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A woman's body goes through many changes over the nine months of pregnancy, with the developing baby making increasing demands. Being as fit and healthy as possible maximizes the chances of a healthy pregnancy. Many women re-evaluate their health and lifestyle once they know they are pregnant. However, by the time a woman has missed her first period, she is already two weeks pregnant, so it's best to prepare for a pregnancy before trying to conceive.
 Folic acid supplements
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* You should take folic acid tablets for at least the first 12 weeks of pregnancy - even if you are healthy and have a good diet. Folic acid is a vitamin which occurs naturally in certain foods. If you take folic acid tablets in early pregnancy you reduce the risk of having a baby born with a spinal cord problem such as spina bifida.
* You should start taking folic acid tablets before becoming pregnant (from the time you plan to become pregnant).
* If the pregnancy is unplanned then start taking folic acid tablets as soon as you know that you are pregnant. For most women the dose is 400 micrograms (0.4 mg) a day. If you have an increased risk of having a child with a spinal cord problem then the dose is higher (5 mg a day - you need a prescription for this higher dose).
* That is, if: you have had a previously affected pregnancy your partner, or a first-degree relative, have a spinal cord defect you are taking medication for epilepsy you have coeliac disease, diabetes, sickle cell anaemia, or thalassaemia.
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Alcohol
| Advice from the Departments of Health everywhere is that you should not drink at all if you are pregnant or trying to become pregnant. It is known that if you drink heavily you have an increased risk of miscarriage, and it may cause serious harm to the baby's growth and brain development. A condition called fetal alcohol syndrome develops in some babies born to mothers who drink heavily. A baby with this syndrome can have severe physical and mental problems. However, the exact amount of alcohol that is safe during pregnancy is not known. This is why the advice is not to drink at all. If you find it difficult to cut down or stop drinking alcohol, then seek advice and help from your practice nurse or GP. |
Smoking
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If you smoke, you are strongly advised to stop smoking before getting pregnant. Tobacco smoke contains poisonous chemicals which pass into the baby's blood and can slow the baby's growth. The risk of having a miscarriage, premature birth, or stillbirth are higher if you smoke. Babies born to mothers who smoked when pregnant also have an increased risk of developing attention deficit hyperactivity disorder (ADHD) when they are older.
Also, after the birth, children of smoking parents have an increased risk of developing chest infections, asthma, 'glue ear' and sudden infant death syndrome (cot death). For many women who smoke, planning to become pregnant is a good incentive to stop smoking. It is often a good time to persuade partners to give up too. If you find it difficult to stop smoking then seek advice and help from your doctor or pharmacist.
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Street drugs
| If you take or inject street drugs, you are strongly advised to stop taking them before getting pregnant. Their effects on pregnancy are not fully known, but they are likely to pose a risk. If you cannot come off drugs easily, see your doctor for help. |
Food and diet
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Aim to eat a 'healthy diet (which everyone should be eating!). Briefly, the bulk of most meals should be starch-based foods (such as bread, cereals, potatoes, rice, and pasta), with fruit and vegetables. Eat protein foods such as meat, fish, pulses, chicken, etc, in moderation. If you are already obese or overweight, try to lose some weight before becoming pregnant to reduce the risk of pregnancy complications. Include foods with plenty of iron, calcium and folic acid:
* Iron is mainly in red meat, pulses, dried fruit, green vegetables and fortified cereals.
* Calcium is mainly in dairy products such as milk, cheese, and yoghurt. (Low-fat milk, cheeses and yoghurts usually contain just as much calcium as the full-fat varieties.)
* Folic acid is mainly in green vegetables, brown rice, and fortified cereals.
Foods and drinks to avoid :
You should not eat the following if you are pregnant or trying to become pregnant.
* Anything with a lot of vitamin A. You need a small amount of vitamin A to keep healthy.However, large amounts can harm an unborn baby. So, avoid: Liver and liver products such as cod liver oil supplements. Vitamin tablets or supplements which contain vitamin A.
* Fish which may contain a lot of mercury. A high level of mercury can damage the developing nervous system of an unborn baby. So: 1. Do not eat shark, marlin, or swordfish. 2. Limit tuna. You should eat no more than two medium sized cans (drained weight = 140 gm per can), or one fresh tuna steak per week. (This would be about six tuna sandwiches, or three tuna salads per week.)
* Limit the amount of caffeine to no more than 300 mg per day. Having a lot of caffeine increases your risk of having a miscarriage and a baby with low birth weight. The main sources of caffeine are coffee, tea, chocolate, cola. It is also added to some 'energy' drinks and to some cough and cold remedies.
As a rough guide: One cup of instant coffee has about 75 mg caffeine One cup of brewed coffee has about 100 mg caffeine. One cup of tea has about 50mg caffeine. One 50g chocolate bar has about 50 mg caffeine. One can of cola, and half a can of an 'energy' drink has up to 40 mg caffeine.
* Peanuts. If you have an atopic disease such as asthma, eczema, or hay fever, or if a close family member has one of these conditions, then you may wish to avoid eating peanuts when you are pregnant. This may reduce the risk of your child developing peanut allergy in later life (which can be a serious and life-threatening allergy). This advice about peanuts in pregnancy is precautionary and further research is needed to clarify this issue.
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Medications
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The effects of some prescribed drugs have been well studied and it is known that certain drugs are safe in pregnancy. For example, paracetamol at normal dose is safe and useful for headaches, backache and other aches and pains that may occur during pregnancy.
However, some drugs are not safe, and may be harmful to a developing baby, particularly if you take them in the early weeks of pregnancy. Therefore, always tell a doctor or dentist who prescribes you medication that you are pregnant, or intend to become pregnant. Also, don't take drugs that you can buy (including herbal remedies) unless they are known to be safe in pregnancy. The pharmacist will advise. If you already take regular medication, (for example, for epilepsy), it is important to discuss this with a doctor before becoming pregnant. If you have an unplanned pregnancy, discuss any medication that you take with your doctor as soon as possible.
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Infections
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* Rubella (German Measles)If you plan to become pregnant for the first time, you should check that you are immune to rubella before becoming pregnant. See your practice nurse for a 'pre-pregnancy' blood test. Most women are immune to rubella as they have been immunised as a child. However, childhood immunisation does not work in every child and you may not be immune. If you are not immune, you can be immunised.
* ToxoplasmosisThis germ is commonly found in raw meat, sheep, lambs and cat faeces. It can sometimes cause serious harm to an unborn baby. To avoid it: Wash your hands after handling raw meat. Do not eat raw or undercooked (rare) meat. Wash salads and vegetables as any dirt may have been contaminated by cat faeces. Wash your hands after handling cats and kittens. Get someone else to clean out any cat litter trays when you are pregnant. Always wear gloves when gardening. Avoid sheep, especially during the lambing season.
* Chickenpox Having chickenpox when pregnant can be a nasty illness, and there is some risk to the developing baby. A vaccine is offered to healthcare workers (doctors, nurses, etc) who have not previously had chickenpox and so are not immune and may catch chickenpox. (About 1 in 10 adults have not had chickenpox as a child.) Therefore, non-immune healthcare workers should consider having this vaccination before getting pregnant. If you are not sure if you have had chickenpox, a blood test can check if you have previously had it.
* Hepatitis B A mother who is infected with hepatitis B has a high risk of passing it on to her new-born baby. If you are at high risk of catching hepatitis B you should be immunised against this virus before becoming pregnant. You are at increased risk and should be immunised if:
1. Your job puts you at risk of contracting hepatitis B. For example, health-care personnel and staff at day care or residential centres.
2. You inject street drugs
3. change sexual partners frequently.
4. You live in close contact with someone infected with hepatitis B. Screening blood tests
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