You’re pregnant! Congratulations! Maybe you’ve been trying for a long time, or maybe you’ve been taken completely by surprise, but either way, there’s a lot to do! We’ll trust you to handle the fun stuff like shopping and showers; here’s the low-down on the logistics:
First Trimester (conception through week 13)
The first trimester is all about making sure your body is a good one to live in for both you and your baby. It can be tough to keep up with it all, especially when common early pregnancy symptoms make doing healthy stuff like eating well and exercising really hard. Just remember that small steps are bigger than no steps, and even small victories are victories! Places to begin:
- Pick up something to use to record information and ideas throughout your pregnancy. You don’t need the fancy baby book just yet, though. Just start with a notebook and use it to keep track of anything you experience: test results, things you want to ask your doctor about, ideas for names, etc.
- Start taking a prenatal vitamin, if you aren’t already. Even if you’re just a few weeks along, there’s already some crucial development going on in the nervous system, and it’s important to have adequate amounts of things like folic acid to make sure this development gets off on the right track. This is important for most pregnancies, but especially so if your diet doesn’t have a good variety of fresh fruits and vegetables. If you’re just planning to get pregnant, it’s a good idea to start taking your prenatal vitamins before you start trying. If you’re not sure what you need, your doctor or pharmacist can point you in the right direction.
- On that note: start trying to eat well. You probably don’t feel too great, either because the nausea has set in or because you’re exhausted, and both of those things make getting a balanced diet difficult, but do your best. Eat frequent small meals to keep your stomach calm (having an empty stomach makes the nausea worse) and try to make those snacks the healthiest thing you can tolerate. If the healthiest thing you can tolerate is “well, plain toast has grains in it, right?” don’t worry, but do your best.
- If you’ve been smoking, drinking, or consuming other drugs, it’s time to work on quitting. If you’re worried you won’t be able to do it on your own, talk to your doctor or an addiction center for a plan that you can stand by. Try not to worry if you were doing any of these things for several weeks before you found out you were pregnant. Just know that the sooner you quit, the more you reduce your chances of harmful side effects for you and your baby.
- Exercise: Birth is hard work, and apart from that, recent studies have shown that regular exercise, even if not especially rigorous, leads to better birth outcomes and healthier babies. If you’re new to this, chat with someone about working out a healthy and realistic exercise plan throughout your pregnancy. Your medical caregiver is a goodplace to start, but other options include nutritionists, personal trainers, or workout instructors, as long as their practice specializes or has some training in pregnancy (ask for credentials, though—there are special considerations for different stages of pregnancy, and it’s important that whoever gives you advice knows what they are).
- Doctors, Midwives, and other Medical Care: regardless of where you live and what kind of birth attendant you’re planning to have, you’ll probably need what’s known as confirmation of pregnancy to start going through the next “official” steps, like getting a provider referral, handling insurance, and getting services if you need them. Your family doctor or general practitioner can usually do this, but if you don’t have one, any walk-in clinic should also be able to help. If you’re worried about the cost, sliding-scale clinics like Planned Parenthood offer reduced fees to uninsured patients (in both the US and Canada) and may even be able to provide your early prenatal care while you look for an OB or midwife. Your first prenatal visit may also involve a pelvic exam and PAP smear, a breast exam, and some blood work to test for STIs and other potentially harmful conditions. If you need a referral for other providers, they can usually offer this as well.
- If your usual doctor doesn’t provide maternity care or you’re hoping to work with a midwife or other provider, you’ll need to start looking right away. This is true whether you’re planning on an OB, a family doctor, or a midwife. In some areas, people find themselves wait-listed even when they’ve started making contact in the first weeks of their pregnancies, so don’t put this off, especially if you’re looking for care from a practice that’s in high demand or want to give yourself more than one option. This is especially true if you’re seeking midwifery care.
- Find out what your insurance will cover in terms of prenatal care, your birth, and postpartum. You may need to add to your current plan to get full pregnancy and birth coverage, which can take time. If private insurance isn’t for you, find out what your options are for government-funded prenatal and birth care. In most cases, having some amount of coverage will save you money on the overall costs.
- See the dentist, especially if you’ve had dental concerns prior to pregnancy. Pregnancy can weaken your teeth, so good dental hygiene and regular check-ups are especially important during and just after pregnancy.
- If you know you're going to take a prenatal class, don't worry about taking it at a specific time in your pregnancy. Although some programs ask you to wait until a particular point in your pregnancy, if you feel like you need more information now, look for a class you can take now. Knowledge matters, and there is no wrong time.
Second Trimester (weeks 14-26)
The second trimester tends to be the easiest on the symptoms front for most people, so take a breath and catch up! Once you've gotten a few good meals down and are feeling a bit more energetic, it's time to tackle the next set of tasks:
- If you haven’t already, start researching your birth options. Pick up a few books and start thinking about the kind of birth you’d like to have. Ask your friends if they have any favorite books or if they had a prenatal class they just loved. If you aren’t sure where to start, I highly recommend books by Penny Simkin, Ina May Gaskin (especially if you’re hoping for an unmedicated birth) and Ann Douglas (who writes good guides in both US and Canadian editions). Unless you’re very comfortable with the medical model of birth, skip the What to Expect books. They’ve got good information, but tend to assume you have a doctor that you trust completely, which doesn’t suit everyone.
- Consider meeting with a financial adviser—this may be a service provided by your bank, or you can find a private adviser. They will help you set up your budget to make sure you save enough to get through on reduced incomes during parental leave, help you redistribute your existing income to meet the expenses of a new baby, or discuss how having a baby will fit into your other plans for your financial future. This can be a stressful step, and it’s one most people put off, but in the end you’ll probably be better off with some professional advice.
- Talk to your employer about parental leave plans as soon as you feel comfortable (if you're worried, know that it's usually best to tell them before someone else does), and look into your government-provided options for leave and benefits. Now is the time to figure out the timeline for applying for benefits, even if you don’t have to do the actual applications for a while.
- If you’re planning to hire a doula, start looking now. This will give you time to interview several options and plan together, as well as leaving some flexibility if you are worried about costs. You generally want to finalize these plans sometime near the end of the second trimester or beginning of the third.
- Start thinking about your birth plan. It’s perfectly ok to start with a checklist to guide you through your research and information-seeking phase, but your final document should be more personalized. Talk about your plan with all members of your birth team, including your medical caregiver. Include some details about what you’d like to have happen if your plans change: how you might make a cesarean a better experience, for example, or what accommodations would make it better for you if your planned home birth needs to be transferred to the hospital. Discuss these plans with your team, as well.
- If you are living abroad or your baby will have dual citizenship, contact your embassy or consulate for information about this process. It is often time-sensitive, and if you don’t live near the embassy, you may need to plan for a visit.
- Find out what you need to do to set up your baby’s health insurance, whether government-issued or private. Some plans cover baby’s first few weeks of well-baby care under your coverage; others require baby to have their own coverage once you’ve left the birth site.
- If you're having a home birth, ask your midwife or doula for advice on finding supplies. Either or both of them may have some items they can provide, but most of the time, you'll need to stock up on at least a few supplies, and if you're hoping for a water birth, you may need to arrange a tub rental. Give yourself plenty of time!
Third Trimester (week 27-birth)
You've made it to the home stretch! You're probably getting ready to meet your baby, but there's still just a little left to do:
- If you haven’t taken a prenatal class yet, do it now. If you’re going with a private prenatal class, arrange a tour of your birth location or your backup location, if you’re planning a home birth. You don’t want the first time you walk through the doors to be when you’re in the midst of labor. If a traditional class doesn't suit you, know that there are options for online classes, individualized classes, and other options, but I strongly advise against neglecting this important step. Even if you're perfectly content to go along for the ride and do what your caregiver thinks is best, knowing what to expect makes a big difference. A good prenatal educator will take input from the class on what their information needs are and will help make sure they're met. As an added bonus, keeping in touch with other members of your prenatal class means you'll have a built-in group of parents who are going through the same stages you are. That support will be important later on.
- Make your postpartum plan. Talk about it with your partner, family members, and other supportive roles. Build up your network, and talk with family and friends about who can help you and how they can help. Consider tools like MealBaby or the services of a postpartum doula, nurse, or other support person, and make a list of resources in your area that you can turn to for support if you have issues. Key points for this are breastfeeding (both peer and professional support options), 24-hour nurse hotlines for help with questions, a few support options for if you face postpartum mood disorders, and support for any special needs you anticipate you or your baby might have after the birth. Tack the list of phone numbers, websites, and/or email addresses on the fridge to have handy if you need them.
- Find a pediatrician for your baby. If you already have a family doctor, they may also be able to take on your child. If not, you’ll want to look for a pediatrician or a family doctor soon. Many states and provinces have systems in place to help connect you to providers. Also ask your pregnancy caregiver if they have any advice.
- Talk to your provider about your finalized birth plan, and update it as needed if anything changes in your pregnancy. Leave a copy to be kept with your records, and have extra copies on hand to take with you to the place of birth. Even if you are planning a home birth, it’s good to be prepared in case you need back-up care.
- Get your car seat installed properly so it's ready when you need it. If you're not sure about your installation, have it checked. There are many local resources for this. Consider baby stores (the store where you bought the seat might be a good option), public health and safety offices, or even your hospital. If they don't have seat check programs of their own, they can almost certainly refer you to somewhere that does.