There is much a pregnant woman can do to take care of herself during pregnancy. If she has any questions about diet, the use of drugs or nutritional supplements, physical activity, and sexual intercourse during pregnancy, she can talk with her doctor or other health care practitioner.
Diet and weight
During pregnancy, the woman’s diet should be adequate and nutritious. If she does not consume enough nutrients for herself and the fetus, nutrients first go to nourish the fetus. However, adding about 250 calories to the daily diet is usually enough to provide nourishment for both. Most of the extra calories should be protein. The diet should be well-balanced and include fresh fruits, grains, and vegetables. Cereals that are high in fiber and low in sugar are a good choice. Seafood contains nutrients that are important for the growth and development of the fetus. However, pregnant women should choose seafood that is low in mercury. See Mercury in seafood Mercury in seafood Some risk factors are present before women become pregnant. These risk factors include Certain physical characteristics, such as age and weight Problems in a previous pregnancy, including the... read more for more information.
In the United States, most women get enough salt in their diet, without adding salt to their food at the table. Commercially prepared foods often contain excessive amounts of salt and should be consumed sparingly.
Dieting to lose weight during pregnancy is not recommended, even for obese women, because some weight gain is essential for the fetus to develop normally. Dieting reduces the supply of nutrients to the fetus.
How much weight a woman should gain during pregnancy depends on her body mass index Osteonecrosis of the Jaw Osteonecrosis is the death of bone cells. Osteonecrosis of the jaw is the death of some cells in your jawbone. Osteonecrosis of the jaw can happen on its own or after you have a tooth pulled... read more (BMI) before pregnancy. BMI is weight in kilograms divided by height in meters squared and is used to determine whether weight for height is normal. Women with a high BMI should gain less weight during pregnancy than those with a BMI classified as normal or underweight. An average-size woman should gain about 25 to 35 pounds (about 11.5 to 16 kilograms) during pregnancy.
Gaining too much weight puts fat on the woman and the fetus. Because controlling weight gain is more difficult later in pregnancy, a woman should try to avoid gaining too much weight during the first months. However, not gaining weight can hinder the growth and development of the fetus. During the 1st trimester (0 to 12 weeks of pregnancy), total weight gain for most women should be between 1.1 and 4.4 pounds (0.5 and 2 kilograms).
Sometimes a pregnant woman gains weight because she is retaining fluid. Fluid may be retained later in pregnancy because when she lies flat, the enlarging uterus interferes with blood flow from the legs back to the heart. Lying on one side, preferably the left side, for 30 to 45 minutes 2 or 3 times a day may relieve this problem. Wearing elastic support stockings may also help.
Drugs and dietary supplements
Generally, avoiding drugs during pregnancy Drug Use During Pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more is best. However, drugs must sometimes be used. A pregnant woman should check with her doctor before taking any drug—including nonprescription (over-the-counter) drugs, such as aspirin, or medicinal herbs—particularly during the first 3 months.
Pregnancy doubles the amount of iron needed. Most pregnant women need an iron supplement because the average woman does not absorb enough iron from food to meet the requirements of pregnancy. If a woman has anemia or develops anemia during pregnancy, she may need to take a larger dose of iron than other pregnant women. Iron supplements may cause mild stomach upset and constipation.
All pregnant women should take a supplement that contains 400 micrograms of folate Folate Deficiency Folate deficiency is common. Because the body stores only a small amount of folate, a diet lacking in folate leads to a deficiency within a few months. Not eating enough raw leafy vegetables... read more (folic acid) each day, although some experts recommend slightly higher amounts, such as 600 or 800 micrograms. Such doses are often available in over-the counter products, such as multivitamins. Ideally, the folate supplement is begun before pregnancy. A deficiency of folate increases the risk of having a baby with a birth defect of the brain or spinal cord (neural tube defect Neural Tube Defects and Spina Bifida Neural tube defects are a certain type of birth defect of the brain, spine, and/or spinal cord. Neural tube defects can result in nerve damage, learning disabilities, paralysis, and death. The... read more ), such as spina bifida. Women who have had a baby with a neural tube defect should take 4,000 micrograms of folate—a much larger amount than usually recommended. Doses of 1,000 micrograms or higher require a prescription. For most other women, even those with a folate deficiency, the amount of folate in a standard prenatal vitamin is sufficient.
Did You Know...
Doctors recommend that pregnant women take a prenatal multivitamin containing iron and folate daily, even if their diet is adequate.
Many pregnant women are concerned about moderating their activities. However, most women can continue their usual activities and exercises throughout pregnancy. Mildly strenuous sports, such as swimming and brisk walking, are good choices. Vigorous activities, such as running and horseback riding, are also possible if done cautiously, to avoid injury, particularly to the abdomen. Contact sports should be avoided.
Sexual desire may increase or decrease during pregnancy. Sexual intercourse is safe throughout pregnancy unless a woman has vaginal bleeding, pain, leakage of amniotic fluid, or uterine contractions. In such cases, sexual intercourse should be avoided.
Preparing for breastfeeding
During pregnancy, women who are planning to breastfeed do not need to do anything to prepare their nipples for breastfeeding Breastfeeding Breast milk is the ideal food for newborns. Although babies may be fed breast milk or formula, the World Health Organization (WHO) and American Academy of Pediatrics (AAP) recommend exclusive... read more . Expressing fluids from the breast manually before delivery may lead to an infection of the breast Breast Infection A breast infection ( mastitis) can occur after delivery ( postpartum infection), usually during the first 6 weeks and almost always in women who are breastfeeding. If the baby is not positioned... read more (mastitis) or even early labor. The body prepares the areola and nipple for breastfeeding by secreting a lubricant to protect the surface. This lubricant should not be rubbed off.
Observing and talking with women who have breastfed successfully may be instructive and encouraging.
Travel during pregnancy
The safest time to travel during pregnancy is between 14 and 28 weeks. Travel time should not exceed 6 hours a day. Women can obtain useful tips and information about travel from their doctor, so discussing their travel plans with the doctor is a good idea.
When traveling in a car, airplane, or other vehicle, pregnant women should always wear a seat belt. Placing the lap belt across the hips and under the expanding abdomen and placing the shoulder belt between the breasts can help make wearing seat belts more comfortable. The belts should be snug but not uncomfortably tight.
During any kind of travel, pregnant women should stretch and straighten their legs and ankles periodically. Travel on airplanes is safe until about 36 weeks. The primary reason for this restriction at 36 weeks is the risk of labor and delivery in an unfamiliar environment.
Prevention in Pregnant Women
Prenatal care Medical Care During Pregnancy Ideally, a couple who is thinking of having a baby should see a doctor or other health care practitioner to discuss whether pregnancy is advisable. Usually, pregnancy is very safe. However,... read more is focused on recognizing and preventing problems that can complicate pregnancy. For example, pregnant women are screened for many disorders, including
Rh(D) blood incompatibility Hemolytic Disease of the Fetus and Newborn Rh incompatibility occurs when a pregnant woman has Rh-negative blood and the fetus has Rh-positive blood. Rh incompatibility can result in destruction of the fetus’s red blood cells, sometimes... read more (which can cause hemolytic disease of the newborn)
Placental and fetal abnormalities (using ultrasonography)
(See also Medical Care During Pregnancy Medical Care During Pregnancy Ideally, a couple who is thinking of having a baby should see a doctor or other health care practitioner to discuss whether pregnancy is advisable. Usually, pregnancy is very safe. However,... read more .)
Before (if possible) and during pregnancy, women are given folate Medical Care During Pregnancy (folic acid) to prevent birth defects. Often during pregnancy, women also are given iron to prevent anemia Anemia During Pregnancy Anemia occurs in up to one third of women during the 3rd trimester. The most common causes of anemia are Iron deficiency Folate deficiency (See also Anemia.) If women have a hereditary anemia... read more . They are counseled to stop using tobacco Cigarette (tobacco) smoking during pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more , alcohol Alcohol during pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more , and recreational drugs Illicit Drugs During Pregnancy More than 50% of pregnant women take prescription or nonprescription (over-the-counter) drugs or use social drugs (such as tobacco and alcohol) or illicit drugs at some time during pregnancy... read more before becoming pregnant and during pregnancy.