You're Pregnant: Now What?

Pregnancy can bring with it a variety of emotions: joy, fear, anxiety and more. It’s an amazing sensation to know that your body is growing a baby and that you are responsible for its healthy growth.

Amid your changing emotions, you will also be offered advice – often whether you ask for it or not:  like when your Aunt Bessie says, “Eat dill pickles and your baby will have green eyes.” It can be challenging to know which advice to follow. Collecting a variety of perspectives from family and friends will give comfort, as will seeking advice from your healthcare provider or midwife.

Here are the top six tips from providers who have helped hundreds of other new expectant moms:

#1 Start Your Prenatal Vitamins Right Away

One of the most important pieces of advice is this: start taking prenatal vitamins right away.

“Prenatal vitamins are most important in the first three months. This is when the body absorbs extra folic acid which helps to prevent birth defects,” says Chad Thomas, MD, a PeaceHealth obstetrician/gynecologist  in Bellingham, Washington. “Babies are good at stealing vital nutrients from you and that’s another reason why you need prenatal vitamins.”

In addition to folic acid, your prenatal vitamin will include:

• Iron: helps your body make a protein called hemoglobin, that helps carry oxygen from your lungs to the rest of your body
• Calcium: helps your baby’s bones, teeth, heart, muscles and nerves develop
• Vitamin D: helps your body’s nerves, muscles and immune system work, protecting your body from infection
• DHA (docosahexaenoic, an omega-3 fatty acid): helps your baby’s brain and eyes to develop
• Iodine: helps your body make thyroid hormones, which aids your body to use and store energy from food; helps your baby’s brain and nervous system develop

“Carefully look at other medications that you are taking, including over-the-counter medications. Safe medications to take include acetaminophen (like Tylenol), Benadryl and Tums. Avoid ibuprofen (found in Advil(R) and Motrin(R)) and aspirin,” advises Hilary Gerber, DO, a PeaceHealth family medicine provider in Vancouver, Washington.

Contact your doctor right away if you are taking anti-seizure or anti-depression medications, which could be harmful. But don’t stop taking these medications until you speak to your doctor, as the benefits to you may outweigh the risk to your pregnancy.

“While we prefer that women talk in person with their doctors, there are apps you can use at home to review safe medications. For example, I recommend InfantRisk to my patients,” adds Gerber. “This way when it’s midnight and you have heartburn and all you want to eat is an antacid tablet, you can easily review if it’s safe for you and the baby.”

#2 Establish Healthy Eating Habits

Nausea is very common in the first six to eight weeks.

“While it seems counter-intuitive, eating throughout the day is ideal as you avoid an empty stomach. In fact, the reason why most women experience nausea in the morning – and why it’s called morning sickness – is because they have an empty stomach,” says Gerber.

“Crackers are your friend, so keep them by your bedside and in your purse,” adds Thomas.

When shopping for groceries, read cereal, bread and pasta labels for ‘fortified’ or ‘enriched’ with folic acid. Good sources of all these vitamins can be found in fresh produce and meats, including: leafy green vegetables (like spinach and broccoli), lentils and beans, orange juice, milk, yogurt, cheese and fish that are low in mercury, like salmon, trout, anchovies and halibut.

Pregnancy can bring with it food cravings. While you are encouraged to eat normally, it’s important to stay away from deli meat, which can contain the bacteria listeria (which causes food poisoning) and can cross the placenta into the baby.

If you’re really craving pastrami on rye, make sure it’s a hot sandwich. Thomas advises to “heat it up to steaming, as that will kill the bacteria.”

“The phrase ‘eating for 2’ is a misnomer as most women required no additional calories during the first trimester. Only a moderate increase in calories is required in the second and third trimester, around 400 extra calories per day,” says Justine Parker, DO, a PeaceHealth family medicine provider in Florence, Oregon.

Gerber adds: “We don’t want women to diet during pregnancy, but we do encourage healthy eating. In fact, pregnancy is an opportune time to make dietary decisions that can have a lasting effect after pregnancy, too.”

Stay hydrated; water is ideal, but orange juice, milk and non-caffeinated teas are also good choices. Try to limit your intake of caffeine (whether it’s coffee, tea or a soda) to one 12-ounce cup per day.

Most women know this, but it’s worth repeating: there is no safe amount of alcohol use once you are pregnant and you should not smoke.

#3 Stay Active

Establishing or maintaining a healthy exercise routine is encouraged for most women. This will help you control your weight, boost your mood and help you sleep.

“We encourage at least five days a week of some type of aerobic activity. This could be walking, yoga, swimming, strength training, stationary cycling or jogging,” says Parker.

“High-impact exercise, like CrossFit training, should be avoided. Of particular concern is your balance while exercising. This won’t be evident in your first trimester, but by month six your center of gravity will be affected,” says Gerber. Talk to your provider about your exercise plan.

You will likely experience fatigue, especially during the first three months. Embrace your inner child and take naps when you are able. Don’t be afraid to ask your partner, friends or family members to help you with laundry, cooking, grocery shopping or other tasks.

For women who have an indoor cat, there is one task you are encouraged to delegate.

“Don’t change kitty litter, as you could be infected with toxoplasmosis (a parasitic infection that can be transmitted through cat feces),” warns Gerber. “Women who have changed cat litter in the past may have already been exposed, but if you first get toxoplasmosis when you're pregnant, it's possible you could get sick and pass the illness on to your baby.”

Also, if you have a green thumb, wear gloves and be careful in the garden, as neighborhood cats also go to the bathroom outdoors.

#4 Begin Your Prenatal Care

An ideal time to establish your prenatal care is around weeks eight to 10 from your last period. You can choose from an obstetrician-gynecologist (OB-GYN), a family physician or a certified nurse-midwife (CNM). In some areas, you might also have the choice of joining a group prenatal or CenteringPregnancy® program. To help make your decision, consider the type of birth experience you want and where you plan to give birth.

“We start by introducing ourselves to you and explaining how prenatal care at our office will work.  We want you to feel like you and your partner understand and know how to utilize the wealth of resources that we have to offer pregnant women and their family,” says Parker.

One important piece of information to bring to your first appointment is the date of your last menstrual period.

“The medical community is slow to change,” Gerber shares with a smile. “We didn’t always understand the process of ovulation, but we always knew when a woman had a menstrual period.”

Your pregnancy timeline, including your due date, will be established from this date.

In your second and third trimester, appointments with your provider will offer the first glimpses of your baby.

“At 12 weeks the fetus is only the size of a fig, so you can picture how tiny the newly forming heart is. The sex is usually revealed at the 20-week ultrasound,” says Parker.

In addition to your partner, family and friends, your provider will become an important part of your ‘pregnancy team.’ Beyond strict medical advice, he or she can provide objective feedback about the type of birth you wish to experience (epidural or drug-free?), the benefits of breastfeeding and much more.

“Our overarching goal is to educate, normalize, decrease risk and celebrate,” adds Parker.

#5 When to Share the News

While knowing you are pregnant is an exciting time, consider keeping the news ‘close to the vest’ until the second or third month.

“It’s a very personal decision, take some time to think about it,” advises Gerber.

This will give you time to adjust to pregnancy, to discuss with your partner how this will impact your lives and decide how to share the news with your employer, if you're employed.

Many women are unaware of how common miscarriage occurs; one in four pregnancies ends in a miscarriage, usually during the first three months. Chances of a miscarriage go way down once there is a heartbeat detected.

#6 Symptoms to Act On

As mentioned earlier, nausea is common in the first trimester, as is vomiting. Signs of concern would be if you have an extremely dry mouth, aren’t producing urine or if you can’t keep any food or beverages down for more than a day or so.

Spotting or bleeding can be normal. Possible causes can include hormonal changes in your body, sexual intercourse or an internal exam from your provider.

“Miscarriage is always a possibility in pregnancy, though it is more common in the first trimester. The incidence in clinically recognized pregnancies is around 20 percent,” shares Parker.

“If you’re going through more than a pad an hour, call your doctor,” advises Thomas.

During the early weeks of pregnancy, you should also be mindful of significant abdominal pain, which could mean an ectopic pregnancy (when the fertilized egg attaches itself in a place other than inside the uterus).

The first several weeks of your pregnancy can be physically and emotionally challenging. You can be your own best advocate by being mindful of changes to your body and contacting your provider with any concerns.

Take it All In

About all that unsolicited advice? Just grin and bear it. In fact, pregnancy will be good practice, as you’ll get unwanted advice once you are a parent, too.

In addition to consulting with your healthcare provider, remember that you can lean on your ‘pregnancy team.’

“Talk with your sisters, female cousins and girlfriends. It’s a great time to bond over this shared experience and offer each other support,” says Gerber.

Sources:  https://www.infantrisk.com | Texas Tech University Health Sciences Center