Maybe you’re starting to think about having a baby or maybe two blue lines already appeared on the pregnancy test. Either way, we know you have questions about what’s in store for your first pregnancy. We asked Nicole L. Swank, DO, an OB/GYN with Main Line Health to answer our questions about what to expect.
Choosing the right doctor and hospital
A preconception appointment is a good idea. Your doctor can assess any medical conditions and offer genetic screening. This is a good time to start researching which hospitals provide the amenities you’re looking for, as well as the level of neonatal care you may need. Dr. Swank stresses “Your doctor should be someone who you feel comfortable with, who listens and answers your questions.”
Nutrition and safety
Ideally, you should make diet and lifestyle changes before you become pregnant. Start taking prenatal vitamins six months before conception or as soon as you find out you’re pregnant. Once pregnant, Dr. Swank encourages women to eat small frequent meals with lots of fruits, vegetables and proteins. During the first trimester, this may help manage any nausea. Avoid foods like raw and deep water fish, unpasteurized foods and caffeine—she says pregnant women should not drink more than two small cups of coffee per day. Therefore, pre-pregnancy is a good time to start preparing yourself for these adjustments.
Some women start feeling nauseous as soon as they miss their first period. In fact, 70 percent of women experience nausea and vomiting during their pregnancy. Dr. Swank says ginger supplements, small frequent meals and Vitamin B6 can help alleviate those symptoms, which usually end by the second trimester. However, some women won’t experience it at all and that’s also normal. You may begin having food aversions or cravings. During early pregnancy, women often experience breast pain as well as fatigue, which is due to their changing hormones.
First prenatal appointment
As soon as you know you’re pregnant, call your doctor to set up an appointment. “At your first appointment, ask your doctor about your delivery schedule and the office’s call schedule,” Dr. Swank says. Some people see one provider the whole pregnancy so you get to know your doctor and other practices have patients see different providers throughout the pregnancy so patients have already met the doctor on call when it’s time to have the baby.”
At your first appointment, you’ll usually have an ultrasound to confirm your due date, doctors will review nutrition and safety again, and order prenatal labs and other screenings tests. In uncomplicated pregnancies, you will typically see your OB/GYN every four weeks until 28 weeks. At 28 weeks you’ll have a visit every two weeks and from 36 weeks on, every week.
For the majority, morning sickness should let up by the second trimester. This is also when women start to gain more weight. With a normal BMI, you should gain 25 to 35 pounds for the whole pregnancy. “Generally weight gain is slow during the first trimester, and increases to about one half to one pound a week in the second and third trimester,” Dr. Swank says. Some women also have pain in their hips and back because their bones and ligaments are readjusting to make a space for the baby. As the uterus grows, women experience ligament pain and stretching in their hips and pelvis. Urinary frequency is also common but it can be a symptom of a urinary tract infection (UTI). UTIs in pregnancy can lead to preterm labor so it should not be overlooked. However, in general, women have to go to the bathroom more often as the baby takes up the space their bladder once occupied.
Work and exercise
Women with uncomplicated pregnancies can continue working until the onset of labor. However, women with medical or obstetric complications of pregnancy may need to make adjustments based on the nature of their activities, occupations and specific complications.
Also as your pregnancy advances, there are physiological changes and you’ll need to adapt your workout routines. It’s important to know that regular exercise while pregnant is safe and encouraged. Your physician may have tips, too. Pregnancy is not the time to take on new, strenuous forms of exercise. Instead, maintain your current workout routines but avoid things like contact sports, scuba diving, downhill skiing and hot yoga.
Often pregnant women experience heartburn, constipation and difficulty sleeping in their first trimester. Feeling a little short of breath is also common as the baby takes up more space. Additionally, many women start to feel like they have “pregnancy brain,” which is when you find that you’re feeling forgetful or absent-minded. This can happen at any point in the pregnancy and may be due to fatigue or the hormonal changes in the body. Dr. Swank explains, “This is completely normal.”
Prepare for delivery
Sure, this time may be when you are finalizing names, packing your suitcase and installing the baby’s car seat, but take time for yourself. Your physical and mental wellbeing is important as you prepare for delivery. Consider getting a prenatal massage or treating yourself to a getaway or “Babymoon” before your baby arrives.
Childbirth education classes and choosing a newborn provider are also important items that should be on your to-do list. Dr. Swank recommends patients take childbirth education classes and an infant CPR course as well. “I really feel this is important for any caregiver to be up-to-date with CPR,” she says.
She strongly encourages first-time parents to take a breastfeeding class if they are interested in breastfeeding. It’s important to educate yourself regarding practices that enable women to achieve their breastfeeding intentions, such as immediate skin-to-skin contact, rooming in, feeding in response to infant cues and avoiding pacifiers or unindicated supplementation.
The postpartum period is over at about six weeks after delivery, but it can take your body up to a year before it goes back to feeling normal. “I think that’s one of the biggest things, it can take months for you to feel like yourself again, it’s really is common for it to take that long,” Dr. Swank says.
Baby blues are common postpartum, which is when women feel tearful or angry. It usually resolves without medication by two weeks postpartum. Postpartum depression lasts longer and it can occur anytime in the first year after birth. It is important that women discuss their symptoms with their doctor. Resources and treatment options are available so ask for help if you need it. Ten to 20 percent of women have postpartum depression – you’re not alone.
There are support groups for parents, both traditional meetings and now on social media as well. Dr. Swank says many communities will have online social media groups of parents or parents-to-be in their local area where members post questions and offer advice and support as well as event pages for prenatal activities and events for mom and baby.
Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.