Health care during pregnancy

Now that you are pregnant, taking care of yourself is more important than ever. Below, you will find information on how to take care of your health and your baby's health.

Prenatal health care:

The key to protecting your baby's health is getting regular prenatal checkups. If you think you may be pregnant, make your first prenatal appointment with your healthcare professional. Many health care professionals will not allow you to make your first appointment before 8 weeks of pregnancy unless there is a problem.

At your first prenatal exam, your chosen healthcare professional will likely do a pregnancy test and estimate how many weeks it is based on the physical exam and the date of your last menstrual period. She will use this information to predict the approximate date of delivery (however, the ultrasound that will be done later in the pregnancy will help to verify that date).

If you are healthy and there are no risk factors that can complicate your pregnancy, prenatal exams will probably suffice:

• Every four weeks until the 28th week of pregnancy

• Thereafter, every two weeks until the 36th week of pregnancy

• And then once a week until delivery

Throughout the pregnancy, the health care professional supervising your pregnancy will weigh you and take your blood pressure while assessing the growth and development of the baby (feeling the abdomen, measuring the belly, and listening to the heartbeat of the fetus from the second trimester of pregnancy). Throughout your pregnancy, you will also have various prenatal diagnostic tests, including blood and urine tests, cervical scans, and probably at least one ultrasound.

If you have not yet chosen a health professional to advise and treat you during pregnancy, you can choose from several possible alternatives:

• Obstetricians/gynecologists (doctors specializing in pregnancy and childbirth, apart from the female reproductive section and women's health in general).
• Family physicians (physicians who provide a wide range of services to patients of all ages - sometimes including obstetrics).

• Registered nurse-midwives (nurses who specialize in the health needs of pregnant women, including prenatal care and care during labor and delivery, as well as postpartum care in uncomplicated pregnancies). There are other types of midwives as well, but you should always choose one who can prove their training and who is specialized in this field.

Either of these options may be a good choice if you are healthy and there is no reason to anticipate possible complications during pregnancy. However, nurse-midwives should be able to access a doctor in the event of unexpected problems during delivery or if a cesarean section is required.

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Nutrition and supplements:

Now that you are eating for two (or more!), this is not the best time to skimp on calories or go on a diet. In fact, the opposite is true - you need about 300 more calories a day, especially when the pregnancy is well advanced and the baby is growing faster. If you are very thin, very active, or expecting multiple babies, you will need to eat even more calories. But if you are overweight, your doctor may recommend not increasing 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 help your baby grow and develop.

Try to eat a balanced diet that incorporates the following foods:

• lean meat

• fruit

• vegetable

• wholemeal bread

• low-fat dairy products

By eating 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 before you got pregnant. Your healthcare professional supervising your pregnancy will prescribe prenatal vitamins to make sure that you and your growing baby are eating well.

However, taking prenatal vitamins does not mean that you can eat an unbalanced diet. It is important to remember to eat well during pregnancy. Prenatal vitamins are dietary supplements, not the only source of these much-needed nutrients.

Calcium:

Most women nineteen years of age and older - including those who are pregnant - do not tend to ingest the recommended 1,000 mg of calcium daily. Because the calcium requirements of a growing baby are high, you should increase the calcium intake to prevent bone loss. The prenatal vitamin supplement your doctor prescribes will likely contain calcium.

Rich sources of calcium include:

• low-fat dairy products, including milk, pasteurized cheese, and yogurt

• calcium-fortified products, such as many marketed orange juices, soy milk, and cereals

•  dark green leafy vegetables, such as spinach, kale, and broccoli

•  the tofu  

• dry beans

•  the almonds

Iron:

Pregnant women need about 30 mg of iron each day. Why? Because iron is necessary to make hemoglobin, the component of red blood cells responsible for transporting oxygen. Red blood cells circulate through 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. That is why pregnant women must get enough iron through their diet, both for their health and that of their babies in the development process.

Although this nutrient can be found in different types of food, iron from meat is more easily absorbed than iron from plants. Foods rich in iron include:

• Red meat

• dark meat poultry

•  the salmon

• the eggs

• the tofu

• iron-fortified cereals

• dried beans and peas

• dehydrated fruits

• dark green leafy vegetables

• black molasses

Folic acid:

The US Centers for Disease Control and Prevention (CDC) recommends that all women of childbearing age - and especially those who want to become pregnant - take a 400 microgram supplement ( 0.4 mg) of folic acid each day, apart from folic acid ingested through the diet. It can be part of the prenatal multivitamin supplement or taken separately.

Why is folic acid so important? Studies have shown that taking folic acid supplements one month before conception and during the first three months of pregnancy reduces the risk of a baby being born with a neural tube defect.

The neural tube - which forms during the first few weeks of pregnancy, possibly before a woman even knows she is pregnant - ends up giving rise to the baby's brain and spine. When the neural tube doesn't form or close properly, the result is a neural tube defect, such as spina bifida.

Again, your health care professional supervising your pregnancy will prescribe a prenatal multivitamin supplement that contains the appropriate amount of folic acid. Some health professionals recommend increasing folic acid intake even further, especially in women who have previously had a child with a neural tube defect.

If you purchase an over-the-counter multivitamin supplement, you should be aware that, although most of them contain folic acid, not all of them contain adequate amounts to meet the nutritional needs of a pregnant woman. So read the leaflets of the various supplements carefully and ask your doctor for advice before purchasing one.

Fluids:

It is 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 you avoid fairly common problems during pregnancy, such as dehydration and constipation.

Exercise

The U.S. Department of Health and Human Services (DHHS) recommends at least 150 minutes (that is, two and a half hours) per week of moderate-intensity aerobic activity for women who do not are very active on their own or engage in vigorous activities. If you are very active or used to doing high-intensity aerobic activities, you may be able to continue your workouts as long as your doctor considers it safe. However, before starting or continuing any physical exercise program, talk to your doctor.

It is proven that exercising during pregnancy is very beneficial. Regular exercise can help:

• prevent excessive weight gain

•  to reduce problems associated with pregnancy, such as back pain, swollen legs, and constipation

•  sleep better

•  increase energy

•  improve mood

•  to prepare for childbirth

•  reduce postpartum recovery time

Low-impact, moderate-intensity activities (like walking or swimming) are great choices. Yoga or Pilates, as well as gentle gymnastics videos for pregnant women, are also good options. They are low-impact activities and work both strength and 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. Activities prohibited during pregnancy include contact sports, alpine skiing, scuba diving, and horse riding.

It is also important that you are aware of the changes taking place in your body. During pregnancy, your body makes a hormone called relaxin. Relaxin is believed to help prepare the pubic area and cervix for delivery. This hormone loosens the ligaments, which can cause some loss of stability and make you more prone to injury.

That is why it is easier for you to do sprains or strains, especially in the joints of the pelvis, lower back, and knees. Also, your center of gravity will change as the pregnancy progresses, making it easier for you to lose your balance and increasing your risk of falls. Keep this in mind when choosing a physical activity, and don't overdo it.

Regardless of the type of exercise you choose, take frequent breaks, and remember to drink plenty of fluids. If you feel short of breath, feel unwell, or have any discomfort, slow down or discontinue the activity. If you have any questions about the practice of an activity or sport during pregnancy, consult your doctor for specific recommendations.

Dream:

You must get enough sleep during pregnancy. You will probably feel more tired than usual. As your baby grows, it will become increasingly difficult to find a comfortable sleeping position.

The position that will be the most comfortable for you as the pregnancy progresses will probably be stretched out on one side with the knees bent. In addition, this posture facilitates heart function because it prevents the baby's weight from compressing 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 the left side. Since one of the large veins runs through the right side of the abdomen, stretching on the left side prevents the weight of the uterus from pressing on it. This position also optimizes the blood flow to the placenta and, therefore, the amount of oxygen that reaches the baby.

Ask the healthcare professional who is supervising your pregnancy which resting position they recommend. In most cases, resting on either side works well and relieves your back of some weight you have to carry during the day. To be more comfortable, put cushions between your legs, behind your back, and under your belly.

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Things to avoid:

During pregnancy, what you avoid getting into the body (or being exposed to) is almost as important as what you get into it. Here are some substances to avoid:

Alcohol:

Although having a glass of wine at dinner or having a beer with friends from time to time may seem harmless, no one has determined what the “safe amount” of alcohol to drink during pregnancy is. One of the most common causes of mental and physical birth defects can cause serious problems in a developing fetus.

Alcohol easily reaches the fetus, who is much less prepared than the mother to eliminate it from her body. This means that the fetus tends to develop a high blood alcohol concentration, which will remain in its body for longer periods than in the mother's body. Moderate alcohol consumption, as well as periodic binge drinking, can take a toll on the developing baby's nervous system.

If you had a drink or two before you knew you were pregnant (as many women do), don't 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 delivery, growth retardation, various birth defects, and learning and behavior problems. And their children could be born addicted to the drugs they used during pregnancy.

If you are pregnant and use drugs, organizations such as the Planned Parenthood health service chain can refer you to health professionals who offer free or reduced-price services to help you get off drugs and have a healthier pregnancy.

If you have used any drug at any time during your pregnancy, you must inform the health professional who is monitoring your pregnancy. Even if you have stopped using drugs, your baby could be at risk of developing health problems.

Nicotine:

Pregnant women who smoke pass nicotine and carbon monoxide to babies. Risks to the fetus of a smoking mother include:

• premature labor, low birth weight

• sudden infant death syndrome (SIDS)

• asthma and other breathing problems in the baby

If you smoke, having a baby can be an additional motivation to quit. Talk to your doctor about the options available to quit smoking.

Caffeine:

Caffeine abuse has been associated with a higher risk of miscarriage, so it is wise to limit or better avoid caffeine consumption altogether if you can do so.

If you are having a hard time quitting coffee suddenly, try the following:

• Start by reducing your 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 regularly.

And remember that caffeine is not only found in coffee. Many types of teas, colas, and other soft drinks contain caffeine. Try switching to decaffeinated products (which may contain some caffeine, albeit in much smaller amounts) or alternatives that do not contain caffeine.

If you're wondering if you should also stop drinking chocolate, which also contains caffeine, the good news is that you can take it, albeit in moderation. While a chocolate bar contains an average of between five to 30 mg of caffeine, a cup of coffee contains between 95 to 135 mg. So, you can have small amounts of chocolate during pregnancy.

Certain foods:

Although you need to eat plenty of healthy foods during pregnancy, you also need to avoid foodborne illnesses, such as listeriosis and toxoplasmosis, which can endanger the life of the fetus and lead to birth defects or miscarriage.

Do not try the following foods:

• non-pasteurized creamy cheeses (often sold as “fresh”), including feta, goat, Brie, Camembert, and blue or Roquefort cheese

•  unpasteurized milk, juices, and apple cider

• raw eggs or foods that contain raw egg, including mousses, tiramisu, pasta made from undercooked dough, homemade ice cream, and salad dressings that contain raw egg yolk (although some brands of industrially made dressings may not contain raw egg)

• raw or undercooked meat, fish (sushi), or seafood

• cold cuts, cold cuts, or hot dogs (unless heated until they start to smoke)

Also, although fish and shellfish can be extremely healthy parts of your diet (being rich in the beneficial omega-3 fatty acids and protein and containing very little saturated fat), you should avoid eating:

• shark

• swordfish

•  giant mackerel

•  tuna steaks

• marlin

• orange roughy

These fish can contain high levels of mercury, which can cause brain damage in the developing fetus. For total fish and shellfish consumption, limit the amount to about twelve ounces (about 340 g) per week - which is roughly two meals. Also, if you eat canned tuna, be aware of the type in the can. Canned tuna contains smaller fish and can be eaten twice a week. But albacore contains a larger fish and can only be eaten once a week. And, before consuming perch that has been caught by recreational fishing, check your local recommendations.

Cleaning the cat litter drawer

If you have cats at home, 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 droppings and can cause serious problems, including premature delivery, growth retardation, and serious eye and brain abnormalities in the fetus. When a pregnant woman contracts this infection, she often has no symptoms, but she can still pass it on to her developing baby.

Prescription and Over-the-Counter Medications:

Even some commonly used over-the-counter drugs that are generally safe are prohibited during pregnancy because of their potential adverse effects on the baby. And some prescription drugs can also be harmful to a developing fetus.

To make sure you don't take anything that could be harmful to your baby:

• Ask your doctor which medications - prescription and nonprescription - are safe during pregnancy.

• Tell your doctor about any medications you are taking.

• Inform all health professionals who care for you that you are pregnant so that they will take this into account when recommending or prescribing any medication.

• Also, remember to discuss any natural remedies, supplements, or vitamins you are considering taking with your doctor.

If you were prescribed any medication for a disease or condition that you still have before becoming pregnant, consult your doctor to help you weigh the benefits and potential risks of continuing and stopping the medication.

If you get sick (for example, you get a cold) or have uncomfortable or painful symptoms (for example, headache or back pain), ask your doctor what medicines you can take and if there are alternative ways to relieve your symptoms without taking medicine.

Healthy habits during pregnancy: from start to finish

Throughout your pregnancy, from the first week to the last, it is very important to take care of yourself to take care of your baby. Although you will need to take some precautions and constantly be aware of how what you do - and what you don't do - could affect the baby, many women say they have never felt as healthy as when they were pregnant.

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