When you find out you’re pregnant, the list of things to buy, take, schedule, and plan for can feel overwhelming. The most important first step is a prenatal vitamin with at least 600 mcg of folate and 27 mg of iron, ideally started before or as soon as you confirm the pregnancy. Beyond that, what you need shifts as the weeks progress, from nutrition and medical screenings to comfort items and preparation for bringing a baby home.
Prenatal Vitamins and Key Nutrients
A good prenatal vitamin is the single most important thing to get early in pregnancy. Your body’s demand for certain nutrients jumps significantly, and diet alone rarely covers the gap. The core nutrients to look for in a prenatal:
- Folate: 600 mcg daily during pregnancy (and 400 to 800 mcg of folic acid from supplements if you’re in early weeks or were trying to conceive). Folate is critical for preventing neural tube defects in the baby’s brain and spine, and the neural tube closes within the first month, often before you even know you’re pregnant.
- Iron: 27 mg daily. Your blood volume increases by nearly 50% during pregnancy, and iron fuels the production of red blood cells for both you and the baby. Low iron is one of the most common pregnancy deficiencies and a major cause of fatigue.
- Calcium: 1,000 mg daily (1,300 mg if you’re under 19). If you don’t get enough from food and supplements, the baby will pull calcium from your bones.
- Iodine: 220 mcg daily. This supports the baby’s thyroid and brain development. Not all prenatals include iodine, so check the label.
- Choline: 450 mg daily in the first trimester, increasing to 550 mg in the second and third trimesters. Choline plays a major role in fetal brain development, yet most prenatal vitamins contain little or none. Eggs, liver, and soybeans are good dietary sources, but a separate choline supplement may be worth considering.
Look for a prenatal that includes DHA as well, an omega-3 fatty acid that supports the baby’s brain and eye development. Some prenatals bundle it in; others require a separate softgel.
Water: More Than You Think
The American College of Obstetricians and Gynecologists recommends drinking 8 to 12 cups of water daily during pregnancy, which works out to 64 to 96 ounces. That’s noticeably more than the general recommendation for adults. Staying hydrated helps maintain amniotic fluid levels, supports the increase in blood volume, and reduces common complaints like constipation, headaches, and urinary tract infections. A large, marked water bottle (32 or 40 ounces) that you can refill two or three times a day makes hitting this target much easier to track.
First Trimester Screenings to Schedule
Between weeks 10 and 14, you’ll typically be offered first trimester screening, a combination of an ultrasound and two blood tests. The ultrasound measures the fluid at the back of the baby’s neck (called nuchal translucency), which can indicate an increased risk of chromosomal conditions like Down syndrome. The blood tests measure two substances produced by the placenta that, at abnormal levels, also signal higher risk.
These screenings are optional but widely recommended. They don’t diagnose anything on their own. Instead, they produce a risk estimate. If the results suggest elevated risk, you’d then be offered diagnostic testing like chorionic villus sampling or amniocentesis for a definitive answer. Knowing the timeline matters because the window for these screenings is narrow, so bring it up at your first prenatal appointment if your provider doesn’t mention it.
Skin Care Products That Are Safe
Pregnancy often brings skin changes like acne, dark spots, and increased sun sensitivity, but some of the products you might normally reach for are no longer safe to use. The two main ingredients to avoid are topical retinoids (including tretinoin, retinol, and adapalene) and hydroquinone, a skin-lightening agent that gets absorbed into the bloodstream in significant amounts.
Safe alternatives that you can use throughout pregnancy include benzoyl peroxide for acne, glycolic acid for exfoliation, and topical antibacterials like clindamycin or erythromycin if prescribed. Sunscreen is safe and especially important since pregnancy hormones can worsen dark spots with sun exposure. Salicylic acid hasn’t been studied directly in pregnancy, but the amount absorbed through the skin is so minimal that it’s generally considered low risk in typical concentrations. Self-tanning lotions using dihydroxyacetone are also fine, since less than 1% reaches your system.
Comfort Items That Actually Help
Pregnancy Pillow
By the second trimester, sleeping on your back starts to compress a major blood vessel that supplies the uterus, which can reduce blood flow to the baby. Side sleeping is recommended, but it puts unusual strain on your hips, knees, and lower back. A pregnancy pillow, typically a large body pillow shaped like a C or U, simultaneously supports your back, belly, knees, and hips. This prevents your joints from collapsing or twisting during sleep, which is a particular problem on softer mattresses. Many people find this is the single purchase that makes the biggest difference in sleep quality from about week 20 onward.
Compression Socks
Swelling in your feet and legs is common, especially in the third trimester, because your body retains more fluid and your growing uterus puts pressure on the veins returning blood from your legs. Graduated compression socks help push that fluid back up. For mild swelling, socks rated 15 to 20 mmHg provide comfortable everyday support. If you develop varicose veins or more significant swelling, 20 to 30 mmHg offers stronger compression. The mmHg rating is printed on the packaging. Knee-high styles are generally enough for pregnancy-related swelling.
Exercise Ball
A birthing or exercise ball is useful throughout pregnancy for relieving back pain, improving posture, and encouraging optimal fetal positioning in the third trimester. Many people also use them during labor. Size matters for comfort and safety: if you’re 5’0″ or under, get a 55 cm ball. Between 5’1″ and 5’8″, go with 65 cm. Between 5’9″ and 6’2″, choose 75 cm. When you sit on the correct size, your hips should be level with or slightly above your knees.
Maternity Clothing Essentials
You don’t need a full wardrobe overhaul, but a few targeted pieces make a big difference. Most people start needing maternity clothes between weeks 14 and 20. Prioritize a supportive maternity bra (your cup size may increase by one or two sizes), a belly band that lets you keep wearing unbuttoned pre-pregnancy pants, and a few pairs of maternity leggings or pants with a stretchy waistband. If you work in a professional setting, two or three versatile tops and a pair of dress pants can carry you through most of the pregnancy.
Preparing for the Baby’s Arrival
You don’t need everything on a registry checklist, but certain items are non-negotiable for safety. The American Academy of Pediatrics recommends that every infant sleep on a firm, flat mattress in their own crib, bassinet, or portable play yard with only a fitted sheet. No loose blankets, pillows, stuffed animals, or bumpers. Babies should always be placed on their backs to sleep, and they should never sleep on a couch, armchair, or in a car seat outside the car.
A rear-facing car seat is legally required to bring the baby home from the hospital. Make sure it meets current federal safety standards (the manufacture date and certification label will be on the side of the seat). Many local fire departments and hospitals offer free car seat installation checks, which is worth doing since studies consistently show a high rate of installation errors.
Beyond safety essentials, the practical items that get the most daily use in those first weeks are a small supply of newborn and size-1 diapers, a few packs of wipes, burp cloths, a handful of onesies and sleep sacks (instead of blankets), and a simple baby carrier or wrap for hands-free holding. Everything else, from swings to bottle warmers, can wait until you figure out what your baby actually responds to.
Maternity Leave and Workplace Rights
If you work in the United States, the Family and Medical Leave Act provides up to 12 weeks of unpaid, job-protected leave after the birth of a child. To qualify, you need to have worked for your employer for at least 12 months, logged at least 1,250 hours in the 12 months before your leave starts, and work at a location where your employer has 50 or more employees within 75 miles. Public agencies and public or private schools are covered regardless of size.
FMLA leave is unpaid at the federal level, but some states have paid family leave programs that provide partial wage replacement. Your employer may also offer short-term disability insurance that covers a portion of your salary during recovery from birth, typically six weeks for a vaginal delivery and eight weeks for a cesarean. It’s worth checking with HR early in pregnancy to understand what benefits are available and how much advance notice is required to file claims.