The First 12 Weeks of Pregnancy

Your Guide to Early Pregnancy Care, Scans and Screening by Miss Baljinder Kaur Chohan

Expert guidance from London Gynaecology, with Consultant Gynaecologist Baljinder Chohan
Finding out you are pregnant can bring an extraordinary mix of emotions – excitement,
anticipation, uncertainty and, sometimes, a lot of questions.

The first 12 weeks can feel particularly overwhelming. There are new symptoms to understand,
appointments to arrange, decisions to make and a huge amount of information to process, often
before you have had much time to adjust to the news.

Early pregnancy is also a period of significant change. While every pregnancy is different, the
first trimester is when your pregnancy is established, your baby’s early development takes
place and you begin to navigate the healthcare and support you may need throughout the
months ahead.

So, what should you actually be thinking about during those first 12 weeks?
We asked Baljinder Chohan, Consultant Gynaecologist at London Gynaecology, who works
across our Harley Street and Richmond clinics, to share her advice on navigating early
pregnancy, including scans, screening and when to seek medical advice.

Finding out you are pregnant

For many women, the first step is simply taking some time to process the news.
Once you have had a positive pregnancy test, it is worth considering what maternity and
pregnancy care you would like and speaking to your GP, midwife or obstetrician about your next
steps.

Your healthcare team can advise you about your medical history, any medications you take,
supplements and any specific considerations that may apply to you.

If you take regular medication, do not stop taking it without speaking to your doctor first.
Similarly, if you have an existing medical condition or have experienced complications in a
previous pregnancy, it is worth discussing this early so that appropriate care can be planned.

“One of the most common reasons women come to see me in early pregnancy is
because they want to know that everything is progressing as it should. It is
completely understandable to have questions or concerns during these first few
weeks, and seeking appropriate medical advice can provide reassurance and help
you understand what is happening at each stage.”

What happens during the first 12 weeks?

The first trimester runs from the beginning of your last menstrual period through to the end of
week 12.
It is a period of rapid development and change, and symptoms can vary enormously from
woman to woman. Some women experience significant nausea and fatigue, while others feel
relatively well. Symptoms can also change from one day to the next.

Common early pregnancy symptoms can include:

• Tiredness
• Nausea or vomiting
• Breast tenderness
• Increased urination
• Changes in appetite or food preferences
• Heightened sensitivity to smells
• Mild abdominal cramping
  Not experiencing many symptoms does not necessarily mean anything is wrong, just as having
  significant symptoms does not necessarily indicate a problem.
  If you are worried about a symptom or simply feel that something is not right, it is always
  appropriate to seek medical advice

Early pregnancy scans: what do you need and when?

There is no single scan that every woman needs at exactly the same point in early pregnancy.
The timing and purpose of an ultrasound will depend on your individual circumstances,
symptoms and what you and your clinician are hoping to establish.

At London Gynaecology, women can access specialist early pregnancy scans from around six
weeks, with appointments available at different stages of the first trimester, including around 6,
8 and 10 weeks, where clinically appropriate.

An early pregnancy scan can provide reassurance and help assess how the pregnancy is
developing. Depending on the stage of pregnancy, it may assess:

• The location of the pregnancy
• Whether the pregnancy is developing within the womb
• The number of pregnancies
• Pregnancy dating and development
• Whether a heartbeat can be seen, depending on gestation
• The cause of symptoms such as pain or bleeding, where possible

For some women, an early scan at around six weeks may be particularly helpful in assessing the
location and early development of the pregnancy. A further scan at eight or ten weeks can
provide additional information and reassurance as the pregnancy progresses.

It is also important to remember that sometimes it can simply be too early to see a pregnancy
clearly on an ultrasound scan. This does not always mean that something is wrong. Pregnancy
dates can vary, particularly if your cycle is irregular or you are unsure when you ovulated, and
what can be seen on ultrasound depends on how far the pregnancy has progressed. In these
circumstances, your clinician may recommend a repeat scan or further assessment before any
conclusions can be made.

This is one reason why having an experienced clinician interpret your symptoms alongside the
ultrasound findings can be valuable.

What happens at an early pregnancy appointment?

An early pregnancy appointment will usually begin with a conversation about your medical
history, symptoms and how far along you believe you are.

An ultrasound may then be recommended depending on your individual circumstances and
gestation. Your clinician can talk you through what can be seen and what the findings mean, as
well as whether any further assessment or follow-up is recommended.

For many women, the opportunity to ask questions and understand what is happening can be
just as important as the scan itself.

Screening during early pregnancy

The first trimester is also when you may begin thinking about prenatal screening.

There are a number of screening options available during pregnancy, and understanding what
each test can and cannot tell you can help you make an informed decision about which options
are right for you.

NIPT

Non-Invasive Prenatal Testing (NIPT) is a blood test that screens for certain chromosomal
conditions. It can generally be carried out from around 10 weeks of pregnancy, although the
exact testing options and suitability will depend on your individual circumstances.

At London Gynaecology, NIPT can be discussed alongside your early pregnancy care, allowing
you to understand what the test can and cannot tell you and which screening options may be
appropriate for you.

It is important to remember that NIPT is a screening test rather than a diagnostic test. Your
clinician can explain the results and discuss whether any further testing may be recommended.

NHS first-trimester screening

Alongside private testing options, women can access routine screening through the NHS.

The NHS dating scan is usually offered between 10 and 14 weeks. Depending on your
circumstances and the screening pathway you choose, this may also form part of first-trimester
screening.

If you are considering private screening such as NIPT, it is worth discussing your options with
your healthcare professional so that you understand how different tests fit together

Your first-trimester timeline

There is no single schedule that is right for every pregnancy, but it can be helpful to understand
what the first few months may look like.

Around 6 weeks: An early pregnancy assessment and ultrasound may be appropriate, particularly if you are
looking for reassurance or have symptoms that need assessment.

Around 8 weeks: A further early pregnancy scan can assess development and provide additional reassurance
where appropriate.

Around 10 weeks: This can be an opportunity for a further early pregnancy scan and, if you choose to have it, NIPT
screening.

Around 10-14 weeks: The NHS dating scan is usually offered during this period. Depending on your circumstances,
you may also have your first-trimester screening.

The important thing to remember is that these are not necessarily appointments every woman
needs. Your pregnancy care should be tailored to you, your medical history and your individual
circumstances.

Looking after yourself in early pregnancy

There is no single checklist that can make pregnancy feel completely predictable, but there are
some important foundations to put in place early.

Take your recommended supplements

Folic acid is recommended before pregnancy and through the first 12 weeks. For most women,
the recommended dose is 400 micrograms daily, although some women are advised to take a
higher dose depending on their individual circumstances.

Vitamin D is also recommended during pregnancy. If you are unsure which supplements you
should be taking, speak to your GP, midwife or healthcare professional.

Review medications

If you take prescription or over-the-counter medication, check that it is appropriate during
pregnancy with a healthcare professional. Do not stop prescribed medication without discussing
it with the person who prescribed it.

Look after your mental wellbeing
Pregnancy can bring significant emotional changes as well as physical ones. Even if this is a
much-anticipated pregnancy, it is completely normal to experience uncertainty alongside
excitement.

If anxiety, low mood or intrusive thoughts are affecting your day-to-day life, speak to your GP,
midwife or another healthcare professional. You do not have to wait until you are struggling
significantly before asking for support.

Know when to ask for help

Some symptoms in early pregnancy are common and do not necessarily indicate a problem.
However, pain or bleeding should always be discussed with a healthcare professional,
particularly if symptoms are significant or you are concerned.

Severe abdominal pain, particularly pain that is concentrated on one side, heavy bleeding,
dizziness, fainting or shoulder-tip pain can require urgent assessment.

An ectopic pregnancy can sometimes present during the first trimester and may not initially
cause obvious symptoms, which is why new or concerning symptoms should not be ignored.
If you are unsure where to seek help, contact your GP, local early pregnancy unit or maternity
service. In an emergency, seek urgent medical attention.

Start thinking about the support you will need

For many women, the first trimester is when they begin thinking about what life will look like
once the baby arrives – from maternity leave and childcare to family support, work and practical
help at home.

You do not need to have everything organised in the first 12 weeks. But starting conversations
early can give you more time to understand your options and make decisions without feeling
under pressure.

Fanny Di Domenicantonio, Founder and Director of Fox & Cubs Nanny & Private Staff Agency,
adds:

“The families who come to us during pregnancy are always the most settled when
their baby arrives. Not because they had everything figured out, but because they
had time to have the right conversations, explore their options and find the support
that was right for them. While childcare may feel like something to think about much
later, pregnancy is actually a valuable time to begin understanding what’s available
and building your support network, so decisions can be made without the added
pressures of life with a newborn.”

Thinking about your support network early does not mean you need to make decisions
immediately. It simply gives you the opportunity to understand what support might be helpful
for your family and when you may need it.

Your care does not stop at 12 weeks

The first 12 weeks are only the beginning of your pregnancy journey.

As your pregnancy progresses, your healthcare needs will evolve. You may want support with
nutrition and wellbeing, preparation for birth, pelvic health or planning for recovery after birth.
For some women, pregnancy can also bring previously unrecognised health concerns to light,
from pelvic floor symptoms to gynaecological conditions that require further investigation.

At London Gynaecology, our aim is to provide women with personalised care that can continue
beyond a single appointment or stage of pregnancy.

Our team includes experienced clinicians across gynaecology, early pregnancy, fertility, and pelvic
health, providing women with access to specialist support as their needs
change.

A final word from our clinical team

Baljinder Chohan, Consultant Gynaecologist at London Gynaecology:

“Whether it is your first pregnancy or not, it’s okay not to have everything figured out
in the first trimester. There may be lots of reasons why you want to seek reassurance
before you see your midwife for your booking appointment or have your first routine
’12-week’ scan on the NHS. You may be experiencing common problems such as pain
or bleeding, perhaps you have had a difficult pregnancy experience before, or maybe
you just want some simple reassurance. It is always okay to ask questions and
access appropriate care early.”

If you would like reassurance or specialist support during early pregnancy, London Gynaecology
offers consultant-led early pregnancy care and scans from six weeks, alongside NIPT from 10
weeks.