Important pregnancy health advice

Our mums may have puffed on fags and quaffed wine happily throughout their pregnancies, but these days ignorance isn’t bliss. More and more studies show what a huge effect our health has on our unborn baby’s. Yes, it may mean making a few sacrifices and adjustments, but, hey, that’s what motherhood’s all about. 


Don’t skip your antenatal appointments 

No playing hookie for these – antenatal appointments are vital. Gail Johnson, midwife and education and professional development advisor at the Royal College of Midwives, says, ‘Antenatal care provides an opportunity to monitor the progress of pregnancy and to detect any problems or complications early, so that any treatment or intervention can be done as appropriate. It’s also an opportunity for women to pick up tips to help them remain well, and on how to prepare for the birth and the new baby.’

Antenatal tests look out for a range of potentially harmful conditions, including anaemia, urine infection, poor fetal growth and pregnancy induced hypertension (high blood pressure).

While, hopefully, you won’t suffer from any of these nasties, appointments can also be an opportunity to address any psychological or social issues, such as antenatal depression or domestic abuse.

‘There is evidence to show that women who have little or no antenatal care have poorer outcomes, for example smaller babies who may be unwell, or lower breastfeeding rates, which may have longer term health implications,’ adds Gail.

Even if everything’s fine and dandy, free to bring up any topics or concerns (about the birth, breastfeeding, or why your belly’s suddenly slightly, ahem, hairy) with your midwife.


You (and your baby) are what you eat

If your diet owes more to Ronald McDonald than Jamie Oliver, it’s time to make some changes. It may seem obvious, but a healthy, balanced diet is essential – the baby eats what you do, so to grow properly, it needs all the relevant nutrients. 

Professor James Walker, at St James University Hospital, says: ‘What the baby eats in the womb (via the mother) programmes the baby for the rest of its life. If the mother eats healthily, the baby grows and develops normally and good nutrition reduces the chances of diabetes, obesity and heart disease when he or she grows up.’

Make sure you get five portions of fruit and vegetables a day, especially iron-rich green veg; starchy foods such as pasta, rice and bread (wholegrain if you can); protein from lean meat, fish, eggs, beans and lentils; and calcium-rich dairy foods such as milk, cheese and yoghurt.

Avoid shellfish, paté, soft cheeses and undercooked egg as these are an infection risk, and anything rich in vitamin A (such as liver) as too much vitamin A can harm the developing baby.

Don’t go in too much for foods that are highly processed (such as most ready meals, cakes, white bread) as they tend to be high in fat, sugar and/or salt and are full of empty calories (you’ll regret those Krispy Kreme ‘cravings’ after the birth, we promise!)


Get hygienic

Those of us who are a bit slack on the food hygiene front (ignoring best before dates, scraping the mould off cheese and wiping surfaces down with a scraggy j-cloth - you know who you are) need to get a bit more Kim and Aggie during pregnancy.

Certain bacteria that cause food poisoning can be very harmful during pregnancy, particularly salmonella, which can be present in raw or undercooked egg or chicken, and listeria, which can be present in soft cheese or undercooked meat.

Store cooked and uncooked meats separately, and be careful not to transfer bacteria to other items via your hands – so always wash your hands after handling uncooked meat. Make sure meat is thoroughly cooked, and wash salad and vegetables well to remove potentially harmful bacteria.

‘Organic foods are more prone to infection but have fewer toxins. All food needs thorough washing,’ advises James.

And be aware of what kitty is up to. ‘Don’t let cats walk across worktops,’ says Gail. ‘There is a risk of transferring toxoplasmosis, which can cause mental retardation in the baby depending on the stage of pregnancy.

Lots of women are immune, but don’t take the risk.’ Leave the litter tray cleaning to someone else, too.


Stub it out!

You’ve probably heard it a million times before but, honestly, giving up smoking is probably the single best thing you can do for your baby during, and after, pregnancy.

‘There is hard evidence that smoking is bad for babies, and increases the rate of miscarriage, pre-term delivery and stillbirth,’ says obstetrician Maggie Blott at University College Hospital, London.

Over 4,000 chemicals are inhaled when you’re smoking a cigarette, and these cross the placenta to your baby. Smoking reduces oxygen in your blood and in the placental blood flow, so babies grow less and tend to be smaller.

Even if you have been sneaking the odd cigarette, it’s not too late - if you stop smoking at any time during pregnancy, the baby will still grow more and has the benefit of a smoke-free environment after delivery.

It’s important that your partner stops smoking too. ‘The incidence of sudden infant death syndrome (SIDS) is higher in babies who have a parent who smokes,’ says James. If you need help giving up, talk to your GP or midwife, or see givingupsmoking.co.uk or call the NHS Pregnancy Smoking helpline on 0800 169 9 169.


Keep on moving

Sorry, but pregnancy just isn’t a good excuse to flop on the sofa watching telly for nine months – you’ll regret it when you get into that delivery room. Women who do strength conditioning exercise during pregnancy tend to have a shorter labour time and fewer delivery complications, according to the Royal College of Obstetricians and Gynaecologists (RCOG) – well worth a few laps of the pool.

Recreational exercise can also relieve tiredness, improve muscle tone, strength and endurance, and promote a feeling of wellbeing. ‘Regular exercise makes the mother fitter, helps her process food better and improves her oxygen-carrying ability, all of which helps the baby,’ says James. ‘It also improves heart and lung function which helps in labour.’

As if that wasn’t enough, exercise helps keep your weight under control too. But it’s important to do what you’re used to – now is not the time to train for a marathon if a Saturday shopping spree’s as energetic as it gets for you.

‘If you ran before, you can continue running until you get too big or it becomes too much of an effort,’ says James. Swimming is good thanks to the buoyancy of the water, and walking, yoga and Pilates can be done throughout, as long as you don’t find them physically difficult.

If you take exercise classes, always tell your instructor you are pregnant, and enrol in a special pregnancy class if you can. See rcog.org.uk for more information on exercise and pregnancy.


Rest up

Moderation and balance in all things, eh? So, as well as exercising, your baby needs you to take it easy too. ‘Rest in pregnancy needs to be balanced with exercise and activity,’ says Gail.

‘Later in pregnancy, as the fetus grows, some women can feel uncomfortable and they have an increased tendency to varicose veins and swelling in the ankles. Resting can alleviate this to a degree.’ Sit down and prop your feet up on a footstool or chair to help swollen ankles.

If you’re not sleeping well, having a rest in the day can be beneficial. ‘If the mother is well nourished and relaxed, the fetus is in a better environment for development,’ says Gail.


Relax and de-stress in pregnancy

We know, we know – easier said than done. You’ve got a million things on your mind, not least the fact that everything you do is affecting your precious unborn baby. But it’s really worth trying to find ways to take your mind off your worries.

 ‘Too much stress can lead to an increase in anxiety and poor sleep patterns,’ says Gail. ‘The fetus tends to cope quite well with stress, but if the mother becomes very anxious and has prolonged raised blood pressure, this could reduce the circulating blood supply to the fetus, which may lead to poor growth.’

If you’re feeling very stressed, try to identify why and seek appropriate help – talk to your doctor or midwife.

And don’t try to be superwoman. ‘Women frequently believe they need to be in control of everything, but they need to realise there are limits to what they can do,’ says Gail.

Set realistic targets (don’t redecorate the whole house – just the nursery will do) and ask for help from family and friends; they are often pleased to be asked. Pregnancy yoga, a warm bath, even a cup of chamomile tea can all help you relax.

And don’t stress about being stressed. ‘There is no clear evidence that stress is a problem, and I have looked after some very stressed women who have had uncomplicated pregnancies,’ says Maggie.


Stay off the sauce

This is a tricky one, as there’s such conflicting opinions on alcohol and pregnancy. Some countries, such as the USA, advise pregnant women to avoid alcohol altogether; in the UK the Government advises that one or two units of alcohol once or twice a week, and avoiding episodes of intoxication (i.e. being drunk), is safe.

‘I believe that an occasional social drink, such as wine, will not be harmful,’ says James. ‘The main risks are with binge drinking, and levels of more than seven drinks per week are associated with problems.’

Excessive drinking is known to harm the fetus, causing a range of problems from brain damage to physical and developmental abnormalities. This is known as Fetal Alcohol Syndrome (FAS), and the effects are scary and permanent.

When it comes to the occasional drink, the RCOG has reviewed the available evidence and advises that there is no evidence to suggest harm to the fetus from low-level alcohol consumption.

Do bear in mind that pub measures have grown over the years, though. There is around one unit of alcohol in a 125ml glass of wine, but most pub ‘small’ glasses are 175ml, and large glasses 250ml (two units).

There is one unit in half a pint of regular lager, and a single measure of spirits. And try not to worry if you drank before you realised you were pregnant. ‘If a pregnant woman has a healthy diet, and is otherwise well, and doesn’t make a habit of drinking, I see no problem,’ says James.


Pop those pills

Folic acid pills, that is. In 1991, a study by the Medical Research Council showed that neural tube defects (such as spina bifida) in the baby could be reduced by up to 75 per cent if the mum-to-be took folic acid supplements.

It’s now recommended that women take 400 microgrammes (mcg) of folic acid a day from the time they stop using contraception until week 12 of pregnancy.

Supplements are easily available over the counter, but if you’re on a low income, talk to your GP about the possibility of getting folic acid on prescription. It’s also a good idea to up your intake of foods rich in folate (the natural form of folic acid).

These include green vegetables, brown rice, and fortified bread and breakfast cereals.

‘Women who have had a previous pregnancy affected by neural tube defects will need to take an increased daily dose of around 5mg of folic acid,’ advises Gail. Talk to your GP or midwife if you’re worried.

If you buy a supplement containing folic acid, make sure it doesn’t contain vitamin A (see Eat Well above).
 

Cut the caffeine

Sometimes that morning latte can seem like the only way to get started in the mornings, so do you really have to forgo this simple pleasure now you’re pregnant?

‘There have been scattered reports of caffeine increasing miscarriage rates, but there may well be other factors,’ says Maggie. ‘There is no hard evidence that caffeine is bad for you but the advice would be to cut caffeine down. Like everything else – have it in moderation.’

The Government recommends pregnant women have no more than 300mg of caffeine a day, but how much is this exactly? ‘It can be very hard to measure how many milligrammes of caffeine you’re getting,’ says Gail.

‘A coffee from a coffee shop will probably have more than a coffee you make at home. Caffeine can raise the maternal and fetal heart rate, so women who have more than three cups of coffee a day should think of reducing this to one or two. And avoid very strong coffee.’

If you drink a lot of coffee, try cutting down gradually or you may get withdrawal headaches.

According to the Food Standards Agency, the following each contain around 300mg of caffeine: four cups of instant coffee; three cups of brewed coffee; six cups of tea; eight cans of cola.

Don’t forget that chocolate (especially plain chocolate) and energy drinks contain caffeine too.