Stay healthy throughout your pregnancy with a trimester-by-trimester plan. Covers prenatal appointments, nutrition essentials, exercise guidelines, symptom management, preparing for delivery, and when to call your doctor immediately.
Schedule your first prenatal appointment at 6-8 weeks
Your first visit includes a confirmation ultrasound, blood work (blood type, Rh factor, CBC, STI screening, immunity checks), urine tests, blood pressure, and medical history review. Choose an OB-GYN, midwife, or family medicine doctor based on your preference for delivery style. If you want a birth center or home birth, a certified nurse-midwife (CNM) is your provider. Hospital births are managed by OB-GYNs or CNMs with hospital privileges. Insurance typically covers all prenatal visits with no copay under the ACA.
Take a prenatal vitamin daily with at least 400 mcg folic acid, DHA, and iron
Folic acid prevents neural tube defects and is most critical in weeks 3-8 (often before you know you are pregnant). DHA omega-3 (200-300 mg) supports fetal brain development. Iron (27 mg) supports increased blood volume. If prenatal vitamins cause nausea, take them at night with food or try gummy versions (which may lack iron, so supplement separately). Prenatal vitamins cost 10-30 USD per month. Start as soon as you know you are pregnant if you were not already taking them.
Manage first-trimester nausea with small frequent meals and ginger
Nausea affects 70-80% of pregnant women, typically peaking at weeks 8-10 and resolving by weeks 12-14. Eat small meals every 2-3 hours (empty stomach worsens nausea). Keep crackers on your nightstand for before you get out of bed. Ginger (ginger tea, ginger chews, 250 mg ginger capsules 4 times daily) is proven effective in clinical trials. Vitamin B6 (25 mg three times daily) reduces nausea by 30-40%. If you cannot keep food or water down for 24 hours, call your doctor as this may indicate hyperemesis gravidarum.
Avoid alcohol, raw fish, deli meats, unpasteurized cheese, and limit caffeine to 200 mg
Alcohol has no known safe amount during pregnancy. Raw and undercooked fish, shellfish, and meat carry listeria and toxoplasmosis risk. Deli meats and hot dogs should be heated to steaming before eating. Soft unpasteurized cheeses (brie, feta, queso fresco) are listeria risks unless labeled pasteurized. Caffeine under 200 mg daily (one 12-ounce coffee) is considered safe by ACOG. High mercury fish (swordfish, king mackerel, tilefish, bigeye tuna) should be avoided entirely. Low mercury fish (salmon, shrimp, tilapia) are encouraged: 2-3 servings per week.
Second Trimester (Weeks 13-27)
Get the anatomy scan ultrasound at 18-22 weeks
The anatomy scan is a detailed ultrasound examining the baby's brain, heart, spine, kidneys, limbs, and other organs. It takes 30-45 minutes and is the most thorough ultrasound of pregnancy. This is when you can learn the baby's sex (if you choose to). The sonographer checks for structural abnormalities, placenta location, and amniotic fluid levels. If any findings are unclear, a follow-up scan may be scheduled. This ultrasound is covered by insurance as part of standard prenatal care.
Continue or start a regular exercise routine: 150 minutes per week
ACOG recommends 150 minutes of moderate-intensity exercise per week throughout pregnancy for women without complications. Safe activities: walking, swimming, stationary cycling, prenatal yoga, and light strength training. Avoid contact sports, activities with fall risk (skiing, horseback riding), exercises lying flat on your back after 20 weeks, and hot yoga or hot tubs. Exercise during pregnancy reduces gestational diabetes risk by 25%, preeclampsia risk by 40%, excessive weight gain, and improves labor outcomes. Start gently if you were sedentary before pregnancy.
Take the glucose tolerance test at 24-28 weeks to screen for gestational diabetes
The 1-hour glucose challenge test involves drinking a 50-gram glucose solution and having blood drawn 1 hour later. If your result is 140 mg/dL or higher, you take the 3-hour test (100-gram solution with blood draws at 1, 2, and 3 hours). Gestational diabetes affects 6-9% of pregnancies and is managed with diet, exercise, and sometimes insulin. Risk factors include BMI over 25, age over 35, family history of diabetes, and previous gestational diabetes. Early detection and management prevent complications for both mother and baby.
Third Trimester (Weeks 28-40)
Attend prenatal appointments every 2 weeks from 28-36 weeks, then weekly until delivery
Third-trimester visits monitor blood pressure (screening for preeclampsia), baby's position, fundal height (measuring belly growth), fetal heart rate, and any symptoms like swelling or headaches. At 35-37 weeks, you will be tested for Group B Streptococcus (GBS), a bacteria that can be passed to the baby during delivery. If positive (25% of women), you receive IV antibiotics during labor to protect the baby. These visits are quick (15-20 minutes) but important for catching late-pregnancy complications.
Take a childbirth education class before 36 weeks
Childbirth classes cover stages of labor, breathing and coping techniques, pain relief options (epidural, nitrous oxide, unmedicated methods), cesarean birth, and newborn care basics. Hospital-based classes cost 50-200 USD for a series of 4-6 sessions. Online options include Evidence Based Birth (subscription model), Lamaze online classes, and YouTube series from certified educators. Partners or support persons should attend. Knowing what to expect during labor reduces anxiety and increases satisfaction with the birth experience regardless of how delivery unfolds.
Pack your hospital bag by 36 weeks
For you: insurance card and ID, loose comfortable clothing for labor and going home, nursing bra and pads, toiletries, phone charger (with a long cord), and a going-home outfit. For baby: 2-3 onesies, a hat, socks, a swaddle blanket, and a car seat installed in your vehicle (hospitals will not discharge without one). For partner: change of clothes, snacks, phone charger, and pillow. Leave valuables at home. The hospital provides gowns, mesh underwear, pads, diapers, and basic baby supplies during your stay.
Know the signs of labor and when to go to the hospital
Early labor signs: regular contractions that get closer together, stronger, and longer over time (5-1-1 rule: contractions every 5 minutes, lasting 1 minute, for 1 hour). Water breaking (a gush or steady trickle of fluid). Bloody show (mucus plug with blood-tinged discharge). Go to the hospital when contractions follow the 5-1-1 pattern or when your water breaks. Call your doctor immediately for: heavy bleeding, severe headache with vision changes, sudden severe swelling, decreased fetal movement, or fever above 100.4 degrees F. This guide is informational only, not medical advice.
Frequently Asked Questions
How much weight should I gain during pregnancy?
ACOG guidelines based on pre-pregnancy BMI: underweight (BMI below 18.5): gain 28-40 lbs. Normal weight (BMI 18.5-24.9): gain 25-35 lbs. Overweight (BMI 25-29.9): gain 15-25 lbs. Obese (BMI 30+): gain 11-20 lbs. First trimester: 2-5 lbs total. Second and third trimesters: approximately 1 lb per week. Weight gain includes the baby (7-8 lbs), placenta (1.5 lbs), amniotic fluid (2 lbs), increased blood volume (3-4 lbs), breast tissue (1-3 lbs), and fat stores for breastfeeding (5-9 lbs).
What prenatal tests are recommended and when?
First trimester (weeks 10-13): NIPT blood test (screens for chromosomal conditions), nuchal translucency ultrasound. Second trimester (weeks 15-20): quad screen blood test (if NIPT not done), anatomy ultrasound at 18-22 weeks. Third trimester: glucose tolerance test at 24-28 weeks, GBS swab at 35-37 weeks, and non-stress tests if high-risk. Optional at any time: carrier screening for genetic conditions (cystic fibrosis, sickle cell, etc.). Amniocentesis or CVS for definitive genetic diagnosis if screening suggests elevated risk.
Is it safe to exercise during pregnancy?
Yes, for most pregnancies. ACOG recommends 150 minutes of moderate exercise per week. Safe activities include walking, swimming, stationary cycling, prenatal yoga, and modified strength training. Stop exercising and call your doctor if you experience vaginal bleeding, regular contractions, fluid leaking, dizziness, chest pain, or calf swelling. Women with placenta previa, cervical insufficiency, preeclampsia, or preterm labor risk may need to modify or restrict exercise. A conversation with your provider establishes your specific exercise guidelines.
When should I call my doctor during pregnancy?
Call immediately for: vaginal bleeding, leaking fluid, decreased fetal movement (fewer than 10 kicks in 2 hours after 28 weeks), severe headache with vision changes, sudden facial or hand swelling, fever above 100.4 degrees F, severe abdominal pain, or painful urination. Call within 24 hours for: persistent nausea preventing food or water intake for 24 hours, contractions before 37 weeks, signs of infection (foul-smelling discharge, chills), or a fall impacting your abdomen. When in doubt, call. Your provider's office has an after-hours line for urgent questions.