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Breast tenderness, morning sickness, fatigue, frequent urination, acne and emotional ups and downs are among the common symptoms of the first trimester of pregnancy, those first six to 14 weeks.

In fact, breast tenderness is typically one of the first pregnancy symptoms, says Dr. Jason Rubin, a family medical practitioner at Snoqualmie Valley Hospital in Washington. “Increased hormones in your bloodstream, estrogen and progesterone, send a signal for your breasts to begin swelling and growing as your body begins preparing for nursing,” he says. “Blood flow increases and the milk ducts mature.” Other breast symptoms may include the areola darkening in color, and the veins becoming more pronounced, Dr. Rubin says. “All women are familiar with the nausea and vomiting of pregnancy, otherwise known as ‘morning sickness,’‘’ Dr. Rubin says. “It tends to occur early in the day, but it can happen anytime as well.”

Fluctuating hormone levels are the culprit, as they stimulate the nausea centers of the brain. Another overwhelming symptom is fatigue, again due to rising pregnancy hormone levels and rapidly dividing cells in the developing embryo, says Dr. Shelley Binkley, an OB/GYN practicing in Glenwood Springs, Colo., and author of DIY Baby: Your Essential Pregnancy Handbook (iUniverse, 2008). “These hormones peak at 12 weeks gestation and then drop off,” she says. “The fatigue usually improves at 14 to 16 weeks gestation when the hormone levels come back down.” As hormones fluctuate during those first weeks, expect an emotional rollercoaster ride, Dr. Binkley says.

In addition, many newly pregnant women feel an increased need to urinate frequently. “About 10 to 20 percent of pregnant women complain of increased frequency of urinary urge,” she says. “This is due in part to the enlarging uterus pressing on the bladder.”

Acne is yet another common symptom of the first trimester. “Approximately one-third of women will experience an increase in facial acne lesions, which are also caused by fluctuating levels of estrogen and progesterone,” Dr. Rubin says.

During both of her pregnancies, Dr. Rubin’s wife, Annette, faced uncomfortable symptoms. Twenty-four-hour nausea, involving “aroma-sensitivities,” and pregnancy-onset acne sum up her first trimester experience. “With my first pregnancy, the vomiting was much more severe,” says Annette Rubin, who found bad odors often triggered vomiting. “I often wondered whether or not I would survive. I would often think – and occasionally complain aloud – ‘I am so sick and tired of being sick and tired!’‘’


Easing the Symptoms
It’s no wonder you’re sick and tired in the first trimester. “An entire formed fetus develops during the first three months of pregnancy from a mere sperm and egg,” Dr. Binkley says. “Although the baby gains the most weight during the last three months of pregnancy, the first three witness the most dramatic organ formation.”

There are steps you can take to ensure you’re taking care of yourself and your growing baby. “Don’t be surprised if you get home from work every day and want to take a two-hour nap,“ Dr. Brinkely says. “Indulge yourself. And don’t use your weekends trying to catch up on all of the house cleaning or activity you missed during the week. Listen to your body, and if it tells you to sleep – sleep!”

To help with your urinary urges, drink a lot of water to prevent bladder infection, Dr. Binkley says. This also may help to ease the “urgent” feeling. To relieve breast discomfort, make sure you buy bras that fit your changing size and shape, Dr. Rubin says. Avoid underwire bras that can dig into your skin. “For additional relief, try soaking in a warm bath, or applying a cool, wet cloth across your chest,” he says. “Most breast tenderness will improve after the first trimester.”

To minimize morning sickness, try eating smaller and more frequent meals. “Crackers and toast are usually well tolerated, but you may have to experiment to find which foods work best for you,” Dr. Rubin says. “The scent and taste of lemon and peppermint are known for their ability to sooth nausea and upset stomach.” Your physician also may consider prescribing an anti-nausea medication, Dr. Rubin says.

Talk to your doctor immediately if vomiting becomes severe or persistent or is associated with dizziness or weakness. Annette Rubin found it was helpful to suck on lemon or peppermint drops and slowly drink white soda. “I had a much better chance of keeping a meal down if I ate small portions and kept the food bland,” she says. “My favorite meal was white rice and maybe a bit of chicken.” She also massaged lemon-scented hand lotion on her hands. “The aromatherapy of lemon would often keep the vomiting at bay,” she says.

For acne, try gentle, effective cleansers. Look for those with pregnancy-safe ingredients, such as lactic acid. “The good news is that in most cases, pregnancy acne tends to clear up after the first trimester,” Dr. Rubin says. “If your symptoms are particularly severe, you should speak to your dermatologist, who may be able to recommend prescription antibiotics or other treatments.”

Annette Rubin used an acne-clearing facial wash, along with a facial brush introduced by her aesthetician. “The combination of the wash and facial brush has kept most of the breakouts under control,” she says.


She worked to keep her emotional ups and downs under control as well. “Emotionally with my first pregnancy, I was excited and anxiously awaited the day I would get to meet our son,” says Annette Rubin, who grew up in a large family of seven. “I was unsure of what to expect and was a bit nervous but still confident. I had assumed I already knew everything a girl would need to know regarding how to care for a baby. I can now humbly admit I had a lot to learn.”

Today Annette Rubin is nearly 5 months pregnant with their second child and is dealing with different emotions. “I found myself in a sea of emotion ranging from not wanting to be pregnant, questioning my abilities to be a good parent to two children, and wondering how it would change my relationships with my husband and son, who will be 8 when the baby is born,” she says.

Their enthusiasm and support quickly melted away her feelings of uncertainly, and renewed her desire to take care of herself and her baby. “I analyze not only what I eat but what I use on my skin topically,” she says. “I want to give my baby the best chance at a healthy start, and that begins in utero.”

Tips to Care for Your Growing Baby
It’s important to keep in mind that during the first trimester, the tiny fetus goes through the critical stages of early development, which includes formation of the brain, spinal cord and major organ systems. “To give your baby every chance at success, you should try to provide the very best possible growing environment,” says Dr. Jason Rubin, a family practitioner in Washington. How can you accomplish this in your early pregnancy?


Dr. Rubin provides the following tips:

• Take your daily prenatal vitamin with folic acid. This has been shown to decrease the risk of neural tube defects.

• Make sure you avoid dangerous chemicals, such as alcohol, nicotine and other drugs. Emerging research studies on caffeine show that as little as one to two cups of coffee per day can lower the baby’s birth weight and possibly increase your risk of miscarriage.

• Be careful of which chemicals you apply to your skin. Small amounts of topical ingredients are absorbed into your bloodstream where they can easily reach the growing fetus. Many commonly used ingredients have remote links to birth defects in published studies.

• Developed by Dr. Rubin, Belli Pregnancy skincare products offer one way to help women guard against harmful and even questionable ingredients. He’s a member of the Teratology Society and Teratology Information Specialists. Teratology is a rapid-screening system for adverse affects on the fetus. For more information, visit



Tips for easing morning sickness, breast tenderness, and other commons symptoms.

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