First Trimester of pregnancy-Medcall(Kannada) Care Plan
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Pregnancy and Importance of Health Care: Taking care of a
woman when she is pregnant till she gives birth to a baby is called the
prenatal care. This starts as soon as you are aware of or you are
suspecting pregnancy (that is a missed period). To confirm that you are
pregnant you can do a urine test for pregnancy at home itself using a
pregnancy card. The instructions for reading the card will be given on
the label. If any difficulty in reading, then you can consult your
doctor for the same.
The total duration of
pregnancy is 40 weeks and it starts from day 1 of your previous
menstrual cycle. A normal pregnancy comprises of 3 trimesters where the
first trimester starts from the time your baby is conceived and runs
through week 14 of your pregnancy. Your doctor might speak to you in
terms of weeks rather than months.
pregnancy is confirmed, schedule your first visit with your doctor. Keep
ample time for the visit. During this visit, your medical history will
be taken in detail. Your doctor will do a physical examination, you will
have to get ultrasound and some laboratory tests done.
Your doctor may ask you questions regarding:
Your menstrual cycle
Use of birth control
Your personal medical history
Your family medical history
Medication use, including prescription and over-the-counter medications or supplements
doctor will calculate your due date for delivery depending on first day
of your last menstrual cycle. This includes counting 40 weeks ahead
from the start of your last period or adds seven days to the first day
of your last period and then subtracts three months or adds 9 months, 7
days to first day of your last period.
If you don't know
the date of your last period or your periods are irregular then your
health care provider might recommend an early ultrasound to help confirm
the date. Physical examination: Your doctor will check
your weight, height and blood pressure. Your heart, lungs, abdomen and
overall health will be assessed. Your doctor will also examine your
vagina and the opening to your uterus (cervix) for any infections or
abnormalities. This will not be repeated until late stages of pregnancy,
unless otherwise indicated. Laboratory tests: Blood tests will be done to check your
which includes your Rh status also. Rhesus (Rh) factor is an inherited
trait that refers to a specific protein found on the surface of red
blood cells. If you are Rh negative and your baby's father is Rh
positive, then special care has to be taken during the pregnancy,
delivery and also subsequently to prevent any complications during
Hemoglobin which is an iron-rich
protein found in red blood cells carries oxygen from your lungs to other
parts of your body, and carbon dioxide from other parts of your body to
your lungs so. Low hemoglobin is a sign of anemia - a lack of healthy
red blood cells.
Immunityto certain infections, like rubella and chickenpox (varicella)
Detect exposure to other infections
such as hepatitis B, toxoplasmosis, syphilis, gonorrhea or chlamydia.
You might also be offered a test to check for HIV, the virus that causes
Urine analysis for signs of a bladder, urinary tract or kidney infection.
It is a simple, painless procedure, which uses sound waves. A probe
will be placed on your belly and images can be seen on a computer
screen. The sound waves will let your doctor or midwife see the baby.
You may have an ultrasound done in the first trimester if you have any
problems, or if there are any doubt about your due date.
The common symptoms that are seen during pregnancy are
Bouts of nausea, commonly called as morning sickness. This can occur at any time of the day. You may also have a heightened sense of smell. So various odours - such as foods cooking, perfume or cigarette smoke may trigger nausea.
Soon after conception, your breasts may feel tender, tingly or sore. It might even feel fuller and heavier. So wearing a more supportive bra or a sports bra might help.
Increased urination is mainly seen in the first trimester itself, which is due to the pressure of the enlarging uterus on the urinary bladder. To prevent any leak during coughing, sneezing etc. empty your bladder whenever you feel the urge.
Food aversions and cravings- this is seen because of hormonal changes.
Dizziness-You may have slight dizziness due to widening of your blood vessels. Stress, fatigue and hunger also contribute to this.
Heart burn and constipation- Your stomach takes longer time to empty. This slowdown gives nutrients more time to be absorbed into your bloodstream and reach your baby. But this leads to heart burn and constipation.
Chloasma or mask of pregnancy - There may be pigmentation on the bridge of the nose, cheeks and neck due to hormonal changes. This usually fades after the birth of your baby.
Stretch marks - These marks are seen due to rapid stretching of your skin during pregnancy causing thinning of the skin than normal. Common sites are abdomen, thighs and breasts.
Linea nigra - Skin pigmentation seen as a dark line will start developing by the end of first trimester which runs from your belly button down to your pubic bone. This fades after the birth of your baby.
Care of breast and nipple during pregnancy
As breast and nipple undergo continuous change throughout the pregnancy, taking care of them forms an important part of prenatal care. Some of the tips are-
Make sure you wear a right sized bra, so that you do not develop stretch marks. Since the size of breast continue to increase take care to change the bra accordingly.
Avoid wearing under-wired bras, as they might hamper the functioning of the milk glands. Never wear a very tight bra.
The nipple might become too rough and might develop cracks. Lightly massage your nipples with coconut oil to reduce this problem.
Sometimes you may develop inverted nipples. So gently pull out the nipples, so that by the time the child is born the nipples are in correct position. This is one of the important breast care tip that has to be followed during pregnancy.
Schedule for Consultations/Diagnostic tests: During the first trimester you will have to visit your doctor every month and sooner if you have any problems. You will be prescribed iron and folic acid tablets that you have to take regularly and continue throughout your pregnancy to maintain the red blood cell counts and also to aid normal development of your baby.
Walking for 30 minutes everyday has the most benefit which can be continued throughout your pregnancy.
Swimming at least for 20 minutes three times a week will keep you in good shape.
Stationary bicycles offer less risk of a fall than standard bicycles.
Relaxation techniques help you breathe and focus, relieve stress, feel more satisfied and energetic and let go of emotional tension. Yoga, meditation, and other breathing exercises can improve your physical and mental health during the first trimester.
Exercises to avoid: Downhill skiing, horseback riding, mountain climbing, scuba diving and contact sports (like soccer and basketball), high impact aerobics. High-impact activities include jumping, hopping, bouncing, both feet leaving the ground at the same time, and other high-energy motions.
Stop exercising immediately if you experience any of the following symptoms: faintness, dizziness, blurry vision, nausea, heart palpitations, vaginal bleeding, new contractions, back, abdominal, or pelvic pain.
To prevent mild dizziness, avoid prolonged standing. Also rise slowly after lying or sitting down.
If you feel dizzy while driving, then pull over to one side.
Stay active and continue your normal activities during pregnancy.
You may feel overheated easily. So wear clothes made of natural fibres and avoid synthetic ones.
As long as your pregnancy is proceeding normally and you are comfortable, you can have sex as often as you like unless your doctor has advised strict abstinence.
Ideal Weight Gain
If your pre-pregnancy weight was in the healthy range for your height (a BMI of 18.5 to 24.9), you should gain between 10 and 15 Kg, gaining 0.5 kg in the first trimester and about 0.5 kg per week for the rest of your pregnancy for the optimal growth of your baby.
If you were underweight for your height at conception (a BMI below 18.5), you should gain 12- 18 Kg.
If you were overweight for your height (a BMI of 25 to 29.9), you should gain 8-10 Kg. If you were obese (a BMI of 30 or higher), you should gain between 5-8 Kg.
If you're having twins, you should gain 18-25 Kg if you started at a healthy weight, 15-20 Kg pounds if you were overweight, and 10-15 Kg pounds if you were obese.12
Weight Management and Exercise
Gaining weight is important but gaining excess or less weight is not healthy. So never go on a diet or try to lose weight during pregnancy. Moderate exercise can help burn extra calories.
The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain.
Smoking and Tobacco
Smoking and second hand smoking are significant factors in miscarriages during the first trimester and also contribute to a number of other threats to the health and development of the foetus. Hence it is advised to quit smoking.15
Drinking alcohol during pregnancy, can permanently damage your developing baby's cells. Heavy drinking can also damage your baby's nervous system developing fetal alcohol spectrum disorders (FASD), with problems that can range from mild learning difficulties or social problems, through to birth defects. Hence avoid alcohol during pregnancy.14
Relaxation techniques like yoga, meditation and breathing exercises help reduce the stress during pregnancy.
Reduce the intake of tea, coffee, colas and chocolate especially later in the day. Lowered caffeine intake is known to induce a better sleep during the night.
Never take over the counter, herbal or any other medications without consulting your doctor.
Avoid fried foods, carbonated drinks, citrus fruits or juices, and spicy foods.
Include plenty of fiber in your diet
Drink lots of fluids.
Gaining adequate weight is very important during pregnancy for your health as well as the development of your baby. So below are some of the tips for a healthy diet.
Fresh fruits and vegetables make good snacks. They are full of vitamins and low in calories and fat.
Eat breads, crackers, and cereals made with whole grains.
Choose reduced-fat dairy products. You need at least four servings of milk products every day. However, using skim, 1%, or 2% milk will greatly reduce the amount of calories and fat you eat. Also choose low-fat or fat-free cheese or yogurt.
Naturally sweetened is better than foods and drinks with added sugar or artificial sweeteners.
Food and drinks that list sugar or corn syrup as one of the first ingredients are not good choices.
Many sweetened drinks are high in calories. Read the label and watch out for drinks that are high in sugar. Substitute water for sodas and fruit drinks.
Avoid junk-food snacks, such as chips, candy, cake, cookies, and ice cream. The best way to keep from eating junk food or other unhealthy snacks is to not have these foods in your house.
Do not add salt to foods when cooking. Salt causes your body to retain water.
Go light on fats. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream, and cream cheese. Try the lower fat versions of these foods.
Most restaurants have menus and nutrition facts on their websites. Use these to plan ahead.
In general, eat at places that offer salads, soups, and vegetables.
Avoid fast food.
Cooking at home:
Prepare meals using low-fat cooking methods.
Frying foods in oil or butter will increase the calories and fat of that meal.
Baking, broiling, grilling, or boiling is healthier, lower-fat methods of cooking.
Sample diet plan:
Early morning Dry fruits, milk shakes, fresh fruits
Whole wheat toast/ bread OR Vegetable omelette OR Cashewnuts