I'm Pregnant, Now What?

with expert input from Lauren Miller Brown, birth and postpartum doula, holistic bodyworker, childbirth educator @laurrielou. Lauren teaches an ‘I’m Pregnant, Now What?’, currently offered through Natural Resources online.

Knowing what to do when you think you might be pregnant can be confusing. When can you take a pregnancy test? If it’s positive, when do you make a prenatal appointment? What are the guidelines on taking care of yourself before you see a care provider? We break things down here with help from SF-based doula Lauren Miller Brown.

When can I take a pregnancy test? How accurate will it be?

For the most accurate result, you can take a pregnancy test a week after your missed period. 

Pregnancy tests pick up the hCG hormone (human chorionic gonadotropin), which supports the normal development of an egg in your ovary and stimulates the release of that egg during ovulation. hCG is only present when you’re pregnant, but your body needs time for it to be detectable. Most home pregnancy tests claim to be 99 percent accurate, but some may be more sensitive in picking up the hCG hormone than others. If you decide to take a test before you’re due and get a negative or a faint positive, you may want to wait to test again until after you’ve missed your period.

How is my ‘due date’ calculated?

Add one year and count back three calendar months from the first day of your last period. Then, add seven days to get your estimated ‘due’ date - I like calling it a ‘guess date’. A word of caution: don’t take this date too seriously.  Only three to five percent of birthing people give birth on their estimated due date!

A bit of history: due date estimations are based on Naegele’s Rule, which was developed in the 1850’s by Dr. Franz Naegele. The formula calculates ten lunar months or 40 weeks gestation and is based on a 28-day menstrual cycle.

When do I make my first prenatal appointment? 

You can call your care provider as soon as you confirm you’re pregnant with a home pregnancy test – but expect them to schedule your first appointment for around eight weeks. If you choose to work with a home birth midwife or midwife who works at a birth center from the beginning, you can start care as early as you’d like. 

Your first appointment happens at close to eight weeks to optimize the chances of detecting a fetal heartbeat, fetal pole, and yolk sac. Before the eight-week mark, you might be too early for some of these important signs to be detected. At this initial appointment, your provider will measure the size of your embryo, they’ll give you your estimated due date, and will confirm if there’s more than one baby in there. 

If you decide to work with a midwife (either home birth or birth center specific), you can start care as early as you like – midwives are trained in well-women care. Midwives are licensed and able to provide all of your initial prenatal bloodwork, but will probably send you in to a hospital to get ultrasounds, though some birth centers even provide these services.

What can I expect at the first appointment, besides confirmation that there’s a baby in there?

The first prenatal appointment with a midwife or an OB/GYN is usually the most comprehensive. The goal of this appointment is to get to know one another, as well as take in your full medical history.  

Your midwife or OB will ask you to share your history – including any abortions, pregnancy losses, vaginal births, or previous cesareans. You will also be asked about your gynecological history and if you’ve had any gynecological surgeries. They’ll also take into account your contraceptive history, family health history, and sexual health history. 

You might be offered a physical exam which includes a breast exam, pelvic exam and vitals check (heart rate, blood pressure, and pulse).

What are the do’s and don’ts for the early weeks/pregnancy in general, especially before seeing a care provider? 

Eating well, getting quality sleep, reducing stress and staying hydrated are all key during all stages of pregnancy.

While it may be nerve wracking during the first few weeks before you see your provider, focusing on these things will hopefully reassure you that you are doing exactly what you can to care for yourself, your body, and your baby. 

If you want more of a, let’s say, tangible, list and review of pregnancy guidelines – check out our evidence-based review of common recommendations during pregnancy. You might also want to explore our pregnancy nutrition article to see what foods to focus on. If you haven’t already started on a prenatal, check out our article on how to choose one.

You could also consider getting acupuncture, especially if you’re experiencing early pregnancy symptoms like exhaustion and nausea.

We know that it isn’t always possible to focus on these things, especially during the first trimester given that you may not feel great. Try to be gentle with yourself. When you can, allow your body to rest, consume nutritious foods, nurture healthy relationships, set aside time for both physical exercise and quiet introspection, and cultivate a positive mental attitude. Together, all of these are powerful (and basically free) self-care practices that you can explore to help bring yourself back into balance and find more space to nurture a healthy pregnancy and a new baby.

What about exercise? Do I have to cut back or modify my regular routine?  

Check out our overview of prenatal fitness to learn more about exercising during pregnancy.

Ok, what about books to read and helpful products (including what to wear)?

Be sure to check out a list of our favorite books, products, and a curated list of our favorite clothing lines.