First Trimester

HOW TO SURVIVE THE FIRST TRIMESTER OF PREGNANCY

by Rosemary Romberg

During the early weeks of pregnancy, shortly after the first menstrual period is missed and (in most cases) the pregnancy is confirmed (by a lab test and/or examination), many women feel a peculiar nausea sensation. This very common nausea of early pregnancy is often called morning sickness because many women find the nauseating feelings most troublesome when they first get up in the morning. However, for many other women the nausea sensations may not follow that pattern. (In my own experience, I tended to feel almost normal upon arising in the morning. A full night’s sleep seemed to greatly ease it. Then as the day progressed it grew increasingly strong, apparently stimulated by the activity of being up and around. By nighttime it was at its worst, until finally going to sleep again brought blessed relief!)

Feelings of nausea during the first weeks of pregnancy are completely normal. For most women these sensations begin by around the 6th week after the last menstrual period, and gradually increase in intensity each day until around the 8th or 9th week when they are usually at their strongest. After that they gradually become less intense each day until usually it has completely subsided by around the 14th or 15th week. However, this is simply a general pattern. Many women may experience nausea earlier than the 6th week, or later than the 15th week, or experience it at its strongest point at some other time.

Some fortunate women experience no nausea of early pregnancy or only experience it very mildly. But most women experience any or all of a number of characteristic sensations. Often it is simply a queasy sensation, in which the stomach feels unsettled. (It is not at all the same type of nausea that one feels during illness, such as with the stomach flu. Instead it is a peculiar feeling, unique to early pregnancy.) Very commonly one is extremely sensitive to odors, not only those of foods but of non-food items such as cosmetics, chemicals, animals, or other people’s body odors. Frequently foods that one normally enjoys may suddenly seem unappealing. Sometimes simply the sight of certain foods or odor producing substances, such as pictures of food in a magazine or cookbooks, food in the grocery store, or dog droppings on the ground can produce strong feelings of revulsion. Sometimes it is particularly disturbing when ones saliva or the lingering taste of a food recently eaten takes on at bitter sensation. Some women experience vomiting as well during early pregnancy, or have difficulty eating certain foods, or large amounts of foods.

Most nausea of early pregnancy can be dealt with at home with non-medical measures. However, you should discuss the matter and any course of treatment with your doctor or midwife, particularly if you are experiencing a large degree of nausea and/or vomiting. In a small number of extreme cases women experience such severe nausea and vomiting during early pregnancy that they are unable to digest any food, and must be hospitalized and fed intravenously until this phase has passed.

Nausea of early pregnancy is caused by the hormonal changes taking place in one’s body during early pregnancy. Be assured that high amounts of nausea during early pregnancy does not, by any means, mean that there is anything wrong with you, either physically or emotionally. Nor does it indicate that there is anything wrong with the baby or the pregnancy itself. It is true that a positive attitude about the pregnancy and about life in general can make the nausea sensations much less troublesome. However, it is not true that even severe nausea means that the woman subconsciously does not want her baby or won’t be a good mother. In fact, high levels of nausea are often considered an indication of a healthy normal pregnancy. They are strongly associated with a healthy baby and placenta and a positive outcome of the pregnancy. Frequently pregnancies that are miscarried during the early weeks are accompanied by little or no nausea.

It is also not uncommon tar women who have experienced more than one pregnancy to feel differently during different pregnancies. They may experience different types or degrees of nausea during each pregnancy. Sometimes different foods will seem either appealing or repulsive during different pregnancies. Sometimes women who have carried both boys and girls will feel distinctly different when carrying a baby of one sex compared to the other, perhaps experiencing much more intense nausea while carrying a baby of one sex, or having different types of foods and odors seem either appealing or objectionable.

I have personally experienced the first trimester of pregnancy 9 times. As a result of these pregnancies I have given birth to six healthy, normal, full term babies, and I have miscarried three times. One miscarriage was at the 12th week and was caused by an IUD. The other two both occurred during the 19th week. These were extremely tragic, traumatic experiences which were caused by fibroid tumors which prevented the developing babies from getting necessary nutrients. The rough draft for this article was written while I was in early pregnancy for the eighth time, while carrying our youngest son, Kevin, who was born in October of 1985.

I have experienced typical nausea of early pregnancy during eight of my nine pregnancies. The only pregnancy in which I did not experience nausea was my second pregnancy, which I miscarried in the 12th week due to the presence of an IUD. I have since learned that the IUD suppresses the hormones of pregnancy, which is why normal nausea was not experienced and why the pregnancy was not sustained.

Because I have experienced so many pregnancies,  I have learned on my own many tricks of the trade for coping with this most difficult stage. By the time I went through this the last time, I found that I had developed quite a useful repertoire of ideas which I have decided to pass on to others.

Not all of the techniques listed here will be helpful for every woman, or will be helpful to the same woman during different pregnancies. You will probably wish to consider or experiment with many different suggestions before deciding which are helpful to you:

Eat Nutritiously

1. First of all, if possible there are some things you can do either before you become pregnant or when you first become pregnant (or suspect that you might be), before the nausea phase begins, that may help you get a head start on this stage. If you are planning to become pregnant, or know or suspect that you have just conceived, but are not yet experiencing nausea, take advantage of this time to eat particularly nutritious, high protein meals. This will give you and your baby some added nutritional insurance before nausea sets in and it becomes difficult to eat the foods that you normally enjoy. Also for dealing with the physical stresses of pregnancy, birth, and breastfeeding, it is most important that you start out in the best possible state of overall health. Besides short- changing the baby’s health, being in a state of poor health caused by a poor diet will make all stages of pregnancy, including the early weeks of nausea, much more difficult to deal with.

Stock up Now

2. From a practical standpoint, if you know or suspect that you are pregnant, but have not yet begun to experience nausea, if at all possible, stock up on groceries now before nausea sets in. During the nausea stage, a trip to the grocery store can be extremely difficult as even the sight of food may seem repulsive.

The remainder of these suggestions almost entirely apply to how to cope once nausea of early pregnancy has begun:

Frequent, Small Meals

3. Eat frequent small meals. Nausea of early pregnancy is usually worse on an empty stomach. Therefore, even though most foods may seem unappetizing, your stomach usually feels much better when it has some food in it. However, you will probably not be able to eat large amounts of food without feeling uncomfortable.

Keeping your stomach partially full, most of the time, with easily digested foods can greatly help keep nausea down to a minimum.

Helpful Foods

4. Foods that tend to be helpful: Some foods are usually much easier to digest and less repulsive during early pregnancy than others. The following are some suggestions. Not all of these may appeal to you. Or you may find a particular food appealing on one day, but unappealing the next, or even very helpful during one pregnancy but not at all helpful during another. Experiment with different foods to find what best helps you get through this stage: Potatoes, most cooked vegetables, light soups, dairy products, fruits (either canned, fresh, or dried), crackers, bread, toast, fruit juices, soy products such as tofu or other vegetarian preparations, cooked dry beans, most grains such as rice, oatmeal, farina type cereals, pasta, and only very small amounts of high protein foods such as meats or peanut butter, and only small amounts of fats such as oil, butter, or margarine.

Eat Appealing Foods

5. Indulge yourself. Sometimes, even though most normal foods and odors seem repugnant at this time, you can think of one specific food that somehow seems unusually appealing. If this is the case, as long as it is something basically nutritious and not harmful, go ahead and indulge yourself. Even if it is something that your normal budget would not justify, such as a fresh fruit that is out of season, or some unusual, expensive item in a health food store, remember you will not be in early pregnancy forever. This is a special, unique time in your life, and it is worth a few extra dollars spent on some unusual item if that is really what will make you feel better.

Difficult Foods

6. Foods that tend to be difficult to digest: Again, the guideline is to go by how you feel. The following foods tend to be difficult for many women to eat during early pregnancy. (This has nothing to do with the nutritional value of these foods. If any of the foods listed here appeals to you anyway, and gives you no problem, by all means do continue to eat it): Nuts and seeds, eggs, raw salads, large amounts of meats or other high protein foods, large amounts of butter, margarine, oils, or mayonnaise, all greasy or fried foods, processed meats, rich meats such as pork or beef.

You may wish to experiment with what you can tolerate. For example a hard boiled egg might go down okay, while a fried egg may seem repulsive.

Avoid Unappealing Foods

7. Avoid any Food that seems particularly repulsive at this time.  Not infrequently a food which you normally like and which may be highly nutritious, such as peanut butter or eggs can seem particularly nauseating at this time. Even the thought, sight or smell of that food can seem repugnant. If this is the case, do not force yourself to eat it, or if possible, prepare it for others. If possible you may even wish to put the objectionable food away in the freezer or high shelf, or get rid of it until the nausea phase is over. Remember, early pregnancy really won’t last forever, and you should be able to put together a balanced diet for you and your baby out of foods that seem appealing or at least not very objectionable, and still avoid foods that seem particularly awful.

If Possible, Avoid Unappealing Tasks

8. Also, if possible, avoid any task that seems particularly repulsive or difficult. For example, if you absolutely cannot stand the prospect of going grocery shopping (not simply because it is a big chore, but because of the sight and odors of food in the market!) ask your husband or someone else to buy and put away the groceries until you have gotten over feeling nauseated. Ditto for preparing and cooking foods, (or at least working with certain types of foods.) If you live on a farm and normally milk the goat, but suddenly cannot stand the smell of the goat barn, get someone else to take over that job until you are feeling better, or even get rid of the goat, temporarily or permanently. If you work in a hospital and normally distribute food trays to patients and suddenly feel repulsed by the sight and smell of the food, get someone else to take over that particular job until you get past the nausea phase. If your co-workers are women who have been pregnant in the past, they should understand your feelings and be very cooperative and helpful.

Avoid Junk Food

9. However appealing, avoid candies and other sugary sweets and “junk” foods. Sometimes sugary things can seem particularly attractive during the first trimester of pregnancy, and some women are tempted to indulge on large amounts of candy or other sweets. Sugary foods do not directly harm the baby, but they are of absolutely no benefit to the baby either. An occasional piece of candy or cookie in addition to an otherwise nutritious, well balanced diet is not harmful. However, overindulging in candy or other sweets can be harmful.
They offer no nutritional value (except for calories) and therefore if too many of them are consumed they will deprive you of what appetite you may have for nutritious essential food, and can seriously deprive you and your baby of important nutrients. Sweets are high in calories, and can add a great deal of unwanted fat to your body. Also, feelings of depression and negativity are sometimes related to ones blood sugar level being low. When sweets are consumed, especially in the absence of other high protein foods, ones blood sugar can become quite high for a short time, and then will drop to a very low level. This can result in emotional depression, negative feelings, and consequent increased difficulty in coping with the nausea.

Fruit, eaten in moderate amounts, can help to satisfy a craving for sweets. Fresh fruit is best, as canned fruit usually has sugar added and dried fruit is extremely concentrated.

As another alternative to indulging in sweets, you may wish to try occasionally chewing a stick of sugarless gum, preferably one that is minty flavored. This can temporarily relieve your mouth of sour or bitter taste sensations and can also satisfy the craving for a sweet taste.

Emphasize Good Nutrition

10. Good nutrition is important! The baby and placenta are just beginning to develop right now, and all of the baby’s essential organs are forming at this time. Many birth defects involving deformities of the face, arms, legs, or internal organs happen during this very early beginning stage of pregnancy when these parts are just starting to develop. Often these defects are caused by disease, drugs, or inadequate nutrition.

However, huge amounts of food are by no means necessary because the beginnings of the baby and placenta are still extremely small. You do not need to eat any more food than normal during early pregnancy. If you are only able to eat very small quantities of food because of nausea, this will not harm the baby as long as you are consuming a basically nutritious diet. As was previously discussed, it is also most Important that you eat a highly nutritious diet before becoming pregnant. The very beginnings of the baby and placenta are made from nutrients from the blood in your uterus that would have been your period had you not become pregnant. That blood came from nutrients in the food that you ate several weeks and even months ago.

Don’t Restrict Calories

11. This is no time to go on a reducing diet!! Since the baby and placenta are extremely small during early pregnancy, very little weight needs to be gained during this stage, no more than 2 or 3 pounds (although some women do gain more due to fluid retention or overeating.) However, some women have a very difficult time eating during early pregnancy and may only maintain their weight or will lose some weight. Probably a small weight loss of only 2 or 3 lbs. will not harm the baby as long as the mother’s diet is nutritious and she is trying to eat as best she can. But occasionally women decide to take advantage of their lack of appetite at this time and lose a substantial amount of weight during early pregnancy. This is an extremely poor and often dangerous decision because the developing baby and placenta can be severely shortchanged of essential nutrients if the mother’s diet is sharply restricted. For this reason, no matter how overweight, no mother should attempt to lose weight during pregnancy.

Pregnancy is an excellent time to quit eating all the high calorie desserts, rich gravies and sauces, soft drinks, chips, etc., which do not benefit the baby and are almost always the cause of extra fat. If you eliminate these foods and eat a simple, balanced diet based on whole grains, protein foods, dairy products, fruits and vegetables, you and your baby should be in excellent health, and you should not gain an excessive amount of weight. (Normal weight gain during pregnancy is considered between 20 and 35 lbs. More than this is not dangerous. – I gained nearly 50 lbs. with my last three full term pregnancies. Weight gains lower than at least 20 lbs. can seriously deprive the baby and placenta of essential nutrients.)

 After the baby is born and you have fully recovered from birth, is an excellent time to lose any additional excess weight. If you breastfeed, this takes a great deal of extra calories. As your body makes milk for your baby, as long as you do not overeat, this can draw on your extra fat reserves and bring about a gradual weight loss over several months. Many nutritional authorities believe that the excess weight gained during pregnancy (beyond what comprises the baby, placenta, water, extra blood, etc.) is deliberately intended by nature to be an extra fat reserve for the mother to draw on when her body is producing milk for her baby. (In my own experience, I always gained quite a bit of weight during my pregnancies, but during the first several months of total breastfeeding, the extra fat went away without dieting or special measures. Breastfeeding is the only painless, hungerless method of weight loss that I know of.)

Avoid Alcohol, Cigarettes, Drugs, etc.

12. Avoid dangerous substances!! This is too important of a subject to leave out of any discussion of early pregnancy. Don’t drink alcohol – even if right now you might think that a drink or two might help you forget how awful you feel. Even moderate social drinking has been proven to be extremely dangerous to a growing baby.

By all means do not take up tobacco smoking. If you already are a smoker, there is no better time for you to quit. It has been proven that tobacco smoking is very dangerous for a baby, both before birth (through the mother’s bloodstream) and after birth (by breathing tobacco smoke contaminated air.) Studies have found that women who smoke have higher rates of miscarriages, premature births, small but full term babies, stillbirths, babies that die soon after birth, and babies that succumb to SIDS (sudden infant death syndrome). Also, babies living in households where one or both parents or other household members smoke are more likely to have breathing disorders or illnesses such as pneumonia. Therefore, if any household member smokes, and is unwilling to quit, have them restrict their smoking to outdoors, or to one area of the house which is away from where the baby will be.

If you smoke, ask your doctor or midwife to direct you to a good stop smoking clinic or program. For most people it is not easy to quit smoking, but doing so will be a wonderful gift to your baby by giving him or her the benefits of excellent health and unpolluted air.

Even if you do not smoke, make an effort to avoid anyone else’s tobacco smoke, especially if anyone else in your household is a smoker. The residual poisons from tobacco smoke in the air can also adversely affect you and your baby. (Other people’s tobacco smoke often can be a particularly repugnant odor for a woman in early pregnancy!)

You should, of course, not use any street drugs such as marijuana, amphetamines, cocaine, etc. as these too have been proven to be harmful to the baby.

Be extremely cautious about all medicines, whether by prescription or over the counter. Check with your health care provider or midwife before using anything, including simple remedies such as aspirin, antacids, laxatives, etc. If you need any type of medical treatment not related to the pregnancy, especially from another doctor who is not taking care of you for the pregnancy, make sure that he or she knows that you are pregnant. Also, unless you are in a life and death emergency situation, do not allow yourself to be x-rayed in your pelvic area during early pregnancy. If another part of your body needs to be x-rayed, such as your mouth for dental x-rays, make certain that you are given a lead apron to shield your uterus from any stray radiation. (Later during pregnancy, after the baby is more completely developed, radiation is less of a danger.)

Finally, the caffeine in products such as coffee, cola drinks, non-herbal tea, and chocolate, has been suggested to be related to birth defects and hyperactivity. These items should be avoided or at least used extremely sparingly during pregnancy. (I was a 6 lb. baby at birth, born three weeks early, and had a great deal of fussiness and digestive difficulties during the first few months of my life. My mother was a heavy coffee drinker, and I have often suspected that there may have been a connection.  – Of course I was also born in 1947 when people did not know very much about these things.) Coffee causes heartburn for many people, and can be difficult to get down during early pregnancy, even for women who normally enjoy coffee. Frequently the smell of coffee can be repulsive at this time. Therefore pregnancy is an excellent time to give up coffee and other caffeinated products, for the sake of your baby’s well being.

Herbal Remedies

13. Mild herbal teas, especially those based on mint or raspberry leaves can be especially soothing when warmed and sweetened with honey if desired. Some herbal tea companies sell blends especially designed for use during pregnancy. Most common, mild herbs that make flavorful beverages are not harmful. However, not all herbs are harmless. Some medicinal herbs such as cohosh, pennyroyal, and goldenseal should not be taken during pregnancy. Some publications on pregnancy and birth include information about herbs and their use during pregnancy and/or breastfeeding. Some midwives know quite a bit about herbal preparations and how they may be either harmful or beneficial during pregnancy. Some health food stores and shops that specialize in herbal preparations employ people who are experts on herbs and will readily give out advice. Be sure to consult an expert on herbs before using any unusual herbal preparation during pregnancy. (This is an area in which a medical doctor may not be highly informed.)

Liquids

14. Drink plenty of liquids, especially water, milk, fruit juices, and mild herbal teas. Nausea of early pregnancy is caused by hormones in the mother’s system. Drinking plenty of fluids helps to keep your body’s system cleansed, remove toxic wastes, and ultimately helps to rinse these hormones out of your system after your body manufactures them. Not drinking enough liquid tends to cause a backlog of the toxins in your system which leads to increased nausea.

Remember, of course, that soft drinks and synthetic punch type drinks are full of sugar and are much less beneficial, even though these are liquids.

By the way, it is completely normal to need to urinate frequently during early pregnancy. The small but growing uterus presses directly on the bladder. Also the hormones of early pregnancy have somewhat of a diuretic effect.

Vitamins

15. Vitamin supplements: Taking extra vitamins is especially important right now because all of the baby’s vital parts and organs are developing, but many nutritious foods seem unappealing. Virtually all doctors and licensed midwives will prescribe specially designed prenatal capsules, which are multiple vitamins usually made up of synthetic vitamins. Some people prefer to take organically based vitamins on the belief that they are more healthful and contain other unknown nutrients that synthetic vitamins, made from chemicals in laboratories may not have. Considerable debate surrounds the “organic vs. synthetic” vitamins controversy, as well as whether or not supplementary vitamins are necessary at all. (The human race has survived perfectly well for thousands of years before vitamins were recognized or put into pills during the early 20th century!) Nonetheless, almost all health care providers do recommend vitamin supplementation during pregnancy, and most will not object if you choose to take an organically based multiple vitamin or other type of vitamin supplement instead of traditional prenatal capsules.

Remember, during pregnancy, as well as at any other time, vitamin supplementation is not a substitute for eating nutritious foods. In most cases, they are simply a back up insurance in case all nutrients are not being obtained from a normal diet. In fact, some authorities contend that almost all nutrients necessary for a healthy pregnancy can be easily obtained from a normal, nutritious diet, except for iron, and perhaps calcium. During pregnancy and breastfeeding the baby’s bones are forming rapidly, hence the need for calcium. Also during pregnancy a great deal of new blood must be formed for the baby and placenta to grow properly. Also the mother’s blood supply itself increases considerably. The iron content of your blood is one of the things that is checked for when your blood is taken during the first prenatal visit. If your blood count is low your doctor or midwife will advise you about additional iron supplementation.

Vitamin B Complex

16. B Vitamins: You may wish to take an extra vitamin supplement that is high in the many different B vitamins (in addition to your regular multiple vitamins.) Many nutritionally oriented books which give advice for pregnancy recommend extra supplementation of B vitamins, particularly vitamin B6, to help alleviate the nausea of early pregnancy. (In fact, synthetic vitamin B6 [pyridoxine hydrochloride] was one of the ingredients in Bendectin, the prescription medication used for nausea of early pregnancy for years, which was taken off the market during the 1980’s.)

The B vitamins should be taken together to work most effectively. (Undoubtedly extra B vitamins are beneficial to one’s overall health. However, they never seemed to effectively relieve nausea for me.)

Hint: While a single vitamin B capsule is virtually tasteless, the odor coming out of a bottle full of B vitamins can be overwhelming! Open the bottle as far away from your face as possible so as not to get a whiff of them!

Ginger

17. Ginger capsules: This is an ancient folk remedy that has recently enjoyed new popularity. Ginger can effectively  curb nausea (both during early pregnancy and from other causes such as motion sickness.) Powdered ginger can be purchased in the spice department of any grocery store. Normally it comes in a small 2 oz. can or jar and you may need several. Some stores sell it in bulk or in larger containers.

Empty gelatin capsules can he purchased in most health food stores, or from most pharmacies. The capsules are in two pieces that pull apart, and then can be filled with ginger. (I used a tiny plastic spoon that came with a child’s dish set to fill the capsules.)

Normally one should take the ginger capsules one or two at a time. They are not a drug, and therefore can be taken as often and in as great of an amount as desired without harm to the mother or the baby. However, taking three or more at a time can cause heartburn. Usually ginger capsules, taken with a small amount of water or juice are most helpful shortly after a meal or between meals.

Mint Toothpaste

18. Brush your teeth as frequently as desired, preferably using a mint flavored toothpaste. Frequently nausea of early pregnancy is accompanied by a bitter, sour, or otherwise unpleasant taste in the mouth and simply brushing your teeth will greatly relieve this.

Pamper Yourself

19. Indulge yourself in some nice personal item. It is easy to feel dragged out and tired from the nausea and abrupt physical changes of early pregnancy. The baby’s birth can seem like a million years away. Buying something special for yourself can greatly help lift your spirits. This need not be anything expensive. Bubble bath, stationary, cosmetics, some small trinket, kitchen item or a new pair of shoes can be a welcome present for yourself.

Maternity Clothes

20. If you face normal expectations of carrying the pregnancy to term, go ahead and buy or make some maternity clothes. It can be fun to think and plan for the future and you will be wearing them sooner than you realize. Even if you already have maternity clothes saved from your last pregnancy, you may wish to treat yourself to at least one or two new items.

Baby Clothes and Other Items

21. Similarly, go ahead and buy or make things for the baby. Knit some booties, sew some night gowns or embroider some bibs. If you don’t know how to sew or do other needle crafts, this might be a good time to learn. Many community education schools, and fabric or craft stores offer beginning and advanced classes in sewing and other handicrafts. Sewing and needle crafts can be fun and money-saving as well.

Making or buying things for the baby helps keep you positively focused on the future. Even if you already have a supply of clothes and other items left over from your last baby, you will probably want a few new things that are special for this baby.

If you wish to paint or refinish furniture for the baby or paint the baby’s room, this should be done by someone else or delayed until early pregnancy is over. The fumes from the paint will probably seem especially bothersome right now when most unusual odors produce nausea. Also toxins in paint fumes may be harmful to the developing baby.

Read

22. It is not too soon to begin reading books and articles about pregnancy, birth, babies, and breastfeeding, particularly if this will be your first baby. There are so many books, periodicals, and other articles available on these subjects that you could read them constantly throughout your entire pregnancy and not have even begun to read them all. Books and other publications such as these can be purchased from book stores, borrowed from friends, checked out of the public library, borrowed from childbirth educators, midwives, or La Leche League groups.

Do become aware and questioning of what you read (or hear from others.) Some publications are overly supportive of tradition and/or established medical practices without presenting thorough information or awareness of all options.

“Early Bird” Classes

23. Early Bird Classes: Most people know about natural childbirth or prepared childbirth classes that expectant mothers and/or couples take to prepare themselves for the actual birth. These usually meet once a week for about 8 weeks, and in most cases should not be taken until you are in the last 2-3 months of pregnancy. However, many communities also offer early bird classes, which usually last only 3-4 weeks, and are to be taken during the very early weeks of pregnancy, even as soon as the pregnancy is diagnosed. Classes such as these usually include simple exercises, nutritional information, helpful ideas for coping with the early weeks of pregnancy, and planning for the rest of your pregnancy, birth, and baby. Your doctor, midwife, birth center, or hospital should be able to direct you to an early bird class if they are available in your community.

Early bird classes are an excellent opportunity to meet new friends and share ideas with other people who are experiencing pregnancy. If classes like this are not available where you live, consider discussing the matter with your local childbirth educators, alerting them to the need for this type of instruction. If possible, consider helping them set up such a program.

La Leche League

24. La Leche League: Leche is Spanish for milk. La Leche League is an organization which began in the 1950’s and today has many thousands of groups all over the world. Their purpose is educating expectant and new parents, the general public, and the medical profession about breastfeeding. Local La Leche League groups usually meet once a month in someone’s home. The meetings usually include only women and babies (because many new nursing mothers may feel self conscious nursing their babies in front of men that they do not know.) However, many groups do have special fathers’ nights as well.

The meetings are informal and fun and are an excellent opportunity to meet and share experiences with other expectant and nursing mothers. By attending La Leche League meetings you can learn a great deal about the art of breastfeeding. (Nursing a baby is normally very easy. However there still are many things you should know that will help make the experience more enjoyable and successful for you and your baby.)

You can attend La Leche League meetings during any stage of pregnancy, or even before you become pregnant. You may attend meetings as frequently as you wish after your baby is born and you may continue to attend meetings after your baby is no longer nursing.

La Leche League’s philosophy includes principles such as nursing the baby totally in accord with his or her needs with no regard to fixed schedules or limitations, no supplementation with bottles of any kind (except in emergencies), introduction of solid foods at around the middle of the first year (between 5 and 8 months), and gradual weaning in accordance with the baby’s or toddler’s needs. (At La Leche League meetings you may see babies who are older than one or two years who are still nursing.)

However, most La Leche League mothers are open and understanding of other peoples needs and preferences, and will allow you to learn and decide which of these choices are right for you. You are most welcome at La Leche League meetings even if you do not plan to do everything according to their philosophy, or even if you are not certain if you wish to breastfeed at all.

La Leche League also has frequent one day workshops, conventions, local picnics and get togethers, for additional information and enjoyment. La Leche League has specially trained leaders who may be contacted by phone at any time to answer your questions or help you with any special needs that pertain to breastfeeding. They also have a specially appointed medical advisory board and are able to recommend doctors and other professionals who are more likely to be especially knowledgeable and supportive of breastfeeding. (Be aware that not all doctors give helpful or supportive advice about breastfeeding.)

La Leche League has a newsletter and several books and information sheets which are supportive of their philosophy.

Sometimes La Leche League announces their meetings in local newspapers or has listings in phone books. Or you can probably find out how to contact them through your local childbirth educator, doctor, midwife, hospital, or birth center. They can also be contacted at their international headquarters: La Leche League, International, 9616 Minneapolis Ave. – Box 1209, Franklin Park, IL. 60131-8209, U.S.A. Telephone: (312) 455-7730. Their website is  http://www.llli.org/resources.html .

Being Busy Helps

25. Keep busy. During early pregnancy the time can seem to drag, and the prospect of the baby’s birth can seem an eternity away. Boredom and inactivity are the worst possible situations for your state of mind. It is most important that you stay involved in interesting activities. This will help you keep up good spirits and take your mind off of how tired or nauseated your may be feeling. If you have an outside job, of course this will occupy much of your time. If you are at home by yourself or with other children, keep your free time occupied with interesting reading, sewing, writing, artistic pursuits, movie viewing, or social activities. If you wish, take a class in something you’ve always wanted to learn. If you are confined to bed during part or all of your pregnancy, have your husband or other helpers supply you with interesting reading material, hand sewing, knitting, crocheting, or interesting movies to watch.

A new baby, however wonderful, is extremely time consuming, leaving you temporarily with little time for extra activities. Therefore, enjoy your free time right now for such pursuits.

Finally, however much you may love babies, and however awe-inspiring you may find the entire pregnancy-birth-new baby experience, do not allow every activity you pursue, article you read, or thought that you think center solely on pregnancy, birth, or babies!! (I have probably tended to be more guilty of this than anyone!) It is very easy for some women during the years that they are pregnant or have babies to allow all of their interests and activities to be based on these subjects alone. While it is important to learn all that you can, and to totally love your babies, it is also essential to keep a balance in one’s life. There is still another “world” out there that is not filled with pregnancy and babies. Remember also that babies all too quickly turn into children, and then teenagers, and eventually adults Although you will not always have a baby, you will always be your child’s (or children’s) mother, and they will have very much different types of needs during the different stages of life. For some women who have been unusually absorbed in the pregnancy and babies scene, there can be a big void in their life if they do not allow themselves to grow as well as their children grow older.

(I have addressed this, in part, because I have been unusually baby crazy. However, there are many women who find babies very difficult and not all that enjoyable, but have found much more pleasure in being mothers to their older children, teenagers, or adult children.)

Exercise May Aggravate Nausea

26. Exercise. Unless there is a medical reason that you should not exercise, all physical activities and exercises that you are already accustomed to can be continued during the first few months of pregnancy. (This is not, however, a time to begin a new, strenuous exercise program or sport if you have been inactive before!) Some women are able to continue active exercising, athletic activities, running, or other strenuous work throughout their entire pregnancies. However, most women find as their uterus enlarges during later pregnancy and they become more tired, that they can only continue with mild or moderate exercises without difficulty. If you are active in any particular type of sport or other unusual physical activity, be sure to consult your doctor or midwife about the advisability of continuing it as pregnancy advances. And of course, go by how you feel when attempting any type of activity. Do not allow yourself to become exhausted. If what you are doing feels too strenuous, stop doing it.

During early pregnancy when you are experiencing nausea, some types of exercises, particularly those involving the mid-section, such as sit-ups and trunk twists can, for some women, tend to stir up the digestive organs too much and can greatly aggravate nausea. These types of exercises are not normally harmful to the pregnancy or the baby, but if they increase nausea they are not worth continuing. In the near future, as your uterus gets large with advanced pregnancy, you will be physically unable to do those types of exercises anyway. Forget your waistline and midsection for now and enjoy your new shape! Save the trunk twists and sit-ups until after the baby is born!

Fresh Air

27. Get fresh air. Talk a walk in the fresh air, or try to get outside to garden or just sit and relax whenever possible. Sometimes just the stale air and odors that are inside a house or other building can be depressing. Simply breathing fresh air can greatly relieve nausea and will help you feel considerably better.

Sleep

 28. Get extra sleep. If possible try to take a nap every day, or whenever you can. Sometimes bustling around and being continually busy for several hours can cause nausea to increase. Also, many women feel particularly tired during early pregnancy and find that they need more sleep than usual. Sometimes napping, or just lying down and relaxing for a while can help your inside organs to settle down, thus greatly relieving nausea.

No Pregnancy Lasts Forever

29. Remember this won’t last forever. As was previously stated, the general pattern of nausea of early pregnancy is for it to begin at around 6-7 weeks, be at its strongest at around 8 or 9 weeks, and then gradually diminish after that until it is completely over by around the 15th or 16th week of pregnancy. Although these weeks can seem to take forever when one is in the middle of it, the nausea phase actually normally lasts for about 8-10 weeks in all, and usually is extremely difficult for only about 2-4 of those weeks.

After this phase is over, for most women the middle trimester of pregnancy (from around 12-13 weeks to around 26-27 weeks) is the most enjoyable stage of all. The fatigue and nausea of early pregnancy goes away. She begins to show – to outwardly appear pregnant to the rest of the world – and to feel the baby move (usually at around 18 to 20 weeks.) Most women feel a greatly increased amount of energy and positiveness at this time.

Then for most women, the final trimester (from around 27-28 weeks until full term birth at around 40 weeks) although welcome because each day brings the birth of the baby closer, becomes more difficult in a different way as the enlarged uterus becomes increasingly heavy and uncomfortable.

Deal With What is Right Now

30. Stay in present time. For many women, understandably, while experiencing nothing but fatigue and nausea during early pregnancy, the advice that “it won’t last forever” offers little comfort. To be told at 8 weeks that she should be over her nausea “in another 6 weeks” can seem extremely discouraging. It can seem like “centuries” before she will be in middle or late pregnancy. The birth or baby itself can seem a total unreality. Therefore this is a good time to cultivate the extremely helpful personal discipline of “staying in present time.”

Often a woman in early pregnancy can become overwhelmed when she thinks about how bad she has been feeling for the past few weeks, and how she may have several more weeks of the same ahead of her before it’s over. Added to this may be memories of how nauseated she may have felt during one or more previous pregnancies. Therefore, she is tripling her problems by dealing not only with her presently existing nausea, but with past nausea and future nausea as well. Chances are, if she concentrates on dealing with only what is happening in the present, apart from memories of the past and worries about the future, her present state may actually not be so bad. This is an important philosophy to apply to all facets of life, particularly during challenging times (For Biblical scripture reference, please see Matthew 6:34. This concept is also prevalent in Eastern spiritual practices.) Many natural childbirth advocates use this same type of philosophy for dealing with labor contractions.

Be Positive

31. Keep a positive attitude. This can make more difference in how you feel than anything else, and may be the reason why some women do not experience nausea of early pregnancy at all or only have it very mildly. Feelings of depression, self-pity, negativity, fears about the pregnancy, birth, your readiness for motherhood, or other things that are going on in your life, especially problems with your other children, or stresses in your relationship with your husband or partner, all can greatly increase the nausea feelings. Attitudes of cheerfulness, peacefulness, positiveness about the pregnancy, baby, your role as a mother, and about life in general can greatly minimize or even totally eliminate nausea.

Pregnancy is a time of stress and tremendous physical and emotional adjustment in life for all women. It is normal to occasionally feel at least concerned, if not worried about the outcome of the pregnancy, your ability to be a good mother, the addition of another child to your family, or other unrelated things in your life. But don’t allow yourself to get into a vicious circle of feeling depressed and guilty because your are nauseated, and therefore becoming even more nauseated because you are feeling so down and rotten. Also, remember that even severe nausea has no relationship to your mothering ability or ability to bond with your baby. Certainly millions of perfectly healthy, beautiful, much loved babies first began life with their mothers going through these horrible weeks of nausea.

However, not everyone can make herself cheerful no matter how much she is told that that is the way she should be. Sometimes depression can he extremely difficult to crawl out from under. If you are particularly weighted down with feelings of negativity and depression, and simple measures such as those listed here (like finding interesting things to do) are of no help, you should obtain professional and/or spiritual help in coping with whatever is bothering you.

c.1987 (Revised – 2013)