Neighbourhood Midwives

Health and wellbeing in the first twelve weeks of pregnancy

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You’re pregnant, how exciting!  But why don’t you feel fantastic? Well on top of keeping the most exciting secret you’ve ever had in your life, your body might be changing, demanding your attention in various annoying ways: morning sickness, feeling unbelievably tired and suddenly growing boobs!

So what can you do during this time to help you feel better and to optimise health for you and your baby?

Here I examine three aspects of pregnancy wellbeing in the first trimester (the time till you’re 12 weeks pregnant): morning sickness, tiredness and nutrition.

Nausea (how can morning sickness last all day?)

For many women the excitement of pregnancy is quickly damped down by the all too common blight of pregnancy: morning sickness. We don’t know exactly why some women get it but there are theories that it is the body trying to protect the fetus by making women avoid highly flavoured or unusual foods. Our bodies don’t actually realise that we live in the 21st Century where our food is safe so many women crave very plain, simple foods especially simple carbohydrates. Of course the problem then is that it is really hard to maintain blood sugars and so the sickness and nausea overcomes us again. Low blood sugars and tiredness are the two main enemies in nausea and sickness.

Many women find that it helps to eat something dry like a cracker or toast before rising in the morning, and to keep eating small amounts regularly throughout the day.  Bananas may help as the potassium can ease symptoms. You will probably crave simple carbohydrates but a little protein might be much more helpful as it will help to stabilise your blood sugars. While this is not is not 100% effective for everyone, maintaining your blood sugars and not getting overtired are vital to keep nausea at least under control. Never leave home without some food to sustain you. On a positive note, research has shown that pregnancy nausea is a good sign and indicates a healthy growing baby!

Also try smelling fresh rosemary or lemon as you will be susceptible to unpleasant or strong smells.


Being uncharacteristically tired is often one of the first signs of pregnancy. It’s your body’s way of saying ‘slow down there! I’m working really hard and I need you to help me out here.’ Your baby is going to take everything he/she needs from your body – so you need to give yourself lots of rest and great nutrition to allow for that. Sleep longer at night, go to bed earlier and have daytime naps.

Don’t be afraid to take some time off work, OK you are not ill, but you FEEL ill and that is a good enough reason. Also if you can get someone, (a mum or mum in law) to cook for you over this period you may find that you start to feel a lot better. Not having to actually prepare food really helps with our appetite. Don’t forget to hydrate yourself, rehydrate powders can be invaluable here. Some women find flat lemonade helps.


Many midwives place a lot of emphasis on making sure that women have exactly the right nutrition both for them and for their baby. Most women are aware of the need to avoid pate, shellfish and certain cheeses. They also know to take Folic Acid for the first 12 weeks to protect against neural tube problems.

However good nutrition is not quite as simple as getting your five a day, though that’s a great start. Only one in twenty people in the UK meet the recommended daily allowances of nutrients, and this doesn’t even take into account the additional requirements of pregnancy. Protein is especially important as you are growing new tissue at an unprecedented rate. So paying special attention to the needs of your body at this time is particularly important.

There are many nutritionists who specialise in pregnancy health, and if your midwife isn’t skilled herself in pregnancy nutrition advice, consider seeing a nutritionist .

These are the key tips we give to our pregnant mums:

Neighbourhood Midwives’ Dietary Information

This is based on a well-balanced, low GI diet and is appropriate for all pregnant women. It may be particularly useful for women who are obese, have a history of large weight gain in pregnancy or a history of large babies (there is some evidence that a low GI diet can reduce the likelihood of having a big baby).

General Rule: Cook from basics fresh foods, avoid ready meals and processed foods

  1. Plenty of protein – meat, dairy, beans, pulses -5 helpings daily if a meat eater, 7 if vegetarian and 9 if vegan (eggs are a great way to increase your protein intake for non vegans)
  2. Complex Carbohydrates – beans, pulses and high fibre whole grain foods (wholemeal bread, brown rice and pasta etc.) – try to eat complex carbohydrates with a protein rather than on their own, only 1 portion of wholemeal bread each day (2 slices). Reduce the amount of simple carbohydrates e.g. white bread, rice, pasta
  3. Vitamin B (from whole grains, meat, nuts etc.)
  4. Vitamin C (from fresh fruit and veg.)
  5. Don’t eat too much fruit (you should eat more veg than fruit every day), and no fresh fruit juices at all.

This is basically a good healthy fresh food diet that we should all be eating!

Note that good nutrition includes fluid too. Water is the best – try to drink between 1.5 and 2 litres a day.

What else can you be doing now?

Get into a gentle exercise routine – brisk walking and swimming are fantastic for pregnancy, and starting now will help you build up strength and flexibility for later on. Some women enjoy yoga and pilates. Don’t do anything strenuous, high-impact or outside your normal limits. It’s a time to be kind to your body.

Now is also the time to find out about your options for the pregnancy and birth. Most women go down the standard NHS care pathway without ever realising that there are other choices- and when they find out about them later, they are often really disappointed. Check out what services your local NHS trust offers, the neighbouring trusts, and also look into other options: some places in the UK now have other groups of midwives who offer care for free, and everywhere has the option of private (or independent) midwifery.

Above all try and enjoy your pregnancy even when feeling less than perky, it will pass.