First trimester worries

Smoking, drinking, folic acid and miscarriage. Get answers to some of the common worries in the first trimester of pregnancy

I drank a lot of alcohol and smoked on a night out before I found out I was pregnant. Will the baby be OK?

It’s very likely that your baby will be fine. Repeatedly exposing the developing baby to alcohol and the poisons in cigarette smoke is much more likely to cause harm than one event. It is safest for baby to avoid alcohol and cigarettes for the rest of your pregnancy however.

Read more here about smoking and pregnancy

Read more here about alcohol and pregnancy

I’ve had a miscarriage before and I’m terrified that I will miscarry again

We’re so sorry to hear that you had a miscarriage before. This is likely to make the countdown to 12 weeks a very anxious time for you, as this is when the risk of miscarriage drops.

However, keep in mind that having had one miscarriage does not make it more likely that you will miscarry again. For the majority of women, a miscarriage is a one-off event and most who have had a miscarriage go on to have a healthy baby afterwards.

Only 1 in 100 women suffer from recurrent (repeated) miscarriage.

Try these tips to ease your anxiety:

  • Talk about your feelings to your partner, family and friends.
  • Don’t beat yourself up if you are not feeling cheerful and happy to be pregnant. Accept that you will be anxious, especially until you pass the point where you lost your first baby. If you need to cry, then do it.
  • Try not to read too much into early pregnancy symptoms. Cramps and light spotting are not uncommon in healthy pregnancies as the baby settles in the womb. However, if you do have bleeding, talk to a midwife or doctor and get checked out.
  • Try relaxation and stress management apps. There are many lovely relaxation apps that help manage anxiety and stress. Try the ones on the NHS app library here.
  • Continue to exercise if you were active before you became pregnant. Exercise has been shown to help with mental wellbeing and sleep. It will not increase your risk of miscarriage. Your baby is embedded deeply in your body. It cannot ‘fall out’ and will not be jolted around by you being active. You may not feel like exercising but even doing 10-15 minutes a day will help your mood and wellbeing.
  • If you were not active before, take up light activity now. Walking, swimming, yoga are all good activities for pregnancy and will help your mental wellbeing and sleep. Start with 15 minutes a day and build up to 30 minutes 4 days a week.
  • Focus on each day at a time. If you feel yourself worrying about the future, stop and think only about today. Each day that passes brings you closer to 12 weeks.
  • If you feel you can’t cope, talk to your GP, they may be able to refer you on for talking therapy or other treatment.
  • If your low mood continues after 12 weeks talk to your midwife. You may be suffering from anxiety or depression, which is not uncommon amongst pregnant women. There is treatment available and it’s important to talk to your midwife early on about it as it puts you at extra risk of postnatal depression.

Read more about mental wellbeing and pregnancy

Read more about staying active in pregnancy

I haven’t been taking folic acid and I’m at week 8. Will it affect my baby?

Folic acid helps prevent neural tube defects, such as spina bifida, but it is most likely that your baby will be fine even if you missed taking it.

Neural tube defects are rare but almost completely preventable by taking folic acid, and this is why health professionals, books and websites all say it is important to take it.

The chances of your baby getting it are very low however. Start taking folic acid now though and until week 12.

Read more about folic acid

I have morning sickness and I can’t keep healthy food down

Morning sickness is common in the first trimester of pregnancy, and it can be upsetting when you are advised to eat healthy food and had planned to eat healthily but are finding that it won’t stay down or that salad and vegetables have suddenly become off-putting to you.

Try not to become anxious about the baby. Although healthy food is important during pregnancy, your morning sickness is likely to come to an end when you move past the first trimester, leaving you another 22 weeks or so to eat healthily. Remember that the growing baby will take what they need from your body too, not just what is in the food you eat.

If you are struggling, focus on eating what will stay down. You need the energy.

Read more here about morning sickness

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

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.

Read about telling people about your pregnancy.

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 tiredness beyond anything they have ever felt before.

This tiredness will usually pass as you move into the middle months. But, for now, these ideas may help:

  • Do some exercise or activity – 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.

Read about other first trimester symptoms.

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.

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.

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. 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.

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Sources

Mund M, Louwen F et al (2013). Smoking and Pregnancy — A Review on the First Major Environmental Risk Factor of the Unborn. International Journal of Environmental Research and Public Health10(12), 6485–6499. http://doi.org/10.3390/ijerph10126485

NHS Choices. Miscarriage. https://www.nhs.uk/conditions/miscarriage/ (Page last reviewed: 01/06/2018 Next review due: 01/06/2021)

Paisley TS, Joy EA, Price RJ Jr. (2003) ‘Exercise during pregnancy: a practical approach’, Current Sports Medicine Reports 2 (6): 325–30: http://www.ncbi.nlm.nih.gov/pubmed/14583162 

RCOG (2006) Recreational Exercise and Pregnancy: Information for you, London, Royal College of Obstetricians and Gynaecologists: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/recreational-exercise-and-pregnancy.pdf

Royal College of Psychiatrists, Mental health in pregnancy, London RCP, 2012. Also available at: http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/mentalhealthinpregnancy.aspx(accessed 1 April 2014)

National Institute for Health and Care Excellence, Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 45, London NICE, 2007. Also available at: http://publications.nice.org.uk/antenatal-and-postnatal-mental-health-cg45 (accessed 7 April 2014)

Bestwick JP et al. (2014). “Prevention of neural tube defects: a cross sectional uptake of folic acid supplementation in nearly half a million women.” Plos One 2014; DOI: 10.1371/journal.pone.0089354

Macdonald S, Magill-Cuerden J (2012), Mayes’ Midwifery, 14th edition, London, Ballière Tindall

Matthews A, Haas DM et al (2014) Interventions for nausea and vomiting in early pregnancy, Cochrane Database of Systematic Reviews, 3: CD007575. doi: 10.1002/14651858.CD007575.pub3.

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.

NHS Choices. Rhesus disease http://www.nhs.uk/conditions/rhesus-disease/pages/introduction.aspx (Page last reviewed: 11/06/2018 Next review due: 11/06/2021)

Kapadia MZ, Park CK et al (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

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

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/

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/

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 June 28th, 2018. Next review date June 21st, 2021.

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    Comments

    Please note that these comments are monitored but not answered by Tommy’s. Please call your GP or maternity unit if you have concerns about your health or your baby’s health.
    • By Aliyah (not verified) on 6 Oct 2019 - 10:10

      Hi im 5 weeks pregnant and i was having morning sickness and tiredness and all of sudden its all disappeared , is that normal ???. Please help im very worried about it

    • By Aliyah (not verified) on 6 Oct 2019 - 07:55

      Hi !! Im 5 weeks pregnant and i was having morning sickness and tiredness but suddenly everything is gone is it normal ??? Is baby safe inside???

    • By Emma (not verified) on 30 Sep 2019 - 15:08

      Is an Indian head massage safe in the first trimester?

    • By Abby (not verified) on 2 Sep 2019 - 12:27

      I’m 6 weeks pregnant and I’ve been randomly getting sharp abdominal pain and stich like feeling, is this normal and should I go to my doctor.

    • By Laura (not verified) on 7 Sep 2019 - 02:40

      From what I've read and from speaking to my doctor it's normal to have some pain and cramps during early pregnancy. If the pain is excessive or gets increasing worse, or if it accompanied by bleeding, then you should go to the doctor.

    • By razia (not verified) on 28 Aug 2019 - 19:28

      Hi i have a little bleeding in 12th week. i am worried why its happen? Is it will effect my baby?

    • By Hollie (not verified) on 13 Aug 2019 - 03:40

      We have been trying for a baby for three months and have been tracking periods m, ovulation etc.
      My period is six days late, any test I have taken has been negative but I have nausea and exhaustion- more so than my first pregnancy. Is it possible all those negative tests are wrong? Nausea only in morning and afternoon. Fine on evenings. Certain foods now making me sick.

    • By Anonymous (not verified) on 1 Aug 2019 - 10:59

      I am 7 weeks pregnant and have pain in lower part of stomach is this normal or should I be worried?

    • By Anonymous (not verified) on 25 Jul 2019 - 18:15

      Hi, I missed my periods and immediately took a home pregnancy test and the results came out positive.After 2 weeks of the test, I started spotting and consulted to the GP.I was told everything still fine and I was then given folic acids. After 3 days of taking the folic acids, I had a sexual intercourse with my partner and the following day I started bleeding with clots but not too much and also having cramps.Is it possible that I could be miscarried?

    • By Modupe (not verified) on 7 Jul 2019 - 10:01

      I am 12weeks pregnant but the scan can't find my baby. I did pregnancy test there times and all was positive. Am so scared right now.

    • By Nena (not verified) on 4 Jul 2019 - 05:25

      I am 4 foot 9 I’m 23 year old an when I found out I was pregnant I weighed 89 pounds An now I’m at 105lb an this is my first pregnancy I’m 22 weeks as of today when I f went to the doctors today they said that I should be at the 10 % mark an I’m at the 9 % mark they said the baby is growing normal Everything is developing normal On my baby I’m 1 % off an I’m worried am scared can u please help

    • By Anonymous (not verified) on 14 Jun 2019 - 22:38

      I felt pregnant in 3rd week though tests came out to be negative. I started to bleed just 3 days before my period date. I did not consult any doctor coz i thought to wait till i tested positive. But i started to bleed before that. Did i have a miscarriage? Should i visit doctor? Im totally confused

    • By Divvya (not verified) on 3 Jun 2019 - 14:15

      I am 6 weeks pregnant today and when I was using my appartment lift I panicked when it suddenly stopped working and I came out as soon as it started working.will this affect my pregnancy?

    • By Lola (not verified) on 25 May 2019 - 09:52

      Hi, im very scared of getting pregnant but i do want to have a little baby one day. I’m scared of 2 things my life changing meaning not being able to work as i do love my job as a nail Technician and im terrified of labor/breastfeeding/postpartum. I have anxiety some time wild having sex just thinking of how getting pregnant would make me feel. Just the idea of the on known scares me from many things I hear from other moms. My husband wants a baby so mad all ready with us being married for 7 years. His more than ready lol. I’m excited of the idea of having a little one running around the house and all of that however I cannot sleep sometimes because of all of the thoughts that go through my mind. I just wish my mind could clear up and be at peace

    • By Hannah (not verified) on 24 May 2019 - 21:42

      Hi, I’m 19 weeks pregnant today. I’ve had a private scan last week which was fine but I keep worrying something will happen to the baby. I have struggled to get pregnant and this is an IVF baby. I’ve miscarried before so this plays on my mind. Everyone keeps telling me to enjoy the pregnancy but I just don’t know how.

    • By Joanna (not verified) on 16 May 2019 - 19:21

      I was having some abdominal pains and diarrhoea for over a week so went to see the doctor. I was referred to the early pregnancy unit, where I was sent for a scan. The scan happened at 5+6. Gestational sac present, but no sign of baby. I hardly have any symptoms, a little tiredness and mildly tender breasts intermittently. I have wanted this baby for so long and don't know how I'll cope if i go back and am told there is no baby.

    • By Carla Miller (not verified) on 12 May 2019 - 19:10

      I'm just under 8weeks and I am exhausted all the time, I had a chemical pregnancy before so this is my first pregnancy to develop as such but I am so nervous that something is wrong it feels like torture waiting for my appointment off the midwife, i feel wet often and panic it's bleeding but it hasn't been. Am I over reacting. Thank you.

    • By Ann (not verified) on 11 May 2019 - 12:17

      Hi, I had a cold in week 6. I didn’t have high fever, just sore throat and running nose for one whole week. Then I started having spotting in week 7. I’m in week 9 now, stepping into week 10 but I’m so worried my child could have a birth defect. My mum kept saying mothers with a cold/flu during pregnancy can cause cleft lips to the baby. I didn’t tell her about my cold but I’m scared to death :( will my baby be okay? And how will I know if the baby will have any birth defects? Many thanks

    • By Sophie (not verified) on 27 Mar 2019 - 07:59

      Hi, I had a scan 5 weeks pregnant to check everything was okay because I was having pains and first scan was too early second they found a heart beat and baby had grown this was at 6 weeks. At the 7th week I noticed that my breasts weren't as sore and Im on my 9th week and I feel the same, feel sick now and then but I feel as though the symptoms aren't as bad as they were 2 /3 weeks ago is this normal? I have no bleeding or pains.

    • By Midwife @Tommys on 11 Apr 2019 - 16:50

      The symptoms of early pregnancy can change as the pregnancy progresses. Hopefully by now you have arranged a booking appointment with your midwife and also have an appointment for your dating scan after 11 weeks. If you have any bleeding or abdominal pain you should contact your GP or local A&E
      Thank you
      Tommy's Midwife

    • By Nichole (not verified) on 23 Mar 2019 - 02:51

      I’m 4 weeks and Im feeling a dull cramp and a sharp pain on one side then the other side, then goes away...is that normal??

    • By Teah (not verified) on 6 Jun 2019 - 00:24

      I’m 18 weeks now. It is definitely common because I was worried but I went to the doctors and they said it was totally normal. It helps to lie on your left side with a pillow between your legs . Get at comfey as possible and you will be alright it will go after about 5 more weeks.

    • By Lucie (not verified) on 8 Mar 2019 - 22:36

      Hi,
      I’m really worried, I had nausea from 6 weeks and felt sick on and off all day everyday. At 7 weeks and 3 days it suddenly stopped and I’m worried something is wrong. I haven’t felt nauseous and my breasts seem less tender. I’m so worried, please help x

    • By Nicole (not verified) on 31 Jan 2019 - 15:25

      I wasn’t thinking and I am 5 weeks pregnant I was staining some wood with wood stain and was around it for About 10 minutes in a badly ventilated area I also got it all over my hands I am worried about something happening to my baby now

    • By Midwife @Tommys on 31 Jan 2019 - 15:38

      It's highly unlikely that painting or being around paint fumes while you're pregnant will harm your unborn baby, as the risk from most modern household paints is very low.
      If you are concerned, please contact your GP/Doctor for advice.

    • By Angel (not verified) on 30 Dec 2018 - 07:53

      Is it safe for me to be pregnant while I have untreated gental herpse ?

    • By Midwife @Tommys on 9 Jan 2019 - 15:23

      Hi Angel
      You should be offered antiviral treatment,to treat outbreaks in pregnancy of herpes to reduce the chance of an outbreak during birth
      from diagnosis until the birth if you first get herpes after 28 weeks of pregnancy
      Many women with genital herpes have a vaginal delivery. You may be offered a caesarean, depending on your circumstances. So please go to see your midwife or doctor as soon as you can for treatment.
      All the best, Tommy's Midwife

    • By Georgia (not verified) on 15 Nov 2018 - 14:42

      Hi, I toke a pregnancy test 3 weeks ago and it calculated 2/3 weeks. This morning I woke up and when to the toilet but when I wiped there was brown now as the day has went on my lower back is killing me and now it’s more red blood than brown. Can you help me please? Thanks

    • By Midwife @Tommys on 15 Nov 2018 - 15:25

      Hi Georgia, Thank you for your comment.

      With any bleeding or abdominal pain in pregnancy this needs to be assessed. We would recommend that you contact your GP or go to your local A and E department to be seen. This can happen in early pregnancy and things can settle down but as you are actively bleeding with pain then it is important that you seek medical help at this time. Take Care, Tommy's Midwives x

    • By L (not verified) on 7 Jan 2018 - 14:19

      I'm 5 + 3 weeks pregnant and have a bad cold. Last night my temperature spiked to 38.5°c and slightly lower again this morning. I took paracetamol both times and that brought the fever down, but I've read some horror stories about the impact of fevers on foetal development in the first trimester, and I'm really anxious. Any advice/ reassurance would be amazing! Lauren

    • By Midwife @Tommys on 10 Jan 2018 - 10:24

      Hi L,
      Having an untreated fever, i.e NOT taking Paracetamol to reduce the fever is far more dangerous to you both than having had the fever at all in the beginning. If your fever last for more than 48 hours, with taking paracetamol (max 8 tablets in 24 hour period), then you should seek medical advice via A&E minors. If you need any further advice, please feel free to email or call us directly to the pregnacyline.
      Sophie- Tommy's Midwife

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