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Since Your Baby Doesn’t Come with an Owner’s Manual Chapter 1:  The First Trimester

5/30/2017

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After delivering babies for the last 9 years, I have yet to see the birth of a baby with an owner’s manual, and no matter how prepared new parents try to be, pregnancy and a new baby are undoubtedly a life-changing experience.  What I’d like to do over my next few blogs is cover the time leading up to and just after delivery.  So here it goes, what to expect from you physician’s perspective.

When do I need to start preparing?  The best pregnancy planning begins even before conception.  Prenatal vitamins are generally advised for several months before attempting to conceive to ensure adequate levels of folic acid during the critical time to prevent neural tube defects (essentially spinal problems) in the developing embryo.  As an added bonus, some studies suggest a decrease in the severity of morning sickness for those who have been taking prenatal vitamins for several months before conception.  Win for baby and win for mommy!

More importantly, how soon can I see my baby?  Unfortunately, despite our expectation of instant gratification, our technology hasn’t quite caught up to the demands of anxious mothers-to-be.  While we may be able to see a gestational sac (the sac the baby grows in) as early as 5-6 weeks, we generally aren’t able to see the 3 parts of a successful pregnancy until around 7 weeks.  We want to confirm: 1. Pregnancy inside the uterus, 2. The part that becomes the baby is present inside the sac, and 3. There is a heartbeat.  While we occasionally see moms before 7 weeks, they may leave even more worried than when they came because we can’t always guarantee that the pregnancy appears healthy.  Not to mention, who wants an extra vaginal ultrasound :( It takes until 7+ weeks for the baby to be even a centimeter long, and even though it’s the cutest 1cm you’ll ever see, we want to be able to reassure you that it’s also the healthiest!   Besides, as a doctor, the last thing we want to cause is more stress to expectant mothers.  That’s the baby’s job for after delivery -- “Liam, are you seriously trying to eat my shirt?!” :P

So, what else happens at that first visit?  Your doctor will likely check labs, probably chat with you about pregnancy expectations, possibly discuss genetic testing and may do an exam.  Your provider may also inquire about any medical conditions or previous surgeries that would affect your pregnancy.  He/she will also answer any questions you may have and discuss any symptoms you may be having to determine if those issues are pregnancy-related or require further evaluation/treatment.  Most importantly, it gives you the opportunity to meet the person who will be helping to bring your bundle of joy into the world!

Speaking of symptoms, which ones are common during pregnancy?  The number one complaint in the first trimester is nausea.  Generally, it’s worst during the second half of the first trimester and begins to subside as the HCG (pregnancy hormone) begins to go down towards the end of the first trimester.  Since no one likes to spend all day hugging the toilet, we do encourage notifying your doctor if you aren’t able to keep any food down, even if it’s before 7 weeks.  The one silver lining to all of that nausea is that women with hyperemesis gravidarum (not nearly as cool as the name sounds!) tend to have a slightly less chance of miscarriage.  Other common symptoms include breast tenderness or enlargement, change in skin pigmentation, increased urination, food aversions and of course, missed menses.  Light vaginal spotting or bleeding with pregnancy implantation can also be normal.  That being said, be sure to notify your doctor for abdominal pain that doesn’t go away with Tylenol, heavy vaginal bleeding (more than a pad per hour) and passing large clots or tissue.  These could be signs of either a failing pregnancy or even a pregnancy outside the uterus, which is potentially a life-threatening emergency.  
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There you have it!  A quick look at the first trimester.  We’ll hit the high notes for second and third trimester in future blogs!  For all of those who are pregnant, congratulations, and for those seeking pregnancy, good luck!  Please give us a call at 208-523-2060 if you’d like our help in achieving a healthy, happy pregnancy for you and your baby!

Dr. Nick

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