Brief Answer: No symptoms of pregnancy is normal Detailed Answer: Hello XXXXXXX Congratulations on your pregnancy! Its so nice and fulfilling...... I understand that you have no symptoms indicating your pregnancy. Let me reassure you that once the pregnancy test is positive, not having any symptoms is not going to harm your pregnant state. This means that even though there are no symptoms of pregnancy, your pregnancy will be fine. Firstly, its not necessary that all patients must have some symptoms. Secondly, symptoms usually start after 6 weeks of pregnancy and i think you are just short of 6 weeks pregnant today. So relax! Don't worry at all on this score. Yes, you are right - the first 3 months are crucial for the pregnancy especially if this is your first pregnancy - we do not know how your system responds to this pregnancy. Naturally one must nurture it and take care. I see from your history that you are not on any medications. May i advise you to start Folic Acid/Folate tablets as soon as possible. These are very important to prevent nerve tissue abnormalities in the baby and this is the time when these tissues are forming. Other than that i don't recommend any other medications/supplements. Please do NOT take any iron and calcium tablets at this stage of pregnancy. Currently it is recommended that all Indian women, being markedly deficient in Vitamin D, should routinely take Vitamin D 60,000 IU every month. However, i am happier to first test the laboratory value first before prescribing Vitamin D even though, in my own practice too, you will be surprised to know that practically all the pregnant women tested had very low levels. If found to have low value, you may in fact need higher doses than what i mentioned. This is important - don't ignore this advice. Avoid all forms of drugs including over-the-counter flu and fever medicines unless prescribed by your doctor. These were a few essential specifics, which i felt were too important to miss and which you should know. Now for some general advice, as requested by you: The pregnant state is a very natural state yet some discomfort here and there may occur. Most of the time you can ignore small, inconsequential aches and pains. Remember that even a non-pregnant human body may have discomfort once a while. You should be able to develop antennae which tell you that something is wrong or not. Treat your pregnancy with intelligence and a sense of XXXXXXX and wonder at the miracle which your body is doing..... Important alert signs are - pain low down front (abdomen) or back, bleeding, watery discharge - all of these either alone or together in some combination. All these may indicate a pregnancy at risk - so get in touch with your doctor immediately. Please don't eat or drink anything from outside especially in tropical countries and warmer climates. This is because the medicines required to treat food poisoning or tummy infections may harm the baby; so are best avoided. Eat only home-made food which should not, preferably, be left-overs or stale. How much to eat - as much as you are hungry for. Please don't 'eat for two', however. Its not required, especially in early pregnancy when the baby does not need much nutrition since its not putting on much weight at this time. Weight gained in pregnancy due to overeating may be very difficult to lose later looking at the poor exercise habits of Indian women. Its wise to eat small amount of food several times a day - instead of a 3-meal day, make it a 6-meal day. This will help reduce the acidity which may occur more frequently in pregnancy. Avoid more than 1 cup coffee every day. Other than that, i do not have any restrictions on what my patients should or should not eat. The best way is to listen to your body - it will always indicate to you what you need and what you should not eat. Unfortunately, listening to the body is an art which we have lost. Pregnancy is a good time to practice :-) Pregnancy is also a good time to quit rubbish things like smoking and alcohol - all fads to make us appear smart; but we are not interested in being smart; only intelligent, isin't it. Sexual activity - scientific data does not say - stop it! But in my practice i usually advise my patients to avoid sexual activity in first 3 months of pregnancy till the pregnancy has 'settled down'. If its not possible to stop, for whatever reason, i suggest you ask your partner to use a condom and not be too hard or too deep. This is to prevent contractions of the uterus either by certain substances present in the semen, prostaglandins, or due to the physical nature of the act. Travel - long distance, should be limited and undertaken only if necessary. All modes of transport are safe except the rickety, unstable, jerky ones. Air travel is safe too because nowadays all aircrafts are pressurized. The best time for long distance travel is not now in early pregnancy but in mid-pregnancy (14-26 weeks). Exercise - if you are used to yoga/gym/exercise program before you became pregnant, you could continue them with some modifications which can be explained by your instructor/trainer. If you are not an exercise person, don't start any new exercise program in these first 3 months of pregnancy. After these 3 months you could go on to a graduated program of yog asanas which would be very beneficial for your general health and a normal delivery. Don't worry. Whenever in doubt, seek information and help. Relax into your pregnant state; enjoy every moment of it including some minor discomforts here and there; everything will just progress smoothly and fine........ My best wishes for you. Take care. Dr Nirja Chawla

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