For most mothers, there aren’t many times in life that compare to the moment when you realize you’re pregnant for the first time. The thrill of getting the news, realizing a little life is growing inside you, and then sharing it with family and friends are things you never forget. It marks a new chapter in life and the moment when your family started growing.
And while the excitement and anticipation of this season in life are wonderful, there are very important things you should be aware of and actions to take as you protect your health and that of your unborn child.
What are the signs?
“Aside from taking a home pregnancy test, there are several telltale signs that you’re pregnant,” said Cynthia Mangubat, MD, an obstetrician-gynecologist (OB/GYN) at OSF HealthCare. “Some women experience a number of symptoms, while some may not have any symptoms at all. They usually start around the sixth week after the last menstrual period.”
Some of the most common symptoms are:
- Breasts that are sore or swollen
- Darkening of the skin around the nipples
- Food cravings and aversions
- Frequent urination
- Light vaginal bleeding – notify OB/GYN immediately
- Nausea, with or without vomiting
- Sensitivity to certain smells that can trigger nausea or vomiting
When to see the doctor
“As soon as a woman realizes she’s pregnant, it’s important for her to make an appointment to see her OB/GYN, especially if she’s over 35 years old or has a history of high-risk pregnancies, such as a previous miscarriage, previous C-section or other complications,” Dr. Mangubat said.
During that first visit, the expectant mother will undergo a complete physical exam, discuss her medical history for risk factors (diabetes, hypertension, family history of heart disease, etc.), and determine the age of the pregnancy, usually based on the date of her last menstrual period. If the mother is unsure of when her last menstrual period occurred, an ultrasound will be ordered.
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The first ultrasound is best done within the first trimester but not necessarily during the first visit. Among other things, it’s important for detecting the fetal heartbeat, measuring the baby’s length, confirming viability and ensuring the fertilized egg has implanted properly inside the uterus.
“An ultrasound at this stage is the most accurate way to determine how far along the pregnancy is,” Dr. Mangubat said. “Beyond the first trimester, the measurement is less accurate, and we must be accurate to ensure the baby is carried as close as possible to full term, especially if an induction or C-section is planned.”
The mother will see her doctor monthly until she reaches 30-32 weeks of pregnancy. At that point, appointments will be every two weeks. Visits will switch to weekly at 37 weeks before delivery, around week 40.
Common health risks during pregnancy
There are several health risks that an OB/GYN is always on the lookout for during pregnancy.
“We always check for high blood pressure, which is common in first pregnancies, teen pregnancies and pregnancies when the mother is over 35 years old,” Dr. Mangubat said.
Other risks include:
- Gestational diabetes: Diabetes that develops due to pregnancy
- Urinary tract infections: Can cause preterm labor
- Preeclampsia: A condition marked by elevated blood pressure (greater than 140/90) and protein in the urine that can decrease blood supply to the placenta and baby, causing reduced amniotic fluid and restricted growth
- Weight gain: The target for weight gain is around 25 lbs. Going over that raises the risk for high blood pressure and gestational diabetes. It also raises the risk for a large baby that can lead to complications during delivery or the need for a C-section.
Of course, the mother’s diet is very important, as she is now eating for two. It’s common for her to have cravings for certain foods during this time. Sometimes, these cravings are due to nutritional deficiencies. But other times, certain foods just sound good to her.
“Since many pregnant women deal with nausea, it’s important for them to eat what sounds good to them to ensure they’re getting at least some nutrients,” Dr. Mangubat said.
But there are certain nutrients they need to make sure they’re getting. These include:
- Protein, which is essential for an unborn baby’s development.
- Fiber, which helps prevent constipation.
- Prenatal vitamins, which aid the baby’s development and mother’s health. An OB/GYN will let the mother know if there are any additional vitamin or mineral supplements she should be taking.
“But while a woman may have cravings for sweets, like chocolate, it’s important not to overdo it due to the risk for gestational diabetes. It’s also important to avoid certain raw foods, such as raw fish and undercooked pork, since they can sometimes carry parasites.”
What to avoid
It should come as no surprise that smoking and alcohol should be strictly avoided during pregnancy. Smoking (including tobacco, marijuana and vaping) can cause preterm births and stillbirths. Alcohol use can result in fetal alcohol syndrome in the baby, which causes various physical defects and problems in the brain and central nervous system.
Caffeine should be limited to about a cup per day. Since exceeding that amount raises the risk for hypertension and has been linked to problems with a baby’s growth and development, it’s recommended to transition to decaffeinated drinks.
While exercise in one form or another is almost always recommended for maintaining our physical and even mental health, it becomes more difficult as the months of pregnancy go by. That’s why Dr. Mangubat suggests that expectant mothers play it safe by avoiding high-impact, strenuous activities.
“While running is OK during the early months of pregnancy, it’s not usually recommended during the later months so as to avoid the risk of injury due to falling,” she said. “Safer exercises include things like stretching, Pilates, walking, aerobics and using dumbbells.”
Prenatal classes are a great learning opportunity for first-time parents. Usually recommended around the sixth month of pregnancy, these classes teach what to expect during labor and delivery, how to cope with pain, how to breastfeed, and more.
The Centers for Disease Control and Prevention recommends three vaccines during every pregnancy: flu, Tdap and COVID-19. The flu vaccine will protect both the mother and baby from the seasonal flu, and the Tdap vaccine protects them from pertussis (whooping cough). And if an expectant mother hasn’t yet been vaccinated for COVID-19, that vaccine is also recommended.
For more information about receiving vaccines during pregnancy, visit cdc.gov.
Last Updated: April 20, 2022