Staying Healthy During Pregnancy
Pregnant women are often bombarded with dos and don'ts. Here is a list of basics to help maintain a healthy pregnancy.
Eating for Two
A pregnant woman needs more protein, iron, calcium, and folic acid than nonpregnant women. You also need more calories.
But "eating for two" doesn't mean eating twice as much. Rather, it means that the foods you eat are the main source of nutrients for your baby.
Sensible, balanced meals combined with regular physical fitness is still the best recipe for good health during your pregnancy.
Weight Gain During Pregnancy
The amount of weight you should gain during pregnancy depends on your body mass index (BMI) before you became pregnant.
- If you were at a normal weight before pregnancy, you should gain about 25 to 30 pounds.
- If you were underweight before pregnancy, you should gain between 28 and 40 pounds.
- If you were overweight before pregnancy, you should gain between 15 and 25 pounds.
- If you were obese before pregnancy, you should gain between 11 and 20 pounds.
Check with your doctor to find out how much weight gain during pregnancy is healthy for you.
You should gain weight gradually during your pregnancy, with most of the weight gained in the last trimester. Generally, doctors suggest women gain weight at the following rate:
- 2 to 4 pounds total during the first trimester
- 3 to 4 pounds per month for the second and third trimesters
Women who gain more than the recommended amount during pregnancy and who fail to lose this weight within six months after giving birth are at much higher risk of being obese nearly 10 years later.
Findings from a large study suggest that gaining more weight than the recommended amount during pregnancy may raise your child's odds of being overweight in the future. If you find that you are gaining weight too quickly, try to cut back on foods with added sugars and solid fats. If you are not gaining enough weight, you can eat a little more from each food group.
Calorie Needs During Pregnancy
Your calorie needs will depend on your weight gain goals. Most women need 300 calories a day more during at least the last 6 months of pregnancy than they do pre-pregnancy. Keep in mind that not all calories are equal. Your baby needs healthy foods that are packed with nutrients — not "empty calories" such as those found in soft drinks, candies, and desserts.
Although you want to be careful not to eat more than you need for a healthy pregnancy, make sure not to restrict your diet during pregnancy either. If you don't get the calories you need, your baby might not get the right amounts of protein, vitamins, and minerals. Low-calorie diets can break down a pregnant woman's stored fat. This can cause your body to make substances called ketones. Ketones can be found in the mother's blood and urine and are a sign of starvation. Constant production of ketones can result in a child with mental deficiencies.
Foods Good for Mom and Baby
A pregnant woman needs more of many important vitamins, minerals, and nutrients than she did before pregnancy. Making healthy food choices every day will help you give your baby what he or she needs to develop. The MyPyramid for Pregnant and Breastfeeding Women can show you what to eat as well as how much you need to eat from each food group based on your pre-pregnancy BMI and activity level. Use your personal MyPyramid plan to guide your daily food choices. Here are some foods to choose often:
Grains – fortified, cooked or ready-to-eat cereals; wheat germ
Vegetables – carrots, sweet potatoes, pumpkin, spinach, cooked greens, winter squash, tomatoes, red pepper
Fruits – cantaloupe, honeydew melon, mangoes, prunes or prune juice, bananas, apricots, oranges or orange juice, grapefruit, avocado
Dairy – nonfat or low-fat yogurt; nonfat milk (skim milk); low-fat milk (1% milk)
Meat and beans – cooked dried beans and peas; nuts and seeds; lean beef, lamb, and pork; shrimp, clams, oysters, and crab; cod, salmon, polluck, and catfish
Talk to your doctor if you have special diet needs for these reasons:
- Diabetes – Make sure you review your meal plan and insulin needs with your doctor. High blood glucose levels can be harmful to your baby.
- Lactose intolerance – Find out about low-lactose or reduced-lactose products and calcium supplements to ensure you are getting the calcium you need.
- Vegetarian – Ensure that you are eating enough protein, iron, vitamin B12, and vitamin D.
- PKU – Keep good control of phenylalanine levels in your diet.
Avoid eating the following foods
- Refrigerated smoked seafood like whitefish, salmon, and mackerel
- Hot dogs or deli meats unless steaming hot
- Refrigerated meat spreads
- Unpasteurized milk or juices
- Store-made salads, such as chicken, egg, or tuna salad
- Unpasteurized soft cheeses, such as unpasteurized feta, Brie, queso blanco, queso fresco, and blue cheeses
- Shark, swordfish, king mackerel, or tile fish (also called golden or white snapper); these fish have high levels of mercury.
- More than 6 ounces per week of white (albacore) tuna
- Herbs and plants used as medicines without your doctor's okay. The safety of herbal and plant therapies isn't always known. Some herbs and plants might be harmful during pregnancy, such as bitter melon (karela), noni juice, and unripe papaya.
- Raw sprouts of any kind (including alfalfa, clover, radish, and mung bean)
Alcohol During Pregnancy
There is no known safe amount of alcohol a woman can drink while pregnant. When you are pregnant and you drink beer, wine, hard liquor, or other alcoholic beverages, alcohol gets into your blood. The alcohol in your blood gets into your baby's body through the umbilical cord. Alcohol can slow down the baby's growth, affect the baby's brain, and cause birth defects.
Caffeine During Pregnancy
Small amounts of caffeine (about one 12-ounce cup of coffee a day) appear to be safe during pregnancy. Some studies have shown a link between higher amounts of caffeine and miscarriage and preterm birth. But there is no solid proof that caffeine causes these problems. The effects of too much caffeine are unclear. Ask your doctor whether drinking a limited amount of caffeine is okay for you.
Food Cravings During Pregnancy
Many women have strong desires for specific foods during pregnancy. The desire for "pickles and ice cream" and other cravings might be caused by changes in nutritional needs during pregnancy. The fetus needs nourishment. And a woman's body absorbs and processes nutrients differently while pregnant. These changes help ensure normal development of the baby and fill the demands of breastfeeding once the baby is born.
Some women crave nonfood items such as clay, ice, laundry starch, or cornstarch. A desire to eat nonfood items is called pica. Eating nonfood items can be harmful to your pregnancy. Talk to your doctor if you have these urges.
Keeping Fit During Pregnancy
Fitness goes hand in hand with eating right to maintain your physical health and well-being during pregnancy. Pregnant or not, physical fitness helps keep the heart, bones, and mind healthy. Healthy pregnant women should get at least 2 hours and 30 minutes of moderate-intensity aerobic activity a week. It's best to spread your workouts throughout the week. If you regularly engage in vigorous-intensity aerobic activity or high amounts of activity, you can keep up your activity level as long as your health doesn't change and you talk to your doctor about your activity level throughout your pregnancy.
Special benefits of physical activity during pregnancy:
- Exercise can ease and prevent aches and pains of pregnancy including constipation, varicose veins, backaches, and exhaustion.
- Active women seem to be better prepared for labor and delivery and recover more quickly.
- Exercise may lower the risk of preeclampsia and gestational diabetes during pregnancy.
- Fit women have an easier time getting back to a healthy weight after delivery.
- Regular exercise may improve sleep during pregnancy.
- Staying active can protect your emotional health. Pregnant women who exercise seem to have better self-esteem and a lower risk of depression and anxiety.
- Results from a recent, large study suggest that women who are physically active during pregnancy may lower their chances of preterm delivery.
For most healthy moms-to-be who do not have any pregnancy-related problems, exercise is a safe and valuable habit. Even so, talk to your doctor or midwife before exercising during pregnancy. She or he will be able to suggest a fitness plan that is safe for you. Getting a doctor's advice before starting a fitness routine is important for both inactive women and women who exercised before pregnancy.
If you have one of these conditions, your doctor will advise you not to exercise:
- Risk factors for preterm labor
- Vaginal bleeding
- Premature rupture of membranes (when your water breaks early, before labor)
Best Exercise Activities for Moms-to-be
Low-impact activities at a moderate level of effort are comfortable and enjoyable for many pregnant women. Walking, swimming, dancing, cycling, and low-impact aerobics are some examples. These sports also are easy to take up, even if you are new to physical fitness.
Some higher intensity sports are safe for some pregnant women who were already doing them before becoming pregnant. If you jog, play racquet sports, or lift weights, you may continue with your doctor's okay.
Keep these points in mind when choosing a fitness plan:
- Avoid activities in which you can get hit in the abdomen like kickboxing, soccer, basketball, or ice hockey.
- Steer clear of activities in which you can fall like horseback riding, downhill skiing, and gymnastics.
- Do not scuba dive during pregnancy. Scuba diving can create gas bubbles in your baby's blood that can cause many health problems.
Tips for Safe and Healthy Physical Activity
Follow these tips for safe and healthy fitness:
- When you exercise, start slowly, progress gradually, and cool down slowly.
- You should be able to talk while exercising. If not, you may be overdoing it.
- Take frequent breaks.
- Don't exercise on your back after the first trimester. This can put too much pressure on an important vein and limit blood flow to the baby.
- Avoid jerky, bouncing, and high-impact movements. Connective tissues stretch much more easily during pregnancy. So these types of movements put you at risk of joint injury.
- Be careful not to lose your balance. As your baby grows, your center of gravity shifts making you more prone to falls. For this reason, activities like jogging, using a bicycle, or playing racquet sports might be riskier as you near the third trimester.
- Don't exercise at high altitudes (more than 6,000 feet). It can prevent your baby from getting enough oxygen.
- Make sure you drink lots of fluids before, during, and after exercising.
- Do not workout in extreme heat or humidity.
- If you feel uncomfortable, short of breath, or tired, take a break and take it easier when you exercise again.
Stop exercising and call your doctor as soon as possible if you have any of the following:
- Chest pain
- Calf pain or swelling
- Abdominal pain
- Blurred vision
- Fluid leaking from the vagina
- Vaginal bleeding
- Less fetal movement
Smoking cigarettes is very harmful to your health and could also affect the health of your baby. Not only does smoking cause cancer and heart disease in people who smoke, a recent large study confirmed that smoking during pregnancy increases the risk of low birth weight. Low-birth-weight babies are at higher risk of health problems shortly after birth. Also, some studies have linked low birth weight with a higher risk of health problems later in life, such as high blood pressure and diabetes. Women who smoke during pregnancy are more likely than other women to have a miscarriage and to have a baby born with cleft lip or palate, types of birth defects. Also, mothers who smoke during or after pregnancy put their babies at greater risk of sudden infant death syndrome (SIDS).
Mothers who smoke have many reasons to quit smoking. Take care of your health and your unborn baby's health by asking your doctor for help quitting smoking. Quitting smoking is hard, but you can do it with help!
Substance Abuse During Pregnancy
Using alcohol and illegal drugs during pregnancy threatens the health of your unborn baby. So does using legal drugs in an inappropriate way. When you use alcohol or drugs, the chemicals you ingest or breathe into your lungs cross the placenta and enter your baby. This puts your baby at risk for such problems as stillbirth, low birth weight, birth defects, behavioral problems, and developmental delays.
When you drink alcohol, so does your baby. Pregnant women should not drink alcohol to eliminate the chance of giving birth to a baby with fetal alcohol spectrum disorder (FASD). FASD involves a range of harmful effects that can occur when a fetus is exposed to alcohol. The effects can be mild to severe. Children born with a severe form of FASD can have abnormal facial features, severe learning disabilities, behavioral problems, and other problems.
You might think a drink now and then won't hurt your baby. But we don't know how much alcohol it takes to cause harm. We do know that the risk of FASD, and the likely severity, goes up with the amount of alcohol consumed during pregnancy. Also, damage from alcohol can occur in the earliest stages of pregnancy — often before a woman knows she is pregnant. For this reason, women who may become pregnant also should not drink.
Many women who use illegal drugs also use tobacco and alcohol. So, it's not always easy to tell the effects of one drug from that of alcohol, tobacco, or other drugs. We do know that using illegal drugs during pregnancy is very dangerous. Babies born to women who use drugs such as cocaine, heroine, and methamphetamine are likely to be born addicted and must go through withdrawal. Mothers who inject drugs are at higher risk of getting HIV, which can be passed to an unborn baby. Some studies suggest that the effects of drug use during pregnancy might not be seen until later in childhood.
Getting Help for Alcohol or Drug Use
If you drink alcohol or use drugs and cannot quit, talk to your doctor right away. Treatment programs can help pregnant women with addiction and abuse.
When to Call the Doctor
When you are pregnant, do not hesitate to call your doctor or midwife if something is bothering or worrying you. Sometimes physical changes can be signs of a problem.
Call your doctor or midwife as soon as you can if you:
- are bleeding or leaking fluid from the vagina
- have sudden or severe swelling in the face, hands, or fingers
- get severe or long-lasting headaches
- have discomfort, pain, or cramping in the lower abdomen
- have a fever or chills
- are vomiting or have persistent nausea
- feel discomfort, pain, or burning with urination
- have problems seeing or blurred vision
- feel dizzy
- suspect your baby is moving less than normal after 28 weeks of pregnancy (if you count less than 10 movements within 2 hours)
- have thoughts of harming yourself or your baby