Surviving the First Trimester

The first trimester of pregnancy (weeks 1–13) is a time of huge change. For many people, it’s also the most physically and emotionally challenging part of pregnancy — even though it’s the least visible.

As an O&G doctor, I often hear patients say, “I didn’t expect this part to be so hard.” If you’ve recently found out you’re pregnant, these are answers to some of the most common questions we hear in clinic.

1. What are some important things to know about the first trimester?

The first trimester is when your baby’s major organs begin to form, which is why early pregnancy care is so important. It’s also when pregnancy hormones rise quickly, often faster than your body can comfortably adapt.

One of the most important things I tell patients is that there is no “normal” first trimester. In the same clinic session, I might see one person who is constantly nauseous and exhausted, and another who feels almost completely fine — both with healthy pregnancies..

The take home message here is everyone’s first trimester looks different, and symptom severity does not reflect how healthy the pregnancy is.

2. What physical changes and ailments are common?

Most early pregnancy symptoms are driven by hormones, especially progesterone and hCG.

Common physical changes include:

Significant fatigue
Nausea or vomiting (not just in the morning)
Breast tenderness or swelling
Bloating, constipation, or reflux
Needing to urinate more often
Food aversions or heightened sense of smell
Mild pelvic cramping as the uterus grows

What’s usually normal

Mild discomfort without bleeding
Clear or white vaginal discharge without a strong smell

When to seek medical advice

Bleeding
Severe or one-sided pelvic pain
Ongoing vomiting where fluids won’t stay down

If something doesn’t feel right, it’s always okay to check in. I’d much rather see someone for reassurance than have them sitting at home worrying.

3. What are first OB/GYN appointments really like?

Your first pregnancy appointment usually happens between 6 and 9 weeks. Most people will elect to see their family doctor/GP after finding out on a home urine pregnancy test that they are pregnant.

At this visit, your doctor or midwife will typically:

Confirm the pregnancy and estimate your due date
Review your medical and family history
Go through any medications or supplements
Order blood tests (an Antenatal screen including blood group, iron levels, infection screen)
Arrange or perform an early ultrasound
Discuss genetic screening options
Give practical advice on food, exercise, work, and travel

After this, first appointment with an OB/GYN (or obstetric care provider) will happen. This is after the initial GP visit or referral, often around 8–12 weeks of pregnancy.

This appointment is more in-depth and focused specifically on your pregnancy. At this visit, your OB/GYN will usually:

Review your medical, surgical, and obstetric history in detail
Go through any pregnancy symptoms you’ve been experiencing
Review blood test results and ultrasounds done so far
Confirm your estimated due date and pregnancy plan
Discuss genetic screening and testing options in more detail
Talk through what to expect for the rest of the first trimester and beyond
Outline the schedule for future appointments and scans

Many patients tell me this is the appointment where things start to feel more real. It’s often the shift from “Am I pregnant?” to “Okay, how are we going to do this?”

4. What medications, vitamins, or supplements are usually recommended?

Most pregnant people are advised to take:

Folic acid – helps reduce the risk of neural tube defects
Iodine – supports baby’s brain and thyroid development
A prenatal vitamin – to cover nutrients like iron and vitamin D

Some people may also need:

Extra iron
Vitamin D supplementation
Medication for nausea or constipation

I often remind patients that “natural” doesn’t always mean safe in pregnancy. Always check before starting anything new — even supplements you’ve taken for years.

5. What is something newly pregnant people often don’t expect?

One of the biggest surprises is how intense the fatigue can be. I’ve had many patients worry something is wrong because they feel exhausted despite resting — when in reality, their body is doing enormous behind-the-scenes work.

Other unexpected experiences can include:

Feeling emotionally flat instead of excited
Anxiety despite a planned pregnancy
Difficulty concentrating
Reduced tolerance for work or exercise
Guilt about not “enjoying” early pregnancy

Mental health support in early pregnancy is safe, common, and strongly encouraged. It’s something we talk about often in obstetrics — and for good reason.

6. What emotional changes might occur — and which need attention?

It’s normal to feel:

Tearful or moody
Irritable
Anxious about miscarriage or the future
Disconnected from the pregnancy early on

You should speak to your doctor if you’re experiencing:

Persistent low mood most days
Anxiety that interferes with daily life
Panic attacks
Intrusive or distressing thoughts
Loss of interest in things you usually enjoy

Mental health support in early pregnancy is both safe and encouraged.

7. How important is self-care in the first trimester?

Self-care in early pregnancy is one of the most important things you can focus on. It helps you stay well and benefits both you and baby.

Your body is doing a huge amount of work, even if it doesn’t look like it yet. Giving yourself permission to slow down can make a real difference.

Helpful strategies include:

Prioritising rest and sleep
Eating small, frequent meals
Staying hydrated in whatever way you can tolerate
Gentle movement like walking
Reducing non-essential commitments
Asking for help earlier than you think you need to

Listening to your body now helps set the tone for the rest of pregnancy.

A Final Word

The first trimester is often harder than people expect — physically, mentally, and emotionally. That doesn’t mean the rest of pregnancy will feel the same.

If you have questions, concerns, or just want reassurance early on, speaking to a doctor can help you feel more supported.

HeyDoc offers quick, supportive pregnancy consultations and referrals, so you don’t have to navigate early pregnancy alone.

This article is intended to provide general information only and does not replace personalised medical advice. Every pregnancy is different. If you have symptoms, concerns, or questions about your individual situation, please speak with your GP, obstetrician, or a qualified healthcare professional.