First Trimester Checklist: 12 Things to Do in Weeks 1–13

The first trimester is a strange no-man's-land. You probably don't look pregnant yet, you may feel terrible, and most of what you "should" be doing is invisible. So this isn't a list of aesthetic things-to-do. It's the real stuff — the appointments, the boring logistics, and the things no one tells you about because they forgot.

If you're at 6 weeks and panicking, start here. If you're at 11 weeks and you haven't done half this, that's fine too. This is a checklist, not a race.

1. Confirm the pregnancy with a blood test (not just a home test)

Home pregnancy tests are accurate, but a quantitative beta hCG blood test gives you a number — and a second number 48 hours later confirms the pregnancy is progressing. Your provider will order this at your first appointment. If you're anxious and want it sooner, an OB or midwife can order it directly.

2. Pick a provider

OB/GYN, midwife, family medicine doctor with OB privileges — there's no wrong answer, only the right answer for you. Things to ask yourself:

• Do you want a low-intervention birth? A midwife-led practice might fit.
• Do you have a high-risk condition? An OB with a maternal-fetal medicine referral network matters.
• Is the practice at the hospital you want to deliver at?

Don't pick a provider based on who has the next available appointment. The next appointment is one visit. This person will be at your birth.

3. Schedule your first prenatal visit (typically 8–10 weeks)

The first official prenatal visit is usually between 8 and 10 weeks. Yes, the wait is brutal. If you have risk factors — prior loss, bleeding, severe nausea — call and ask to come in earlier. Most practices will see you for a reassurance check at 6 weeks even if they don't do a full intake yet.

4. Start a prenatal vitamin with folate (not folic acid)

Folate and folic acid are different things. Folate (the natural form, often labeled as L-methylfolate) is what your body uses directly. Folic acid is the synthetic version that some people — particularly those with MTHFR variants — convert less efficiently. Either is fine for most people. The key is starting before week 6, because the neural tube closes by week 4.

If you're already past week 6, don't panic. Just start now. The folate matters for the whole pregnancy, not just the first few weeks.

5. Figure out your nausea strategy

Morning sickness (it's not just mornings) usually peaks around weeks 8–11. A few things that consistently help:

• Vitamin B6 + Unisom — the combo your provider will likely suggest. B6 25 mg three times a day, Unisom 25 mg at bedtime.
• Small, frequent protein-heavy meals — not crackers. Cheese sticks, hard-boiled eggs, nuts.
• Ginger capsules — 250 mg, up to four times a day.
• Acupressure wristbands — feel silly, work for some people.

If you can't keep water down for 24 hours, call your provider. Hyperemesis is real and treatable.

6. Start thinking about the announcement timeline (not the announcement itself)

There's no "right" time to tell people. Most people wait until after the 12-week mark, but plenty of people tell earlier — and plenty wait longer. What actually matters is deciding, with your partner, who you tell when, and why. It's a decision that gets harder the longer you postpone.

7. Check your medications and supplements

Now is the time to tell your provider about every prescription, OTC, and supplement you take. Common things to re-evaluate:

• Acne treatments — most retinoids are out. Azelaic acid is usually fine.
• Antidepressants — most SSRIs are safe in pregnancy, but the decision is yours with your prescriber.
• Herbal supplements — many are not studied. Default to "ask first."

If you need a structured way to think through this, the prompt at /prompts/medication-review-first-trimester walks you through it.

8. Start a simple pregnancy log

Not a cute journal. Just a notes file with:

• Last menstrual period date
• First positive test date
• First appointment date
• Any symptoms that worried you (with date)
• Any medications started or stopped

When you're 30 weeks and someone asks "when did you first feel nauseous," you'll know.

9. Review your workplace rights (yes, now)

In the US, the Pregnant Workers Fairness Act requires reasonable accommodations. In the UK, your employer must do a risk assessment. Wherever you are, look up your leave policy, your right to time off for appointments, and your right to accommodations for things like nausea, fatigue, or lifting limits.

Do this before you need it. Negotiating while you're vomiting is awful.

10. Move your body — but don't start a new intense program

If you were already running, keep running. If you were sedentary, start walking. The first trimester is not the time to suddenly start CrossFit. The first trimester is a good time to build the habit you'll keep for the next 7 months.

11. Set up a "questions for the OB" running list

Every time you Google something at 11pm — and you will — drop it into a single note. By your first appointment you'll have 30 questions. Don't try to remember them. Don't try to filter them for "good" questions. Bring them all.

If you want help organizing them, the prompt at /prompts/questions-for-first-OB-visit builds a categorized list tailored to your stage.

12. Tell one safe person (if you want to)

You don't have to wait. You don't have to tell. But if there's one person in your life who would catch you if something went wrong — and you'd want them to know — tell them. The first trimester is emotionally heavy. Doing it in silence makes it heavier.

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The Three Rules

🩺 This is not medical advice. Your provider gives the answers. 🤝 This is not therapy. Find a real human when you need one. 📚 A thinking partner, not a verdict.

If the first trimester feels like a lot — it is. The 12 things above are a lot. Pick the three that matter most this week. The rest will wait.