Pregnancy Advice: A Trimester-by-Trimester Guide to Staying Comfortable and Healthy

In short: Key advice for pregnancy: sleep 8 hours at night with a rest during the day, wear comfortable cotton clothes and low shoes, walk and do light housework without heavy lifting, eat 6 small meals instead of 3 large ones, and cut down on fried food, tea and coffee. Care of the skin, breasts and teeth is advised throughout pregnancy.

How can you organize your daily life during pregnancy? Small, consistent habits can make pregnancy more comfortable. Here are some practical tips to help you feel your best.

• Rest During Pregnancy:
• Any pregnant woman should aim to sleep about 8 consecutive hours each night.
• A short nap at midday can also help you recharge.

From about 28 weeks, try to go to sleep lying on your side (left or right) rather than flat on your back; if you wake up on your back, simply turn onto your side.

• Avoid squatting and putting pressure on the abdomen, as this can lead to back and abdominal discomfort.
• Avoid sitting and standing improperly and try not to carry heavy items. Bending your knees is essential when picking things up.

Appropriate Clothes for Pregnant Women:

• It’s best to wear clothing that feels both attractive and comfortable.
• Women who have had previous pregnancies (multiparas) often notice a larger waist earlier than first-time mothers (primigravidas).

• Around 5 months, your lower abdomen will begin to enlarge, and your regular clothes may start to feel snug.
• When shopping for maternity clothes, choose pieces that are comfortable, easy to care for, and roomy enough as your body changes.
• Comfortable clothing matters, but so does feeling good about how you look — choose pieces that make you feel confident.
• Most women of normal weight gain about 11.5-16 kg during pregnancy (less if you started pregnancy overweight – ask your doctor what is right for you), and your upper body may increase by about 10 cm. By your last month, your abdominal circumference may be around 1 meter, though this varies by body type.
• Wide sleeves can make it easier to move your arms freely.
• Cotton clothing is a great choice as it absorbs moisture and allows good ventilation.

Polyester blends can also work well, as they comfortably cover your baby bump.

• Choose cotton underwear for comfort and breathability.
• Wear low-heeled, non-slip shoes — high heels can contribute to back pain and leg cramps.
• As your bump grows, it may become harder to see your feet, and higher heels increase your risk of losing balance. Preventing falls is important for both your safety and your baby’s.

Exercises during pregnancy:

• In a healthy pregnancy, regular exercise is recommended – aim for about 150 minutes a week of moderate activity such as brisk walking, swimming or pregnancy exercise classes. Avoid contact sports, activities with a risk of falling, and very heavy lifting, and stop and contact your doctor if you have bleeding, pain, dizziness or leaking fluid.
• You can learn safe, appropriate pregnancy and postpartum exercises — we have approved exercises available on our site.

Diet during pregnancy:

• You don’t need to “eat for two.” Instead, focus on a healthy, balanced diet rich in essential vitamins. Try to limit fatty and spicy foods, and reduce your intake of tea, cocoa, and coffee.

• Include protein

Make sure meat, poultry and eggs are well cooked, choose pasteurised cheese and milk (avoid soft mould-ripened cheeses unless cooked), and avoid fish high in mercury such as shark, swordfish and king mackerel.-rich foods such as eggs, cheese, meat, poultry, and fish, along with plenty of vegetables — especially leafy greens — and fruits.

• If you’re overweight, try reducing your intake of rice, potatoes, and sweets.
• Eating 6 small meals a day is often easier on digestion than 3 large meals.

Take folic acid 400 micrograms (0.4 mg) daily, ideally from before pregnancy until 12 weeks (a higher dose if your doctor advises), and vitamin D 10 micrograms (400 units) daily throughout pregnancy.

• Gestational Diabetes

Sex during pregnancy:

• Intercourse is generally safe during pregnancy. However, your doctor may advise avoiding it if you have vaginal bleeding, a low-lying placenta (placenta previa), leaking of fluid, a weak cervix, or signs of preterm labor in this pregnancy.
• In a healthy pregnancy, intercourse can continue until the end of pregnancy; mild tightenings afterwards are common and harmless. Contact your doctor if you notice bleeding, pain or leaking fluid.
• Intercourse does not harm the baby, who is well protected by the fluid and the womb, but as your bump grows, positions that avoid pressure on the abdomen are usually more comfortable.

Skin Care during pregnancy:

• You may notice skin changes such as stretch marks on your belly, breasts, thighs, and buttocks, as well as darker patches on your face.
• Darkening around the nose or eyebrows can also occur. A diet rich in protein and vitamins — especially vitamin B2 and vitamin C, found in vegetables, mussels, oysters, beans, apples, oranges, and lemons — may help support healthy skin.
• Facial fullness may cause fine lines, so a gentle facial massage with a small amount of moisturizer can help.
• Since skin can become more sensitive during pregnancy, it’s best to stick with familiar skin care products rather than trying new ones. Bright lipstick and makeup can be a nice confidence boost.
• Massaging the belly with olive oil or a moisturiser can relieve dryness and itching, although studies have not shown that any cream or oil reliably prevents stretch marks.

Breast care during Pregnancy:

• Wear a well-fitting, supportive bra that isn’t too tight or uncomfortable.
• Clean your nipples with warm water and avoid soap. From the 5th month of pregnancy, gentle massage with olive oil, cocoa butter, or lanolin may help. Breast pumps and nipple stimulation are not needed before birth and can cause contractions; some women (for example those with diabetes) may be advised to hand-express and store colostrum from about 37 weeks, but only if your doctor recommends it.
• After delivery, breastfeeding early and often, with the baby well attached to the breast, is the best way to prevent breast engorgement and discomfort.

Gums and Teeth Care during Pregnancy:

• Brush your teeth after each meal and before bed.
• Visit your dentist if you notice any dental issues.

Changes and Complications during Pregnancy:

Breast changes during Pregnancy:

• Your breasts will feel soft in early pregnancy, then gradually enlarge. The areola darkens, and small glands become more visible, causing the nipple to protrude more.
• Once the milk ducts form, colostrum may appear, especially with breast massage.
• After about 4 months, you may need a larger bra size.

Keeping your breasts clean with plain water is enough; after birth, good attachment of the baby to the breast is the most important way to prevent cracked nipples.

Back pain during Pregnancy:

• As your pregnancy advances and your belly grows, extra weight shifts your posture, often requiring you to lean back slightly to balance.
• Many women experience back pain during pregnancy, which often eases with rest. However, if pain persists, it could be related to nerve compression or disc issues — in that case, consult your doctor.

Constipation during Pregnancy

During pregnancy, bowel motility decreases due to muscle relaxation, which can sometimes lead to anal fissures or hemorrhoids.

Eating fruits and vegetables and drinking plenty of water can help maintain healthy digestion.

Numbness in the hands and feet during Pregnancy:

• Numbness is common during pregnancy, though its exact cause isn’t fully understood. It may be related to posture changes in the back and neck, or to hormonal shifts affecting the nerves in the arms.
• This usually resolves after delivery, but if it persists, check with your doctor.

Nausea during pregnancy:

• The exact cause is not fully understood, but pregnancy hormones produced by the placenta (such as hCG and a hormone called GDF15) are thought to play the main role.
• Try to avoid fried or fatty foods, or anything that seems to trigger nausea.
• Resting in bed briefly after waking, and eating small, frequent meals, can help.
• Safe medicines are available and your doctor may recommend them if symptoms are troublesome. Nausea usually peaks between weeks 9 and 12 and settles by weeks 16-20 in most women. If you cannot keep fluids down, contact your doctor promptly.

Normal vaginal delivery video | Caesarean section video

Carpal tunnel syndrome during pregnancy:

• This condition can cause wrist pain and numbness due to increased pressure from joint swelling, which compresses nerves — especially the median nerve. Symptoms are often worse in the morning and typically resolve after delivery. Gentle wrist movement, along with treatments your doctor may suggest, can help manage symptoms.

Joint pain during pregnancy:

Pregnancy hormones cause natural softening of the ligaments that support the joints, which increases flexibility but can sometimes lead to joint discomfort, especially in the pelvis.

• As pregnancy advances, the growing uterus shifts your posture and puts more pressure on pelvic joints, muscles, and tendons — contributing to back pain.
• Adequate calcium intake supports bone health during pregnancy and breastfeeding. Speak with your doctor about whether your diet is providing enough calcium.

Heartburn during Pregnancy:

• Heartburn affects roughly a third to half of pregnant women, caused by relaxation of the valve between the stomach and esophagus, along with increased abdominal pressure. It typically resolves after delivery.
• To ease heartburn, avoid bending forward or squatting, and try sleeping with your upper body slightly elevated.
• Eat smaller, more frequent meals instead of large ones.
• Avoid spicy foods.
• Ask your doctor about safe antacid options if needed.

Anemia during Pregnancy:

• Anemia is diagnosed when hemoglobin is below 11 g/dL in the first three months, or below 10.5 g/dL later in pregnancy, and it’s a fairly common concern in pregnancy.
• As pregnancy progresses, iron demands increase for both mother and baby, which can lower hemoglobin levels if intake isn’t sufficient.
• Types include iron-deficiency anemia (the most common), anemia due to lack of folic acid or vitamin B12, and inherited conditions such as thalassemia trait, which is common in our region and needs a different approach from simple iron deficiency.
• Untreated anemia can affect fetal growth and increase the risk of complications, so monitoring is important.
• Your doctor will typically check hemoglobin levels early in pregnancy and recommend iron supplements or other treatment as needed.

Spontaneous Miscarriage:

• Miscarriage refers to pregnancy loss before 20 weeks of gestation.
• It occurs in about 15-20% of recognised pregnancies (more often as the mother’s age increases), most often because of chromosomal problems in the egg or sperm. Certain maternal health conditions can also play a role:

These may include poorly controlled diabetes, untreated thyroid disease, antiphospholipid syndrome, and (for losses in the middle of pregnancy) cervical incompetence. Normal work, exercise and everyday stress do not cause miscarriage.

• Recurrent miscarriage refers to two or more pregnancy losses (some guidelines use three or more); investigations are often offered after two losses.
• Women who have had one previous miscarriage have a somewhat increased chance of another.

For women with recurrent miscarriages, further evaluation may be recommended to look for underlying anatomical or medical causes. If you have bleeding in early pregnancy and have had a miscarriage before, your doctor may recommend vaginal progesterone, which has been shown to slightly improve the chance of the pregnancy continuing.

• Most miscarriages occur during the first trimester.
• Cervical cerclage (a stitch in the cervix) is only helpful for women who have lost pregnancies in the middle of pregnancy because of a weak cervix, not for early miscarriages.

Frequency of Urination during Pregnancy:

• Increased urination is common in the first trimester due to normal pregnancy-related changes.
• As the uterus grows, it presses on the bladder, increasing the urge to urinate. This often eases once the uterus rises out of the pelvis, then returns again later as the baby’s head engages before delivery.
• Increased frequency is normal, but pain during urination is not — if you notice this, contact your doctor, as it may indicate a urinary tract infection.

Vaginal discharge during pregnancy:

An increase in vaginal discharge is common during pregnancy due to higher cervical mucus production.

Sometimes increased discharge may be due to a yeast or other infection. If discharge becomes thick, discolored, or has an odor, your doctor can recommend appropriate treatment.

Mild symptoms may not need treatment, but more noticeable symptoms should be evaluated by your doctor, who may prescribe an appropriate antifungal or other medication.

Vaginal bleeding during Pregnancy:

1- Bleeding in the 1st half of pregnancy:

• Any vaginal bleeding during pregnancy should be discussed with your doctor promptly.
• Possible causes include cervical changes or infection, pregnancy with an IUD in place, ectopic pregnancy, or molar pregnancy.
• If bleeding is minor, you can continue your normal daily activities – bed rest has not been shown to prevent miscarriage – but you may prefer to avoid intercourse until the bleeding stops. The most common cause is a threatened miscarriage, and most such pregnancies continue normally.
• Heavier bleeding leading to anemia may require medical intervention.
• Bleeding with regular uterine contractions may indicate a miscarriage or ectopic pregnancy and needs prompt evaluation.

Go to the emergency department immediately if bleeding comes with severe pain on one side of the abdomen, pain at the tip of the shoulder, dizziness or fainting – these can be signs of an ectopic pregnancy.

• Continued contractions, cervical dilation, or rupture of membranes may indicate that the pregnancy cannot continue.

2- Bleeding in the 2nd half of pregnancy:

• Causes can include cervical changes, placental abruption, or low-lying placenta. These situations may need urgent medical care to protect both mother and baby.
• A “bloody show” can also occur, which may signal that labor is approaching.

What about rubella?

• Rubella is not typically dangerous for someone who isn’t pregnant.
• However, if a pregnant woman contracts rubella, it can increase the risk of congenital abnormalities, particularly if infection occurs early in pregnancy.
• Risk is highest in the first 11 weeks of pregnancy (when most babies are affected), falls between 11 and 16 weeks, and is very low after 20 weeks.

Possible effects include congenital cataracts, glaucoma, vision or hearing problems, and growth delays.

• Early diagnosis and prompt consultation with your doctor are important if rubella exposure is suspected.

Immunity and vaccination during pregnancy:

• Vaccine recommendations depend on your vaccination history and doctor’s guidance.

Recommended in pregnancy: the flu vaccine (at any stage of pregnancy during flu season), the COVID-19 vaccine, and the RSV vaccine late in pregnancy (around 28-36 weeks, depending on local guidance), which protects your newborn against serious chest infection. These vaccines are safe for you and your baby.

• The whooping cough vaccine (Tdap, which also protects against diphtheria and tetanus) is recommended in every pregnancy, usually between 20 and 32 weeks, to protect your newborn baby – even if you were vaccinated before.
• Polio vaccine is generally avoided unless you’re in an endemic area, and only inactivated forms are used.
• The measles, mumps and rubella (MMR) vaccine is not given during pregnancy. Ideally check your rubella immunity before pregnancy and wait one month after MMR before trying to conceive; if you are not immune, the vaccine is given after your baby is born.
• Typhoid vaccination may be considered only if travel to an endemic area is necessary.
• Cholera vaccine is generally only given with travel to an endemic area or known exposure.
• Rabies vaccine may be given according to standard protocols if needed.
• Hepatitis vaccination may be considered for travel to endemic areas or known exposure — always discuss with your doctor first.

Preterm labour:

• [Preterm labor refers to labor and birth before 37 completed weeks of pregnancy. (A birth weight under 2500 g is called low birth weight, which can happen in preterm babies or in small babies born at term.)
• Typical average weights by gestational age: about 300g at 20 weeks, 650-700g at 24 weeks, 1100-1200g at 28 weeks, 1600-1700g at 31 weeks, 2500-2600g at 35 weeks, and about 3300-3400g at full term (40 weeks).
• Factors that may contribute to preterm labor include:
• Rupture of membranes.
• Cervical incompetence.
• Polyhydramnios.
• Placental abruption.
• Maternal infections such as pneumonia or pyelonephritis.
• Babies born preterm may need time in an incubator for extra care and monitoring.

Fetal movement:

• Many women first feel fetal movement, known as quickening, between 16 and 24 weeks of pregnancy – often around 18-20 weeks in a first pregnancy and earlier in later pregnancies.
• If you have not felt your baby move by 24 weeks, tell your doctor so it can be checked.
• Quickening can sometimes be mistaken for bowel movement or muscle cramps.
• While fetal movement is a helpful sign of well-being, healthy babies don’t move constantly throughout the day.
• Do not try to make your baby move by tapping your abdomen, drinking something cold or waiting to count kicks – if you feel your baby is moving less than usual, contact your doctor or hospital the same day. Babies do not move less towards the end of pregnancy.
• If you notice an absence of fetal movement, contact your doctor promptly for evaluation.
• If movement decreases noticeably, your doctor may recommend a non-stress test to check the baby’s heart rate and wellbeing. Always mention any changes in movement to your care provider.

What are the medications that may harm the baby?

• Some medications can cross the placenta and affect the baby. Always check with your doctor or pharmacist, and confirm FDA guidance, before taking any medication during pregnancy:
• Medications generally considered harmful during pregnancy:

Alcohol, nicotine, isotretinoin (a treatment for acne), valproate and some other epilepsy medicines, warfarin, ACE-inhibitor and ARB blood pressure medicines, methotrexate and most anticancer drugs, testosterone and other male hormones, tetracycline and streptomycin antibiotics, high-dose vitamin A, and mercury, lead and cadmium. Many other antibiotics are safe, and medicines for thyroid disease or epilepsy must never be stopped without your doctor’s advice, because the untreated illness can also harm the baby.

• Medications considered particularly high-risk:

Older diabetes tablets such as chlorpropamide and tolbutamide, reserpine, and regular use of tranquilizers. (Nitrous oxide – ‘gas and air’ used for pain relief in labour – is safe, and metformin is commonly used to treat diabetes in pregnancy.)

• Medications that may carry some risk and should be discussed with your doctor:

Caffeine (keep below 200 mg a day, about two mugs of instant coffee), diazepam, chlordiazepoxide, and meprobamate. Insulin, on the other hand, is the safest treatment for diabetes in pregnancy and must never be stopped, and meclizine is a safe, commonly used medicine for nausea.

Always consult your doctor before starting, stopping, or continuing any medication during pregnancy.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist

For personalized guidance throughout your pregnancy, the team at Dr. Layyous’s clinic is here to support you with attentive, experienced care.