Before You Start Trying

Follow these helpful hints for a healthy pregnancy.

• Get all essential vitamins and minerals every day. Women need a lot more iron when pregnant. And sometimes it's hard to get enough by eating alone. Ask your doctor if you should be taking a daily prenatal vitamin or multivitamin.
  
• Get 400 micrograms (or 0.4 mg) of folic acid daily. Getting enough folic acid (or folate) reduces the chances of some birth defects. Some women eat lots of certain foods and others take multivitamins to get enough folic acid during pregnancy.

• Eat a healthy diet. Load up on fruits, vegetables, and whole-grains (such as whole-wheat breads or crackers). Eat plenty of calcium-rich foods (such as non-fat or low-fat yogurt, milk, and broccoli) that your baby needs for strong bones and teeth. If you live in areas where fruits and vegetables aren't in season, frozen vegetables are a good option. Avoid eating a lot of fatty foods (such as butter and fatty meats). Choose leaner foods when you can (such as skim milk, chicken and turkey without the skin, and fish).
  
  
• Gain a healthy, not excessive amount of weight. Research shows that women who gain more than the recommended amount during pregnancy have an elevated risk of obesity. On average, 25 to 30 pounds is a healthy weight gain over the 40 weeks of pregnancy. Check with your doctor to find out how much weight you should gain during pregnancy.
  
  
• Get enough sleep (try to get seven to nine hours every night). Aches, pains, anxiety and bathroom runs keep many pregnant women awake at night. To get some zzzzs, eat any large meals at least three hours before going to bed, get some easy exercise (like walking) and avoid long naps during the day. Sleep on your left side and use pillows between your legs and under your belly to help you get comfortable.
  
  
• De-stress. If you can, control the stress in your life. When it comes to work and family, figure out what you can really do. Set limits with yourself and others. Don't be afraid to say NO to requests for your time and energy.
  
  
• Get Moving! Getting regular, low-impact exercise is good for you and your baby. Talk to your doctor about what is safe.

• Get a handle on health problems. Talk to your doctor about how your health problems can affect you and your baby. If you have diabetes, control your blood sugar levels. If you have high blood pressure, monitor it closely. If you are overweight, talk to your doctor about whether you should lose weight.
  
  
• Ask your doctor before taking any medicines . Prescription, over-the-counter, and herbal medicine all can harm your baby. Find out if should continue taking prescription medicines. 
  
• See your doctor regularly. Prenatal care can help keep you and your baby healthy, spot problems if they occur and prevent difficulties during delivery.
  
  
• Consider getting a flu shot. The flu can be dangerous for some moms-to-be. The Centers for Disease Control and Prevention (CDC) suggests vaccinations for all women who are at least 14 weeks pregnant during the flu season. Ask your doctor if you should get a flu shot.
  
• Wear your seat-belt correctly. Seat belts used correctly protect you and your unborn baby during a crash.The American Academy of Family Physicians recommends that pregnant women use seat belts that have a lap belt and a shoulder strap (3-point restraint). Seat belt straps should never go across your belly. The lap strap should go under the belly, across the hips. The shoulder strap should go off to the side of your belly and between your breasts. If you are not driving, the back seat is the safest place to sit.
  
  
• Ease the aches and pains. Don't just accept discomfort as a necessary part of pregnancy. Hemorrhoids, heartburn, and leg cramps can all be helped.

Pregnancy Don'ts

Steer clear of these pregnancy no-nos to help keep you and your baby safe and healthy.

• Don't eat fish with lots of mercury.
  
• Don't disregard foodborne illness. Eat, cook, handle and clean food safely! For both mother and baby, foodborne illness can cause serious health problems - or even death.
  
• Don't use chemicals. Products including herbicides, pesticides, paint, stains, and some cleaning solutions may be harmful to your baby. If you must use these things, wear gloves, a mask, and keep the room well-ventilated.
  
  
• Don't clean or change a cat's litter box. This could put you at risk for an infection called toxoplasmosis. Toxoplasmosis is caused by a parasite that cats can carry in their feces. Toxoplasmosis can harm a fetus.
  
  
• Don't take very hot baths, hot tubs, or saunas. High temperatures can be harmful to the fetus, or cause you to faint.
  
  
• Don't use scented feminine hygiene products. Pregnant women should avoid scented sprays, sanitary napkins, and bubble bath. These products might irritate your vaginal area, and increase your risk of a urinary tract infection or yeast infection.
  
  
• Don't douche. Douching can irritate the vagina, force air into the birth canal and increase the increase the risk of infection. Always ask your doctor before douching.
  
  
• Don't have optional x-rays. X-rays are a form of radiation that is linked to a very small risk of cancer for an unborn baby. But x-rays are usually safe during pregnancy. So if your doctor says you need x-rays for a health problem you should follow her advice. But sometimes doctors can use other tests in place of x-rays. And other times, x-rays can wait until after the baby is born.
  
  
• Don't smoke tobacco. Tell your doctor if you smoke. Quitting is hard, but you can do it. Ask your doctor for help. Smoking during pregnancy passes nicotine and cancer-causing drugs to your baby. Smoke also keeps your baby from getting needed nourishment and raises the risk of stillbirth and premature birth (a small baby born too early).
  
  
• Don't drink alcohol. Stop drinking alcohol if you drink it regularly. Experts are still unsure of the exact amount of alcohol needed to cause problems in your baby. But, both drinking every day and drinking a lot of alcohol once in a while during pregnancy can harm the baby.
  
  
• Don't use illegal drugs. Tell your doctor if you are using drugs. Marijuana, cocaine, heroin, speed (amphetamines), barbiturates, and LSD are very dangerous for you and your baby.

Body Changes

Everyone expects pregnancy to bring an expanding waistline. But many women are surprised by the other body changes that pop-up. Get the low-down on stretch marks, weight gain, heartburn and other "joys" of pregnancy. Find out what you can do to feel better.

Aches, pains, and backaches

As your uterus expands pains in the back, abdomen, groin area, and thighs often appear. Many women also have backaches and aching near the pelvic bone due the pressure of the baby's head, increased weight, and loosening joints.

To ease some of these aches and pains try:

• Lying down
• Resting
• Applying heat

If you are worried or the pains do not get better, call your doctor.

Breast Changes

A woman's breasts increase in size and fullness during pregnancy. As the due date approaches, hormone changes will cause your breasts to get even bigger in preparation for breastfeeding. Your breasts may feel full and heavy, and they might be tender or uncomfortable.

In the third trimester, some pregnant women begin to leak colostrum from their breasts. Colostrum is the first milk that your breasts produce for the baby. It is a thick, yellowish fluid containing antibodies that protect newborns from infection. If leaking becomes embarrassing, put nursing pads inside your bra.

Try to these tips to stay comfortable:

• Wear a soft, comfortable maternity or nursing bra with extra support.
• Wash your nipples with water instead of soap. Soap can dry and irritate nipples. If you have cracked nipples, use a heavy moisturizing cream that contains lanolin.

Dizziness

Many pregnant women complain of dizziness and lightheadedness throughout their pregnancies. Fainting is rare but does happen even in some healthy pregnant women. There are many reasons for these symptoms. The growth of more blood vessels in early pregnancy, the pressure of the expanding uterus on blood vessels and the body's increased need for food all can make a pregnant woman feel lightheaded and dizzy.

To feel better follow these tips:

• Stand up slowly.
• When you're feeling lightheaded, lay down on your left side.
• Avoid sitting or standing in one position for a long time.
• Eat healthy snacks or small meals frequently.
• Don't get overheated.

Call your doctor as soon as possible if you faint. Dizziness or lightheadedness can be discussed at regular prenatal visits.

Hemorrhoids

Up to 50% of pregnant women get hemorrhoids. Hemorrhoids are swollen and bulging veins in the rectum. They can cause itching, pain and bleeding.

Hemorrhoids are more common during pregnancy for many reasons. During pregnancy there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The expanding uterus also puts pressure on the veins in the rectum. Plus, constipation can make hemorrhoids worse. Hemorrhoids usually improve after delivery.

Follow these tips to help prevent and relieve hemorrhoids:

• Drink lots of fluids
• Eat plenty of fiber-rich foods like whole grains, raw or cooked leafy green vegetables, and fruits
• Try not to strain for bowel movements
• Talk with your doctor before taking any laxative.
• Talk to your doctor about using witch hazel or ice packs to soothe hemorrhoids.

Leg Cramps

At different times during your pregnancy, you might have cramps in your legs or feet. They usually happen at night. This is due to a change in the way your body processes, or metabolizes, calcium.

Try these tips to prevent and ease leg cramps:

• Eat lots of low-fat calcium-rich foods.
• Get regular mild exercise, like walking.
• Ask your doctor if you should be taking a prenatal vitamin containing calcium.
• Gently stretch the muscle to relieve leg and foot cramps. If you have a sudden leg cramp, flex your foot towards your body.
• Use heating pads or warm, moist towels to help relax the muscles and ease leg and foot cramps.

Nasal Problems

Nosebleeds and nasal stuffiness are common during pregnancy. They are caused by the increased amount of blood in your body and hormones acting on the tissues of your nose.

To ease nosebleeds blow gently when you blow your nose. Stop nosebleeds by squeezing your nose between your thumb and finger for a few minutes. If you have nosebleeds that do not stop in a few minutes or happen often, see your doctor.

Drinking extra water and using a cool mist humidifier in your bedroom may help relieve nasal stuffiness. Talk with your doctor before taking any over-the-counter or prescription medicines for colds or nasal stuffiness.

Shortness of Breath

As the baby grows, your expanding uterus will put pressure on all of your organs, including your lungs. You may notice that you are short of breath or might not be able to catch your breath.

Tips to ease breathing include:

• Take deep, long breaths.
• Maintain good posture so your lungs have room to expand.
• Use an extra pillow and try sleeping on your side to breathe easier at night.

Swelling

Most women develop mild swelling in the face, hands, or ankles at some point in their pregnancies. As the due date approaches, swelling often becomes more noticeable. If you have rapid, significant weight gain or your hands or feet suddenly get very puffy, call your doctor as soon as possible. It could be a sign of high blood pressure called preeclampsia or toxemia.

To keep swelling to a minimum:

• Drink 8 to 10 eight-ounce glasses of fluids (water is best) daily.
• Avoid caffeine.
• Try to avoid very salty foods.
• Rest when you can with your feet elevated.
• Ask your doctor about using support hose.

Teeth and Gums Problems

A pregnant woman's teeth and gums need special care. Pregnant women with gum disease are much more likely to have premature babies with low-birth weight. This may result from the transfer of bacteria in the mother's mouth to the baby during pregnancy. The microbes can reach the baby through the placenta (a temporary organ joining the mother and fetus which supplies the fetus with blood and nutrients), through the amniotic fluid (fluid around the fetus), and through the layer of tissues in the mother's stomach.

Every expectant mother should have a complete oral exam prior to or very early in pregnancy. All needed dental work should be managed early, because having urgent treatment during pregnancy can present risks. Interventions can be started to control risks for gum inflammation and disease. This also is the best time to change habits that may affect the health of teeth and gums, and the health of the baby.

Remember to tell your dentist that you are pregnant! You can ease bleeding gums by brushing with a soft-bristled toothbrush and flossing at least twice a day.

Varicose Veins

During pregnancy there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. Plus, pressure on the large veins behind the uterus causes the blood to slow in its return to the heart. For these reasons, varicose veins in the legs and anus hemorrhoids are more common in pregnancy.

Varicose veins look like swollen veins raised above the surface of the skin. They can be twisted or bulging, and are dark purple or blue in color. They are found most often on the backs of the calves or on the inside of the leg.

Try these tips to reduce the chances of varicose veins:

• Avoid tight knee-highs or garters.
• Sit with your legs and feet raised when possible.

Digestive Difficulties

Constipation

Many pregnant women complain of constipation. High levels of hormones in your pregnant body slow down digestion and relax muscles in the bowels leaving many women constipated. Plus, the pressure of the expanding uterus on the bowels boosts the chances for constipation.

Try these tips to stay more regular:

• Eat fiber-rich foods like fresh or dried fruit, raw vegetables, and whole-grain cereals and breads daily
• Drink eight to ten glasses of water everyday.
• Avoid caffeinated drinks (coffee, tea, colas, and some other sodas), since caffeine makes your body lose fluid needed for regular bowel movements.
• Get moving. Mild exercise like walking may also ease constipation.

Heartburn and Indigestion

Almost every pregnant woman experiences indigestion and heartburn. Hormones and the pressure of the growing uterus cause this discomfort. Pregnancy hormones slow down the muscles of the digestive tract. So food tends to move more slowly and digestion is sluggish. This causes many pregnant women to feel bloated.

Hormones also relax the valve that separates the esophagus from the stomach. This allows food and acids to come back up from the stomach to the esophagus. The food and acid causes the burning feeling of heartburn. As your baby gets bigger, the uterus pushes on the stomach making heartburn more common in later pregnancy.

Try these tips to prevent and ease indigestion and heartburn:

• Avoid greasy and fried foods.
• Eat six to eight small meals instead of three large meals.
• Don't gain more than the recommended amount of weight.
• Take small sips of milk or eat small pieces of chipped ice to soothe burning.
• Eat slowly.
• Ask your doctor if you can take an antacid medicine.

Stretch Marks and Other Skin Changes

Stretch Marks

Worried about the dreaded stretch marks of pregnancy? Just about all pregnant women are. The good news is that only about half of pregnant women get stretch marks.

Stretch marks are red, pink, or purple streaks in the skin. Most often they appear on the thighs, buttocks, abdomen, and breasts. These scars are caused by the stretching of the skin, and usually appear in the second half of pregnancy.

The color of stretch marks depends on a woman's skin color. They can be pink, reddish brown, or dark brown streaks. While creams and lotions can keep your skin well moisturized, they do not prevent stretch marks from forming. Most stretch marks fade after delivery to very light lines.

Other Skin Changes

Some women notice other skin changes during pregnancy. For many women, the nipples become darker and browner during pregnancy. Many pregnant women also develop a dark line (called the linea nigra) on the skin that runs from the belly button down to the pubic hairline. Blotchy brown pigmentations on the forehead, nose and cheeks are also common. These spots are called melasma or chloasma and are more common in darker-skinned women. Most of these skin changes are caused by pregnancy hormones and will fade or disappear after delivery.

Tingling and Itching

Tingling and numbness of the fingers and a feeling of swelling in the hands are common during pregnancy. These symptoms are due to swelling of tissues in the narrow passages in your wrists, and they should disappear after delivery.

About 20 percent of pregnant women feel itchy during pregnancy. Usually women feel itchy in the abdomen. But red, itchy palms and soles of the feet are also common complaints. Pregnancy hormones and stretching skin are probably to blame for most of your discomfort. Usually the itchy feeling goes away after delivery.

In the meantime, try these tips to feel better:

• Use thick moisturizing creams instead of lotions on your skin.
• Use gentle soaps.
• Avoid hot showers or baths that can dry your skin.
• Avoid itchy fabrics and clothes.
• Try not to get over-heated. Heat can make the itching worse.

Rarely, itchiness can be a sign of a serious condition called cholestasis of pregnancy. If you have nausea, loss of appetite, vomiting, jaundice or fatigue with itchiness, call your doctor. Cholestasis of pregnancy is a serious liver problem.

Sleeping Troubles

During your pregnancy, you might feel tired even after you've had a lot of sleep. Many women find they're particularly exhausted in the first trimester. Don't worry, this is normal! This is your body's way of telling you that you need more rest.

In the second trimester, tiredness is usually replaced with a feeling of well being and energy. But in the third trimester, exhaustion often sets in again. As you get larger, sleeping may become more difficult. The baby's movements, bathroom runs, and an increase in the body's metabolism might interrupt or disturb your sleep. Leg cramping can also interfere with a good night's sleep.

Try these tips to feel and sleep better:

• When you're tired, get some rest.
• Try to get about eight hours of sleep every night, and a short nap during the day.
• If you feel stressed, try to find ways to relax.
• Sleep on your left side. This will relieve pressure on blood vessels that supply oxygen and nutrients to the fetus.
• If you have high blood pressure during pregnancy, always lay on your left side when you're lying down.
• Avoid eating large meals three hours before going to bed.
• Get some mild exercise like walking.
• Avoid long naps during the day.

Weight gain

The amount of weight you need to gain during pregnancy depends upon how much you weighed before you became pregnant. According to the American College of Obstetricians and Gynecologists (ACOG) women who have a normal weight before getting pregnant should gain 25 to 35 pounds. Women who are underweight before pregnancy should gain 28 to 40 pounds. And women who are overweight should gain 15 to 25 pounds.

Research shows that women who gain more than the recommended amount during pregnancy have a higher chance of being obese 10 years later. Ask your doctor how much weight gain during pregnancy is healthy for you.

Is it Safe to have Sex?

Unless your doctor tells you otherwise, sexual intercourse is safe throughout your pregnancy. For many women, pregnancy increases their sex drive. For others, it has the opposite effect. And almost all women need to try different positions when they start to get large bellies.

If you have problems during your pregnancy or have had miscarriages in the past your doctor may suggest you avoid sexual intercourse. Call your doctor if you have any of the following problems during or after sexual intercourse:

• pain in the vagina or abdomen
• bleeding from the vagina
• leaking of fluid from the vagina

When to Call the Doctor

When you are pregnant you should not hesitate to call your doctor or midwife is something is bothering or worrying you. Sometimes physical changes can be signs of a problem.

Call your doctor immediately if you:

• are bleeding or leaking fluid from the vagina
• have sudden or severe swelling in the face, hands, or fingers
• get severe or long-lasting headaches
• have discomfort, pain or cramping in the abdomen
• have a fever or chills
• are vomiting or have persistent nausea
• feel discomfort, pain or burning with urination
• have problems seeing or blurred vision
• feel dizzy
• sense a change in your baby's movement
• suspect your baby is moving less than normally after 28 weeks of pregnancy ( if you count less than 10 movements in 2 hours or less)

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