Nothing can suck a woman into an Internet black hole quite like pregnancy. Trying to figure out how soon you can tell if you’re pregnant, what foods aren’t going to make you feel like hurling, if having a second cup of coffee is a big deal, if you can still go to your Pilates class in your third trimester… The questions are endless.
As for the answers, it’s important to make sure you’re getting them from reputable sources. (In other words, not random Reddit threads or TikTok.) Enter: our bonafide pregnancy experts, here with science-backed information to guide you through this important time.
What Is Pregnancy, Technically?
Pregnancy describes the period of time when a fetus develops inside a woman’s uterus. A couple things have to happen for pregnancy to occur. (Promise we’re not heading into a birds-and-bees convo…)
The first is conception, which is the moment the sperm fertilizes the egg, which can take 24 hours. About a week after conception comes implantation, or when an embryo makes the lining of the uterus its new home. This is the official start of pregnancy.
The earliest someone can know they are pregnant is a couple of days before a missed period, explains Luisa Vera, M.D., an obstetrician/gynecologist at UNC Rex Hospital in Raleigh, North Carolina. And there are home pregnancy tests that are designed to be used before you’re expecting your monthly pal.
That said, home pregnancy test results are most accurate when taken after the first day of a missed period, notes Winifred Soufi, M.D., Ph.D, an obstetrician/gynecologist in Atlanta, Georgia. “That's because shortly after implantation, the placenta begins forming,” she says.
The placenta makes the pregnancy hormone human chorionic gonadotropin (HCG), which is what pregnancy tests detect in your pee. “HCG can be found in blood and urine and is present in the body only during pregnancy,” Dr. Soufi explains.
Signs That You Might Be Pregnant
Like everything, pregnancy symptoms aren’t one-size-fits-all. But there are some common signs you are likely to experience in early pregnancy. They include:
Missed period
Women do not get a period during pregnancy. This is because the body retains the lining of the uterus during pregnancy instead of shedding it every month. Some women experience vaginal bleeding during pregnancy, but this bleeding is not a period.
Nausea and vomiting
About 70% of pregnant women experience nausea and vomiting. This happens mostly in the first trimester and less in the second and third trimesters, says Dr. Vera.
Not having any food in the stomach is what typically triggers nausea and vomiting, she explains. Eating small meals throughout the day can prevent you from feeling so icky so often or so intensely.
Breast tenderness
Swirling hormones can affect your boobs. This can feel like soreness or a dull ache. Any kind of touch (from sex, working out, or whatever) can be irritating, or breasts can feel swollen. Nipples may also become more sensitive and even change color, usually getting darker.
Cramping
Even though women don’t get a period when pregnant, cramping in early pregnancy is still common, says Dr. Vera. This is because the uterus is expanding to make room for the baby.
Cramps at this point are typically mild and might feel like pulling or stretching. You can always talk to your doctor to make sure that what you are experiencing is normal.
Fatigue
“A lot of women experience fatigue and are very, very tired during the first trimester,” Dr. Vera says. Again, hormones are at play. Particularly the hormone progesterone, which spikes during early pregnancy. Take this as a sign to rest up!
Let’s Get Into the Trimesters
Okay, so you’ve confirmed that you’re pregnant and are starting to experience the signs. Welcome to the first of your three trimesters. (Well, actually four, if you count the three months postpartum, commonly referred to as the “fourth trimester.”)
Now what? Below is what you can expect—and what’s going on with your baby—in those first three trimesters.
First Trimester
You should have your first prenatal appointment eight weeks after the start of pregnancy, says Dr. Soufi. But there are reasons to have this visit a little earlier, at six weeks. These include if you…
- Have any pre-existing health conditions
- Have a history of miscarriages or ectopic pregnancies
- Prescription medications
- Abdominal pain or bleeding after a pregnancy test
At your first appointment, you’ll get a lot of info from your doctor about how to keep yourself and your baby healthy during pregnancy, shares Annelise Swigert, M.D., an obstetrician/gynecologist at Southdale Obgyn in Minnesota. You’ll also have basic lab work done, as well as an ultrasound. This will triple-confirm the pregnancy (and find out if you’re having more than one baby) and detect the baby’s heartbeat.
Expect to see your doctor every four weeks during the first trimester. The second and third visits serve as checkups to make sure you and the baby are healthy, and to answer any questions you have, says Dr. Swigert.
Genetic testing can also be done during the first trimester to see if the fetus has any spontaneous genetic abnormalities like Down Syndrome. In addition, genetic testing will reveal the sex of your baby if you would like to find out. These usually are done during the 10th and 12th weeks of pregnancy and include a blood test and ultrasound. “Typically [doctors] screen for diseases including cystic fibrosis, fragile X, sickle cell disease, and spinal muscular atrophy. However, if [the mother] is of a certain ethnicity, we may screen for other diseases as well,” says Dr. Soufi.
If a parent or family member has a genetic abnormality, it could be passed to the baby. “Genetic abnormalities can also happen randomly, even if there are no risk factors,” Dr. Soufi explains. It’s important that you give your healthcare provider as much information as you can about your and the father’s family history.
How big is your baby during the first trimester? Really small—just a few centimeters. But it’s still a crucial time because all the major organs are developing, including the stomach and heart. They are formed by 10 weeks, says Dr. Vera. The brain also begins developing in the first trimester.
Second Trimester
Let’s start with some welcome news: For many women, nausea and fatigue tend to subside in the second trimester. Hooray! Okay, back to our original programming…
As with the first trimester, it’s good to see your doctor once every four weeks during your second trimester. You may need to go more often if you have any complications or have a high-risk pregnancy.
“During each appointment, we always start by listening to the baby’s heartbeat. We will check blood pressure and do a urine sample, making sure there are no proteins or [glucose] in the urine,” Dr. Swigert says. Glucose in urine during pregnancy can be a sign of gestational diabetes. Protein in urine could be a sign of preeclampsia.
At your 20-week appointment, typically referred to as the Anatomy Scan, an ultrasound is done to “measure the baby, making sure there’s appropriate growth based on the due date, and evaluate the placenta to make sure it is healthy. ” Dr. Swigert explains.
During this time, the fetus is continuing to grow. While the heart is completely formed in the first trimester, the lungs continue to develop, and the brain keeps growing in the second trimester. “A lot of times during the first trimester, the baby looks like a little peanut [on an ultrasound],” says Dr. Vera. “But in the second trimester, you can start seeing portions of the brain, the kidneys, and the bladder.”
Hitting the 24th week can be a relief. At the end of the second trimester and the beginning of the third trimester, a baby can start to hear. It’s why a lot of people like to sing and talk to their bellies. At this point, the heart, lungs, and other vital organs have developed enough that with the help of the NICU (Neonatal Intensive Care Unit) they would be likely to survive.
Third Trimester
The third trimester starts in your 28th week of pregnancy. Prepare for a doctor bestie: In the last month before your due date, you will see your doctor weekly. Monitoring things closely now can help prevent complications during childbirth. For example, the doctor may check the position of the fetus as you approach your due date; if the baby is breech—where the baby’s butt and legs, not the head, are nearest the cervix—you can form a plan of how to proceed.
During the third trimester, the fetus is primarily growing in size, since all the major organs are in place. The fetus is developing fatty tissue, which is why many women experience even more weight gain at this point, says Dr. Vera. This weight is important for the fetus, she emphasizes, so consider it a good thing!
That said, carrying more weight can make all forms of activity more difficult and can cause lower back pain. You’ll feel wiped out a lot easier than before. Also, since the fetus is moving deeper in the pelvis, you’ll probably have to pee a lot more often.
Changes in hormone levels relax the connective tissue in the pelvic area, which can lead to pelvic and hip pain. Hormone fluctuations can also relax the valve between the stomach and esophagus. Translation: You might get heartburn.
Factors That Can Affect Pregnancy
There’s a lot that can influence the health of the fetus and the risk of miscarriage. Some are controllable, to some extent. But others are completely out of your hands. Here, the pregnancy factors that ob/gyns want everyone to know.
Maternal Age
Few people would consider age 35 “old”. At this age and beyond, you might hear “advanced maternal age”. Why? Getting pregnant later in life comes with an increased potential of complications. “The risk of miscarriage is higher in women older than 35, and there is also an increased risk of stillbirth in women older than 40,” explains Dr. Soufi.
Because of this, women who are older than 40 may need to see their doctor more often after 32 weeks. This could include more frequent ultrasounds, plus nonstress tests, also known as fetal heart rate monitoring. “During a nonstress test, a baby's heart rate is monitored using external monitors to see how it responds to the baby's movements,” Dr. Soufi says. “The term ‘non stress’ refers to the fact that nothing is done to place stress on the fetus during the test.”
While pregnant women 40 and older can require more careful monitoring, Dr. Soufi emphasizes that many women in this age range give birth to healthy babies. It’s just good to know the possible increased chance of genetic abnormalities.
Health Conditions
Certain health conditions can increase the risk of miscarriage. These include high blood pressure, obesity, lupus, kidney disease, and thyroid disorders. If you have any of these health conditions, you likely will have to see your doctor more frequently during pregnancy.
Diet and Nutrition
What a woman eats (and drinks) during pregnancy can impact your baby—for better or for worse. This doesn’t mean you can’t have ice cream! (Please do.) It does mean being aware that you’re getting certain nutrients to support your baby’s health. (We’ll get into this more below.)
Weight
How much weight is considered healthy to gain during pregnancy? Weight during pregnancy will depend on your pre-pregnancy weight, and should be discussed with your care team. Most women will gain anywhere from 15 to 40 pounds, says Dr. Swigert. Women who were overweight before pregnancy need to gain less weight than women who were not overweight, and vice versa. If you have specific concerns about weight and pregnancy, talk to your care team.
Complications During Pregnancy
“There’s a complication” is a phrase no one wants to hear during pregnancy. But knowing about potential pregnancy issues means you’ll be better prepared if one does occur.
The most common complications during pregnancy include:
Gestational Diabetes
This is a type of diabetes that happens when the body can’t make enough insulin during pregnancy. It can happen to any woman, whether they had diabetes before pregnancy or not.
How? The hormonal changes and weight gain of pregnancy cause the body to use insulin less efficiently, which can lead to insulin resistance. For 50% of women with gestational diabetes, blood sugar levels return back to normal after giving birth. But the other 50% go on to develop type 2 diabetes.
Here’s a good “but”: There are things you can do to prevent gestational diabetes. Staying active, eating nutrient-rich foods, and working closely with your doctor to monitor your blood sugar levels are a few of them.
Preeclampsia
Preeclampsia is a type of high blood pressure that can happen after the 20th week of pregnancy. This is accompanied by a high level of protein in your urine. Most women with preeclampsia have healthy babies, however if left untreated it could cause serious complications for both you and your baby. This only affects between 5%-8% of pregnancies in the United States.
We don’t know the exact cause of preeclampsia, but there are some things that could put you at an increased risk like: having preeclampsia in a previous pregnancy, you are pregnant with multiples, you have high blood pressure, kidney disease or another auto-immune disease before you become pregnant. The good news is that if you have any of these risk factors your doctor may have you take low dose (81 mg) aspirin to help prevent it. Low does, or baby aspirin is available over the counter.
What should you look out for? If you have blurred vision, swelling in your hands and face, or a severe headache or belly pain, contact your doctor immediately.
The Mother’s Health During Pregnancy
If you’re pregnant, it’s natural to wonder how your own habits may impact your baby. Is coffee completely off the table? Is it still safe to take my prescription medications? Should I stop kickboxing class? Here’s what you need to know about diet, exercise, meds, and lifestyle habits, during pregnancy.
Diet During Pregnancy
“A healthy diet is the best way to get the vitamins and minerals you need, but during pregnancy you might fall short on key nutrients,” Dr. Soufi says. This is why taking prenatal vitamins starting in the first trimester is always the recommendation.
The most important thing to look for in a prenatal vitamin is folic acid, which supports the baby’s brain and spinal development, says Dr. Swigert. Women who are pregnant should aim to get 400 micrograms of folic acid a day. You can supplement your supplement with foods high in folic acid. These include leafy greens, broccoli, Brussels sprouts, orange juice, legumes, and beans.
Besides folic acid, iron is another key nutrient during pregnancy. “Iron supports the development of the placenta and fetus. [It also] helps your body make blood to supply oxygen to the fetus. Iron helps prevent anemia, a condition in which blood has a low number of healthy red blood cells,” says Dr. Soufi. The goal is 1,000 milligrams a day through foods such as white beans, chickpeas, beef, spinach, and tofu, along with the prenatal vitamin. Most prenatals have about 27 milligrams of iron, so you’ll still want to put iron-rich foods on your plate.
Other nutrients to prioritize during pregnancy:
- Calcium and vitamin D help ensure healthy development of the baby’s teeth and bones.
- “Omega-3 fatty acids, a type of fat found naturally in many kinds of fish, help promote a baby's brain development,” says Dr. Soufi. “If you don't eat fish or other foods high in omega-3 fatty acids, your healthcare provider might recommend omega-3 fatty acid supplements in addition to prenatal vitamins.”
- Your prenatal vitamin should also contain vitamin C, vitamin A, vitamin E, B vitamins, zinc, and iodine.
What about caffeine? Dr. Swigert says it’s okay to have your morning cup of coffee. But don’t swig more than two or three cups a day. Too much caffeine can negatively impact the fetus.
As for alcohol, tobacco, cannabis, or any recreational drugs: Just. Say. No. Studies show that all of these substances during pregnancy are bad for the fetus.
Exercise During Pregnancy
In general, it’s okay to exercise during each trimester—and is, in fact, healthy to do so, says Dr. Swigert. But always listen to your body and pay attention to how you’re feeling. If you feel fatigued or light-headed, skip working out and allow your body to rest.
There are certain activities and situations where exercise isn’t the wisest move. For example, you don’t want to be doing things where you could fall and hurt yourself (like skiing), says Dr. Swigert. And with certain health issues—for example, if you have preeclampsia or are at risk for delivering early—discuss with your doctor what types of exercise are and are not safe for you.
Lifestyle Habits and Pregnancy
If you smoke, vape, or use recreational drugs, you’ll want to stop. These can have detrimental effects on the baby’s health, says Dr. Swigert. Smoking during pregnancy has been scientifically linked to cognitive disabilities and premature birth. The jury is still out on how cannabis impacts the fetus, so Dr. Swigert says it’s best to avoid cannabis during pregnancy to be on the safe side.
It is common to experience insomnia, or just waking often for bathroom breaks, however this is a time to put sleep as a top priority. Poor sleep during pregnancy could increase the risk of preeclampsia, gestational diabetes, or preterm birth.
Medications During Pregnancy
Another good topic of conversation with your doctor. Talk to them about any prescription or any over-the-counter medications or supplements you’re taking, advises Dr. Swigert. Some meds are completely fine to continue during pregnancy. Others, not so much
More bodily changes occur during pregnancy than perhaps any other time in a woman’s life. It can be confusing and overwhelming to go through. That’s why you really want a doctor you trust. Remember, no question is too small or weird to ask. Your care team wants you to have a healthy pregnancy—and that includes giving you all the information you need to make it happen.
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