The First Trimester

Is This Real?

Accepting the reality of a pregnancy is the first mental hurdle a woman faces, says Raphael Good, M.D., a clinical professor of psychiatry and obstetrics-gynecology at the University of Miami School of Medicine. There's the miracle of biology to grasp, for one thing. "It can seem unbelievable that something so tiny could grow arms and legs and eventually walk around," Good says. Then self-doubts appear: Are we ready to be parents? Can we afford a child?

Survival Tips: If you feel ambivalent about impending motherhood, remind yourself that this is a normal reaction. To help the baby seem more real, take a look at the miraculous photographs of fetal development in Lennart Nilsson's classic book A Child Is Born.

Above all, realize that you may continue to experience conflicting emotions, says Matthews. And beware of the "Pollyanna pregnancy" trap - feeling you must be grateful and beaming all the time - especially if conception was difficult for you.

The Wait-and-See Weeks

For many women, the big news is too exciting to hold back for more than a few hours - or even a few minutes. Others choose not to reveal their pregnancy until they feel more confident. But waiting can bring both secret pleasure and agony. "So much was changing on the inside - wondering how I would fit my work in, feeling sick and fat - that didn't match the outside, which still looked just the same," says Sarah Pierce of Seattle, who kept quiet for 13 weeks to be on the safe side.

Whether you decide to go public or not, the specter of miscarriage hovers over even the most joyful expectant mothers during the first 12 to 14 weeks. "Every little drop of blood is anxiety-producing in patients, even though 30 percent of all pregnant women will have some bleeding," says Johanna Abernathy, M.D., an ob-gyn in Cedar Rapids, IA.

When Laura Patyk of Charlotte, NC, had some spotting at seven weeks, she cried. "I thought I was being punished for something I'd done wrong," she says. Women tend to berate themselves for all sorts of things they can't change, says Abernathy. "What have I eaten? Did I drink any alcohol or a lot of caffeine before I found out?" During the first few weeks of a pregnancy, women can torture themselves with questions like these.

Survival Tips: Matthews says that the anxious early weeks are a good time to follow the pregnant woman's credo: Do whatever you think is best. If you're the kind of person who wouldn't mind if others knew that you'd had a miscarriage, you may be more comfortable spreading the news of your pregnancy than a more private person would be.

Consider, too, whether you're willing to confront the possible reactions. Will your mother overwhelm you with advice? Will your boss panic? Until you're ready to deal with such responses, it may be best to keep the news under wraps. Whatever you decide, it's wise to confide in at least one friend or coworker to give yourself a supportive sounding board.

One way to ease your worries is to have a talk with your obstetrician or midwife about your fears of miscarriage or birth defects, suggests Abernathy. "You can't change the past, so focus on having healthy habits from here on out," she says.

Finally, balance your concern for the baby with care for yourself. As Louden says, "We think of nurturance as something we do for others, but be good to yourself as well."

Who's In Control?

Just when you're inspired to do your best on the baby's behalf, here comes the counterpunch - an unnerving loss of control. Chicago parents-to-be Lisa Wilkinson and Dave Kay call their unborn baby Captain Picard, after the Star Trek commander. "This kid is running the show - when I eat, when I sleep. I'm just the starship Enterprise," says Wilkinson. "Giving up control is not a normal component of my personality."

Survival Tips: Let go of the reins a little. Louden advocates what she calls "Zen and the art of peeing": Turn repetitive activities, such as going to the bathroom or taking your prenatal vitamins, into your own mini relaxation getaways. "Take a deep breath and say a word or phrase that makes you feel calmer," she says. Basically, do anything that will make your life easier - get a low-maintenance haircut, take taxis, wear sneakers at work. Most important, learn to ask for help. That's a special challenge if you pride yourself on your self-sufficiency. "If it's hard to do," she adds, "imagine that you're asking on behalf of your unborn child."

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