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Pregnancy: How To Survive Your First Trimester

For some women, it feels like the longest 12 weeks of their lives.

28/09/2017 7:07 AM AEST | Updated 28/09/2017 7:19 AM AEST
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What you don't see is this same woman bent over a toilet bowl in 2-3 weeks time.

For many women, the first trimester of pregnancy is the hardest. The side effects have the potential to be fairly extreme (around the clock nausea, anyone?), not to mention the emotional adjustment of realising you're going to be a parent.

On top of all that, lots of people choose not to tell anyone they're pregnant until they hit the 12-week mark, so they can't even bemoan their ailments to co-workers or friends.

It can be an exciting, daunting, revealing, trying and lonely time all at once, and for some people it seems like those three long months will never end.

So in order to help you through your first trimester woes, HuffPost Australia spoke to obstetrician and senior clinical research fellow in the Pregnancy Research Centre at The Royal Women' Hospital, Penny Sheehan, about what to expect and how to cope.

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Morning sickness

Probably the most well-known of early pregnancy side effects, morning sickness can present as nausea and/or vomiting and, unlike its name suggest, can strike at any time.

Women may also find themselves super-alert to certain smells (good and bad) and that they have turned off foods they normally enjoy.

"Sometimes if you're getting that nausea but you don't want to broadcast [your pregnancy], you can try nibbling on dry crackers and things," Sheehan told HuffPost Australia. "Trying to keep your stomach always with a little bit of something in it -- that can really help.

"If you're not in a job where you can [snack all the time], taking your morning tea much more seriously might be a way to do it."

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Welcome to your new lunch.

It's also recommended women stay hydrated (if you can't handle water, dry ginger ale or flat lemonade may help) and attempt to eat smaller meals more often.

Also, if something's making you feel sick? Avoid it.

"In terms of nausea and the relation to smell, if the smell of, say, cooked food getting to you, then don't cook," Sheehan advised. "If you have really gone off certain foods, avoid them."

The good news is, for most women, Sheehan says the nausea should settle by 12 - 14 weeks.

"There is a group of women where it may persist, but that's only about five to 10 percent," she said. "And even for the worst ones, it's only a very small number -- one percent or so -- where the nausea goes on all pregnancy."

Tender breasts

This may be one of the first signs a woman is pregnant and can be surprisingly painful.

"Breast tenderness can actually be quite alarming for some women," Sheehan said. "Even from as early as six weeks, and especially the first time, you can have very, very sore breasts.

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You're going to want a comfortable bra.

"I remember a friend saying her husband just brushed against her breasts and she was like, 'Ahh! That really hurts!'"

Sheehan's tip?

"Swap to softer bras or an old bra that might be a bit stretched. They might be a bit more soothing."

Fatigue

This is another symptom which can really bowl women over in their first trimester, and can also prove problematic to women who work full-time or already have young children to manage.

"For this you just need to make sure you're going to bed really early and getting as many naps as you can," Sheehan said. "That feeling of dead tiredness sets in at about eight to 10 weeks and it's important you make sure you get enough sleep in that patch.

"Have naps on the weekend, go to bed earlier, and make sure you get your full eight hours at least. It may not help with that sluggish feeling but we can try."

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Be prepared to be tired. Very tired.

The good news is, like nausea, the fatigue should ease as the pregnancy progresses.

"Most of the time, the tiredness is a feature of the hormone changes of the first trimester," Sheehan said.

"About the 18-20 week mark you should be feeling like you have a bit more energy again."

Bleeding

While this can't really be classified as a 'normal' side effect, that's not to say it's not common in plenty of women during pregnancy.

"A lot of women do experience a little bit of bleeding which is terribly common, and often doesn't mean anything about the pregnancy," Sheehan said.

Particularly for women who have had miscarriages before, the first trimester can be a time of terrible anxiety.

"As every case is different I don't want to say to anybody, 'This is what's happening', but if you do have any degree of spotting, I do advise rest. No one has evidence it improves the outcome but it helps, I believe, should you go on to miscarry, at least you can think, 'I did everything I could'. It helps with the grief."

While Sheehan went onto say in most cases light bleeding is not likely to be an issue, if you are concerned, seek the advice of a medical professional as soon as possible.

All the emotions

Aside from all the lovely new pregnancy hormones flooding through your body, for many women, the fact they are pregnant may take some getting used to.

"There is potentially the shock of dealing with the fact of something that was a theoretical possibility is now becoming a real possibility. I can't tell you how many people start renovating and moving house and things like that," Sheehan said.

"Honestly, so many women end up in the third trimester saying 'but my bathroom's not quite ready yet!'"

Sheehan also notes some groups -- namely older women, those who have been trying for a long time or those who have miscarried before -- may also experience anxiety surrounding their pregnancy.

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Initial feelings of excitement may give way to anxiety, particularly for those with high risk pregnancies.

"Particularly for women who have had miscarriages before, the first trimester can be a time of terrible anxiety. Combined with the fact they don't want to tell anyone just yet, it can be a really difficult time for them," Sheehan said.

"They can be suffering quite a lot in relative silence. Any degree of spotting can send them into quite a panic."

In this situation, Sheehan recommended seeing if it is possible to have regular appointments -- every week if necessary -- to put the woman's mind at ease.

"That is one of the managements for recurrent miscarriage, to make sure everything looks okay," she said.

"Though this in turn can throw up some difficulties like time away from work, and reasons for coming away from work so often."

Decisions, decisions

In between all the nausea, fatigue and emotional rollercoaster-ing, there's actually quite a few vitally important decisions that need to be made in the first few months of pregnancy.

"Quite aside from the physical challenges, there are lots of other little things like all the scheduling you have to do," Sheehan said. "You have to get in for the early testing and also have the discussion about what kind of screening you'll like to do."

For instance, some women may elect to have a non-invasive prenatal test in order to find out whether there's a high risk of their baby being affected by a genetic abnormality. Not only is the decision to proceed with this test highly personal, because as the test is not available with Medicare, it's a costly exercise which some families may not be able to afford.

Older women or those with higher risk pregnancies may opt for further diagnostic tests which are sometimes invasive and can carry a small risk of complications, including miscarriage.

"These are all things that can take time and effort and shouldn't be taken lightly," Sheehan said.

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