Jaime Lewis (Host): Meaningful Medicine is a Novant Health Podcast, bringing you access to leading doctors who answer questions they wish you would ask. From routine care to rare conditions, our physicians offer tips to navigate medical decisions and build a healthier future. Today, I'm sitting down with Dr. Eboni Ogunbekun, a board-certified obstetrician and gynecologist at Novant Health to discuss what moms can expect during the first trimester of pregnancy.

But before we dive into first trimester guidance, Dr. Ogunbekun, welcome, and I would just love to know how Obstetrics became a passion of yours. What made you decide to become a doctor?

Eboni Ogunbekun, MD: Yeah. So, I actually just started this journey as far back as I can remember, probably about the age of six years old when I first wanted to be a doctor. And then, around the age of 10 when I ran into my own little issues, that's when I knew I wanted to be in Obstetrics and Gynecology.

Host: Oh, very cool. Okay. So, let's talk about having a baby. Why is it so important to find an OB-GYN during your first trimester?

Eboni Ogunbekun, MD: Yes. Well, this is a very vulnerable time. It's a time that is very important and lot of people have a lot of questions, whether it's your first time around or your fifth time around. Every pregnancy is different. So, we want to establish care early and establish care with a provider that you feel comfortable with. And you want to know that sooner rather than later.

Host: You mentioned that expecting mothers have lots of questions. I know I did when I had my first child. What is the most common first-time mom question you receive in clinic?

Eboni Ogunbekun, MD: I bet the most common question is, "What do I do when I find out I'm pregnant?" That is kind of, you know, the most important question. And the first thing I say is you do not have to run to the emergency room. It is okay. We're glad about it as long as you're glad about it. And giving them some steps and guidance on what to do once you have a positive pregnancy test.

Host: Okay. Are there any normal or expected-- I hesitate to use the word symptoms-- but you know, what are the symptoms? What do moms go through in that first trimester and when do they need to seek help?

Eboni Ogunbekun, MD: So, one of the main things that a lot of women go through, of course, is nausea and vomiting. That's very common in the first trimester, and we want you to seek help once you get to the point that you can't take things down, especially water. If we're getting to that point, then we need to be probably talking about hospitalizations, medications, et cetera, et cetera. Some nausea, vomiting is normal and it's okay, but we want mom to be as healthy in her normal self as possible, and we have ways and tools to help you get there.

Host: I have two children, and when I was pregnant with each of them, I knew that I was supposed to be gaining weight, but there is of course a lot that surrounds a lot of feelings and a lot of just triggers, I think, around the concept of gaining weight. "Am I gaining enough? Am I not gaining enough?" Why do you monitor weight and BMI for expecting moms? Is there like a target weight that patients should be expecting to reach, or is it different for everybody in the first trimester?

Eboni Ogunbekun, MD: I'm glad you asked because there's a lot of stigma around weight gain in pregnancy. And to be honest, everyone's different. Some people don't gain weight at all. Some people gain more than the average. We have a target, depending on what your BMI is. Usually, anywhere from 11 to 25 or 35 pounds, depending on what you're starting out at. But even if you don't hit those targets or hit those targets too much, it doesn't really change our management. The main thing we're looking for, especially as you get to the end of that pregnancy, is that you're not retaining water, because sometimes that can be a sign of different diseases such as preeclampsia or other hypertensive disorders or concerns. So, that's kind of why we're focused on weight. Otherwise, it's just more to lose If you do you gain more than the expected.

Host: Again, we all know about pregnant women having cravings, that sort of thing, along the same lines of gaining weight and what to eat. Are there certain foods that you recommend pregnant women enjoy or stay away from in their first trimester?

Eboni Ogunbekun, MD: Yes. So, I try to be as gracious as possible with this because pregnancy is a tough time for a lot of people. So if you can eat a well balanced diet, great. If you can get your protein in, of course protein's good for you, good for baby, vegetables. But sometimes, I have some mom who are struggling so much with nausea and vomiting, eat what you can, even if it's cupcakes and cookies. Baby's going to get what baby needs, but we also want mom to be as healthy as possible. So if you are just not eating or craving or able to tolerate some of those healthier options, you might have to do some of the non-healthy options just to try to get through the pregnancy as best you can.

Host: In that sort of sensitive first trimester time, is it still safe for a mom to exercise?

Eboni Ogunbekun, MD: Yes. So honestly, I have moms do what they've been doing prior to the pregnancy and then listen to your body throughout the pregnancy. But what I don't want is-- this is not the time to join a CrossFit program if you've never worked out before. But if you've already been working out, that is perfectly fine. Just again, pay attention to your body.

And then, the other thing to be mindful of is spotting in pregnancy. That can happen sometimes earlier on. We always want to know about it because it can be signs of miscarriage or ectopic pregnancies, things like that. But if you have spotting, sometimes it can just be implantation bleeding. But either way, we'd want to know.

Host: With regard to mental health, I remember being pretty surprised by how much I was affected by hormonal changes. I was teary sometimes, I was irritable sometimes, and then sometimes I was elated. I mean, these are things that I think we often link to maybe postpartum, but don't always think about in terms of pregnancy. What can a new mother expect in terms of mental wellness?

Eboni Ogunbekun, MD: Definitely that is absolutely normal. And I think, I'm glad that you mentioned that because we do associate it with the postpartum period. But kind of what leads to that postpartum depression is all the hormones that you get enfleshed with during the pregnancy then leaving, but your hormones surge tremendously during pregnancy, and that can absolutely affect your mental health. So if you already have problems or a prior history of depression, anxiety, just know that sometimes that can be heightened during the pregnancy and we'd rather stay ahead of it than behind it because a lot of those medications, if you choose that route, might take some time to get in your system and be effective.

Host: So, some of the really exciting things to think about are when can you expect to see a bump or feel kicks? Those are some of the rewards of being able to carry a child.

Eboni Ogunbekun, MD: Yep. Yep. So in that first trimester, I'm sure it's tough because you're feeling all the symptoms of pregnancy, but you don't see the pregnancy yet. So, it's oftentimes a lot of patients are a lot happier in that second trimester, because you're starting to see the fruits of your labor. A lot of times, right around that 18 to 20-week mark, is when you start to feel the kick. And some people start to feel or see a bump then, sometimes it doesn't show a little bit later, maybe until like 24 or so weeks, but everybody's a little bit different. So, absolutely kind of in that second trimester is the sweet spot where you kind of start to feel good again before the third trimester woes come.

Host: This is all bringing back a lot of good and interesting memories as well. I don't know, just it's a wild time. It's such a wonderful time, but also just, really, it has a lot of effects on the mom. What kind of advice do you give for moms expecting maybe their second or third baby? Do they experience the same sorts of things or is it different?

Eboni Ogunbekun, MD: Every pregnancy is different. And honestly, the trend that I probably see the most is sometimes the aches and pains pregnancy get a little bit worse with each pregnancy. Sometimes that nausea can get worse. I mean, a few cases, you know, of course, you see it get better, but I just want moms to remember that every pregnancy is different. It doesn't mean anything's wrong with baby. I know sometimes we link it to, "Oh, well, maybe it's a different gender," and that's fine too. But each one's different and that is absolutely okay. And if you ever have any questions or concerns, of course, we're available.

Host: Thank you, Dr. Ogunbekun, so much for sharing all your expertise and helping new moms out in the beginning of their journey.

Eboni Ogunbekun, MD: Absolutely. Thank you for having me.

Host: Once again, that was Dr. Eboni Ogunbekun, obstetrician and gynecologist at Novant Health. To find a physician, visit novanthealth.org. And for more health and wellness information from our experts, visit healthyheadlines.org. And thank you for joining us.