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I'm Pregnant
Staying Healthy in the First TrimesterFirst Trimester

Introduction

One of the best things you can do for you and your baby is to take good care of yourself both physically and emotionally.

On this page, you’ll find first trimester specifics about healthy eating, physical activity, mouth and teeth care, mental health, and more. You’ll also learn about the routine tests that form part of your prenatal checkups in the first trimester.

Healthy body and mind

You don’t need to gain much weight in the first trimester, only about 1.1–4.4 lbs (0.5–2.0 kg). This is a good time to start setting weight gain goals for the rest of your pregnancy. Learn more about healthy weight gain.

Eat a variety of healthy foods each day. In the first trimester you will not need any extra calories above what you normally ate before you were pregnant. If you’re not already taking a daily multivitamin, start now and take it for the rest of your pregnancy. Make sure your multivitamin has:

  • 0.4 mg (400 mcg) folic acid
  • 16–20 mg iron
  • 2.6 mcg vitamin B12
  • 400 IU vitamin D

Talk with your health care provider about starting or continuing your physical activity. You may need to adjust as your pregnancy progresses. Listen to your body and try not to overdo it.

Teeth and mouth care

Good mouth care habits are an important part of a healthy pregnancy. For good oral health:

  • Brush your teeth with fluoride toothpaste twice a day, especially before bedtime.
  • Floss once a day.
  • If you use tobacco or tobacco-like products, try to cut down and quit.
  • Limit foods with sugar and starch to mealtimes whenever you can.
  • Drink water throughout the day.
  • Try not to sip on sweetened drinks like specialty coffees, sugar-sweetened drinks and flavored water. Carbonated beverages like diet pop also have acid in them that can be harmful to your teeth if sipped on all day.

Take care of your mouth and teeth and continue to see your dentist regularly or schedule an extra appointment if you have concerns. If you vomit, have heartburn or reflux, wait at least 30 minutes to brush your teeth. Stomach acids can damage the tooth surfaces even more if you brush your teeth sooner. You can rinse your mouth with a teaspoon of baking soda in a cup of water and then spit it out. If you don’t have baking soda, rinse with water.

Common conditions that affect the mouth during pregnancy are:

Pregnancy gingivitis

A gum disease that causes your gums to become red, swollen, tender to touch and bleed easily. It can increase your risk of tooth decay, especially if you do not brush your teeth and gums often. Changes in hormone levels during pregnancy make gums more sensitive to plaque and bacteria. Tobacco or tobacco-like products can also cause pregnancy gingivitis. Sometimes you can get a more serious form of pregnancy gingivitis known as periodontal disease. If this happens, you may need to visit your dental office more often during your pregnancy.

Tooth decay

Bacteria in your mouth make acids from the sugars and starches you eat. The acids attack the surface of the teeth for about 20 minutes after eating. Eating and drinking foods that have sugar and starch in them throughout the day—even natural sugar—increases the number of times the teeth are exposed to these acids. This can increase your risk of developing tooth decay, and is why you need to keep brushing and flossing.

It’s safe to have dental care when you’re pregnant. Tell your dentist or dental hygienist that you’re pregnant. They will work with you to create a dental care plan to help you prevent pregnancy gingivitis and tooth decay, and to deal with any other dental concerns. They may also suggest using products to fight bacteria and strengthen teeth. If you haven’t been to a dentist or dental hygienist in the last year, or if you see changes in your mouth, make an appointment during your first trimester.

Living on a low income

If you’re living on a low income, contact the Government of Alberta – Alberta Adult Health Benefit program. You may qualify for this benefit if you’re pregnant or have ongoing prescription medicine needs. This benefit covers dental care, eyeglasses, ambulance services, diabetic supplies and prescription medicine. To see if you qualify, call them toll-free at 1-877-469-5437 or visit their website.

You may also qualify for other resources and programs in your area. To learn more, call Health Link at 811 or talk with your health care provider.

Mental health

Your mental health is just as important as your physical health and both contribute to your overall health. Finding out that you’re pregnant may bring about many different emotions that can affect your mental health. Here are some tips to help you along the way:

  • Set reasonable expectations for yourself. Take time every day to rest and relax. Nap if you need to.
  • Eat regularly and make sure you drink plenty of water. A walk outside and some fresh air can help you feel refreshed.
  • Don’t be afraid to ask questions or talk about any concerns with your health care provider or the other health care professionals at their office.
  • Talk with other expectant parents. They’re probably going through many of the same feelings as you. Getting to know them now will help extend your support system once your baby is born. There are also online groups to connect you with other expectant parents.
  • Talk with your partner, friends and family who will listen and support you.

Changing emotions, including stress, anxiety and depression, can happen anytime in pregnancy. Learn more about mental health.

“Be positive and don’t get stressed: relax, breathe deep and dance!”

~Leta, expectant mom

Healthy sexuality

You may find that your level of sexual desire comes and goes as your body changes. Share how you’re feeling with your partner and talk about what works and doesn’t work.

Sexual intercourse is usually safe during pregnancy. Contractions from orgasm are not the same as labour contractions.

Pregnant person and partner sitting on a couch together, looking at one another, with their hands on pregnant person's abdomen.

Prenatal care

Prenatal checkups

Your first prenatal checkup should be around 6–10 weeks or after you’ve missed your first period. Your health care provider will talk about your general health, your health history including any previous pregnancies, may do a complete physical checkup and order some tests.

If you’re a partner

You can build attachment with your baby and support your partner by going to appointments like prenatal checkups and ultrasounds together.

Your checkup may include:

  • a pelvic exam to check your cervix and the size and position of your uterus
  • checking your blood pressure
  • a breast exam
  • checking your weight and height and talking about healthy weight gain during pregnancy
  • a Pap test to check for cancer of the cervix or abnormal cells that could lead to cancer. This test is only done if your Pap test is due.
  • routine blood and urine tests
Person sitting in a chair with their left arm extended while a health care provider wearing gloves prepares to draw blood.

Routine tests

Your health care provider will want to do some routine tests after your first appointment. Routine tests are recommended for all pregnant individuals. The most common routine tests during the first trimester are blood tests, urine tests and an ultrasound.

Depending on your risk factors, they may also talk with you about prenatal genetic screening, screening for infections, and checking to see if you’re immune to certain diseases.

Your health care provider will talk with you more about these tests and answer your questions.

Hemoglobin

This blood test checks your blood to make sure it has enough healthy red blood cells to carry oxygen for you and your baby. Hemoglobin is found in red blood cells. It carries oxygen to the cells of your body and your baby’s body. When pregnant, your body makes more red blood cells and more blood. Sometimes the increase in red blood cells doesn’t keep up with the increase in the amount of blood. You may need more iron to increase your red blood cells.

Blood type and antibodies

This blood test identifies your blood type and your Rh factor. There are 4 blood types: O, A, B and AB. Everyone’s blood also has an Rh factor. You’ll be either Rh positive or Rh negative. This may affect your care, your baby’s health and later pregnancies, so it’s important to know this information early in your pregnancy. If you’re Rh negative, you’ll be given an injection of Rh immune globulin in case your baby is Rh positive:

  • at 28–32 weeks and after the birth of your baby, to prevent Rh problems in later pregnancies
  • if you have any bleeding during your pregnancy, to prevent possible health problems in later pregnancies
  • if you have an abdominal injury during your pregnancy, to prevent possible health problems in later pregnancies

To learn more about Rh immune globulin, visit MyHealth.Alberta.ca – When You Need Rh Immune Globulin.

Rubella titre

This blood test checks if you’re immune to German measles (rubella). If you’re not, your health care provider will talk with you about how to prevent getting rubella during your pregnancy. Your provider will recommend you get immunized against rubella after your baby is born. Getting rubella when you’re pregnant may cause eye, ear and heart damage to your baby.

Varicella titre

This blood test checks if you’re immune to the chicken pox virus. If you’re not, your health care provider will talk with you about how to prevent getting chicken pox during your pregnancy. Your health care provider will recommend you get immunized against chicken pox after your baby is born. If you get chicken pox during the first 20 weeks of pregnancy, your baby has a slight risk of having a rare group of serious birth defects. If you get chicken pox just before birth, your baby may be born with a possible life-threatening infection.

Hepatitis B antigen

This blood test checks if you’ve been exposed to hepatitis B. Many people with hepatitis B don’t know they have it. This infection can be passed on to your baby at birth. If your health care provider knows you’re hepatitis B positive, you may be treated during pregnancy. Your baby can be given antibodies right after birth and start on an immunization series. This will likely prevent your baby from getting hepatitis B.

Syphilis screening

This blood test checks if you’ve been in contact with syphilis, an STI. If untreated, syphilis can cause late-term miscarriage, birth defects and stillbirth. If you test positive, which means you’ve had or been exposed to syphilis, you can pass the bacteria on to your baby through the placenta. Babies can also be exposed by contact with an active genital lesion or open sore during birth. If you test positive, you’ll be treated with medicine to prevent the infection being passed to your baby. Syphilis can damage your baby’s bones, teeth, vision, and hearing as well as affect their brain development. It can also cause anemia and lung infections.

HIV screening

This blood test checks if you have HIV antibodies in your blood. This virus may lead to AIDS. If there are HIV antibodies, it means that you’re HIV positive—but it doesn’t mean you have AIDS. HIV can be passed to your unborn baby through the placenta. It can also pass to your baby at birth. Knowing if you’re HIV positive ahead of your baby’s birth gives your health care provider more time to prevent the virus from passing to your baby and to start your treatment earlier.

Gonorrhea screening

This test checks if you’ve been exposed to gonorrhea. Most tests use a sample of urine or a swab from the cervix, urethra, rectum or throat. If untreated, gonorrhea can cause early delivery or rupture of the membranes. If you have a vaginal delivery, the infection can pass to your baby during birth and cause serious eye, blood, and joint infections. If you test positive, you’ll be treated with medicine to treat the infection and prevent it from being passed to your baby. Your partner also needs to be tested and treated.

Chlamydia screening

This test checks if you’ve been exposed to chlamydia. Most tests use a sample of urine or a swab from the cervix, urethra or rectum. If untreated, chlamydia can cause miscarriage, preterm birth, or rupture of membranes. The infection can also be passed to your baby during birth, causing serious eye and lung infections, or infections of the nose and throat. If you test positive, you’ll be treated with medicine to treat the infection and prevent it from being passed to your baby. Your partner also needs to be tested and treated.

Urine tests

During these tests, your urine will be checked for bacteria and blood cells. Your urine is tested for bacteria, whether you have symptoms or not. It’s important to catch and treat a urinary tract infection (UTI) when you’re pregnant—you can have an infection even if you don’t have any symptoms. If you have symptoms of a UTI, your urine will be tested for bacteria as well as white blood cells. If either shows up, the urine sample will be sent to the lab for more testing. The test will show if you have a UTI and which antibiotic will be best to treat the infection while you’re pregnant.

Ultrasound

An ultrasound is sometimes done in the first trimester if you’re not sure how many weeks pregnant you are (early dating ultrasound). It may also be done if the size of your uterus doesn’t match how many weeks pregnant you think you are. Your health care provider will talk with you about other ultrasounds you may need during your pregnancy.

Most ultrasounds are abdominal ultrasounds. Before the ultrasound, you’ll need to drink enough water to make your bladder full. This helps raise the uterus closer to the surface of the abdomen. You’ll lie on a bed in a dimly lit room. Gel is spread over your abdomen before the ultrasound technician moves a small handheld device over your abdomen. The ultrasound takes 20–45 minutes. A health care provider will discuss the results with you, at your next prenatal clinic visit, or at the ultrasound clinic.

Other tests

All pregnant individuals will be offered a prenatal screening test for the most common chromosome differences. Diagnostic tests may be recommended to show if their baby has a chromosome or birth defect. Sometimes genetic abnormalities or birth defects may be serious enough that the baby could have severe disabilities or even die.

Prenatal genetic screening

Prenatal genetic screening is offered to show the chance that your baby has a chromosome or birth defect. Genetic screening tests don’t diagnose how your baby is growing and developing. They only tell your health care provider if more testing needs to be done to make a diagnosis. Your health care provider will give you more information to help you decide whether or not to have more prenatal genetic testing done.

The benefit of having these tests is that you’ll be given your screening results earlier in your pregnancy. This gives you time to think about the results and whether you want more testing, if it’s recommended.

  • Maternal blood test is done between 9–13 weeks plus 6 days of pregnancy. It measures 2 substances that are released from the placenta and found in your blood. Changes to the levels of these substances may mean there’s an increased likelihood that your baby has Down syndrome, trisomy 13 or trisomy 18. This blood test is done with the nuchal translucency ultrasound (NT) as part of the first trimester screen. No results are available with this blood test alone.
  • NT ultrasound is scheduled between 11–13 weeks plus 6 days of pregnancy. It measures the thickness of the layer of fluid at the back of your baby’s neck. This measurement and the results of the maternal blood test are combined with your age to estimate your likelihood of having a baby with Down syndrome, trisomy 13 or trisomy 18. This is called a first trimester screen. It’s also possible to find certain major birth defects. The NT ultrasound may also be completed without the maternal blood test.
  • Non-invasive prenatal testing (NIPT) is a maternal blood test to screen for an increased likelihood for Down syndrome, trisomy 13 or trisomy 18. This test can be done any time after 10 weeks gestation. The cost of this test is not covered by Alberta Health Care.

Prenatal test used to make a diagnosis

  • Chorionic villus sampling (CVS) is a diagnostic test done between 11–14 weeks of pregnancy after screening tests show a higher likelihood of a genetic or chromosomal disorder. An ultrasound is used to pass a small plastic tube (catheter) through the cervix or a needle through the abdomen into the uterus to the chorionic villi in the placenta. A sample of cells is removed for testing. There is a risk of miscarriage of 1/100 after the procedure.

A health care professional will review the results and speak with you about your options and what to expect.

To learn more about prenatal screening tests, visit MyHealth.Alberta.ca – First Trimester Screening for Birth Defects.