Taking Care of You and Your Baby While You're Pregnant

Is prenatal care important?

Prenatal care is very important. To help make sure that you and your baby will be as healthy as possible, follow some simple guidelines and check in regularly with your doctor.

 

What will happen during prenatal visits?

After you find out you are pregnant, you should make an appointment with your doctor. Your first prenatal visit will likely be when you are 6 to 8 weeks pregnant. Your doctor will probably start by talking to you about your medical history and how you've been feeling. You'll be weighed and have your blood pressure taken. These measurements will most likely be taken during each doctor's visit.

On your first visit, you'll also have a pelvic exam to check the size and shape of your uterus (womb) and a Pap smear to check for abnormalities of the cervix (the opening of the uterus).

Urine and blood tests samples will be taken on the first visit and again at later visits. Other tests are performed, such as urine tests to check for bacteria in your urine, high sugar levels (which can be a sign of diabetes) and high protein levels (which can put you at risk for preeclampsia, a type of high blood pressure during pregnancy). Blood tests to check for low iron levels (anemia), blood cell count, infectious diseases (such as syphilis and hepatitis) and blood type are also performed.

Sometimes, an ultrasound may be done to help figure out when your baby is due or to check on your baby's growth and position in your uterus. An ultrasound uses sound waves to create an image of your baby on a video screen.

Other tests may be needed if you or your baby are at risk for any problems.

 
How much weight should I gain during pregnancy?
Talk to your doctor about how much weight you should gain. It's different for everyone, but most women gain about 25 to 30 pounds. If you don't weigh enough when you get pregnant, you may need to gain more. If you're overweight when you get pregnant, you may need to gain less.

 
What should I eat?

Eating a balanced diet is one of the most important things you can do for yourself and your baby. There are a few foods that you should be more careful about eating while you are pregnant. Meat, eggs and fish that are not fully cooked could put you at risk for an infection. Do not eat more than 2 or 3 servings of fish per week (including canned fish). Do not eat shark, swordfish, king mackerel or tilefish. These fish sometimes have high levels of mercury, which could hurt your baby. If you eat tuna, make sure it is light tuna and eat no more than 6 ounces per week of albacore tuna and tuna steaks. It is safe to have 12 ounces per week of canned light tuna.

Wash all fruit and vegetables. Keep cutting boards and dishes clean. Eat 4 or more servings of dairy foods each day. This will give you enough calcium for you and your baby. Do not drink unpasteurized milk or eat unpasteurized milk products. Soft cheeses such as Brie, feta, Camembert, blue cheese and Mexican-style cheeses such as queso fresco may have bacteria that can cause infections.

If you drink coffee or other drinks with caffeine, do not have more than 1 or 2 cups each day.

It is okay to use artificial sweeteners such as aspartame (some brand names: Equal, NutraSweet) and sucralose (brand name: Splenda) while you are pregnant, but you should use them in moderation. If you have a genetic disease called phenylketonuria, or PKU, you shouldn't use aspartame at all.

 
Should I take vitamins?

You should take 1,000 mcg (1 mg) of folic acid every day during your pregnancy. Folic acid can help prevent problems with your baby's brain and spinal cord. It is best to start taking folic acid before you get pregnant.

Your doctor might want you to take a prenatal vitamin. If you do take a prenatal supplement, make sure you're not taking any other vitamin or mineral supplement along with it unless your doctor recommends it.

 
Is it okay to take medicine?

Check with your doctor before taking any medicine, including pain relievers or other over-the-counter medicines. Even medicine you can buy without a prescription may cause birth defects, especially if it's taken during the first 3 months of pregnancy.

 
How long can I keep working?

This depends on whether you have any problems with your pregnancy, what kind of work you do and if you're exposed to anything at work that could harm your baby. For instance, lifting heavy objects or standing for long periods can be hard on your body. Radiation, lead and other heavy metals, such as copper and mercury, could be damaging to the baby. However, working in front of a computer screen is not thought to cause harm to an unborn baby. Talk with your doctor about your work environment.

                                  Download Pregnancy Guide pdf here

What about exercise?
Unless you have problems in your pregnancy, you can probably do whatever exercise you did before you got pregnant. Exercise can help ease discomfort during pregnancy. Try to get at least 30 minutes of exercise each day. Talk to your doctor about any special conditions that you may have.

Some women say exercising during pregnancy makes labor and delivery easier. Walking and swimming are great choices. If you didn't exercise before pregnancy, start slowly. Don't overdo exercise. Listen to your body. Call your doctor if you have symptoms such as blurred vision, dizziness, chest pain or abdominal pain while you are exercising. Don't get overheated. Be sure to drink plenty of water so that you don't get dehydrated. It's best to avoid anything that could cause you to fall, such as water skiing or rock climbing. It's also best to avoid contact sports such as basketball or soccer.

Is it okay to have sex?

Yes, unless your doctor believes you're at risk for problems. Don't be surprised if you're less or more interested in sex while you are pregnant. As you get larger, you may find you need to try different positions, such as lying on your side or being on top. If you have oral sex, tell your partner not to blow air into your vagina. This could force air inside you, which could cause an air embolism. Air embolisms can cause permanent brain damage and even death to a pregnant woman and her baby.

 
What can I do to feel better?
Here are the most common discomforts of pregnancy and some tips for handling them:

Morning sickness. Nausea or vomiting may strike anytime during the day (or night). Try eating frequent, small meals and avoid greasy foods. Keep crackers by your bed to eat before getting up.
Talk to your doctor if morning sickness lasts past the first 3 months of pregnancy or causes you to lose weight.

Tiredness. Sometimes tiredness in pregnancy is caused by anemia, so tell your doctor. Get enough rest. Take a daytime nap if possible.

Leg cramps. Gently stretch the calf of your leg by curling your toes upward, toward your knee.

Constipation. Drink plenty of fluids. Eat foods with lots of fiber, such as fruits, vegetables and bran cereal. Don't take laxatives without talking to your doctor first. Stool softeners may be safer than laxatives.

Hemorrhoids. Don't strain during bowel movements. Try to avoid becoming constipated. Clean yourself well after a bowel movement (wet wipes may be less irritating than toilet paper). Take several warm soaks (sitz baths) a day if necessary.

Urinating more often. You may need to urinate more often as your baby grows because he or she will put pressure on your bladder. This can't be helped.

Varicose veins. Avoid clothing that fits tightly around your legs or waist. Rest and put your feet up as much as you can. Move around if you must stand for long periods. Ask your doctor about support or compression hose, which may help ease or prevent varicose veins.

Moodiness. Your hormones are on a roller coaster ride during pregnancy. Plus, your life is undergoing a big change. Don't be too hard on yourself. If you feel very sad or think about suicide, talk to your doctor.

Heartburn. Eat frequent, small meals. Avoid spicy or greasy foods. Don't lie down right after eating. Ask your doctor about taking antacids.

Yeast infections. The amount of discharge from the vagina increases during pregnancy. Yeast infections, which can also cause discharge, are more common during pregnancy. It's a good idea to talk with your doctor about any unusual discharge.

Bleeding gums. Brush and floss regularly, and see your dentist for cleanings. Don't put off dental visits because you're pregnant, but be sure to tell your dentist you're pregnant.

Stuffy nose. This is related to changes in the levels of the female hormone estrogen. You may also have nosebleeds.

Edema (retaining fluid). Rest with your legs up. Lie on your left side while sleeping so blood flows from your legs back to your heart better. Don't use diuretics (water pills). If you're thinking about cutting down on salt to reduce swelling, talk with your doctor first. Your body needs enough salt to maintain the balance of fluid and cutting back on salt may not be the best way to manage your swelling.

Skin changes. Stretch marks appear as red marks on your skin. Lotion with shea butter can help keep your skin moist and may help reduce the itchiness of dry skin. Stretch marks often can't be prevented, but they often fade after pregnancy.

Other skin changes may include darkening of the skin on your face and around your nipples, and a dark line below your belly button. Staying out of the sun or using a sunscreen may help lessen these marks. Most marks will probably fade after pregnancy.


 
Call your doctor if you have:

•     Blood or fluid coming from your vagina
•     Sudden or extreme swelling of your face or fingers
•     Headaches that are severe or won't go away
•     Nausea and vomiting that won't go away
•     Dizziness
•     Dim or blurry vision
•     Pain or cramps in your lower abdomen
•     Chills or fever
•     A change in your baby's movements
•     Less urine or burning when you urinate
•     Any illness or infection
•     Anything that bothers you

 
Warnings !!!
"Don't do this, don't do that." You've probably heard every old wives' tale. Here are some warnings worth heeding:

    Don't smoke. Smoking raises your risk for miscarriage, premature birth, low birth weight and many other problems.
    Don't use drugs. Cocaine, heroin, marijuana and other drugs increase your risk of miscarriage, premature birth and birth defects. Your baby could also be born addicted to the drug you've been abusing, which can cause serious health problems.
    Don't drink alcohol. Drinking alcohol during pregnancy is the major cause of preventable birth defects, including fetal alcohol syndrome.
    Don't clean your cat's litter box or eat raw or undercooked red meat. You could get toxoplasmosis, a disease that can cause birth defects.
    Don't sit in a sauna or hot tub. The high heat raises your risk of miscarriage and birth defects.
    Don't douche. Douching could force air into the vagina, which can cause an air embolism. The vagina doesn't require cleansing in addition to normal bathing. Douching disrupts the helpful bacteria that keep the vagina clean.


                                  Download Pregnancy Guide pdf here

Stay Healthy While Working During Pregnancy

If you are a working woman, if you feel well during your pregnancy, and if your job is one you can continue without risk or strain, you can probably plan to work until your due date or until your labor starts!

Consider your needs and decide how long you wish to work.  Some women like to work as long as they can so that they don’t waste any maternity leave and can use more of it after their baby is born.  Others get tired or uncomfortable and it becomes difficult for them to work, especially if they have a strenuous or stressful job or commute.  Talk to your doctor about your situation.  

While you are working, you want to maintain your health and ensure that your baby has a healthy environment in which to grow and develop.  

Here are some tips:

Some foods and smells can trigger nausea during pregnancy. The sweet roll you used to love for your morning snack may now cause your stomach to churn.  Recognize these changes and stay clear of these foods and smells so you don’t make your nausea worse.

Keep crackers in your desk at work and use them to stave off nausea – a stomach that is very empty or very full will cause more problems.

Drink 6-8 glasses of water a day to stay hydrated.  Dehydration will make your morning sickness worse.

Get plenty of sleep and allow yourself more time to get ready for work in the morning.  Fatigue and stress will also increase nausea.

You might feel tired much of the time, especially during the first and third trimesters and even more so after a long day at work.  Take regular breaks, take a short walk (outside if you can) and move around.  If your job is physical, try to take more rest periods.  Rest periods will also help you concentrate.  You may want to close your office door, put your feet up and close your eyes for a few minutes during lunch or on a break.

In early and very late pregnancy you may be tired by afternoon.  In this case, change your work schedule if you can so that you can get the higher-energy tasks out of the way in the morning while you are feeling fresh.

If you have a demanding job, try to cut back on commitments outside work and get more rest after work so that you will be prepared for the work day.  

Regular exercise will help your energy level as well.  If you were exercising before pregnancy, continue to do so with guidance from your doctor.  If you want to start exercising during pregnancy talk to your doctor about what you can do to stay active.  

Don’t be too proud to accept help at home and at work where you can.  You can always return the favor after you and your baby are on a regular schedule and you are feeling like your old self again.  Cleaning, mowing the lawn, or grocery shopping can be done by others or, if you have the financial wherewithal, you can hire someone to do these things for you until you can take on these responsibilities again.  That way, you can get the extra rest you’ll need to do your job every day.

Go to bed when you are tired!  You don’t have to stay up until midnight to get that extra work done, just because you always did before.  Your body is changing and you and your baby deserve a little extra sleep.

Move around frequently to ease the stress on your muscles and back.  You may find that standing, lifting and even sitting for long periods of time will make you tired or sore now, so listen to your body.  Many companies supply an ergonomic chair for office workers if you have a note from your doctor.  Chairs with adjustable arms and height, and a firm back can help.  You can also bring in a small pillow to support your lower back while you sit.   Put your feet up on a box, wastebasket or stool to take the weight off your lower back and reduce foot and leg swelling.

Plan for those extra trips to the bathroom.  Don’t try to hold it!  

                                           

                                              Download Pregnancy Guide here

If you have to stand a lot in your job, put your foot up on a stool or box to change your position and take the strain off of your low back. Change the leg you elevate every so often to be sure you pay attention to both legs throughout the day.  Wear comfortable shoes (you may have to get a larger size shoe when you are pregnant) and use pregnancy or support pantyhose to support your legs.

If you have to lift during the course of your day, be sure your doctor is OK with the weight you are lifting.  You may have to stop working sooner if your job is strenuous or requires you to lift heavy weight.  Remember to lift the right way so you don’t strain your back.  Your abdominal muscles are already strained so they can’t help much with lifting!

If your job is very stressful, you need to rest more and may need to stop working sooner.  Stress can be much harder on a pregnant woman and her unborn child.

Talk to your boss, your co-workers and others to see if you can reduce some of the usual stress.  Talk to your doctor so she knows what you are up against.  She may suggest an earlier leave or other options.

Learn relaxation exercises, or take a Yoga class for pregnant women.  You can use this to relieve stress and relax and you will feel much better.

Be sure you talk to your doctor about the demands of your particular job.  Some jobs will increase your risk of pregnancy complications.  

Jobs that should be carefully evaluated include:

• Those that require heavy lifting or require a LOT of lifting (a recent study found a significant association between physically demanding work and premature birth. Increased risk of low birth weight infants and maternal hypertension or pre-eclampsia) 

• Jobs with lots of standing or strenuous climbing or walking (prolonged standing at work is also associated with increased incidence of premature birth) 

• Jobs in toxic environments (hazardous chemicals, gas, dust, fumes, radiation, or infectious diseases)

• Environs with constant loud noise or where machines are very loud or have lots of vibration

• Jobs that require long or intense commutes 

• Jobs with very long hours or frequent shift changes (shift work and increased levels of work related fatigue are also associated with premature birth)

• Jobs in very cold or very warm environs

• Jobs that require a lot of flexibility or balance

If you must continue to work throughout your pregnancy and your job is high-risk, talk to your employer about taking a temporary position elsewhere until after the baby is born. 

Talk to your doctor and/or your midwife about what you are feeling and change your plans if your condition or health is being affected by work.  

                                               Download Pregnancy Guide here

Healthy Travel During Pregnancy

With proper planning and advice, travel during pregnancy is not a problem.  To ensure that you and your baby remain healthy during travel, you need to consider the stage of your pregnancy, your current physical condition, and any restrictions or problems you and your doctor have discussed.

Also, talk to your doctor about visits or tests you need to schedule, so that you are not away during the time these are to take place.  Prenatal visits, scheduled ultrasound tests, glucose screening tests or Rh immunoglobulin injections (for those whose blood type is Rh negative).

Assuming your doctor says it is OK for you to travel, be sure you prepare a complete list of contact names and phone numbers to take with you.  If you have problems during your trip and need care or attention, health care professionals or other travelers can ensure that you get appropriate care. 

This information should include:

• Your name, age and blood type, and any medications you are taking, as well as your health care insurance information.  Also include your due date, the date of your most recent doctor appointment, any allergies you may have to medication or foods, and any immunizations you may have had before travel.
• Your doctor’s name and contact information
• Any doctor’s name and phone number you may be using while you are away from home
• Emergency contact information for your family (include more than one contact)
• Be sure you have ample supply of prescription and over the counter medications, and prenatal vitamins.

Make certain that your health insurance polity covers pregnancy, delivery and other complications during travel and be sure to double check any restrictions that may apply to travel in foreign countries. 
 
Check the availability of travel insurance on your airline, or other carrier, to be sure that you are covered if you have to miss part of, or your entire, trip because of pregnancy related health problems or if you incur emergency expenses during your trip.  Ask if this insurance covers complications from pregnancy and emergency transport.
Carry a cell phone, especially if you're traveling alone, and be sure that your cell phone will function in any foreign country to which you may be traveling.
                

 
 

                                                      Download Pregnancy Guide pdf here

You can plan normal activities while you are traveling, but understand that you are likely to get tired m ore quickly when you are pregnancy, so plan for extra rest during each travel day.  Take a relaxing bath, use room service, sit on the beach or watch an in-room movie.

Eating healthy is important, and your schedule is likely to be different on the road, so take nuts, dry fruit, and cheese and crackers with you.  Drink plenty of water and avoid dehydration, especially if you are flying to your destination.
 
Take your bathroom schedule into consideration.  As an expectant mother, you are likely to need to use the bathroom often.  Don’t plan vacation or travel activities that require you to be out in the middle of nowhere, away from facilities.  And plan extra time for ‘pit stops’ if you are traveling by car.

Remember that your feet and legs are likely to swell during pregnancy if you are sitting for long periods of time.  Wear comfortable, expandable shoes and socks and elevate your feet whenever possible.  Get up and walk around whenever you can on a plane, train or bus and if you are traveling by car, be sure to walk around a bit when you stop to use the bathroom.

If you are traveling to a foreign country, you and your doctor will have to consider any vaccines you will require to determine whether they are safe to administer during pregnancy.   Avoid live vaccines like varicella for chicken pox, measles, mumps, and rubella. The Centers for Disease Control (CDC) report no fetal damage from live vaccines, but they admit that their information is limited, so these vaccines should still be considered risky.  Vaccines for Hepatitis B, Hepatitis A, and tetanus, are safe and recommended for pregnant women at risk of getting these diseases.  

In many developing countries local healthcare and the quality of available food and water are questionable.  It is best to avoid travel to these countries while you are pregnant.
If you are traveling to a hot, humid destination, avoid yeast infections by wearing lightweight, loose-fitting clothes, and cotton underwear.  Change out of wet bathing suits as soon as you can, and talk to your doctor about carrying a tube of anti-fungal cream, just in case you need it.

Avoid risky activities, especially late in pregnancy:  snow skiing, water skiing, surfing, horseback riding, parasailing, scuba diving, water slides and some more extreme amusement park rides.  You may also wish to avoid very hot saunas and hot tubs, as they elevate your temperate beyond what is normal in a regular bath.
You can walk and hike at low altitudes, swim in calm waters (not in heavy surf or rapids), ride a stationary or regular bike, exercise in the hotel gym (if you have been used to exercising before and during your pregnancy) and jog if you jogged before pregnancy.  Talk to your doctor about your planned activities before you leave for travel or vacation.

Be smart!  If you start to feel tired, overheated, dizzy or uncomfortable, slow down, rest, take a break or stop what you are doing.

Travel, especially to other time zones, can throw your eating schedule off and cause more problems with bloating, and indigestion.  Try eating several small meals during the day.  Don’t eat close to bedtime (allow 2-3 hours to digest your food).  Sleep with your upper body propped on pillows.  Avoid alcohol, carbonated beverages, caffeine, chocolate, acidic foods (citrus fruits, tomatoes, and vinegar), and spicy foods.  Try to eat high-fiber foods to avoid constipation and bloat, and stay active to keep your digestive tract moving.

Avoid motion sickness by sitting in the front seat of the car and keeping the window open to get plenty of fresh air. In an airplane, sit over the wing, and on a boat, try to stay on the deck and focus on the horizon.

You can try wearing a specially designed wristband to deliver mild electrical current to a nerve at an acupuncture point on the underside of your wrist.  Studies show that this device helps some pregnant women with morning sickness and motion sickness. 

If you follow these suggestions, you should have a pleasant and healthy trip. 

And, remember, that if your doctor advises against travel, you are wise to follow her/his suggestion.  It is best to put off the trip for another time after the baby is born, rather than to risk your health and the health of your unborn child!

                                            Download Pregnancy Guide pdf here