What Black Women Should Know About the First Trimester

The first trimester sets the tone for your pregnancy. Whether you’re a new momma or a seasoned pro, this is the start of an exciting new chapter of your life. Unfortunately, giving birth is not an equal experience for all. People of color, particularly Black women, are at higher risk for pregnancy complications partly due to implicit bias in our medical system.¹ This is true regardless of education level, income, or location. These are hard facts to face, but awareness is the first step toward a solution. Follow these tips to confidently own the first trimester of your maternal journey.

What Black Women Should Know in the First Trimester

Your first trimester starts on your last period and lasts until you are three months along.¹⁷ During the first three months of pregnancy, your baby grows faster than at any other time. You’ll be experiencing physical changes while mentally preparing for what comes next. This is an excellent opportunity to develop good habits by taking care of yourself and planning for the rest of your pregnancy.

Common First Trimester Symptoms

These are some of the pregnancy symptoms you’ll likely experience during the first trimester:

Exhaustion

It’s normal to feel fatigued or exhausted during the early months.² Growing life is hard work! Prioritize rest, and don’t be tempted to skip meals. You need your strength, momma.

Nausea

Pregnancy nausea, aka morning sickness, is common. The purpose of nausea is to protect your baby from harmful chemicals and food-borne illnesses.³ If you’re experiencing bad nausea in your first trimester, eat foods that are easy to digest as regularly as possible. Drinking nausea or “pregnancy” teas that contain ginger can also help settle your stomach.^17,18

Food Cravings

Have a hankering for a hot dog? Food cravings tell you which nutrients (e.g., calcium, iron, or folic acid) your body needs most. Many people notice they start to crave foods they rarely ate before or are turned off by foods they used to love. Feel free to follow your cravings and grab that pickle! As with managing nausea, the best course is to skip heavy meals in favor of small, regular snacks.¹⁷

Nutrition Is Key

Here’s a guide on maintaining a nutritious diet during your first trimester of pregnancy:

Don’t Eat This

Good nutrition is vital to the health of your baby. After all, the foods you eat are the “fuel” your pregnancy needs for your baby to grow. Before pregnancy, some people eat a “Standard American Diet” (SAD), which is generally low in nutrients.¹⁹ Typical “SAD” foods to avoid include:

• Processed meats
• Fried foods
• Candy
• Pastries
• Refined cereals

Many people look forward to eating more when pregnant, but you won’t need to increase your calories until you are in the second trimester to approximately 300 extra calories per day.^4,14 Losing weight can lower birth complications if you are obese, but dieting is not always necessary. If you plan to reduce your intake, discuss it with your doctor first. A good pregnancy “diet” doesn’t mean eating less but choosing nutrient-dense options.

Do Eat More of This

The best way to take care of your growing baby is to select nutritious foods. These nutrient-dense foods are rich in vitamins, minerals, and protein. They’re also low in saturated fat, added sugars, or salt. Examples of nutrient-dense foods that are great for your first trimester include:¹⁴

• Fruits and vegetables
• Whole grains
• Lean meat and skinless poultry
• Nuts and seeds
• Beans, lentils, and peas

Swap Your Snacks

A great way to maximize nutrient-dense foods is by doing “the swap.” Let’s say you are deciding between two packages of bread. One has 80 calories per slice but few vitamins and minerals. The whole-grain version has about the same calories but way more protein, three times the magnesium, and more than double the fiber, potassium, vitamin B6, and zinc. The whole-grain option is the more nutrient-dense choice! Here are other easy swaps for nutritional density in your first trimester are:^4,14

• Try plain, nonfat Greek yogurt instead of a big dollop of sour cream on your chili or baked potato.
• Switch from processed deli meat to sliced roasted chicken for a hearty sandwich.
• Add one more veggie instead of meat or cheese when adding toppings to pizza, tacos, or sandwiches.
• Switch from white rice to brown rice.
• Snack on crunchy vegetables or nuts instead of chips.
• Satisfy a sweet tooth with naturally sweet fruit instead of candy and cookies.
• Replace sugary drinks with water, unsweetened tea, or coffee.

Ways To Eat Well

Think eating healthy is out of reach? It’s true that affordable, fresh, and nutrient-dense foods are generally less available to low-income groups and areas, but making healthier choices doesn’t have to be expensive. Larger chain supermarkets and grocery stores typically charge less for fresh fruits and vegetables than convenience stores and small food markets. Here are some options for finding affordable, nutritious foods:

• Shop at a weekly farmer’s market.
• Visit a community garden with fruit or vegetable plots.
• Buy fruits and vegetables in their season when prices are lower.
• Buy frozen or canned versions of nutrient-dense foods.
• Buy items with a low price per pound, like onions, carrots, artichokes, asparagus, and broccoli.

Healthy Habits To Start Now

Consider following these tips in the first trimester to help you stay healthy during your pregnancy:

Take a Multivitamin

Though food is critical, there are other ways to get the nutrients your baby needs. Take a prenatal vitamin with folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C to help cover any gaps in your diet.¹⁴ Be sure to tell your healthcare professional about any other vitamins you have been taking. Remember that prenatal vitamins complement, rather than substitute, healthy eating.¹⁴

Up Your Water Intake

Humans are 60% water, so don’t be afraid to drink up!⁵ Water helps your digestion and eases constipation. It also forms the amniotic fluid around your fetus. During pregnancy, aim to drink 8 to 12 cups (64 to 96 ounces) of water daily. Need motivation? Buy a large (32-ounce) reusable bottle, and commit to drinking the entire bottle in three two-hour windows.¹⁵

Example:

• 8 a.m. to 10 a.m.: (1) 32 ounces of water
• 12 p.m. to 2 p.m.: (1) 32 ounces of water
• 4 p.m. to 6 p.m.: (1) 32 ounces of water

= 96 ounces of water for the day

Stop All Alcohol

Despite misinformation that circulates stating it is okay to drink one alcoholic beverage per day while pregnant, it is not safe to consume alcohol at all. Drinking while pregnant may contribute to fetal alcohol syndrome (FAS). As the Surgeon General’s Advisory states, “There is no known safe amount of alcohol to drink while pregnant.”⁶

Avoid High Mercury Fish

Mercury is a toxic metal that can pollute water sources and be absorbed by fish. When consumed in high amounts, it can cause serious health issues. Luckily, many types of fish pose a low risk of mercury poisoning. Avoid high-mercury varieties like king mackerel, tuna, and marlin. According to the FDA, low-mercury fish like cod, tilapia, and salmon are fine to eat up to three times a week.⁷

Ban Undercooked or Raw Meat

Eating undercooked or raw meat increases your risk of infection from various bacteria or parasites like Vibrio, salmonella, and listeria. According to the Centers for Disease Control and Prevention (CDC), pregnant women are 10 times more likely than other people to get a listeria infection called “listeriosis.”⁸ Hispanic women are 24 times more likely to get listeriosis, which can be passed on to your unborn baby and cause miscarriages, stillbirths, and preterm labor.⁸

Possible First Trimester Complications

As we are biologically the same, our first-trimester experiences as women should be similar. However, Black birthing women face more significant barriers to accessing prenatal care. Black women have the lowest rates of first-trimester care compared to white or Latinx women. As a result, they are at a higher risk for pregnancy complications.⁹ Here are some potential first-trimester complications for Black women:

Preeclampsia

Preeclampsia is one of the most common and severe disorders that occurs during pregnancy and the postpartum period. Characterized by high blood pressure and damage to the kidneys and liver, it affects at least 2-8% of all pregnancies.^10,16 The preeclampsia rate is 60% higher in Black women than in white women, and Black women are more likely to develop severe cases.¹¹ Black women have higher rates of chronic diseases known to be risk factors for preeclampsia. This condition can lead to multiple adverse outcomes, including seizure, stroke, heart disease, infant growth restriction, preterm birth, and maternal or infant death.^11,16

Gestational Diabetes

Black women also face higher odds of developing gestational diabetes.¹² Babies born to diabetic mothers can have low blood sugar and breathing problems and are more likely to become obese.¹³

Make sure to communicate with your doctor and receive testing to screen for these common conditions. An oral glucose tolerance test (OGTT) can be performed at your doctor’s office during the second trimester.²⁰ Preeclampsia and gestational diabetes can be treated with lifestyle changes or medication when caught early.²¹

Choose the Right Pregnancy Team

When choosing an OB/GYN or midwife, start with providers covered by your insurance (if you are insured) to reduce financial stress. Next, limit your list to doctors with offices nearby. Lastly, and very important for people of color, choose the provider you feel a connection toward. If you think your doctor doesn’t listen to you or answer your concerns, don’t be afraid to find someone new. Many barriers can make this more difficult for some people, including lack of insurance, living in a maternal care desert, or the inability to find a provider you feel comfortable with.

Your baby’s health is in your hands. Setting up good habits in the first trimester can set the course of your pregnancy on the right track. Though systematic issues in the healthcare system exist, they do not have to stop you from having a happy and successful pregnancy. Good nutrition and healthy lifestyle habits are the keys to achieving the life you want for yourself and your baby.