So you're going to be a mom. The first 13 weeks are all about adjustment: You're getting used to the idea of that little being developing inside you, while your body is adapting to the demands of building that baby. No wonder you're so tired!
Mood swings are completely normal. Not only are your hormones going crazy, but the prospect of parenthood may be a bit overwhelming. You're also probably worried about birth defects and other problems. (Reality check: You've got a 97 percent chance of having a healthy baby, according to the March of Dimes.) Then there's the humbling experience of watching your brain fly right out the window. Whether it's due to those pesky hormones or to a preoccupation with your growing baby, "pregnancy brain" is common. So don't be surprised if you put your car keys in the microwave and a cup of tea in your handbag.
What to avoid
Acne medications Steer clear of all oral and topical treatments that contain vitamin A or its derivatives, such as Accutane, Retin-A and Renova. High doses of this vitamin can cause severe birth defects in your developing baby.
Alcohol Since no amount of alcohol has been proven safe during pregnancy, the March of Dimes and virtually all other experts recommend that pregnant women totally abstain.
Caffeine Excessive amounts have been linked to an increased risk of miscarriage and birth defects; moderate amounts—up to 300 milligrams per day—seem to be safe. (However, that's only about two 8-ounce regular coffees.)
Cigarette smoke Smoking is, of course, off-limits throughout pregnancy. Also beware of exposure to secondhand smoke—it's been linked to an increased risk of miscarriage, low birth weight and other pregnancy complications.
Risky foods To avoid listeriosis, a serious food poisoning that can cause major problems with the baby, don't eat hot dogs or lunch meats—including packaged items and those from the deli counter—unless they're steaming hot. Also forgo unpasteurized milk and soft, blue-veined and Mexican cheeses, such as feta, Brie, Roquefort and queso blanco. (Hard, processed, cream and cottage cheeses are safe.) Steer clear, too, of pates and meat spreads, as well as smoked seafood unless thoroughly cooked.
Do not eat large predatory fish such as shark, swordfish, king mackerel or tilefish, as these types typically have the highest mercury content. But do eat up to 12 ounces a week of fish and shellfish that are lower in mercury: shrimp, canned light tuna, salmon, pollock and catfish. Limit your intake of albacore, or "white," tuna to 6 ounces per week.
Toxoplasmosis This parasitic disease can be contracted by coming into contact with the feces of infected cats or, more commonly, by eating undercooked meat. It can cause lifelong problems with the baby's brain, eyes, heart and other organs. Make sure any meat you eat is well-cooked. And delegate the litterbox duties, or wear gloves while cleaning the box.
Constipation Increased progesterone, which slows intestinal movement, is the culprit. Drink at least eight large glasses of water a day; eat plenty of high-fiber foods (fruits, vegetables, whole grains); and exercise. If you're really stopped up, talk to your doctor about taking a fiber supplement or laxative.
Fatigue You may experience mind-numbing fatigue from the moment you wake up until the minute you hit the sheets—no surprise, considering all the work your body is doing. Master the art of napping; even 20 minutes can give you an energy boost. And remember, the sleepies usually ease after the first trimester.
Headaches Hormonal havoc is at play here. While it's best to avoid using nonessential medications throughout pregnancy, if you're really in pain, talk to your doctor about taking Tylenol (acetaminophen). Most experts consider it safe.
Nausea "Morning sickness" can last all day. The good news: It usually disappears by the second trimester. In the meantime, eat several small meals throughout the day, and try eating foods that contain ginger or lemon and wearing seasickness wristbands.
Tender breasts These are often the first sign of pregnancy. Find a supportive bra—many women say maternity bras work best. Consider investing in a sleep bra as well.
Vitamins and medications
When you call for your first prenatal appointment, ask for a prenatal-vitamin prescription (request one with a stool softener if constipation is a problem). Also consider taking supplemental folic acid: While the American College of Obstetricians and Gynecologists recommends that all pregnant women get 0.4 mg a day—the amount in most prenatal vitamins—to help prevent neural-tube defects such as spina bifida, taking 5 mg daily reduces the risk of these defects 30 percent to 40 percent more.
If you're taking any other medications, be sure to alert your doctor's office—do not discontinue them until you talk to your OB. "Many conditions, including depression and asthma, require ongoing treatment, and if you alter your medications suddenly because you're pregnant, you could harm yourself as well as your baby," says Gideon Koren, M.D., author of The Complete Guide to Everyday Risks in Pregnancy and Breastfeeding (Robert Rose Inc.). Do, however, quit taking any over-the-counter medications, including herbs, until you get your doctor's OK.
Chorionic villus sampling (CVS) is usually performed between 10 and 12 weeks. While it cannot detect neural-tube defects such as spina bifida, it can diagnose chromosomal abnormalities such as Down syndrome. It poses a 1-in-370 risk of miscarriage.
Nuchal translucency is a relatively new screening test for Down syndrome and other chromosomal abnormalities. It must be done between 11 and 14 weeks. Combined with a test of the mother's blood, the procedure uses ultrasound to measure the fold at the back of a baby's neck.
Unfortunately, miscarriages do happen—about 15 percent of women under age 35 will have one. The vast majority are due to chromosomal problems with the embryo or fetus and cannot be prevented. In fact, many miscarriages occur so early in pregnancy that the woman isn't even aware she has conceived.
But here's the good news: "Once you pass the eight- to 12-week mark and we see the fetus's heartbeat by ultrasound, you have a 98 percent chance of giving birth to a full-term, healthy baby," says William P. Hummel, M.D., a reproductive endocrinologist who specializes in miscarriage and infertility at San Diego Fertility Center in California.