Early pregnancy care

What to expect in the first trimester

The first trimester of pregnancy is a critical period of development. It spans from conception to 12 weeks and involves rapid changes for both you and your baby.

• Weeks 1–4: the fertilized egg implants in the uterine lining. You may not notice any changes yet.
• Weeks 5–8: the embryo’s organs begin to form. You might have morning sickness, fatigue and breast tenderness.
• Weeks 9–12: the fetus is now fully formed. Symptoms may continue, and you might start to show a small baby bump.

Common symptoms and how to manage them

• Morning sickness: eat small, frequent meals, and avoid spicy or greasy foods. Ginger tea and vitamin B6 supplements may help. If this is not helping, Ginger Gravol or a prescription for Diclectin will help with the nausea and vomiting. If you take Diclectin, you must take it consistently for it to be effective. If you would like a Diclectin prescription, please ask your Primary Care nurse.
• Fatigue: rest as much as possible, and maintain a balanced diet.
• Breast tenderness: wear a supportive bra and avoid heavy lifting.

Prenatal appointments and tests

Regular prenatal care is crucial for monitoring your health and the development of your baby.

• Initial appointment (6–8 weeks): confirm pregnancy, discuss medical history, and schedule your first ultrasound.
• First trimester screening (10–13 weeks): blood tests and a nuchal translucency ultrasound to assess the risk of certain genetic conditions. This testing is not completed with your fertility care team, but with your GP or OB after discharge from the clinic. It is important that you connect with your GP or OB to make sure this testing is ordered and completed within this time frame.
• Managing pre-existing conditions: if you have any pre-existing medical conditions, such as diabetes or hypertension, it is important to manage them closely with your healthcare provider to ensure a healthy pregnancy.

Nutrition and diet

A balanced diet is vital for your health and your baby’s development.

• Essential nutrients: we will advise you to take a prenatal vitamin with 1 mg of folic acid. Prenatal vitamins also include iron, calcium and DHA to support a healthy pregnancy.
• Foods to avoid: raw or undercooked seafood, deli meats and unpasteurized dairy products. Limit caffeine to 1 cup a day.

Exercise and physical activity

Regular, moderate exercise can benefit both you and your baby.

• Recommended activities: walking, swimming and prenatal yoga.
• Activities to avoid: high-impact sports, contact sports, and activities with a risk of falling.

Coping with anxiety and stress

It is normal to feel anxious during early pregnancy. Here are some strategies to help manage stress:

• Relaxation techniques: practise deep breathing, meditation or prenatal yoga.
• Stay informed: knowledge can reduce anxiety. Attend prenatal classes and read reputable pregnancy books.
• Seek support: talk to your partner, family or friends about your feelings. Consider joining a support group for pregnant women.

Your care in our Early Pregnancy Program

Here is what to expect once your care has been transferred into our Early Pregnancy Program (EPP).

What happens after my first positive hCG test?

After your first positive pregnancy test, you will be asked to repeat another pregnancy test in 2–3 business days to ensure the hCG level is rising appropriately. At the same time, we will also check estrogen, progesterone and TSH to ensure these hormones are in the normal ranges for pregnancy.

Depending on your prior treatment plan, you may already be on estrogen and progesterone supplementation. These medications may be continued, adjusted or weaned off under the direction of your Primary Care Team.

If you are already on thyroid medication, please be sure to tell your team. This may be continued, adjusted or weaned off under the direction of your Primary Care Team.

What happens after my second positive hCG test?

If your second pregnancy test is rising appropriately, you will be scheduled for your first obstetrical (OB) ultrasound around 7 weeks of pregnancy at the clinic. Your physician will review the results and advise your next steps.

What happens at the OB ultrasound?

Your OB ultrasound will be a pelvic and transvaginal ultrasound. This requires a full bladder: please drink 4–5 cups of water about an hour before your appointment. The ultrasound technician will scan your pelvic area. Once completed, you will be asked to empty your bladder and then a transvaginal ultrasound will be performed. The purpose of this ultrasound is to confirm the viability of your pregnancy and to measure your baby’s size and heart rate.

Can my support person be in the room?

You are allowed to have one support person with you during the ultrasound.

Do I continue medications started by my fertility physician?

If applicable, you will also complete blood work for estrogen, progesterone and TSH to ensure they are in the normal ranges for your pregnancy.

If you are already on estrogen and progesterone supplementation, most patients will likely continue up to 10 weeks of pregnancy. Your Primary Care Team may also advise you to adjust your dose or wean off, if appropriate. Always follow your Primary Care Team’s instructions.

If you are on thyroid replacement, you will continue even after discharge from our care. Your prenatal care team (OB or midwife) will continue to monitor this throughout your pregnancy.

If you are on any other medications not noted here, please tell your Primary Care Team and they will advise you.

OB referral

You will be advised to see your GP for an obstetrician (OB) referral. We will send a letter to your GP with relevant test results, so that they can include it with your referral.

If you wish to use a midwife, you do not need a referral. You may contact the midwife directly to begin prenatal care. Please share your midwife’s information with us so that we can send relevant pregnancy results to their office.

How long am I under your pregnancy care?

Depending on your pregnancy, we will discharge you at 7 or 8 weeks of pregnancy. If you have questions or concerns, you will be under our care up to 10 weeks of pregnancy.

After discharge from our care, your OB or midwife will take over your pregnancy care. If you do not have an OB or midwife at discharge, your family physician will take over care until your OB or midwife begins care, which typically happens around weeks 12–14 of your pregnancy.