Preparing for Pregnancy

Preparing for a Healthy Pregnancy

Developing good habits before you get pregnant can give you a head start on having a healthy baby. If you're thinking about having a child, it's best to begin preparing for pregnancy long before you conceive. That way, you'll be sure that you're doing all you can for your baby in the earliest weeks of pregnancy, which is a crucial time in fetal development. The fact is, more than half of pregnancies aren't planned. Many women are pregnant for weeks—or even months—before they realize it. That's why it's important for all women to follow this advice during their childbearing years.

Eat right. You should eat a well-balanced diet, and drink plenty of liquids. One of the most important things you can do is get enough folic acid in your diet. Folic acid is a B vitamin that helps guard against birth defects of the brain and spinal cord. You should consume 0.4 mg of folic acid every day if you're of childbearing age. Citrus fruits and juices, whole grains, poultry, liver, and green, leafy vegetables are good sources of folic acid. Since it may be difficult to get all the folic acid you need from diet alone, check with your health care provider about taking a vitamin supplement to make up the difference.

Get healthy and fit. If you're thinking of becoming pregnant, schedule an appointment with your health care provider. Now is also the time to get any health problems you may have—such as high blood pressure or diabetes—under control. If you need a rubella vaccination, get it at least three months before you conceive. Beginning a regular exercise program now will make it easier for you to keep fit during pregnancy and can help ease delivery. Ideally, you should start a program at least three months before you get pregnant. This allows your body to adjust to exercise before the physical demands of pregnancy begin.

Kick the habit. You should quit smoking now. Women who smoke have a higher risk of miscarriage, premature labor, and delivery of a low-birthweight baby, which can lead to other health problems for your baby. If someone else in your household smokes, this is a good time for him or her to quit, too, since smoking affects the quality of the air you breathe.

Avoid alcohol and other substances. Since no amount of alcohol has been proven safe, and the unborn baby is extremely vulnerable to damage during very early pregnancy and susceptible throughout the entire pregnancy , it's best to avoid alcohol if you're thinking of becoming pregnant. Avoid recreational drugs. They can cause serious health problems to the fetus.

Check out your risks. Ask your health care provider if any prescription or over-the-counter medications you take could be harmful to your baby if you become pregnant. Also, ask your provider if you or your baby face any risks from chemicals you may be exposed to at work or at home.

Now That You Are Pregnant

Due to the demands on your body and the needs of your developing baby, you should pay special attention to your health when you are pregnant.

Visiting Your Health Care Provider. When you first realize that you are pregnant, make an appointment with your health care provider. He or she will help you figure out your due date, which will be about 40 weeks after your last period began. You and your provider can discuss any special pregnancy risk factors you may have, so that you can make any changes that will help the health of you and your baby.

This is also the time that you and your health care provider will talk about a schedule for visits during your pregnancy. The standard timetable is once a month for about the first 28 weeks of pregnancy, then every two to three weeks from 28 to 36 weeks, then once a week from 36 weeks until delivery. Your provider may also schedule certain tests, depending on your pregnancy risk factors, such as diabetes, high blood pressure, or previous preterm delivery. In later months, you will also discuss delivery options and visit the labor and delivery suite.

If yours is a high-risk pregnancy—for example, if you have high blood pressure, diabetes, develop gestational diabetes, or are expecting more than one child—your provider may refer you to a specialist. Your health care plan may have a special program for women with high-risk pregnancies.

Nutrition . Eating right is extremely important now. You will need about 300 more calories a day than you did before you were pregnant. If you're of average weight, you should gain 25 to 35 pounds while you are pregnant. Folic acid continues to be important. You should also be sure you're getting enough protein, calcium, and iron. It is crucial that you get enough to drink now, too.

Exercise. Staying fit while you're pregnant will help you deal with the demands pregnancy places on your body, and it also may make labor and delivery a little easier. Swimming, brisk walking, and participating in prenatal exercise classes are excellent ways to stay fit. But don't overdo it. Working out too hard can affect blood and oxygen flow to your baby. Discuss your exercise plan with your health care provider before you begin. Avoid getting overheated, drink plenty of water, and make sure you wear comfortable shoes and a supportive bra.

• How Your Body Will Change. Your body will change dramatically during pregnancy. Some of these changes may be uncomfortable. Talk with your health care provider about the best ways to ease discomfort. You may have to try a few different methods before you discover ones that work best for you. While each woman's experience is different, the following symptoms are common during pregnancy.

• First trimester (0 to 12 weeks) This is when most women experience morning sickness. You may need to urinate more often than usual, and you may feel tired and moody. Your breasts will begin to change now, and may be swollen and very tender. They may leak colostrum, a fluid the breasts produce as you prepare for lactation, although this is more common later in pregnancy. Any nipple discharge should be discussed with your provider.

• Second trimester (13 to 28 weeks) Many women experience a return to normal energy levels, and morning sickness will often disappear. Your breasts and belly will grow. You may experience leg cramps, constipation, and a faster heartbeat. During the fourth month of pregnancy, you may feel the baby move for the first time.

• Third trimester (29 to 40 weeks) Since your baby is growing and your uterus is getting bigger, you may experience shortness of breath because the baby is crowding your lungs. You may have heartburn as your stomach is squeezed and hormones relax parts of your digestive system. Fatigue may return, mainly from the extra work your body is doing, carrying around a baby who is nearly fully grown. You may also have backaches. Your legs and feet may swell, and you may have a difficult time sleeping.

Self-Care Steps for Discomfort During Pregnancy

Backache

• Pay attention to your posture. Tilt your pelvis under slightly, and keep your spine straight.

• Avoid exercises that exaggerate the arch of your back.

• Avoid bending from the waist-bend at the knees instead.

• Wear comfortable, low-heeled shoes.

• Take warm, but not hot, baths.

• Apply a heating pad or an ice pack, or have your partner or a friend rub or gently apply pressure to the sore area.

• Sleep on a firm mattress.

Constipation

• Drink plenty of fluids.

• Exercise.

• Gradually add high-fiber foods to your diet such as bran, whole-grain cereals, vegetables, fruits, and dried fruits, or drink prune juice.

• Ask your provider to recommend a stool softener.

Faintness

• Don't skip meals, and be sure to drink plenty of fluids without caffeine.

• Carry snacks such as fruit and whole wheat crackers to eat throughout the day.

• Change positions regularly, but don't rise suddenly.

• Lie down with your feet up, or put your head between your knees.

• Get some fresh air.

Fatigue

• Get at least 6 hours of sleep per night. You may need more.

• Take a rest period or nap at least once during the day.

• Pace yourself during physical activity. Quit before you're tired.

• Check your diet to be sure you're getting enough iron and protein.

Frequent Urination

• Relieve your bladder completely as soon as you feel the need.

• Drink most of your fluids early in the day.

• If you often feel like you have to urinate immediately or if urination is accompanied by a burning sensation, call your health care provider. You could have a bladder infection.

Headache

• Take a warm bath.

• Minimize stress if possible.

• Practice relaxation techniques.

• Get enough rest.

• Eat frequent, healthy snacks.

• Drink warm milk, decaffeinated tea, or cocoa.

• Lie down with a cool, damp cloth on your forehead.

• Check with your provider to find out if you can take acetaminophen.

Heartburn

• Avoid clothing that's tight around the waist.

• Avoid bending at the waist to pick things up.

• Eat slowly.

• Eat small, frequent meals.

• Avoid rich, greasy foods, coffee, carbonated beverages, and snacking before bedtime.

• Ask your provider about antacids.

• Prop up the head of your bed by putting an object beneath the mattress.

Hemorrhoids

• Follow recommendations above for avoiding constipation.

• Avoid sitting or standing too long in one position.

• Check with your provider before using any medications.

Leg Cramps

• Sleep on your left side to improve circulation. The major vein that takes blood from the heart to the lower body is on the right side. Use a pillow to support your abdomen, and place another between your knees.

• Stretch the cramped muscle by flexing your foot so your heel points, not your toe.

• Wear support hose.

• If they occur frequently or are severe, contact your provider.

Mood Swings

• Talk about your feelings and your fears with your partner, your provider, and close friends.

• Recognize that mood swings are normal.

• Take a walk.

• Keep busy, but don't overdo it.

• Get plenty of rest.

Nasal Congestion

• Use a humidifier (clean the filter often).

• Apply petroleum jelly to your nostril openings.

• Drink plenty of water and other clear fluids.

Nausea and Vomiting

• Avoid foods, beverages and smells that make you feel nauseous.

• Eat small meals frequently.

• Eat crackers before you get up in the morning.

• Sit on the side of the bed for a few minutes before you stand up.

• Move slowly in the morning.

Preterm Labor

• You should call your health care provider immediately if you experience any of the symptoms below while you are pregnant. During your second and third trimester, the following symptoms may indicate preterm labor:

• changes in the type of vaginal discharge (watery, mucous, bloody)

• a sudden increase in amount of vaginal discharge

• pressure in the pelvic area or lower abdomen

• low, dull backache

• abdominal cramps, with or without diarrhea

• regular contractions or uterine tightening

Sore Breasts

• Wear a comfortable, supportive bra.

Swelling (Fluid Retention)

• Rest on your left side to improve circulation.

• Continue to drink plenty of water.

• Check with your provider about limiting your salt intake.

• Don't sit or stand for long stretches of time.

• Elevate your legs when possible.

• Wear support hose and comfortable shoes.

• Avoid socks with elasticized cuffs.

Varicose Veins

• Wear support hose.

• Avoid socks with elasticized cuffs.

• Avoid crossing your legs and standing with your knees locked.

• Lie on your side.

• Elevate your feet.

• Exercise regularly.

• Do ankle rolls: As you sit, circle one foot in each direction several times. Repeat with your other foot.

Labor and Delivery

To distinguish real labor from false labor, time the length of your contractions and the time between them. Your partner can learn about how to watch for labor, when it's time to go to the hospital, and what to expect once you get there.

During the final weeks of pregnancy you may experience cramps that don't actually signal the start of labor. These cramps are called false labor, or Braxton Hicks contractions. To distinguish real labor from false labor, time the length of your contractions and the time between them. Call your health care provider if the contractions

• last at least 30 to 70 seconds

• occur at regular intervals

• don't go away if you move around

Also call your provider if your water breaks, even if you're not having contractions. Write down the time it happens. Go to the hospital if any of the following things happen:

• You are bleeding vaginally (more than spotting).

• Contractions are five minutes apart or closer (or as advised by your health care provider).

• You are in steady, severe pain.

Labor usually lasts 12 to 14 hours for the first child, and may be shorter for later births. It is divided into three stages. The first stage consists of the cervix beginning to open and reaching full dilation. In the second stage, you begin helping to push the baby out. This stage ends with the delivery of the baby. The third stage is the delivery of the placenta, the organ that develops along with the baby during pregnancy and allows oxygen and other nutrients to pass from the mother's blood to the baby.

There are several different methods available to ease the pain of labor, and you and your health care provider should talk about them in advance. Some women choose natural childbirth, and manage pain with relaxation techniques and special breathing patterns. Other women opt for pain relievers, or anesthesia that blocks pain in the pelvic area without putting you to sleep, such as a spinal or epidural block. Many women use a combination of techniques and medication.

Because of a difficult labor, a mother's medical condition, or the position of the fetus, it may be necessary to deliver a baby through a cut made in the abdomen and uterus. This is known as cesarean delivery. Recovery after cesarean delivery takes longer than after vaginal birth. You may still be able to deliver vaginally if you have another child.

The amount of time you spend in the hospital after your baby is born will vary, depending on your health plan and the health of you and your baby. Many plans are sending women home earlier and providing care at home with special nursing visits.