First Trimester Checklist: Everything to Do

The first trimester is one of the most important periods of your pregnancy. From confirming your pregnancy to your first ultrasound, there is a lot to do in those first 13 weeks. This first trimester checklist covers every essential task so nothing falls through the cracks.

According to ACOG, early prenatal care is one of the best things you can do for a healthy pregnancy. Women who begin prenatal visits in the first trimester have better outcomes for both themselves and their babies. Let this checklist be your roadmap.

First Trimester Checklist: Quick Overview

Category	Key Tasks	When
Medical	Confirm pregnancy, schedule first appointment	Weeks 4-6
Medical	First prenatal visit and blood work	Weeks 8-10
Medical	First ultrasound (dating scan)	Weeks 8-12
Medical	Optional genetic screening (NIPT, NT scan)	Weeks 10-13
Nutrition	Start prenatal vitamins with folic acid	Immediately
Nutrition	Adjust diet (avoid unsafe foods)	Immediately
Lifestyle	Stop alcohol, tobacco, recreational drugs	Immediately
Lifestyle	Review medications with doctor	Weeks 4-8
Financial	Review health insurance and maternity coverage	Weeks 6-10
Emotional	Decide when to share your news	Weeks 8-13

Medical Appointments and Tests

Confirm Your Pregnancy (Weeks 4-6)

Your first step after a positive home test is to confirm your pregnancy with a healthcare provider.

• Take a home pregnancy test after a missed period
• Call your OB-GYN, midwife, or family doctor to schedule your first prenatal appointment
• If you do not have a provider, ask for referrals or check your insurance network

According to the Cleveland Clinic, home pregnancy tests are about 99% accurate when taken after a missed period. A blood test at your doctor's office can confirm the result and measure your exact hCG levels.

First Prenatal Visit (Weeks 8-10)

Your first prenatal appointment is usually the longest and most comprehensive. According to Mayo Clinic, expect it to last 45 minutes to an hour. Your provider will:

• Confirm your due date (use our pregnancy calculator to estimate yours)
• Review your complete medical history
• Perform a physical exam including a pelvic exam
• Order blood work: blood type, Rh factor, CBC, immunity to rubella, hepatitis B, syphilis, HIV
• Check for urinary tract infections
• Discuss your medications, supplements, and lifestyle
• Answer your questions

First Ultrasound / Dating Scan (Weeks 8-12)

The dating scan confirms your due date and checks the baby's heartbeat. According to the NHS, this ultrasound is accurate to within 5 days when performed between weeks 8 and 12.

• Confirms single or multiple pregnancy
• Checks for a heartbeat (typically visible from week 6)
• Measures crown-rump length to establish gestational age
• Checks for ectopic pregnancy

Optional Genetic Screening (Weeks 10-13)

ACOG recommends that all pregnant women, regardless of age, be offered genetic screening.

• NIPT (Non-Invasive Prenatal Testing) — a blood test available from week 10 that screens for chromosomal conditions like Down syndrome with over 99% detection rate
• Nuchal translucency (NT) scan — an ultrasound at weeks 11-13 measuring fluid at the back of the baby's neck
• First trimester combined screening — combines NT scan results with blood work for a risk assessment

Discuss with your provider which screening options are right for you. These tests are screening tools, not diagnostic. A positive result may lead to follow-up diagnostic tests like amniocentesis or CVS.

Nutrition and Supplements

Start Prenatal Vitamins Immediately

If you are not already taking them, begin a prenatal vitamin as soon as you find out you are pregnant.

• Folic acid: 400-800 mcg daily. According to the CDC, taking folic acid before and during early pregnancy reduces the risk of neural tube defects by up to 70%.
• Iron: 27 mg daily to support increased blood volume
• DHA/Omega-3: Supports baby's brain and eye development
• Calcium: 1,000 mg daily (from food and supplements combined)
• Vitamin D: 600 IU daily
• Iodine: 150 mcg daily for thyroid function and brain development

Adjust Your Diet

Your first trimester checklist should include reviewing what you eat and drink.

Foods to eat more of:

• Leafy greens (folate)
• Lean proteins
• Whole grains
• Fruits and vegetables
• Dairy or calcium-fortified alternatives

Foods to avoid:

• Raw or undercooked meat, fish, and eggs
• Unpasteurized dairy and juice
• High-mercury fish (shark, swordfish, king mackerel, tilefish)
• Deli meats and hot dogs (unless heated until steaming)
• Excessive caffeine — ACOG recommends limiting caffeine to less than 200 mg per day (about one 12-oz cup of coffee)

Stay Hydrated

According to ACOG, pregnant women should drink 8-12 cups (64-96 ounces) of water per day. Staying hydrated helps prevent constipation, urinary tract infections, and headaches — all common first trimester complaints.

Lifestyle Changes

Substances to Eliminate

There is no known safe amount of alcohol during pregnancy. According to the CDC, drinking alcohol during pregnancy can cause fetal alcohol spectrum disorders (FASDs).

• Stop all alcohol consumption immediately
• Quit smoking — the NHS reports that smoking during pregnancy increases the risk of miscarriage, premature birth, and low birth weight
• Avoid recreational drugs — discuss any substance use honestly with your provider
• Limit caffeine to under 200 mg per day

Review Your Medications

Many common medications are not safe during pregnancy. Schedule a medication review with your doctor to discuss:

• Prescription medications (especially for acne, seizures, or mental health conditions)
• Over-the-counter medications (ibuprofen should be replaced with acetaminophen)
• Herbal supplements (many are not tested for pregnancy safety)
• Topical treatments (retinoids are not safe)

According to the FDA, about 10% of birth defects are linked to medication exposure. Never stop a prescribed medication without talking to your doctor first.

Exercise Safely

According to ACOG, most women should aim for 150 minutes of moderate-intensity exercise per week during pregnancy.

• Walking, swimming, and prenatal yoga are excellent choices
• Avoid contact sports, hot yoga, and activities with a risk of falling
• Listen to your body — if you feel dizzy, short of breath, or in pain, stop
• Stay hydrated and avoid overheating

Environmental Safety

• Avoid cat litter (toxoplasmosis risk)
• Limit exposure to harsh chemicals (cleaning products, paint fumes)
• Check that your workplace is safe (discuss concerns with your provider)
• Avoid hot tubs and saunas — ACOG advises keeping core body temperature below 102.2 degrees Fahrenheit

Financial and Administrative Tasks

Review Health Insurance

• Verify your maternity coverage, including prenatal visits, ultrasounds, and delivery
• Understand your deductible, copays, and out-of-pocket maximum
• Check if your preferred hospital and providers are in-network
• Research adding your baby to your plan after birth

Start a Baby Budget

According to the USDA, the average cost of raising a child from birth to age 17 is over $230,000. Starting early helps:

• Estimate delivery costs after insurance
• Begin saving for baby gear (crib, car seat, stroller)
• Research workplace maternity/paternity leave policies
• Look into life insurance and updating your will

Emotional Well-Being

Process Your Feelings

It is completely normal to feel a mix of excitement, anxiety, and overwhelm. According to March of Dimes, about 14-23% of women experience depression during pregnancy.

• Talk to your partner, a friend, or a counselor about how you feel
• Prioritize sleep (fatigue is intense in the first trimester)
• Practice stress management — deep breathing, meditation, gentle walks
• Know that mood swings are driven by hormones and are very common

Decide When to Share Your News

Many couples wait until after the first trimester to announce their pregnancy, since the risk of miscarriage drops significantly after week 12. According to ACOG, about 10% of known pregnancies end in miscarriage, with the majority occurring in the first trimester.

There is no right or wrong time to share. Consider telling:

• Your partner (if they do not know yet)
• A close friend or family member for support
• Your employer — you do not have to tell them yet, but consider timing if your job involves physical labor or hazardous materials
• Your dentist — dental care is important during pregnancy

Week-by-Week First Trimester To-Do Summary

• Weeks 1-4: Take a prenatal vitamin, stop alcohol and smoking, take a pregnancy test
• Weeks 5-6: Call your provider, schedule your first appointment, start tracking symptoms
• Weeks 7-8: Attend your first prenatal visit, get blood work, review medications
• Weeks 9-10: Discuss genetic screening options, adjust diet and exercise
• Weeks 11-12: First ultrasound, optional NIPT/NT screening, review insurance
• Week 13: Celebrate finishing the first trimester, consider sharing your news

Track every milestone and to-do with MyBumpGuide's weekly checklist. Our app walks you through each week from week 1 to week 40, so you never miss an important step.

Frequently Asked Questions

What is the most important thing to do in the first trimester?

Start taking a prenatal vitamin with at least 400 mcg of folic acid and schedule your first prenatal appointment. According to ACOG, folic acid in the first trimester is critical for preventing neural tube defects, which form in the first 28 days after conception — often before you even know you are pregnant.

When should I schedule my first prenatal appointment?

Most providers schedule the first appointment between weeks 8 and 10. If you have a history of complications, ectopic pregnancy, or are experiencing bleeding or pain, call sooner. According to Mayo Clinic, early prenatal care is associated with healthier outcomes.

Can I exercise during the first trimester?

Yes, exercise is generally safe and encouraged. ACOG recommends 150 minutes of moderate exercise per week throughout pregnancy. Walking, swimming, and prenatal yoga are great options. Avoid contact sports and activities with a high fall risk. Always check with your provider if you have concerns.

What foods should I avoid in the first trimester?

Avoid raw or undercooked meat and eggs, unpasteurized dairy, high-mercury fish, deli meats unless heated, and limit caffeine to under 200 mg per day. According to the NHS, these precautions reduce the risk of infections like listeriosis and toxoplasmosis that can harm the developing baby.

Is it safe to travel during the first trimester?

For most women with healthy pregnancies, travel during the first trimester is safe. According to ACOG, the safest time to travel is the second trimester (weeks 14-28). If you experience heavy nausea or have risk factors, discuss travel plans with your provider. Stay hydrated and move frequently on long flights.

Sources

1. American College of Obstetricians and Gynecologists (ACOG). "Prenatal Care." acog.org
2. Mayo Clinic. "Prenatal care: 1st trimester visits." mayoclinic.org
3. Cleveland Clinic. "First Trimester: What to Expect." clevelandclinic.org
4. National Health Service (NHS). "Your antenatal care." nhs.uk
5. March of Dimes. "Prenatal care." marchofdimes.org
6. Centers for Disease Control and Prevention (CDC). "Folic Acid." cdc.gov