If you think you’re pregnant or just got a positive test, the first steps are confirming the pregnancy, scheduling a prenatal appointment, and starting a prenatal vitamin with folic acid right away. Everything else, from diet changes to exercise adjustments, can follow in the days and weeks ahead. Here’s what to do and when.
Confirm the Pregnancy
Home pregnancy tests detect a hormone called hCG in your urine, and manufacturers claim they work as early as the first day of a missed period. In reality, most aren’t sensitive enough to catch every pregnancy that early. Testing found that only 44% of major brands could reliably detect hCG at the concentrations typical around a missed period. If you test on day one and get a negative result, that doesn’t necessarily mean you’re not pregnant.
For the most reliable result, wait until at least three days after your missed period. By then, hCG levels are high enough for nearly all home tests to pick up. Test with your first morning urine, when the hormone is most concentrated. A faint line still counts as positive. If you get a positive result, or if your period still hasn’t come after a negative test, call a healthcare provider to schedule a visit.
Start Folic Acid Immediately
You need 400 micrograms of folic acid every day starting as early in pregnancy as possible. This B vitamin helps prevent neural tube defects, which are serious problems with the baby’s brain and spinal cord that develop in the first few weeks, often before you even know you’re pregnant. Most prenatal vitamins contain at least this amount. If you had a previous pregnancy affected by a neural tube defect, the recommended dose is 4,000 micrograms daily.
Pick up a prenatal vitamin from any pharmacy. You don’t need a prescription. Beyond folic acid, prenatal vitamins typically include iron, calcium, and DHA, all of which support a healthy pregnancy. If one brand makes you nauseous, try a different formulation or take it with food or before bed.
Schedule Your First Prenatal Visit
Call your provider as soon as you have a positive test. Many offices schedule the first prenatal appointment between 8 and 10 weeks, though the timing varies by practice. Set aside extra time for this visit because it covers a lot of ground.
Your provider will ask about your menstrual cycle, past pregnancies, family medical history, medications (including supplements), and lifestyle habits like smoking, alcohol, and caffeine use. Be honest about everything, including sensitive topics like past drug use or domestic abuse. This information directly affects the care plan they build for you.
You’ll get a physical exam that includes your weight, height, and blood pressure. Depending on your history, you may also have a breast exam, pelvic exam, or Pap test. Blood tests check your blood type, Rh status, and screen for infections like hepatitis B, syphilis, chlamydia, gonorrhea, and HIV. A urine sample screens for urinary tract infections.
Your due date is calculated as 40 weeks from the first day of your last period. If an early ultrasound shows a date that differs by more than seven days, the ultrasound date is used instead.
Choose Your Provider
You have two main options: an OB-GYN or a certified nurse-midwife. OB-GYNs are medical doctors trained in both pregnancy care and surgery. They can handle high-risk pregnancies and perform cesarean sections. Certified nurse-midwives hold graduate degrees in nursing or midwifery, tend to spend more time on patient education and hands-on support, and are often trained in a broader range of non-medical pain management options for labor.
Midwives generally care for low-to-moderate-risk pregnancies and collaborate closely with OB-GYNs when complications arise. If you have a chronic condition like diabetes or high blood pressure, or if you’ve had previous pregnancy complications, an OB-GYN is typically the better fit. If your pregnancy is uncomplicated and you prefer a more holistic approach, a midwife may be a good match. Many hospital-based practices have both on staff, so you don’t always have to choose one or the other.
Adjust Your Diet
Pregnant women are 10 times more likely to get a listeria infection than the general population, and listeria can cause miscarriage, stillbirth, or serious illness in a newborn. The main dietary changes revolve around avoiding foods that carry a higher risk of listeria or other foodborne pathogens.
Foods to avoid or handle carefully:
- Deli meats, hot dogs, and cold cuts unless heated to steaming hot (165°F)
- Raw or undercooked meat and poultry (use a food thermometer: poultry to 165°F, ground beef to 160°F, whole cuts of beef, pork, and lamb to 145°F)
- Soft cheeses made from unpasteurized milk
- Raw or unpasteurized milk and juice
- Raw sprouts like alfalfa and bean sprouts
- Premade deli salads such as tuna salad, chicken salad, and egg salad from a deli counter
- Raw fish and sushi (also limit high-mercury fish like swordfish, shark, king mackerel, and tilefish)
- Unwashed fruits and vegetables
Keep caffeine under 200 milligrams per day, which is roughly two standard cups of coffee. That limit includes all sources: tea, soda, chocolate, and energy drinks. You don’t need to cut caffeine entirely, but tracking your total intake matters more than most people realize.
Alcohol has no known safe amount during pregnancy. The safest approach is to stop drinking entirely.
Stay Active Safely
Exercise during pregnancy is not only safe for uncomplicated pregnancies, it’s recommended. The current guideline is at least 150 minutes of moderate-intensity aerobic activity per week, spread across several days. Walking, stationary cycling, swimming, water aerobics, dancing, resistance training with weights or bands, and stretching are all well-studied and considered safe.
Concerns that regular exercise causes miscarriage, poor fetal growth, or premature delivery have not been supported by evidence in women with uncomplicated pregnancies. If you were already doing vigorous workouts before pregnancy, you can generally continue them. The old advice about keeping your heart rate below a specific number has been retired. Instead, use the “talk test”: if you can carry on a conversation while exercising, your intensity is in a good range.
Avoid contact sports, activities with a high fall risk (like skiing or horseback riding), and exercises that involve lying flat on your back for extended periods after the first trimester. Hot yoga and anything that raises your core temperature significantly should also be skipped.
Know Which Medications Are Safe
Many common over-the-counter medications are not safe during pregnancy, and this catches people off guard. Acetaminophen (Tylenol) is considered the pain reliever of choice and is safe in all trimesters. Ibuprofen (Advil, Motrin) and naproxen (Aleve) should be avoided, especially in the third trimester, when they can cause serious problems for the baby’s heart.
For cold and allergy symptoms, first-generation antihistamines like diphenhydramine (Benadryl) and second-generation options like loratadine (Claritin) and cetirizine (Zyrtec) are generally considered safe. Saline nasal sprays are a good drug-free option for congestion. Oral decongestants containing pseudoephedrine or phenylephrine should be avoided in the first trimester. Cough suppressants containing dextromethorphan appear to be safe.
As a general rule, check with your provider before taking anything new, including herbal supplements. Many products marketed as “natural” have not been studied in pregnancy.
First Trimester Screening
Between weeks 11 and 13, you’ll be offered a combination of a blood test and an ultrasound to screen for chromosomal conditions like Down syndrome and certain heart defects. The blood test measures two proteins in your blood, and abnormal levels of either one can signal a higher chance of a chromosomal disorder. The ultrasound measures a small pocket of fluid at the back of the baby’s neck. Extra fluid there can also indicate a chromosomal or heart issue.
These are screening tests, not diagnostic ones. An abnormal result doesn’t mean something is wrong. It means further testing, like a more detailed blood test or amniocentesis, may be recommended. These screenings are optional, and your provider will walk you through what the results can and can’t tell you.
Warning Signs That Need Immediate Attention
Some symptoms during pregnancy require urgent medical care. Contact your provider right away or go to the emergency room if you experience any of the following:
- Vaginal bleeding heavier than light spotting, especially bleeding that resembles a period
- Severe belly pain that is sharp, stabbing, or cramp-like and doesn’t go away, or pain that starts suddenly and gets worse
- Fluid leaking from your vagina
- Vaginal discharge with a foul smell
- Severe chest, shoulder, or back pain
Light spotting in early pregnancy is common and often harmless, but any bleeding that soaks a pad warrants a call. The same goes for intuition: if something feels off even without a specific symptom on this list, trust that instinct and reach out to your provider.