10 steps to a healthy pregnancy

Approved by the BabyCenter Philippines Medical Advisory Board Last reviewed: August 2011 Show references

Highlights

1. Organize your prenatal care early 2. Eat well 3. Be careful about food hygiene 4. Take folic acid supplements and eat fish 5. Exercise regularly 6. Begin doing pelvic floor exercises 7. Quit the alcohol 8. Cut back on caffeine 9. Stop smoking 10. Get some rest

Pregnancy is an ideal time to start taking really good care of yourself both physically and emotionally. You give yourself the best chance of having a problem-free pregnancy and a healthy baby if you follow few simple guidelines:

1. Organize your prenatal care early

Good prenatal care is essential to your baby's health. Choosing your health care provider early means you'll have months to build a good relationship in preparation for the birth. Even if you are not offered a choice of carer -- if for instance, you choose to give birth in a government hospital -- you may be able to develop a rapport with one particular midwife or obstetrician you have met during the course of your pregnancy care.

2. Eat well
Although you don't necessarily have to eat more when you are pregnant, it is important to eat a well-balanced and healthy diet. Many women go off certain foods, but it's always possible to substitute those with others that provide similar nutritional value. Make sure that your diet includes some vegetables and fruit, some carbohydrates (preferably wholegrain so you get plenty of fiber), some protein, which might be fish, meat, eggs, nuts, or pulses, and some milk and dairy foods, every day.

3. Be careful about food hygiene

Now more than ever, it is better to avoid certain foods in pregnancy because they carry a health risk for your baby. Listeria, which can cause miscarriage or severe illness in newborns, can be caused by mould-ripened, non-

pasteurized soft cheeses, such as Brie and Camembert, and blue-veined cheeses, such as Stilton and Roquefort. Hard cheeses, such as Cheddar, and soft-processed cheeses, such as cottage cheese, Philadelphia and Boursin, are safe to eat. To avoid toxoplasmosis, which is rare, but can seriously affect an unborn baby, it is important to wear gloves when handling cat litter and garden soil, avoid eating undercooked or raw meat (no sushi or kinilaw), and wash vegetables and salads thoroughly to remove any soil or dirt. Salmonella infections may be caused by eating undercooked poultry, and raw or soft-cooked eggs. (Read more about food hygiene in pregnancy).

4. Take folic acid supplements and eat fish

The only supplement that is considered truly vital is folic acid (also called folate), which can help prevent spina bifida and other neural tube defects in babies. Spina bifida is a serious congenital condition. It occurs when the tube housing the central nervous system fails to close completely and may give rise to severe disabilities. All women planning a pregnancy are advised to take a daily supplement of 400mcg of folic acid starting around the time of conception through the first three months of pregnancy. You can also increase your intake of natural folate through your diet. Folate is found in many different foods, particularly vegetables and fortified breakfast cereals. Other nutrients that are important to your health and your baby's are iron and calcium, which can generally be provided by your diet. Some studies have shown that calcium supplements, multivitamins and fish oils, which contain omega-3 fatty acids, may help prevent pre-eclampsia. Intake of foods rich in omega 3 fatty acid may have a beneficial effect on a baby's birth weight and on the development of a baby's brain and nerves in late pregnancy. Oily fish contain proteins, minerals, vitamin D and omega-3 fatty acids, which your baby needs as he grows and develops, but it also contains mercury and other pollutants. The current recommendation is to eat oily fish such as herring, mackerel, salmon, or sardines no more than twice a week, but you can still eat other types of fish as much as you like. If you don't like fish, fish oil supplements are available (chose a brand free of the retinol form of Vitamin A, which is not recommended in pregnancy).

5. Exercise regularly
A good exercise program can give you the strength and endurance you'll need to carry the weight you gain during pregnancy and to handle the physical stress of labor. It will also make it much easier to get back into shape after your baby is born. Exercise can boost your spirits and help ward off depression in pregnancy. Experts aren't sure exactly how, but there is growing evidence that it has a positive effect on brain chemicals, such as serotonin and dopamine, which help regulate your emotions and mood.

If you are used to taking exercise in the form of a sport, you can continue with this as long as it feels comfortable for you, unless your particular sport carries a risk of falls or knocks. More gentle exercise such as walking, swimming, aqua-aerobics, pilates, and yoga are also very beneficial.

6. Begin doing pelvic floor exercises

It's very common for women who are pregnant or who have had children to experience stress incontinence: when small amounts of urine leak out during activities, including sneezing, laughing and exercise. You can help prevent this happening by doing pelvic floor exercises, starting before you get pregnant or during pregnancy. The pelvic floor muscles are the hammock of muscles at the base of your pelvis that support the bladder, vagina, and rectum. They can feel weaker than usual in pregnancy because of the extra pressure upon them, and because the hormones of pregnancy cause them to slacken slightly. Your pelvic floor can be toned and strengthened by a daily exercise pattern. Current recommendations are that you should do pelvic floor exercises eight times, three times a day. Read our article on pelvic floor exercises during pregnancy for more information on how to do them properly.

7. Quit the alcohol

Since any alcohol you drink rapidly reaches your baby via your blood stream and placenta, you should decide to cut it out completely. The Department of Health warns again excessive alcohol intake in the first 12 weeks of pregnancy to avoid the risk of fetal alcohol syndrome (FAS). To be completely safe, the Philippine Obstetrical and Gynecological Society asserts that there is no safe level of alcohol and that it should be entirely avoided at any stage of pregnancy. In fact, it advises women planning to conceive that they should abstain from alcohol as early as three months before getting pregnant to ensure adequate folic acid in their systems. Alcohol consumption is associated with miscarriage, mental retardation, and other disabilities. Women who drink heavily during pregnancy are known to be at greater risk of giving birth to a baby with fetal alcohol spectrum disorders (FASD), which describes problems ranging from learning difficulties to more serious birth defects.

8. Cut back on caffeine

Coffee, tea, and cola-style beverages are mild stimulants, and although the research evidence is not clear, some researchers feel that too much caffeine may contribute to a risk of having a low birth weight baby, or increase your risk of miscarriage. The current advice suggests that up to four cups or three mugs of coffee (equivalent to six cups of tea or eight cans of cola) a day won't hurt your baby, although one study suggests that even low levels of caffeine can increase your risk of miscarriage. It's best to err on the side of caution and you may prefer to cut down on caffeine significantly, or switch to decaffeinated coffee, tea, or fruit juices, instead, particularly in the first trimester. A refreshing alternative is a glass of mineral water with a twist of lemon or calamansi.

9. Stop smoking
Women who smoke increase their risk of miscarriage, premature delivery, stillbirth, and crib death. Smoking in the first trimester also slightly increases the risk of having a baby with a cleft lip or palate. While it is best to give up smoking before you even try to conceive, any reduction in the number of cigarettes you smoke per day will give your baby a better chance. (Read more advice on how to quit smoking in pregnancy.)

10. Get some rest

The fatigue you feel in the first and third trimesters is your body's way of saying "slow down." A nap in the middle of the day may seem like a luxury you can't afford, but you and your baby will both benefit. If you can't sleep, at least put your feet up and relax for 30 minutes or more, in whatever way suits you best. If backache is disturbing your sleep, try massage, aquanatal classes, or exercise classes specifically for back care. Exercise and relaxation can also help with sleep problems related to stress. Try relaxation techniques, which are safe in pregnancy, such as yoga, stretching, deep breathing, and massage. Always tell the teacher of any exercise or relaxation class that you attend that you're pregnant or choose classes tailored for pregnant women.