What the first trimester doesn't tell you

The middle trimester gets the glow and the third gets the sympathy. The first one gets neither, and it is frequently the hardest of the three.

The exhaustion is not ordinary tiredness

It is a flattening, unignorable tiredness that arrives early and has nothing to do with how much you slept. Women describe sitting down on the stairs partway up.

Nothing is visible yet, so nobody adjusts anything for you, and you are usually still doing everything you were doing before while feeling significantly worse.

Morning sickness is badly named

It affects most pregnancies, is rarely confined to mornings, and typically shows up around week five or six, peaks around nine, and eases somewhere between weeks twelve and eighteen.

Eating small amounts often helps more than eating well. Cold food smells less. Plain carbohydrates before you sit up are a cliché because they work for a lot of women.

If you cannot keep fluids down, are losing weight, or feel faint, that is beyond ordinary sickness and there are effective treatments. You do not have to earn help by being sick enough for long enough.

Being unable to eat vegetables for three months does not harm your baby. Dehydration does. Aim at fluids and let the rest go.

The secrecy is the heaviest part

The convention is to wait until twelve weeks, and the reasoning is usually given as avoiding having to un-tell people.

It is worth noticing what that costs. It means the weeks when you feel worst and are most frightened are the weeks you are managing alone.

Plenty of women now tell a small handful of people early — not the office, but a sister, a friend, the person who would drive you somewhere. If it went wrong, those are the people you would want to know anyway.

About the fear

Early pregnancy loss occurs in about 10% of clinically recognised pregnancies, and roughly 80% of losses happen in the first trimester. Around half are caused by chromosomal problems in the pregnancy itself.

That last part is the part worth holding onto, because the instinct is to audit everything you did. It is almost never something you did or didn't do.

Knowing the number helps some women and frightens others. If you are in the second group, the useful version is simply this: most pregnancies continue, and worrying does not change the odds in either direction.

What is worth calling about

• Heavy bleeding, or bleeding with cramping
• Severe one-sided pain, or shoulder-tip pain
• Fainting or dizziness
• Vomiting so persistent you cannot keep fluids down
• A fever

Light spotting is common and often nothing, but it is always allowed to be a phone call. Nobody at that office thinks you are overreacting.

What actually helps

• Lower your standards, deliberately and out loud, for twelve weeks
• Eat what you can keep down and stop grading it
• Go to bed absurdly early without justifying it
• Tell someone. One person is enough to make it survivable
• Take the prenatal vitamin at night if mornings are impossible