By Leigh Farmer

The first trimester of pregnancy can be a thrilling time for a family. The anticipation of welcoming a little one can come with lots of smiles and celebration. However, it can come with a lot of anxiety, too. There are so many choices that need to be made. Your pre- and post-natal healthcare should be at the top of the list.

Meghan Noonan, lead certified nurse midwife at VCU Health, says taking care of yourself and making sure you kick any vices or bad habits is a great way to jump start a healthy pregnancy.

“Once you get that positive pregnancy test, take a look at your own health and your own health decisions,” Noonan said. “Feel comfortable and feel like you can really ask those questions, whether they feel silly or not. And if you don't find what you're looking for, feel empowered to look for a different provider. Really advocate for yourself and what you need during this time.”

On the Healthy with VCU Health podcast, Noonan discusses some of the choices a newly pregnant person must make in their first trimester and how to navigate those options with limited anxiety and maximum excitement.

Listen to Healthy with VCU Health's episode on the decisions you make in the first trimester of pregnancy

Choosing whether to deliver with a midwife or OB-GYN is a key decision you make in the first trimester. But are you locked into this decision, or can you change your mind?

You can absolutely change your mind, and I really encourage you to be an advocate for your own health. If you don't feel like you're getting what you need from a care team or provider, seek out other options. We are fortunate that as midwives working at VCU Health, we practice with a collaborative group of physicians, both generalists and high-risk pregnancy specialists. Often people start with a midwife, but sometimes complications arise, and they need to transfer care. And fortunately, those doctors are right down the hallway so it’s a smooth transition. This access to resources and specialists allows our team to provide personalized patient-centered care.
There are many reasons why people might switch back and forth between seeing a midwife and seeing an OB-GYN. It could be related to a medical complication, or it could just be personal choice. You may decide that you want to explore a low intervention pregnancy approach; we encourage you to meet with one of our midwives to learn more.

What are some other big decisions you make in the first trimester of a pregnancy?

A lot of the focus of the first trimester is caring for yourself and sometimes just surviving the early pregnancy symptoms. One of the biggest decisions is often related to genetic testing. Your provider will talk with you about the different options available and whether you're at increased risk for any reason – maybe related to age or family history.

Your own health is also a big consideration during your first trimester. Often, it's a time when many people decide, “You know what? I'm going to kick that smoking habit for good now that I have not just myself to think about, but this growing baby that I really want to care for.” Focusing on making good nutrition choices – lots of great protein, lots of fruits and vegetables, cutting out alcohol, and cutting down on caffeine consumption – is important.

What can you expect to learn during your first appointment?

The first appointment is usually longer than most. We really want to get to know you. We want to get to know about your history. Have you had medical problems in the past? Have you had surgeries in the past? Are you taking any medications? We'll talk about your family - are there any known genetic conditions that that perhaps we can talk about screening for?

We might also start that discussion of what are you looking for? Some people come in and say, “Hey, I really know I want to see a midwife or I really know I want to work with this provider.” But for a lot of people, that first pregnancy test opens the door to many possibilities. We might talk a bit about what the options are and what might be the best route given your needs and preferences.

We often recommend doing some routine tests. The standard panel of blood work and urine tests looks for infection, checks for things like anemia and your blood type, which can affect some of the recommendations in your pregnancy. There may also be an ultrasound, or an ultrasound may be recommended later, depending on if we need to find out how far along you are.

Then we'll talk about the plan going forward. There is sort of a standard schedule for prenatal care, but some people may need more than that. We start making that plan with you during the first appointment, so you have a better idea of what to expect for the next 8 to 9 months.

What other advice do you have for new moms during their pregnancy journey?

I always recommend you come to your appointment with a list of questions -there are no dumb questions. Find a provider with whom you can ask all your questions. We have a good range of OB-GYN’s midwives and nurse practitioners for you to choose from. We are partners in creating the birth plan you want.