Jessica and Quoc Nguyen proudly display their ultrasound photos. Early pregnancy can be a mixed bag of excitement and overwhelming physical symptoms. (David Claremon)

The excitement of a newly confirmed pregnancy may leave you giddy, but tradition, at least in the United States, is to keep it secret for the first trimester. It’s never been easy to hide those symptoms (hello, nausea and body changes) in the early weeks, especially from co-workers and bosses. Here are some challenges mamas-to-be face, and ways to manage those sure signs of pregnancy, if you’re sticking with the 12-week rule before sharing the news.

Tired, nauseated and tired of being nauseated

“I negotiated a licensing deal all through the first trimester of my recent pregnancy, and I’m shocked that I managed to do it without throwing up or falling asleep in a meeting. If I was not working I was in bed. I felt so sick — and not just in the morning but 24/7. I tried the usual citrus, crackers and other remedies, but I was just sick as a dog and wondering how a blueberry-sized ball of cells could drain me the way it did.”

— Hitha Palepu

And how about later pregnancies? Better, right? No.

“Strangely, the second time around I only got nauseous when I was hungry. I was a bit of a slave to my Luna bars and cheese sticks, though really any breakfast pastry I could get my hands on did the trick. I was so busy with my toddler — in some way I think the hunger/nausea problem was really a reminder that not only was I a mom, an executive, a wife — I was also pregnant. Otherwise, it was almost too easy to forget about the baby with so much else going on.”

— Kaity Velez

The early physical symptoms vary from person to person but can be overwhelming. “ Your body is working on a new equilibrium, and the elevated hormone levels play a role,” says Isabel Blumberg, an OB/GYN in New York. “If women do experience nausea, that can be pretty debilitating and exhausting in and of itself.”  

Though common, these symptoms can interfere with work. “For the majority of women, these symptoms do pass. Always check in with your doctor if you cannot find relief,” Blumberg says. She offered some reliable ways to manage the physical discomfort for the first few months:

Fatigue. “Be sure to get your normal eight hours of sleep. If possible, structure your day to get rest in afternoon.”  Blumberg also suggests consuming a small amount of caffeine (one or two servings) to make it through the rough afternoon hours (but check with your doctor first). Another suggestion from Blumberg: “Try a snack of anything that combines protein and carbohydrate. Consider fruit with almond butter, cheese and whole grain crackers or even cottage cheese with fruit as caffeine-free ways to boost your afternoon lull.”

Nausea. This sick feeling and/or vomiting may come in waves or longer stretches.

Lauren Messinger, a physician in the D.C. area, is a big fan of carbohydrates to keep the stomach from ever getting too empty. “Keep saltines next to your bed (eat them before you ever get up in the morning), in your car, really everywhere to assure that you always have something in your stomach,” she said. That can help.

Blumberg says an acupuncture bracelet can provide reliable relief.  She also suggests consuming foods with ginger and citrus in them, having frequent small meals and avoiding rich or fatty foods. Another option is to modify when you take your vitamins (night or morning), Blumberg says, depending on when you are feeling nauseous.

Messinger also mentioned vitamins. “For some people, just the size and even the smell of prenatal vitamins is too much,” she says. Messinger suggests switching to a chewable vitamin to manage that sick feeling through the first trimester, though she warns, “the chewable has no iron content, so getting back to the standard prenatal pill once the sickness ends should be a goal.”

If all else fails, Blumberg says, there are FDA-approved medications that can help manage extreme symptoms. Consult your doctor about options.

The incredible shrinking bra

“Mornings were lousy — I was tired, dragging, slightly ill and not at all feeling comfortable in my clothes, especially my bras. There was nothing good about it. Getting dressed for work was the worst — I was coming out of my bras — from the top, from the sides — I was pretty much just a mess of flesh — I was sure everyone could tell.”

— Megan Konieczka

And what of those suddenly sore and swollen breasts? The feeling of being suddenly top-heavy and achy can be a startling part of the first trimester. Pat Meers, a nursing bra fitting specialist at the Pump Station in Santa Monica, Calif., shared how she helps women who come in distressed and in a great deal of discomfort.

Go pro. Take the time to get the help you need from a professional who knows nursing bras and understands how the pregnant body changes. “The goal is to get comfortable but not lose your ‘street look’ —  for many women, this means transitioning from a structured, underwire bra to a stretchy bra,” Meers says. “Choose a bra with a foam liner to keep your lift and the pre-pregnancy look you are used to.”

Consider wearing a sleep bra for extra support. There is a range from which to choose. “The real goal is to help a mother feel comfortable and familiar with her new body,” Meers says.

Buddies make everything better

And don’t underestimate the value of peer support. Find a “pregnancy buddy” — someone who has recently gone through what lies in front of you, and in whom you can confide. Ask questions, listen and learn from their experiences both personally and professionally. Their firsthand knowledge is key. Plus the simple fact of having someone trustworthy to whom you can talk, and who will offer commiseration and understanding, goes a long way in those early and sometimes overwhelming days.

Most of all, listen to your body and treat yourself well as you make your way to what is likely to be a much more recognizable version of yourself in the second trimester. With luck, your energy, appetite and confidence will return.

Julia Beck is the founder of the It’s Working Project and Forty Weeks and is based in Washington where she is the matriarch of a blended family that includes a loving husband, a loyal golden retriever and four children — all of whom are her favorite. She tweets @thejuliabeck.

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More reading:

Should we tell others about our pregnancies earlier?

The important lesson new moms should learn from Serena Williams’s scary childbirth experience