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Finding out you’re pregnant—whether you’ve been planning to become a parent or it’s a complete surprise—marks the beginning of a mystifying journey. The first trimester is one of the most fragile periods, in part, because the majority of miscarriages happen before the 12-week mark. These early months can be especially anxiety-filled if you’ve experienced a previous loss or trauma, but it’s also natural to be apprehensive if it’s your first pregnancy.
For such a monumental moment, it’s a bit anticlimactic to process this news alone or nearly alone. Some people might text or call their closest friends and family, but many folks don’t share the news right away (for lots of understandable reasons). And that can feel isolating, considering the radical changes going on in your body.
The rapid effects of fluctuating pregnancy hormones can trigger symptoms like intense nausea, heartburn, and vomiting, Kamilah Dixon, MD, a clinical associate professor of obstetrics and gynecology at The Ohio State University Wexner Medical Center, tells SELF. You’ll feel exhausted and your body will start to ache—but to the rest of the world, you might look virtually unchanged. Depending on your situation, you may already be attending regular doctor appointments too.
As this all unfolds and you try your best to carry on with everyday life, your pregnancy might start to feel like an overwhelming secret. That’s why it’s so important to think about the support you need now. You deserve to be mentally and physically well from the very start—even if your friends, family, and employer might not know yet. Here are some ways to feel better during your first trimester.
1. Prioritize your mental health.
“Anxiety is increased in the first trimester for all pregnancies,” Julia N. Riddle, MD, a reproductive psychiatrist and an assistant professor at the UNC School of Medicine, Center for Women’s Mood Disorders, tells SELF. But this mood shift can be especially prominent in people who have experienced a pregnancy loss or related trauma in the past.
The American College of Obstetricians and Gynecologists (ACOG) recommends that providers conduct a mental health screening for all pregnant people at least once during the perinatal period (which is broadly defined as the period before and after birth). Unfortunately, this screening occurs most often at the postpartum checkup.
“Obstetricians don’t often receive sufficient training in mental health care due to all the other demands of training, and we are hard at work to bridge that gap. If you are worried about perinatal mood and anxiety disorders, it is always okay to let your clinician know,” says Dr. Riddle, who is part of the National Curriculum in Reproductive Psychiatry (NCRP), an educational program produced by MONA, a perinatal mental health research society.
Working with a licensed therapist or a reproductive psychiatrist who specializes in perinatal mood disorders can be a huge relief. “The goal is to be able to hold some natural anxiety and hope or happiness at the same time. Like any fear, holding it in can give it more power,” Dr. Riddle says. “Talking it out and working through it with a skilled professional really does help.”
Speak to your doctor, midwife, or doula (more on that below) about getting a screening, or ask to speak with a social worker who could provide more resources that are individualized to your needs. You can also search for a licensed professional using online directories like Psychology Today and Inclusive Therapists, and find mental health resources through Postpartum Support International, The Postpartum Stress Center, and The Motherhood Center.
There is also a national maternal mental health hotline (1-833-TLC-MAMA), which offers 24/7, free, confidential support before, during, and after your pregnancy. You can learn more about those services here.
2. Connect with your community.
It might feel a little daunting to share parts of your personal life with total strangers, but joining a parent or pregnancy support group can validate your emotional ups and downs. Even if you’ve decided to share your news with only a few close friends or family members, you can still benefit from hearing from others who are on the same journey as you.
“Being part of a community can help to find camaraderie in the very real changes [pregnant people] are going through, even in early pregnancy. The most important thing is to monitor whether these types of groups are providing support and knowledge,” Dr. Riddle says. If it’s heightening your anxiety or making you feel more emotionally exhausted, then you should find a new space, Dr. Riddle adds. There are many options—in person or online—out there, so don’t feel bad about looking around for the right one for you.
Check out in-person and virtual groups hosted by Postpartum Support International, Dear Sunday Motherhood, Cooper Parenting, RTZ Hope, LGBTQ Perinatal Wellness Center, Tinyhood, Mocha Moms, and MOPs. You can also find helpful information and explore different perspectives by checking out the Two Truths newsletter and The Mother Chapter.
3. Enlist the help of a full-spectrum doula.
Full-spectrum doulas typically work with pregnant people throughout the perinatal period and during postpartum, and they can provide profound emotional support during the first trimester.
Ultimately, working with a doula can make you feel more empowered in your pregnancy. Their job is to advocate for you and offer resources to bring your ideal birth and postpartum experience to life, Amanda Gloria Valdes, RYT-500, a full-spectrum doula and yoga instructor based in New York City, tells SELF.
You can find a doula through credible organizations, including DONA International, the largest doula-certifying organization in the world; use an app, like Irth, which provides reviews of doulas and birth practitioners; or look for local services. Asking for recommendations from your health care provider, close friends, or people in your support groups is also a great way to start your search. When interviewing a doula, ask them about their training and services to ensure that their expertise aligns with your needs, Valdes says.
“Some doulas have more education and awareness around specific needs of clients, like affirming births for folks who are LGBTQ+ and BIPOC,” Valdes says. If you have certain religious or family customs you’d like to incorporate into your perinatal experience, it’s also helpful to have a doula who is culturally competent or identifies with your needs and the traditions you would like to follow.
For example, in addition to being a doula, Valdes is a certified yoga teacher, so she often works with clients who are also interested in doing prenatal yoga. “I can provide tools that can help them navigate [their anxiety], like centering moments of meditation, breath work, and a mindfulness session using yoga,” she explains.
Here are some questions you may want to ask a doula if you’re interested in working with them:
How do you typically serve and show up for your client?Do you do most of your meetings in person or over Zoom?Are you available to accompany me to some prenatal appointments?Do you offer birth education classes?Are you also a certified lactation consultant, who can offer advice on breastfeeding and formula feeding?Do you have a backup person in case you’re unavailable at the time of my birth?How do you provide emotional support to your clients?
4. Ask yourself if your provider makes you feel seen and heard.
The major physical, mental, and emotional changes caused by pregnancy don’t only happen during the first 12 weeks, but for 40 weeks and then into the postpartum period. The first trimester, however, is notorious for nausea and vomiting—and these symptoms can be pretty debilitating. Your provider—whether you’re working with an ob-gyn, midwife, or both—is going to play a central role in supporting you, so beyond offering the basic tenets of prenatal care, like monitoring your health alongside the development of the fetus, they should really ask you about how you’re feeling.
“One of the early signs [that you are being fully supported] is whether a provider first asks you what’s on your mind or if you have any concerns that you are hoping to address during the appointment,” Dr. Riddle says. “You want to sense they are checking on how you are doing holistically, not just a single organ system.”
Take some time to prepare before your appointments: “I encourage my patients to keep a notebook (or a list on their phone) of questions that they have and we review them at each visit,” Dr. Dixon says. “I emphasize the fact that I am here as their consultant to find the information they are looking for to help them make decisions about their health. I warn against googling in the middle of the night—we all do it!—but it’s better to send me a message so we can discuss concerns.”
Many obstetric practices also have a team of people who have varying expertise, so it’s a good idea to meet other providers who may be helpful to you in different ways. For example, one may be a surgeon while another may have a more extensive background in mental health care, Dr. Riddle says.
“The most important thing is that the patients feel heard, and feel like they are partnering with their provider in their care and understand the plan,” says Dr. Dixon.
5. Be honest about your limits.
Keeping up with the demands of daily life can be tough when you’re often feeling incredibly tired and unwell. We know it can be hard to do, but asking your family and friends for help can make your life easier, whether you need someone to drop off groceries or step in for school drop-off.
Write out a list of all the tasks you need help with, and the people you feel most comfortable reaching out to. “You can say, ‘I’ve been overwhelmed recently.’ You don’t have to talk about the why if you are not ready. Needing help doesn’t need to be qualified,” Dr. Riddle says. “Imagine if you were asked to help someone in your circle? How would you respond? You’d probably be honored they asked you and trusted you.”
If you’ve decided to keep the news under wraps, you might be tempted to push yourself by trying to maintain your day-to-day responsibilities and social calendar. But things aren’t the same for you mentally or physically, so it’s important to be kind to yourself.
That doesn’t mean you simply need to enjoy more baths; self-care is also about setting boundaries and saying no to things that aren’t necessary or serving you—say, a family member suggests hosting a small gathering in your home (cleaning up sounds like a nightmare) or a friend insists that you attend an event with them (you don’t want to think of an excuse for not drinking right now). “The art of saying no isn’t always easy so I encourage people to discuss with a trusted mentor or a therapist their strategy of saying no gracefully. It’s very empowering!” Dr. Riddle says.
Additionally, it’s crucial to know your legal rights around pregnancy and employment. If you need accommodations—say, work-from-home days when you aren’t feeling well—don’t hesitate to speak with your doctor and HR department at work.
6. Lean on your partner.
Whether this is your first pregnancy or your third, it’ll shift your relationship with your partner, if they’re in the picture. They might not understand all the changes you’re going through, but that doesn’t mean that they don’t care. Keep them in the loop about your needs and check in about how they’re feeling too. Otherwise, a lack of communication can build resentment and make you feel even less supported.
“In many relationships, we can get into a ‘Why can’t you read my mind?’ mindset. We don’t mean to, but we all do it sometimes,” Dr. Riddle says. “So being explicit—‘I need an hour of quiet time’ or setting up some tasks that your partner can do that would help ease your load—is critical.”
The ideal time to communicate your needs is when you’re both feeling calm and can truly listen to each other, she notes. Messages are better digested when you’re both able to hear each other out and aren’t stewing in negative feelings.
And don’t forget to have fun when you can: Plan nights out together to keep some levity in your relationship. “If you can afford it, make [a date night] a regular weekly thing—leave the house, go to dinner, a movie, yoga, whatever it is, but have it be your time,” Dr. Riddle says. “This is a great time to discuss needs, goals, and a team strategy for whatever you are facing.”
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