Pregnancy

You’re Pregnant!
Prenatal CareDiet & NutritionExerciseStressOral Health

Smoking Cessation & PregnancyDrugs & AlcoholJust for Dads-to-be!

Prenatal Care

Q. What should I be eating?
A. The March of Dimes suggests the following daily food portions for a pregnant woman:

  • 6 to 11 servings of breads and whole grains
  • 3 to 5 servings of vegetables
  • 2 to 4 servings of fruits
  • 4 to 6 servings of milk and milk products
  • 3 to 4 servings of meat and protein-rich foods
  • 6 to 8 glasses of water and no more than one soft drink or cup of coffee a day to limit caffeine

See the section on Diet & Nutrition for more information.

Q. What vitamins should I be taking?
A. A prenatal vitamin supplement helps ensure that you are getting all the necessary vitamins and minerals. Choose a supplement that contains vitamin A, folic acid, vitamins D and C, niacin, iron, iodine and calcium. Talk to your doctor early on about prenatal vitamins. But remember, a vitamin supplement should not replace a good, balanced diet.Q. How often should I see my doctor?
A. You should have an initial prenatal exam as soon as you know you are pregnant (six to ten weeks) or in your first trimester of pregnancy.

  • Write down a list of questions you want to ask and be sure to bring it with you for this visit.
  • Don’t forget to discuss any medications you may be taking.
  • Know the date of your last menstrual period. This will help your physician determine your due date.
  • If you are seeing a family doctor, you may want to discuss health care provider options (Obstetrician or Midwife) for monitoring your pregnancy and overseeing the delivery.

If your pregnancy is progressing normally, you will probably be scheduled for health care visits once a month in the beginning. These visits will become more frequent closer to your due date. If you have concerns — like bleeding, cramps or other problems — in between your appointments, contact your health care provider immediately.

Q. Now that I’m pregnant, are there any special things I need to avoid?
A. Topics such as smoking cessation and use of drugs and alcohol are discussed in their own sections. You should also:

  • Continue to avoid exposure to toxic substances and chemicals, including some cleaning products and insecticides, paint thinners, lead, etc.
  • Avoid eating undercooked meat or handling cat litter, which cause toxoplasmosis and can seriously harm a developing fetus.
  • Avoid anything that will elevate your body temperature above 102°F (38.9°C) and keep it there for a long time, including a long, hot bath; hot tubs; overzealous workouts in hot weather; electric blankets and heating pads or catching a virus. An elevated body temperature can be potentially hazardous to the development of the fetus, especially in the early months.
  • While there may be a need for X-rays to be taken during your pregnancy, elective and dental X-rays should be avoided. Be sure to inform health care providers that you are pregnant before the examination begins.

Other Resources:

http://www.healthy-beginnings.com/healthybeginnings

http://my.webmd.com/content/article/1680.51792

Sources:

March of Dimes

Pregnancy and Birth, Your Questions Answered, Dr. Karina Reynolds, Dr. Christoph Less, Grainne McCartan, Firefly Books.

The Children’s Hospital of Philadelphia Book of Pregnancy and Child Care, Patrick S. Pasquariello, Jr., M.D., John Wiley & Sons, Inc.

The Society of Obstetricians and Gynaecologists of Canada

What To Expect When You’re Expecting, Arlene Eisenberg, Heidi E. Murkoff, Sandee E. Hathaway, B.S.N., Workman Publishing. ^ Top

Diet & Nutrition

Q. Should I continue my normal eating habits now that I’m pregnant?
A. That depends on what you normally eat. Remember, you’re eating for two now. During pregnancy, give your baby the best possible start in life by eating the right foods. Good nutrition is important so those extra calories should come from a balanced diet of protein, fruits, vegetables and whole grains. Limit your sugar and fat intake.

Q: How many extra calories will I need while I’m pregnant?
A. It takes about 300 extra calories a day to maintain a normal pregnancy. Your baby will benefit more from nutrient-rich calories rather than mostly empty ones — a 150 calorie doughnut is not equal to the 150 calories in whole-grain muffin.

Q: How much weight will I gain?
A. An average-sized woman will probably gain 25 to 35 pounds during pregnancy. Too much weight gain, or too little, can put you and your baby at risk. Though your appetite will increase, try not to overeat. Don’t diet and never skip a meal. Even if you are not hungry, your baby is. Your doctor will monitor your weight at each visit to ensure that your weight gain is on target. After the birth of your baby, sensible eating will get you back to your normal weight range.

Q: Do I need to take vitamin supplements during pregnancy?
A. If you are not getting the necessary Recommended Dietary Allowances (RDAs) for pregnancy through the food you eat, your doctor may recommend a vitamin supplement. The National Academy of Sciences (1989) RDAs for pregnant women are:

Other Resource:http://my.webmd.com/content/article/1680.51792

Sources:March of DimesPregnancy and Birth, Your Questions Answered, Dr. Karina Reynolds, Dr. Christoph Less, Grainne McCartan, Firefly Books. The Children’s Hospital of Philadelphia Book of Pregnancy and Child Care, Patrick S. Pasquariello, Jr., M.D., John Wiley & Sons, Inc. What To Expect When You’re Expecting, Arlene Eisenberg, Heidi E. Murkoff, Sandee E. Hathaway, B.S.N., Workman Publishing. ^ Top

Exercise

Q. How active should I be during pregnancy?
A. Chances are you already have a busy lifestyle. Daily activities, including housework, walking and gardening will help keep you in shape. Adding some regular, gentle exercise during your pregnancy could help you feel better and cope with the extra stamina required to carry a baby and during delivery.

Q. Are there any special exercises for pregnancy?
A. Before embarking on any type of exercise routine check with your health care provider to discuss what’s right for you.

  • Swimming is a great exercise because it supports your body weight without strain, tones your muscles and improves stamina.
  • Some pregnant women enjoy walking and yoga.
  • Pelvic toning exercises are important since the pelvic muscles can be stretched by the weight of the womb causing discomfort and possible bladder incontinence.
  • Relaxation techniques, like breathing and concentration, help conserve energy for when you need it most, and increase body awareness and focus. These techniques can help you meet the challenges of childbirth.
  • Check to see if there are exercise classes for pregnant women in your community.

Q. Are there any physical activities I should avoid?
A. Remember, you’re carrying another life. It’s up to you to ensure your baby is out of harm’s way.

  • If you’re a jogger, ask your health care provider whether it’s safe to continue running and when the best time is to slow the pace.
  • If you are into competitive sports, pregnancy probably means time-out. Any contact sport where there is risk of injury can also injure your baby.
  • There are times when vigorous exercise is not recommended. For example, if you have a temperature, or when you are not feeling well, and during periods of very hot weather.
  • Potentially hazardous activities, like horseback riding and downhill skiing should probably be reserved for after the baby is born.

If you’re unsure about whether or not to take part in any activity, consult your health care provider for advice.

Other Resources:

http://my.webmd.com/content/article/3608.304

http://my.webmd.com/content/article/1680.51796

http://www.fittodeliver.com

http://www.expecting-fitness.com

http://www.marchofdimes.com/pnhec/159_515.asp

Sources:

Pregnancy and Birth, Your Questions Answered, Dr. Karina Reynolds, Dr. Christoph Less, Grainne McCartan, Firefly Books.

The Children’s Hospital of Philadelphia Book of Pregnancy and Child Care, Patrick S. Pasquariello, Jr., M.D., John Wiley & Sons, Inc.

What To Expect When You’re Expecting, Arlene Eisenberg, Heidi E. Murkoff, Sandee E. Hathaway, B.S.N., Workman Publishing.^ Top

Stress Free Zone: Understanding and Managing Stress During Pregnancy

Q. What is stress?
A. Stress is defined as a demand on our physical and mental energy. When we encounter a situation that our body determines to be stressful, it secretes hormones to stimulate the nervous system, preparing us to react. In some cases, this can actually be good, like when we are walking and we move to avoid stumbling on something. But when stress is extreme, our body reacts by releasing an excessive amount of hormones that can increase heart rate, blood pressure and breathing or cause other physical reactions. It can also evoke emotional responses like anxiety, fear and anger.

Q. I’ve always had stress in my life so what difference will it make if I’m pregnant?
A. Now, more than ever, it’s important to take care of yourself and your unborn baby. Large amounts of stress can take its toll on your health and the health of the fetus. Prolonged stress has been linked to many health problems, including sleep disruption, ulcers, high blood pressure, heart disease, stroke and lower resistance to infectious diseases. In some cases, stress has been shown to have a possible association with increased rates of infertility, increased nausea, low birthweight, premature birth and miscarriage.

Q. What causes stress?
A. Because everyone is different, our reactions to situations vary, but there are some common physical and emotional situations that often lead to stress. These can include busy schedules, demands at work and home, marital discord or single-parenting issues, caring for young children or aging parents, financial worries, life-threatening illness or death of a loved one.

During pregnancy, fluctuating hormone levels can exacerbate emotional or physical responses to these situations. You may also find that the pregnancy brings on new concerns as some women find themselves wondering:

  • How do people think I look now that I’m pregnant?
  • How does my partner feel about the fact that I’m gaining weight?
  • Will I be able to handle the labor?
  • Will I have a safe delivery?
  • Will my child be healthy when it’s born?
  • Will I be a good parent?
  • How will I get everything done (painting the nursery, buying clothes, etc.) before the baby comes?

Q. How much is too much?
A. When managed properly, stress can make you feel energized and provide you with motivation to meet new challenges. But when stress reaches uncomfortable levels, it can be harmful. When high levels of stress continue for prolonged periods, it can lead to serious health problems and pose risks to both mother and baby during pregnancy.

“Stress that is damaging is uncomfortable stress evoking feelings of being trapped anxious and eager to escape.” (Nathanielsz, Peter)

Q. What are the signs and affects of stress during pregnancy?
A. Prolonged or severe stress can take an emotional and physical toll on you, which can also affect your baby.

  • Sleep disturbances can leave you feeling exhausted all the time.
  • You may feel anxious or upset at minor problems and disappointments.
  • Situations that might not have bothered you before may evoke feelings of anger.
  • You may experience physical symptoms, including headache, backache or chronic pain.
  • Your appetite may be affected. For some people this means losing interest in food that can be dangerous to you and your baby during pregnancy. Some people overeat, often making unhealthy food choices. Empty calories won’t provide the proper nourishment your baby needs and can result in excessive weight gain for the mother.
  • Your immunity may be decreased, which means you’re more susceptible to viruses, colds or other contagious illnesses.
  • You may begin to exhibit signs of low self-esteem or suffer from self-doubt.

In severe and prolonged instances of stress, depression can result.

Q. How could excessive stress affect my baby?

A. High levels of stress over a prolonged period of time may:

  • Put your pregnancy at risk.
  • Have a lifelong effect on how your child’s brain and body develop.
  • Affect your child’s temperament.
  • Make your child overreact to stress in the future.
  • Make your child more susceptible to depression and other mental disorders. (Nathanielsz, Peter)

Q. How can I eliminate the stress?

A. It’s almost impossible to completely eliminate stress from our lives but we can learn how to reduce it to a comfortable level. The first step is recognizing the signs of stress and becoming aware of the risks it poses to you and your baby. The second step is learning to relax and taking control of situations so that stress doesn’t get out of hand. Here are some other ideas that can help:

  • The first and most important thing is attitude change. Positive thinking will go a long way to relieving stress. When you start to have a negative thought, tell yourself to “stop.” Relax for a moment and look at the situation objectively. Is it really that important? If so, is there another way to handle the situation?
  • If a situation with someone else is causing you stress, talk to that person about it and about them how you’re feeling. Try to find a resolution.
  • Seek help from your support network (partner, family and friends). Preparing for the baby should be fun and can be shared with your partner. Household chores and caring for your other children (if you have them) should be a team effort.
  • Don’t be a perfectionist. Be flexible. If something doesn’t get done when and the way you hoped it would be, it’s not the end of the world. There’s always tomorrow. Right now, the most important thing is to relax, rest and take care of yourself.
  • Reassess your priorities. Learning to be flexible will also help once the baby arrives. Little ones have a habit of disrupting routine and you’ll need to attend to the baby’s needs first, letting go of other things that used to be a priority.
  • Start doing relaxation exercises every day. This will help you relieve tension and cope with stress during the day. There are numerous books available on the subject. Find the relaxation exercises that you are most comfortable with, but remember to check with your doctor before you start any new exercise routine.
  • Take some quiet time alone to read, mediate or write in a journal while listening to your favorite music.
  • Make sure you’re eating right. During pregnancy, your baby needs nourishment so don’t let go of good eating habits, especially when things are hectic. Good nutrition also provides your body with the energy you need to get through stressful times.
  • Most important, whenever possible avoid stressors. And remember, tomorrow is a new day. Every situation will pass.

Other Resources:

Pregnancy Sickness – Using Your Body’s Natural Defenses to Protect Your Baby-to-Be,Margie Profet, Addison-Wesley Publishing Company Inc.

What to Expect When You’re Expecting, Arlene Eisenberg, Heidi E. Murkoff, Sandee E. Hathaway, B.S.N., Workman Publishing.

Pregnancy & Childbirth, Avon Books.

The March of Dimes, Stress and Pregnancy: How Pregnant Women Can Help Manage Stress In Their Lives. http://www.modimes.org/HealthLibrary2/stress.htm

The Mother of All Pregnancy Books, Ann Douglas, Canadian Edition: Hungry Minds Canada/Macmillan Canada, 2000; U.S. Edition: Hungry Minds, January 2002 (http://www.having-a-baby.com).

The Unofficial Guide to Having A Baby, Ann Douglas, Hungry Minds, 1999. (http://www.having-a-baby.com).

The Prenatal Prescription, Peter Nathanieslz, Promethean Press, 2000.

Zero to Three, http://www.zerotothree.org/brainwonders/FAQ.html

National Mental Health Association www.nmha.org (1-800-969-6642)

CBS HealthWatch, Stress Takes its Toll on Pregnancy http://cbshealthwatch.medscape.com/cx/viewarticle/221802

About.com, Stress and Pregnancy http://pregnancy.about.com/library/weekly/aa042798.htm

Nutrition for you, nutrition for two, Staying Well http://www.cyberdiet.com/modules/ip/staying_well/stress/relaxation.html

Yogaclass.com, Free Real Audio Yoga exercises http://yogaclass.com/

Mind/Body Medical Institute, Mini Relaxation Exercises http://www.thebody.com/mb/mini.html

MCKINLEY Heath Centre, Relaxation Exercises for Improved Sleep http://www.mckinley.uiuc.edu/health-info/stress/rela-exe.html^ TopOral Health

Q. How can my oral health affect my pregnancy?
A. Recent research suggests that serious gum disease, called periodontitis, can cause your baby to be born too early (premature birth) and too small. For a long time we’ve known that many risk factors contribute to mothers having premature, low birth weight babies—smoking, alcohol use, drug use and infections. Now mounting evidence suggests a new risk factor—periodontal disease. Pregnant women who have periodontal disease may be seven times more like to have a baby that is premature.

Q. What are the health risks for a baby born too early and too small?
A. Premature birth can lead to some serious consequences for the baby. It is the leading cause of neonatal death (within the first month of life), and can lead to serious lifelong health problems like mental retardation, blindness, chronic lung disease and cerebral palsy.

Q. Should I still visit my dentist when I’m pregnant?
A. Yes. Normal pregnancy can affect your gums causing swelling, inflammation or bleeding due to pregnancy hormones. This is called pregnancy gingivitis. It often begins in the second or third month of pregnancy and increases in severity throughout the eighth month, so it’s a good idea to have your teeth checked and cleaned regularly. You should make appointment with your dentist at least once during the nine months. If you can afford to do so, visit your dentist once each trimester. In addition, because women with periodontal disease are at risk for having a premature birth, it is a good idea to ask your dentist to refer you to a periodontist for a periodontal evaluation as part of your prenatal care.

Q. Will dental work pose a risk to my unborn baby?
A. Normal dental work shouldn’t be cause for concern, but delaying needed dental work could pose a risk to your baby. For example, badly decayed teeth or impacted wisdom teeth can be a source of infection that can spread putting both mother and fetus in danger. Be sure to tell your dentist that you are pregnant so he or she can take necessary precautions. X-rays should be avoided unless absolutely necessary. Routine repair work requiring anesthetic should be postponed because even a local anesthetic can enter your bloodstream and reach the fetus.

Q. Can I do anything to help ensure that my teeth are healthy during pregnancy?
A. Yes.

  • Be sure to follow a good diet, avoiding refined sugar, which contributes to decay and gum disease (see section on Diet & Nutrition).
  • Eat foods high in Vitamin C to strengthen gums.
  • Stay on top of your calcium requirements to keep teeth and bones strong and healthy.
  • Floss and brush regularly, at least twice a day.
  • Brush your tongue when you brush your teeth to further reduce bacteria and keep your breath fresh.

Other Resources:

http://www.perio.org/consumer/women.htm#pre

http://www.washingtonfamilies.com/archive/gum-disease.htm

http://womenshealth.about.com/library/weekly/aa121499e.htm

http://www.marchofdimes.com/prematurity/index.asp

Sources:

American Academy of Periodontology Patient Page, November/December 2000, Vol. 1, No. 4.

Brush for Two, National Healthy Mothers, Healthy Babies Coalition, 2000.

Pregnancy and Birth, Your Questions Answered, Dr. Karina Reynolds, Dr. Christoph Less, Grainne McCartan, Firefly Books.

Pregnancy and Periodontal Disease, American Academy of Periodontology, 1998.

Premature Birth, March of Dimes, 2003.

What To Expect When You’re Expecting, Arlene Eisenberg, Heidi E. Murkoff, Sandee E. Hathaway,B.S.N., Workman Publishing. ^ Top

Smoking Cessation & Pregnancy

Q. How can smoking harm my newborn?
A. Studies show that mothers who smoke run the risk of complications during pregnancy. Studies also reveal that there is increase in the fetal heart rate that continues for 15 minutes after each smoking episode. Severity of the side effects is proportional to the amount of smoke inhaled (whether directly or passively). Other risks include:

  • Increase in miscarriage and stillbirth
  • Increase in ectopic (tubal) pregnancy
  • Increase in placental problems
  • Increase in premature rupture of the membranes
  • Increase in chorioamnionitis (infection of amniotic sac)
  • Increase in pre-term delivery
  • Increase in low birthweight

Q. I’m a smoker and just found out I am pregnant. If I stop smoking now will it reduce the long-term risks?
A. No matter what point in your pregnancy that you quit, there are always benefits to the baby and you. A woman who quits smoking during the first three to four months of pregnancy can lower the chances of complications or risks to her fetus. When the baby is born, do not start smoking again. Remember, second hand smoke can lead to increased risk of sudden infant death syndrome (SIDS) and more frequent colds and ear infections for your little one.

Q. What if I quit and my partner does not?
A. Encourage him to quit with you and try to support for each other through this. If your partner does not quit, ask him to smoke outside or away from you, the baby and areas where the baby resides.

Q. It is so hard to quit. What can I do to make it easier?
A. Unfortunately, kicking the habit doesn’t come easily for most people. Here are some suggestions to help you get through the difficult times.

  • Identify your motivation for quitting. Pregnancy can be a strong motivator so remember why you want to quit and the adverse affects smoking has on your baby.
  • If possible find a non-smoking friend, your partner or someone who will support you and be there during the cravings and moodiness.
  • Avoid tempting social situations where you normally smoke.
  • Treat yourself every day, week or month that you don’t smoke. Do something you enjoy, use the money you save by not purchasing cigarettes to take your partner to your favorite restaurant or enjoy a movie.
  • If you smoke to reduce tension, try relaxation techniques, listen to soothing music or take long walks. If you associate smoking with specific routines in your life, alter your routines to reduce cravings.
  • See your health care provider for possible medical solutions to help you quit. Ask about organizations that specialize in helping smokers kick the habit.
  • Take it day-by-day. If you slip you can start again tomorrow.

Other Resources:

http://pregnancy.about.com/health/pregnancy/msubsmoking.htm

http://www.marchofdimes.com/professionals/681_1116.asp

http://mywebmd.com

Sources:

American Cancer Society

March of Dimes

Pregnancy and Birth, Your Questions Answered, Dr. Karina Reynolds, Dr. Christoph Less, Grainne McCartan, Firefly Books.

The Children’s Hospital of Philadelphia Book of Pregnancy and Child Care, Patrick S. Pasquariello, Jr., M.D., John Wiley & Sons, Inc.

What To Expect When You’re Expecting, Arlene Eisenberg, Heidi E. Murkoff, Sandee E. Hathaway, B.S.N., Workman Publishing.^ Top

Drugs & Alcohol

Q. What risks are associated with drug use and pregnancy?
A. Recreational or illicit drugs are harmful to both mother and fetus. Exact risks vary and some are difficult to determine, but studies show that Marijuana, Cocaine, Heroin and Methadone all pose high risk to both mother and baby. Anything that poses a risk to you or your fetus should be eliminated from use. Risks associated with over-the-counter or prescribed medication vary. Be sure to ask your health care provider about any medications before taking them.

Q. How is my fetus affected if I drink alcohol during pregnancy?
A. When a pregnant woman drinks, the alcohol passes through the placenta to her fetus. In the unborn baby’s immature body, alcohol is broken down much more slowly than in an adult’s body. As a result, the alcohol level of the fetus’s blood can be even higher and can remain elevated longer than in the mother’s blood.

Q. Are there long-term risks to my baby associated with consuming alcohol during pregnancy?
A. Many people know that heavy drinking during pregnancy can cause birth defects, but don’t realize that moderate drinking can also harm the fetus. In fact, no level of alcohol use during pregnancy has been proven safe. Some risks to the fetus associated with alcohol, include:

  • Physical and mental birth defects, including Fetal Alcohol Syndrome (FAS) with psychological and behavioral problems that can last a lifetime.
  • Lesser degrees of alcohol-related damage, termed fetal alcohol effects (FAE), can include learning and behavioral problems.
  • Increased risk of miscarriage, low birthweight, stillbirth and death in early infancy.
  • Limited fetal growth.
  • Heavy drinkers are more likely to miscarry between the fourth and sixth months of pregnancy than non-drinkers.
  • Heavy drinkers are more likely to lose their babies during the perinatal period (28th week of pregnancy through the first week after birth).

Other Resources:

http://www.ObGyn.net

http://my.webmd.com

http://www.nofas.org

Sources:

March of Dimes ^ Top

Just for Dads-to-be!

Q. My partner’s moods seem to be changing all the time. How long does this last?
A. The first three months are the most difficult until your partner’s hormone levels begin to stabilize, but some women continue to exhibit mood swings and periods of weeping throughout their pregnancy. Be a source of support for your partner. Don’t take everything that happens personally and try to be patient and a good listener too. Remember, this is only temporary.

Q. My partner’s pregnant and I’m experiencing morning sickness. What’s going on?
A. Studies reveal that many expectant fathers suffer from couvade syndrome during their partner’s pregnancy. Symptoms, which often appear in the third month and during delivery, can include nausea, vomiting, abdominal pain, appetite changes, weight gain, food cravings, constipation, leg cramps, dizziness, fatigue and mood swings. If your doctor doesn’t find anything physically wrong, then you may be suffering from sympathy symptoms. Identifying the cause, which can be due to anxiety over handling a newborn, jealousy or a number of other feelings, may lead to the cure. If you don’t suffer from couvade syndrome don’t worry. It doesn’t mean you don’t empathize with your wife.

Q. I am worried that I won’t make it through labor and delivery with my partner. What can I do to prepare?
A. Most fathers feel this way but they come through the delivery without a problem. To relieve some of your anxiety, try getting some insight into what’s ahead. Find some reading materials. Attend childbirth classes with your partner. Watch films about childbirth and talk to other fathers who have been through this. And, most important, relax. Many fathers-to-be have been through this and did as well as you will when the time comes!

Other Resources:

http://www.fatherhood.org

http://fatherhood.about.com/parenting/fatherhood/mbody.htm

http://www.1st-spot.freeservers.com/topic_fatherhood.html

Sources:

National Fatherhood Initiative

Pregnant Fathers, Entering Parenthood Together, Jack Heinowitz, Ph.D., Parents as Partners Press.

The Children’s Hospital of Philadelphia, Book of Pregnancy and Child Care, Patrick S. Pasquariello Jr. M.D., Ed., John Wiley & Sons Inc.

What To Expect When You’re Expecting, Arlene Eisenberg, Heidi E. Murkoff, Sandee E. Hathaway, B.S.N., Workman Publishing.