"I'm pregnant! Now what?"

You’ve been trying for months or maybe a year or maybe just a week and you finally missed a period and took a test, and it was positive. You are pregnant! Now what?

Often women spend months attempting to become pregnant only one day to find out that they are pregnant, but they don’t know what to do next. First, you will need to make an appointment to see an OB/GYN. If you don’t already have one, then often your primary care doctor or friend can recommend an OB for you. Most OB/GYN offices will schedule your first visit around 8 weeks, but it can be anywhere from 6-10 weeks.  Often around 8 weeks, you will have an ultrasound confirming the pregnancy and dating.  If you are healthy and have no history of pregnancy complications, you may prefer to see a midwife and attend a birthing center rather than a hospital for your delivery. It is important to think about and ask about the location where the doctor or midwife delivers to be sure it is what you want.

What to expect? Some women start experiencing pregnancy symptoms immediately while others don’t notice any until 6-8 weeks and still others have no pregnancy related symptoms. You might start to experience some breast tenderness, bloating, nausea, and extreme fatigue which are the most common first trimester symptoms.  If you have any vaginal bleeding or abdominal pains, you should call your doctor. 

If you are experiencing a lot of nausea, you can try ginger tea or candies or ginger ale. Vitamin B6 at 25mg three times a day can also be helpful. Some women will use the over-the-counter sleeping medication Unisom with the vitamin B6 to treat nausea, but obviously be cautious as the Unisom can cause sedation. Some women find C-bands which are pressure point bracelets helpful for nausea as well as acupuncture. If nothing is working, please contact your doctor as some women need prescription medication for nausea and vomiting in pregnancy.

If you are not already taking a prenatal vitamin, start! Any brand of prenatal is fine as long as it has at least 400mcg of folic acid. Most will also contain other vitamins and minerals including calcium and iron that you will need through the pregnancy. If you are not able to tolerate a typical prenatal vitamin, you can try a chewable or gummy vitamin.  Start limiting your caffeine to 1-2 servings a day and make sure you have stopped alcohol intake. Safe medications that you might need early on in pregnancy include Tylenol or acetaminophen, Zantac, Tums, Colace, Claritin, and Benadryl. If you are ever unsure about the safety of a medication, feel free to call your doctor’s office to check.

Although some women don’t have much of an appetite early in pregnancy, many have questions on what dietary precautions to take. Any pasteurized cheeses are safe to eat.  Large fish that eat other fish (Swordfish, Tilefish, Mackerel) have higher mercury content and thus should be eaten sparingly. The FDA website has information regarding mercury content in fish so that you can eat larger amounts of fish with lower mercury content since in general fish is a healthy addition to your diet. Also, many women hear about a bacteria called listeria. Listeria is a bacteria that can contaminate foods and cause gastrointestinal illness, but it can also cross the placenta and cause miscarriage.  Some women avoid deli meats for this reason while others heat the meat as cooking kills the bacteria. Listeria can actually be found in many types of foods including uncooked meats, uncooked vegetables, unpasteurized milk, foods made from unpasteurized milk, and processed foods.  The overall risk of being exposed to listeria is very low given the FDA’s careful surveillance and testing of food in the US.

Hopefully at this point you have made it successfully to your first visit and all of your remaining questions can be answered!  Most obstetricians are happy to see you prior to conceiving as well if you have more questions about getting pregnant and what to expect in pregnancy.