Now that you're pregnant, taking care of yourself has never been more important. Of course, you'll probably
get advice from everyone - your doctor, family members, friends, co-workers, and even complete strangers - about what you
should and shouldn't be doing. But staying healthy during pregnancy depends on you, so it's crucial to arm yourself
with information about the many ways to keep you and your baby as healthy as possible.
Health
Care
Key to protecting the health
of your child is to get regular prenatal
care. If you think you're pregnant, call your health care provider to schedule an appointment.
You should have your
first examination during the first 6 to 8 weeks of your pregnancy, which is when your menstrual period is 2 to 4 weeks late.
At this first visit,
your health care provider will figure out how many weeks pregnant you are based on a physical examination and the date of
your last period. He or she will also use this information to predict your delivery date (however, an ultrasound performed
sometime during your pregnancy will help to verify that date).
If you're healthy and
there are no complicating risk factors, you can expect to see your health care provider:
- every 4 weeks until the
28th week of pregnancy
- then every 2 weeks until
36 weeks
- then once a week until
delivery
Throughout your pregnancy,
your health care provider will check your weight and blood pressure while also checking the growth and development of your
baby (by doing things like feeling your abdomen, listening for the fetal heartbeat starting during the second trimester, and
measuring your belly). During the span of your pregnancy, you'll also have prenatal
tests, including blood, urine, and cervical tests, and probably at least one ultrasound.
If you still need to
choose a health care provider to counsel and treat you during your pregnancy, there are several options:
- obstetricians/gynecologists
(also known as OB/GYNs - doctors who specialize in pregnancy and childbirth, as well as women's health care)
- family practitioners (doctors
who provide a range of services for patients of all ages - in some cases, this includes obstetrical care)
- certified
nurse-midwives (advanced practice nurses specializing in women's health care needs, including
prenatal care, labor and delivery, and postpartum care for "normal" pregnancies; there are also other kinds of midwives, but
you should look for one with formal training who's been certified in the field)
Any of these is a good
choice if you're healthy and there's no reason to anticipate complications with your pregnancy and delivery. However, nurse-midwives
do need to have a doctor available for the delivery in case an unexpected problem arises or a cesarean section (C-section)
has to be performed.
Nutrition
and Supplements
Now that you're
eating for
two (or more!), this is not
the time to cut calories or go on a diet. In fact, it's just the opposite - you need about 300 extra calories a day, especially
later in your pregnancy when your baby grows quickly. If you're very thin or carrying twins, you'll need even more. But if
you're overweight, your health care provider may advise that you consume fewer extra calories.
Healthy eating is always
important, but especially when you're pregnant. So, it's important to make sure your calories come from nutritious foods so
they can contribute to your baby's growth and development.
Try to maintain a well-balanced
diet that incorporates the dietary
guidelines including:
- lean meats
- fruits
- vegetables
- whole-grain breads
- low-fat dairy product
By eating a healthy,
balanced diet you're more likely to get the nutrients you need. But you will need more of the essential nutrients
(especially calcium, iron, and folic acid) than you did before you became pregnant. Your health care provider will
prescribe prenatal vitamins to be sure both you and your growing baby are getting enough.
But taking prenatal
vitamins doesn't mean you can eat a diet that's completely lacking in nutrients. It's important to remember that you still
need to eat well while pregnant. Prenatal vitamins are meant to supplement your diet not be your only source of much-needed
nutrients.
Calcium
Most women 19 and older - including those who are pregnant
- don't often get the daily 1,000 mg of calcium that's recommended. Because your growing baby's calcium demands are high,
you should increase your calcium consumption to prevent a loss of calcium from your own bones. Your doctor will also likely
prescribe prenatal vitamins for you, which may contain some extra calcium.
Good sources of calcium
include:
- low-fat dairy products
including milk, cheese, and yogurt
- calcium-fortified products,
including orange juice, soy milk, and cereals
- dark green vegetables including
spinach, kale, and broccoli
- tofu
- dried beans
- almonds
Iron
Pregnant women need
27 to 30 mg of iron every day. Why? Because iron is needed to make hemoglobin, the oxygen-carrying component of red blood
cells. Red blood cells circulate throughout the body to deliver oxygen to all its cells.
Without enough iron,
the body can't make enough red blood cells and the body's tissues and organs won't get the oxygen they need to function well.
So it's especially important for pregnant women to get enough iron in their daily diets - for themselves and their
growing babies.
Although the nutrient
can be found in various kinds of foods, iron from meat sources is more easily absorbed by the body than iron found in plant
foods. Some examples of iron-rich foods include:
- red meat
- dark poultry
- salmon
- eggs
- tofu
- enriched grains
- dried beans and peas
- dried fruits
- leafy green vegetables
- blackstrap molasses
- iron-fortified breakfast
cereals
Folate
(Folic Acid)
The U.S. Centers
for Disease Control and Prevention (CDC) recommends that all women of childbearing age - and especially those who
are planning a pregnancy - get about 400 micrograms (0.4 milligrams) of folic acid supplements every day. That can be from a multivitamin or folic acid
supplement in addition to the folic acid found in food.
So, why is folic acid
so important? Studies have shown that taking folic acid supplements 1 month prior to and throughout the first 3 months of
pregnancy decrease the risk of neural tube defects by up to 70%.
The neural tube - formed
during the first 28 days of the pregnancy, usually before a woman even knows she's pregnant - goes on to become the
baby's developing brain and spinal cord. When the neural tube doesn't form properly, the result is a neural tube defect such
as spina bifida.
Again, your health
care provider can prescribe a prenatal vitamin that contains the right amount of folic acid. Some pregnancy health care providers
even recommend taking an additional folic acid supplement, especially if a woman has previously had a child with a neural
tube defect.
If you're buying an
over-the-counter supplement, keep in mind that most multivitamins contain folic acid, but not all of them have enough folic
acid to meet the nutritional needs of a pregnant woman. So, be sure to check labels carefully before choosing one and check
with your health care provider.
Fluids
It's also important to drink plenty of fluids, especially
water, during pregnancy. A woman's blood volume increases dramatically during pregnancy, and drinking enough water each day
can help prevent common problems such as dehydration and constipation.
Exercise
The 2005 dietary guidelines recommend that healthy pregnant
women get 30 minutes or more of moderate intensity physical activity every day. Exercising
during pregnancy has been shown to be extremely beneficial.
Regular exercise can
help:
- prevent excess weight gain
- reduce pregnancy related
problems, like back pain, swelling, and constipation
- improve sleep
- increase energy
- improve outlook
- prepare for labor
- lessen recovery time
If you've been involved
in an exercise program before becoming pregnant, talk to your health care provider about whether it's safe to continue. If
you haven't been active and/or you have a high-risk pregnancy, ask your health care provider how you can safely start.
Low-impact, moderate
intensity exercise activities (such as walking and swimming) are great choices. You can also opt for yoga or pilates classes,
DVDs, or videos that are tailored for pregnancy. These are both low-impact and work on strength, flexibility, and relaxation.
But you should limit
high-impact aerobics and avoid certain sports and activities that pose a risk of falling or abdominal injury. Typical limitations
include contact sports, downhill skiing, and horseback riding.
It's also important
to be aware of how your body changes. During pregnancy, your body produces a hormone known as relaxin, which is believed to help prepare the pubic area and the cervix for the birth. The relaxin
loosens the ligaments in your body, making you less stable and more prone to injury.
So, it's easy to overstretch
or strain yourself, especially the joints in your pelvis, lower back, and knees. In addition, your center of gravity shifts
as your pregnancy progresses, so you may feel off-balance and at risk of falling. Keep these in mind when you choose an activity,
and don't overdo it.
Whatever type of exercise
you choose, make sure to take frequent breaks and remember to drink plenty of fluids. And use common sense - slow down or
stop if you get short of breath or feel uncomfortable. If you have any questions about doing a certain sport or activity during
your pregnancy, talk to your health care provider for specific guidelines.
Sleep
It's important to get enough
sleep during your pregnancy. Your body is working hard to accommodate a new life, so
you'll probably feel more tired than usual. And as your baby gets bigger, it will be harder to find a comfortable position
when you're trying to sleep.
Lying on your side
with your knees bent is likely to be the most comfortable position as your pregnancy progresses. It also makes your heart's
job easier because it keeps the baby's weight from applying pressure to the large blood vessels that carry blood to and from
your heart and your feet and legs. Lying on your side can also help prevent or reduce varicose veins, constipation, hemorrhoids,
and swelling in your legs.
Some doctors specifically
recommend that pregnant women sleep on the left side. Because your
liver is on the right side of your abdomen, lying on your left side helps keep the uterus off that large organ. Lying on your
left side also optimizes blood flow to the placenta and, therefore, your baby.
Ask what your health
care provider recommends. In most cases, lying on either side should do the trick and help take some pressure off your back.
To create a more comfortable resting position, either way, prop pillows between your legs, behind your back, and underneath
your belly.
Some Things to Avoid
When you're pregnant,
what you don't put into your body (or expose your body
to) is almost as important as what you do. Here are some things to avoid:
Alcohol
Although it may seem harmless
to have a glass of wine at dinner or a mug of beer out with friends, no one has determined what's a "safe amount" of alcohol
to consume during pregnancy. One of the most common known causes of mental and physical birth defects, alcohol produces more severe abnormalities in a developing fetus than heroin, cocaine,
or marijuana.
Alcohol is easily passed
along to the baby, who is less equipped to eliminate alcohol than the mother. That means an unborn baby tends to develop a
high concentration of alcohol, which stays in the baby's system for longer periods than it would in the mother's. And moderate
alcohol intake, as well as periodic binge drinking, can damage a baby's developing nervous
system.
If you had a drink
or two before you even knew you were pregnant (as many women do), don't worry too much about it. But your best bet is to not
drink any alcohol at all for the rest of your pregnancy.
Recreational Drugs
Pregnant women who use drugs
may be placing their unborn babies at risk for premature
birth, poor growth, birth defects, and behavior and learning problems. And their babies could also be born addicted
to those drugs themselves.
If you're pregnant
and using drugs, a health clinic such as Planned Parenthood can recommend health care providers, at little or no cost, who
can help you quit your habit and have a healthier pregnancy.
If you've used any
drugs at any time during your pregnancy, it's important to inform your health care provider. Even if you've quit, your unborn
child could still be at risk for health problems.
Nicotine
You wouldn't light
a cigarette, put it in your baby's mouth, and encourage your little one to puff away. As ridiculous as this scenario seems,
pregnant women who continue to smoke are allowing their fetus to smoke, too. The smoking mother passes nicotine and carbon
monoxide to her growing baby.
The risks of smoking
to the fetus include:
If you smoke, having
a baby may be the motivation you need to quit. Talk to your health care provider about options for stopping your smoking habit.
Caffeine
High caffeine consumption
has been linked to an increased risk of miscarriage, so it's probably wise to limit or avoid caffeine altogether if you can.
If you're having a
hard time cutting out coffee cold turkey, here's how you can start:
- Cut your consumption down
to one or two cups a day.
- Gradually reduce the amount
by combining decaffeinated coffee with regular coffee.
- Eventually cut out the
regular coffee altogether.
And remember that caffeine
is not limited to coffee. Green and black tea, cola, and other soft
drinks contain caffeine. Try switching to decaffeinated products (which may still have some caffeine, but in much smaller
amounts) or caffeine-free alternatives.
If you're wondering
whether chocolate, which also contains caffeine, is a concern, the good news is that you can have it in moderation. Whereas
the average chocolate bar has anywhere from 5 to 30 milligrams of caffeine, there's 95 to 135 milligrams in a cup of brewed
coffee. So, small amounts of chocolate are fine.
Changing the Litter
Box
Pregnancy is the prime
time to get out of cleaning kitty's litter box. Why? Because an infection called toxoplasmosis can be spread through soiled
cat litter boxes and can cause serious problems, including prematurity, poor growth, and severe eye and brain damage. A pregnant
woman who becomes infected often has no symptoms but can still pass the infection on to her developing baby.
Over-the-Counter
and Prescription Medications
Even common over-the-counter
medications that are generally safe may be considered off-limits during pregnancy because of their potential effects on the
baby. And certain prescription medications may also cause harm to the developing fetus.
To make sure you don't
take anything that could be harmful to your baby:
- Ask your health care provider
which medicines - both over-the-counter and prescription - are safe to take during pregnancy.
- Talk to your health care
provider about any prescription drugs you're taking.
- Let all of your health
care providers know that you're pregnant so that they'll keep that in mind when recommending or prescribing any medications.
- Discuss any questions
about natural remedies, supplements, and vitamins.
If you were prescribed
a medication before you became pregnant for an illness, disease, or condition you still have, consult with your health care
provider, who can help you weigh potential benefits and risks of continuing your prescription.
If you become sick
(i.e., with a cold) or have symptoms that are causing you discomfort or pain (i.e., a headache or backache), talk to your
health care provider about medications you can take and alternative ways to help you feel better without medication.
Healthy Pregnancy
Habits: From Start to Finish
During pregnancy, from
the first week to the fortieth, it's important to take care of yourself in order to take care of your baby. Even though you
have to take some precautions and be ever-aware of how what you what you do - and don't do - may affect your baby, many women
say they've never felt healthier than when they carried their children.