Care during Pregnancy
Prenatal care should start as soon as you know you are pregnantat which point (if you haven’t already heard it) your doctor will caution you about the potential hazards of using tobacco, alcohol, and drugs. All three can impair fetal development in different ways, and you should avoid them entirely, except for drugs that you take at your doctor’s direction.
Pregnancy and Nutrition
Nutrition can have a profound effect on your health and your baby’s. Poor eating habits not only can interfere with your baby’s growth but can also aggravate some of the common discomforts of pregnancy.
The 38 weeks of a normal pregnancy is one period in your life when you are encouraged to gain weight. Recommendations about healthy weight gain vary somewhat among experts, but according to current guidelines from the Institute of Medicine at the National Academy of Sciences, most women should gain 25 to 35 pounds: three to five pounds during the first trimester, and one to two pounds per week after that.
A large percentage of this weight gain is from the baby, the placenta, and the increased volume of fluid in a woman’s body. Failing to gain sufficient weight can be harmful to the baby’s health. At the same time, pregnancy is not an excuse to become excessively heavy. Too much weight can complicate delivery, impede postpartum weight loss, and result in other complications such as hypertension. It is also harder to lose excess weight after pregnancy.
Your doctor or other caregiver will assess how much weight is best for you to gain. Women who are overweight at conception may need to add weight at only half the rate of an average-weight woman, but it is important that they gain at least 15 to 25 pounds, since lower increases are associated with retarded growth of the fetus. Similarly, underweight women and some very young women may need to gain more weight than the average womanup to 40 pounds, depending upon their stature and weight at conception.
The demands of pregnancy will require, on average, an additional 300 calories daily. In addition to extra calories, pregnant women should eat a nutritious diet based on the food groups and portions shown in the food guide pyramid devised by the U.S. Department of Agriculture, which provides specific amounts of food to be eaten daily. If you’re having trouble gaining weight, eat more breads and other grains, rather than consuming foods high in fat. If you’re gaining too much weight, reduce your consumption of high-fat foods like butter and margarine, packaged snack foods, salad dressings, and rich desserts.
The National Research Council, which sets recommended daily amounts of nutrients, advises that pregnant women who eat a well-balanced diet don’t need vitamin and mineral supplements. Many women, however, may have trouble meeting the recommended amounts of iron, calcium, and folacin, and, depending on their diet, other nutrients as well. Women following a vegetarian diet, for example, may need additional zinc and possibly some B vitamins. Many doctors, therefore, will prescribe a supplement especially formulated for pregnant women to provide various essential nutrients. These supplements are not a substitute for a balanced diet; your health and that of your child depend on getting the bulk of your nutrients from foods.
Pregnancy and Exercise
Proper exercise during pregnancy can have many benefits. For a woman who enjoys working out, it can be important psychologically to continue with a regular exercise program after she becomes pregnant. If you do not already exercise, pregnancy can help you feel more in control as your body changes. Moderate exercise during pregnancy can also help prevent pregnancy-related complaints such as excessive weight gain, back strain, and constipation. Another potential benefit: Exercise may help ease or shorten labor and delivery, and help speed recovery after birth. Medical experts say that your exercise program must be geared to your level of fitness, your medical history (particularly any problems during past pregnancies), the stage of development of the fetus, and maternal complicating factors. Therefore, it is important to consult your physician.
Remember that being pregnant puts extra demands on your heart and lungs, so cut back on the intensity of any exercise routine. As pregnancy advances, breathing becomes harder work because each breath must displace the enlarging uterus downward.
For exercise to be effective, it should be regular. Try to exercise at least three times a week in half-hour sessions. The best exercise is an activity you enjoy. Walking and swimming are particularly good for pregnant women who have been relatively sedentary. Muscle-strengthening and joint flexibility exercises are also excellent for helping you support the extra weight you’ll carry and improving your balance.
Be sure to warm up and cool down—but stretch carefully because muscles and joints are looser than usual. Cool down with leisurely walking, which helps return blood to your heart from your lower extremities.
If you feel comfortable and your doctor allows it, you can continue most forms of exercise into your ninth month, although you may have to make some modifications to meet your body’s changing demands.
What to avoid. Avoid bouncing, jarring, twisting, and any activity that could lead to a fall or a blow to the abdomen. Contact sports are too risky, as is any activity that requires rapid stops and starts, since your center of gravity has changed and it is easier to lose your balance.
In addition, take the following precautions:
- Avoid exercising to exhaustion. If you feel very tired or experience discomfort, stop and rest. You should not exercise so intensely that you are unable to talk. You should recover your preexercise heart rate within 15 minutes after your exercise session.
- After 20 weeks into your pregnancy, don’t exercise for more than a few minutes while lying on your back This can block the blood supply to the uterus and depress the fetal heart rate.
- If you need to rest during an exercise session, lie down on your side, not on your back.
- Don’t exercise vigorously in hot, humid weather; always drink plenty of water before and after exercising. This avoids the dehydration and elevated body temperature that could injure the fetus.
- Remember that your muscles and connective tissues are gradually undergoing hormonal changes that will relax them. This will facilitate the baby’s birth, but it also makes you more susceptible to strains and sprains. Wear properly fitting shoes that support your feet in whichever activity you choose.