First trimester: Having a healthy pregnancy

Eating a variety of healthful foods will promote both your baby's health and your own. You'll feel better if you eat often enough to keep your blood glucose stable and your energy constant. Try to:

• Eat healthful foods in small amounts.
• Limit or avoid foods high in calories from sugar or fat.
• Choose whole grains, fruits and vegetables for their nutrients and fiber.
• Choose lean sources of protein such as chicken, turkey and fish.
• Eat foods high in calcium and iron.

Eat a variety of foods to get the carbohydrates, fats and protein needed to give you energy and grow your baby. For information on how to choose healthful foods, see the nutrition section and our top 20 foods for pregnancy.

Your pre-pregnancy body mass index (BMI) can be used to help set your weight gain goal. After you find your BMI, use the chart below to estimate your recommended weight gain.

The table below shows where weight goes over the course of a pregnancy. Maternal energy stores, however, are not the last weight to be gained. Your body stores some fat during pregnancy.

Keep up your routine dental care and tell your dentist that you are pregnant. Routine X-rays can be delayed until after your baby is born. But if you have a dental problem, it's important to take care of it. It's fine to have Novocaine™ if you need it.

Wear a lap/shoulder belt every time you drive or ride in a car. Wear the lower part of the belt under your belly, against your upper thighs. The shoulder portion should rest between your breasts and to one side of your belly. Tighten the belt as snugly as you can.

As a general rule, use as few medicines as possible during your pregnancy. Tell your health care provider all the prescription, over-the-counter medicine, herbals or natural products and vitamins that you currently take.

Although many medicines are safe when used correctly, you'll want to make sure they are safe to continue taking. Don't stop taking prescribed medicines without your health care provider's approval.

Many health care providers approve the use of over-the-counter medicines to treat pain, headaches, cough, colds and other discomforts. These medicines include acetaminophen (Tylenol® and other brands), adult Robitussin® or the equivalent for coughs and antacids like Maalox®, Mylanta® and Tums® for heartburn. However, be sure to ask your health care provider which medicine is best for you.

Natural herbs, supplements and some vitamins are not necessarily safe to use during pregnancy. For example, don't take mega-doses of any vitamin. Taking more than 10,000 units a day of vitamin A during the first trimester can cause problems with a baby's development.

Some natural herbs can be toxic or have unwanted effects when used in pregnancy. Check with your health care provider before starting or continuing herbal products and supplements. In addition, do not use lotions that contain Retin-A®.

You can use the Medicine List to keep track of the medicines you are taking.

Most pregnant people can continue exercising during pregnancy, adapting their routine as pregnancy progresses. Regular exercise like walking, swimming, yoga and bicycling is usually encouraged during a low-risk pregnancy. If you have been exercising, talk with your health care provider about continuing your program.

If you are not used to exercising, talk with your health care provider before you start an exercise program. Then, start slowly and gradually increase the difficulty and amount of time.

The following tips and guidelines contain general information. If you have specific questions about exercise, talk with your health care provider.

• Wear a supportive bra and light, comfortable clothing.
• Avoid exercising in hot, humid weather or if you have a fever.
• Drink plenty of water before, during and after exercise.
• Start with a warm-up to slowly increase your heart rate and breathing.
• When stretching before and after a workout, slowly stretch only to the point of feeling gentle tension and keep breathing during the stretch.
• Do all exercises in a slow, controlled manner. Avoid jerky, bouncy movements that over-stretch and strain muscles.
• Exercise at a moderate level. You should be able to talk normally during exercise.
• Stop exercising if you feel tired or if your heart rate is higher than 140 beats per minute.
• Avoid doing sit-ups or crunches.
• End your exercise with a cool-down period to allow your heart rate and breathing to return to normal.

To prevent or reduce lower backache, start doing pelvic tilt exercises. This exercise tightens your abdominal muscles and moves your pelvis. The action of a pelvic tilt flattens your back.

During the first trimester, you can do this exercise lying on your back. However, if you begin to feel dizzy while on your back, roll onto your side right away.

• Lie on your back with your feet flat on the floor and your knees bent.
• Take in a comfortable breath.
• Tighten your abdominal muscles and push the small of your back to the floor. Hold for the count of five seconds. Let your breath out (exhale) slowly when you tighten and hold.
• Release and take in another breath (inhale).
• Rest for five to 10 seconds.
• Repeat the cycle 10 times

If you put your hand under the small of your back, you should feel your back pushing on your hand when you tilt your pelvis.

Using tobacco increases your chances of risks and problems during your pregnancy (see the list below). Quitting smoking as soon as possible is the best for you and your baby. All tobacco products, including electronic forms, are considered dangerous to you and your unborn baby.

Risks to you

Smoking during your pregnancy increases your risk for:

• an infection in your uterus
• high blood pressure or preeclampsia
• placenta previa
• premature birth
• postpartum depression

Risks to your baby

Smoking during your pregnancy puts your baby at a higher risk for:

• getting less oxygen and food
• stillbirth or miscarriage
• premature birth
• birth defects
• brain and lung damage
• SIDS (sudden infant death syndrome)
• childhood behavior problems

Secondhand and thirdhand smoke

Being around secondhand smoke is as dangerous to you and your baby as smoking yourself.

No amount of secondhand smoke is safe. Rolling down windows or opening windows in your home does not reduce secondhand smoke.

Thirdhand smoke is the chemical residue left from secondhand smoke. It is what you smell on your clothes, hair, furniture or in the car. The residue clings to the surfaces babies and children explore, such as the floor, toys or furniture.

About quitting

Quitting smoking is the only way to lower the risks to you and your baby. Cutting down on the amount you smoke will not lower these risks.

Smoking causes more stress to your baby than quitting.

If you would like help with quitting smoking, please talk to your health care provider. You can also call a tobacco treatment specialist. Please see the resources list in the quit smoking section of the resources page.

Drinking alcohol (including beer, wine and wine coolers) during pregnancy will harm a developing baby. The result can be birth defects and lifelong learning problems. Even small amounts of alcohol can hurt brain development. That is why pregnant people should avoid drinking alcohol.

If you are worried about alcohol you drank before you knew you were pregnant, talk with your health care provider. If you need help to stop drinking, talk with your health care provider and see the stop drinking alcohol section of the resources page.

Using street drugs during pregnancy can harm a developing baby. There is no safe amount.

• Marijuana (weed, pot) may affect brain development that results in behavior and learning problems in childhood. Because marijuana can be stored in the body, a developing baby can be exposed to the drug long after the pregnant person's use.
• Cocaine and methamphetamines (meth, crank, speed) can damage blood vessels and cause premature labor. Babies born to pregnant people who use these drugs are often fussy and irritable and have sleeping and feeding problems.
  • Cocaine can cause significant health problems for the pregnant person, including stroke and heart attack, and can cause the death of an unborn baby.
  • Methamphetamine use increases the risk of birth defects and may affect a baby's brain development.
• Heroin use significantly increases the risk of pregnancy complications. In addition, many babies are born early and with low birth weight. Heroin and opiates cause physical dependence. Babies born to users have withdrawal symptoms after they are born.

If you can't stop using drugs, talk to your health care provider or and see the stop using drugs section of the resources page. There are resources that can help you.

Caffeine can increase your heart rate and stimulate your central nervous system. It can also cause problems sleeping.

It's best to limit the amount of caffeine each day to two, 8-ounce cups of coffee, or three cups of tea, or two cans of caffeinated soda. Don't drink it all at once.

Coffee bought at coffee shops generally contains more caffeine than home-brewed coffee. The amount of caffeine can vary by coffee bean and blend. Limit your coffee shop purchases to less than 12 ounces each day. (This will be your total daily caffeine intake.) Watch for the caffeine content in specialty coffees like espresso.

Caffeine is measured in milligrams (mg).

• Wash your hands often with soap and water. This is especially important after you use the bathroom; touch raw meat, eggs or unwashed vegetables; prepare food and eat; handle pets; touch sick people; get saliva on your hands; and care for or play with a child while changing diapers.
• If soap and water aren't handy, use an alcohol-based hand gel.
• Try not to share forks, cups and food with young children.
• Stay away from wild or pet rodents and their droppings.

Toxoplasmosis is an infection caused by a parasite that may be found in cat feces and raw meat, especially pork. Although the symptoms are mild in adults, the infection can cause problems in a developing baby, especially in the first trimester. To avoid exposure:

• Have someone else change your cat's litter box.
• Wear gloves when you work in the garden or handle outdoor soil. Wash your hands carefully after you've taken off your gloves.
• See food safety for tips to prevent exposure through raw or undercooked meat.

Protect yourself and your baby from exposure to: 

• chickenpox
• cytomegalovirus (CMV)
• fifth disease (parvovirus)
• gastrointestinal parasites
• hepatitis
• Lyme disease
• measles
• sexually transmitted diseases
• HIV

These diseases can cause complications.

Ask your health care provider about precautions you can take and notify them if you know you have been exposed.

See food safety for information on how to keep your food safe from harmful bacteria.

Overheating your body can cause dehydration and pregnancy complications. It is best to keep your body temperature below 100.4 F. Most health care providers suggest avoiding hot tubs, saunas and sunbathing during the first trimester.

Ask your health care provider about how best to limit these activities later in pregnancy.

• Reduce your risk of exposure to lead, which can affect your baby's brain development.
  • Lead may be found in drinking water. The most common source of this lead is from metal pipes. If you have metal water pipes, you can lower your exposure risk by cooking only with cold water, which is less likely to leach the lead. Also, run the water until it is as cold as it can get. This assures the water has not been stored in the pipes.
  • If you live in a house built before 1978, avoid being around when old paint is disturbed by scraping and sanding. Stay away until the area has been vacuumed and wiped down with a damp cloth.
  • Don't use ceramic dishes that have lead in the glaze.
  • Don't eat or drink from crystal because it can leach lead. This is especially true if the food or liquid is acidic and has been in contact with the crystal for more than a few hours.
• Avoid exposure to chemicals that kill insects or plants. Let someone else apply them. If a pesticide is applied indoors, stay away for several hours. Then, have someone else wash all surfaces that come in contact with food.
• Talk with your health care provider if your job or a hobby involves chemicals or heavy metals.
• Ask your health care provider for a lead exposure questionnaire if you think you have been exposed to lead through work, home remodeling or hobbies (such as stained glass or pottery).
• Although most home cleaning products are safe to use, avoid strong and noxious fumes. These can make you dizzy. Read product labels and use them as directed in well-ventilated areas. If you are bothered by the odor, ask someone else to use the product if you can't find a milder one.