First trimester worries

Common worries in the first trimester of pregnancy

My pregnancy wasn't planned and I'm scared my partner won't be pleased. What should I do?

First, you need to get your own thoughts in order, especially if you're worried about what your partner will say. It may help you to confide in a close friend or talk to a nurse at your family planning clinic or doctor's surgery.

It may be best to tell your partner early on, rather than putting it off. Otherwise he will also have to deal with the fact that you have been keeping such a huge secret as well as the fact that you are pregnant.

His first reaction might not show his true feelings. Like you, he will be in shock when he first hears and will need time to get used to the idea of a baby. Try to give him some time to think about the news. If you think he might react angrily, tell him in a public place, such as a café or restaurant.

There are some other things you might like to think about when you’re telling your partner:

  • Think about the best time of day for breaking the news.
  • Choose a moment when they’re in a good mood if possible.
  • If you’re worried about their reaction ask someone you trust to be with you when you break the news.

If you think you might not get emotional (or practical) support from your partner during the pregnancy, let your midwife know. You can talk to her about how you feel. You should also let your friends and family support you.

How will my baby grow if I'm being sick all the time?

Your baby will take the nutrients they need from your body, so if you have bad morning sickness it’s only you who suffers! You only need to worry if you’re being so sick that you can’t keep any food or water/fluid down. If you can’t keep anything down you may be suffering from hyperemesis gravidarum. which is a severe form of morning sickness. Talk to your doctor if this is the case as you are at risk of dehydration.

If your morning sickness isn’t severe, it’s important to try to keep your strength up. Choose healthy snacks, such as wholegrain sandwiches and fruit instead of fatty foods such as crisps or chocolate. There’s no safe proven cure, unfortunately, but some women find that it helps if they make changes to their lifestyle, such as eating little and often instead of having big meals.

It’s important to drink enough fluids. Try to keep a glass of water near you and keep taking regular sips.

Read more about morning sickness.

I'm exhausted. Why am I feeling so tired?

In the first few months of pregnancy, your baby is growing very fast and using up a lot of energy. Your body is changing and developing to support your growing womb and baby. Many pregnant women say they feel very tired in these months, with a tiredness beyond anything they have ever felt before. This tiredness will pass as you move into the middle months. But, for now, these ideas may help:

  • Take some gentle exercise – it can actually give you more energy!
  • Rest when you can.
  • Try to take some time out for yourself each day, even if it’s just ten minutes.
  • Read a magazine, have a relaxing bath or simply close your eyes for a few minutes.
  • Go to sleep earlier if this is possible.

What does it mean if my blood is rhesus negative?

As well as finding out if your blood group is A, B, AB or O, your midwife will want to find out whether you are rhesus or D group (RhD) factor positive or negative.

Around 85 percent of people have red blood cells with the RhD factor. They are called ‘rhesus positive’. The other 15 percent have red blood cells that don’t have the RhD factor in them. These people are called ‘rhesus negative’.

Knowing which group you are in is important – if you have rhesus negative blood, but your partner has rhesus positive blood, your baby has a chance of having rhesus positive blood too. If this happens, your body might see your baby’s blood as different to yours and develop antibodies. These antibodies can pass across the placenta and attack your baby’s blood cells.

The good news is that this won’t normally affect your first pregnancy, but it can be very serious in later pregnancies. Because of this, if you have rhesus negative blood your midwife will offer you an injection called anti-D during your pregnancy to protect your baby. If tests after the birth show that your baby is rhesus positive, you’ll be offered another injection then.

My BMI is 31 and I am classed as obese. Do I need to lose weight even though I'm pregnant?

Trying to lose weight is best left until after your baby is born. However, your extra weight does put you at increased risk of pregnancy complications such as pregnancy diabetes and pre-eclampsia, as well as creating possible health problems for your baby. Your healthcare team will be aware of this and they are likely to give you extra care and support during your pregnancy.

You can reduce your risk of these problems by managing your weight – follow a healthy eating plan and be more active. You’re also likely to enjoy your pregnancy more.

Concentrate on making sensible food choices so you’re eating a balanced diet and cutting out foods that are high in sugar and fat. This way, you can keep your pregnancy weight gain to a healthy level and ensure your baby gets all the nutrients she needs.

There are no UK guidelines about how much weight a woman should put on in pregnancy, but guidance from the US says that someone who has a BMI of 30 or more should put on between 11lbs (5kg) and 20lbs (9kg). Healthy changes to your diet mean you might not gain any weight in pregnancy, however – you might even lose a small amount. The Royal College of Obstetricians and Gynaecologists says that this is not harmful.

Find out more about managing your weight in pregnancy

 

Sources

  1.  NHS Choices [accessed 28 February 2015]  ‘Severe vomiting in pregnancy’, :http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/Severe-vomiting-in-pregnancy-hyperemesis-gravidarum.aspx 
  2. van Stuijvenberg ME, Schabort I, Labadarios D, Nel JT (1995) ‘The nutritional status and treatment of patients with hyperemesis gravidarum’, American Journal of Obstetrics and Gynecology, 172 (5): 1585–91:http://www.ncbi.nlm.nih.gov/pubmed/7755076
  3.  Macdonald S, Magill-Cuerden J (2012) Mayes’ Midwifery, 14th edition, London, Ballière Tindall
  4.  Matthews A, Haas DM, O’Mathúna DP, Dowswell T, Doyle M (2014) ‘Interventions for nausea and vomiting in early pregnancy’, Cochrane Database of Systematic Reviews, 3: CD007575. doi: 10.1002/14651858.CD007575.pub3.
  5. Crowther CA, Keirse MJ (2013) ‘Anti-D administration in pregnancy for preventing rhesus alloimmunisation’, Cochrane Database of Systematic Reviews, 2: CD000020. doi: 10.1002/14651858.CD000020.pub2.
  6. Patient.co.uk [accessed 28 February 2015] ‘Haemolytic disease of the newborn’, :http://www.patient.co.uk/doctor/haemolytic-disease-of-the-newborn
  7. NHS Choices [accessed 28 February 2015] ‘Rhesus disease’, :http://www.nhs.uk/conditions/rhesus-disease/pages/introduction.aspx 
  8. Kapadia MZ, Park CK, Beyene J, Giglia L, Maxwell C, McDonald SD (2015) ‘Can we safely recommend gestational weight gain below the 2009 guidelines in obese women? A systematic review and meta-analysis’, Obesity Reviews, 16 (3): 189–206. doi: 10.1111/obr.12238: http://www.ncbi.nlm.nih.gov/pubmed/25598037
  9. NICE (2010) ‘Weight Management Before, During and After Pregnancy’, NICE Public Health Guideline 27, National Institute for Health and Care Excellence:http://www.nice.org.uk/guidance/ph27
  10. Institute of Medicine (1990), Committee on Nutritional Status During Pregnancy and Lactation (1990) Nutrition During Pregnancy. Part 1: Weight Gain. Part 2: Nutritional Supplements, Washington DC, National Academies Press. http://www.ncbi.nlm.nih.gov/books/NBK235228/
  11. Institute of Medicine (2009) Weight Gain During Pregnancy: Reexamining the Guidelines, Washington DC, National Academies Press. Available at:http://www.ncbi.nlm.nih.gov/books/NBK32813/
  12. RCOG (2011) Information for you: Why your weight matters during pregnancy and after birth, London, Royal College of Obstetricians and Gynaecologists
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Last reviewed on April 1st, 2015. Next review date April 1st, 2018.

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