test for group beta strep, a bacteria that many women carry. If positive, you will need antibiotics in labor. Although you may be furiously prepping the nursery and filling the freezer with frozen meals, remember the value of a good night’s sleep.
Month 9: Weeks 36-40 and Beyond
Hang in there — the home stretch can be tiresome. But it’s worth it! Be on the lookout for labor or ruptured membranes. Your provider will want to see you weekly toward the end to keep a close eye on your blood pressure and watch for other complications. You may feel pressured to accomplish some last-minute tasks, which is fine within reason, but remember that what your baby will need most is you (and the rest will fall into place).
So enjoy your pregnancy, and remember to take it one month at a time. Your journey will be rewarded!
Margaret K. Chory, MD, is a general obstetrician/gynecologist practicing in Pittsburgh, PA.
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