Welcome to the first trimester of pregnancy! This is an exciting—and maybe a little scary—time. And sometimes the excitement of seeing a positive test is quickly quelled by the onset of morning sickness, exhaustion, breast pain, heartburn…ugh.
Even before you see a positive test, your body is already changing. And while pregnancy is a special time for most expectant mothers, the physical symptoms can be a real burden.
Let’s take a look at what’s happening in your body during those first 13 weeks, what foods to eat in the first trimester to get the nutrients you and your baby need, and what to do if you feel sick from sunrise to sunset.
What’s happening in your body?
Before you get pregnant, you can prepare your body to grow a healthy baby, and if possible, you should. Folic acid is one of the most important nutrients to have on your radar long before conception.
“Folic acid is an important vitamin that helps prevent neural tube defects. Women should take at least 400 mcg of folic acid daily, starting at least one month before conception and continuing throughout pregnancy. Most prenatal vitamins contain 400-800 mcg of folic acid, but always check the label when choosing a vitamin or supplement to be sure,” says Sara Tingle, NP-C, a family nurse practitioner in Athens, Georgia.
Folic acid is found in dietary supplements like your daily prenatal pill and added to fortified grains, including cereal, bread, pasta and rice. Folic acid is the naturally occurring form of the vitamin found primarily in dark green vegetables like broccoli, asparagus and romaine lettuce and in other plant foods, including avocado, beans and oranges. The Centers for Disease Control and Prevention recommends that women of childbearing age who may become pregnant consume 400 mcg of folic acid daily, along with a diet that includes foods rich in folic acid.
Even though your pregnancy may have just been confirmed by a test, you are already about four weeks pregnant when you see that plus sign, since pregnancy dating is counted from the first day of your last menstrual period. The first trimester is the first 13 weeks of pregnancy.
“Physically, the body experiences a surge in pregnancy hormones, specifically estrogen and progesterone, which can cause nausea and morning sickness,” says Crystal Karges, MS, RDN, a San Diego-based dietitian and lactation consultant.
Human chorionic gonadotropin (HCG) is also on the rise. This hormone is the one that shows up on your home pregnancy test, and some believe it is responsible for nausea and frequent urination.
Progesterone slows down muscle movement in the body, which can lead to constipation in some people. Also expect very sore — and possibly slightly larger — breasts as your body prepares to produce milk to nourish your baby after he or she comes into the world.
A lot happens in those first 13 weeks. By the end of the first trimester, your baby weighs about 1 ounce and all of his organs are starting to form. It’s no wonder you’re exhausted: your amazing body is doing an impressive job!
Important nutrients
Recipe to try: Peanut Butter & Jam Smoothie
Every nutrient is important, but there are a few that are extra important during pregnancy, as your body grows and supports another human being.
Folic acid: Found in fortified foods and dietary supplements.
Calcium: Found in dairy products (milk, yogurt, and cheese), dark green leafy vegetables, and fortified foods including orange juice and breakfast cereals.
Iron: Found in meat, poultry, seafood, beans and dark green leafy vegetables.
Choline: Found in eggs, meat, poultry, seafood and soy products.
Vitamin B12: Found in meat, poultry, eggs, seafood, and fortified grains.
Omega-3 fatty acids: Found in oily fish, chia seeds, flaxseeds and fortified foods.
Pregnant or not, food is your fuel—and when you’re pregnant, that fuel is extremely important. Your baby eats what you eat, and it needs vitamins and minerals to support its brain and body growth, no matter how small. Karges notes that important nutrients during the first trimester to support a healthy pregnancy include calcium (1,000 milligrams/day), folic acid (600 mcg/day), and iron (27 mg/day). “These increased nutritional needs can typically be met by eating a diet that provides a wide variety of healthy foods and supplementing with prenatal vitamins.”
“As your baby’s nervous system begins to develop, it’s also important to get enough choline, B12, and omega-3 fatty acids,” adds Ingrid Anderson, RDN, founder of Simply Confident Nutrition. “Sources of these nutrients include eggs, salmon, and walnuts.”
Even though your body is working hard, you don’t need extra calories until the second trimester, unless you’re carrying multiples (twins, triplets, or more). According to the American College of Obstetricians and Gynecologists (ACOG), women carrying a single baby can gain between 1 and 5 pounds during the first trimester. First-trimester weight gain can be due to increased blood and fluid volume, as long as you don’t overeat.
Coping with morning sickness
Recipe to try: Raspberry-peach-mango smoothie bowl
Morning sickness is a common occurrence for many people in the first trimester. But “morning sickness” is actually a misnomer: it doesn’t necessarily only happen in the morning. You can feel sick at any time of day, and anything can trigger it. Food aversions are also common and can be related to nausea.
“Helpful tips to manage nausea include avoiding an empty stomach, eating smaller amounts of food more often, eating less fat, and drinking plenty of fluids,” says Lindsey Janeiro, RDN, CLC, a registered dietitian and owner of Nutrition to Fit.
“Eating foods that are easier to digest can also help with nausea. Examples include rice, applesauce, fresh fruit, wholegrain crackers and breads, clear broths and soups, potatoes, yogurt, and dry, bland wholegrain cereals,” Karges advises.
Many people can’t stand the thought of fruits or vegetables and simply want comfort food during the first trimester. “Try adding some health to the foods you crave,” Anderson advises. “For example, if you’re craving French fries, try cutting sweet potatoes into strips, drizzling them with oil and salt, and baking them in the oven until crispy. Or if you’re more of an ice cream lover, try blending a frozen banana with a small amount of milk to create an ice cream-like texture and flavor.”
Your diet doesn’t have to be perfect during pregnancy. If you’re feeling well, take the opportunity to eat your fruits and veggies. If you’re not feeling well, eat whatever you can tolerate at the time.
“It’s important to eat foods that you can tolerate and that feel good in your body,” says Karges.
And just do your best. “Sometimes that means a salad with that pizza you’ve been craving, and sometimes that means just eating what you can keep down,” Janeiro says.
If nausea, vomiting, or food aversions persist, you may be dehydrated. Contact your prenatal doctor.
Some foods that help with nausea include:
- Cold foods, such as yogurt, smoothies and frozen fruit
- Ginger
- Peppermint
- Lemon
- Bland foods
“Vitamin B6 has also been shown to help with nausea,” Anderson adds. But check with your prenatal doctor before adding supplements.
Exercise during the first trimester
While you may have heard that you should exercise less during pregnancy, this isn’t necessarily true. In fact, exercise is good for both mom and baby. You can generally continue doing whatever you were doing before, as long as it’s not dangerous and you listen to your body and stop if you start to feel lightheaded, dizzy, or shaky.
ACOG recommends that pregnant women get 150 minutes of moderate-intensity exercise each week, with a mix of cardio and strength training. If you’re new to exercise, start slowly and gradually increase the time and intensity. You can also spread your exercise throughout the day instead of doing it all at once, if that works better for you. However, avoid activities that put you at risk of bumping your abdomen or falling, such as horseback riding and contact sports. Also, don’t do activities that cause pressure changes, such as diving.
According to a 2021 review in the Journal of Perinatal MedicineExercising during pregnancy can prevent excessive weight gain, reduce the risk of gestational diabetes, prevent hypertensive disorders (high blood pressure), prevent urinary incontinence, relieve back and pelvic pain, help prevent anxiety and prenatal depression, reduce the risk of cesarean section, and shorten recovery time after delivery.
Take advantage of the moments when you feel good and get moving, but don’t stress if you can’t exercise every day. Rest is just as important. Some exercises to try include:
- To walk
- Swimming
- Weight training
- Stationary bicycles
- Yoga
- Pilates
It comes down to
Pregnancy can bring a lot of changes and feelings that run the gamut, both emotionally and physically. How well you take care of yourself during pregnancy, including the first trimester, can help your pregnancy go more smoothly. That being said, your body is pretty amazing at giving your baby what it needs, even if you’re having trouble eating or keeping food down. Eating as healthy as possible, moving your body, managing your stress, and getting plenty of rest will go a long way toward ensuring a healthier outcome. You’re doing great!