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 Dr Chris Brown advises perspective mums to give mother-nature a helping hand.
As in many other situations, like running a marathon or taking an exam, the chances of a successful outcome are greatly increased by thoughtful preparation. As pregnancy and parenthood are life's biggest project, it makes sense to do everything you can to make sure things go well. Here are some things to consider.
At least 4 months ahead
Book a pre-conception appointment with the midwife attached to your GP surgery. She will offer general advice about preparing for a pregnancy and will take some blood to check immunity against german measles (Rubella).It's likely you were immunised against Rubella in your teens, but not all women get lasting immunity, so it?s best to check. If you are not immune, the midwife can vaccinate you, but it is important to continue with reliable contraception for 3 months after the.
Start taking folic acid 400mcg daily. This should be started as soon as you stop contraception, and continued until you are 12 weeks pregnant. It reduces the risk of having a baby with spina bifida.
If you are significantly overweight, try to get your weight down before getting pregnant. Obesity can reduce fertility, and those who do get pregnant are at greater risk of developing diabetes in pregnancy.
Stop smoking. Smoking in pregnancy increases the risk of miscarriage, premature labour, and low birth weight babies. Your surgery should be able to put you in touch with a `stop smoking' service.
If you are taking any drugs, either prescribed, over the counter, or recreational, ask your doctor or pharmacist for advice about their safety in early pregnancy. Many occasional use medications and over the counter products can be bad for developing babies. Some prescribed medications such as epilepsy medication and some anti-depressant treatments can cause foetal abnormalities if taken in pregnancy. It may be necessary to make some changes before conceiving.
In early pregnancy.
Minimise your alcohol intake. Medical opinion is divided as to whether a small amount of alcohol in pregnancy is OK, or whether it should be avoided altogether. If you drink at all, it should be no more than 1or 2 units at a sitting, and no more than once or twice a week.
Certain foods should be avoided in pregnancy as they may contain bacteria that can harm the baby. The list is long, and your midwife should be able to give you some written information at your pre-conception check, but here is a list of common foods that can cause problems: soft, ripened cheeses such as Brie and Camembert, blue cheeses, prepared pates, ready cooked poultry and cooked-chilled meals. It's also best to avoid any products made with unpasteurised milk or raw eggs.
Throughout the pregnancy
Healthy eating in pregnancy mostly involves improving the quality rather than increasing the quantity of food. The aim is to eat a varied, balanced diet and avoid excessive weight gain. An average weight gain in pregnancy is 10-12.5 kg (22-28 lbs), around 4kg (8-9lbs) of which is gained in the first 20 weeks. The main things to think about are:
Energy
You will need about an extra 250 calories a day. This is equivalent to a piece of fruit and 2 extra slices of bread. You should not be `eating for two' in terms of calorie intake. Neither should you be dieting in pregnancy. A recent study suggests that British women are dieting like never before in pregnancy. This may lead to an increase in birth defects or impaired organ development.
Calcium
Calcium requirement more than doubles during pregnancy. Try to drink a pint of milk or equivalent every day. 30g (1oz) of cheese or a small pot of yoghurt contains the same amount of calcium as 200mls (1/3 pint ) of milk. Non-dairy sources of calcium include broccoli, white bread, and small bones in oily fish such as sardines, pilchards or whitebait.
Iron
You need more iron, and iron tablets are no longer routinely prescribed in pregnancy, so you need to eat more iron-rich foods. Good sources include lean red meat, iron fortified breakfast cereals, eggs, dried fruits and all green leafy vegetables. Liver is no longer recommended as a regular source of iron due to its very high vitamin A content. It can however be eaten in small quantities occasionally.
Exercise in pregnancy. Unless you have previously miscarried, or are threatening to miscarry, it's fine to carry on with your usual level of exercise providing it's not too extreme. I usually advise against working out with heavy weights or doing contact sports such as Judo. Swimming is good exercise throughout pregnancy, especially when you get heavier and find other forms of exercise taxing. The same philosophy applies to your sex life (which is a good form of exercise) and which can carry on as usual, providing there are no miscarriage concerns. And don't forget to make time just to rest, relax, and enjoy being an expectant Mum. You'll get precious little time to yourself after the baby arrives!
Antenatal Care. It's really important to go for regular antenatal check ups. You may be feeling fine, but the check can pick up problems before you become aware of them. You should also contact your doctor or midwife, in between routine checks, if you experience any vaginal bleeding, abdominal pain, or unusual vaginal discharge. During the pregnancy, you will get used to feeling the baby moving around, and get used to the variation in the movement pattern. If you feel that the movement pattern has radically changed, or if you haven't felt any movements for 24 hours, you should contact your midwife or doctor.
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