First Trimester Essentials: Weeks 1–13 Checklist

The first trimester is a time of huge change, most of it invisible. Your baby's major organs are forming, and your body is working overtime even before you have a bump. This guide covers what to expect in weeks 1–13, which appointments to book, and the small things that make these weeks easier.

A quick note: every pregnancy is different. Use this guide as a starting point and follow the advice of your own doctor or midwife.

What's happening

• Weeks 4–8: the neural tube (which becomes the brain and spine) closes, and the heart begins beating. Cardiac activity can often be seen on an ultrasound around 6 weeks.
• Weeks 8–13: arms, legs, fingers and toes form, and by the end of the trimester your baby is about the size of a lemon.

Common symptoms

• Nausea and vomiting ("morning sickness," which can strike any time of day). It often peaks around weeks 8–10 and eases for most people by weeks 14–16.
• Deep tiredness, thanks to rising progesterone.
• Tender, swollen breasts and darker areolas.
• Needing to pee more often, food aversions and a heightened sense of smell.
• Mild cramping or light spotting can be normal, but always mention bleeding to your provider.

Your first-trimester to-do list

1. Start (or keep taking) a prenatal vitamin with at least 400 mcg of folic acid. See our prenatal vitamins guide.
2. Book your first prenatal visit. It's usually around 8–10 weeks and often includes a dating ultrasound, blood tests (blood type and Rh factor, blood count, infection screening) and a urine test.
3. Review every medication and supplement you take with your provider, including over-the-counter ones and skin care.
4. Ask about genetic screening options. Cell-free DNA blood tests can be done from about 10 weeks, and a nuchal translucency ultrasound is done between about 11 and 14 weeks. These are optional; your provider can explain what each one does and doesn't tell you.
5. Get your flu shot if it's flu season. It's recommended in any trimester.
6. Check your insurance and how your plan covers prenatal care and delivery.

Easing nausea

• Eat small amounts every 2–3 hours so your stomach is never empty.
• Keep plain crackers by the bed and eat a few before you get up.
• Try ginger (tea, chews or capsules) and cold, bland foods, which tend to smell less.
• Sip fluids between meals rather than with them.
• Ask your provider about vitamin B6, alone or with doxylamine. It's a common first step for pregnancy nausea, but check the dose with them first.

Call your provider if you can't keep fluids down for 24 hours, you're losing weight, you feel dizzy, or your urine is very dark. Severe vomiting (hyperemesis gravidarum) is treatable and you don't have to tough it out.

What to avoid

• Alcohol, smoking, vaping and cannabis. There's no known safe amount of alcohol in pregnancy.
• Hot tubs and saunas, since overheating is a concern especially in early pregnancy.
• Cleaning the cat's litter box (toxoplasmosis). Ask someone else, or wear gloves and wash your hands well.
• Raw or undercooked meat, fish and eggs, unpasteurized dairy, and high-mercury fish. Our healthy meals guide has the full list.
• More than 200 mg of caffeine a day, about one 12 oz coffee.
• Retinoid skin care (retinol, tretinoin). See our skin care guide.

Movement and rest

If your provider says it's fine, aim for about 150 minutes of moderate activity a week, such as brisk walking, swimming or prenatal yoga. On the hard days, rest is productive too: go to bed early and nap when you can.

First-trimester essentials checklist

• Prenatal vitamin with folic acid (and iodine, choline and DHA if possible)
• Ginger chews or tea, and plain crackers
• A large water bottle you'll actually carry
• A soft, supportive wire-free bra
• A notebook or app for appointment questions and dates
• A fragrance-free body cream. Starting a gentle belly routine early keeps skin comfortable as it begins to stretch.

When to call right away

• Heavy bleeding (soaking a pad), or bleeding with strong cramps
• Severe or one-sided belly pain, or shoulder-tip pain
• Fever of 100.4°F (38°C) or higher
• Pain or burning when you pee
• Fainting or severe dizziness

More in our pregnancy guide

• Second trimester essentials (weeks 14–27)
• Third trimester essentials (weeks 28–40)
• Hospital bag checklist
• The fourth trimester: postpartum essentials
• Healthy meals and fruits · Prenatal vitamins · Pregnancy skin care

This article is for general information only and is not medical advice. Always talk to your doctor or midwife about your own pregnancy.