1) PLAN AHEAD
“Start getting healthy even before you become pregnant,” advises Siobhan Dolan, M.D., M.P.H., medical adviser to the March of Dimes and professor of obstetrics and gynecology and women’s health at the Albert Einstein College of Medicine/Montefiore Medical Center in New York. (Already pregnant? Just do all these things as early as possible, and don’t worry.) On your must-do-first list: Begin taking a daily multivitamin with at least 400 micrograms of folic acid, a B vitamin that helps prevent neural tube defects, such as spina bifida; quit smoking, drinking alcohol and/or using recreational drugs.
Schedule a pre-conception checkup, too. Have your doctor review your medications for pregnancy safety; ask your doctor to test you for sexually transmitted infections; make sure your immunizations are up to date; and have any infections or health problems properly treated.
2) SURROUND YOURSELF WITH SUPPORT
Practical and emotional support can be crucial in helping you stay healthy and avoid prenatal anxiety and depression. Your circle could include your partner, family members, friends and coworkers, a childbirth instructor or your doctor or midwife.
Continuous support during labor has been shown to lower a mother’s need for pain medication and her risk for interventions, including Cesarean sections, and to lead to a more satisfying delivery. It’s important to have a sympathetic caregiver, but also to seek the support of family and friends. According to a recent study published in Clinical Psychological Science, getting lots of emotional support from your family while you’re expecting helps prevent postpartum depression (PPD).
3) FIND THE RIGHT PRACTITIONER
“Choose someone who respects you and sees birth as a healthy process and not a disease,” says Raymond De Vries, Ph.D., a member of the Center for Bioethics and the Social Sciences at the University of Michigan Medical School and author of A Pleasing Birth (Temple University Press).
Your best choice is an OB-GYN or midwife with excellent credentials who also respects your opinions and choices. If your pregnancy is considered high-risk because you’re expecting multiples, you’ve experienced previous pregnancy or delivery complications, or you’ve been diagnosed with certain medical conditions, including diabetes, obesity or high blood pressure, it’s important that your primary-care caregiver have a collaborative relationship with a specialist in maternal fetal medicine.
4) KNOW THE RED FLAGS
During pregnancy, seemingly mild symptoms may signal something serious; signs include dizziness, fainting, shortness of breath, rapid heartbeat, nausea and vomiting, trouble walking, pain or burning during urination, blurry vision, pronounced swelling or decreased fetal activity for more than 24 hours.
“About 1 in every 8 babies is born prematurely, so contact your care provider immediately if you have such symptoms as uterine cramping that gets stronger, gripping backache, leaking amniotic fluid and vaginal bleeding,” says Nancy Green, M.D., associate professor of clinical pediatrics, division of hematology, at Columbia University Center for Bioethics in New York.
Also get a flu shot and regular dental checkups (skip the X-rays, though); untreated gum infections have been linked to premature births. If you get sick, don’t take anything that hasn’t been OK’d by your doctor or midwife.
5) EAT WELL (BUT NOT FOR TWO)
Pregnancy is the time to make every calorie count. Foods rich in essential nutrients such as protein, folate and iron will nourish you and your baby, and high-fiber foods can help prevent constipation. So can drinking plenty of water, which you also need to support your increased blood volume. Eating four or five mini-meals a day can help prevent heartburn and keep your blood-sugar levels steady and prevent binging.
Avoid foods that can be dangerous during pregnancy, including undercooked meats and cold cuts; raw seafood; raw or undercooked eggs; unpasteurized soft cheeses; and large fish, such as swordfish, which can contain high levels of mercury and other toxins. Also, limit your caffeine consumption to 200 milligrams daily, the equivalent of about 12 ounces of coffee.
6) GET MOVING
According to the American College of Obstetricians and Gynecologists, pregnant women should exercise a minimum of 30 minutes a day, six or seven days a week, unless they have medical reasons not to do so. Regular stretching and exercise can relieve backaches, constipation and morning sickness. Plus, having a strong heart and lungs will help you get through your upcoming marathon: giving birth.
7) STAY SAFE
“Injuries are the leading cause of maternal death during pregnancy,” says Andrea Gielen, Sc.D., director of the Center for Injury Research and Policy at Johns Hopkins Bloomberg School of Public Health in Baltimore. According to the Centers for Disease Control and Prevention, motor vehicle injuries are the leading cause of death and injury for pregnant women. In a crash, those who aren’t wearing seat belts are three times as likely to lose their baby as those who are buckled up.
Be sure to adjust the lap belt across your hip-pelvis area and below your belly.
The second most common source of traumatic injury in pregnancy is domestic violence, Gielen says. Women who are being abused can call the National Domestic Violence Hotline for help (800-799-SAFE, or visit thehotline.org).
8) GO GREEN
Minimize your exposure to chemicals, including those in commonly used household cleaners, solvents, paints and beauty products. Avoid lead dust, which can be generated during renovations in older homes. And steer clear of bisphenol-A (BPA), a synthetic estrogen found in countless products, including plastic containers and thermal cash register receipts.
Avoid secondhand smoke, stay away from cat litter and gardening soil, and buy organic foods as often as you can to minimize exposure to pesticides, growth hormones and other chemicals. Be sure to wash all fruits and vegetables before eating: Studies have linked prenatal exposure to pesticides to an increased risk in obesity, infertility, attention deficit disorders and cognitive problems in children.
9) WATCH THE WEIGHT GAIN
Current guidelines call for women of normal weight to gain 25 to 35 pounds, underweight women up to 40 pounds and overweight women 15 to 25 pounds. But in light of the obesity epidemic, some experts are questioning the latter recommendation.
Research is showing that most women gain too much weight during pregnancy,” says Raul Artal, M.D., professor and chairman of the department of obstetrics, gynecology and women’s health at Saint Louis University School of Medicine. Overweight moms are at greater risk for pregnancy complications, including gestational diabetes and high blood pressure. They’re also more likely to give birth to larger babies, go through more complicated labors and have Cesarean sections.
However, pregnancy is not the time to diet, either, so don’t stop eating or start skipping meals.
10) SEEK OUT HELP FOR STRESS
Some studies suggest that experiencing severe or chronic stress may affect the fetus.
“One out of 10 women experiences depression during pregnancy,” says Janet Rich-Edwards, Sc.D., M.P.H., director of developmental epidemiology at Mary Horrigan Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital in Boston. “Many suffer without seeking the treatment that could help.”
Intimacy is a great stress reliever, and research from the Ohio State University Medical Center confirms that unless you have risk factors for premature labor or other complications, you can enjoy a healthy sex life until you give birth.
3 Things Not to Worry About
1) The drink you had before you missed your period. It takes about seven days for the fertilized egg to implant in your uterus. The placenta begins to develop about 12 days after conception, which is just before your period is due. Before then, there’s no exchange of blood between mother and baby.
2) That morning sickness will rob your baby of nutrients. Generally, nausea and vomiting taper off by the end of the first trimester. During much of that time, the embryo and, later, the fetus will leech what it needs (which isn’t a lot) from your body. Be sure to take a prenatal vitamin.
3) That something you do will cause a miscarriage. Most early miscarriages are the result of chromosomal abnormalities within the developing embryo. Smoking, alcohol and drug use may increase miscarriage risk, but normal everyday activities, including exercise and sexual intercourse, do not.