11 steps to a healthy pregnancy

 Monday, September 26, 2016

Pregnancy is an ideal time to start taking really good care of yourself, both physically and emotionally. You give yourself the best chance of having a problem-free pregnancy and a healthy baby if you follow our simple guidelines:

1. Organise your antenatal care early in your pregnancy

As soon as you find out you're pregnant, get in touch with your doctor. Good antenatal care is essential for your baby's health. 

Organising your care early means you’ll:

1. Get good advice for a healthy pregnancy right from the start.

2. Have plenty of time to organise any ultrasound scans and tests that you may need.

3. Have months to build a good relationship with your doctor before your baby is born.

When choosing your doctor, get recommendations from friends and family. A good doctor is one who is able to give you personalised care, encourages you to ask questions, treats you with respect and answers all your queries patiently. 

Ideally, choose a doctor with a clinic or hospital close to your home. You might need to reach her quickly in an emergency, so it's a good idea to have her mobile number close at hand. Print our handy emergency contact list!

2. Eat well

There's no need to 'eat for two' when you're pregnant. Although latest research suggests that a pregnant mum only needs 200 extra calories a day in her last trimester, most doctors recommend 300 extra calories a day in the second and third trimesters.

This is equivalent to about:

1. two chapattis or idlis

2. two slices of wholemeal toast and butter

3. a serving of upma or poha

4. an extra glass of milk

5. one slice of cheese on toast

But, you may need more or less calories if you were underweight or overweight before getting pregnant or if you are pregnant with more than one baby. Your doctor will be able to recommend what calorie count best suits you during your pregnancy.

Here are some tips on healthy eating:

1. Eat a balanced and varied diet. You might go off certain foods, but it's always possible to swap these with others of similar nutritional value.

2. Aim to eat a diet with plenty of vegetables and fruit, and some carbohydrates such as roti, bread and rice (preferably wholegrain). You also need protein. This could be from fish, meat, eggs, nuts or pulses.

3. Have some milk and dairy foods every day, such as milk, yogurt, ice cream, buttermilk and cheese. However, if you are lactose intolerant, choose other calcium-rich sources, such as chickpeas (chhole), kidney beans (rajma), oats (jai), almonds (badaam), soymilk and tofu.

4. You might find it better to eat five or six small, well-balanced meals a day rather than three larger meals. Don't skip any meals if you can help it. You can keep up your energy levels with healthy snacks.

5. Keep yourself well hydrated by drinking at least eight to 12 glasses of water every day. Avoid caffeinated and artificially flavoured drinks and have fresh fruit juices, soups, and milk. See more ideas for nutritious and refreshing drinks.

3. Be careful about food hygiene

There are some foods that are safest not to eat in pregnancy. This is because they can carry a health risk for your baby. 

Listeria 

Listeriosis is an infection caused by listeria bacteria. It's rare and doesn't usually pose a threat to your health. However, it can cause pregnancy or birth complications. Listeriosis can even lead to miscarriage or severe illness in newborns.

The listeria organism may be present in raw milk, non-pasteurised milk, raw meat and unwashed vegetables. So buy pasteurised milk, cook meat well and wash vegetables carefully. As listeria bacteria are destroyed by heat, make sure you heat any ready meals thoroughly. Refrigeration does not stop the growth of listeria. 

Toxoplasmosis 

Toxoplasmosis is a parasite. It is rare, but can seriously affect an unborn baby. It is found in raw and undercooked meat and in soil and cat faeces. So make sure that meat is well cooked. Wash vegetables and salads to remove any traces of soil or dirt. If you have a cat, ask someone else to clear up any cat mess. 

Salmonella

Salmonella is a food poisoning bacteria. It does not harm your baby, but may make you feel very unwell. Salmonella can be found in undercooked poultry, and raw or soft-cooked eggs. So cook poultry well, and cook eggs until the white and yolk are solid.

Try following the tips below:

1. In a warm humid country like ours, good food hygiene is especially important to make sure the food you eat is safe. Ensure all food is cooked well. But even cooked food stored in the refrigerator overnight can be contaminated. Keep cooked food covered and refrigerate within two hours of cooking. Take special care if there are power cuts in your area.

2. Eat freshly prepared meals whenever possible. If you do have a ready meal, check the best before date and that the packaging is not damaged.

3. Do not eat out of packaging that is bloated, leaking or damaged. It indicates potential risks of contamination.

4. Keep up your iron

India has the highest prevalence of iron-deficiency anaemia among women in the world. This means that many women in India are already deficient in iron before they become pregnant. You need iron to produce haemoglobin, the protein in red blood cells, which carries oxygen to the various organs and tissues in the body.

Eat plenty of iron-rich foods to keep up your iron levels and prevent anaemia. Vegetarian diets are usually low in iron. So it is all the more important to have a check on your iron intake if you are a vegetarian. Some foods that contain iron include:

1. non-vegetarian foods such as mutton, chicken and shellfish

2. green leafy vegetables namely mustard leaves (sarson), fenugreek (methi), mint (pudina), coriander (dhania), radish leaves (moolie ka saag) 

3. iron-rich vegetables such as beetroot (chukandar), pumpkin (kaddu), and broccoli (hari gobhi)

4. raisins (kishmish), nuts, seeds and dried fruits

5. legumes and pulses

Vitamin C helps your body to absorb iron so add some vitamin C-rich food to your iron-rich diet. For example, you could add lime to your dals or accompany your meal with a glass of orange juice or nimbu pani.

Try these easy ways to boost your iron levels and use our handy printable guide to keep your iron levels up!

5. Take antenatal supplements

Pregnancy vitamin supplements aren't a substitute for a balanced diet. But they can help if you're worried you're not eating well, or you're too sick to eat much.

Folic acid (also called folate) is the only supplement that all pregnant women must take independent of how good their diet is. It can help prevent spina bifida and other neural tube defects in babies.

Spina bifida is a serious congenital condition affecting the central nervous system that can cause severe disabilities. All women planning a pregnancy are advised to take a daily supplement of 5mg of folic acid starting around the time of conception and continuing through the first three months of pregnancy. Some doctors recommend you continue taking folic acid supplements throughout your pregnancy and for the first six months of breastfeeding.

You can also increase your intake of natural folate through your diet. Folate is found in vegetables like spinach (paalak), peas (matar), lady's finger (bhindi), lettuce (salad patta), beans and capsicum (shimla mirch) as well as in fortified breakfast cereals. You could also try our folate enriched recipes.

Calcium is another essential nutrient that is important to your and your baby’s health. Calcium-rich foods are milk, cheese and tinned sardines (pedvey machli) with bones, soy milk, tofu, leafy green vegetables, sesame seeds (til ke beej), kidney beans (rajma), chickpeas (chhole), nuts, and oats. If you think your diet may lack calcium, speak to your doctor who may prescribe a suitable calcium supplement. 

Fish oils have been found to have a beneficial effect on birth weight and on the development of brain and nerves in late pregnancy. Try to eat oily fish such as herring (bhing machli), mackerel (bangda), salmon (raawas) or sardines (pedvey machli) two or three times a week. 

If you're not keen on fish, you could take fish oil supplements (choose a brand free of the retinol form of vitamin A). But talk to your doctor before taking any over-the-counter medications or herbal remedies.

6. Exercise regularly

A good exercise programme can give you the strength and endurance you'll need to carry the weight you gain during pregnancy and to handle the physical stress of labour. It will also make it easier to get back in shape after your baby is born.

Exercise can boost your spirits and help ward off the pregnancy blues. A recent study has found that staying active can boost your level of serotonin, a brain chemical linked to mood. 

1. If you're used to taking exercise in the form of a sport, you can continue with this as long as it feels comfortable for you, unless your particular sport carries a risk of falls or knocks.

2. More gentle exercise such as walking, swimming, aqua-aerobics, and yoga are also very beneficial.

3. In summer, walk in cool, shaded areas and stay indoors when it is very hot. Wear comfortable, loose clothing, suitable walking shoes and a well-fitting, supportive bra. Read more on how to stay fit during the hot and humid months.

4. Learning some breathing exercises now will help you when your baby is born. They might help you to control your breath and your stress levels during labour.

7. Begin doing pelvic floor exercises

The ideal time to begin pelvic floor exercises is adolescence, but many women don't hear about them until pregnancy.

Your pelvic floor comprises a hammock of muscles at the base of your pelvis. These muscles support your bladder, vagina and back passage. They can feel weaker than usual in pregnancy because of the extra pressure upon them. Pregnancy hormones can also cause your pelvic floor to slacken slightly.

Weak pelvic floor muscles put you at risk of developing stress incontinence. This is when small amounts of urine leak out when you sneeze, laugh or exercise. 

Strengthening your muscles by doing pelvic floor exercises regularly throughout your pregnancy can help. Having a toned pelvic floor may help your baby's birth go more smoothly too. 

You'll feel the benefit if you do eight pelvic floor squeezes, three times a day. Try and do them frequently throughout the day - when you wash your hands, brush your teeth, or wait for the food to cook.

8. Limit your alcohol intake

Because any alcohol you drink rapidly reaches your baby via your bloodstream and placenta, you may decide to cut it out completely, or at least to monitor the amount you consume. 

Pregnant women should drink no more than eight units of alcohol per week, and no more than two units at any one time. However, since there are no standardised levels for 'a unit' in India, it could be quite difficult to gauge how much you are actually drinking. 

Women who have more than two drinks a day are at greater risk of giving birth to a baby with fetal alcohol syndrome (FAS). Children born with FAS suffer from mental and growth retardation, behavioural problems, and facial and heart defects.

9. Cut back on caffeine

Coffee, tea, cola and energy drinks are mild stimulants. Some research suggests that too much caffeine may increase the risk of having a low-birth-weight baby.

The current advice is that two cups of coffee or tea per day (or up to five cans of cola) won't hurt your baby.

You may prefer to switch to decaffeinated coffee or tea, or drink fruit juices instead. A refreshing alternative is a glass of mineral water with a twist of lime (nimbu) or tender coconut water. You could also drink fresh fruit or vegetable juices as they contain plenty of vitamins and minerals for you and your baby.

10. Stop smoking

Smoking during pregnancy can cause serious health problems, for you and your baby. These risks include an increased risk of:

1. miscarriage

2. premature birth

3. low birth weight

4. cot death (SIDS)

Smoking may even be associated with the loss of a baby at birth.

Smoking makes the following pregnancy complications more likely:

1. Nausea and vomiting (morning sickness).

2. Ectopic pregnancy.

3. Placental abruption, where the placenta comes away from the uterus wall before your baby is born.

If you smoke, it's best to stop, for your own health and that of your baby. The sooner you stop smoking, the better, but it's never too late. 

It is best not to be exposed to cigarette smoke at all. Encourage your husband and family members to give up as well, or at least to avoid smoking inside the house.

11. Get some rest

The fatigue you feel in the first and third trimesters is your body's way of saying 'slow down'. 

A nap in the middle of the day may seem like a luxury you can't afford, but you and your baby will both benefit. Take any offers of help. To make sure you get enough rest, try to reduce your working hours, and perhaps cut down on some social commitments.

If you can't sleep, at least put your feet up and relax for 30 minutes or more. Relaxation techniques such as yoga, stretching, deep breathing and massage are all good at reducing stress and can help you get a better night's sleep.(You'll find more useful advice in our pregnancy sleep section.)

There's nothing like chatting with others who are at just the same stage of pregnancy as you. Why not check in at the community forums.

 

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