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Thank you for choosing Texas Children’s Pavilion for Women for your care during pregnancy. This guide will give you a general overview of information you’ll need during this important time. Your care will be individualized based on your medical needs. Always follow your healthcare team’s instructions and contact their office with any questions.
Pregnancy Checklist
Pregnancy lasts about 40 weeks, starting from the first day of your last menstrual period. It’s divided into three trimesters. Your due date is an estimation of when your baby will be born. Most babies are born before or after their due date.
1st Trimester (Weeks 0-13)
During the first trimester of pregnancy, fertilization occurs and your baby’s major organs and systems develop. Your hormones change, which may cause you to feel very tired, have breast tenderness and swelling, need to urinate more often, and you may feel sick to your stomach (usually called “morning sickness” though it can happen at any time of day).
- Attend all scheduled appointments with your healthcare provider (usually one per month)
- Expect to have an ultrasound to evaluate the pregnancy and confirm your due date
2nd Trimester (Weeks 14-27)
During the second trimester, your baby continues to develop and grows quickly in length and weight. For many pregnant people, tiredness, breast tenderness and nausea lessen during this time. Most people’s pregnancy becomes visible within this trimester, and you will begin to feel the baby move around weeks 20-24.
- Attend all scheduled appointments with your healthcare provider (usually one per month)
- Expect to have your anatomy ultrasound around 20-24 weeks
- Expect to have your glucose test between 24-28 weeks
- Complete pre-registration for delivery
- Register for a virtual hospital tour and prenatal classes (attend in the 3rd trimester) Visit our classes and tours page to schedule
3rd Trimester (Weeks 28-Delivery)
During the third trimester, your baby’s brain is growing and developing rapidly, their lungs are getting ready to breathe on their own, and your baby is gaining more layers of fat. Your baby will probably turn head down by week 37. You may feel Braxton-Hicks (“warm up”) contractions throughout the 3rd trimester. It’s common for you to feel a number of discomforts during this time.
- Attend all scheduled appointments with your healthcare provider (usually every two weeks from 28-36 weeks and weekly from 36 weeks until delivery)
- Expect to have an ultrasound to estimate your baby’s weight, position and amniotic fluid volume
- Submit FMLA paperwork to your doctor by week 30
- Attend your virtual hospital tour and prenatal classes
- Talk with your doctor about breastfeeding, request breast pump prescription at your 35-36-week appointment
- Expect to have your Group B Strep (GBS) test during your 36-week appointment
- Consider birth control options and talk with your doctor about your thoughts
- Choose a pediatrician for your baby – visit Texas Children's Pediatrics for more information
- Pack your hospital bag
- Install your car seat – visit safekidsgreaterhouston.org for a free car seat check
Prenatal Genetic Testing
Genetic testing can potentially detect health concerns in your baby caused by inherited diseases or a genetic condition. Genetic testing is an option you may choose, but you are not required to have genetic testing during your pregnancy. Some tests are done in the first trimester, and some tests are done in the second trimester. Carrier tests can be done before or during pregnancy to find out if either parent carries a gene that may cause a disease in the baby. These are blood tests. Screening tests can show if there is an increased risk of your baby having a genetic condition, and to help decide if further testing is recommended. These usually involve blood tests and ultrasounds and have little risk to you or your baby. Diagnostic tests are used to determine if your baby has a genetic condition. Diagnostic tests usually involve using a needle to take amniotic fluid or tissue from the placenta and have a slightly higher risk for you and your baby. If you’re unsure about whether to have these tests, talk with your doctor or a genetic counselor.
Health and Wellness During Pregnancy
When to Contact Your Doctor
Use MyChart for non-emergency questions or concerns only, such as refills and minor illnesses. Phone support is available 24 hours a day, 7 days a week. The nursing team answers phone calls on weekdays during business hours. After hours support is available for urgent concerns.
Urgent Concerns – Call the office or after-hours line
- You think you’re in labor
- Severe cramping or painful contractions
- Vaginal bleeding
- Temperature over 100.5°F
- Sudden belly pain
- You’ve had a fall or motor vehicle accident
- Very bad headache
- Sudden swelling of your face or hands
- Breaking your water or leaking vaginal fluid
- Major decrease in your baby’s movements
Nutrition and Exercise
Eat nutritious foods, take a daily prenatal vitamin and drink 8-12 cups of water daily.
Foods and drinks to avoid
- Alcoholic beverages
- Raw or undercooked meat, fish and eggs
- Unpasteurized milk or cheese
- Unpasteurized juice
- Cold deli meats and refrigerated pâté
- Fish with high levels of mercury (e.g. shark, swordfish, tilefish, king mackerel, big eye tuna)
Foods and drinks to limit
- Caffeinated beverages – limit to 200 mg of caffeine (about 10 oz of coffee)
- White tuna – limit to 6 oz or less per week
If you are healthy and having a normal pregnancy, exercise is safe and recommended. Talk with your doctor about your exercise plans.
Prescription Medications
Talk with your obstetrician about all prescription medications before taking them.
Over-the-Counter Medications
Unsafe medications during pregnancy include naproxen, aspirin, and NSAIDs like ibuprofen. Medications that are generally considered safe during pregnancy are listed below.
| Symptom | Medication |
| Allergies | Antihistamines including diphenhydramine HCl, chlorpheniramine or loratadine |
| Constipation | Stool softeners or laxatives including methylcellulose fiber, psyllium, polycarbophil, docusate, senna |
| Cough, colds and/or congestion | Nasal spray, cough drops, sore throat lozenges, decongestants, cough suppressant (dextromethorphan), expectorant (guaifenesin), antihistamines |
| Diarrhea | Loperamide |
| Heartburn or indigestion | Antacids (calcium carbonate), magnesium hydroxide, alumsimethicone (for gas), famotidine, lansoprazole |
| Hemorrhoids | Hemorrhoid creams or suppositories, medicated cooling pads with witch hazel |
| Mild fever, headache, minor aches and pains | Acetaminophen |
| Nausea | Motion sickness medication (dimenhydrinate), sodium citrate dehydrate, Vitamin B6 |
| Yeast infection | Miconazole nitrate suppositories or cream |
If you have questions about over-the-counter medications, contact your obstetrician.
Vaccinations
The American College of Obstetricians and Gynecologists (ACOG) recommends you receive certain vaccinations during pregnancy.
| Vaccination | When to get it | Why it's important to get during pregnancy |
| Tdap | Between weeks 27-36 | You’ll give your baby short-term, early protection against whooping cough by creating protective antibodies that pass to your baby |
| Flu | By the end of October | This vaccination protects pregnant people from the flu and creates protective antibodies that pass to your baby. These antibodies protect your baby from the flu until they can get the vaccine at 6 months of age. |
| RSV | Between weeks 32-36 from Sept.-Jan. If you received this vaccination during a previous pregnancy, you do not need to get it again. | This vaccination protects your baby from getting very sick with RSV |
| COVID-19 | As soon as possible during pregnancy | Pregnant people are more likely to become very sick if they get COVID-19, and this vaccination protects you and your baby from severe illness |
Hazardous Substances to Avoid
The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant people avoid the following hazards:
- Alcohol
- Tobacco, including cigarettes, e-cigarettes, vaping, and chewing tobacco
- Secondhand smoke
- Marijuana
- Illegal drugs
- Prescription medications used for non-medical reasons
Reducing the Risk of Toxoplasmosis Infection
Toxoplasmosis is an infection caused by a parasite, which can potentially cause serious health problems for your developing baby. To reduce the risk of toxoplasmosis infection, wash your hands thoroughly after handling raw meat, ensure any meat or shellfish you eat is thoroughly cooked, wash fruits and vegetables before you eat them, avoid contact with cat feces and use gloves when gardening.
Sexual Activity
If you are having a normal pregnancy, sexual activity including intercourse and orgasm, is safe. Mild cramping or spotting after sex with penetration is normal. Call your doctor if you have bad cramping or heavier bleeding (like a period).
Sleep Position
You may sleep in any position you find comfortable. As your pregnancy progresses, you may find sleeping on your right or left side to be most comfortable.
Travel
Travel during pregnancy is generally safe. If you are taking a long car, bus, train or plane trip, walk and stretch regularly. Let your doctor know that you’ll be traveling so that they can provide you with individualized instructions or recommendations.
For more information about pregnancy, visit ACOGs website.
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