Early signs of pregnancy: first-trimester checklist

In short

• Start or continue folic acid, and keep taking it through pregnancy.
• Book your first prenatal visit as soon as you know, and sooner if you have bleeding or pain.
• Bring a full list of medicines, supplements and herbal products to discuss with your provider.
• Avoid alcohol, tobacco and drugs, and limit specific foods that carry infection risk.
• Learn the urgent warning signs and seek care immediately if you have any of them.

What to do in the first days

1. Book prenatal careCall your provider and set up your first visit. At that visit, providers typically review your health and family history, check blood pressure and weight, order routine blood and urine tests and set your due date.
2. Take folic acidThe CDC says folic acid is the type of folate shown to help prevent neural tube defects, serious birth defects of the brain and spine. It is recommended for anyone who could become pregnant, starting before pregnancy and continuing through it. If a previous pregnancy was affected, talk with your doctor first.
3. Write down everything you takeList prescription medicines, over-the-counter products, supplements and herbal remedies, and check before starting or stopping any of them.
4. Stop alcohol and tobaccoTobacco, alcohol and drugs can harm the fetus. Ask your provider for help if stopping is hard.
5. Note the first day of your last periodYour provider uses it to set your due date.

Food: what to limit

• Raw or undercooked meat, and undercooked eggs.
• Unpasteurized milk products, and soft cheeses unless they are thoroughly cooked.
• Liver, which is high in vitamin A.
• Raw fish and raw shellfish, and swordfish, shark and marlin because of mercury. The FDA also lists king mackerel, orange roughy and bigeye tuna among fish to avoid.
• Alcohol, which the NHS says can cause long-term harm to your baby.
• Caffeine, which should stay within the limit your provider or the NHS recommends. High intake is linked to a higher risk of miscarriage and stillbirth.

Listeria can be found in unpasteurized dairy, cold cured meats and prepackaged sandwiches and salads, and it can cause miscarriage, stillbirth or serious illness in a newborn. A small amount of something you should not have eaten is unlikely to harm your baby if you feel well, but call your provider if you are worried or become unwell after eating.

Morning sickness: what helps

1. Eat small, frequent, plain mealsFoods high in carbohydrate and low in fat, such as toast, crackers, rice or pasta, are easier to tolerate.
2. Choose cold foodsIf the smell of hot food bothers you, cold food has less smell.
3. Avoid triggersStay away from foods and smells that set off nausea.
4. Sip fluids regularlyRegular sips may help prevent vomiting.
5. Try ginger and restGinger foods or drinks may help. Check with a pharmacist before taking ginger supplements, and rest, since tiredness makes nausea worse.

Morning sickness usually improves by weeks 16 to 20 and does not harm the baby. If these steps are not enough, a provider can prescribe a short course of an anti-sickness medicine that is safe in pregnancy. Severe cases, called hyperemesis gravidarum, may need injections, suppositories or hospital care.

What to expect and when to call

Symptoms differ a lot from one pregnancy to the next. Some people feel sick for weeks, others hardly at all, and how strong your symptoms are does not by itself show how the pregnancy is going. Ask your provider at the first visit what is expected for you.

Call your provider the same day if you are vomiting and have very dark urine, cannot keep food or fluids down for 24 hours, feel weak or dizzy when you stand, have abdominal pain or a high temperature, see blood in the vomit or are losing weight.

Activity

Moderate activity such as walking, swimming and yoga is fine for most pregnancies and counts toward the recommended weekly activity. A simple check is the talk test: you should be able to talk but not sing.

Avoid contact sports and activities with a risk of falling or being bumped, such as hockey, rugby and mountain biking. Avoid scuba diving, do not start new vigorous activities, and do not exercise on an empty stomach.

Medicines

Check with your provider before starting or stopping any medicine, because some can be harmful. Never stop a prescribed medicine on your own, since stopping can also harm you and your baby. Not all herbal and homeopathic products are safe in pregnancy.

If you took something before you knew you were pregnant, do not panic. Tell your provider what you took and when, and they will assess it.

Red flags: when to seek care now

Red flags: seek medical care immediately, and call 911 for severe symptoms, if you have any of the CDC's urgent maternal warning signs. These include vaginal bleeding beyond spotting, fluid leaking or foul-smelling discharge, severe belly pain that does not go away, dizziness or fainting, trouble breathing, chest pain or a fast or irregular heartbeat, and severe nausea and vomiting with no fluids staying down.

Also urgent are a headache that will not go away or gets worse, changes in vision, a fever of 100.4 degrees Fahrenheit or higher, extreme swelling of the hands or face, severe swelling, redness or pain in an arm or leg, and thoughts of harming yourself or your baby. Say that you are pregnant when you call.

Questions for the first visit

• Which folic acid and prenatal vitamin should I take?
• Are my current medicines safe, or do any need to change?
• Which tests and screenings are coming, and when?
• Which activity is right for me?
• What can I use for a cold, a headache or heartburn?
• When should I call you, and when should I call 911?

Questions and answers

Sources

1. CDC — About folic acid
2. CDC — Urgent maternal warning signs
3. MedlinePlus — Prenatal care
4. NHS — Vomiting and morning sickness
5. NHS — Foods to avoid in pregnancy
6. NHS — Exercise in pregnancy

Sources checked on 29 October 2026.