First Trimester Tips: Setting the Stage for Self-care

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Pregnancy is one of the most exciting, awe-inspiring, fear-inducing, overwhelming and life changing periods of a woman’s life. Knowledge is power and whether it is your first or tenth pregnancy, understanding the process can help make pregnancy related changes more manageable. The first trimester spans from 0-12 weeks and starts with the fertilization of an egg, spotting/ irregular bleeding and the end of menstruation (FitforBirth, n.d.). During this time, hormones including relaxin and progesterone are surging (FitforBirth, n.d.). Relaxin in the hormones that promotes joint laxity which is why we are told not to overstretch during pregnancy (FitforBirth, n.d.). Progesterone helps your body tissues prepare for implantation, prompts your glands to secrete appropriate nutrients and suppresses uterine contractions (FitforBirth, n.d.). It can also cause changes in blood pressure which can lead to dizziness in the first trimester. Other common first trimester symptoms include shifting food preferences, fatigue, frequent urination and nausea/ vomiting (FitforBirth, n.d.). During this time, the primary goal of our body is to develop a placenta to nourish our baby in the second and third trimester (FitforBirth, n.d.). During the first trimester our blood volume is also increasing which can cause dizziness, rapid heart rate and the feeling that you are not able to take a deep breath (MomsintoFitness, n.d.). 

There are certain goals that we should aim to accomplish by the end of the first trimester to set ourselves up for a healthy and happy pregnancy. The first is to manage the medical or determine what we want our birth story to look like and who we want involved (NM, 2021). This is different for everyone and it is important to explore our options for care providers including OBGYNS, midwives, doulas and locations including hospitals, birthing centers and our home. Second, it is important to beat bad habits including smoking, drinking alcohol and using certain prescription medications (NM, 2021).. This is also a good time to start putting money aside for the baby. Third, it is important for us to acknowledge our emotions given the fact that 1 ⁄ 2 of all pregnant women experience anxiety and/or depression during pregnancy (NM, 2021). Developing self-care practices such as meditation, therapy, journaling etc. can be helpful to maintain our mental health with so many changes occuring. 

Fourth, it is important to eat twice as well including eating adequate quantities of protein, folate, fiber and calcium (NM, 2021). Especially for those that struggle with “morning” aka all-day sickness, this can be challenging. I have suffered from hyperemesis gravidium for two of my four pregnancies and it is easy to feel guilty when all we can eat tends to be bread and processed foods. The goal is to try our best to eat the greatest variety of fruits, vegetables, protein sources and dairy sources to help build a strong placenta and healthy baby. This is not a time for guilt though, you are already doing so much mama! Eating something upon waking, drinking plenty of water, eating small meals throughout the day and having someone else prepare your food are all ways to help cope with the “all-day” sickness so many suffer from. Fifth, it is important to get plenty of rest and start to create healthy sleep patterns before the second and third trimesters come with their discomforts (NM, 2021). Finally, it is important to develop a realistic and manageable exercise routine to stay strong and prepare for labor and delivery (NM, 2021)!

There is a great deal of confusion surrounding prenatal exercise and specifically, exercise in the first trimester. According to the ACOG, “women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during and after pregnancy,” (MomsintoFitness, n.d., p.1). There are many benefits to exercise for both mothers and babies. Babies of mothers who exercise regularly during pregnancy have increased physical health scores, increased intelligence scores at age 1 and age 5, have fewer fetal interventions and fewer pregnancy related complications (FitforBirth, n.d.). Mothers who exercise during pregnancy have easier labors including a 35% decrease in need for pain relief, a 50% decrease in need to stimulate labor, reduced risk of surgical interventions including C-sections, and reduced time spent in labor (FitforBirth, n.d.). Mothers also report fewer pregnancy discomforts including less weight gain, a reduced risk of gestational diabetes and a reduced risk of preeclampsia (FitforBirth, n.d.). Finally, women also experience improved sleep, improved mood, and reduced stress and anxiety (FitforBirth, n.d.). 

How do you safely exercise during pregnancy? First, it is important to utilize a modified borg scale or talk test to monitor intensity given that increased blood volume and surging hormones make heart rate a less reliable indicator (FitforBirth, n.d.). A woman should be able to carry on a conversation or be at a 7-8 out of 10 meaning intense but not max on the modified borg scale. When exercising in hot temperatures it is important to drink plenty of water, wear loose fitting clothing and avoid heated pools/ saunas (Huizen, 2023). Water consumption in general is important especially given that 75% of people are chronically dehydrated to begin with (Huizen, 2023). Drinking plenty of water (at least ½ your body weight in ounces of water each day) can reduce the risk of morning sickness, edema (swelling), upset stomach, heartburn, constipation, leg cramps, dizziness and joint pain (Huizen, 2023). 

A goal of 150 minutes per week of aerobic exercise and moderate strength training (or 30 minutes 5 days a week) is a good goal to work towards but it is important to start gradually if you do not have a pre-established exercise program (Huizen, 2023). It is best to favor low to moderate intensity exercise including walking, yoga, swimming, jogging and moderate weightlifting especially in the first trimester (Huizen, 2023). The first trimester is also a good time to start building a strong pelvic floor with elevator lift and lowers (Huizen, 2023). Yoga and pilates are great to include in a prenatal exercise routine to improve posture, strength, balance, reduce fall risk and ease aches and pains (Huizen, 2023). 

Dos of Prenatal Exercise	Don'ts of Prenatal Exercise
Stay hydrated	High impact exercise (especially if you are not accustomed to it)
Wear cool and loose fitting clothing	Contact sports
Wear supportive footwear	Exercise with a high risk of falling
Adjust intensity to moderate	Jarring pressure to the pelvic ex. Horseback riding
Set realistic goals
Diaphragmatic breathing (fill your belly with air expanding in all directions as you breathe in, exhale and press out all your air engaging your belly like a corset).

Signs to Stop Exercising	Signs to Seek Emergency Attention
Nausea	Vaginal discharge/ bleeding
Dehydration	Abdominal/ pelvic pain
Overheating	Loss of consciousness
Dizzy/lightheaded	Vomiting/ diarrhea
Difficulty breathing	Chest pains
Unsteady heart rate	Contractions
Headache	Rapid/ slow pulse
	Calf pain/ swelling

Knowledge is power at all times of life and pregnancy is no different. It is so important that we understand what our bodies are going through and doing so that each new symptom does not bring fear but can instead sometimes even bring excitement. The first trimester brings many changes and (not so pleasant) symptoms. It is also a time where so many important things are becoming established including the creation of our placenta and our prenatal eating, sleeping and exercise habits. Try to move as much as you can, eat as well as you can and sleep as much as you can without beating yourself up when the nausea, fatigue or dizziness get in the way. Let’s set the tone of self-love and appreciate all the amazing things our bodies are doing for us!

References 

FitforBirth (n.d.). Pre & postnatal corrective exercise specialist. FitforBirth. https://getfitforbirth.com/

Huizen, J. (2023). Which exercises are safe during pregnancy? Medical News Today. https://www.medicalnewstoday.com/articles/321983

Moms into Fitness (n.d.). First trimester exercises. Moms into Fitness. https://www.momsintofitness.com/first-trimester-exercise/

NM (2021). First trimester to-do’s. Northwestern Medicine. https://www.nm.org/healthbeat/healthy-tips/first-trimester-to-dos