“I’m Pregnant, Now What?” – with Dr. Stephanie Melka

By MFM on October 9, 2026

In this episode of the Healthful Woman podcast, Dr. Nathan Fox speaks with Dr. Stephanie Melka about what to do after a positive pregnancy test. Together, they cover when to schedule a first appointment, how to choose a provider, which vitamins and foods matter, and which common worries patients can let go of.

Healthful Woman · "I'm Pregnant, Now What?" – With Dr. Stephanie Melka

Timing Your First Appointment

Many patients are surprised that they can’t see their doctor the day they get a positive test. Pregnancy is dated from the first day of the last menstrual period, about two weeks before conception, so most tests turn positive around four to five weeks. An ultrasound done that early often shows very little.

For that reason, most offices schedule the first prenatal visit around six to eight weeks from the last period. Until then, Dr. Melka’s advice is to keep living normally. Stop drinking alcohol, review any medications you take, and let your provider know about past complications such as an ectopic pregnancy.

Choosing the Right Provider

Expectant parents have several options: a gynecologist who may refer them to an obstetrician, an OB directly, a midwife, or a high-risk specialist. Dr. Melka explained that “midwifery typically is lower risk healthier patients, as well as uncomplicated deliveries.” Patients with medical conditions or a complicated history may benefit from maternal-fetal medicine care from the start.

It’s also fine to shop around early in pregnancy. Practice structure is worth considering, since appointments with a solo provider may get moved when that doctor is called to a delivery.

Vitamins, Food, and Everyday Habits

Prenatal vitamins. Folic acid is the most important early nutrient. The recommended dose is 400 mcg, and many people take 800 mcg. As Dr. Fox noted, “it does lower the risk of certain birth defects so it’s good to be on it.” Prescription prenatals are usually unnecessary, and chewable or smaller vitamins can help if nausea makes pills hard to swallow.

Food and drink. Patients should avoid raw or undercooked foods, unpasteurized dairy, deli meats (because of Listeria), and high-mercury fish such as shark, swordfish, and mackerel. Tuna is lower in mercury, and one to two servings per week is considered fine. Our complete guide to prenatal nutrition covers this in more detail. Dr. Fox and Dr. Melka also reassured listeners that light drinking before a positive test is generally not a medical concern.

Medications and skincare. Patients should not stop prescribed medications without talking to the prescriber, since most can be continued or switched. Isotretinoin (Accutane) is an exception that needs prompt review. Topical retinoids are usually avoided, while benzoyl peroxide is generally considered acceptable. For anything else on the bathroom shelf, Dr. Fox’s advice was simple: “Take it up with your dermatologist.”

Separating Myths from Real Risks

Early miscarriage is common, especially before a heartbeat is seen on ultrasound. Dr. Fox noted estimates as high as 40 to 50% at that stage, falling to under 10% once a heartbeat is confirmed. Most early losses are caused by chromosomal abnormalities, not by anything a patient did. If you have experienced a loss, our post on understanding and coping with a miscarriage may help.

Running, yoga, swimming, and biking can continue, scaled back as needed. About exercise, Dr. Fox said, “It will not cause a miscarriage.” Hot yoga and hot tubs are worth avoiding, especially in the first trimester. Sex does not cause miscarriage, though it may cause some spotting or cramping. Sleep position doesn’t matter early in pregnancy, and everyday cleaning products and paint smells are generally not harmful at typical exposure levels.

Early symptoms such as breast tenderness and fatigue vary widely and don’t reliably reflect how a pregnancy is going. When to share the news is a personal choice. Many people wait until after the first visit or around 12 weeks.

Learn More

Listen to the complete episode, “I’m Pregnant, Now What?” with Dr. Stephanie Melka, on the Healthful Woman podcast to hear Dr. Melka’s full guidance for the first weeks of pregnancy. For pregnancy care in New York, from that first appointment through delivery, contact Maternal Fetal Medicine Associates today by completing the online contact form.

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!