Health Measures to Consider

Smoking

If you are a smoker, you would be wise to consider giving up completely. When you inhale cigarette smoke, 4,000 chemicals - including carbon monoxide and nicotine - pass directly into your bloodstream. The result of this is that your baby receives less oxygen and does not grow as well as it should, which can lead to a low birth weight. In addition, the nicotine has the effect of making your baby's heart beat faster. For every cigarette you smoke, your baby's blood flow will be disrupted for 15 seconds.

If you give up smoking, and avoid passive smoking by other people, your baby is less likely to be born underweight and contract infections in the first year. Further, the child will more easily avoid chest illnesses and asthma at a later stage.

You will benefit from quitting too - mothers who quit smoking face fewer complications during pregnancy and labour, a lower risk of miscarriage, bleeding and sickness, and less chance of a premature or stillbirth.

The most damaging effects of smoking take place between the fourth to ninth months of pregnancy but remember that it is never too late to cut down or preferably stop smoking altogether and your baby will feel the benefits immediately.

If your partner smokes or you resume smoking after the baby is born, it is important to remember that you will still expose your baby to the risks associated with passive smoking. In fact, young babies and toddlers tend to be more at risk to the effects of inhaling second hand smoke because their bodies are still developing and they breathe faster (therefore inhaling more smoke) than adults.

Research shows that children who grow up in a household where a parent smokes, they are twice as more likely to develop respiratory and lung diseases. During just two hours in a house or car with someone smoking, your child will have inhaled the equivalent of four cigarettes.

Remember, you do not have to quit alone. The NHS Stop Smoking Service is available through many local pharmacies.

Through this service your pharmacist can advise you on different smoking cessation aids and meet regularly with you to discuss your progress. There are many different options these days to help you find methods for quitting that suit you.

You should ask your GP for advice before using nicotine substitutes (such as patches or capsules) during pregnancy. If you live in England contact Smokefree NHS on 0300 123 1044

Drugs

Drugs other than those prescribed by your GP should be avoided during pregnancy. These include proprietary drugs, over the counter medicines and 'natural' remedies. Speak to your GP about any prescribed drugs, medicines or vitamin supplements you may already be taking.

Of course, if you suffer from epilepsy or diabetes (or some other long-term illness), your doctor will need to monitor and advise on your prescription. Never change or stop using prescribed medicines without first consulting your GP.

If you are using illegal drugs while pregnant, you are advised to inform your GP or midwife immediately once you have confirmed your pregnancy so that they can give you the right support and advice. Illegal drugs will harm your baby. With prior notice, your GP will be in the position to refer you to a maintenance reduction programme that is the most sensible course of action. You can also call FRANK on 0300 123 66 00 or Text 82111

Alcohol

Research shows that heavy drinking can cause serious harm to your baby, and women who drink are at risk of having babies with Foetal Alcohol Spectrum Disorder (FASD), which can cause problems with physical and mental development, behavioral problems, facial and heart defects.

You should avoid alcohol completely during your whole pregnancy..

It's important to stress that many women have a drink before they know they are pregnant and their babies are perfectly fit and healthy.

If you are concerned, please speak to your GP or midwife. Also, there are also other confidential help and support groups available. Please see further contacts and useful organisations section.

You can contact Drinkline - the national alcohol helpline on 0300 123 1100

Sex During Pregnancy

There is no physical reason why you should not continue to have sex throughout a normal pregnancy. Sex during pregnancy is not harmful since the muscles at the neck of your womb, and a plug of specially formed mucus, completely seal the womb. The baby is also cushioned by the amniotic fluid that surrounds it.

However, if you have experienced a previous miscarriage, you should talk to your doctor or midwife about the advisability of continuing with sex, especially during the first three months of your pregnancy. This may also apply if you have a problem such as placenta praevia or bleeding. It is a fact that some couples would rather not have sex during the pregnancy period. For others, pregnancy brings a freedom from contraceptives, periods and PMS and can be very arousing for both partners. Whatever the case, it is important for partners to speak candidly about their feelings in this respect.

Sex will not start labour unless the woman's body is ready, but intercourse can be a natural way to induce labour if your baby is overdue. This is because semen is rich in prostaglandins - hormones that are known to soften the cervix. Some women will experience slight bleeding after sexual intercourse during pregnancy due to the thinning of their cervix.

Some women will experience slight bleeding after sexual intercourse during pregnancy due to the thinning of their cervix. Although this is usually nothing to worry about, it is advisable to alert your midwife to any bleeding in case it is because of something more serious.

Exercise

Keeping fit during pregnancy can be most beneficial and, with your GP's permission, you can continue your existing exercise regime. However, avoid highly competitive sports and over-exertion as your ligaments tend to loosen during pregnancy to allow your pelvis to accommodate the baby, which means that you may sprain your muscles more easily. Walking, swimming and yoga will help you to keep fit; but always bear in mind that regular, gentle exercise is much better than sport. If you attend exercise classes or go to a gym, tell your instructor that you are pregnant so that they can offer you appropriate advice.

Once you've had the baby, you may decide you want to get back into shape as quickly as possible, consult with your GP or gym instructor about what sort of exercise would be suitable. Swimming is great for new mums who may still be experiencing the effects of loosened ligaments (this happens to enable your pelvis to widen for the birth).

In addition, many areas now have exercise groups for mums who meet to power walk their pushchairs around local parks.

Diet

The quality of your food choices is the key to a healthy diet. Prepare a balanced diet that includes bread, cereals, fresh fruit and vegetables, dairy foods, meat, poultry, oily fish and peas, beans and lentils.

In order to prevent excessive weight gain, it is advisable to strictly limit your intake of highly processed foods such as sweet, fatty and fast food. Also to be avoided is liver and any foods fortified with Vitamin A. Liver contains high levels of Vitamin A, which can be toxic.

Organisations such as the British Nutrition Foundation can give you more advice about following a healthy diet. You can phone them on 020 7557 7930 or visit the website at www.nutrition.org.uk for more information.

If you do need help managing your weight during and after your pregnancy a nutritionists can be an excellent source of practical advice and support. A sensible rule of thumb is nine months to go on, nine months to come off when it comes to baby weight you may have gained.

Peanut Allergy

For most people, peanuts are a useful and nutritious food. However, peanuts can cause a dangerous allergic reaction in a few children.

There's no evidence that eating peanuts or foods containing peanuts, while you're pregnant affects whether or not your baby develops a peanut allergy. It's fine to eat peanuts during pregnancy, unless of course you're allergic to peanuts yourself.

However, you may still feel like you do not want to pat peanuts, or foods containing peanuts, such as peanut butter. Talk to your GP or midwife if you have a family history of allergies and are worried. As long as you're eating a healthy, balanced diet, excluding peanuts from your diet certainly won't do you or your baby any harm.

Ask your GP or midwife if you have any concerns about this.

Caffeine

Caffeine is a stimulant, which speeds up the functions of your body. However, during pregnancy and for about a month after the birth, your body metabolises (uses) caffeine more slowly. Some research suggests a high intake of caffeine may be harmful to your baby but these risks are largely unproven. However, experts recommend that pregnant women (and women planning a pregnancy) should avoid too much caffeine, limiting their intake to 200mg a day - this is roughly equivalent to two mugs of instant coffee, four cups of tea or four cans of cola.

Food Preparation And Hygiene

Good hygiene in food preparation will help prevent infections from bacteria such as salmonella and listeria, and it is easy to achieve. All you have to do is follow a few basic rules.

1. If you work on a farm where there are sheep, you must take extra care because sheep faeces also carry harmful organisms. You should be particularly careful at lambing time.
2. Always wash your hands after visiting the lavatory or disposing of cat or dog faeces. Wear gloves when gardening.
3. Wash hands, cooking utensils and surfaces after preparing raw meat.
4. Make sure that eggs and meat are well cooked before consumption; likewise, ready-to-eat meals and TV dinners.
5. Thoroughly wash vegetables, fruit and salads before eating.
6. Avoid pate, ripened soft and blue veined cheeses.
7. Don't drink unpasteurised cow, goat or sheep's milk or cream.
8. Don't eat cold-smoked or cured fish, unless cooked until smoking hot

Travel During Pregnancy

During pregnancy, travelling can be especially tiring and it is a good idea to plan your journey carefully to avoid unnecessary stress.

• Break car journeys every two hours and take a short walk.
• Make sure your seat belt fits properly, under rather than across your bump.
• You may need a cushion for the small of your back to give you extra support while driving.
• Place your seat as far back as you comfortably can to drive.
• If sitting in the passenger seat, move the seat as far back as possible.
• Wear loose comfortable clothes and flat shoes to drive in.
• Pack healthy snacks, so that you can eat little and often to keep your blood sugar level.
• Drink lots of water to avoid dehydration and reduce swelling.

Airlines usually accept pregnant women as passengers up to 28 weeks, after this point they may ask for a note from your doctor stating that you are fit to fly. After 37 weeks, you will not usually be allowed to fly. Check with the airline for their policy.

If you are planning a holiday abroad while you are pregnant make sure your travel insurance covers you for any pregnancy related medical care or premature birth and the cost of changing the date on return flights if you go into labour, remember to check if any vaccinations are needed for the country you want to visit. Many vaccinations are not recommended during pregnancy, so double check before you book.

Check out water supplies and hygiene levels in your destination country and remember to pack a first aid kit. For more information, talk with your midwife, practice nurse or contact a specialist travel centre.

Be aware of your body

As your pregnancy develops, you will notice certain physical changes within your body, as well as changes to your psychological outlook.

Back pain during and after pregnancy

Pregnancy is a unique and powerful experience, enormous physical, hormonal and emotional changes take place that the body has to cope with in a relatively short time. The body may carry between 22lbs to 28lbs, most of this is from the baby, waters and placenta and this can cause aches and pains during the pregnancy.

A Chiropractor or Osteopath can help with problems such as back pain, leg pain, tension in the neck and shoulders to name but a few. As the body changes shape to accommodate the increased size and weight of the uterus, expectant mothers will benefit from treatment by a Chiropractor or Osteopath to help with posture problems which are caused by these changes.

After giving birth, caring for a new born baby can place a great deal of strain on the back whilst nursing in poor positions, lifting car seats and carrying the baby for example, the body also needs to recover from any effects before and after delivery. Chiropractic and Osteopathic treatment aims to help the mother to return to normal, physically and emotionally, after birth by releasing strains from both pregnancy and labour or a specialist post-natal massage therapist may be able to help you relieve some tension.

Always seek professional advice from a registered Chiropractor or Osteopath. www.gcc-uk.org (General Chiropractic Council) www.osteopathy.org.uk (General Osteopathic Council).

Weight Gain

Weight gain will be an obvious physical sign. In the normal course of events, you will gain 2-4lbs (1-2kg) in the first three months. The average total weight gain during pregnancy is in the region of 22-28 pounds (10-12.5kg). Much of this weight can be attributed to your growing baby, placenta and amniotic fluid but your body will also build up its fat stores to help with breastfeeding.

Morning Sickness

Nausea and sickness is very common in the early stages of pregnancy, but does not often last longer than 16 - 20 weeks. A plain or ginger biscuit before getting out of bed may bring relief. To try to combat morning sickness, frequent small meals high in carbohydrates are easier to digest and will have a better effect than two or three large meals consisting of fatty, highly-spiced foods. If you are vomiting frequently or your life is being hugely impacted by this, have a chat with your midwife as there may be things that can be offered to help.

Other Physical Changes

As the baby grows, your uterus will begin to press against your bladder and you will pass urine more frequently. Further, your usual vaginal discharge will increase, your breasts will feel full and tender, and your nipples will darken in colour and become more pronounced. It is essential, therefore, to wear a comfortable well-fitting bra it is a recommended that you avoid underwired bras if you are intending to breastfeed as these can inhibit your milk supply by blocking your milk ducts.

Changes in hair shade and texture are common, as is a transformation in your skin, it may become blotchy, dry or oily. On the other hand, your skin may ‘bloom’ as a result of the blush caused by an increase in tiny blood vessels on the surface of the skin.

Heartburn and indigestion can occur at any stage in your pregnancy. This can be due to the change in your hormones or as a result of your growing baby pushing on your stomach.

Mood Swings in Pregnancy

Hormonal changes within your body can cause you to have mood swings, you may feel on top of the world one day and in floods of tears the next. Be kind to yourself, it is perfectly natural to worry about the health of your baby and whether you will be able to cope with motherhood, and that’s before you throw hormones into the mix! Such moods do not linger, but it helps to adopt a positive approach.

You may find that your mood swings become more manageable within the second trimester. If you feel like you are unable to manage your moods or you are constantly feeling low then you may need extra help. Around 12% of pregnant women experience depression during pregnancy and about 13% suffer from anxiety.

If you are struggling with depression or anxiety at any time throughout your pregnancy or you are experiencing pre-natal depression then please speak to your midwife or GP to receive the help and support you need.

Cravings in Pregnancy

You may develop sudden food cravings and perhaps lose your appetite for tea and coffee. A metallic taste in the mouth is equally common and should not concern you. Many women experience a heightened sense of smell during pregnancy.

Possible Problems

Now and again during pregnancy, you may experience uncomfortable physical feelings. Most of these will be perfectly natural, but there are certain problems of which you should be aware and able to recognise.

Vaginal Bleeding

While slight vaginal bleeding sometimes occurs in the early months of pregnancy due to a thinning of the cervix or an implantation bleed, it is better to report any signs of bleeding to your midwife or GP immediately.

Bleeding in the later stages may indicate that there is a problem with the placenta and could necessitate early admission to hospital.

You may experience period-type cramps during your pregnancy. These are usually just the result of the muscles of your uterus being stretched by your growing baby (also known as round ligament pain) but it is important to report these pains to your GP or midwife as a precaution as they can indicate something more serious.

Problems with Vision, Abdominal Pain or Headaches

Report any problems with your eyesight including flashing lights behind the eyes and make your GP or midwife aware of any persistent abdominal pain or headaches.

Pre-eclampsia

Risk factors for pre-eclampsia, which poses life threatening dangers to mother and baby. At each antenatal appointment blood pressure is checked for signs of pregnancy induced hypertension (PIH). Also your urine will be tested for protein. Raised levels can be possible signs of pre-eclampsia. Other symptoms can develop like, swollen feet, ankles, face and hands caused by fluid retention, severe headaches, vision problems and pain just below the ribs.

If you notice any symptoms contact your midwife or GP immediately.

Gestational Diabeties

This type of diabetes is a temporary change that can occur during pregnancy and usually disappears within hours of your baby being born. It causes a higher level of sugar in your blood.

At your first antenatal appointment, your midwife or GP will ask questions to determine if you are at an increased risk of gestational diabetes. If you are at high risk then you will be offered an OGTT test (Oral Glucose Tolerance Test) between 24 and 28 weeks pregnant and the test can take around two hours.

If you have had gestational diabetes before then you will be offered the OGTT earlier in your pregnancy. If you do have gestational diabetes then depending on the results, you may be asked to measure your own blood sugar levels, modify your diet by cutting out sugary food, or possibly insulin.

Pelvic Girdle Pain

During pregnancy, your hormones loosen all the pelvic ligaments in order to allow the baby easier passage at birth. However, these ligaments can loosen too much, making the pelvis move when weight is put on it (i.e., the weight of your baby). This can result in mild to severe pain in the pelvic region, and is known as Pelvic Girdle Pain (PGP) or symphysis pubis dysfunction (SPD) and affects 1 in 5 pregnant women.

Pelvic girdle pain usually improves after you have given birth, however for around 1 in 10 women the pain can still be ongoing. It is important to keep receiving treatment and take regular pain medication until your symptoms are better.

You can contact your GP, Midwife or a private clinic/provider who specialises in pre and post-natal health issues.

Waters Breaking

Fluid leaking from the vagina, or waters breaking maybe a sign that you may be about to go into labour. Immediately contact your midwife, GP or maternity hospital.