Managing First Trimester Challenges
Most people will experience a few of these issues at some point in their pregnancy. If you’re experiencing something not listed here, it may be on the Second Trimester and Third Trimester Challenges pages.
Emotional Challenges
Worry:
Worry can take many forms throughout pregnancy, and beyond:
If you’re feeling terribly sick, you may be worried that it’s going to be like this forever and have doubts about your ability to handle it
On the other hand, if you’re experiencing very few symptoms, people may say you’re lucky, but it can actually be quite nerve wracking since you have very little evidence that anything is still really happening in there!
Worry about miscarriage is very common (and understandable) during this period - you can learn more about the miscarriage stats, risk factors and signs here
There are long gaps between doctors visits and ultrasounds, in which you’ll worry if everything is developing normally (especially before you can feel movement, which doesn’t usually happen until 18-22 weeks on average). There is also lots of waiting for test results such as genetic testing.
And there are also many valid worries around birth itself, which is months away!
This worrying voice will likely remain until the baby is delivered healthily, and even continue throughout infancy and beyond (I bet your own parents still worry about you!)
My advice: don’t deprive yourself of joy
The goal is not to eliminate this worrying voice, but to make sure it doesn’t drown out the joy. This is also a period for beautiful emotions like awe, as your body is doing something extraordinary, and love as you and your partner embark on one of the most bonding experiences a couple can undertake together.
Some people hold back celebrating until after the highest miscarriage risk window is over, or until genetic testing confirms a healthy baby, or until the baby is born, etc.
But if anything did go wrong at any of these points, it won’t make it any less difficult if you withheld joy. It would still be painful and horrible.
And chances are, things will go right! So why not give yourself permission to experience all the excitement and happiness along the way?!
Avoid the “second arrow”
This is a Buddhist concept that explains that pain is an inevitable part of life - this is the “first arrow”. But it is actually our reaction to pain - the “second arrow” - that causes real suffering. This second arrow is optional and within our control to prevent.
Applied to this topic, I believe that a certain amount of worry in pregnancy is unavoidable. But people often also feel a secondary emotion on top of it - shame or embarrassment, worrying about worrying.
It is helpful to remind yourself that worrying is normal and even adaptive. Just spend just a few minutes on any online pregnancy forum and it’ll be clear that there are plenty of expecting moms feeling similarly!
Do your best to have self-compassion when you are feeling worry, and avoid the “second arrow”
Listen to Affirmation Meditations
I created the below meditation to help you acknowledge and navigate these feelings, and connect to the more positive, magical aspects of your pregnancy experience
If this meditation resonates with you, see if you can make time to listen to these affirmations on a weekly (or even more regular!) basis to shift your mindset
Loss of Control:
For those of us who crave a sense of control, pregnancy (and parenthood) is particularly challenging because many aspects are fully beyond our control. There’s no way to just work/study harder to ensure success, which is what many high-achievers are used to.
If you can, try to use this challenge as an opportunity for personal inner growth- such as focusing on the present moment and acceptance/letting-be (the type of mindsets people cultivate through meditation practice). The present is really the only thing that can be truly known, so try your best to embrace this fact and let go of the desire to know or control the future.
This is obviously way more easily said than done! But you will have many chances to practice throughout the upcoming months/years.
Small tweaks of language that can help move towards this attitude shift:
Instead of using your specific due-date when people ask, get in the habit of saying “mid-July” or “end of October”, which more accurately reflects the reality that we don’t know when babies will actually come! (only ~5% are born on their due date!)
Instead of writing a “Birth Plan” later in pregnancy, write your “Birth Preferences” - birth is unpredictable and rarely goes exactly to plan!
Isolation:
You just found out some of the biggest news of your life, and yet - according to convention - you’re not supposed to share it with anyone for many weeks until you’re past the window of highest miscarriage risk.
I say screw convention - it should be totally based on your own privacy comfort levels! Is there an inner crew who you’d want by your side, even and especially if things do go wrong?
If you’re experiencing really rough symptoms that are making it difficult to function normally at work or in your personal life, it can be a big relief to share your pregnancy news earlier so people have more context
Physical Challenges
I’ve included a bit of the science here to show how these uncomfortable symptoms are the side-effects of amazing changes designed to support your pregnancy
Connecting to this greater purpose may be helpful, or it may be eye-roll inducing in the moment, so feel free to ignore ;)
Nausea & Vomiting:
Why it happens:
70-80% of women experience nausea or vomiting, typically beginning around 4-6 weeks, peaking at 9-13 weeks, and then subsiding between 14-20 weeks
The term “morning sickness” is misleading because it can happen at any time; it’s often worst after a night of poor sleep
Caused by rising levels of human chorionic gonadotropin (HCG), the pregnancy hormone produced by the placenta
While it doesn’t alleviate the physical discomfort, you may at least take some psychological comfort knowing that women who experience nausea are less likely to miscarry. Your body is working in overdrive to build all the parts of a new person!
Severe nausea/vomiting that is frequent (vomiting multiple times a day) and persists far beyond the first trimester is known as “hyperemesis gravidarum”. This is much less common and more worrisome, especially if vomiting causes dehydration or weight loss. Definitely take this seriously and discuss possible anti-nausea medication or IV fluids with your OB.
How to relieve:
Smaller, more frequent meals (hunger can make nausea worse)
Crackers or pretzels throughout the day
Ginger or Fennel can help (in form of chews, teas, etc)
B6 Vitamins or Lollipops! (consider taking preemptively, as it can take a while to build up)
Unisom - OTC drug that helps with sleep and nausea and is safe for pregnancy (you can safely take it every day of your pregnancy!)
Diluted Gatorade/Powerade/Pedialyte especially if vomiting and need to rehydrate
If the smell/taste of your prenatal is making things worse, consider trying this brand that is geared towards morning sickness
Fatigue:
Why it happens:
This is another extremely common symptom and can vary in severity from just a slight “bleh” feeling to utter exhaustion
Reason is obvious - your body is working in overdrive to build a placenta and a new human!
How to relieve:
Give yourself grace! Don’t beat yourself up about having more lazy days than pre-pregnant you. Know that your energy will come back in second trimester
Try to get extra sleep or rest, and be okay with saying “no” to social activities if you’re not feeling up to it
If you’re struggling to get through the work day, it might be worth letting your team know that you are pregnant - even if it’s earlier than you may have otherwise - so they have more context on why you’re not at your typical energy level
Sore or Tender Breasts:
Why it happens:
This may be one of your earliest pregnancy symptoms as your body is already starting to get your boobs ready for breastfeeding
More blood starts to flow there and your milk ducts begin to grow
Over the course of the next months, you’ll also notice the veins become more prominent and nipples become larger and darker
How to relieve:
Wear comfier bras and looser clothing, consider sleeping in a bra to minimize painful movement
Cold compresses or warm showers may help
Strengthening your pec and back muscles with exercises like pushups and reverse fly can help minimize future back pain as your boobs grow larger and heavier
Constipation:
Why it happens:
Rising levels of progesterone slow down your bowels so there is more time to absorb important nutrients
The downside is waste stays inside you longer and gets more dried out, which makes poops harder and less frequent
Iron in your prenatals or supplements can also exacerbate constipation. And later in pregnancy, your growing uterus squishes your bowels
How to relieve:
Eat more fiber and hydrate
Exercise to get things moving down there
Pregnancy Safe OTC medicine: Colace (stool softener), Miralax (laxative), Metamucil (fiber-based laxative)
Get a “squatty potty” which helps get you in the optimal position to poo
Peeing all the time:
Why it happens:
Progesterone - which increases right away when you get pregnant - is a diuretic
hCG also increases blood flow to your kidneys, stimulating them to get rid of waste more quickly
Another factor later in pregnancy is the increased pressure on the bladder from the uterus and other organs as they get more smushed
How to relieve:
Make sure you are fully emptying your bladder when you go - pelvic tilts on the toilet can help ensure you’re getting it all out
Cut yourself off from drinking past a certain time at night
Plan to take more pee breaks for long car rides
Breathlessness:
Why it happens:
Previously easy activities like walking up stairs might cause you to feel out of breath
Again, the “culprit” is progesterone - but even though it might feel like you’re getting less air, it’s actually helping to get more oxygen into your blood by increasing the frequency and depth of your breaths
Plus your blood volume increases by 30-50% starting in 1st trimester, so a lot more oxygen is crossing the placenta to your baby
Later in pregnancy, another factor contributing to this symptom is your expanding uterus, which pushes into the abdomen and can squeeze your diaphragm/lungs.
How to relieve:
Standing/sitting up straight and tall can help give your lungs as much space as possible to expand
Don’t rush - leave extra time to get from place to place so you can take it easy if you’re feeling winded
Congestion:
Why it happens:
You can find yourself with a stuffy nose at any stage of pregnancy, even though you aren’t sick
Pregnancy hormones increase blood flow everywhere, including in the lining of your nose which can make it swell
The only real issue with this is it can negatively impact your sleep
Bloody noses can also occur because of the increased blood flow
How to relieve:
Elevate your head while sleeping
Use Nasal Strips and Saline Mist to clear the nasal passage
