First trimester medical care: Who to see and what to expect

A good early step is to book your first prenatal visit with your primary care provider. In Newfoundland and Labrador, a primary care provider is usually a family doctor or nurse practitioner with a Family Care Team. If you currently do not have a primary care provider, you can request one through Patient Care Connect NL [1]. They’ll ask if you’re pregnant and will prioritize connecting you with a primary care provider as soon as possible.

Your primary care provider may continue to follow you through your pregnancy, birth and postpartum. However, they will also need to refer you to another healthcare provider who specializes in prenatal care, birth and postpartum. Here in Newfoundland and Labrador, the options are:

• Family Centred Maternity Care: a group of family doctors in St. John’s who specialize in prenatal care, low-risk obstetrics, labour and delivery, and postpartum care

• Killick Clinic Family Care Team: a group of family doctors in Grand Falls-Windsor who care for pregnant people who do not have a primary care provider, and specialize in prenatal care, low-risk obstetrics, labour and delivery, and postpartum care

• Midwives: in certain areas of the province, you may be able to access midwifery care; you can find more information at [2].

• Obstetrician (OB): if needed or preferred, your primary care provider can refer you to an OB

Talk with your primary care provider to help inform your decision about which option is best for you.

Early prenatal visits typically include a review of your medical history, estimated due date, current medications and any previous pregnancies. Blood tests, early genetic screening or a dating ultrasound may also be offered.

Mental health screening is important during pregnancy, and your care provider should ask you about your emotional and mental health during this time. Providers may use short, validated questionnaires such as the Edinburgh Postnatal Depression Scale (EPDS) to better assess your mental health. The EPDS is a brief check-in on how you’ve been feeling. If your care provider does not ask about your mental health or offer screening, you can bring it up and request a screening. This is especially important if you have a history of mental health concerns or are currently diagnosed or taking medication for a mental health condition.

If you're already taking medication for a health condition, talk with your provider before changing anything. Many medications, including mental health medications, are safe to continue, and stopping abruptly carries its own risks. Your provider can help you make a medication decision and point you to trusted resources on perinatal-specific medication information. If you find yourself vomiting often while taking medication, a conversation with your pharmacist/prescriber about medication management might be necessary.

Some things need same-day care

Most of the first trimester unfolds without emergency, but a few signs warrant urgent assessment. If you experience any of the following, contact a healthcare provider or emergency services right away:

Heavy bleeding Severe pain, especially on one side, which can be a sign of ectopic pregnancy, a medical emergency

Other reasons to seek prompt medical advice include severe dehydration from vomiting, fever, fainting, or symptoms that feel sudden or severe. If you're unsure whether something is urgent, contacting a healthcare provider is usually the safest approach.

In Newfoundland and Labrador, you can call 8-1-1 to speak with a nurse who can provide medical advice based on your symptoms.

Call 9-1-1 for immediate emergencies. Reaching out when you're unsure is not an overreaction — it's the right step.

This article was developed using sourced educational content from Canadian Perinatal Mental Health Trainings CPMHT, and informed by the collective knowledge and expertise of CPMHT professionals and Karen Clarke, BA, MSW, RSW, Doula Open Book Doula, Counselling and Consulting Services, as well as the following cited research and clinical practice guidelines: