First trimester (conception to 12 weeks)

• Schedule an appointment for your first prenatal visit, usually between weeks 8 and 10.
• Begin or continue taking a prenatal vitamin that includes folate/folic acid. Calcium is also important to your body during this time to build your baby’s teeth and bones.
• Avoid substances such as caffeine, tobacco, alcohol, drugs or medications that may harm your baby.
• Begin to read pregnancy books and sign up for pregnancy newsletters, such as Healthy Beginnings at kp.org/maternity.
• Research and/or sign up for classes, like the childbirth, breastfeeding, and yoga classes offered by Kaiser Permanente.
• Begin gathering items to make your pregnancy more comfortable: a body pillow, belly band, sports bra, body lotion, and a soft headed toothbrush are a good start.

Ideally, you should start taking your prenatal vitamins the month before your pregnancy begins. You should continue to take them until you stop breastfeeding, or until 6 weeks after your baby is born if you bottle-feed.

Look for a prenatal vitamin that includes:

• 400 micrograms (mcg) of folate/folic acid
• 400 IU of vitamin D
• 200 to 300 milligrams (mg) of calcium
• 70 mg of vitamin C
• 3 mg of thiamine
• 2 mg of riboflavin
• 20 mg of niacin
• 6 mcg of vitamin B12
• 10 mg of vitamin E
• 15 mg of zinc
• 17 mg of iron
• 150 mcg of iodine

You can take over-the-counter vitamins as long as they have a USP seal or NSF International certification. These organizations monitor supplement quality.

Aversion to prenatal supplements

Often in your first trimester, prenatal vitamins can increase your nausea and vomiting. If you are having difficulty tolerating your prenatal vitamins, try breaking them in half, taking half in the morning and half in the evening. You can also try crushing them between two spoons and mixing them with applesauce or yogurt.

Finally, if they are still causing nausea, you can try replacing your regular prenatal with 2 children’s Flintstones™ vitamins during the first trimester. While not the same as a true prenatal tablet, they are a good substitute for those who need a gentler supplement.

A note on gummy vitamins: While they may be more palatable, gummy prenatal vitamins are not the same as regular tablet prenatal vitamins and should be avoided. Certain essential nutrients are not well absorbed when in a gummy format. Additionally, most gummy vitamins are coated with sugar, adding empty calories to your day.

Get top-notch pregnancy care—but fewer trips to your clinician’s office—with our new at-home toolkit. Learn more about the Kaiser Permanente Connected Pregnancy program here.

• Now your care comes to you – With our new at-home toolkit to help track your pregnancy
• Ahora su equipo de atención viene a usted – El nuevo kit para el hogar le ayudará a monitorear su embarazo

Remember to enroll your newborn in a health insurance plan within 31 days after birth. Check with your employer’s human resources department or a Kaiser Permanente Member Services representative to learn about coverage for your baby.

Contact Member Services with the number on the back of your Kaiser Permanente ID card if you have questions about your coverage.

You should check to see what maternity-care coverage you have under your medical plan. You will want to know how much the plan will pay for your expenses, such as charges for delivery, hospital, and doctor charges.

If you are an expectant mother and have not selected a doctor yet, you should choose an obstetrician for yourself and a pediatrician for the baby.

Having a baby is a qualified family-status change. If you are eligible for benefits, this means that you can change certain benefits without waiting until the next open enrollment period.

After you have your baby, be sure to record the birth on HRConnect and enroll the baby in benefits within 31 days of the birth. Please note:

• This is a two-step process. You are required provide documentation that supports your qualified change in status.
• You should not wait to receive the baby’s birth certificate to record the birth and enroll the baby in benefits. A verification of birth letter from any hospital can be used in lieu of a birth certificate.

Remember, if you increase your benefits coverage, or make any other changes, your payroll deductions will change accordingly.

With the new addition to your family, you may want to review your beneficiary elections for all of your benefit plans. Generally, for life insurance plans, you can name anyone you wish as a beneficiary, including a trust or an estate or you can name more than one beneficiary who will split the benefit.

When you change your dependent(s) to a benefits plan due to a family qualified status change, you are required to provide supporting documentation.

Contact Member Services with the number on the back of your Kaiser Permanente ID card if you have questions about your coverage.

Your Kaiser Permanente maternity benefits cover your baby for 31 days from birth (including the date of birth). Please note that if you do not enroll your baby in a health plan within 31 days of birth, your baby may lose his or her health coverage.

To ensure your baby has health coverage, it is important that you take these 4 simple steps in the first few days of your baby’s life:

1. Maintain your health plan membership. Your health-plan benefits include prenatal and postpartum care for you and your baby. You may be charged non-member fees for any care you or your baby receives after your membership lapses.
2. During your hospital stay, fill out a form to enroll your baby in your Kaiser Permanente health plan. Your baby’s name will be needed for enrollment and for his or her birth certificate, so please be prepared to name your baby before leaving the hospital.
3. Within 31 days of your baby’s birth, fill out any necessary forms for your employer, group, or trust fund. If your health coverage is through your employer or your spouse or partner’s employer, you will need to contact them to have your baby added to the plan. If you are enrolled in a group plan, your employer or trust fund will typically require a written change of enrollment.
4. Your group’s forms are often in addition to the forms you fill out during your hospital stay. Be sure to ask your employer or group administrator which forms you will need and the date by which you must submit them.

Note: If you are a Direct Pay member, you must also submit a written Change of Account Status card to Direct Pay Accounts within 31 days of your baby’s birth. The coverage will begin the first of the month following the date of birth.

Enrollments received after the 31-day enrollment period will be reviewed on a case-by-case basis.

• Some cramping as the uterus enlarges and contracts. During this time, your uterus will increase in weight from about 1 ounce to more than 2 pounds.
• Your breasts may feel larger and more tender when touched.
• Some bleeding in your gums is common but don’t forget to brush and floss regularly.
• Whitish vaginal discharge is normal throughout pregnancy. You may also have yeast infections that reoccur or are difficult to get rid of.
• Many women feel sick to their stomachs, or even throw up, during the first few months of pregnancy. This uncomfortable feeling is commonly referred to as “morning sickness” (even though you may feel sick all day).

Your baby starts as a tiny fertilized egg. At about 3 weeks, the egg burrows into the uterine wall, where it will make its home for the next 9 months. At 4 weeks, the heart, brain, and lungs are forming, and the structures of the eyes and ears are beginning to develop. Arm and leg buds are visible and some bones are forming.

At 5 weeks, your baby resembles a tadpole. At 6 weeks, your baby’s nose, mouth, and ears are beginning to form, and the heart has started to beat (almost twice as fast as yours). By 8 weeks, your baby is about 1 inch long. Your baby is also starting to look human. The arms, legs, muscles, and skin are growing. And the head may seem larger than the rest of the body because your baby’s brain is developing faster than the other organs.

At 9 weeks, your baby is moving around, although you can’t quite feel it. Most of your baby’s critical development is complete. The reproductive organs have developed, but an ultrasound won’t show clearly whether the fetus is a girl or a boy until later (about week 20). At 10 weeks, fingers and toes are emerging from your baby’s growing arms. Your baby also has soft nails and eyelids. By the end of week 12, your baby is about 2 to 3 inches long and weighs about 1 ounce.