Do’s and don’ts during early stages of pregnancy

Pregnancy Do's and Don'ts: Safe activities while expecting

When I was pregnant I was afraid of practically everything. Paint the baby’s room? No thanks, too many fumes. I’ll wait. Cheese? Don’t want to risk bacteria, I’ll skip it. (I did eat a lot of crackers though!) Working out? Too much jostling. I stuck to walking. By my second pregnancy, I was a little calmer and more confident, and didn’t want to be as neurotic. But how was I to know what was safe during pregnancy and what wasn’t? I turned to Dr. Carly Rogenstein, family physician and emergency medicine fellow in Toronto (and a new mom, herself) to sift through the myths and realities when it comes to normal daily aspects of life.

What can you do? Dr. Rogenstein weighs in on these activities:

  • CAN – Dying Your Hair: There have been no studies looking at occasional use of hair dye products during pregnancy. Due to minimal systemic absorption of these products (unless there is preexisting skin breakdown), it is unlikely for them to cause harmful fetal effects. Motherisk, a program run out of the Hospital for Sick Children in Toronto, suggests that using these products three to four times during pregnancy is likely safe.
  • CAN – Getting A Massage: Massage therapy, when performed by a registered massage therapist, is a highly safe and effective form of low back and pelvic pain control in pregnancy.
  • CAN’T – Enjoying Hot Tubs: Maternal hyperthermia, or exposure to high temperatures during pregnancy, has been associated with gastrointestinal and neurological abnormalities in the fetus, especially during the first trimester. Therefore, hot tubs during pregnancy should be avoided.
  • CAN’T – Hot Yoga: As already mentioned, maternal hyperthermia poses risk to the fetus during pregnancy. Although physical activity is encouraged during pregnancy, hot yoga could be unsafe. Therefore, hot yoga should be avoided at all stages of pregnancy.
  • CAN – Using Bug Spray: The available evidence on DEET containing insect repellant in pregnancy is reassuring. The CDC states that prevention of West Nile virus through use of protective clothing and DEET containing insect repellant is likely safe in pregnancy. (Keep in mind that DEET bug repellents should not be used unless instructed by a physician on babies less than two months of age.)

“Note, these rules relate to uncomplicated pregnancies,” says Dr. Rogenstein. She recommends Motherisk as a great resource for moms-to-be. “If you have any questions about environmental exposures, medications in pregnancy, or even going to the gym, you can ask them.”

Originally published in ParentsCanada magazine, August/September 2014.

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Do’s and don’ts during early stages of pregnancy

You are pregnant. Jump for joy and be grateful for this blessing, and then sit down and let the large, monumental responsibility of parenting sink in. Congratulations! You are going to do great! Even now, in the earliest of days, there are steps you can take so your baby has the best start in life. While you certainly cannot protect against every possible complication, there are guidelines you can follow to ensure your baby is growing in as nurturing and healthy of an environment as possible. This list of do’s and don’ts in the first trimester will help your growing baby thrive inside the womb.

DO think of food as fuel. Think of your body as a vehicle: It is carrying your most precious cargo right now. Would you want to fuel your car with sub-par gasoline? Of course not! You would not want to take the chance of it breaking down. Similarly, you do not want to fuel your body with sub-par energy sources. Choose organic foods whenever possible and eat from local food sources if you can. This limits your exposure to pesticides.

DO focus on folate. Have you been taking your folic acid? If you were not already taking folic acid supplements in advance of getting pregnant, start immediately.

You should be taking 600 micrograms of folic acid in the first trimester of pregnancy. This helps prevent two common and serious birth defects: spina bifida and anencephaly. In fact, the U.S. Public Health Service and Centers for Disease Control (CDC) recommend all women aged 15 to 45 take 400 micrograms of folic acid daily – not just those who are pregnant. This recommendation is based on the fact that half of the pregnancies in the U.S. are unplanned, and these two birth defects can occur three to four weeks after conception, before most women even know they are pregnant.

Once your pregnancy is confirmed, your physician most likely will recommend you take a prenatal vitamin. These vitamins are designed to meet the recommendations for folic acid intake. Folate does occur naturally in some foods, such as dark, leafy vegetables, whole grains, citrus fruits, fish and shellfish, but the body does not absorb it through foods as well as it does folic acid, which is the synthetic form of folate.

DO take your prenatal vitamins. Not only will these vitamins supply the necessary folate, but they also will help cover your needs for calcium, iron and zinc. Additionally, they provide the appropriate amounts of DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), two types of omega-3 fats that help your baby’s brain develop. Not a fan of the big pills? Talk to your OB provider about an alternative vitamin regimen.

DO eat the rainbow. Not literally, of course, but while you are meal-planning or find yourself in need of a snack, try to eat foods that are colorful: dark green spinach, orange carrots, red apples, yellow bananas, blueberries.

Not only do such brightly colored foods generally offer the most nutrients and antioxidants, but having a varied diet will expose your baby to a range of tastes and flavors. Your baby eats what you eat through the amniotic fluid, so if you eat a wide variety of foods, your baby will also.

DO sleep. Are you surprised to find yourself so tired? Don’t be! Your body is going through tremendous changes and is developing an entirely new life-providing system for your baby. As it grows the placenta, you will likely find yourself beyond exhausted some days. Plus, you are going through monumental hormonal and emotional changes.

Take naps. Frequently! If you work, you might want to schedule a little bit of rest time into your lunch hour. Set bedtimes and stick to them! Your body will need a solid eight to nine hours of sleep each night.

DO exercise. Did you exercise regularly before getting pregnant? Great! Keep it up. Regular exercise helps you combat the frequent mood and hormonal changes and fatigue occurring in this first trimester. It also helps prevent weight gain and battle insomnia.

Were you not so faithful about getting enough exercise prior to getting pregnant? No worries! There are several ways you can adopt a more active lifestyle, even during pregnancy. But before you begin any kind of new exercise regimen, contact your OB provider who will suggest options specific to your needs, taking into account your current state of health and what is best for your baby.

DO get a flu shot. Not only can pregnant women get a flu shot, they are highly encouraged to do so! According to the CDC, the flu is more likely to cause severe illness in pregnant women than in healthy women who are not pregnant. Because of changes to your immune system, heart and lungs, you are more prone to serious illness from the flu. Also, some evidence shows that contracting the flu during pregnancy can raise the risk of complications, including premature labor. The flu vaccine reduces that risk.

Even better, the flu vaccine can also protect the baby from contracting the flu after birth. Since a mother’s antibodies are passed on to her child during pregnancy, the vaccine will help protect the baby against the flu for the first few months after birth.

DO visit the dentist. Do you have a regular dental checkup coming up? Don’t skip it! The American Congress of Obstetricians and Gynecologists (ACOG) says that teeth cleaning and dental X-rays are safe for pregnant women. In fact, OB/GYNs are now advised to do oral health assessments during an initial prenatal visit and to encourage dental visits during pregnancy.

The ACOG reports that 40 percent of pregnant American women have some degree of periodontal disease and that the physical changes from pregnancy can result in changes to a woman’s gums and teeth. A dental visit can identify any potential dental needs.

DO stay hydrated. Hydration helps prevent preterm labor. It also helps prevent headaches, kidney stones and dizziness. Are you already battling constipation and hemorrhoids? Good news: staying hydrated helps fight both. If your urine is light yellow to clear, you are getting enough hydration. If it is dark yellow, you need to increase your water intake.

DO ask for help. Are you already more tired than usual? Ask your partner to help out more, maybe picking up a few extra tasks around the house to ease your burden.

Are you going it alone in this pregnancy? Ask a friend or family member if he or she can help. Do what you need to do in order to ensure you are getting enough rest, not only for yourself but also for your growing baby. Having extra help or having fewer tasks to accomplish will allow you more rest time.

DON’T smoke. Are you smoker? Now is the best time to quit! Not only for your health, but also for the health of your baby. Talk with your provider today about ways to quit.

According to the CDC, women who smoke during pregnancy are more at risk of miscarriage, and babies born to women who smoked during pregnancy are at increased risk for birth defects, such as a cleft lip or cleft palate, premature birth, low birth weights and infant death. These babies also are at greater risk for learning disabilities. Smoking during and after pregnancy also is one of the risk factors for Sudden Infant Death Syndrome (SIDS).

Additionally, babies born to women who smoked during pregnancy are more likely to become smokers earlier in their own lives due to a physiologic nicotine addiction.

What about e-cigarettes? Are those just as dangerous for growing babies? The CDC says that while the aerosol of e-cigarettes typically has fewer harmful substances than cigarette smoke, e-cigarettes that contain nicotine still are not safe during pregnancy. The nicotine alone is a health danger for pregnant women and developing babies, and can damage a developing baby’s brain and lungs.

DON’T drink alcohol. There is no amount of alcohol that is safe during pregnancy, according to the CDC. Likewise, there is no time during pregnancy when digesting alcohol does not carry risk.

Drinking alcohol when pregnant can cause problems for the developing baby in all stages of pregnancy, including the days and weeks before a woman knows she is pregnant. The CDC says that drinking alcohol in the first three months of pregnancy, specifically, can cause the baby to have abnormal facial features and growth and central nervous system problems. Drinking alcohol during pregnancy can lead to miscarriage, stillbirth and a range of behavioral and intellectual disabilities known as Fetal Alcohol Spectrum Disorders (FASDs). Children with FASDs may have abnormal facial features, poor coordination, poor memory, difficulty with attention, learning disabilities, difficulties in school, speech and language delays, low IQs, poor reasoning and judgment skills, sleep and sucking problems as infants, vision and hearing problems, and problems with the heart, kidney or bones. To learn more about the potential side effects of drinking alcohol while pregnant, read the facts of FASDs at the CDC website.

If a woman drinks during pregnancy, it is never too late to stop. The sooner she stops, the better the health benefits are for herself and her baby. Are you a pregnant woman who needs help? Talk to your provider right away; there are resources available to help you.

DON’T eat raw meat. Pregnant women who eat raw or undercooked meat and eggs are at risk of contracting listeriosis and toxoplasmosis, which can lead to serious and life-threatening illnesses. These illnesses can cause severe birth defects and miscarriage. Cook your meat and eggs thoroughly prior to eating.

DON’T visit the sauna. Avoid the sauna and hot tub. There is a risk of overheating, dehydration and fainting every time you use a sauna, whirlpool, hot tub or steam room. Your body is unable to lose heat effectively by sweating and your body’s core temperature rises. It is very possible that a significant rise in your core temperature could affect your baby’s development, especially in the first trimester of pregnancy. In fact, some research suggests that your risk of miscarriage doubles if you use one of these during the first trimester.

DON’T drink too much caffeine. This is an especially tricky one in this first trimester because you are so very tired. But caffeine can cross the placenta and affect your growing baby’s heart rate. What if you just can’t seem to stay away from the coffee pot? Don’t fret. Research suggests that some caffeine is OK in the first trimester – up to about 200 milligrams a day, about two cups of coffee – but some studies suggest that drinking too much caffeine during pregnancy might be associated with a greater risk of miscarriage.

DON’T clean the litter box. There’s no reason to fear or avoid your pet cat but leave the cleaning of the litter box to your partner or a friend. There are millions of parasites in feline waste and one – toxoplasma gondii – is especially dangerous to pregnant women. Miscarriage or stillbirth can result, and babies who are born with this parasite could develop serious health problems, including seizures and mental disabilities. It also can lead to vision problems.

DON’T eat for two. Sure, this saying has been around for decades. But ignore it! Studies show that half of women gain too much weight during pregnancy. When that happens, the baby is at greater risk of obesity later in life. You do generally need additional calories in the second and third trimesters, but doctors disagree about whether you actually need any extra calories in this first trimester. My recommendation? Eat until you are satisfied. Then stop.

This list of do’s and don’ts in the first trimester of pregnancy might, at first glance, seem a bit intimidating. But don’t let it scare you! Most of these can be summed with one simple sentence: Take care of yourself. Be sure to eat healthful foods, drink lots of water, and get enough sleep.

Before you know it, your little one will finally be here, physically in your arms. Then, as you hold and snuggle with your healthy newborn, remember to thank yourself for following this list of do’s and don’ts in the first trimester of your pregnancy. A healthy, happy baby makes it all worthwhile.

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Bleeding and pain in early pregnancy is a very common symptom, and it is also a very common sign of a miscarriage. There is a varying intensity of the pain one can experience when going through a miscarriage. However, the majority of the pain that comes along with a miscarriage can be managed with a simple analgesic such as paracetamol. Some patients may describe the pain as being a constant dull pain while others mentioned it as being abdominal cramps.If the diagnosis has been confirmed and it’s being managed medically then again the hospital or the early pregnancy clinic may prescribe you some painkillers to alleviate the symptoms of miscarriage.

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