The first thing to do when you find out you’re pregnant is schedule a prenatal appointment. From there, pregnancy involves a series of practical changes to how you eat, move, and care for your body over the next nine months. Most of these changes are straightforward once you know what they are.
Schedule Your First Prenatal Visit
You should book your first prenatal appointment as soon as you get a positive test. At this visit, your provider will draw blood for a panel of screening tests that check for infections like hepatitis and HIV, confirm your blood type, and look for conditions like anemia. You’ll also provide a urine sample.
All pregnant women are offered genetic screening to check for conditions like Down syndrome and spinal cord defects. One common screening combines an ultrasound measurement of the back of the baby’s neck with a blood test. A newer option, called cell-free DNA testing, analyzes tiny fragments of the baby’s genetic material found in your blood. These are screening tools, not definitive diagnoses, so your provider will walk you through what the results mean and whether further testing makes sense.
Start a Prenatal Supplement
The World Health Organization recommends pregnant women take 400 micrograms of folic acid and 30 to 60 milligrams of iron daily. Folic acid is critical for preventing neural tube defects in the baby’s brain and spine, and it’s most effective when started as early as possible, ideally even before conception. Iron supports the significant increase in blood volume your body undergoes during pregnancy and helps prevent anemia. Most prenatal vitamins cover both of these, but check the label to confirm the amounts.
Foods to Avoid
Pregnancy weakens parts of your immune system, making you more vulnerable to foodborne bacteria like listeria and toxoplasma. Several foods carry higher risk:
- Deli meats and hot dogs unless heated until steaming. Cold cuts straight from the package are a common source of listeria.
- Raw or undercooked meat, poultry, fish, and eggs. This includes sushi, sashimi, ceviche, and runny eggs. Homemade Caesar dressing, raw cookie dough, and homemade eggnog also contain raw egg.
- High-mercury fish: shark, swordfish, king mackerel, and tilefish. Other fish and shellfish are fine and encouraged in moderate amounts for their omega-3 content.
- Soft cheeses like queso fresco, brie, camembert, and blue cheese, especially if made from unpasteurized milk. Hard cheeses and pasteurized soft cheeses are generally safe.
- Unpasteurized milk, juice, and cider.
- Refrigerated smoked seafood (labeled as lox, nova-style, or kippered) unless it’s in a cooked dish.
- Raw sprouts like alfalfa and bean sprouts, which can harbor bacteria even when washed.
Wash all fresh fruits and vegetables before eating them. Don’t leave cut melon sitting out for more than two hours, or one hour if it’s above 90°F. And skip raw flour products: raw dough and batter can carry harmful bacteria on their own, separate from the egg risk.
Caffeine and Alcohol
Limit caffeine to 200 milligrams per day. One standard cup of brewed coffee contains about 137 milligrams, so you can safely have roughly one and a half cups daily. Keep in mind that tea, chocolate, energy drinks, and some sodas also contribute to your total. There is no established safe amount of alcohol during pregnancy, so the standard guidance is to avoid it entirely.
Exercise During Pregnancy
Staying active is one of the best things you can do. The goal is at least 150 minutes of moderate-intensity aerobic activity per week. That’s about 30 minutes on most days. Walking, swimming, stationary cycling, and prenatal yoga all count. If you were active before pregnancy, you can generally continue your routine with some modifications.
Avoid lying flat on your back for extended periods, especially as your pregnancy progresses. In that position, the weight of the uterus presses on a major vein that returns blood to your heart, which can make you feel dizzy or lightheaded. Also avoid standing completely still for long stretches. Contact sports and activities with a high fall risk (skiing, horseback riding) are worth setting aside until after delivery.
Healthy Weight Gain
How much weight you should gain depends on your pre-pregnancy BMI. The recommended ranges for a single baby are:
- Underweight (BMI under 18.5): 28 to 40 pounds
- Normal weight (BMI 18.5 to 24.9): 25 to 35 pounds
- Overweight (BMI 25 to 29.9): 15 to 25 pounds
- Obese (BMI 30 to 39.9): 11 to 20 pounds
For twins, the numbers are considerably higher. A woman at a normal weight carrying twins would aim for 37 to 54 pounds. Most weight gain happens in the second and third trimesters. Your provider will track your weight at each visit, and small fluctuations from week to week are normal.
Vaccines You’ll Need
Three vaccines are recommended during pregnancy, each timed for a specific window:
- Whooping cough (Tdap): Given between weeks 27 and 36, preferably toward the earlier end. This passes protective antibodies to the baby before birth, since newborns are too young to be vaccinated themselves.
- Flu shot: Recommended by the end of October if your pregnancy overlaps with flu season. Pregnancy increases your risk of severe flu complications.
- RSV vaccine: Available between weeks 32 and 36 during September through January. Alternatively, your baby can receive RSV immunization directly after birth during their first RSV season.
Medications to Be Cautious About
Many over-the-counter medications have not been well studied in pregnant women, so lists of “safe” options online can be misleading. Even acetaminophen (Tylenol), long considered the go-to pain reliever during pregnancy, has come under closer scrutiny. Some studies have found an association between chronic use throughout pregnancy and neurological conditions in children, though a direct cause has not been confirmed. Occasional use for a headache or fever is a different situation than daily use for months.
The safest approach is to review every medication, supplement, and herbal product you take with your prenatal provider. This includes things that seem harmless, like sleep aids, allergy pills, and herbal teas. Some common medications that are fine when you’re not pregnant can affect fetal development at specific stages.
Reducing Chemical Exposures at Home
You don’t need to overhaul your entire life, but a few simple swaps reduce your exposure to chemicals that can cross the placenta. Choose personal care products labeled “fragrance free” rather than “unscented,” since unscented products often contain chemical mixtures designed to mask odors. When possible, avoid products listing phthalates, parabens, oxybenzone, or triclosan in the ingredients.
In the kitchen, heat food in glass or ceramic containers instead of plastic. Avoid storing food in pewter, brass, or lead crystal. Cut back on fast food when you can, since the packaging often contains chemicals that can leach into the food. For cleaning, simple combinations of vinegar and baking soda handle most household tasks, or look for products labeled nontoxic.
Warning Signs That Need Immediate Attention
Most pregnancy symptoms are uncomfortable but harmless. A few, however, signal something that needs urgent evaluation. Contact your provider or go to the emergency room if you experience any of the following:
- Vaginal bleeding heavier than light spotting, or fluid leaking from the vagina
- Severe headache that won’t go away, gets progressively worse, or comes on suddenly with intense “thunderclap” pain
- Vision changes like flashing lights, bright spots, blind spots, or blurry or double vision
- Extreme swelling in your hands (enough to make it hard to bend your fingers) or face (enough to make it hard to open your eyes)
- Fever of 100.4°F or higher
- Severe belly pain that is sharp, stabbing, or cramp-like and does not resolve
- Decreased fetal movement once you’re far enough along to feel regular kicks
- Trouble breathing, chest tightness, or a fast or irregular heartbeat
- Severe nausea or vomiting that prevents you from keeping down any fluids
- Leg pain with swelling, redness, or warmth, particularly in one calf, which may indicate a blood clot
- Thoughts of harming yourself or your baby, extreme hopelessness, or overwhelming anxiety
These symptoms don’t always mean something is seriously wrong, but they overlap with conditions like preeclampsia, placental problems, and blood clots that require prompt treatment. It is always better to call and be reassured than to wait.