Some women manage to fly gracefully through their first
twelve weeks of pregnancy without ever indicating they are pregnant – never
caught retching in the office bathroom, their stomachs remaining perfectly in place, emotions at least
appearing balanced. I am not one of those women.
In fact, this pregnancy, my second, found me around my ninth
week clutching my boss’s desk with my head between my knees, desperately trying
to avoid throwing up in front of her. When she asked me if I was OK, I said something
along the lines of “No. In fact, I think I’m dying. Actually, I’m
Despite my best intentions to wait until after the first
trimester ended, especially given my
Advanced Maternal Age (AMA) status, the
nausea I experienced felt paralyzing at times, and while my clothes still fit
at nine weeks they no longer did at twelve.
I am happy I shared my news earlier than traditionally recommended but
it made me wonder. Why, during perhaps the most difficult trimester of
pregnancy, when even the smell of dry cereal can make a pregnant woman gag and
her exhaustion is at its height, is she expected to keep the information
private? Biologically, what puts her at a greater risk for miscarriage at eight
weeks as opposed to eighteen?
To understand what information is most important for women
to know during their first trimester, I turned to Draion Burch, M.D., an
obstetrician and gynecologist (ob-gyn) with Magee-Womens Hospital of UPMC
. He advised that planning for your first
trimester start early with a pre-conception
with an ob-gyn in order to identify risk factors that could affect their
According to Dr. Burch, women can expect to experience any
of the following symptoms during their first trimester: nausea, vomiting,
breast tenderness, food aversions, food cravings, increased urination,
heartburn, fatigue, constipation, dizziness, fainting, mood swings, bloating,
vaginal spotting, darkening of the areolas and headaches.
“If you experience significant nausea and vomiting, which we
often refer to as morning sickness but can actually last throughout the day,
try eating smaller, more frequent meals five to six times a day,” said Dr.
Burch. “You could try the BRAT diet (banana, rice, applesauce, toast), but make
sure you include high protein snacks like milk and yogurt. Avoiding spicy and
fatty foods should help, as should drinking plenty of water and beverages
containing electrolytes. Do your best to avoid smells that bother you.”
I also asked Dr. Burch to walk us through the first obstetric
appointment after becoming pregnant.
“At your first prenatal visit, your doctor will test your
urine and blood, and obtain cultures from your cervix. You may have to have a
PAP smear to screen for cervical cancer,” Dr. Burch said. “We test everyone for
HIV, gonorrhea and chlamydia, Hepatitis B, and syphilis so please don’t be
offended by those tests!”
Doctors will also check a pregnant woman’s blood for a
variety of factors, including determining her hemoglobin level, blood type, Rubella
status, and blood glucose levels if she is at risk of diabetes. There are also carrier screening blood
tests that can be ordered depending on ethnicity and family history such as
cystic fibrosis, sickle cell disease, thalassemia, or Tay-Sachs disease.
“All of these
tests are conducted to make sure you are in the best health possible to carry
your baby,” Dr. Burch said.
As for when the “safest” time is to announce your pregnant,
Dr. Burch said the majority of miscarriages occur before the thirteenth week
and can be caused by several factors.
“It’s important to emphasize to women that they cannot control most miscarriage
factors. In fact, the most common cause of miscarriage is chromosome problems
in the baby. Most of these problems are chance occurrences and unlikely to
happen with another pregnancy,” he said.
During the first trimester, women have the option of
screening for various birth defects and Down’s syndrome. Dr. Burch also walked me through the testing
“If you choose to have your baby screened for birth defects
in the first trimester, you will have your blood drawn and tested for pregnancy-associated
protein plasma A and human
chorionic gonadotropin. You may
also have an ultrasound to look at your baby’s skin thickness at the back of
the neck, also known as neck-nuchal translucency. These tests look for trisomy
18, which is another chromosomal defect, and Down’s syndrome. The ultrasound,
blood work and your age are combined to help understand your risk of having a
baby with a birth defect.”
Whether you are riddled with early-pregnancy symptoms – like
me! - or flying through the first trimester seamlessly, make sure to rest when
you feel the need to, and take good care of yourself. Stay hydrated, eat food
you think you can keep down and relax when possible. And don’t hesitate to take
any concerns you have to your ob-gyn.
This is the one in an occasional series examining pregnancy from the viewpoint of an expectant mom. Courtney McCrimmon is a Manager in the Media Relations department at UPMC.
Labels: Magee-Womens Hospital of UPMC, pregnancy