Lesson 3 · Pregnancy & Parenthood
Nine weeks in which nothing is visible and everything is happening. Your one real skill here: tell the difference between grim-but-normal and get-help-now — and know which number to ring.
Lesson 1 gave you the map, Lesson 2 the money. Both were about the future. This one is about now: Hannah is 4+0 today, and the first trimester runs to about 8 November 2026. It is the stretch where partners most often become bystanders, because there is no bump, no movement, and no appointment yet. There is, however, a job.
From roughly week 4 to week 10 the embryo goes from a ball of cells to something with a heartbeat, limb buds and a spine. Almost all of the structural building — including the neural tube, which is why folic acid matters right now and not later — happens in this window.
Meanwhile the placenta is being built, and until it takes over hormone production at around 10–12 weeks, her body is running on a hormone (hCG) that peaks around week 9. That single fact explains the shape of the whole trimester: symptoms ramp from about week 6, are worst around week 9 (~4 October), and usually ease from week 12 (~25 October).³
Sickness is not a malfunction. It correlates with a healthy hormone level, which is why it tracks the hCG curve so precisely. Useful to know, completely useless to say out loud to someone who has just been sick in a bin. Know it; don't deploy it.
Most of what is coming is miserable and entirely expected. The column that matters to you is the third one.
| What she gets | When | Your actual job |
|---|---|---|
| Nausea & vomiting 8 in 10 pregnancies | ~wk 6, worst ~wk 9, easing wk 12–14. 1 in 10 carry on past wk 20.¹ | Plain dry carbs within arm's reach of the bed — she needs to eat before sitting up. Take over all cooking; smell is the trigger, not taste. Small and often beats meals. |
| Exhaustion | Weeks 6–13, then usually lifts | This is the big one and it is invisible. Absorb the domestic load without being asked and without narrating it. Protect her evenings — say no to things on her behalf. |
| Food aversions, hyper-smell | Whole trimester | Don't take it personally when a meal you cooked is unbearable. Bin the offending thing, no commentary. |
| Sore breasts, constipation, weeing constantly | From ~wk 5 on | Fluids and fibre; aisle-seat and toilet-locations on any journey. |
| Mood swings, anxiety, weepiness | Whole trimester | Hormonal and real at the same time. Don't problem-solve. Ask what would help and then do that thing. |
| Mild cramping, occasional spotting | Common in early weeks | Not automatically bad — but bleeding always gets a phone call. See the card below. |
Also live right now, from Lesson 1: 400 µg folic acid daily to week 12 and 10 µg vitamin D year-round, plus the food rules — Reference · Food & Drink Safety. If the self-referral isn't in yet, that is still the most time-critical thing on your list.
This is the part to actually learn. Three tiers, and the top one is time-critical because of ectopic pregnancy — a pregnancy implanted outside the womb, most often in a fallopian tube. It presents between weeks 4 and 12, which is exactly where you are now, and a rupture is a surgical emergency.⁴
Any one of these with bleeding = 999. Shoulder-tip pain on its own = 999.⁵
Under 20 weeks and with no midwife yet, the route is the early pregnancy unit (EPU) at your local trust — most take self-referrals by phone. Find your local EPU number and put it in your phone tonight. Looking it up while frightened is the worst time to look it up.
Printable version for the fridge and her bag: Reference · Red Flags, First Trimester.
You will both be thinking about it, so here it is straight. Around 10–20% of known pregnancies end in early miscarriage. But the figure people carry around is a snapshot of the whole trimester, and it drops fast: once a heartbeat is seen at 6–7 weeks, the risk falls to roughly 10%, and it drops sharply again after 12 weeks.²
Which is the real reason the "wait until 12 weeks" convention exists — the dating scan (yours, 11–25 October) is the point at which the odds change materially. The convention has a cost, though, and it's worth deciding deliberately rather than by default: telling nobody means that if it happens, you grieve without support and Hannah takes time off work explaining nothing. Many couples split the difference — a handful of people who would be a help, told early; everyone else after the scan. That's a conversation to have with her, not a rule to follow.
It is not caused by lifting something, an argument, a glass of wine before she knew, or stress. The large majority are chromosomal accidents in the embryo, present from the start and not preventable.² Two things not to say: "at least it was early" and "you can try again". The thing to say is that you're sad too — because you are a parent who lost a pregnancy as well, and partners routinely get treated as the support staff rather than the bereaved.
Week 7. She has sharp pain low on the right side and pain in her shoulder tip. No bleeding. What do you do?
Shoulder-tip pain plus one-sided tummy pain is the classic ectopic picture — the shoulder pain is blood irritating the diaphragm. No bleeding is required. It presents between weeks 4 and 12, and a rupture is a surgical emergency.
Week 9. Light painless spotting on the loo roll, once, this morning. What now?
Light bleeding with no pain is often harmless — but the NHS line is that any bleeding in pregnancy is assessed, and under 20 weeks the route is the early pregnancy unit or 111. It doesn't warrant 999 and it doesn't wait for the next appointment.
Week 10. Vomiting all day, kept nothing down since yesterday, barely weeing. Verdict?
Not keeping fluids down plus reduced urination is dehydration, and the threshold for hyperemesis gravidarum — 1–3 in 100 pregnancies. It's treatable with anti-sickness drugs and, if needed, a drip. Getting help early is what prevents the hospital admission.
Week 11. Her sickness stops almost overnight and she's frightened by it. True?
Symptoms typically ease from 10–12 weeks as the placenta takes over hormone production. Sudden improvement in that window is the usual pattern, not a red flag. Bleeding and pain are the things that trigger a call.
Spacing check, from Lesson 2: what does written notice of the pregnancy to Herman Miller do?
Written notification switches on priority for suitable alternative vacancies, running to 18 months after the birth. Verbal doesn't start the clock. Given her contract ends 28 May 2027, this is the single most valuable free thing she can do — see Lesson 2.
Free recall: name the four things that mean 999, and the one non-obvious symptom most people have never heard of.