If you’ve just found out you’re pregnant, the single most important step is scheduling your first prenatal appointment. Everything else, from adjusting your diet to staying active, builds on that foundation. Here’s a practical walkthrough of what to do in these early weeks and throughout your pregnancy.
Schedule Your First Prenatal Visit
Call to book an appointment as soon as you get a positive test. This first visit is longer than the ones that follow because your provider will go through your full medical history, including past pregnancies, family health conditions, medications you currently take (prescription, over-the-counter, and supplements), and any exposure to tobacco, alcohol, or recreational drugs.
You’ll have your weight and height measured so your provider can calculate how much weight gain is healthy for your pregnancy. Expect a physical exam that may include a breast exam, pelvic exam, and a Pap test if you’re due for one. Blood work at this visit checks your blood type and Rh status, your immunity to rubella and chickenpox, and screens for infections like hepatitis B, syphilis, chlamydia, gonorrhea, and HIV. You’ll also give a urine sample to check for urinary tract infections.
Choose the Right Provider
You have a few options for who manages your care, and the right choice depends largely on your risk level and what kind of birth experience you want.
An OB-GYN specializes in reproductive health and is trained for any birth situation: low-risk pregnancies, high-risk conditions like diabetes or high blood pressure, twins, vaginal deliveries, and cesarean sections. If you have known complications or a history of difficult pregnancies, an OB-GYN is typically the best fit.
A midwife follows the same prenatal screening guidelines as a doctor but takes a more holistic approach, emphasizing education, limiting intervention unless medically necessary, and encouraging the natural birthing process. Midwives work with low-risk patients and can manage certain complications like gestational hypertension or diet-controlled diabetes. They’re also trained to recognize when a situation requires transferring care to an OB-GYN.
Start Prenatal Vitamins Right Away
Folic acid is the most critical nutrient in early pregnancy. It helps prevent neural tube defects, which are serious problems with the brain and spine that develop in the first weeks, often before you even know you’re pregnant. The recommended daily amount is 400 micrograms. If you’ve had a previous pregnancy affected by a neural tube defect, the recommendation jumps to 4,000 micrograms daily, starting at least one month before conception and continuing through the first three months.
Most prenatal vitamins contain the right amount of folic acid along with iron, calcium, and other nutrients your body needs more of during pregnancy. If you’re not already taking one, start now.
Foods and Drinks to Avoid
Certain foods carry a higher risk of bacterial infection or mercury exposure during pregnancy. The biggest concerns are listeria (a bacteria that can cause miscarriage or stillbirth) and methylmercury (a heavy metal that accumulates in the fetus and can affect brain development).
- Raw or undercooked seafood: sushi, sashimi, ceviche, raw oysters, scallops, and clams.
- High-mercury fish: bigeye tuna and other large predatory fish like swordfish, shark, and king mackerel.
- Smoked or refrigerated seafood: anything labeled lox, nova style, kippered, or smoked, unless it’s in a cooked dish.
- Soft cheeses: brie, feta, and blue cheese, unless the label confirms they’re made with pasteurized milk.
- Deli meats and hot dogs: don’t eat these unless heated until steaming hot, as they can harbor listeria.
- Refrigerated pates and meat spreads.
- Raw sprouts: alfalfa, clover, radish, and mung bean sprouts.
- Unpasteurized juice or cider.
- Alcohol: no amount has been shown to be safe during pregnancy.
- Herbal tea: check with your provider before drinking any, as some herbs can affect pregnancy.
Caffeine is another one to watch. The long-standing guideline has been to stay under 200 milligrams per day (roughly two cups of coffee), but NIH-funded research found that even intake below that threshold was linked to smaller birth size and lower lean body mass in newborns. If you can cut back further or switch to decaf, that’s a reasonable step.
Be Careful With Medications
Many over-the-counter medications that feel routine, like pain relievers, cold medicine, or allergy pills, may not be safe during pregnancy. Even acetaminophen, long considered the go-to pain reliever for pregnant people, has come under scrutiny. Some studies have found an association between chronic use throughout pregnancy and a higher risk of neurological conditions in children, though a direct cause hasn’t been established. The CDC notes that pregnant people should consider avoiding it as a precaution.
Before taking anything, including supplements and herbal remedies, check with your provider. This applies to medications you were taking before pregnancy too. Some need to be stopped, others switched to safer alternatives.
Environmental Hazards to Watch For
Toxic exposures can come from places you might not expect. Certain workplaces carry higher risks: agriculture (pesticides), manufacturing (solvents and heavy metals), dry cleaning, cleaning services, beauty salons (solvents and chemicals found in nail and hair products), and healthcare settings (radiation exposure). If your job involves any of these, talk to your provider about whether modifications are needed.
At home, be aware of lead in older paint or water pipes, especially if you live in an area with water safety advisories. Chemicals also show up in food packaging, personal care products, and household cleaners. Simple steps like improving ventilation when cleaning, switching to fragrance-free products, and avoiding handling cat litter (which can carry a parasite that causes toxoplasmosis) all reduce your exposure.
Staying Active During Pregnancy
Exercise is not only safe for most pregnancies, it’s strongly recommended. The goal is at least 150 minutes of moderate-intensity aerobic activity per week. “Moderate intensity” means you’re moving enough to raise your heart rate and sweat, but you can still hold a conversation (you just couldn’t sing). You can break this into 30-minute sessions five days a week, or even 10-minute blocks throughout the day.
The safest options include brisk walking, swimming and water workouts (the water supports your weight and reduces strain), stationary cycling (regular bikes become risky as your center of gravity shifts), and prenatal yoga or Pilates classes designed to accommodate a changing body. If you were already a runner or played racquet sports before pregnancy, you can generally continue, though it’s worth confirming with your provider.
First Trimester Screening Tests
Between weeks 11 and 13, you’ll be offered a combination of tests that screen for chromosomal conditions like Down syndrome and certain heart defects. This typically involves a blood test measuring two proteins and an ultrasound that looks for extra fluid behind the baby’s neck, which can indicate a chromosomal or cardiac issue. These are screening tests, not diagnostic ones, meaning they estimate risk rather than give a definitive answer. If results suggest elevated risk, your provider will discuss further testing options.
Warning Signs That Need Immediate Attention
Some symptoms during pregnancy require prompt medical care. Contact your provider or go to the emergency room if you experience:
- Severe belly pain: sharp, stabbing, or cramp-like pain that doesn’t go away, starts suddenly, or gets progressively worse. This includes severe chest, shoulder, or back pain.
- Vaginal bleeding beyond light spotting: anything resembling a period, passing clots larger than an egg, or passing tissue.
- Fluid leaking from your vagina or vaginal discharge with a foul smell.
Light spotting in the first trimester is common and often harmless, but heavier bleeding is not something to wait out. Trust your instincts. If something feels wrong, getting checked is always the right call.