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Staying healthy during pregnancy

Larissa Hirsch, MD Now that you're pregnant, taking care of yourself has never been more important. Of course, you'll probably get advice from everyone - your doctor, family members, friends, co-workers, and even complete strangers - about what you should and shouldn't be doing. But staying healthy during pregnancy depends on you, so it's crucial to arm yourself with information about the many ways to keep you and your baby as healthy as possible. Prenatal Health Care Key to protecting the health of your child is to get regular prenatal care. If you think you're pregnant, call your health care provider to schedule an appointment. You should schedule your first examination as soon as you think that you are pregnant. At this first visit, your health care provider likely do a pregnancy test, and will figure out how many weeks pregnant you are based on a physical examination and the date of your last period. He or she will also use this information to predict your delivery date (however, an ultrasound performed sometime during your pregnancy will help to verify that date). If you're healthy and there are no complicating risk factors, most health care providers will want to see you: every 4 weeks until the 28th week of pregnancy then every 2 weeks until 36 weeks then once a week until delivery Throughout your pregnancy, your health care provider will check your weight and blood pressure while also checking the growth and development of your baby (by doing things like feeling your abdomen, listening for the fetal heartbeat starting during the second trimester, and measuring your belly). During the span of your pregnancy, you'll also have prenatal tests, including blood, urine, and cervical tests, and probably at least one ultrasound. If you still need to choose a health care provider to counsel and treat you during your pregnancy, there are several options: obstetricians/gynecologists (also known as OB/GYNs - doctors who specialize in pregnancy and childbirth, as well as women's health care) family practitioners (doctors who provide a range of services for patients of all ages - in some cases, this includes obstetrical care) certified nurse-midwives (advanced practice nurses specializing in women's health care needs, including prenatal care, labor and delivery, and postpartum care for uncomplicated pregnancies; there are also other kinds of midwives, but you should look for one with formal training who's been certified in the field) Any of these is a good choice if you're healthy and there's no reason to anticipate complications with your pregnancy and delivery. However, nurse-midwives do need to have a doctor available for the delivery in case an unexpected problem arises or a cesarean section (C-section) has to be performed. Now that you're eating for two (or more!), this is not the time to cut calories or go on a diet. In fact, it's just the opposite - you need about 300 extra calories a day, especially later in your pregnancy when your baby grows quickly. If you're very thin, very active, or carrying multiples, you'll need even more. But if you're overweight, your health care provider may advise that you consume fewer extra calories. Healthy eating is always important, but especially when you're pregnant. So, make sure your calories come from nutritious foods that will contribute to your baby's growth and development. Try to maintain a well-balanced diet that incorporates the dietary guidelines including: lean meats fruits vegetables whole-grain breads low-fat dairy product By eating a healthy, balanced diet you're more likely to get the nutrients you need. But you will need more of the essential nutrients (especially calcium, iron, and folic acid) than you did before you became pregnant. Your health care provider will prescribe prenatal vitamins to be sure both you and your growing baby are getting enough. But taking prenatal vitamins doesn't mean you can eat a diet that's lacking in nutrients. It's important to remember that you still need to eat well while pregnant. Prenatal vitamins are meant to supplement your diet not be your only source of much-needed nutrients. Most women 19 and older - including those who are pregnant - don't often get the daily 1,000 mg of calcium that's recommended. Because your growing baby's calcium demands are high, you should increase your calcium consumption to prevent a loss of calcium from your own bones. Your doctor will also likely prescribe prenatal vitamins for you, which may contain some extra calcium. Good sources of calcium include: low-fat dairy products including milk, pasteurized cheese, and yogurt calcium-fortified products, including orange juice, soy milk, and cereals dark green vegetables including spinach, kale, and broccoli tofu dried beans almonds Pregnant women need about 30 mg of iron every day. Why? Because iron is needed to make hemoglobin, the oxygen-carrying component of red blood cells. Red blood cells circulate throughout the body to deliver oxygen to all its cells. Without enough iron, the body can't make enough red blood cells and the body's tissues and organs won't get the oxygen they need to function well. So it's especially important for pregnant women to get enough iron in their daily diets - for themselves and their growing babies. Although the nutrient can be found in various kinds of foods, iron from meat sources is more easily absorbed by the body than iron found in plant foods. Iron-rich foods include: red meat dark poultry salmon eggs tofu enriched grains dried beans and peas dried fruits dark leafy green vegetables blackstrap molasses iron-fortified breakfast cereals The Centers for Disease Control and Prevention (CDC) recommends that all women of childbearing age - and especially those who are planning a pregnancy - get about 400 micrograms (0.4 milligrams) of folic acid supplements every day. That can be from a multivitamin or folic acid supplement in addition to the