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1st Trimester: The Ultimate Guide to Pregnancy Issues

1st Trimester: The Ultimate Guide to Pregnancy Issues

As an OB-GYN with a practice in New York City, I’ve helped my mom-to-be with almost every kind of 1st-trimester pregnancy issue you can imagine. And I have good news: Most issues women deal with during pregnancy are completely normal, even if it feels like you’re the only one in the world going through it at the time! It’s also important to remember that many of the issues you’ll encounter are things that are affecting you, not your baby. Throughout history, healthy babies have been born in all types of challenging situations, like famines, floods, and, yes, pandemics. So rest assured, your baby is getting what it needs from you. Let’s take a look at the most common issues in each trimester and what you can do to get some relief from symptoms, big and small.

Your 1st Trimester

At this early stage, I always tell my patients that every pregnancy and everybody is different, so try not to stress about all the early symptoms—or lack of symptoms. Some of my patients swear they felt the baby growing even before they peed on the stick. Other patients don’t feel a thing for months and wonder if something’s wrong. So in this very exciting first trimester, keep calm and positive. And of course, if you have concerns—serious or otherwise—talk to your doctor.


This is the number one complaint of my first-trimester moms. Nausea usually kicks in at around the six-week mark and escalates from there to a peak between 10 and 15 weeks before subsiding. And even though it’s called 'morning sickness,' it’s really any time-of-day sickness. It's caused by a confluence of factors, mostly related to all the big hormone changes that happen when your body is working hard to grow a baby. Food aversions can be put in this category, too. Often the things you loved pre-pregnancy—your grande cappuccino or that glass of wine with dinner—suddenly don’t seem appealing at all. This is your body’s wise way of protecting the embryo from the not-so-healthy things. It’s also interesting to note that even if you had horrible nausea with your first baby, you may not have it all with your second or third (or vice versa).

How to soothe it:

  • The best way to conquer nausea is to eat tiny, bland (sorry!) meals at two- to three-hour intervals throughout the day. I tell my moms to have a little bit of protein and a few complex carbs in every meal to help prevent sugar level spikes and drops.
  • One of the most positively researched remedies for nausea is ginger, and besides using it fresh in the kitchen, you can get it in a lot of other ways: ginger chews, lollipops, ginger ale.
  • Pressure point bracelets also work to some extent for some of my patients.
  • One thing I don’t recommend for everyday nausea in pregnancy is an anti-nausea prescription medicine. This is something I reserve for the rare patient who is vomiting all day, getting dehydrated, and losing weight (the medical term for this syndrome is Hyperemesis Gravidarum, which comedian Amy Schumer suffered from during her first pregnancy; check out her special about the experience, Expecting Amy).

Feeling queasy? Try this:

Mommy’s Bliss Prenatal Multivitamin + Probiotics This prenatal multivitamin is formulated with probiotics, ginger, and vitamin B6 to help with nausea, gas, constipation, and upset tummy. One small pill, once a day!


Reflux—including indigestion and heartburn—is common in pregnancy, affecting about three in four moms-to-be. It happens because hormones like progesterone kick in and slow the digestive system down. Then another hormone called relaxin amps up to relax the muscle between the esophagus and the stomach, allowing acid to come back up. All of this means more food is sitting in your stomach, so you get more bloating, gas, and reflux (that not-so-great feeling of acid in your throat). If you had reflux prior to getting pregnant, I hate to be the bearer of bad news, but it’s likely to get worse.

How to soothe it:

  • I usually recommend my patients start with making changes to how and what they eat. I usually say, 'Try not to eat dinner after 8 pm.' And when they push back, I let them know I’m okay if you have a little snack before bed, but it’s got to be really bland: graham crackers with peanut butter and frozen yogurt are great options.
  • I know you might not want to hear it, but it’s true: if you’re having reflux, stay away from spicy foods, acidic foods (citrus, tomato sauce), and, of course, alcohol, though you’ve hopefully limited that already. Eat bland foods that absorb the acid like crackers, biscuits, milk, yogurt.
  • When you’re going to sleep, sit in bed first and prop yourself up against a pillow rather than lying down immediately. This will help keep the acid down in the stomach where it belongs.

Want a sneak peek of your next trimester?

Go to Dr. Fiss’s guide to Trimester 2
By Caitlin Fiss, MD

This site is intended for informational purposes only and does not provide medical advice. Please consult your physician or other health-care professional.

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