Written by Sophie Martin. Reviewed by Dr. Phoebe Howells.

Sophie Martin has worked in maternity services for the past 13 years, ranging from Central London, to being a Lead Midwife for Antenatal Clinic services in Essex. She has a particular focus on supporting parents who face challenging paths to parenthood. Sophie is the author of The Infertile Midwife and is also a Medical Advisor for BabyCentre UK and Emma's Diary. When she's not working, she's busy raising two young children.

Trigger warning: sensitive content relating to pregnancy. 

This blog discusses pregnancy symptoms and provides advice for those currently in the first trimester. We recognise that this may feel sensitive or emotionally challenging while you are trying to conceive. Please take care if you decide to read this, and please stop reading if at any point you feel you need to. 

Your wellbeing matters and that is the biggest priority. OVUM is here to create a community that is safe and accessible to all; so we recognise that we need to have boundaries in place to make sure everyone is comfortable when we share information and education. 

Support is available for you, and some resources include: 

• Tommy’s Charity: a charity supporting those through pregnancy and baby loss

• Mind UK: a mental health service available to adults in the UK

• Fertility Network UK Support Groups: available to those who wish to share experiences with others.  

My experience as a midwife

Having worked in maternity services for the past 13 years, I have had the opportunity to listen to a whole host of questions from parents-to-be. However, I understand that people have different access to services and information, so I have compiled some of my answers to the most popular questions I get asked relating to the first trimester! 

How long does pregnancy sickness last?

Pregnancy sickness, sometimes known as morning sickness, usually starts around 6 weeks and, for most people, eases by the end of the first trimester. For others, it will continue until around 20 weeks of pregnancy, and for some people who suffer more severely, they may experience nausea throughout the entire pregnancy. 

Pregnancy sickness is a common pregnancy symptom where you may experience nausea, vomiting or both. The exact cause is still unknown; however, it is thought to be a hormonal response to the pregnancy. It is very common, affecting around 8 in 10 pregnant women, and for 90% of those, it will have resolved by around 20 weeks of pregnancy.

More severe nausea or vomiting is called hyperemesis gravidarum and goes beyond the common symptoms experienced by many in early pregnancy. This includes being sick regularly, extreme fatigue, headaches, fainting and dizziness. Research has suggested that this condition is caused by the hormone GDF15, which is released during pregnancy, but to which some people are more sensitive. Tommy’s estimates that this impacts between 1% and 3% of pregnancies in the UK, and you are more likely to have this if your mother has had it. I recommend that you speak to your midwife or GP if you are unable to keep much food or water down, as it is essential that you do not get dehydrated, and there are treatment options available. 

When will my bump begin to show?

This can vary from person to person, but if it is your first baby, it can take a little bit longer for your bump to show; even after twenty weeks could be normal. You might find that your bump is more noticeable depending on what you’re wearing or at certain times of day.

If this isn’t your first baby, you may find that your bump pops much sooner. This is because, as your abdominal muscles have stretched before, it is easier for them to stretch once again, and your uterus can expand forward more readily. 

What is the best prenatal supplement?

The NHS recommends that pregnant mums take 400mg of folic acid for the first twelve weeks to support the neural tube development and to try and prevent conditions like spina bifida. 

It is also recommended that you take 10mcg of Vitamin D daily throughout your pregnancy.

Taking a high-quality prenatal supplement is essential for ensuring you and your baby get all the nutrients you need.

I have also found this blog post on the differences between the nutrients needed for preconception, prenatal, and postpartum very useful as a guide to educate in this area. It explains the key nutrients required at each stage (and therefore why 3-in-1 supplements can be a cause for concern). 

Information surrounding supplementation, fertility, and pregnancy in general can be incredibly confusing; therefore, OVUM’s PIF Accreditation really reassures me that, as a midwife, the content produced has met the highest standards, as this is the gold-standard, independent trust mark for health information.

Is it normal to be this tired?

The first trimester is exhausting. It’s normal to feel like you have little to no energy during this time. Considering your baby is so small during the first trimester, it’s amazing how much of an effect it can have on your body.

Your midwife will check your haemoglobin levels during the first trimester, as low levels can also contribute to feeling tired. Haemoglobin is the part of a red blood cell that carries oxygen around your body. If you have a low haemoglobin level, it means there is less oxygen available to be delivered to the organs in your body. This can leave you feeling tired, breathless, and some people may look paler than usual.

If your midwife or doctor diagnoses you with anaemia (the term for low haemoglobin levels) you will be given dietary advice (such as eating red meat), and you may also be given some iron supplements too.

When shall I tell people I’m pregnant?

There is no right time to tell someone that you are pregnant. My advice would be to tell who you want, when you want. There is an unwritten rule to keep pregnancy a secret until 12 weeks, but I would encourage you to do what feels right for you and, where relevant, your partner.

Is it normal for pregnancy symptoms to come and go?

Yes, it is. Pregnancy symptoms can fluctuate from day to day. Some people won’t experience any pregnancy symptoms, and others will experience everything from nausea to heartburn. If you have any concerns, please speak with your midwife or GP.

What foods can I eat during pregnancy?

Try to eat a balanced diet and drink plenty of water, too. Some common advice I give includes:

• Avoid raw or rare meat, liver or pate products (including vegetarian pate) and game meats. This is because these products may contain high levels of Vitamin A, which can be harmful to your unborn baby. Eating raw or rare meat is not recommended due to the risk of toxoplasmosis, which has been linked to miscarriage. Toxoplasmosis is caused by the parasite Toxoplasma gondii, which can be found in some raw meat. This rarely impacts healthy adults, but infection during pregnancy carries risks, as this parasite can cross the placenta. Cooking meat properly kills this parasite which is why the NHS recommends only eating well-cooked meat during pregnancy. 

• Stay away from soft unpasteurised or mould-ripened cheeses (unless they are cooked and piping hot). This is due to the risk of Listeria, which has been linked to miscarriage and stillbirth. Listeria is caused by the bacterium, Listeria monocytogenes, which can be carried in these foods. This bacterium can cross the placenta; therefore, it is best to avoid any infection and these foods. 

• Avoid deep-sea fish such as swordfish, marlin, and sharks, and don’t eat any raw or smoked/cured fish. Again, this is due to the risk of Listeria.

• You can eat raw or semi-cooked eggs as long as they carry the British Lion stamp. You should check any homemade mayonnaises to ensure they were made with British Lion eggs. Eggs without these stamps could contain Salmonella, which, although it is unlikely, could harm your baby and lead to food poisoning.

• It’s recommended to eat fish during pregnancy, but limit your oily fish intake to 2 portions a week, and no more than two tuna steaks or four cans a week. Eating more than this may increase your exposure to mercury, which can be harmful to your baby. The fetal brain and nervous system are particularly sensitive to mercury because they are rapidly growing. 

• There is no known safe limit of alcohol during pregnancy, and therefore it is recommended that you avoid alcohol whilst you’re pregnant.

Can I drink caffeine during pregnancy?

It is advised that you limit your caffeine intake whilst pregnant, as it can cause complications if you drink too much. Coffee crosses the placenta and is metabolised more slowly during pregnancy, with risks increasing as the dose increases.

This is why is recommended you have no more than 200mg caffeine a day, but it’s also worth remembering that coffee is not the only source of caffeine. Caffeine is also present in energy drinks, some carbonated drinks and chocolate bars (up to 30mg in a large bar of dark chocolate!). Here’s a quick guide to help you understand what this is equivalent to: 

• 2 cups of instant coffee

• 1-2 cups of filter coffee

• 4 cups of tea 

• 2 small energy drinks 

• 5-6 fizzy drinks 

Can I exercise in pregnancy?

Yes, you can. In fact, for most people, exercise is encouraged during pregnancy.

Walking, swimming, and pregnancy yoga can be excellent low-impact exercises to do throughout pregnancy. It is not recommended to start any new high-intensity exercises during pregnancy; however, it may be fine to continue this if you are used to it.

Always tell any exercise instructors that you are pregnant, and you may need to tailor some exercises as your pregnancy progresses.

Most importantly, listen to your body - if it’s telling you to rest, then you really must listen to your body and slow down.

If you have any concerns or questions, please speak with your midwife or Doctor.

When will I meet my midwife?

When you find out you are pregnant, please self-refer to your local maternity unit as soon as you can. You will be contacted for your first midwife appointment around 8-10 weeks into your pregnancy. This is called the ‘booking in’ appointment and will last around an hour. You will also be sent details for your first pregnancy scan, which takes place between 11 and 14 weeks of pregnancy.

Key Takeaways: 

• Sophie Martin is a midwife with over 13 years of experience in the field and answers some of the most frequently asked questions. However, it is essential to remember that all questions are entirely valid, and if you still have any, please ask your midwife, who should be more than happy to provide further support. 

• Nutrition, exercise, symptoms and support all play a crucial role in the first trimester, but can often be shrouded in confusion. What’s really important is to listen to your body and receive information from trusted sources, such as your healthcare provider or PIF Accredited organisations. 

• For further pregnancy information, please speak with your midwife or refer to the Tommy’s Pregnancy Information Page here.