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Pregnancy: First trimester changes and challenges

A look at some of the things you can expect as you begin your pregnancy.

Welcome to your first trimester.

Change—big and small—is the name of the game now that you are pregnant. From the physical to the emotional, you're at the beginning of a nine-month transformation.

Here are some of the most common changes you'll likely see in these early weeks.

Fatigue. Many women feel exhausted during the first trimester. Your body is making pregnancy hormones, and your heart and other organs are doing extra work. Adjusting to the changes is a recipe for exhaustion.

To fight fatigue, try to get in eight hours of sleep at night. And take a nap during the day if you can. At the very least, try to take a break and rest when you feel tired. Avoid stress as much as possible. It can add to your fatigue.

Headaches. Many women experience headaches in the first trimester. These headaches should decrease as you enter your second trimester and your body adjusts to changing hormone levels.

Always talk to your doctor before taking any medicine to ease a headache, says the March of Dimes. You can also:

  • Use warm compresses on the front and side of your face if you have a sinus headache. Or try a cold compress on the back of the neck for a tension headache.
  • Rest in a dark, quiet room.
  • Avoid foods or stressors that you think might bring on a headache.

Occasionally a headache can be a sign of a more serious problem. Let your doctor know right away if your headache came on suddenly and is severe; you also have a fever and a stiff neck; or the headache worsens and you also have changes in your vision, speech, alertness or sensation.

Breast changes. Even this early in the pregnancy, your body is preparing for breastfeeding. From almost the first days of pregnancy, you may notice tenderness and sensitivity in your breasts. Your breasts will increase in size, possibly feeling itchy and developing stretch marks.  

Wearing a maternity bra can help with the discomfort. You might also want a special sleep bra for nighttime support.

Morning sickness. Don't be fooled by the name—the nausea and vomiting of morning sickness may strike at any time of day.

If you have morning sickness, take heart: This problem will most likely go away by your second trimester. In the meantime, there are many coping strategies you can try:

  • Eat small meals throughout the day.
  • Reach for a starchy snack before you get up in the morning and whenever you feel nausea coming on. Try toast or soda crackers. High-protein snacks, like nuts and peanut butter, may also be helpful.
  • Sip carbonated drinks, like ginger ale, between meals.

Let your doctor know if steps such as these don't help. Also talk to your doctor if you are constantly nauseated or can't keep food or fluids down. You may need treatment to keep you and your baby safe.

Congestion and nosebleeds. Toward the end of this first trimester, you may notice an increase in sinus symptoms. Hormones and an increased blood supply can wreak havoc on the membranes of the nose. And the result can be swelling, dryness and even bleeding. According to the March of Dimes and the Office on Women's Health, you can help ease the problem by:

  • Keeping the air moist with a humidifier. This is especially helpful in the bedroom if congestion is keeping you from getting a good night's rest. A warm, steamy shower before bed may also help.
  • Drinking plenty of fluids.
  • Using saline (not medicated) nose drops.
  • Blowing your nose gently to avoid worsening the irritation.

More to come

These are just a few of the changes you can expect during pregnancy. If you have any questions or concerns about what is normal and what to expect, talk to your doctor.

Reviewed 3/22/2024

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