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

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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

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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)

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

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Comments

  • 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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