First Trimester Tips From a Labor & Delivery Nurse

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Guest blogger Flynn Millard co-founded Stork, LLC, a childbirth education company in the Washington, DC metropolitan area, in 2014.Flynn completed her undergraduate education at the University of Virginia, where she received a Bachelor of Science in Nursing. She completed her Master of Science degree at Georgetown University in 2008 completing their Family Nurse Practitioner program. During her schooling she worked as a labor and delivery nurse at Sibley Memorial Hospital. 

As a newly pregnant woman with my first baby, I had no idea how I was going to feel and how my pregnancy would impact my own body, even though I have worked in women’s health for over a decade. To become the patient, instead of the caregiver, was a new role for me. I am generally very healthy and usually feel well, so to feel what all my patients have described for years was still totally new for me. I hope to share some of my knowledge as a caregiver in the field but also some realistic impressions of someone going through pregnancy alongside you.


The first trimester is really hard. The worst part for me was the fatigue, literally feeling like I was dragging my body and mind to work.  It was hard sometimes to find energy to get through the day in our fast paced office! It is hard to explain the feeling to your spouse and it's hard to keep a happy face when all you want to do is sleep. Just know this will pass. For me, at 12 weeks I woke up one day and it was as if a veil had been lifted and I could exercise again during the day with much more energy.  Speaking of exercise - you should be doing it as you are able to. I give my patients a pass in the first trimester since the fatigue, nausea, and sometimes vomiting can make it really hard. But once you are feeling better, there is no excuse to not be exercising at least 3-5 times per week. Many of my patients actually say exercising helps their nausea improve. A normal weight woman should gain 25-35 pounds in her pregnancy, but we really do not need to gain any weight in the first twelve weeks. As long as you are not losing weight from vomiting severely, your weight may fluctuate within a few pounds, but generally stays about the same in first trimester.


To ensure healthy weight gain during pregnancy, your body needs about 300 extra calories per day after the first 12 weeks. Three hundred calories isn’t much, so pregnancy is not a full 10 months of the freedom to eat anything you want. In fact, you actually require more calories when you breastfeed than when you are pregnant.Making healthy food choices helps you and your baby  to grow appropriately. In the early weeks, when I was not feeling good, I was craving carbs and felt ravenous. It is normal and healthy to soothe those cravings within moderation, but as your energy and appetite normalize, you should be eating a well rounded diet of whole grains, fruits, veggies, proteins and dairy. The occasional sweet is safe, but try apples with peanut butter or graham crackers for dessert instead of full fat ice cream and candies. Those simple sugars do nothing but make your energy crash and they do not provide nutrition for your growing baby. What you eat matters, and so does what you drink. In a perfect world, I would advise just drinking water - and lots of it. I have heard at least 100 ounces per day or half an ounce for every pound you weigh. There is no need for artificially sweetened drinks or soda in your diet, as they are full of sugars that don’t provide any benefit to you or baby. If you are sick of water, switch to seltzer or add fresh lemons to your drink. The occasional ice tea and juice for breakfast is safe but do not add more sweeteners.


Diet aside, the first trimester is also a time when you are getting many tests offered and completed on you and your baby. Genetic testing is widespread in the obstetric world now and counseling will be tailored to your family history, your age and your partner’s history. Each patient likely will receive specific recommendations, but make sure you feel well educated and see your obstetrician by 8-10 weeks so you do not miss the window of certain early tests if you chose to pursue them. Some of this testing, like carrier screening for recessive diseases, can be done prior to your pregnancy, so let your gynecologist know you are planning pregnancy and meet with them before hand. Getting this done before pregnancy can alleviate the stress of waiting in your early trimester when your fears of miscarriage and problems is heightened.

Stay tuned for the next newsletter for Flynn's tips for the second trimester!  

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