First Trimester

NAUSEA AND VOMITING

Nausea and vomiting are common during pregnancy. They are especially common during the first trimester (3 months) of pregnancy. Increasing hormone levels may play a part in these symptoms. Often called “morning sickness,” nausea and vomiting can happen during any time of the day.

Most of the time, nausea and vomiting aren’t harmful and do not mean that your baby is sick. However, these symptoms can seriously affect your day-to-day activities. When nausea and vomiting are severe, they can affect your health. It is important to talk to your provider if nausea and vomiting are getting in the way of your everyday life.

What Can You Do to Feel Better?

Lifestyle Changes:

  • Get plenty of rest.
  • Avoid smells that bother you.
  • Eat five or six small meals each day instead of three large meals.
  • Eat a few crackers before you get out of bed in the morning. This can help settle your stomach.
  • Eat small snacks high in protein (i.e. a glass of milk or a cup of yogurt) throughout the day.
  • Avoid spicy foods and fatty foods.
  • Stay hydrated. Take small sips of fluids throughout the day or eat ice chips.

Available Remedies:

Sometimes women need more help to feel better. There are remedies available at your local pharmacy. You can buy these without a prescription:

  • Ginger capsules: Ginger may help soothe your stomach. Take 250mg by mouth every six (6) hours, as needed for symptoms.
  • SeaBands: These work by applying pressure to a certain point on your wrist. This is thought to help with nausea and vomiting.
  • Vitamin B6: This vitamin may help relieve nausea during pregnancy. Take 25mg by mouth every 4 to 6 hours as needed for symptoms.
  • Doxylamine (aka Unisom): This is a medicine used for sleep, but can safely help pregnant women treat nausea and vomiting. Take 12mg by mouth every 12 hours as needed. If you buy Unisom, break the pill in half. This medicine may cause drowsiness.

Preventing Dehydration:

Nausea and vomiting cause you to lose fluids. If you are experiencing nausea and vomiting, some ways that you prevent dehydration are:

  • Drink water
  • Drink sports drinks with electrolytes
  • Eat ice chips

Call your provider at 617.414.2000 or come to the emergency room if you have the following signs of dehydration:

  • Small amount of urine and it is dark in color
  • You cannot keep down liquids
  • You are dizzy or faint when you stand up
  • You have a racing or pounding heart
  • You are vomiting blood
  • You have pain in your upper abdomen or behind your breast bone that does not go away

CHANGES IN YOUR BODY MONTHS 1 TO 3

Nausea (feeling like you want to vomit)

What Will I Notice?

You may wake up with nausea. Or you may have nausea all day. Notice smells more than before. Feel like you need to spit.

What Can I Do?

Eat some crackers or dry cereal before lifting your head off the pillow in the morning. Keep some food in your stomach at all times. Eat every 2 to 3 hours. Eat plain foods not greasy or fried foods. Drink fluids between meals instead of with your food.

Breast changes

What Will I Notice?

Your breasts get larger and may feel heavy and tender. Your nipples get darker and bigger. Your breasts get ready to make milk. You may leak some early milk (colostrum).

What Can I Do?

Wear a bigger bra that gives you good support.

Feeling tired

What Will I Notice?

You may feel very tired, like you want to sleep all day.

What Can I Do?

Take naps if you can. Go to bed earlier.

Need to urinate (pee) more often

What Will I Notice?

Your growing uterus or womb presses on your bladder. You may feel like you need to urinate more often.

What Can I Do?

Avoid drinks with caffeine that make you urinate more. These drinks include coffee, tea, and soda.

Headaches

What Will I Notice?

Some women get headaches.

What Can I Do?

Drink 8 to 10 glasses of water each day. Eat healthy food every 2 to 3 hours.

Mood changes

What Will I Notice?

You may have feelings that change quickly from happy and excited to unsure or worried.

What Can I Do?

Talk about your feelings. Decide what you need and ask for help.

 

Second Trimester

Your uterus grows bigger

What will I notice?

You start to look pregnant.

What can I do?

Wear loose-fitting clothes or maternity clothes. Avoid very high-heeled shoes as they can cause your lower back to hurt.

You can feel your baby move

What will I notice?

You will feel your baby move at about month 5. This feels like a flutter at first. The moves will feel stronger as your baby grows.

What can I do?

Learn when your baby is most active and when your baby rests. Enjoy feeling your baby move!

More energy, less nausea

What will I notice?

You may feel less tired and less nauseated.

What can I do?

Enjoy it!

Skin changes

What will I notice?

You may have brown marks on your face or a dark line down your stomach. The skin around your nipples gets darker and bigger. You may get stretch marks on your stomach, hips, and breasts. These are brown or dark red lines that come from your skin stretching.

What can I do?

Avoid drinks with caffeine that make you urinate more. These drinks include coffee, tea, and soda.

Stuffed-up nose

What will I notice?

Pregnancy hormones may make your nose feel stuffed up like you have a cold.

What can I do?

Use saline drops (Ocean® spray drops) to clear your nose.

Bleeding gums

What will I notice?

Pregnancy hormones can make your gums bleed more easily.

What can I do?

Use a soft toothbrush and floss every day. Go to a dentist for a cleaning.

Heartburn

What will I notice?

Your growing baby and uterus put pressure on your stomach. Pregnancy hormones relax the opening to your stomach. Acid from your stomach can burn your esophagus (the tube from your mouth to your stomach).

What can I do?

Eat small meals every 2 to 3 hours. Sit up after meals. Eat plain food not spicy or greasy foods. Talk to your provider about medicine to help heartburn.

Sharp pulling feeling on the side of your uterus

What will I notice?

You may feel a sharp cramp or pulling feeling on the side of your uterus. This is called round ligament pain. This happens when the ligaments on the sides of your uterus stretch.

What can I do?

Change your position. This might be sitting instead of standing or turning onto your other side if you are lying down.

Constipation

What will I notice?

Pregnancy hormones slow digestion. This may cause constipation. Your stool (poop) or bowel movement may be hard and painful to pass. You may not pass stool as often as before.

What can I do?

Drink 8 to 10 glasses of water a day. Eat vegetables, fruit, and whole grains to make softer stools.

Hemorrhoids

What will I notice?

Many women get hemorrhoids during pregnancy. They feel sore and may bleed when you pass stool. They may itch as they heal.

What can I do?

Use witch hazel pads (Tucks®) or hemorrhoid cream prescribed by your provider.

Feelings

What will I notice?

You may feel:

  • Happy to feel less tired and less nauseated.
  • Excited to feel your baby move.
  • A sense of well-being.

What can I do?

Enjoy this exciting time in your pregnancy!

Third Trimester

Aches and pains

What will I notice?

You may have a backache, pain under the ribs, pain in the groin, pain over the pubic bone, or leg cramps.

What can I do?

Change your position. Avoid standing for a long time. Sleep with a pillow behind your back and between your knees. Try stretching. Call your provider about any pain that does not go away.

Braxton Hick’s contractions

What will I notice?

You may feel your stomach get hard. This is not painful. These contractions do not come at regular times.

What can I do?

Rest when you need to. Drink 8 to 10 glasses of fluids a day. Call your provider for more than 4 Braxton Hick’s contractions in an hour.

Swollen feet, ankles, and hands

What will I notice?

Your feet, ankles, and hands may look swollen or puffy. Your shoes or rings may not fit.

What can I do?

Raise your legs when you sit or lie down. Drink 8 to 10 glasses of fluids a day. Swimming helps.

Vaginal discharge

What will I notice?

You may have more white or yellow discharge. This is normal. Discharge keeps your vagina clean and healthy.

What can I do?

Wear cotton underwear. Do not wash inside your vagina or douche. Call your provider if you have discharge that is red, green, smelly, or itchy.

Varicose veins

What will I notice?

The veins in your legs may stick out or seem bigger.

What can I do?

Raise your legs when you sit or lie down. Try not to sit, stand or cross your legs for a long time. Ask your provider about support stockings.

Feelings

What will I notice?

You may feel:

  • Tired of being pregnant.
  • Excited and scared about birth.
  • Eager to get everything done.

What can I do?

Talk to your support person about your feelings.

HOW TO CHECK YOUR BABY'S MOVEMENTS?

Step 1: Have a meal or some juice and a snack.

Step 2: Find a watch, clock or your phone to keep time.

Step 3: Lie down on your left side in a quiet place and put your hands on your belly.

Step 4: Time how long it takes for your baby to move 5 times (kicks, rolls, swishes all count). Hiccups do not count.

Step 5: Write it down and tell your midwife or doctor at your televisit.

If your baby is moving less than normal, or does not get to 5 times in an hour, or you are worried about your baby’s movements, please call your provider or the hospital at (617) 414-4364.