top of page

General advice in first trimester


1. To avoid toxoplasmosis, avoid:

a) eating undercooked contaminated meat (especially beef, pork, lamb, venison) or shellfish (e.g. oysters, clams and mussels)

b) eating food that was contaminated by knives, utensils, cutting boards or other foods that had contact with the undercooked contaminated meat or shellfish, or not washing hands thoroughly after handling undercooked contaminated meat or shellfish.

c) drinking unpasteurised goat's milk.

d) accidental eating or drinking contaminants from an infected cat's faeces (e.g. avoid handling cats' litter - ask someone else to clean the litter box, wash hands thoroughly with soap after gardening, wash fruits and vegetables before eating them).

2. To avoid listeriosis, drink only pasteurised or UHT milk, and avoid eating ripened soft cheese (e.g. Camembert, Brie or blue-veined cheese), pate, undercooked food. There had been some listeriosis outbreaks internationally and the risk for infection increases significantly when such cheeses are made from unpasteurised raw milk.

3. To avoid salmonella, avoid eating raw or partially cooked eggs or food that may contain them (e.g. some types of mayonnaise or mousses), and raw or partially cooked meat (e.g. poultry and shellfish).

4. Go generous on fruits and vegetables.

5. Fish is healthy but some health authorities have recommended pregnant women to eat no more than 2 portions of oily fish, such as mackerel or salmon, a week. This is because too much mercury may be found in oily fish which can be harmful to an an unborn baby's development. Also avoid eating more than 2 fresh tuna steaks or 4 medium-sized cans of tuna a week, and avoid eating shark, swordfish or marlin.

6. Advice about alcohol during pregnancy:

a) Knowing what we know today, it is advisable not to drink during pregnancy.

b) An occasional drink earlier in pregnancy probably didn't harm your baby, so you

don't have to worry about it.

c) Even if you only drink socially, a few drinks an evening throughout pregnancy can

interfere with your baby's development.

d) To avoid any possibility of alcohol-related birth defects, any drinking during

pregnancy is probably too much.

7. Limit coffee intake as recent studies show that too much coffee consumption may be associated with an increase in risk of miscarriage. It may be best to avoid coffee as a new study suggests that even up to half a cup of coffee a day may be associated with having low birth weight babies.

8. Tea - There isn't any similar studies with tea but I would generalise the study to include tea as some tea also contain caffeine and we don't really know if it is the caffeine or other constituents in the coffee that is associated with the increased risk of miscarriages.

Supplements 1. Folic acid 400-800 micrograms (or 0.4-0.8 mg) every morning - this reduces the risk of fetal brain and spinal abnormalities e.g. anencephaly and spina bifida.

2. Multivitamins containing iron, calcium supplements and vitamin D supplements - I generally avoid these till after 12 weeks as they may exacerbate nausea and vomiting which is rather common during the first trimester.

3. DHA supplements - These are now quite popularly taken during pregnancy as DHA is an important constituent of the brain and the retina, and is thought to be useful for the development of the brain and retina in the fetus. I normally start on this from 12 weeks gestation.

Habits 1. Avoid smoking.

2. Avoid certain medications - tell the GP that you are pregnant.

3. Eat well - You may have to modify your meals to small frequent meals and actively avoid smells or foods that may cause you to have more nausea and vomiting during this period.

4. Have regular physical activity 3-5 times a week - brisk walking and swimming are some good activities.

5. Sexual intercourse - in general, sexual intercourse does not cause complications unless there are risk factors e.g. bleeding during pregnancy, a low-lying placenta, high risk for preterm labour.

When to see the doctor 1. Have an ultrasound scan at about 6-7 weeks - this is to date the pregnancy accurately, to determine if it is one or more babies, and to confirm that the pregnancy is within the uterus (and not an ectopic pregnancy).

2. Inform the doctor of any family history of children with disabilities / genetic diseases, vaginal bleeding and/or abdominal pain.


bottom of page