Tiny bump, Big questions, Making your way through the first trimester by Dr. Ekawali Gupta
In Episode 2 of The Care Circle by Motherhood Hospitals, host Sahiba Sengupta is joined by Dr. Ekawali Gupta, Consultant Obstetrician and Gynecologist at Motherhood Hospitals, Mohali, to talk about everything you need to know during the first trimester of pregnancy. Dr. Ekawali, who has helped deliver over 10,000 babies, shares valuable insights on early symptoms like morning sickness, panic partners often deal with, fatigue, and mood swings, while also breaking down the dos and don’ts of diet and physical activities. The episode also covers important prenatal tests, emotional well-being, and how partners should be a support system during this delicate phase, as well as stay calm and aligned with the expert’s advice. Whether you’re preparing for parenthood or supporting someone who is, this episode offers trusted medical advice and gentle reassurance to help you through those crucial first 12 weeks.
Here are the key takeaways you shouldn’t miss from this episode:
- Visiting a doctor is very essential once the test is positive.
- Balanced nutrition is vital before and during early pregnancy.
- Fatigue and mood swings are normal in the first trimester.
- Regular check-ups and scans are crucial for tracking progress.
- Emotional support from partners makes a big difference.
- Balance rest with light physical activity for better well-being.
- Be in the moment and enjoy your pregnancy.
- How not to panic and stay calm and aligned.
Dr. Ekawali Gupta – Consultant, Obstetrician and Gynecologist at Motherhood Hospitals, Mohali
Dr. Ekawali Gupta, the best Gynaecologist in Mohali, Chandigarh Panchkula, has impressive array of qualifications, including an MBBS and MS in Obstetrics & Gynaecology. She is a FOGSI-certified Infertility specialist & Laparoscopic Surgeon. She is highly efficient in handling high-risk cases and has successfully performed numerous complex Obstetric & Gynaecological surgeries. Dr. Ekawali Gupta actively manages high-risk Obstetric cases in the Tricity of Chandigarh, Panchkula, Mohali, and the adjoining states. With her expertise in managing high-risk pregnancies, she has overseen more than 10000+ successful pregnancies. As one of the best Gynaecologist in Chandigarh, she provides personalized care to mothers & children, ensuring their optimal health.
0:00 – Introduction
1:07 – Guest’s Introduction
1:48 – Early signs and symptoms of Pregnancy
2:25 – Next move after a positive test
4:26 – Diet Advice for the first trimister
7:14 – Screenings and monitoring
10:14 – Challenges faced by soon to be mothers
11:41 – Role of partner in the first trimister
12:41 – Myths vs facts round
17:10 – One golden tip
(0:00) Sahiba : The moment those two pink lines appear, your world changes. You are now on one of the most miraculous journeys of your life, that is, pregnancy. But what happens in those crucial first three months Welcome back to The Care Circle, a podcast series powered by Motherhood Hospitals. Today, we are joined by an incredible expert to break down exactly what to expect in your first trimester.
(0:30) Sahiba : Let’s be real, the first trimester is often a whirlwind. You are trying to wrap your head around being pregnant, while managing morning sickness, doctor visits, mood swings, and of course, googling everything. Today we are diving into everything that matters in those first 12 weeks. What’s happening in your body, what foods to stock your fridge with, and when to reach out to your doctor. Whether you are expecting or planning or just curious, this episode is for you. I am Sahiba Sengupta, your host for today’s conversation.
(1:07) Sahiba : Joining me today is Dr. Ekawali Gupta, consultant, obstetrician and gynecologist at Motherhood Hospitals, Mohali, who brings over 15 plus years of experience in handling high-risk pregnancies and complex surgeries, with over 10,000 plus safe deliveries to her name. As a mother of two lovely daughters, she blends medical expertise with real-life empathy, making her a true champion for every mom-to-be. Welcome Dr. Ekawali to the care circle.
(1:43) Dr Ekawali : Thank you, Sahiba for having me !
(1:48) Sahiba : Okay, Doctor, let’s jump in.
Those early signs and symptoms of pregnancy, are they always obvious or do they show up unexpectedly when you least expect it?
(1:57 ) Dr Ekwali : See, they happen both ways. Sometimes people are very cautious and even if before they miss their menses, they may start feeling some symptoms of pregnancy. They may feel tired, they may feel lazy, they may have some breast tenderness, and sometimes we have patients who do not feel them till they get a positive pregnancy test. So both ways it works, it can happen any way for you.
(2:25) Sahiba : And once the test turns positive, I think then the real emotional coaster begins, right doctor? Like it’s a mix of excitement, anxiety, joy, maybe even a little panic for the couple. So doctor, in this situation, how shall couples deal with such a panic situation in their life?
(2:44) Dr Ekawali : Yes, you’re very right. These days when a test turns positive, I think everybody, almost every couple, they panic. They have lots of anxiety, yes, some happy emotions too, but panic and anxiety is there, what to do, what not to do.
(2:59) Dr Ekawali : So what I would advise is when your test comes positive, you visit your doctor, decide on what doctor you want to show to, and visit your doctor and take advice from the doctor.
(3:09) Sahiba : Completely agree with you doctor on this part. So doctor, I also want to understand, so when a couple visits the gynaecologist, what shall they expect? Like how their first consultation will go?
(3:22) Dr Ekawali : See, during the first visit, let us say that the pregnancy test just turned positive.So you’ll go to the doctor, the doctor will assess you, record your BP, pulse, will evaluate your weight and height, calculate your BMI, and order some tests, because there are certain tests which need to be done as early as possible. We say preferably prenatal, so that we can start some medicines as soon as possible. Ultrasound usually is not done in the first visit, because it is too early to see the fetal heartbeat. Until and unless you have some complication or have a history of ectopic pregnancy, we do not do ultrasound at this time. So the doctor will examine you, talk to you, give you advice about diet, about exercise, and will also start you on some prenatal vitamins on folic acid basically, and will give you a date for ultrasound when that needs to be done. Interesting, interesting doctor.
(4:18) Sahiba : So doctor, we have talked about the emotional rollercoaster that kicks, but let’s not forget one of the other important things that hits in, that are the cravings, aversions and a confused appetite.So doc, what should moms focus on during this tricky first trimester, especially when food suddenly becomes the villain and the hero?
(4:38) Dr Ekawali : So during the first trimester, you may feel a lot of food aversions, your food preferences may change, and you may start feeling pukish, nauseous at the sight of food. So what can be done at this time, is you can have whatever you like in moderation.
(4:55) Dr Ekawali : It is, we advise patients to take something cold and bland, no masalas in the diet, and small frequent meals are to be taken, to gargle your mouth after every meal. And even if these things are not helping you, then you can visit your doctor, she can give you a medicine for the same. So it is okay for the first three months, if you are not able to eat anything, we can compensate with high protein diet later on, once you are able to digest food.
(5:23) Sahiba : Understood doctor. So I also have a doubt in this, like if someone is already like, you know, towards the higher weight side, so how to manage that? Because, you know, cravings are something that can hit anytime at any moment. So how to balance the calories in that ways?
(5:40) Dr Ekawali : See, when you visit the doctor for the first time, the doctor will take your height, weight and calculate your BMI. Then according to the range of BMI you fall in, whether you are overweight, whether you are pre-obese, you are obese or you are in the normal BMI range, the doctor will advise you what calories you should be taking in a day.
(5:59) So let us say if somebody is overweight, so we give them a calculated diet in which we restrict some carbohydrates, but we increase the protein content. And for the cravings, definitely we allow time for some cravings, like once in 15 days, she can have whatever she wants to have.
Not too much of junk and not too much of oily or fried food. But yes, to some extent she can have.We do not want to punish the pregnant lady as well.
(6:26) Sahiba : Understood, understood, doctor. But still, doctor, in some cases, like, you know, if the food is not just incorporating and everything makes the women pukish, what then? Are there any some golden tips and tricks which the women can follow?
(6:42) Dr Ekawali : Yes, like I told you, when you get up in the morning, take two bread toast and because they will give you carbohydrates and the glucose sink, what happens in the night, that is compensated for. So you will have less nausea and vomiting. Small frequent meals are to be taken. Planned diet, non-oily, non-fatty food, avoid caffeine, avoid citric fruits. And even if it does not settle with this, then you can go to your doctor. There are very nice medicines which can be given for the same.
(7:12) Sahiba : Understood, doctor. So now let’s talk about one of the most important pieces of the first trimester puzzle, that is the screenings and the monitoring, which play a huge role in ensuring everything is progressing just as it should for both mom and the baby.
So, Dr. Ekawali, what are these essential screenings in the first trimester?
(7:34 ) Dr Ekawali : See, when the lady is coming for the first time, like I told you, we get some basic investigations done.Before investigations, we check her BP, pulse and her BMI. Then about the investigations, we get her hemoglobin levels checked, then her sugars are normal or not, because you know, India is a diabetic capital of the world, so a lot of people are diabetic, and then gestational diabetes is more common.
(7:59) Dr Ekawali : We check her blood group, so that we know if it is negative or positive. We check for viral markers, HIV, HBs, antigen, HCV so that she’s not suffering from some disease which she can transmit to the baby. Thyroid, again, is very important because thyroid hormone is responsible for baby’s brain development. So, if she is found deficient in that, we replace that. And then some infections like rubella and varicella. Again, if a woman contracts these infections during pregnancy, they may harm the baby, so we need to know about them.
(8:30) Dr Ekawali : And lastly, thalassemia screen, because thalassemia, again, is very common. And if your child is found to have thalassemia major, that means if mother and father have thalassemia minor, and the child inherits the defective gene from both the parents, the child may have thalassemia major, which is blood transfusion dependent. So, all these things we screen at the first visit. Apart from that, we also get an ultrasound done at seven weeks. This is to confirm the date, so that later on, we do not label the pregnancy as growth restricted. And we confirm the heartbeat also. We confirm whether it is a triplet or a twin pregnancy. There is no ectopic pregnancy. So, all these things are done at the first visit.
(9:13) Sahiba : Got it, got it, doctor. And doctor, so once all these screenings are done, there is also one thing that parents can track the baby’s growth during this time?
(9:23) Dr Ekawali : See, during this time, parents have no way of tracking baby’s growth. We just know that they are at this week of pregnancy. Later on, yes, after 20 weeks, when she starts feeling the baby’s movements, she can be sure that the baby is fine. But at this point of time, it is just the doctor’s visits which you need to do. So, after the seven weeks visit, the doctor will call you at around 12 to 13 weeks, where the next NTNB scan is done. The NTNB scan, main purpose of NTNB scan is to rule out any genetic disease in the baby, just like Patau syndrome, Down syndrome, Edwards syndrome. Those are ruled out at this 12-week visit. NTNB scan along with a genetic blood test, which may be a dual screen or an NIPT test that may be prescribed by your doctor.
(10:14) Sahiba : Okay, so doctor, let’s talk about some common challenges soon to be mother’s face. Morning sickness, fatigue, mood swings, backaches. What other symptoms do you see the mother’s face? What are the other challenges they face? And what can be done to ease such symptoms?
(10:30) Dr Ekawali : See, starting from head to toe, she’ll feel tired, lazy and very sleepy. So, what I would say is, go ahead, take some rest, your body deserves it. Then she might have some nausea, vomiting, we have already discussed that. A lot of bloating she might have. Again, have bland food, no masalas in your diet. And before and after taking food, walk for 10 minutes each time.
(10:55) Dr Ekawali : And you may have some breast tenderness.For that, you can wear a tight brazier, use ice packs. You may have some joint stiffness, you can use hot fermentation for that. You may pee a lot, that is okay. Keep drinking water and go pee, nothing can be done about that. Then you may have some backache and some swelling in the feet. For backache, keep your posture right, keep a stool under your feet. May take a massage while sitting in sitting position. And for swelling in your feet, again, some massage for the feet. Or whenever you’re sitting, keep a stool under your feet. And then while you are lying down, you can keep a pillow under your feet.
(11:39) Sahiba : Interesting, interesting, doctor. And I’m also curious to understand, like, what role does the partner play during these three months? You know, how they can contribute when it comes to women’s health and easing her during this phase?
(11:54) Dr Ekawali : See, It is very important. The role of a partner is very important. It is not just the lady who is getting pregnant. It is the couple who is getting pregnant. So the partner should be available at each and every visit. Communication should be open. He should take out some time for the wife.
(12:10) Dr Ekawali : There may be some mood swings for that. He has to be very patient and receptive to the wife. Then I think if some outings are needed, he can take them out and go to each and every doctor visit. That is, I think, and be there. Emotionally be there. Just listen to her doubts. Just listen to her fears, her anxieties. That is what he can do. I think, doctor, that’s a great mantra all the husbands out there can follow for their wives.
(12:38) Sahiba : Yes. Okay.So now it’s time for a quick myth versus fact round, doctor.
Let’s burst some common misconceptions about early pregnancy. Most of the women have. So first one is morning sickness only happens in the morning.
Dr Ekawali : That’s a myth. Morning sickness can happen anytime. In fact, 50%, half of the ladies feel nausea throughout the day, even in the evenings. Understood.
(13:06) Sahiba : So jumping on to the second one, you are eating for two. So double your portion size. I think this is the most common myth that everyone has in their brains.
Dr Ekawali : So it is a common and a very dangerous myth. You do not need to eat for two because that will lead to excessive weight gain and will decrease the chances of having a normal vaginal delivery.
You just need to have 300 kilocalories extra in your diet. You know, one chapati has 150 kilocalories. So just two chapatis extra in a day will do the job. Understood. Understood.
(13:38)Sahiba : The third one is, doctor, no exercise during the first trimester.
Dr Ekawali : Again, a very common and dangerous myth. You should be active. And the level of activity you were doing before getting pregnant can be done even after getting pregnant. You don’t need to quit your job. It is just that prolonged squatting or lifting very heavy weights should be avoided. Apart from that, everything needs to be continued.
(14:03) Sahiba : Understood. The fourth one is, doctor, if you feel fine, you can skip prenatal appointments.
Dr Ekawali : So no, you cannot skip your prenatal appointments if you’re feeling fine.
There are certain tests. There are certain ultrasounds which are time bound and which need to be done at that proper time. Because if you miss them, then there is no replacement. And they’re very important scans and tests. Like NTNB scan needs to be done at 11 to 13 weeks.So if you miss that, there is no replacement for NTNB scan. Similarly is the case with level 2 scan and fetal echo later in second trimester. So whenever your doctor is calling you, you need to go and visit the doctor. Another thing is, you may feel that there is no ultrasound, there are no tests.So why go to the doctor? Again, it is very important because there may be some vaccinations. The doctor may just need to examine you by your tummy. So never miss any of the doctor’s appointments.
(14:57) Sahiba : Okay, doctor. So the next myth is, you should avoid traveling during the first trimester.
Dr Ekawali : This is not a myth. This may be right. Yes, we tell patients to avoid traveling in the first trimester because she’s already not feeling good. There’s lots of nausea and vomiting. So travel might make her more uncomfortable. Secondly, you’re lazy, sleepy. Your body requires extra rest. So traveling gets in the way of that. Understood, doctor.
(15:28) Sahiba : The next one is, caffeine should be eliminated in early pregnancy.
Dr Ekawali : Caffeine should, yes. There is a limit to what amount of caffeine you can have in pregnancy. So we recommend one cup of coffee in a day. More than that, you should avoid.
(15:44) Sahiba : Got it, doctor. I think I can relate. Not relate, but then the lifestyle which we follow nowadays, it’s like four to five caffeine shots in a day. So if someone is coming from that particular field, like an IT job or something, how to manage that with the patient? Because in a way, they crave caffeine in their day-to-day life.
(16:07) Dr Ekawali : So here comes the role of prenatal counseling. And healthy lifestyle. Coffee is good, but not so much of coffee that you’re having five to six cups of coffee in a day. So for that, we need to raise awareness about coffee intake. Just routinely stress management, lifestyle management, some yoga and meditation, which can be done for everybody, not just pregnant females, pre-pregnant females, males, everybody that should be done.
(16:35) Sahiba : Okay. So the last myth is that you should avoid fish due to the mercurial content in it.
Dr Ekawali : This is again a myth. Low mercury fish can be taken during pregnancy. The only thing is it should be well cooked. And two to three servings of low mercury fish per week is safe.
Avoid eating raw fish and check for local fish advisories. And I think that is it. You can have fish. It is a very good source of omega-3 fatty acids.
(17:05) Sahiba : So I think it’s a wrap for this particular episode. But before we wrap up, I love to hear one golden tip from you, doctor, that you would like to give our mom-to-be’s.
(17:19 ) Dr Ekawali : See, I would say that enjoy your pregnancy. It is the most magical time of your life. You can eat, you can take rest, and you can enjoy yourself to the fullest. So keeping your anxieties apart, just try to be in the moment and enjoy your pregnancy.
(17:36 ) Sahiba : That sounds like a great, great advice, doctor. I think every mom-to-be shall follow that. And like, you know, I also believe that the mums should, you know, give themselves the grace. And, you know, they are growing a human, so they should enjoy this whole journey.
(17:53) Sahiba : And with that, thank you so much, Dr. Ekawali, for such an insightful and reassuring conversation. It’s been a pleasure having you on The Care Circle. Thank you so much, doctor, for giving your time to the episode. To our listeners, thank you for tuning in. If today’s episode helped ease some of your worries, subscribe to The Care Circle for your very own expert-led safe space. Follow us on social media for updates and exclusive content. Until next time, stay healthy and take care.
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