The first 13 weeks, turned into a list you can actually tick off
Folic acid, your booking appointment, the early blood tests and the dating scan, in the order they really happen.
Quick answer
A first trimester checklist comes down to five fixed points. Start 400 micrograms of folic acid a day and keep taking it until week 12 (NHS). Stop smoking and drop alcohol completely (NHS, ACOG). Contact your GP or midwife as soon as you get a positive test, so your booking appointment can happen before 10 weeks. Attend that booking appointment and its blood tests, usually between weeks 8 and 10. Then go to the dating scan, offered between 11 weeks plus 2 days and 14 weeks plus 1 day in the UK. Everything else, including screening choices and telling work, slots around those five.
The first trimester is the strangest stretch of a pregnancy to organise. You often feel your worst, you may not have told anyone yet, and almost nothing is visible from the outside. Meanwhile there is a surprising amount of admin: a supplement to start, appointments to book, blood tests to sit through, and a screening decision that has a real deadline attached to it.
This guide lays it all out by week. It is written for a first pregnancy, using the NHS antenatal schedule as the backbone, with notes where guidance from ACOG (United States) and RANZCOG (Australia and New Zealand) differs. If you are further along, our week 14 to 27 checklist picks up where this one stops.
Folic acid recommended daily before conception and through the first 12 weeks (NHS)
When the NHS aims for your booking appointment to take place
Minimum routine antenatal contacts recommended by the World Health Organization (2016)
How many appointments to expect
Knowing the shape of the year ahead makes the first trimester feel less like an ambush. Antenatal schedules vary by country and by whether this is your first baby.
10
8
7
Source: World Health Organization antenatal care recommendations, 2016; NHS antenatal appointment schedule.
Only two or three of those contacts fall inside the first trimester. The rest are spread across the second and third, which is why this stretch feels quiet on the calendar and loud in your body.
Weeks 1 to 4: start folic acid and change what you can
Dating is counted from the first day of your last period, so weeks 1 and 2 happen before conception. That quirk means most people discover they are pregnant somewhere around week 4 or 5, already a month into the official count.
The single most time-sensitive action is folic acid. The NHS advises 400 micrograms daily from before conception until the end of week 12, because it lowers the risk of neural tube conditions such as spina bifida. A higher 5 milligram dose is advised for some people, including those with diabetes, a raised BMI, epilepsy treated with certain medicines, or a previous pregnancy affected by a neural tube condition. Your GP decides that, not a supplement label.
Alongside it: stop smoking and vaping, stop alcohol entirely (ACOG states no amount is known to be safe), and check every medicine and herbal supplement you take with a pharmacist or GP rather than stopping anything on your own. The NHS also advises 10 micrograms of vitamin D daily throughout pregnancy.
Weeks 5 to 6: get it confirmed and get into the system
A home test is enough. In the UK you do not need a GP to confirm it with a second test, and many areas let you self-refer straight to the midwifery service. The point of contacting someone this early is not the pregnancy itself, it is getting your booking appointment scheduled before the 10 week mark, because several tests and screening options are keyed to specific weeks.
This is also the fortnight to write down the first day of your last period somewhere you will not lose it. You will be asked for it repeatedly. A single running record beats scattered notes, which is the whole argument in our planner versus app comparison.
Weeks 7 to 8: the booking appointment
The booking appointment is the long one, often an hour or more. Expect a full medical and family history, height and weight, blood pressure, and a conversation about mental health, domestic safety and any previous pregnancies. You will be offered blood tests covering blood group and rhesus status, full blood count for anaemia, and screening for HIV, syphilis and hepatitis B. You will also be offered a urine test.
Bring the date of your last period, a list of medicines, and any family history of inherited conditions. If nausea is already making daily life hard, raise it here rather than waiting. Effective treatments exist, and our companion piece on what is normal week by week in the first trimester covers the point at which sickness stops being ordinary.
Weeks 9 to 10: decide what screening you want
You will be offered screening for Down's syndrome, Edwards' syndrome and Patau's syndrome. In the UK the combined test pairs a blood sample with the nuchal translucency measurement taken at the dating scan, and it is only available between 11 weeks plus 2 days and 14 weeks plus 1 day. Miss that window and the quadruple blood test at 14 to 20 weeks is the alternative, and it screens for fewer conditions.
Screening is genuinely optional. It gives a chance, not a diagnosis, and some people decline it. What matters is deciding on purpose rather than by accident, because the deadline is short and it arrives while you may still be feeling awful.
Weeks 11 to 13: the dating scan
The dating scan confirms how many babies there are, checks the heartbeat, and measures the baby to set your estimated due date, which is generally more accurate than period-based dating. If you have consented to combined screening, the nuchal translucency measurement happens at this appointment too.
Most units allow one support person. Bring your notes, and ask for the printout if you want one, since some trusts charge a small fee.
Any time in the first trimester: the practical admin
None of this is medical, and all of it is easier now than at 34 weeks.
- Work. You are not obliged to tell your employer until 15 weeks before your due date in the UK, but telling them earlier unlocks paid time off for antenatal appointments and a workplace risk assessment.
- Money. Check your entitlement to maternity pay or allowance and note the qualifying dates, which depend on employment history.
- Food safety. Learn the avoid list once, properly: certain soft cheeses, raw or partly cooked eggs outside British Lion standards, liver and high-dose vitamin A, high-mercury fish, and unpasteurised milk.
- Caffeine. The NHS advises no more than 200 milligrams a day, roughly two mugs of instant coffee.
- Dental care. NHS dental treatment is free during pregnancy and for 12 months after birth in the UK. Apply for the maternity exemption certificate at your booking appointment.
The whole first trimester on one page
| Weeks | What happens | What you need to do |
|---|---|---|
| 1 to 4 | Dated from your last period. Conception around week 2 to 3. | 400 mcg folic acid daily, 10 mcg vitamin D, stop alcohol and smoking, review medicines with a pharmacist. |
| 5 to 6 | Positive test for most people. Symptoms often start. | Contact your GP or self-refer to midwifery. Note the date of your last period. |
| 8 to 10 | Booking appointment, the longest antenatal visit. | Attend, give history, accept or decline the offered blood tests, raise sickness or mental health early. |
| 9 to 10 | Screening options explained. | Decide on combined screening. The window closes at 14 weeks plus 1 day. |
| 11 to 14 | Dating scan and, if chosen, nuchal translucency measurement. | Attend the scan, confirm the due date, collect notes. |
| Any time | Nothing is visible yet, which makes the admin easy to postpone. | Work notification plan, maternity pay dates, food safety, dental exemption form. |
Countries differ. In Australia and New Zealand, RANZCOG guidance also places the first ultrasound and combined screening in the 11 to 14 week window, while in the United States ACOG recommends offering both screening and diagnostic testing to everyone, regardless of age.
What most first trimester checklists get wrong
Two things, in our experience of writing this stuff.
The first is treating every item as equally urgent. It is not. Folic acid and the screening window have real deadlines. Choosing a pram does not. If you only do three things this trimester, make them the supplement, the booking appointment and the scan.
The second is ignoring how you will actually feel. Plenty of first trimester lists assume an organised person with energy. Most people reading them are exhausted, quietly nauseous, and pretending to be fine at work. Build the list so it survives a bad week: one place for everything, and nothing that needs re-deciding.
Keep the whole trimester in one place
Our Pregnancy Planner and Journal is a 40 page printable that runs trimester by trimester, with appointment logs, question pages for your midwife, symptom tracking and the dates you keep being asked for. It is a one-time $7 download with no subscription and no app to keep opening. Use code GLOW20 for 20 percent off.
Frequently asked questions
When should I contact a midwife or GP after a positive test?
As soon as you can. The NHS aims for the booking appointment to happen before 10 weeks, and in many areas you can self-refer to the midwifery team without seeing a GP first. Early contact matters more for the timing of tests than for anything urgent about the pregnancy itself.
Do I have to take folic acid if my diet is good?
The NHS advises 400 micrograms daily as a supplement through the first 12 weeks, in addition to food sources, because it is difficult to reach the recommended level from diet alone. Some people are advised a higher 5 milligram dose, and that decision belongs to your GP.
Can I skip the dating scan?
Yes. Every antenatal test and scan is offered, not imposed. The dating scan sets a more accurate due date than period-based dating and is the only chance to combine with nuchal translucency screening, so most people choose to attend, but declining is a valid option.
When do I have to tell my employer?
In the UK the legal deadline is 15 weeks before your due date. Telling them sooner gives you the right to paid time off for antenatal appointments and triggers a workplace risk assessment, which is worth having if your job involves standing, lifting or chemicals.
Should I start pelvic floor exercises now or wait?
Pelvic floor work is generally encouraged during pregnancy, not just after it, and the NHS suggests starting early. Core rebuilding is different: that belongs to the postpartum period, and our first six weeks postpartum checklist covers when it makes sense to begin.
Sources: NHS, Your pregnancy and baby guide and antenatal care schedule; NHS, Vitamins, supplements and nutrition in pregnancy; World Health Organization, WHO recommendations on antenatal care for a positive pregnancy experience, 2016; American College of Obstetricians and Gynecologists (ACOG), prenatal care and prenatal genetic screening guidance; Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), prenatal screening and diagnostic testing guidance.
This article is general education, not medical advice, and Mumma Glow is not affiliated with the NHS, WHO, ACOG or RANZCOG. Antenatal schedules and screening windows differ by country and by local service. Results and experiences vary from mum to mum. Always speak to your GP, midwife or obstetrician about your own pregnancy, and seek urgent care if you are worried.