The first thing to do after a positive pregnancy test is call your doctor or midwife to schedule a prenatal appointment. From there, a handful of straightforward changes to your diet, medications, and daily habits can make a real difference in how your pregnancy goes. Here’s what to focus on, roughly in order of priority.
Schedule Your First Prenatal Visit
Call as soon as you get a positive test. Many offices book out several weeks, so calling early helps you get seen at the right time. At that first visit, expect blood draws to check your blood type, iron levels, and immunity to infections like rubella and chickenpox. You’ll also be screened for hepatitis B, syphilis, HIV, and urinary tract infections. Your provider will likely offer genetic screening tests, which can include blood work or an ultrasound to check for conditions like Down syndrome.
If you don’t already have a provider in mind, you’ll need to choose between an OB-GYN and a midwife. OB-GYNs are physicians trained to handle all pregnancies, including high-risk ones, and can perform C-sections and other surgeries. Midwives focus on pregnancy as a normal process rather than a medical condition, often spend more time on patient education, and tend to offer a wider range of non-medical pain management options during labor. Midwives typically care for low-to-moderate-risk pregnancies. If you have a chronic health condition or a history of pregnancy complications, an OB-GYN is the safer choice.
Start a Prenatal Vitamin With Folic Acid
If you aren’t already taking one, start a prenatal vitamin right away. The most critical ingredient is folic acid, which helps prevent neural tube defects (serious problems with the baby’s brain and spine) that develop very early in pregnancy. The recommended daily dose is 400 to 800 micrograms. Most over-the-counter prenatal vitamins contain this amount. Ideally, you’d start folic acid before conception, but starting now still matters because the neural tube forms in the first several weeks.
Review Every Medication You Take
Don’t assume that over-the-counter drugs are automatically safe during pregnancy. The CDC warns against relying on online lists of “safe” pregnancy medications, because many common drugs simply haven’t been studied well enough. Even acetaminophen (Tylenol), long considered the go-to pain reliever during pregnancy, has come under scrutiny. Some studies have found an association between chronic use throughout pregnancy and neurological conditions in children, though a direct cause hasn’t been confirmed.
Before your first prenatal visit, make a list of everything you take: prescriptions, over-the-counter medications, vitamins, herbal supplements, and anything else. Bring it to your appointment so your provider can tell you what to keep, what to stop, and what to substitute.
Adjust What You Eat and Drink
Pregnant women are 10 times more likely than the general population to get a Listeria infection, which can cause miscarriage or serious illness. That single fact drives most of the food-avoidance list. The main categories to skip or handle carefully:
- Deli meats, hot dogs, and cold cuts unless heated until steaming
- Soft cheeses like queso fresco, brie, camembert, and blue cheese, especially if made from unpasteurized milk
- Raw or undercooked eggs, including homemade Caesar dressing, raw cookie dough, and runny yolks
- Raw or undercooked seafood, including sushi, sashimi, and ceviche
- High-mercury fish like shark, swordfish, king mackerel, and tilefish
- Refrigerated smoked seafood (labeled lox, nova-style, or kippered) unless cooked into a dish
- Unpasteurized milk, juice, or cider
- Raw sprouts of any kind
- Premade deli salads like chicken salad, egg salad, or tuna salad from a deli counter
- Raw flour or batter
For caffeine, the World Health Organization and European Food Safety Authority recommend staying below 200 to 300 milligrams per day. A standard 8-ounce cup of brewed coffee contains roughly 80 to 100 milligrams, so you’re generally fine with one to two cups. Keep in mind that tea, soda, chocolate, and some medications also contain caffeine, so the total adds up.
Alcohol has no established safe amount during pregnancy. The simplest approach is to stop entirely.
Stay Active, but Modify Your Routine
Exercise during pregnancy is not only safe for most people, it’s recommended. Walking and swimming are two of the safest options because they work your whole body without stressing your joints. The key guideline from the American College of Obstetricians and Gynecologists: moderate intensity is the target. That means you’re sweating and your heart rate is up, but you can still hold a conversation (just not sing).
A few things to avoid: high-impact or jerky movements that raise your injury risk, exercises that involve lying flat on your back for extended periods, and anything that overheats you, which is especially important in the first trimester. If you were already doing intense workouts before pregnancy, talk to your provider about how to scale back safely rather than stopping cold.
Reduce Chemical and Environmental Exposures
A developing fetus is especially vulnerable to certain chemicals because of how rapidly cells are growing and dividing, particularly in early pregnancy. Some practical changes worth making:
If you have a cat, have someone else handle the litter box. Cat feces can carry a parasite that causes toxoplasmosis, which is dangerous during pregnancy. If no one else can do it, wear gloves and wash your hands thoroughly afterward.
At work, pay attention to chemical exposures. Workplace chemicals can enter your body through the air, through skin contact, or by swallowing, and pregnancy changes your metabolism in ways that can increase how quickly you absorb certain substances like metals. Exposure to some workplace hazards has been linked to preterm birth, low birth weight, birth defects, and miscarriage. If your job involves chemicals, radiation, heavy lifting, or long hours on your feet, bring it up at your prenatal visit. Other non-chemical workplace factors like loud noise, shift work, and prolonged standing can also affect pregnancy outcomes.
At home, switch to fragrance-free or low-toxicity cleaning products when you can, and make sure rooms are well ventilated when you’re painting or using strong solvents.
Know the Warning Signs
Light spotting in early pregnancy is common and usually harmless, but certain symptoms require immediate medical attention:
- Heavy vaginal bleeding (more than spotting, similar to a period)
- Severe belly pain that is sharp, stabbing, or cramping and doesn’t go away, or that starts suddenly and worsens
- Severe chest, shoulder, or back pain
- Fluid leaking from your vagina
- Vaginal discharge with a bad smell
These can be signs of ectopic pregnancy, miscarriage, or other serious complications. Don’t wait to see if they improve on their own.
Sort Out Your Insurance Coverage
Under the Affordable Care Act, all Marketplace health plans and many employer plans must cover a range of prenatal services with no copay or coinsurance, even before you’ve met your deductible. Covered services include folic acid supplements, gestational diabetes screening, hepatitis B screening at your first prenatal visit, preeclampsia screening, syphilis screening, Rh incompatibility screening, urinary tract infection screening, and breastfeeding support and supplies. If you don’t currently have insurance, pregnancy qualifies you for a Special Enrollment Period on the Marketplace, and Medicaid covers pregnancy in every state with expanded income limits.
Call your insurance company early to understand what’s covered, which hospitals and providers are in-network, and what your out-of-pocket costs will look like for delivery. These details vary widely between plans, and sorting them out now saves stress later.