At the end of my lengthy post on getting pregnant after an infertility diagnosis, I promised a recap of my first trimester. Here it is!
After getting a positive pregnancy test on a Sunday morning in mid-April, I called my reproductive endocrinologist’s office first thing on Monday morning. When my hormones were tested a couple of months before getting pregnant my progesterone was extremely low, and adequate levels of progesterone are necessary to sustain a pregnancy. They had me come right in for a blood test measuring HcG (the hormone that confirms you’re pregnant) and progesterone. The results came back later that day: my HcG was 330 (pretty much any level of HcG means you’re pregnant) and my progesterone was 8. The nurse explained that my progesterone level was on the lower end of the normal range, so they wanted to supplement just in case. I was prescribed progesterone pills that I took until I was about 10 weeks, when the doctor said the placenta takes over progesterone production.
(As a note, most doctors will not test for progesterone or even HcG in early pregnancy–pregnant women are often told they don’t need to see the doctor at all until they’re 8 or 10 weeks along. However, if you have had fertility issues or miscarriages, your doctor may want to do these tests and if not, maybe you can convince them to!)
They also had me come back in for another blood test a few days later so they could see if my HcG levels were rising adequately (they should double in about two days in early pregnancy). When it’s still too soon to see anything on an ultrasound, rising HcG levels are one of the best indicators that a pregnancy is progressing normally. The precise level of HcG does not matter as much as the rate at which it’s increasing. I actually can’t remember exactly what my second HcG reading was, but it had more than doubled, so things were looking good. I set up an ultrasound appointment for May 3rd, when I would be about 6 weeks pregnant. Any sooner than that and there’s just not much, if anything, to see!
During those first few weeks, my main pregnancy symptom was extreme fatigue (although I also experienced breast tenderness). I remember coming home from work extra tired a few days before I even realized I was pregnant and falling asleep on the couch right after dinner. This exhaustion was different from anything I’d experienced before–it was constant, and although I felt like there was no end to how much I could sleep, no amount of sleep made me feel any more rested. If I had free time in the afternoon, I could nap from 2-5 PM and still be ready to go to bed around 10 (and sleep til 8 or so the next day). This exhaustion lasted for the whole first trimester and even a bit beyond–it wasn’t until around 17 weeks that my energy began to return. I’m still not quite back to pre-pregnancy energy and productivity levels, but I’m much closer than I was before.
Ben and I were both super anxious waiting for that first ultrasound appointment. Miscarriages are very common in early pregnancy, and may be especially common in women with fertility issues. The morning of the appointment, I woke up to something very disconcerting: spotting. Bleeding during pregnancy is very common (about 1/3 of women experience it), but it can also mean you’re miscarrying. I was so glad we were already planning to see the doctor that day so I wouldn’t have to wait to get checked out. The bleeding was not super heavy (nothing close to a period), but it did get a bit worse in the hours before our ten AM appointment. By time we left, I was distraught, and spent the drive to the doctor’s office fighting back tears.
Luckily, we got good news once we arrived! The ultrasound showed an embryo (just a little circle at this point) and they could already detect a heartbeat. The doctor could see where there was some subchorionic hemorrhaging (bleeding near the embryo), but said that since it was not all the way around and there was a good heartbeat, things would probably be fine. She prescribed pelvic rest (no sex) until the spotting stopped. As part of the ultrasound, they measure the embryo and a due date is automatically calculated based on its size. She told us ours was Christmas Day!
I experienced spotting one more time a little over a week later, so I went back in for another ultrasound. The heartbeat was still good and the baby was growing appropriately. I’m now 22 weeks and haven’t had any spotting since (crossing my fingers I’ll continue to be free of it!).
Other than excessive napping, my first trimester was characterized by lots of cravings for ice cream and baked goods. Initially I just wanted cake and ice cream (together) all the time, and was dreaming of being invited to lots of birthday parties. Then I experienced successive cravings for croissants, muffins, and chocolate chip oatmeal cookies. For weeks 11-12 we were on our very belated honeymoon in Europe, so it was easy to get my fill of croissants and delicious sweets.
During our honeymoon, I began drinking coffee again. I had been caffeine-free for about 10 months as part of my fertility diet (you can read about the changes I made to get pregnant here). Coffee is often thought of as taboo during pregnancy and some studies have shown that excessive coffee consumption early on can increase miscarriage risk, but other studies have shown no association. Most sources seem to say that it’s fine to have one or two (or perhaps even three) cups of coffee a day. Since I was close to the end of the first trimester and already sad about having to miss out on all of Europe’s great wine, I started indulging in a bit of caffeinated goodness. Usually I would order a latte and drink about half of it, then give the rest to Ben. This worked well because one whole latte was a little much for me and not quite enough for him, so he’d order his own and also polish off some of mine.
Toward the end of the first trimester, I also started experiencing some heartburn. At 21 weeks, this has not gone away. I’m having a hard time noticing patterns in terms of which foods might make it worse, but eating right before bed and eating spicy food definitely seem to be triggers. Since the heartburn started around when I began drinking coffee again the two may be related, but I tend to get more heartburn later in the day, not in the morning after my coffee. I haven’t taken any heartburn medicine–it’s usually just mild to moderate, so I wait it out.
I also got some terrible migraines during the first trimester (so far, thankfully, these seem to be much rarer in the second trimester). I’ve always gotten migraines, but they became more frequent and more difficult to treat since my go-to painkiller, ibuprofen, is not recommended in pregnancy. I found an ice pack held to my head and neck provided some relief, but I often just had to lie down and wait for the headache to go away.
The last notable pregnancy symptom of my first trimester was extremely vivid dreams (these have continued, although I don’t think I have them quite as often as I used to). I occasionally dreamed about pregnancy, childbirth, and babies (nothing helpful for gender prediction, though–I dreamed once that I was having a boy and once that I was having a girl). Most of my dreams were just the everyday sort, but more detailed and surreal. I sometimes had dreams in which nothing was going right (in one, I forgot that I was supposed to pick up my dad at the airport until an hour after his flight landed. Before leaving I had to feed the cat and turn off the music, but the cat was injured in a ditch and the CD player was jammed and would not turn off). I had one dream in which I’d given birth to boy-girl twins and was getting started with breastfeeding, and the girl was having trouble latching. This dream was so vivid that I woke up feeling like I knew what breastfeeding was like!
I am lucky because I experienced virtually no nausea. At least, no spontaneous nausea–I did notice that I became carsick more frequently (only when others were driving and especially in the backseat) and gagged more easily when swallowing pills and brushing my teeth. I also became nauseous if I went hungry for too long. That’s something that’s always happened to me, but I seem to be more susceptible to it while pregnant. I did not vomit once (in fact, I haven’t vomited in over five years–hope I’m not jinxing myself by saying that! I’ve just never been a person who throws up frequently).
Do you have any questions about my first trimester experience? Was it similar to or different from yours? I’d love to hear from you in the comments!