Thursday, June 23, 2022

The First Trimester

Our little bean at 12 weeks.

Some personal news: I'm pregnant, due in mid-December! When this post goes live, I'll be in my 15th week of pregnancy, just past the first trimester. K and I are so excited to become parents. I also feel incredibly fortunate that everything's been going smoothly so far, according to my OB/GYN it's all proceeding as expected and low-risk.

Today's post is about my first trimester. Be forewarned, I mention some detail about things like ovulation tests, irregular cycles when coming off the pill, side effects of pregnancy, and that sort of thing. Along with that, an important disclaimer: I am not a medical professional, but I always take seriously the advice of the team at my OB/GYN's office.   

Finding Out

We technically started trying right after we got married last September. But from my past experience temporarily stopping the birth control pill - just on a whim, really; I only got to seven months without before my acne got so bad I decided to go back on - I knew it could take as long as six months for my body to get back to normal cycles, and this wouldn't be a cause for concern if I went to a doctor about it. So I wouldn't have really started the "clock" on how long before I started to think about consulting with a fertility doctor until I felt like my body had adjusted to being off the pill. That ended up taking around four months this time, until mid-January or so. 

Even after that four months, my cycle was still extremely irregular, and sometimes very long. I started using ovulation test strips, but never quite figured out the timing of when I should test or even used one at the right time to get a positive result. I wasn't worried or anything, it seemed to obviously be due to user error on my part.

Because of my irregular cycles and inability to figure out the timing on ovulation tests, I didn't really think anything of my period being late. I'd had a 38-day cycle once since stopping the pill, and there seemed to have been a general trend of my cycle getting longer from an average of 34 days. (If that trend continued, it might have made sense to start thinking about consulting a fertility doctor sooner rather than later. But work was so busy back then, I didn't have the mental capacity to think about that.) 

By day 40 of my then-current cycle, I could totally feel what I thought were standard PMS symptoms, some mild cramps and feeling a little bloated, so I didn't really think I could be pregnant. But I took a test anyway, thinking why not just check? And lo and behold there was a clear "positive" line. We were so excited, but didn't want to start telling our friends and family until a little later, after I'd been to the OB/GYN. 

The First Seven Weeks

Who knew it could be difficult to find an OB/GYN in NYC, of all places? It felt like it took the better part of three days of searching online and making more than a few phone calls - none of which were actually picked up - to figure it out. 

My gynecologist from before didn't do obstetrics, so that wasn't an option. With the big OB/GYN practice affiliated with the hospital nearest our apartment - which was also in-network with our insurance - I couldn't even get anyone on the phone after two days of trying to call them, and there wasn't even a way to get through to a voicemail inbox to request an appointment either. There was another big OB/GYN practice in my neighborhood, but it had tons of reviews complaining about highly disorganized and error-filled billing practices, and that's a huge deal-breaker for me. 

When I got frustrated with the search, I ended up just going with a doctor who had book-online appointment availability in the next three day on ZocDoc, and who was affiliated with another large OB/GYN practice that didn't seem to have too many complaints online. That choice has turned out pretty well, the practice has multiple office locations that aren't the most inconvenient relative to my apartment and workplace. The only downside is they're affiliated with a hospital which isn't that near where we live. 

Because my cycles were so irregular, it was initially difficult to pinpoint my due date. My first prenatal appointment ended up taking place at what I later found out to be the start of my 5th week of pregnancy. Not much could be seen on an ultrasound at that point, just a gestational sac and no fetal pole. The doctor assured me this was well within the range of normal at what was likely still a fairly early stage - though we didn't know exactly how early at that point - and asked that I book a follow-up dating ultrasound for roughly two weeks later. 

At my second prenatal appointment, they were able to see a fetal pole, a fetal heartbeat, and that I was measuring at 6 weeks 5 days, which placed my due date in mid-December. Then they didn't need to see me again until the 12th week of pregnancy. 

The Next Five Weeks

The next prenatal appointment was the 12-week scan. Mine took around half an hour because the baby was not being super-cooperative, and the ultrasound tech needed to apply so much pressure from so many different angles to get all the required measurements. They pressed parts of my stomach so hard that it was sore the next day, and even a little bit the day after that!

I was so glad to learn that everything they were looking for seemed healthy and right on track. My next appointment is not until 16 weeks, and that one should be fairly quick; most likely no ultrasound - just a doppler - and taking some more blood for more routine tests. (I also had blood tests at my first appointment and at the 12-week scan. Some of the tests weren't that likely to be covered by insurance, and so I paid directly without going through insurance.) 

We've now told many of our friends and family about the pregnancy, and that's pretty exciting! 


Overall, I haven't had any particularly disruptive side effects or symptoms of pregnancy. There are a ton of smaller symptoms that have popped in and out throughout the first trimester, some of which are really quite uncomfortable or not especially pleasant. But almost none of the side effects have been persistent enough or difficult enough to be particularly worth bringing up at my prenatal appointments. I feel very lucky that it's been a relatively "easy" pregnancy so far, since I know a lot of people have a really hard time, especially with nausea and vomiting. 

Acne. Many of the medications I've relied on throughout my adult life to try and control my acne are, unfortunately, forbidden when one is trying to conceive, and also when one is actually pregnant. Thus, I've been off almost all my regular acne-targeting medications since last September, and that hasn't been fun at all. I've had pretty bad breakouts off and on in the months since, and I think pregnancy made my acne worse, not better. Alas, it's not just on my face, it's now on my neck and chest as well. 

Curology is able to offer a formula with only active ingredients generally considered safe while trying to conceive, so I used that until I got pregnant. Completely understandably, I was still breaking out a lot, since the more effective ingredients like topical tretinoin could not be part of that formula. Curology asks that you consult your OB/GYN once you're pregnant, and mine says benzoyl peroxide only during pregnancy (I understand this to be a fairly hard-line view that may be a bit of an outlier), so I stopped using Curology after I knew I was pregnant. 

I'm currently using Neutrogena On-the-Spot (also here or here, affiliate links), which I think is one of the only over-the-counter 2.5% benzoyl peroxides commonly available at most drugstores. (Many OTC benzoyl peroxides are 10% concentration.) It helps some, but it definitely is not equal to the task of completely controlling my acne. 

Morning Sickness. I've had very little morning sickness, and have never even actually thrown up during this pregnancy so far, fingers crossed that continues! I do get nauseous throughout the day; this was at its worst around seven to ten weeks and still comes and goes to this day. When I feel nausea coming on, it helps a lot to eat something small immediately, and I usually pick raw almonds for that (but sometimes it's peanut M&Ms instead). Then when I'm feeling a bit better, I sometimes reach for a bigger snack. 

In general, my morning sickness has been so mild that I've been able to eat typical amounts of basically all the foods I ate pre-pregnancy, though I've been snacking more than before throughout the day to fend off the nausea. On the recommendation of my OB/GYN, I do use some of the commonly recommended over-the-counter medications (namely, a half dose of Unisom and some vitamin B6) to help with keeping nausea at bay.

Earlier in pregnancy, the nausea would come up at random times throughout the day, but recently I find it most noticeable in the early morning. It even sort of wakes me up an hour or two before my alarm sometimes, but is usually mild enough that I can fall back asleep. 

Food Aversions or Cravings. I haven't had any particularly noteworthy food aversions or cravings, but coffee and tea generally just haven't tasted right throughout the pregnancy. My former habit of getting 3-4 lattes/week while on the way to the office is all but gone, which saves me a little money. I occasionally find that other foods taste a bit off, but usually not enough to reject eating them completely. Often the feeling that a food doesn't taste right only lasts for the first few bites and also isn't present the next time I eat the same thing. 

Digestion. I understand from reading various pregnancy-focused subreddits, including the one for my due date, that I probably can't expect my digestive system to behave normally until after the pregnancy is over. This is by far my most persistent and noticeable set of symptoms, and it's not very comfortable, to say the least. There's gas, bloating, and constipation and it all never really seems to go away. My OB/GYN recommended an entire laundry list of over-the-counter medications for these issues, and I take most of them, which helps keep things more manageable, but far from back to pre-pregnancy normal. 

Work and Pregnancy

As you can probably guess, my current condition likely complicates that government job search I was just posting about. When I filed those job applications last April, I knew that there was a good chance the lengthy interview and background check process would interact poorly with my family planning timeline. K and I had discussed these issues at length beforehand, and we decided we had no way to fully control the timing of either the government job hiring process or pregnancy, and we also didn't want to wait on starting either. Whatever happened or however inconvenient it got, so be it. 

I haven't really fit comfortably into any of my business suits since week 7 or 8, and I've had the beginnings of a definite bump since week 13 - and also so much bloating since week 7 that it looked like a sizable bump most of the time regardless - so at this rate, any future rounds of interviews will probably involve my wearing obvious maternity clothes. I honestly don't know what I can expect if I get invited to that second round or third round interview that way, I don't have any professional mentors who've had this exact experience. The legal industry is, unfortunately, not always known for being the most tolerant of employees who are pregnant or who are parents. 

Then there's the complications surrounding parental leave. At most legal jobs I'm familiar with - including biglaw - it's fairly standard policy that only attorneys with a full year of service under their belts beforehand are eligible for full parental leave benefits, at least according to the letter of the law in the company handbooks. Furthermore, the parental leave policies in government are typically far less generous than at most private-sector law firms. (For the category of government job I'm thinking of, I'm pretty sure there actually was no paid parental leave available at all until very recent years.) 

I've known for a long time that I could end up on the wrong side of eligibility for paid parental leave when transitioning to a government job on my desired timeline. It's one of the reasons my "emergency fund" cash savings are on the larger side of average, at a full year of living expenses. If I'm lucky enough to get that dream government job offer at a time that makes me ineligible for paid leave, I'm planning to take the job offer anyway, and to draw on my emergency fund to "self fund" a period of unpaid family leave. 

And yes, we recently renewed our lease on our one-bedroom apartment while taking into account that we'll have a newborn joining us in mid-December. Among our biglaw and recently-in-biglaw peers, it's quite typical to have a newborn while living in a small-ish one-bedroom NYC apartment. Though when our lease expires next summer, we probably will need to move elsewhere, maybe out of NYC and into the nearby, commuting-distance suburbs. 

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