First Trimester Expectations

Every stage of your pregnancy brings new experiences. As your baby grows and develops, you will experience different symptoms. Pregnancy affects every woman very differently. You can't even know for sure what symptoms will be a problem for you from one pregnancy to another. It will help to be prepared by knowing what changes your body will likely go through, how your baby is developing, and what nutritional concerns you should focus on.

Your Baby's Development

Pregnancy is generally divided into trimesters. Your first trimester of pregnancy ends at about twelve weeks, or three months after your last menstrual period. Your doctor may discuss your progress in weeks, which are measured from the first day of your last menstrual period-the day your doctor uses to calculate your due date and the baby's gestational age. Since it is usually impossible to pinpoint the exact date of ovulation and the date of conception, medical experts use your last menstrual period as the starting point for your next nine months. Basically, this means that the first week of your pregnancy is actually the week that you started your last period. Therefore, your baby can be up to two weeks younger than his gestational age. Every baby develops differently and at different rates in utero.

The First Month (1 to 4 Weeks)

About two weeks after the first day of your last menstrual period, your ovary released an egg into the fallopian tube. Your actual pregnancy began when that egg was fertilized by a sperm cell. In other words, you are not actually pregnant for the entire first month of pregnancy-weeks one through four.

Over the next week, the fertilized egg grows into a group of cells called a blastocyst. Once the blastocyst completes its journey down the fallopian tube, it implants in the uterus and divides into two parts. One half of the blastocyst attaches to the wall of the uterus and becomes the placenta while the other half develops into the embryo. This group of cells is already composed of different layers. The outer layer eventually becomes the nervous system, skin, and hair. The middle layer becomes bones, cartilage, muscles, circulatory system, kidneys, and sex organs. The inner layer becomes the respiratory and digestive organs.

The implantation of the egg into the uterus triggers the beginning of hormonal and physical changes. The amniotic sac, which cushions the fetus in the months ahead, begins to form. The early stages of the placenta and umbilical cord are visible and under rapid construction.

During the first month of pregnancy, the embryo looks like a tadpole. The neural tube, which will become the brain and spinal cord, starts to come together. A very primitive face begins to form, with large dark circles where the eyes will be. The mouth, lower jaw, and throat also begin to develop. The baby's blood cells are taking shape, and circulation will soon begin. By the end of the first month, the embryo is about a quarter of an inch long and is smaller than a grain of rice.

The Second Month (5 to 8 Weeks)

You may not look pregnant yet, but by the second month of your pregnancy, plenty is going on. Major body organs are beginning to develop, including the heart, brain, kidneys, liver, intestines, appendix, lungs, and body systems. The baby's facial features continue to develop. The baby's ears, fingers, toes, and eyes begin to form. Tiny buds that will become the baby's arms and legs are forming. The digestive tract and sensory organs are now beginning to develop.

During this time, bone starts to replace cartilage. The baby's heart starts its contractions, which will become distinct heartbeats within the next week. The eyelids form and grow-though sealed shut-and nostrils begin to form.

The neural tube will eventually connect the brain and spinal cord, and by about the fifth week it closes. Blood circulation becomes evident at this time. The placenta and amniotic sac continue to develop. By the end of the second month, the embryo has started to look more like a person than a tadpole. It measures about 1 inch long and weighs less than 1/3 ounce.

The Third Month ( 9 to 12 Weeks)

During your third month of pregnancy, the embryo has developed into a fetus. The baby is active, even though you may not yet be able to feel the activity. All major organs, muscles, and nerves are formed. The mouth has twenty buds that will eventually become teeth. The irises of the eyes are now forming. The liver, intestines, brain, and lungs are now beginning to function on their own. At around week eleven, it is possible to hear the "swooshing" sound of the baby's heartbeat for the first time with a special instrument called a Doppler sound-wave stethoscope.

Several of the baby's ribs are now visible, and tissue that will eventually form bones is developing around the baby's head, arms, and legs. By the end of your first trimester, or third month, your baby is fully formed. Your little one has arms, hands, fingers, feet, and toes. Fingers and toes are separate, and they now have soft nails. Your baby's reproductive organs are developing, and the circulatory and urinary systems are working. The liver is producing bile.

Throughout the remainder of your pregnancy, the baby's body organs will mature and the fetus will gain weight, become longer, and fully develop. By the end of your third month, your baby is about four inches in length and weighs about 1 ounce. The most critical point of formation of the organs is finished, and your chance of miscarriage at this point drops considerably.

Changes in Mom

Along with changes in your baby's development, you will experience changes in your own body. The embryo secretes a hormone called chorionic gonadotropin (hCG), or the pregnancy hormone. This hormone triggers your first signs of pregnancy. In your first trimester, you may begin to experience nausea, vomiting, dizziness, headaches, a feeling of fullness or bloating, light cramping, constipation, poor appetite, frequent urination, and breast tenderness. You may need to go to the bathroom more often. This is because your growing uterus is pressing on your bladder and because hormones may be affecting your body's fluid balance.

Around week eight, your uterus grows from the size of your fist to about the size of a grapefruit, which can cause some mild cramping or pain in your lower abdomen or sides. Some of these problems will decrease as you continue on with your pregnancy.

Moodiness and anxiety can surface and make you feel like you are on an emotional roller coaster. Feeling happy one day and crabby the next is completely normal, due partly to fluctuating and very high levels of hormones. For many women, this moodiness and anxiety continues through­out pregnancy. You may begin to notice changes in your figure by the end of your first trimester. Your breasts have become larger, and you may notice that your waistline is beginning to expand just a bit.

Worried About Lack of Appetite?

During the first trimester, a lack of appetite can be very normal. It is normal to experience nausea or morning sickness and to have a constant feeling of fullness that may cause you to eat less or just not want to eat. Don't make yourself too crazy about your lack of appetite-your good nutritional stores are nourishing the baby at this time. Even though you shouldn't worry too much, you should still do all you can to eat as nutritiously as possible. Follow the helpful tips given in Chapter "Dealing with Discomforts" for dealing with morning sickness, such as eating small meals throughout the day, eating starchy foods before getting out of bed, and staying away from foods with strong odors.

Do the best you can to keep up your nutritional intake during this time, and keep in mind that by your second trimester these feelings should diminish.

Food Aversions

Food aversions during pregnancy are almost as common as food cravings. It is quite normal in pregnancy to suddenly be disgusted by the taste, sight, and/or smell of a certain food or beverage that you have always enjoyed. Food aversions can go as quickly and they come and differ from woman to woman as much as cravings do. Meat is probably the most common food aversion, though other popular aversions include water, coffee, tea, fried and fatty foods, highly spiced foods, alcohol, and eggs.

What They Occur

Like food cravings, the cause of food aversions is pretty much unknown. There is some evidence that hormonal changes in pregnant women cause a heightened sense of smell, which may impact foods that are craved or avoided. Some speculate that food aversions are your body's way of telling you that you should avoid certain foods or beverages that are not good for you during pregnancy. Developing an aversion to coffee or alcohol can help you avoid something you shouldn't be having anyway.

On the other hand, some experts worry about aversions to foods that you should be eating and that can cause nutritional deficiencies. If you develop an aversion to specific healthy foods such as milk, make sure you try substituting something nutritionally similar such as yogurt. If you develop an aversion to water, it is essential that you do something to replace it. Try drinking water flavored with 100-percent fruit juice. Remember that food aversions come and go quickly. If you can't stand the sight of a food one day, make sure you try it again soon.

Fighting the Fatigue

Pregnancy, especially during the first trimester, can work your body over­time. It is normal to feel a little worn out when you are busy building another person! You may feel tired to the point of complete exhaustion. In addition to the obvious reasons for being tired, vomiting and/or lack of appetite can also zap your energy, as well as rob you of some essential nutrients. Hormonal changes in particular can cause fatigue. Being worried and anxious about being pregnant, along with frequent trips to the bathroom at night, can rob you of needed sleep. Most of these problems diminish in the second trimester, and you will feel much more alert. Feelings of fatigue usually surface again around the seventh month, when you are carrying more weight around.

You can't always completely fight fatigue, but you can give it a valiant try. Here are a few tips you can follow to help yourself deal with fatigue:

• Go to bed early and at a regular time to keep your body on a regular schedule. Shoot for at least nine to ten hours of sleep a night if your schedule allows it.
• Take short fifteen-minute catnaps during the day. Be careful of sleeping too much and interfering with your sleep at night. Your body will tell you when you need to rest.
• Keep as active as you can during the day with regular exercise. Even though you may feel too tired to even think about exercise, just a short walk during the day can help energize you.
• Take short breaks throughout the day to do some stretching and breathing exercises.
• Eat small, frequent meals throughout the day, and make sure you are eating a healthy diet that includes all the food groups. Eating through­out the day will fuel and help energize your body all day long.
• Stay hydrated by drinking plenty of water throughout the day, and make sure you have cut back on your caffeine intake.
• Eat energy-boosting foods, especially in the middle of the day. Include a good source of protein as well as carbohydrates, such as peanut butter on bread, grilled chicken and veggies on pita bread, chicken noodle soup, grilled cheese sandwich, or an egg white with cheese on a whole­wheat bagel.
• Good, energy-boosting snacks to nibble on during the day include dried fruit, fortified cereal and milk, yogurt with fruit and granola, cheese and crackers, nuts and/or seeds, frozen grapes or bananas, a granola bar, a milkshake, or vegetable juice.
• Don't be afraid to ask for help with household chores that may be zapping your energy, and do as many of your chores as you can while seated.
• Stay within your weight-gain guidelines. The more weight you have to carry around, the more fatigued you will feel.
• Ensure you are taking your prenatal vitamins, as directed by your doctor. If your exhaustion become debilitating or continues into your second trimester, speak with your doctor. Extreme exhaustion can be a sign of other problems such as anemia or thyroid problems.

Nutritional Concerns

The first trimester of pregnancy is most important for the development of your baby. Experts don't exactly understand how the mother and baby divvy up the nutrients, but we do know that the baby lives on the nutrients from the mother's diet and the nutrients already stored in her bones and tissues. The baby's health and proper growth are directly related to the mother's diet before and during pregnancy. It is essential for both you and your baby that you make sure you are eating a healthy diet and following the guidelines discussed in previous chapters. You should also be taking a prenatal vitamin at this time to ensure you are getting all of the nutrients that are essential to a healthy pregnancy, including folic acid, calcium, and iron. Good nutrition and a healthy lifestyle are essential throughout your entire pregnancy, though certain nutritional considerations may be more important at different stages along the way. In your first trimester, important nutritional considerations include folic acid intake, prevention of malnutrition, and dehydration.

Prevention of Malnutrition

Many critical nutrients play very important roles in the development of your baby, especially in the first trimester. As your baby develops, the demands on your body grow, requiring lots of extra nutrition. Because morning sickness often plagues women during their first trimester, malnutrition can be a nutritional concern during this time.

Even if you are suffering with nausea and/or vomiting through your first trimester, you still should make every effort to find ways to eat as nutritiously as possible. The first trimester is a critical time for the development of your baby. Most women, even though experiencing these symptoms, will get the nutrition they need with a little effort and some helpful tips. Women who suffer from excessive nausea and vomiting may deplete their nutritional stores and could become high risk for malnutrition.

If you have problems eating healthier foods or finding healthier substitutes during your first trimester, you should speak to a dietitian who can help you to ensure proper nourishment during this critical time. If you are able to eat but you still can't keep anything down, you should speak with your doctor immediately.

Dehydration

You need extra fluids in pregnancy for your increased blood volume and for amniotic fluid. Keeping properly hydrated can also help prevent urinary tract infections, constipation, and hemorrhoids, all common problems during pregnancy. Dehydration can be a concern in the first trimester if you are experiencing vomiting. Vomiting can remove vital fluids that your body needs to keep you in balance. Dehydration may also be a concern if you are not eating the proper amount of calories and if you are not drinking fluids due to feelings of nausea or fullness. If your doctor is concerned about dehydration, he may use a urine test to determine if you are maintaining a proper fluid level.

You should aim to drink at least eight to ten glasses of fluids per day. If you are nauseated, fluids such as ginger ale or lemon tea can help soothe your stomach and contribute to your fluid intake. If you are vomiting, products such as Gatorade can help to replenish electrolytes. Some women who have a hard time getting plain water down do well with lemonade and/or juice. Stay away from caffeinated beverages-caffeine can act as a diuretic and compound the problem of dehydration. If you feel signs of dehydration, such as dry lips or a dry mouth, make sure you are drinking enough fluids. Be careful not to fill up on too many fluids at meals and not leave room for food. Drink your fluids between meals instead of with your meals.