Whether you are becoming a first-time parent or growing your family, now is the time to focus on yourself for the betterment of the little bundle growing within. Pregnancy is the first step toward a very different life, and it begins with a whole host of restrictions and dos and don'ts. These includes what foods to eat and what foods to avoid, how to exercise properly, common bodily discomforts you may experience, what medications are safe to take and which ones are not, and other questions you may have about activities in which you can partake.
Nutrition during pregnancy
The key to a healthy baby is a healthy mama, and the first step toward healthful eating is to look at your daily diet. Having healthful snacks that you eat during the day is a good way to get the nutrients and extra calories that your body need. Pregnant women need to eat an additional 100–300 calories per day, which is equivalent to a small snack such as half of a peanut butter and jelly sandwich and a glass of low-fat milk. The American College of Obstetricians and Gynecologists specicially make recommendations on the following with regard to nutrition during your pregnancy:
- Prenatal Vitamins
- Folic Acid
- Vitamin D
- Oils and Fats
- Fatty Acids
Prenatal vitamins: A daily prenatal vitamin helps provide the best balance of nutrition for you and your baby. Either an over-the-counter or prescription vitamin is fine. If you cannot tolerate a prenatal vitamin, try to take two children’s chewable vitamins a day instead. If vitamins are causing nausea, try taking them at night with a snack. If constipation is an issue, increase the fiber in your diet, drink more fluids and increase activity. An over-the-counter stool softener may be added if needed.
Folic acid: During pregnancy, you need more folic acid and iron than a woman who is not pregnant. Folic acid, also known as folate, is a B vitamin that is important for pregnant women. Taking 400 micrograms of folic acid daily for at least one month before pregnancy and 600 micrograms of folic acid daily during pregnancy may help prevent major birth defects of the baby’s brain and spine called neural tube defects. It may be difficult to get the recommended amount of folic acid from food alone. For this reason, all women who may become pregnant should take a daily vitamin supplement that contains the right amount of folic acid.
Iron: Iron is used by your body to make a substance in red blood cells that carries oxygen to your organs and tissues. During pregnancy, you need extra iron—about double the amount that a non-pregnant woman needs. This extra iron helps your body make more blood to supply oxygen to your baby. Your body will create up to 50% more blood to be used by the baby, some of which is captured during cord blood banking.
The daily recommended dose of iron during pregnancy is 27 milligrams, which is found in most prenatal vital supplements. You can also eat iron-rich foods, including lean red meat, poultry, fish, dried beans and peas, iron-fortified cereals, and prune juice. Iron can also be absorbed more easily if iron-rich foods are eaten with vitamin C-rich foods, such as citrus fruits and tomatoes.
Calcium: Calcium is used to build your baby’s bones and teeth. All women, including pregnant women, aged 19 years and older should get 1,000 milligrams of calcium daily; those aged 14–18 years should get 1,300 milligrams daily. Milk and other dairy products, such as cheese and yogurt, are the best sources of calcium. If you have trouble digesting milk products, you can get calcium from other sources, such as broccoli, dark, leafy greens, sardines or a calcium supplement.
Vitamin D: Vitamin D works with calcium to help the baby’s bones and teeth develop. It is also essential for healthy skin and eyesight. All women, including those who are pregnant, need 600 international unit of vitamin D a day. Good sources are milk fortified with vitamin D and fatty fish such as salmon. Exposure to sunlight also converts a chemical in the skin to vitamin D.
Oils and fats: The fats that you eat provide energy and help build many fetal organs and the placenta. Most of the fats and oils in your diet should come from plant sources. Limit solid fats, such as those from animal sources. Solid fats can also be found in processed foods.
Fatty acids: Omega-3 fatty acids are a type of fat found naturally in many kinds of fish. They may be important factors in your baby’s brain development both before and after birth. To get the most benefits from omega-3 fatty acids, women should eat at least two servings of fish or shellfish (about 8–12 ounces) per week while pregnant or breastfeeding.
Key Food Nutrients During Pregnancy
|Nutrient (Amount per Day)
|Calcium (1,000 mg)
||Helps build and maintain strong bones and teeth
||Milk, cheese, yogurt, sardines
|Iron (27 mg)
||Helps create the red blood cells that delivery oxygen to the baby and helps prevent fatigue
||Lean red meat, dried beans, pease, iron-fortified cereals
|Vitamin A (770 mg)
||Forms healthy skin, helps eyesight, and helps with bone growth
||Carrots, dark, leafy green vegetables, sweet potatoes
||Helps form red blood cells, helps use protein, fat and carbohydrates
||Carrots, dark, leafy green vegetables, sweet potatoes
|Vitamin B12 (2.6 mcg)
||Maintains nervous system, needed to form red blood cells
||Liver, meat, fish, poultry, milk (only found in animal foods; vegetarians should take supplements)
|Vitamin C (85 mg)
||Promotes healthy gums, teeth and bones. Helps your body absorb iron.
||Oranges, melon, strawberries
|Vitamin D (600 IU)
||Helps build and maintain strong bones and teeth
||Liver, egg yolks, fortified cereal and milk
|Folate (600 mcg)
||Needed to produce blood and protein, helps some enzymes
||Leafy green vegetables, liver, orange juice, legumes and nuts
||Helps with formation of enzymes, antibodies, muscle and collagen
||Leafy green vegetables, liver, orange juice, legumes and nuts
Foods to avoid during pregnancy
- Caffeine: Limit caffeine intake to the equivalent of one cup of coffee a day (200 mg) or less. Excess caffeine may be associated with miscarriage, premature birth, low birth weight, and withdrawal symptoms in infants.
- Fish with mercury: Fish is very good for you and the baby during pregnancy and increases the baby’s brain and eye development. You should try to eat 2 servings per week (12 oz.) of low-mercury fish such as salmon, catfish or tilapia. Medium-mercury fish such as tuna or halibut can be consumed, but you should have no more than 6 oz. per week. You should completely avoid high-mercury fish which include shark, swordfish, tile fish and mackerel.
- Raw meat: Avoid uncooked seafood and undercooked beef or poultry due to risk of bacterial contamination, toxoplasmosis and salmonella. Prepared meats or meat spreads including pate, hot dogs, and deli meats should be avoided due to the risk of listeria (a bacterial illness) unless they are heated until steaming hot.
- Raw shellfish: Including clams, oysters, and mussels can cause bacterial infections. Cooked shrimp is safe.
- Smoked seafood: Refrigerated, smoked seafood should be avoided due to risks of listeria contamination.
- Soft cheeses: Imported soft cheeses may contain listeria. Soft cheeses made with pasteurized milk are safe.
- Unpasteurized milk: May contain listeria which can lead to miscarriage.
- Unwashed vegetables: Wash all vegetables well to avoid exposure to toxoplasmosis, which may contaminate the soil where vegetables are grown.
NOTE: Artificial sweeteners are O.K. to use, but it is recommended to limit them to 1 or 2 servings per day. If you have diabetes, the artificial sweeteners are better than sugar to help control your blood sugars.
Special dietary concerns
If you are a vegetarian, be sure you are getting enough protein, about 75 grams per day. You will need to take supplements, especially iron, B12 and vitamin D.
During pregnancy, symptoms of lactose intolerance often improve. If you are still having problems after eating or drinking dairy products, talk with your doctor. He or she may prescribe calcium supplements if you cannot get enough calcium from other foods. Calcium can also be found in cheese, yogurt, sardines and certain types of salmon, spinach, and fortified orange juice.
How much weight should you gain during pregnancy?
Healthful weight gain
According to the American College of Obstetricians and Gynecologists, if you were a normal weight before pregnancy, you should gain between 25 and 35 pounds during pregnancy. If you were underweight before pregnancy, you should gain more weight than a woman who was a normal weight before pregnancy. If you were overweight or obese before pregnancy, you should gain less weight than the normal 25–35 pounds. Recommendations for weight gain during a single pregnancy are as follows:
- Underweight women (BMI less than 20): 30 lb.–40 lb.
- Normal weight women (BMI 20–25): 25 lb.–35 lb.
- Overweight women (BMI 26–29): 15 lb.–25 lb.
- Obese women (BMI >29): up to 15 lb.
Underweight women with a low weight gain during pregnancy have an increased risk of a pre-term delivery or an infant with a low birth weight; on the other hand, obese women have an increased risk of a large-for-gestational-age infant, a post-term delivery, and other pregnancy complications. These problems include gestational diabetes, high blood pressure, pre-eclampsia and cesarean delivery. Babies of overweight and obese mothers are also at greater risk of certain problems such as birth defects, macrosomia and childhood obesity.
Exercise during pregnancy
Exercise is recommended in pregnancy for 30 minutes interval 5 days per week. A combination of cardio and core strengthening is advised. For cardio (running, biking, swimming, elliptical, stair climber, aerobics, etc.) you should avoid high-impact activities and keep your breathing and heart rate in an aerobic zone. (Reach a rate where you can continue to converse without having to catch your breath.) For core strengthening (yoga, Pilates, sit ups, other abdominal and back exercises), avoid lying flat on your back after 20 weeks. You may be on an incline, exercise ball, or on your side, etc. For weight lifting, you should lift weights that you can lift relatively easily and don’t need to strain to lift. It is important to maintain adequate hydration during exercise.
Exercising can benefit your health during pregnancy in the following ways:
- Helps reduce backaches, constipation, bloating and swelling
- May help prevent or treat gestational diabetes
- Increase your energy
- Improve your mood
- Improve your posture
- Promote muscle tone, strength, and endurance
- Help you sleep better
- Help keep you fit during pregnancy and may improve your ability to cope with labor
- Make it easier for you to get back in shape after the baby is born
When you exercise, follow these general guidelines, spelled out by the American College of Obstetricians and Gynecologists, for a safe and healthy exercise program:
Exercise during pregnancy can aid labor and delivery.
- After the first trimester of pregnancy, avoid doing any exercise on your back.
- If it has been some time since you have exercised, start slowly. Begin with as little as 5 minutes of exercise a day and add 5 minutes each week until you can stay active for 30 minutes a day.
- Avoid brisk exercise in hot, humid weather or when you have a fever.
- Wear comfortable clothing that will help you remain cool.
- Wear a bra that fits well and gives lots of support to help protect your breasts.
- Drink plenty of water to help keep you from overheating and dehydrating.
- Make sure you consume the daily extra calories you need during pregnancy.
There are some warning signs for when you should halt exercising. Stop exercising and call your health care provider if you have any of these symptoms:
- Vaginal bleeding
- Dizziness or feeling faint
- Increased shortness of breath
- Chest pain
- Muscle weakness
- Calf pain or swelling
- Uterine contractions
- Decreased fetal movement
- Fluid leaking from the vagina
When you are not feeling like you: common discomforts of pregnancy
You will initially experience several new discomforts during pregnancy. Some will be fleeting while others will be somewhat more long-lasting. Some may occur in the early weeks while others emerge closer to delivery. Some will be reoccurring while others may never repeat.
Each trimester can seem to bring its own set of problems
Aches and Pains: As your baby grows, backaches are common. You may feel stretching and pulling pains in the abdomen or pelvic area. These are likely due to pressure from your baby’s head and increasing weight and the normal loosening of joints. Practice good posture and try to rest with your feet elevated.
Braxton–Hicks contractions: Experiencing some cramps and contractions are normal. When they occur, empty your bladder, drink 1–2 glasses of water and try to rest. If you are less than 36 weeks pregnant and having more than six contractions per hour, call your doctor.
Constipation: It is a common complaint related to hormone changes, low fluid intake, increased iron or lack of fiber. Try to include more whole grains, fresh fruit, and vegetables in your diet and drink plenty of water. There are also safe over-the-counter medications. If you develop hemorrhoids, try sitz baths 3–4 times per day for 10–15 minutes each time. If the pain persists, call your doctor.
Cramping: Experiencing some cramps and contractions are normal. When they occur, empty your bladder, drink 1-2 glasses of water and try to rest. If you are less than 36 weeks pregnant and having more than six contractions in an hour after trying these measures, make contact with your doctor.
Discharge: An increase in vaginal discharge that is white and milky is common in pregnancy. If the discharge is watery or has a foul odor, call your doctor.
Dizziness: You may feel lightheaded or dizzy at any time during your pregnancy. Try lying down on your left side and drink 1–2 glasses of water and try to rest. If you faint or the symptoms persist, call your doctor.
Heartburn: You may experience heartburn throughout the pregnancy. This is a particularly common problem during the latter part of your pregnancy when your baby is larger. Try to eat 5–6 smaller meals a day, avoid drinking fluids with meals and avoid lying down immediately after eating. Some over-the-counter medications are also safe for use.
Leg cramps: Cramping in your legs or feet can also be common. Eating bananas, drinking more low-fat or non-fat milk and consuming more calcium-rich foods like nuts, grains, beans and dark green vegetables may help. To relieve the cramp, try to stretch your leg with your foot flexed toward your body. A warm, moist towel or heat pad wrapped on the muscle may also help.
Nausea or vomiting: Feeling nauseated during the first three months of pregnancy is very common. For some women, it can last longer while others may not experience it at all. Try to eat 5–6 smaller meals a day in order to keep your stomach full at all times. Try bland foods like plain crackers, toast, dry breakfast cereals and carbonated drinks like ginger ale or 7-Up. Ginger is a natural treatment for nausea. Peppermint can also be used. Some over-the-counter medications are also safe. If the symptoms become severe or you are unable to keep fluids down without vomiting for more than 12 hours, contact your doctor.
Swelling: Because of the increased production of blood and body fluids, normal swelling, also called edema, can be experienced in the hands, face, legs, ankles and feet. Elevate your feet, wear comfortable shoes, drink plenty of fluids and limit sodium. Supportive stockings can also help. If the swelling comes on rapidly, or is accompanied by headache or visual changes, make contact with your doctor immediately.
Urinary frequency: Urination frequency varies throughout the pregnancy; this is normal. If urinary frequency is accompanied by burning, low back pain or blood or has a bad odor, schedule an appointment with your doctor.
Mediciations while pregnant
During pregnancy, women can be more susceptible to ailments like cold and flu and other conditions. Only certain medications are safe during pregnancy. The following are considered relatively safe, but you should check with your doctor first and use sparingly if allowed to do so, especially decongestants of any kind. Prescription medications should be taken exactly as directed, and you should check with your doctor before starting any new prescription. Follow the labels for dosage and directions. Call your doctor's office with questions.
Safe Medications During Pregnancy
Benadryl, Claratin, Zyrtec
Sudafed PE Pseudoephedrine**
Tylenol Cold & Sinus**
Vicks Vapor Rub
**AVOID if have problems with blood pressure
Phenergan w/codeine if prescribed
Robitussin (plain & DM)
|Crabs or Lice
Tylenol (Regular or Extra Strength)
(Avoid lying down for at least 1 hour after meals)
Milk of Magnesia
Tums (limit 4 per day)
(RX: Analapram 2.5%)
Vaseline lotion applied to tissue
Saline Nasal Spray
Vitamin B6 (25 mg 3 times daily)
Unisom 1/4 or 1/2 tablet at bedtime
Ginger Root (250 mg 4 times daily)
Complex Carbs at Bedtime
**Narcotic medications should only be used when prescribed for a legitimate medical problem by a doctor for a short period of time.
1% Hydrocortisone Cream
Warm milk—add vanilla or sugar for flavor
Salt Water Gargle with Warm Water
Activities to avoid during pregnancy
- Avoid hot tubs, saunas, rollercoasters, sky diving, skiing, scuba diving, and motorcycle riding.
- Do not change cat litter boxes.
- Do not smoke, drink or use illicit drugs. According to the American College of Obstetrics and Gynecology, there is no amount of alcohol during pregnancy that is definitely safe.
About other activities
Dental care: Gum disease and bacteria in the gums become more common during pregnancy and can have potential negative impacts on your pregnancy. You should be sure that you have your teeth cleaned by your dentist every six months during pregnancy. Postpone routine X-rays until postpartum.
Hair-coloring: Hair-coloring and nail care should always be done in large, well-ventilated areas.
Seatbelt: You should wear your seatbelt throughout pregnancy. The shoulder belt should sit between your breasts and the lap belt below your belly, over your hips.
Sex: Sex during pregnancy is safe unless you are having bleeding or pre-term labor or have been otherwise specifically advised not to by your doctor.
Travel: Travel during a normal pregnancy is fine up to 34 weeks. Consult with one of our providers at one of your visits before traveling. Drink plenty of fluids so you do not get dehydrated. While traveling (whether by car, plane, train, etc.), get up and stretch your legs at least every two hours to insure that you do not get a blood clot in your legs or lungs, which you are much more susceptible to while pregnant.
Working/school: A woman can usually continue working or attend school until she goes into labor. Your doctor may want to restrict your work if you are having pregnancy complications depending on your job activities.
Depression can occur during and after pregnancy. Many women experience mood changes after their delivery. This most commonly starts 2–3 days after delivery and usually goes away by two weeks. It is important to eat properly, get adequate sleep and reduce stress during this time to help with symptoms. Sometimes the symptoms require treatment especially if mom is not bonding or enjoying her baby, unable to care for herself or the baby or feeling excessive sadness, depression or anxiety. If you ever feel you may hurt yourself, the baby or someone else, you should go to the emergency room right away. If you or your partner have any concerns that you may be depressed, please contact your doctor for evaluation.
When should I call the doctor?
While you should try to hold questions to your regularly scheduled doctor's appointments during your pregnancy, you may have some problems that occur between your visits to the doctor’s office, and you should not be afraid to make contact with your doctor's office for questions that don't think can wait for the next visit. In these cases below, you should definitely get a hold of your doctor's office as soon as possible:
- You have vaginal bleeding.
- You have any severe pain.
- You experience persistent uterine cramping, backaches, or contractions of any frequency prior to 36 weeks (one month before your due date or earlier).
- You do not feel your baby move for several hours or if you think there is a significant decrease in your baby’s activity (less than 3 movements per hour or less than 10 movements in a day).
- You are having regular painful contractions every five minutes or less for one hour and are more than 36 weeks.
- Your bag of water breaks, regardless of presence/absence of contractions including repetitive leakage or a gush of fluid from the vagina.
- If you have a temperature greater than 101 degrees.
- Abdominal trauma or a car accident.
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