First Trimester Checklist: What to Do After That Positive Pregnancy Test

Last Updated: February 16, 2024
Liesel Teen, RN-BSN

By Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

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Are you wondering what to do after that positive pregnancy test? Looking for a first trimester checklist to put your mind at ease during these next 12 weeks? Well, mama, you are in the right place!

First of all, if no one has said it yet, let me be one of the first to give you a BIG congratulations! A positive pregnancy test comes with A LOT of emotions. Maybe this was something you’ve been hoping and praying for, maybe it was a bit of a happy accident, or maybe it’s a surprise you’re still processing.

But in any of these cases, there are definitely some first trimester checklist items that will set the stage for a healthy, happy, and less stressful pregnancy!

I know in these early weeks a lot of you might be keeping your pregnancy quiet. And that it can also be a time that’s filled with some anxiety and uncertainty. My hope is that this checklist will help you gain a little bit of control in a time that can feel like everything is left to chance. And that it can serve as a distraction when those first trimester symptoms hit, too.

Most of all, I’m so happy you’re here! And so honored to be a part of your pregnancy journey – right from the start!

Ready to dive in? Let’s do this!

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1. Review the dos and don’ts of pregnancy

I always like to remind pregnant mamas that they are not ill or sick. For the most part, you can go on living your life just like you did before you were pregnant, just with a few tweaks and safety precautions in mind. Since your pregnancy is so new, it’s a good time to familiarize yourself with some of the dos and don’ts of pregnancy.

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Of course, there are some aspects to this that will be unique to your situation that you should discuss with your provider, but here I put together a list that covers most of the basics:

  • Start taking a prenatal vitamin ASAP if you aren’t already
  • Stop drinking alcohol and using any recreational drugs
  • Quit smoking
  • Call your provider to find out about the safety of taking any prescription medications you’re currently taking
  • Don’t eat raw or undercooked meat
  • Don’t eat raw or undercooked fish
  • Don’t eat deli meat (your provider may say this is okay if you microwave it first)
  • Skip any unpasteurized dairy products (this is mostly just imported cheese and raw milk products)
  • Limit your caffeine intake. Research suggests consuming up to 200mg (or 1-2 cups of coffee per day) doesn’t pose a risk to your baby
  • Start focusing on your nutrition if you are feeling well enough
  • Continue with your usual exercise routine if you are feeling up to it
  • Start an exercise or activity routine if you weren’t active before (it’s a great time to get motivated!)
  • Don’t use a hot tub or sauna
  • Avoid any activities that may cause trauma to your abdomen such as horseback riding, jumping on a trampoline, etc.
  • Avoid fish with high mercury levels like shark, swordfish, mackerel, and some kinds of tuna. But DO eat fish high in omega-3s like salmon

Phew! While that list may seem like a lot, when you break it down, the lifestyle changes aren’t too drastic.

I know parting with sushi that contains raw fish for 9 months and not indulging in a glass of wine can be tough, but you’ve got this, mama! And the prize at the finish line is well worth the sacrifice.

2. Research where you plan to give birth

The idea of researching your hospital right after you get your positive pregnancy test takes some first-time mamas by surprise, but I can’t emphasize this enough!

If you have more than one hospital or birthplace to choose from for your birth do some research so that you can schedule your prenatal care with an OB or midwife that delivers at your preferred hospital.

But aren’t most hospitals and L&D units the same? Actually, they can vary quite a bit!

Here are some things to find out:

  • What hospital is closest to me geographically?
  • What is the rate of induction at the hospital?
  • What is the C-section rate at the hospital?
  • What are the rates of other interventions (such as epidural use, forceps, etc.)
  • What is the rate of mamas breastfeeding upon discharge?
  • What is the hospital’s culture surrounding breastfeeding and family-centered care?
  • Does the hospital have midwives and doctors on their unit?
  • What level NICU does the hospital have? What might this mean in an emergency?

I know it may seem a little early to be thinking about these things. And some of them might not even be things you’ve ever heard of! But trust me. Take the time now to learn the answers to these questions and make an educated choice about your provider and hospital! If you’re leaning towards a birth center for your delivery, all of this still applies!

And don’t forget to research your provider choices too! You’ll need to decide if you want to deliver with an OB or midwife. Check out the post below for more info.

A quick overview of OBs

They are doctors that specialize in pregnancy, childbirth, and women’s reproductive systems. Delivering with an OB is the norm in the U.S. with 9/10 births attended by a doctor. Doctors often approach pregnancy from a preventative standpoint and tend to favor more screenings and treatments (which isn’t a bad thing!). If you are pregnant with multiples or have a high-risk pregnancy, delivering with an OB may be necessary.

And Certified Nurse Midwives

Midwives are registered nurses with extra training and certification in pregnancy, childbirth, and women’s reproductive health. They are highly trained and capable of providing prenatal care and delivering your baby.

Midwives are known for caring for the whole woman during pregnancy.  They focus on both the emotional and physical changes that happen as you grow a baby. Appointments tend to be longer and more personal, and they take a “wait and see” approach whenever possible vs. a preventative approach. CNMs are an especially great choice for mamas with low-risk pregnancies hoping to have natural births.

Related Reading: What is a Midwife? All Your Questions Answered

3. Schedule and prep for your first prenatal appointment

Your first prenatal appointment is going to be here before you know it! Usually, you won’t have your first appointment until week 8-10 of pregnancy. I remember it feeling like an eternity waiting for that first appointment. It really helps it all feel more, well, real.

For the most part, this appointment is mostly a meet and greet with your provider. It’ll be one of your longest appointments, usually about an hour for first time mamas.

You’ll get to know each other and they’ll ask a lot of questions about your lifestyle, habits, diet and exercise, and family history. You’ll have a chance to ask all of your questions, too!

To get the most out of this appointment, I recommend preparing a list of questions ahead of time. It’s so easy to blank out in the moment! Also, if possible, this is a great appointment to have your partner join since it’s the first one!

Some questions to ask at your first appointment

  • What foods should I avoid? What’s your stance on deli meat during pregnancy?
  • How about caffeine intake?
  • What will a healthy weight gain look like for me during pregnancy?
  • Any changes I should make to my exercise routine or daily habits?
  • What do you recommend for ‘xyz’ symptom?
  • Am I at a higher risk for pregnancy complications for any reason?
  • How often will I have prenatal appointments? Will I always have appointments with you? How does this work?
  • Who should I contact with questions or concerns between appointments?
  • What red flags would warrant a call, or worse, ER visit?

At this appointment you will also give a urine sample, get a weight check, and have your blood pressure checked. These three things will happen at every . single . prenatal . appointment. So always come ready to pee ? These are all screenings that can alert your provider to possible issues and red flags.

Additionally, you will probably discuss first trimester screenings, possibly schedule a dating ultrasound, and listen to baby’s heartbeat. Sometimes, the baby’s heartbeat can’t be heard this early on, but it’s not a reason to panic! In fact, some providers don’t even try at the first appointment because it can cause undue stress.

Read more tips about How to Rock Your Prenatal Appointments before your first one! You might also be interested in reading up about early pregnancy scans and ultrasounds to discuss this at your first appointment, too.

4. Learn about first trimester symptoms

Morning sickness, extreme fatigue, and other unpleasant early pregnancy symptoms usually start up between weeks 6 and 8. And let me tell you, they are seriously tough!

The first trimester is hard on a lot of mamas. You feel like crap and usually choose to keep your pregnancy a secret until week 13 when the risk of miscarriage diminishes, which leaves you alone and uncomfortable. Solidarity, mama! With my first, I was feeling overall SO terrible for the entire first trimester.

The good news is, for most the second trimester is FAR easier with symptoms like nausea and fatigue disappearing almost completely. There IS a light at the end of this tunnel!

So if you’re like me, you’ve probably googled every list, tip, and trick for dealing with the first trimester. And if your symptoms haven’t hit yet, then let me get you some info so you’re ready when they do!

Some tips to get you started

As a labor and delivery nurse, and mama who also went through the throes of the first trimester, here are a few of my top tips:

  • Try sea sickness bands for morning sickness. The acupressure is super helpful for many mamas
  • Sniff an alcohol swab when you think you might puke. This is a nurse’s trick that works so well!
  • Keep a weekly journal or write to baby as a distraction and way to bond. It makes it so much easier to deal with the symptoms when you remember the why
  • Eat before you get out of bed. Seriously, even a few bites of crackers before you get up can help keep that early morning, empty stomach nausea at bay
  • Vitamin B6 is proven to ward off nausea and vomiting during pregnancy. Get it in your diet by focusing on frequent protein-packed meals
  • Lemons and ginger are both ingredients that can help quell nausea
  • Get moving! It may seem counter-intuitive but getting moving, like for a walk around the block during your break at work, can give you a boost of energy on those days you just want to sleep for 16 straight hours

Do yourself a favor and assemble a little morning sickness survival kit to keep in your car or at work. Include some ginger tea bags, alcohol swabs, Preggie Pop Drops, saltines, an extra hair tie, chapstick, toothbrush and toothpaste (in case of vomit), and a clean shirt!

Oh and don’t miss these related articles:

5. Make some time each week to journal and document this special time

I know these early weeks of pregnancy can feel like an eternity – but really this special time in your life is going to fly by! I always like to tell mamas to take weekly pictures, journal, write letters to your baby, and document this special time in any other way that means something to you. You will love having these things to look back on and share with your son/daughter someday.

To help you with this, we’ve put together a totally FREE First Trimester Prep Pack. Inside you’ll find Weekly Pregnancy Journal Pages, a printable First Trimester Checklist to accompany this article, and a Prenatal Appointment Guide. Click here to grab yours today!

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6. Learn about the red flags for every pregnant mama

Okay, so now that you have a positive pregnancy test, I want to make sure you are familiar with all the things you should NEVER ignore during pregnancy. Many providers do a great job of letting mamas know when to call, but some don’t, which is why I’m including it here.

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These are essentially the FIRST four questions I ask my patients when they come into triage. You should ALWAYS give your provider a heads up if any of these four things are happening regardless of how pregnant you are.

  1. Is your baby moving around normally?
  2. Are you bleeding?
  3. Are you having any leakage of fluids?
  4. Are you having contractions (or severe abdominal pain)?

If you roll up to triage and answer no to these four questions it rules A LOT of scary stuff out, which is why we ask them! Now, you probably realize that baby moving around normally doesn’t apply (not yet anyway!) BUT the others are pretty much fair game no matter where you’re at in your pregnancy.

There are a few other things you should bring up to your provider that aren’t pictured above such as:

  • A headache that won’t go away
  • Blurry vision
  • Sudden, excessive swelling
  • Nausea or excessive vomiting that’s keeping you from drinking enough water
  • Fever, or any other flu symptoms
  • Itchy palms or soles of feet (this can be a sign of Cholestasis)

You can read a little more about signs to watch for in pregnancy HERE!

Hopefully, you never need to call your provider about a serious issue, but knowledge is power and it’s important to know these things! And believe me, your provider would rather you call and it NOT be serious than for you to have a serious complication. No issue is too small! Believe me, we’ve heard it all and will NOT judge you for calling.

I recommend making a little cheat sheet for your fridge with a list of reasons to call your provider, their phone number, and the 24/7 nurse line (if it’s a different number).

7. Call your insurance company to learn about your prenatal coverage

Okay so now that you’re pregnant, you probably have a sense that budgeting for your baby is a big task. You’ll undoubtedly need to acquire the baby basics, be ready to pay for a million diapers and wipes, and plan for a (likely) unpaid maternity leave (don’t get me started on that!). One thing mamas may overlook is the cost associated with prenatal care and birth.

Too often mamas are four weeks postpartum only to receive a HUGE and unexpected hospital bill that they hadn’t planned for. I don’t want this to happen to you. By researching and understanding your coverage now, you can’t change the amount of that bill, but you can plan for it financially.

Here’s what I want you to find out:

  • What are my prenatal care copays?
  • Are lab tests included in my prenatal care or will there be an additional cost?
  • What is the copay and coverage for an uncomplicated vaginal birth?
  • What is the copay and coverage for a C-section birth?
  • What is covered in terms of postpartum care? Check-ups? Possible PT?

Now, don’t stop there! If your partner has different insurance than you, find out the same things about their plan. If you act now, and their plan has better coverage for pregnancy and birth, you can try to switch to their plan!

If open enrollment falls during your pregnancy, get your paperwork together to switch to their plan during that window. If you plan to quit your job before you give birth, this is another opportunity to get on their plan regardless of it being open enrollment. There is usually a set time frame for you to be picked up by their plan. Contact their human resources personnel to get the details!

So yeah, mama, please do this! No but seriously. Make sure you understand your coverage and the costs associated with pregnancy and birth. This will help you plan better financially and avoid the shock and stress of a big bill down the road. If your partner’s plan is better, figure out if and when a switch is possible!

8. Research early genetic testing options

One of the first really big decisions you’ll face in your prenatal care has to do with first trimester screenings. There are two big first trimester screening choices, the NT scan and NIPT. Both of these screenings set out to assess your baby’s risk of chromosomal abnormalities which can indicate things like Down’s Syndrome, Edward’s Syndrome, Patau Syndrome, and a few others.

Both of these screenings also usually take place between weeks 11 and 14 of pregnancy. So let’s learn more about the differences to help you choose which is right for you:

NT Scan (Nuchal Translucency Scan/12-week screening)

  • Standard screening recommended between 11-14 weeks
  • Covered by insurance
  • Checks for chromosomal abnormalities
  • Involves an ultrasound and blood test done in the same day
  • During the ultrasound, the technician will measure baby’s neck length and the length of clear space in the tissue at the back of baby’s neck
  • Often, when more fluid is present in this space, it will be larger
  • Your provider will take this measurement and combine it with info from your blood draw + your medical health and history to draw conclusions about baby’s risk factor
  • The AAP reports the test is approximately 85% accurate
  • The false positive rate is fairly high, at 5%
  • Remember this is NOT a diagnostic test. Based on the results of these screenings, your provider will recommend further follow-up testing

NIPT (Non-Invasive Pregnancy Testing):

  • Is an alternative to the NT scan and is becoming more widely available
  • Uses a blood draw to screen and analyze your baby’s DNA for genetic disorders (how cool is it that they can isolate your baby’s DNA from your own in a blood draw!)
  • Can provide an early gender result if you wish
  • Is 97-99% accurate at identifying common genetic disorders such as Down’s Syndrome, Edward’s Syndrome, and Patau Syndrome
  • Is usually NOT covered by insurance unless you are over 35 or are at a high risk of carrying a baby with a genetic disorder
  • Companies that offer the testing, such as Counsyl, offer a better rate for those paying out of pocket (usually between $300-$400) so check with your provider about this!

That pretty much covers the basic points of each test…but a longer discussion with your partner and your provider about the pros and cons of the two options is a must!

You’ll want to take into consideration your age, your risk factors, and how the results would affect the remainder of your pregnancy.

9. Find ALL the fun pregnancy apps and pregnancy podcasts

Girl, yes! This is one of the things on your first-trimester checklist that is fun, and a total must! Apps and podcasts are SUCH a good distraction when you are in the throes of the first trimester, just trying to make it through the day.

If you haven’t checked out The Mommy Labor Nurse Podcast, definitely do! We feature expert interviews, birth stories, and Q&As on pregnancy, birth, and motherhood.

And for more suggestions check out these round-ups I put together:

10. Start thinking about when and how you plan to announce your pregnancy

How and when you announce your pregnancy is a big decision, and the truth is – there’s really no right or wrong way (or time!) to do it! Many families wait to publicly announce their news until week 12 because the rate of miscarriage drops off dramatically at that point. But at the end of the day,  you do you!

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Things to consider when announcing your pregnancy

  • Do you want to do it now, or wait until you know the gender? Some mamas wait until week 20, but lots can’t keep it in that long!
  • Do you want work to know yet? Sadly, pregnancy discrimination is a real thing in the workplace. It might be to your benefit to wait to let your supervisor know. This might be a reason to keep your announcement off of social media for a while too
  • Make sure you tell everyone who you want to in-person before putting it on social media! This way no one finds out secondhand
  • How do you want to announce your pregnancy? More on this below!
  • How does your partner feel about the announcement and attention? Make sure you are on the same page about the whole thing

How to announce your pregnancy?

Now comes the fun part – planning out your pregnancy announcement! There are so many fun, custom ways to announce your pregnancy.

Here are some of my favorite ideas:

  • Get a custom printed shirt, mug, ornaments, hats, or other object for grandparents-to-be with their new title – this is especially great if it’ll be their first grandkid. Works really well for new aunts and uncles, too!
  • Wear a matching shirt with your partner that reveals the big news in a clever way
  • Wrap up an adorable onesie to reveal the news
  • Serve a meal with all “baby items” and see if anyone catches on…baby corn, baby back ribs, baby shrimp, baby carrots…you get the idea ?
  • Crack a joke about a “bun in the oven” with an actual bun in the oven and watch your family’s faces light up!
  • Use dessert! Nothing beats a cake with an exciting message on it

Don’t miss this article with TONS of great ideas for announcing your pregnancy to your family.

My big tip related to this is to make a pregnancy announcement plan with your partner. Even if you don’t want a big announcement, it’s important to get on the same page.

Discuss who you want to tell right away, whether or not you’ll put it on social media, and when you plan to tell your workplace (and theirs!). Discussing this now will prevent people finding out before you’re ready!

Feeling ready to rock the first trimester?

Well mama, my hope for this first trimester checklist is that it will feel a bit like a lifeline for these early weeks! I know that the first trimester is full of challenges from physical to mental to everything in between. This should make things a bit easier!

Here’s to a happy, healthy pregnancy!

Prenatal care workshop
Liesel Teen, RN-BSN

Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

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