First Trimester of Pregnancy

What are the symptoms of the first trimester of pregnancy?

Missed Period

A missed period is usually the first sign of pregnancy.

Since pregnancy starts from the first day of the last period, a woman is already 4 weeks pregnant by the time she misses her period.

Sometimes, a pregnancy can occur without previous regular periods – for example, in breastfeeding mothers, perimenopausal women  or women with irregular periods , especially in conditions like PCOS. 

Some women may have a slight bleeding at the time of the missed period due to implantation bleeding. Implantation bleeding  may  be mistaken for a regular period.

But, implantation bleeding is typically very minimal – it may only be a brownish or pinkish discharge, far less than the usual menstrual flow.  Sometimes, it may be only a single drop of blood.

Nausea with or without vomiting

Many pregnant women have morning sickness, often known as pregnancy sickness, in the early stages of their pregnancies.

Morning sickness occurs due to increasing HCG levels ( Human Chorionic Gonadotrophin), secreted by the corpus luteum in the ovary. Morning sickness with nausea and vomiting  increases gradually and peaks around 8-9 weeks. Then it gradually decreases  and becomes minimal by the  start of the second trimester.

But for some women, nausea and vomiting may persist right up to the final month of pregnancy. This is especially true if there is also heartburn and acid reflux, as acidity  increases the symptoms of morning sickness.

Antacids can reduce the intensity of morning sickness by reducing gastric acidity.

While  the nausea and vomiting can be controlled to some extent  by medicines, morning sickness cannot be totally cured.

First-time mothers are more likely to experience morning sickness.

Morning sickness is generally manageable with medicines. But in a condition known as Hyperemesis gravidarum, the vomiting may be so severe that  it can interfere with regular health. The pregnant women may then need to be hospitalized to get supportive care.

Sore Breasts

One of the early indicators of pregnancy in many women, even before the first missing period, may be aching breasts.

The high progesterone levels required to support pregnancy causes the breasts to expand and enlarge, preparing them for lactation. The nipples grow quite fast and become very sensitive to touch.

The nipples and areola may also become darker due to pigmentation and fine veins may appear on the breasts.

Wearing a seamless, soft cotton bra that doesn’t irritate the nipples can help to reduce breast soreness to some extent The discomfort brought on by sore breasts can also be lessened by using a sports bra that keeps the breasts securely in place and restricts mobility.

Despite the fact that breast growth continues throughout pregnancy, the body adapts to the expansion, and in the second trimester,  there may be decrease in breast soreness.

Excessive Fatigue in Pregnancy

 A common symptom of early  pregnancy is extreme tiredness. The high level of progesterone decreases metabolism  and makes the body sluggish – this  slows the digestion as a whole and decreases absorption of food  from the intestines.

Loss of appetite and dehydration as a result of nausea and vomiting may cause decreased nutrition. This is especially so if the diet is not supplemeted by vitamins and minerals.

 Lack of adequate  sleep at night in the first trimester  can make you may feel more drowsy and exhausted throughout the day. Indigestion and heartburn, leg cramps, more frequent urination, and  stressing over pregnancy and childbirth can also be factors for loss of sleep.

Increased frequency of passing urine

You may feel an increased need to pass urine in the first trimester. This is due to pressure by the growing uterus on the bladder reducing bladder capacity. It is also due to the increased blood volume during this time and the increased  blood flowing  through the kidneys.

Increased Vaginal Discharge

Many women complain of excessive vaginal discharge in early pregnancy. The discharge is usually thin, white   or clear. This discharge comes from cervical glands stimulated by progesterone. Like  the other parts of the reproductive tract, the cervix too is stimulated by the hormones of pregnancy.

You shouldn’t be concerned as long as the vaginal discharge doesn’t smell, doesn’t itch or burn, and isn’t brownish in color (brown color may indicate blood in the discharge).

Increased Salivation in Pregnancy

A lot of pregnant  women complain that one of the most irritating symptoms they have is excessive salivation.  They have  to spit constantly throughout the day.  But since the mouth fills practically immediately, spitting is ineffective. Some women may even drool at night.

Headaches in Pregnancy

Some women, especially in the beginning of pregnancy, may experience chronic headaches on a regular basis.  Headaches in pregnancy can be due to dehydration, increased blood volume or stress.Or it can be due to a flare up of a previous migraine.

Weight gain

Weight gain is minimal in the first trimester –   maximum weight gain may be 1-2 kgs or less.  Most of this weight gain is in uterus, the placenta,  the breasts, and the extra blood volume during this time. Fetal weight gain is very low.

Growth of the Uterus

The uterus is not palpable through the abdominal wall during the first trimester. It continues to be a pelvic organ through the 12th week, that is, it stays inside the pelvic bone cavity and cannot be felt through the abdominal  muscles.

The enlargement of the uterus can be felt only by a pelvic examination. It is around the size of a tiny plum at 6 weeks, an orange at 8 weeks, and a newborn baby’s head at 12 weeks.

Regular, gentle contractions and relaxations of the uterus, often known as a Braxton Hicks contraction can also be felt at this time.