Trimester by trimester guide to pregnancy symptoms

Whether your first sign of impending parenthood was nausea, headaches or just a positive pregnancy test, they’re only the start of a long list of things to come. The question is, what’s normal? Many pregnancy symptoms can be both signs of a totally normal pregnancy and a signal to call your doctor. Broken down by trimester, here’s what to expect when you’re expecting and what should put your mommy sense on alert.

First trimester

Odds are you’re not going to be feeling great-fatigue, nausea, vomiting and mild pelvic cramps are all normal symptoms during this time. The severity of these symptoms is what you should keep track of, however, when deciding when to call your doctor.

“You should not be so tired that you can’t get through normal activities without some extra rest,” says Dr. Mark Gapinski, an obstetrician and gynecologist at Central DuPage Hospital. “If it’s ‘I can’t get through my day and have to go home from work,’ it could be something else wrong, such as a thyroid disorder that needs to be evaluated or anemia.”

Although many women have spotting at various times in their pregnancy with no ill effects, Gapinski says spotting is never normal and you should always contact your doctor when it happens, especially if it is accompanied by significant pain.

Second trimester

Often known as the “honeymoon period,” many of the difficult symptoms of the first trimester go away in the second trimester. It’s not necessarily smooth sailing for all expectant moms, though.

“It’s a very individual thing and the key for the patient to know if it is a problem or not is if there is a dramatic change,” says Dr. Alex Lin, attending obstetrician at Northwestern Memorial Hospital and a professor in clinical obstetrics and gynecology at Northwestern University. “If they feel crummy in the first and second trimesters but nothing has really changed, it’s probably just going to be a difficult pregnancy for the patient.”

Common symptoms include random, sharp pains in the groin area (called round ligament pain) and some swelling in the legs and fingers. You should call your doctor if the pains take on any organized pattern or are accompanied by bleeding or increased discharge (or if you just have a huge increase in discharge without pain) since these can be symptoms of early labor. Swelling in just one leg and not the other can be a sign of a blood clot and a dramatic increase in swelling along with headaches and/or blurry vision can be an early sign of preeclampsia and should be addressed with your doctor immediately.

Third trimester

Aches and pains typically increase during this time, along with swelling and fatigue. Your baby’s movement will also usually slow down, but Lin says there should still be three episodes of movement per day. Increased (or returned) nausea is also a possibility during the third trimester. Some contractions are normal at 35 and 36 weeks of pregnancy, but call your doctor if they are strong or follow a timed pattern. Some mucus discharge is also normal, but you should notify your doctor of any dramatic increase in discharge or any watery or bloody discharge.

All nine months

Although you don’t need to call your doctor every time you get a cough or runny nose, you should contact him if your symptoms don’t go away within a week or are accompanied by a fever. You should also make a call if you’ve never had chicken pox and are exposed to it at any point during your pregnancy. Any exposure to Fifth’s Disease (symptoms include fever and red cheeks) should be noted. No matter what the situation, though, you should feel comfortable contacting your doctor.

“You should have good communication with your physician,” says Gapinski. “If not, it could be a sign that you could have a difficult time when you need to get a hold of them.”

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