Prenatal Health Care
Getting regular prenatal checkups is the key to protecting your baby’s health. Be sure to make your first prenatal appointment with your healthcare provider as soon as possible if you think you may be pregnant. Most healthcare professionals will not allow you to make your first appointment before 8 weeks of pregnancy unless there is a problem.
At the first prenatal exam, the doctor you have chosen will probably do a pregnancy test and estimate how many weeks pregnant you are based on your physical exam and the date of your last menstrual period. This information will be used to predict your approximate due date (however, the ultrasound you will have later in your pregnancy will help to corroborate that date).
If you are healthy and there are no risk factors that could complicate your pregnancy, prenatal testing will probably be sufficient:
– Every four weeks until the 28th week of pregnancy.
– Every two weeks thereafter until the 36th week of pregnancy
– and then once a week until delivery
Throughout your pregnancy, the health care provider overseeing your pregnancy will weigh you and take your blood pressure while assessing your baby’s growth and development (feeling your abdomen, measuring your belly, and listening to the fetal heartbeat beginning in the second trimester of pregnancy). Throughout your pregnancy, you will also have several prenatal diagnostic tests, including blood and urine tests, cervical scans, and probably at least one ultrasound.
Nutrition and Supplements
Now that you are eating for two (or more!), it’s not the best time to cut calories or go on a diet. In fact, just the opposite is true – you need about 300 calories a day more, especially when your pregnancy is well underway and your baby is growing faster. If you are very thin, very active, or expecting several babies, you will need to take in even more calories. But if you are overweight, your doctor may advise you not to increase your calorie intake as much.
Eating healthy is always important, especially during pregnancy. Therefore, make sure that the calories you eat come from nutritious foods that will contribute to your baby’s growth and development.
Try to eat a balanced diet that incorporates the following foods:
– lean meat
– fruit
– vegetables
– whole-grain bread
– low-fat dairy products
If you eat a healthy, balanced diet, you are more likely to get the nutrients you need. But you will need more essential nutrients (especially calcium, iron and folic acid) than you did before you became pregnant. The health care professional overseeing your pregnancy will prescribe prenatal vitamins to be sure that both you and your growing baby are getting good nutrition.
However, taking prenatal vitamins does not mean that you can follow an unbalanced diet. It is important to remember to eat well during pregnancy. Prenatal vitamins are supplements to supplement your diet, not the only source of these much-needed nutrients.
Calcium
Most women age nineteen and older – including those who are pregnant – usually do not get the recommended 1,000 mg of calcium daily. Because the calcium requirements of a growing baby are high, you should increase your calcium intake to prevent bone decalcification. The prenatal vitamin supplements your doctor prescribes will probably contain calcium.
Rich sources of calcium include:
– Low-fat dairy products, including milk, pasteurized cheese, and yogurt.
– Calcium-fortified products, such as many commercially available orange juices, soy milk, and cereals
– Dark green leafy vegetables, such as spinach, kale, and broccoli
– Tofu
– Dried beans
– Almonds
Iron
Pregnant women need to ingest approximately 30 mg of iron each 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 carry oxygen to all cells.
If a person does not have enough iron, their body will not be able to make enough red blood cells and their tissues and organs will not receive the oxygen they need to function properly. Therefore, it is especially important for pregnant women to get enough iron in their diets, both for their health and for the health of their developing babies.
Although this nutrient can be found in different types of foods, iron from meat is more easily absorbed than iron from plant sources. Iron-rich foods include:
– Red meat
– Dark meat poultry
– Salmon
– Eggs
– Tofu
– Iron-fortified cereals
– Dried beans and peas
– Dried fruits
– Dark green leafy vegetables
– Blackstrap molasses
Folic Acid
The U.S. Centers for Disease Control and Prevention (CDC) strongly recommends that all women of childbearing age – and especially those who want to become pregnant – take a supplement of 400 micrograms (0.4 mg) of folic acid each day, in addition to the folic acid ingested through the diet. It can either be part of the prenatal multivitamin supplement or taken separately.
Why is folic acid so important? Some studies suggest that taking folic acid supplements one month before conception and during the first three months of pregnancy reduces the risk of the baby being born with a neural tube defect.
The neural tube – formed during the first few weeks of pregnancy, possibly before a woman even knows she is pregnant – eventually gives rise to the baby’s brain and spine. When the neural tube does not form or close properly, the result is a neural tube defect, such as spina bifida.
Once again, the healthcare professional overseeing your pregnancy will prescribe a prenatal multivitamin supplement that contains the proper amount of folic acid. Some healthcare professionals recommend further increasing folic acid intake, especially for women who have previously had a child with a neural tube defect.
Although most multivitamins contain folic acid, not all of them contain adequate folic acid to meet the nutritional needs of a pregnant woman, if you purchase an over-the-counter multivitamin supplement. Please read the package inserts of the various supplements carefully and ask your doctor’s advice before purchasing one.
Fluids
Getting enough fluids, especially water, is also important during pregnancy. A woman’s blood volume increases dramatically during pregnancy, and drinking enough water every day can help you avoid problems that are quite common during pregnancy, such as dehydration and constipation.
Exercise
The U.S. Department of Health and Human Services (DHHS) recommends at least 150 minutes (or 2.5 hours) per week of moderate-intensity aerobic activity for women who are not already very active or do a vigorous activity. However, if you are very active or are used to high-intensity aerobic activity, you may be able to keep up the workouts, as long as your doctor thinks it is safe for you to do so. However, before starting or continuing any exercise program, talk to your doctor.
Exercising during pregnancy is proven to be very beneficial. Regular exercise can help to:
– Prevent excessive weight gain
– Reduce problems associated with pregnancy, such as back pain, swollen legs, and constipation.
– Sleep better
– Increase energy
– Improve mood
– Prepare for childbirth
– Reduce postpartum recovery time
Low-impact, moderate-intensity activities (such as walking or swimming) are great choices. Yoga or the Pilates method, as well as gentle fitness videos for pregnant women, are also good choices. These are low-impact activities and work on strength, flexibility, and relaxation.
However, you should limit high-impact aerobic exercise and avoid sports or activities that carry a risk of falls and/or abdominal injuries. Examples of forbidden activities during pregnancy include contact sports, downhill skiing, scuba diving, and horseback riding.
Also, it is important to be aware of the changes that are occurring in your body. During pregnancy, your body produces a hormone called relaxin. Relaxin is believed to help prepare the pubic area and cervix for childbirth. This hormone loosens ligaments, and this can cause you to lose some stability and make you more prone to injury.
As a result, it is easier for you to strain or sprain your pelvic, lumbar, and knee joints. In addition, your center of gravity will change as your pregnancy progresses, making it easier for you to lose your balance and increasing the risk of falling. Keep this in mind when choosing a physical activity, and don’t overdo it.
Therefore, regardless of the type of exercise you choose, take frequent breaks and remember to drink plenty of fluids. If you feel short of breath, begin to feel unwell, or have any discomfort, slow down or stop the activity. If you have any doubts about practicing an activity or sport during pregnancy, consult your doctor for specific recommendations.
Sleep
Getting enough sleep during pregnancy is important. You will probably feel more tired than usual. And, as your baby grows, you will find it harder and harder to find a comfortable sleeping position.
As your pregnancy progresses, the position that will probably be most comfortable for you will be lying on your side with your knees bent. In addition, this posture facilitates cardiac function because it prevents the weight of the baby from compressing the large veins and arteries that carry blood between the heart and the lower extremities. Stretching on one side also helps prevent varicose veins, constipation, hemorrhoids, and swollen legs.
Some doctors recommend that pregnant women sleep specifically on their left side. Since one of the large veins runs through the right side of the abdomen, lying on the left side prevents the weight of the uterus from pressing on it. This position also optimizes blood flow to the placenta and, therefore, the amount of oxygen that reaches the baby.
Talk to the healthcare professional overseeing your pregnancy about a recommended resting position. In most cases, resting on either side works well and relieves your back of some of the weight it has to carry during the day. To be more comfortable, place cushions between your legs, behind your back, and under your belly.
Things to avoid
During pregnancy, what you avoid putting into (or exposing yourself to) is almost as important as what you put into your body. Here are some substances to avoid:
Alcohol
Although having a glass of wine at dinner or a beer with friends from time to time may seem harmless, no one has determined what is a “safe amount” of alcohol to drink during pregnancy. Alcohol, a common cause of mental and physical birth defects, can cause serious problems in a developing fetus.
Alcohol easily reaches the fetus, which is much less prepared than the mother to eliminate it from its body. Thus, the fetus tends to develop a high blood alcohol concentration, and it will remain in the fetus for longer periods of time than in the mother’s body. And moderate alcohol consumption, as well as periodic binge drinking, can have an impact on the developing baby’s nervous system.
If you had a drink or two before you knew you were pregnant (as many women do), do not worry too much about it. But, from now on, your best bet is not to drink a drop of alcohol during pregnancy.
Drugs
Pregnant women who use drugs expose their babies to multiple risks, including premature birth, growth retardation, various birth defects, and learning and behavioral problems. And their children may be born addicted to the drugs they used during pregnancy.
Organizations such as Planned Parenthood can refer you to health professionals who offer free or reduced-cost services to help you get off drugs and have a healthier pregnancy if you are pregnant and using drugs.
It is important to tell the healthcare professional overseeing your pregnancy if you have used any drugs at any time during your pregnancy. Even if you have stopped using drugs, your baby could still be at risk of developing health problems.
Nicotine
Pregnant women who smoke pass nicotine and carbon monoxide to their babies. Risks to the fetus of a smoking mother include:
– Premature delivery
– Low birth weight
– Sudden Infant Death Syndrome (SIDS)
– Asthma and other respiratory problems in the baby.
If you smoke, having a baby may be an additional motivation to quit. Talk to your doctor about smoking cessation options.
Caffeine
Caffeine abuse has been associated with an increased risk of miscarriage, so it makes the most sense to limit, or rather avoid caffeine consumption altogether if you are able to do so.
Try the following if you are having a hard time quitting coffee cold turkey:
– Start by reducing consumption to one or two cups of coffee a day.
– Gradually reduce the amount of caffeine ingested by combining decaffeinated coffee with caffeinated coffee.
– In the end, try to completely stop drinking caffeinated coffee on a regular basis.
And keep in mind that caffeine is not only found in coffee. Many types of teas, cola drinks, and other soft drinks contain caffeine. Try switching to decaffeinated products (which may contain some caffeine, although in much smaller amounts) or caffeine-free alternatives.
In case you are wondering whether you should also give up chocolate, which also contains caffeine, the good news is that you can have it, albeit in moderation. While a bar of chocolate contains an average of between five and 30 mg of caffeine, a cup of coffee contains between 95 and 135 mg. So you can have small amounts of chocolate during pregnancy.
Certain foods
While you need to eat plenty of healthy foods during pregnancy, you also need to avoid foodborne illnesses, such as listeriosis and toxoplasmosis, that can endanger the life of the fetus and cause birth defects or miscarriage.
Do not try the following foods:
– Unpasteurized creamy cheeses (often sold as “fresh”), including feta, goat cheese, Brie, Camembert, and blue cheese or Roquefort
– Unpasteurized milk, juices, and apple cider
– Raw eggs or foods containing raw eggs, including mousses, tiramisu, pasta made with undercooked dough, homemade ice cream, and salad dressings containing raw egg yolk (although some brands of industrially manufactured dressings may not contain raw egg).
– Raw or undercooked meat, fish (sushi), or seafood.
– Sausages, cold cuts, or sausages (unless heated until they start to smoke).
Cleaning the cat litter box
If you have cats at home, then pregnancy is a period during which you should refrain from cleaning your pet’s litter box. Why? Because toxoplasmosis can be contracted by coming into contact with cat feces and can cause serious problems, including premature delivery, growth retardation, and severe eye and brain abnormalities in the fetus. When a pregnant woman contracts this infection, she often has no symptoms but can still pass it on to her developing baby.
Prescription and Over-the-Counter Medications
Although some commonly used over-the-counter medications that are generally safe are banned during pregnancy because of their potential adverse effects on the baby. And some prescription drugs can also be harmful to the developing fetus.
To make sure you don’t take anything that could be harmful to the baby:
– Ask your doctor which medicines – prescription and over-the-counter – are safe during pregnancy.
– Tell your doctor about any medications you are taking.
– Tell all of your healthcare providers that you are pregnant so that they will keep this in mind when recommending or prescribing any medications.
– Also remember to discuss any natural remedies, supplements or vitamins you are considering taking with your doctor.
If you were prescribed medication before you became pregnant for an illness or condition you still have, consult your doctor to help you weigh the benefits and potential risks of continuing and stopping your medication.
If you become ill (e.g., you get a cold) or have bothersome or painful symptoms (e.g., headache or backache), ask your doctor what medications you can take and if there are alternative ways to relieve your symptoms without medication.
Healthy Pregnancy Habits: From Start to Finish
Throughout your pregnancy, from the first week to the last, it is very important that you take care of yourself to take care of your baby. Although you will need to take some precautions and be constantly aware of how what you do – and don’t do – could affect your baby, many women say they have never felt healthier than when they were pregnant.
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