The First Trimester with PCOS: Getting the Best Start
Congratulations! You are embarking on one of the most exciting and transformative journeys of your life. Pregnancy is a wild ride, and if you have PCOS, it comes with a few extra considerations—especially when it comes to managing insulin levels.
The first trimester is a time of rapid development for your baby. While you might be battling nausea, exhaustion, or food aversions, behind the scenes, your baby is forming everything from their brain to their tiny fingers. And believe it or not, your insulin levels play a big role in this process.
Why Insulin Levels Matter in the First Trimester
The early weeks of pregnancy are crucial for fetal development. Your baby is not just growing; they are also laying the foundation for their long-term metabolic health. Research shows that high maternal insulin levels can impact gene expression in the fetus, setting the stage for potential metabolic issues later in life.
This is called fetal programming, and it explains why maintaining lower insulin levels during pregnancy is so important. By keeping your insulin levels in check, you are not just protecting your own health—you are giving your baby the best possible start in life.
How Insulin Impacts Pregnancy Outcomes
The first trimester is more than just morning sickness and cravings. The way your body regulates insulin in these early weeks can influence how the rest of your pregnancy unfolds.
When insulin levels are too high in the first trimester, they can increase the risk of:
- Gestational diabetes (which can lead to larger babies and delivery complications)
- Preeclampsia (a dangerous rise in blood pressure)
- Preterm birth (leading to potential health concerns for your baby)
The good news? You have control over this. Making the right choices early on can reduce these risks and help you feel better throughout your pregnancy.
Managing PCOS and Pregnancy Hormones
Pregnancy itself naturally increases insulin resistance, and if you have PCOS, you are already more prone to it. This means staying on top of your insulin levels is more important than ever.
At the same time, your hormones are all over the place. Progesterone is rising to support the pregnancy, estrogen is increasing, and your body is adjusting to a completely new reality. This can lead to:
- Extreme fatigue
- Food aversions
- Nausea
- Cravings for carbs and sugar
It is totally normal to feel like you are barely keeping it together some days. But small, strategic choices can help keep insulin stable, even when pregnancy symptoms make things feel unpredictable.
You Are Not Eating for Two
One of the biggest myths about pregnancy is that you need to “eat for two.” In reality, your body only needs a slight increase in calories, and overeating—especially on insulin-spiking foods—can do more harm than good.
By the first trimester, your baby is still tiny, and their calorie needs are minimal. Your nutritional needs increase, but that does not mean doubling portion sizes or indulging every craving without mindfulness. What matters most is quality over quantity. Instead of focusing on eating more, focus on eating the right foods that keep insulin stable and support healthy fetal development. Take your prenatal vitamin!
Tips for Keeping Insulin in Check During the First Trimester
- Eat to Manage Insulin, Not Calories
This is not the time for restrictive eating. Instead, focus on foods that keep insulin low and provide steady energy:- Lean proteins like eggs, poultry, and fish
- Non-starchy vegetables like zucchini, peppers, and leafy greens
- Healthy fats like avocado, nuts, and olive oil
- Whole fruits (because yes, fruit is fine!)
If you are struggling with nausea, just do the best you can and keep insulin in mind. It’s not about being perfect.
- Listen to Your Body, But Stay Mindful of Cravings
Pregnancy cravings are very real, and they often lean toward high-carb, starchy foods. If you are craving carbs or sugary foods, try some of the desserts in the Recipe section.
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Rest When You Need To
Your body is working overtime right now, and stress increases insulin levels. If you need extra naps or downtime, take it. Prioritizing rest helps keep cortisol and insulin in balance, which is important for both you and your baby. -
Keep Moving in a Way That Feels Good
Exercise can help improve insulin sensitivity, but this is not the time to overdo it. Gentle movement like walking, stretching, or prenatal yoga can help keep insulin stable without adding unnecessary stress to your body. -
Advocate for Insulin Testing
Most doctors focus on glucose levels, but insulin resistance starts long before glucose levels are affected. If you have PCOS, asking for an insulin test early in pregnancy can give you a better picture of your metabolic health. You can also test your insulin levels using a Lilli Metabolic Testing Kit.
You Are Already Doing So Much Right
If you are reading this, you care about your health and your baby’s health—and that means you are already doing an amazing job. No pregnancy is perfect, and some days will be harder than others. Do what you can, give yourself grace, and remember that every small step toward keeping insulin levels in check makes a difference.
By sticking to a Low Insulin Lifestyle, prioritizing nutrient-dense foods, and listening to your body, you are giving your baby the best possible start. This is your journey, your pregnancy, and your body—and you are already an incredible mother.
