A trimester-by-trimester guide to prenatal health, covering nutrition, medical appointments, exercise, mental health, and preparing for labor and delivery.
Your first visit typically happens between weeks 6-8 and lasts 45-60 minutes. This appointment includes blood work, urine tests, and an ultrasound to confirm the due date. Book it as soon as you get a positive test.
Confirm insurance covers prenatal care
Ask about the practice's delivery hospital
Start taking a prenatal vitamin with 400-800mcg of folic acid
Folic acid reduces neural tube defects by up to 70% when taken before and during early pregnancy. If you have a family history of neural tube defects, your doctor may recommend 4mg (4,000mcg) daily.
Eliminate alcohol, tobacco, and recreational drugs
There is no known safe amount of alcohol during pregnancy. Smoking increases miscarriage risk by 24% and doubles the risk of low birth weight. Talk to your doctor before stopping any prescription medications.
Review your medication list with your doctor
About 90% of pregnant women take at least one medication. Some common drugs (ibuprofen, certain acne treatments, some antidepressants) are unsafe during pregnancy. Never stop a prescription without medical guidance.
Understand first trimester screening options
Screening tests at 10-13 weeks assess the risk of chromosomal conditions like Down syndrome. These are optional and include blood tests and an ultrasound. Results are available within 1-2 weeks.
Nutrition and Diet
Increase your calorie intake appropriately by trimester
First trimester: no extra calories needed. Second trimester: add 340 calories per day. Third trimester: add 450 calories per day. This equals about one extra snack, not eating for two.
Get 70-100 grams of protein daily
Protein supports fetal growth, especially in the second and third trimesters. Good sources: 3 ounces of chicken has 26g, 1 cup of Greek yogurt has 17g, and 1 cup of lentils has 18g of protein.
Avoid high-risk foods for foodborne illness
Skip raw or undercooked meats, unpasteurized dairy and juice, raw fish (including sushi), and deli meats unless heated to 165°F. Listeria infection during pregnancy is 10 times more likely than in the general population.
Avoid raw fish and high-mercury fish
Heat deli meats until steaming before eating
Stay hydrated with 8-12 cups of water daily
Blood volume increases by 45% during pregnancy, requiring more fluids. Dehydration can trigger contractions. Carry a water bottle and drink at least 1 cup per hour during waking hours.
Limit caffeine to 200mg per day or less
200mg is roughly one 12-ounce cup of coffee. Caffeine crosses the placenta and the fetus cannot metabolize it efficiently. Remember that tea (25-50mg), soda (30-55mg), and chocolate (12mg per ounce) also contain caffeine.
Prenatal Appointments and Testing
Keep all scheduled prenatal visits
Standard schedule: monthly visits through week 28, every 2 weeks from 28-36, and weekly from 36 until delivery. This totals about 12-15 visits. Missing appointments increases the risk of undetected complications.
Complete the glucose screening test at 24-28 weeks
Gestational diabetes affects 6-9% of pregnancies. The 1-hour glucose test requires drinking a 50-gram glucose drink and having blood drawn 1 hour later. If the result is above 140 mg/dL, a 3-hour follow-up test is needed.
Get the Group B Strep (GBS) test at 36-37 weeks
About 25% of healthy women carry GBS bacteria. A positive result means you will receive IV antibiotics during labor to protect the baby. The test is a simple swab and results return within 2-3 days.
Discuss your birth plan with your provider by week 32
Cover your preferences for pain management, labor positions, who will be in the room, and intervention preferences. Keep the plan to 1 page. About 50% of births do not go exactly as planned, so build in flexibility.
Get the Tdap vaccine between 27-36 weeks
The Tdap vaccine during the third trimester passes protective antibodies to the baby, covering them until their own vaccination at 2 months. This reduces infant whooping cough by 78% in the first 2 months of life.
Exercise and Physical Wellness
Aim for 150 minutes of moderate exercise per week
Walking, swimming, and prenatal yoga are the safest options. Break it into 30-minute sessions 5 days per week. Regular exercise during pregnancy reduces the risk of gestational diabetes by 30% and shortens labor by an average of 50 minutes.
Avoid high-risk activities after the first trimester
Stop contact sports, activities with fall risk (skiing, horseback riding), hot yoga, and exercises lying flat on your back after week 20. Your center of gravity shifts forward by 2 inches during pregnancy, increasing fall risk.
Do pelvic floor exercises daily
Kegel exercises strengthen the pelvic floor for labor and prevent incontinence. Do 3 sets of 10 reps daily, holding each contraction for 5 seconds. Start in the first trimester and continue postpartum.
Listen to your body and modify as needed
Stop exercising if you feel dizzy, short of breath, have chest pain, or experience contractions. As pregnancy progresses, reduce intensity by 10-20%. If you can talk but not sing during exercise, you are at the right intensity.
Mental Health and Support
Screen for prenatal depression and anxiety
Prenatal depression affects 10-20% of pregnant women. Ask your provider to screen you at each trimester. Warning signs include persistent sadness for more than 2 weeks, loss of interest in activities, and excessive worry about the pregnancy.
Build a support network before delivery
Identify 3-5 people you can call for practical help (meals, rides, childcare for older kids) and emotional support after the baby arrives. Have at least 2 people confirmed for the first 2 weeks postpartum.
Take a childbirth education class
Classes typically run 4-8 weeks and cost $50-200, though many hospitals offer free sessions. Take the class in your third trimester (weeks 28-34). Partners should attend too; educated partners provide 35% more effective labor support.
Plan your postpartum support in advance
Discuss postpartum depression signs with your partner and at least 1 close family member. About 1 in 7 women experience postpartum depression. Having a plan in place before birth speeds treatment by an average of 3 weeks.
Frequently Asked Questions
What prenatal vitamins should I take during pregnancy?
Start a prenatal vitamin with at least 400-800 mcg of folic acid, 27 mg of iron, 1,000 mg of calcium, 600 IU of vitamin D, and 200-300 mg of DHA (omega-3). Folic acid is most critical in the first 12 weeks to prevent neural tube defects. Take the vitamin with food to reduce nausea. Consult your doctor for advice specific to your situation.
How often are prenatal appointments during pregnancy?
The standard schedule is once every 4 weeks through week 28, every 2 weeks from weeks 28-36, and weekly from week 36 until delivery. High-risk pregnancies may require visits every 1-2 weeks throughout. You will have about 12-15 total visits in an uncomplicated pregnancy, with ultrasounds typically at weeks 8-10 and 18-22.
What foods should I avoid while pregnant?
Avoid raw or undercooked fish, meat, and eggs; unpasteurized dairy and juice; deli meats and hot dogs unless heated to steaming (165°F); high-mercury fish like swordfish, shark, king mackerel, and tilefish; and alcohol completely. Limit caffeine to 200 mg per day (about one 12-oz cup of coffee). Consult your doctor for advice specific to your situation.
How much weight should I gain during pregnancy?
The recommended total weight gain depends on your pre-pregnancy BMI: 28-40 pounds if underweight (BMI under 18.5), 25-35 pounds if normal weight (18.5-24.9), 15-25 pounds if overweight (25-29.9), and 11-20 pounds if obese (BMI 30+). Most of the gain happens in the second and third trimesters at about 1 pound per week.
Is exercise safe during pregnancy?
For most pregnancies, 150 minutes of moderate exercise per week is safe and recommended. Walking, swimming, stationary cycling, and prenatal yoga are excellent choices. Avoid contact sports, activities with fall risk, hot yoga, and exercises on your back after the first trimester. Stop exercising and call your doctor if you experience bleeding, dizziness, or contractions. Consult your doctor for advice specific to your situation.