What to expect the first trimester of pregnancy

When you find out you’re pregnant, you’ll likely have a lot of questions about what is happening to your body and what is happening with your baby’s development. Jade Elliott spoke with Leah Moses, a certified nurse midwife with Intermountain Healthcare, about some of the most common questions she has women ask when they come in for their initial prenatal visit and to explain why those visits are the best place to get information and answers about your pregnancy.

If you’re thinking about becoming pregnant or think you might be pregnant it’s important to contact your provider.

Your provider can help check for many things to help ensure your pregnancy and baby are as healthy as possible. Once they know your medical history, they can provide answers for your unique circumstances.

At your first visit for a normal pregnancy that would be at about 7 weeks or so, your provider will likely:

  • Check your urine sample for infection and to confirm your pregnancy.
  •  Calculate your due date based on your last menstrual cycle or ultrasound exam.
  •  Recommend prenatal vitamins that include at least 400 micrograms (0.4 mg) of folic acid. This can reduce the risk of a child born with serious birth defects of the spinal cord or brain.
  •  Help explain the risks that come if you drink alcohol or use illegal drugs, and also answer questions about what prescription or over the counter medications are safe or not safe for you to take during pregnancy.
  •  Perform blood tests to check your health and for infections that can affect pregnancy including hepatitis B, hepatitis C, HIV, rubella, syphilis, chlamydia, and gonorrhea.
  • Discuss immunizations and recommend a flu or COVID vaccine if you haven’t already received them.
  •  Do a complete physical exam, which may include a pelvic exam.
  •  Offer genetic testing: screening for Down syndrome and other chromosomal fetal abnormalities, cystic fibrosis, or other specialized testing depending on your medical history.
  •  Talk with you about how to avoid toxic substances in foods or your environment.

If your pregnancy is healthy, your health care provider will help determine a care plan and regular schedule for visits. For a normal pregnancy it’s typically a visit each month during the first and second trimesters and more frequent visits during your third trimester. If you have a chronic health condition or complications during pregnancy you may need to be seen more often.

Your provider will also discuss any symptoms you are having or may experience during this time of your pregnancy.

Some of the common symptoms during the first trimester and why they occur:

Feeling tired – Your body is working hard to adjust to all the new physical changes. This can cause extreme fatigue. You may need to sleep longer than usual at night or take naps. Your energy will likely return in the second trimester.

Morning sickness – may include nausea and/or vomiting. It’s caused by pregnancy hormones. It’s fairly common in the first trimester. Morning sickness can occur at any time of day. Certain foods or smells might trigger these symptoms. Eating a saltine cracker, dry cereal or toast first thing in the morning before you get out of bed may help, as you may feel more nausea on an empty stomach. Morning sickness usually goes away by the second trimester.

There are over-the-counter vitamins and herbal supplements that may help with morning sickness. Taking vitamin B6 may help with nausea, even though it may not prevent vomiting. Ginger supplements also may relieve nausea.

Frequent urination – as your uterus grows, it pushes on your bladder. You may even leak a little urine when you cough or sneeze.

Lightheadedness – your body works overtime to make extra blood to support your baby and this can cause dizziness. If you are too hungry you might feel lightheaded.

Heartburn – This occurs because the muscles that break down food become more relaxed during pregnancy and hormone changes slow down the digestive process to give your body more time to absorb nutrients. Heartburn may increase in later pregnancy. Over the counter remedies such as Tums can help.

Constipation – The iron in prenatal vitamins may lead to constipation. Be sure to drink 6-8 glasses of water and eat fiber-rich foods such as whole grains, beans, legumes, fresh vegetables and fruit. And keep moving by walking or exercising.

Skin changes – With hormones causing increased blood circulation and extra oil production, you may have a “pregnancy glow.” You may also have flares of acne.

Breast changes – The hormones in your body change to prepare for breastfeeding. As this occurs, your breasts may feel tender and swollen. You might notice small bumps forming in the area around your nipples. Your breasts may feel bigger and fuller.

Vaginal changes – The lining of your vagina will become thicker and less sensitive. It’s normal to have a thin, white vaginal discharge or mild vaginal bleeding (spotting). However, call your doctor if you have significant vaginal bleeding. If the bleeding is heavy or painful, go to an emergency room.

Expanding waistline – Your waistline will expand as your baby and uterus grow larger. You may not notice this change until the second trimester. It is normal to gain no or little weight in your first trimester.

Emotional changes – Hormones change significantly during pregnancy, and you may feel moody, forgetful, or unable to focus. Fatigue and stress can increase these symptoms. Take time for yourself and practice self-care.

Your baby’s development during the first trimester, week by week

Conception usually happens about 2 weeks after the start of your last menstrual period (LMP).

You may not know the exact day you get pregnant. Healthcare providers use your LMP to find out how far along you are in pregnancy.

During weeks 3-4, the fertilized egg moves through the fallopian tubes towards your uterus and attaches to the lining of the uterus. Once it’s implanted, it begins to grow and the placenta forms. At the end of four weeks, you may notice you’ve missed your period.

At week 5, the embryo’s neural tube forms. The neural tube becomes your baby’s brain, spinal cord, and backbone. Tiny buds start to appear that become your baby’s arms and legs. Your baby’s heart and lungs are developing, and your baby’s heart starts to beat. Your embryo is producing hCG, the hormone that can be detected in a pregnancy test.

At week 6, your baby’s heart beats about 105 times a minute. Her nose, mouth, fingers, toes and ears are forming and begin to take shape.

At week 7, your baby’s bones start to form but are still soft. Your baby develops eyelids, but they stay shut. Your baby’s genitals begin to form.

At week 8, all of your baby’s major organs and body systems are developing. The placenta is working.

At week 9, your baby is close to ½ an inch long now. Tiny buds appear that become your baby’s teeth.

At week 10, you may be able to hear your baby’s heartbeat at your prenatal checkup. Fingers and toes continue to develop and your baby’s nails grow.

At week 11, your baby if now officially a fetus and her bones will begin to harden. Her skin is still thin and transparent, but becomes less so over time. Her head makes up about half of her size.

At week 12, your baby’s hands develop faster than her feet. She moves around, but you may not be able to feel her move yet. She’s about 2 inches long and weighs about ½ an ounce

During the first trimester your baby is making vital developments. It’s a critical time to see your provider and make healthy choices and take precautions to keep your baby safe.

For more information about pregnancy or to find a women’s health provider or calculate your due date, visit intermountainhealthcare.org

Intermountain offers online childbirth preparation and breastfeeding classes or you can call your local hospital for more information.

Other pregnancy resources:



The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.