Handling a Tough First Trimester of Pregnancy

Exhaustion, nausea, sore breasts, and other symptoms are very common during the first trimester. They usually improve by the fourth month, but in the meantime, it helps to know how to cope with some of the typical discomforts.

"I'm exhausted."

Fatigue is by far the most common complaint during the first trimester, says Roger Harms, MD, editor of The Mayo Clinic Guide to a Healthy Pregnancy. Aside from the simple fact that building a baby uses a tremendous amount of your body's resources, you can also blame a steep increase in the hormone progesterone, which is known to have a sedating effect. The extreme sleepiness usually tapers off by eight to 10 weeks and rarely lasts beyond 13 weeks.

Feel better fast: The most important thing is to slow down. Take naps, go to bed early, and let the housecleaning slide for now. You should also continue to exercise -- though you may need to cut back on the intensity of your workouts. In addition to helping you tolerate pregnancy and labor better, exercise can actually increase your energy level, says Terry Hoffman, MD, an ob-gyn at Mercy Medical Center in Baltimore. Not used to working out? Ask your doctor if it's okay to start a simple routine, such as walking for 20 minutes a day.

Pregnancy Month by Month: Month 2
Pregnancy Month by Month: Month 2

"I feel queasy."

For most women, nausea tends to rear its ugly head early in the day -- hence the term "morning sickness" -- but you can also feel sick in the afternoon or even all day long. Increased levels of estrogen in early pregnancy seem to stimulate a part of the brain that triggers nausea and vomiting. Estrogen also affects your gastrointestinal tract, relaxing smooth muscle tissue and causing your food to digest at a slower pace, which can result in an upset stomach. Generally, the queasiness settles down around 13 or 14 weeks.

Feel better fast: Doctors advise eating frequent, small meals and staying away from fatty, fried, or spicy foods. "Plain saltine crackers cured me every time," says James Mowery-Bromberg, a New York City mother of three. Keep some by your bed and eat a few before sitting up in the morning. Ginger ale or ginger tea can also help. For a severe case, talk to your doctor.

"I have to pee a lot."

Frequent urination is another common complaint of the first trimester. It partly has to do with anatomy: As your uterus grows during early pregnancy, it puts more pressure on your bladder, making you feel like you have to pee more often. Also, the amount of blood in your body increases dramatically in pregnancy, which means your kidneys process more fluid that ultimately winds up in your bladder. The situation usually improves by 14 to 16 weeks, when the weight of your growing uterus pulls it forward so it's resting more on your abdominal wall and less on your bladder. But don't be surprised if you're urinating frequently again at the end of your pregnancy, when your baby drops deeper into your pelvis and again puts pressure on your bladder.

Feel better fast: There's not much you can do beyond going when you need to go. Don't cut back on liquids: Your body needs more water, not less, to sustain your increased blood levels and amniotic fluid during pregnancy.

"My breasts hurt!"

Tender, swollen breasts or sore nipples are typical in early pregnancy, as surging hormones prompt them to begin preparing to make milk. "Mine got so big I named one Everest and the other Kilimanjaro," says Lori Richmond, of Brooklyn, who grew into an E cup when she was pregnant with her son, Cooper. Your breasts will keep growing throughout the nine months, but the soreness should subside by week 12.

Feel better fast: Look for a bra made with soft, stretchy fabric: Avoid restrictive underwires, which can dig painfully into your tender breasts. If you're a D cup or larger, you might also want wide, padded straps for extra support. At night, try wearing a snug-fitting tank top or a soft cotton sleep bra.

4 Signs You Shouldn't Ignore

  1. Persistent Belly Pains: A twinge here and there is nothing to worry about, but strong, steady pains in the lower abdomen or pelvic area during the first trimester could mean an ectopic (tubal) pregnancy, which can be dangerous.
  2. Severe Nausea and Vomiting: If you haven't been able to keep any food or fluids down for 24 hours, you could be at risk for dehydration or an electrolyte imbalance, both of which are hazardous to you and your baby. Not being able to pee for more than six hours is another red flag.
  3. Heavy Bleeding: Occasional light spotting usually isn't a problem, but if the bleeding resembles a period, it can spell trouble. Talk to your doctor about any bleeding you experience while pregnant.
  4. Frequent Constipation: Irregularity is common during pregnancy, but be sure to let your healthcare provider know if it's been more than three days since you've had a bowel movement.

Originally published in the February 2009 issue of Parents magazine.

All content, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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