# First Trimester: Symptoms, To-Dos and What's Normal in Weeks 1-13

> What the first 13 weeks feel like, what to do first, and how to get through nausea and exhaustion.

Stage: pregnancy - Topic: Your pregnancy - Page: https://www.askcladle.com/guides/pregnancy/first-trimester-what-to-expect

Grounded in: ACOG patient guidance on early pregnancy, prenatal care, nausea and vomiting of pregnancy, and early pregnancy loss; CDC guidance on folic acid and medicines in pregnancy. Summarized in Cradle's own words; none of these sources endorse Cradle. General information, not medical advice.

Reviewed: 2026-11

## TLDR

- Exhaustion and nausea at any time of day are common, peaking around 9 weeks and easing for most by 14-16. No nausea is normal too.
- Take a prenatal vitamin with folic acid, book a first visit around 8-12 weeks, and don't stop prescribed medicines on your own.
- Call the same day for bleeding like a period or if you can't keep fluids down for a day.

## How the weeks are counted

- Pregnancy is dated from the first day of the last period, so you are already about 4 weeks
  pregnant when a test turns positive. After IVF, dating comes from the transfer date.
- An early ultrasound (often 7-12 weeks) gives the most reliable due date. Only a small share of
  babies arrive on that exact day.
- By the end of week 13 the baby is about 3 in (7-8 cm) long, with all major organs formed.

## What your body may be doing

- Tiredness that feels out of proportion, often the strongest you will feel all pregnancy.
- Nausea, with or without vomiting, at any time of day. It usually starts around weeks 5-6, peaks
  around 9, and eases for most people by 14-16. Having little or no nausea is also normal.
- Sore, fuller breasts; peeing more often; bloating; constipation; a stuffy nose.
- Food aversions, a metallic taste, a strong sense of smell, and moods that swing quickly.
- Mild cramping and light spotting can happen early and are often harmless, but mention them.

## Your first to-do list

- Start or keep taking a prenatal vitamin with at least 400 mcg of folic acid.
- Book a first prenatal visit, usually around 8-12 weeks. See the prenatal visits and tests guide
  for the blood work and optional genetic screening offered now.
- Review every medicine and supplement with your provider or pharmacist. Don't stop a prescribed
  medicine (for example for depression, seizures or thyroid) on your own.
- Stop alcohol, smoking, vaping and cannabis. If you drank or smoked before you knew, tell your
  provider; stopping now still helps.
- Learn the food basics in the eating well in pregnancy guide (listeria, mercury, caffeine).
- Keep moving if you feel up to it; see the exercise in pregnancy guide.

## Getting through the hard days

- Eat something small every 1-2 hours; keep plain crackers by the bed.
- Rest without guilt. Shorter workdays, earlier bedtimes and help with meals are reasonable asks.
- If nausea makes daily life hard, treatment exists, including vitamin B6 options. See the common
  pregnancy discomforts guide.

## Feelings and telling people

- Joy, shock, worry and ambivalence can all show up in the same week. That is normal, whether the
  pregnancy was planned for years or a surprise.
- Many people wait until after 12-13 weeks to share the news widely, once the chance of loss drops,
  but there is no rule. Some prefer to tell the people who would support them through a loss.
- Partners, co-parents and intended parents have their own adjustment too.

## When to check in

- Mention spotting, mild cramps, or nausea that is wearing you down at your next visit or by
  phone.
- Contact your provider the same day for bleeding like a period, or for being unable to keep
  fluids down for a day.
- See the miscarriage and early pregnancy loss guide if bleeding or cramping is getting heavier.
- If you have severe one-sided belly pain, shoulder-tip pain, or feel faint, call 911; these can be
  signs of an ectopic pregnancy.