January 2017

Pregnancy and Beyond
Make Healthy Choices for Yourself and Your Baby

Illustration of a pregnant woman walking with a friend through a snowy neighborhood.

You’re having a baby! Now what? When you’re about to be a new mom, it can feel like there’s a lot to do and learn. You’ll likely hear well-meaning advice from family, friends, and even total strangers. You may feel a mix of emotions. Whether you’re overjoyed or overwhelmed—or both—you can take steps to keep yourself and your baby healthy throughout pregnancy, and after.

“First, don’t expect the worst. Expect the best,” says Dr. Kimberly Yonkers, a researcher and psychiatrist at Yale University. “While some information or statistics might seem scary, keep in mind that the vast majority of the millions of pregnancies in the U.S. each year are healthy.”

Sometimes it’s helpful to focus on the positive aspects of pregnancy, and on the things you can control, like what you eat and how much you exercise. There may even be a silver lining to “morning sickness,” the nausea and vomiting you might get during pregnancy. One NIH-funded study found that nausea and vomiting early in pregnancy is associated with reduced risk for pregnancy loss.

Healthy eating is always important, but it’s even more so during pregnancy. A well-balanced diet can help ensure that you and your baby get all the nutrients you both need. Select a variety of fruits, vegetables, whole grains, lean meats or other protein sources, and low-fat dairy products.

Be sure to get enough of the vitamin folate, found in foods like orange juice and leafy green vegetables. Experts recommend that all women of childbearing age add to, or supplement, their diet by taking 0.4 mg (400 micrograms) of folic acid, a form of folate, every day. Taking folic acid supplements at least a month before becoming pregnant and throughout the first 3 months of pregnancy can lower a baby’s risk for certain birth defects by as much as 70%. Other nutrients that play essential roles during pregnancy are found in most prenatal vitamins.

For your baby’s safety, avoid certain foods such as raw fish, undercooked meat, deli meat, and unpasteurized cheese. Fish and shellfish can contain varying levels of methylmercury—a toxic metal—that may harm an unborn baby. During pregnancy, choose options that generally have low levels of this metal, such as shrimp, canned light tuna, salmon, pollock, and catfish. Pregnant women can eat up to 12 ounces of these fish each week.

While you may want to eat twice as healthy while pregnant, try not to eat twice as much. In an NIH study of more than 8,000 pregnant women, 73% gained more than the recommended amount of weight. The study found that gaining too much during pregnancy can raise the risk for gestational high blood pressure, cesarean section, and larger infants.

“It’s common for women to think that when they’re pregnant, they can ‘eat for two.’ But that’s a myth,” says Dr. Uma Reddy, an obstetrician and gynecologist at NIH. “You only need to eat a little more during pregnancy, not double the amount you usually eat.” In general, pregnant women need to eat about 300 extra calories per day.

Keeping your body moving while you’re pregnant can help you stay strong, feel and sleep better, and prepare your body for birth. Walking groups for moms and prenatal yoga classes might be a good place to find support and community while staying active. “With a few considerations, most women can continue their regular levels of physical activity throughout pregnancy,” Reddy says.

Since gaining too much or too little weight during pregnancy can raise the risk of problems for both you and your baby, talk to your health care provider about the right amount of weight gain based on your pre-pregnancy weight. Ask about how much food you should eat, the nutrients you’ll need, and the amount and type of physical activity that’s safe for you.

Also talk to your doctor about any medications and supplements you take, chemicals or potentially toxic things you’re exposed to, and any habits or behaviors you may be concerned about, like alcohol or drug use. Together, you can make a plan to help keep yourself and your developing baby safe.

You might be surprised to learn that some aspects of your health might be easier to improve while you’re pregnant. “Our research is showing that previously existing depression often improves, substance misuse significantly decreases, and that women generally get rid of a lot of negative health habits during pregnancy, at least temporarily,” Yonkers says.

For instance, some women may find that changes like eliminating alcohol or cutting back on caffeinated coffee is easier than before pregnancy, or they may just feel less interested in these drinks. “Smoking is another habit that women often find is easier to control during pregnancy,” Yonkers says.

When you’re pregnant, your teeth and gums might be the last thing on your mind. But your gums are more likely to become inflamed or infected because of the changes in your body. Make sure you keep up your regularly scheduled checkups. And, wash those hands! “A lot of people forget about handwashing, but this simple action makes a big difference and can really help you avoid some viruses that can be dangerous to your unborn baby,” Reddy says.

You may be tempted to schedule an earlier delivery. As eager as you might be to meet your new baby, studies show that it’s important to wait until at least 39 weeks of pregnancy unless there are medical reasons to deliver early.

There’s a lot to think about when you’re pregnant. It’s normal to have a variety of strong emotions during this period. But if you’re struggling with certain feelings or thoughts, it’s important to seek help. “Get help and talk to someone you trust,” says NIH’s Dr. Triesta Fowler, a pediatrician and coordinator of the Moms’ Mental Health Matters initiative. “You’re important and you matter. Though the baby is often the primary focus, women need to understand that they are just as important.”

NIH and its partners created the Moms’ Mental Health Matters initiative to raise awareness among pregnant and new mothers, their families, and health care providers about depression and anxiety during pregnancy and after the baby is born. Resources include an action plan for depression and anxiety, and conversation cards to help women and their families talk more easily about their feelings. Free materials are available in both English and Spanish at www.nichd.nih.gov/ncmhep/initiatives/moms-mental-health-matters.

Getting early and regular prenatal care is the best thing you can do to keep yourself and your baby healthy while you’re pregnant. Every woman and each pregnancy is unique. See your health care provider throughout your pregnancy to ask about what’s right for you, and to help you stay physically and mentally healthy. 

 

References
Pregnancy Outcomes With Weight Gain Above or Below the 2009 Institute of Medicine Guidelines. Obstet Gynecol. Johnson J, Clifton RG, Roberts JM, et al. 2013 May;121(5):969-75. DOI: 10.1097/AOG.0b013e31828aea03 PMID: 23635732.

Perinatal Substance Use: A Prospective Evaluation of Abstinence and Relapse. Drug Alcohol Depend. Forray A, Merry B, Lin H, Ruger JP, Yonkers KA. 2015 May 1;150:147-55. DOI: 10.1016/j.drugalcdep.2015.02.027 PMID: 25772437.

Association of Nausea and Vomiting During Pregnancy With Pregnancy Loss: A Secondary Analysis of a Randomized Clinical Trial. JAMA Intern Med. Hinkle SN, Mumford SL, Grantz KL, et al. 2016 November;176(11):1621-1627. DOI: 10.1001/jamainternmed.2016.5641 PMID: 27669539.

 

NIH News in Health, January 2017