MEDICAL MONDAYS
TOPIC: PREGNANCY: Before, During & After
Monday, August 9, 2010
Kelly Williams, MD: OB/GYN
Middle Tennessee Medical CenterNews notes via www.webmd.com
Pre-Pregnancy To-Do List
- Take a folic acid supplement every day. This reduces the chance of certain birth defects. Do not wait until you are pregnant to do this.
- Make a doctor's appointment for a checkup/wellness visit.
- Make sure to get and begin taking prenatal vitamins.
- Check with your doctor about any over-the-counter and prescription medications you currently take.
- See your dentist for a cleaning or checkup if you have not done so in the last six months. Untreated gum disease is linked to preterm birth.
- Look into local prenatal exercise classes.
- Review maternity/paternity leave options at work and your health insurance's maternity coverage.
- Develop a maternity and baby budget.
- If you smoke, quit.
- Limit alcohol and caffeine intake.
- Stock your refrigerator with healthy foods and snacks.
Healthy Lifestyle Choices Before, During, and After Pregnancy
- ·Prepare for pregnancy by eating well and taking a daily prenatal vitamin, exercising regularly, getting necessary dental work out of the way, charting your menstrual cycle, avoiding or limiting caffeine, and stopping use of any potentially harmful medicines or illegal drugs, alcohol, and tobacco.
- ·Maintain a healthy pregnancy by eating well, exercising regularly, getting plenty of rest, and avoiding high temperatures and activities that could lead to a fall or abdominal injury, including contact sports. Drink plenty of water before, during, and after you are active. This is very important when it's hot out and when you do intense exercise.
- ·Do pelvic floor (Kegel) exercises during and after pregnancy. They strengthen your lower pelvic muscles. This may help prevent a long period of pushing during labor.8 They also may help prevent urine control problems (incontinence) after childbirth.
- ·Take childbirth education classes to learn what to expect and how to best handle labor and delivery.
- ·Plan ahead for breast-feeding by learning about breast-feeding and finding a good lactation consultant ahead of time, buying necessary supplies, and making advance arrangements for a private place to pump if you plan to work away from your baby after a maternity leave. For more information, see the topic Breast-Feeding.
EXERCISE TIPS
Exercise safely during pregnancy. Try to do at least 2½ hours a week of moderate exercise.9, 10 One way to do this is to be active 30 minutes a day, at least 5 days a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week. Moderate exercise means things like brisk walking or swimming. In addition to moderate exercise, particular stretching and strengthening exercises are also well suited to pregnancy.
NUTRITION TIPS
- ·Strive for proper nutrition and weight gain during pregnancy. Pay close attention to your folic acid, iron, and calcium intake and the need for slow, gradual weight gain.
- ·A vegetarian diet during pregnancy and breast-feeding requires special attention to getting enough protein, vitamin B12, vitamin D, and zinc, in addition to the extra folic acid, iron, and calcium that all expectant mothers need. These nutrients are vital to your fetus's cellular growth, brain and organ development, and weight gain.
- Calcium is an important nutrient, especially during pregnancy. If you can't or don't eat dairy products, you can get calcium in your diet from nonmilk sources such as tofu, broccoli, fortified orange juice or soy milk, greens, and almonds.
- · Getting enough vitamin C may help protect against premature rupture of membranes, according to one study.11 Vitamin C is important for keeping the membranes around the fetus strong and healthy. You can get enough vitamin C by taking your daily prenatal vitamin and eating fruits and vegetables. Common foods that have high vitamin C content include citrus fruits, peppers, tomatoes, berries, broccoli, cabbage, and brussels sprouts.
WHAT TO AVOID
- ·Drug use and medicines that are not approved by your health professional (for example, NSAID use during conception and early pregnancy, which may increase the risk of miscarriage1)
- Papaya, when at all unripe, because it can cause the muscles of the uterus to contract.12 Contractions of the uterus can lead to a miscarriage.
- Caffeine. Or limit your intake to 1 cup of coffee or tea each day.
- Alcohol
- Tobacco smoke
- Hot tubs and saunas
- Sources of food poisoning that may cause listeriosis or toxoplasmosis infection. Some sources may be raw meat, poultry, or seafood; unwashed fruits or vegetables; and cat feces or outdoor soil that cats commonly use.
- Fish that may contain mercury, such as shark, swordfish, king mackerel, tilefish, more than 6oz of white albacore tuna per week, or fish caught in local waters that haven't tested as safe.
- Hazardous chemicals, radiation, and certain cosmetic products
Top Surprises of Life After Baby Arrives
All Your Time Is Baby Time
You may have set the agenda once, but not anymore. Your baby's schedule is now your schedule. Sure, newborns sleep up to 18 hours a day. But that's broken up into small chunks. And between naps, there's feeding, changing, and a whole lot of holding going on.
Tip: After the first hectic weeks, babies take longer naps at predictable times. And you'll become a much better time manager.
Your Relationship Changes
The dynamics have changed. There's one more person to interact with, and that means less time for just you and your partner. If one parent is providing most of the baby care, the other can feel slighted. And couples can get so busy they forget to talk.
Tip: Set aside time for just the two of you. Make a date and share what's happening in each other's life.
Night's No Longer for Sleeping
You remember when night was for sleeping, don't you? Well, your new baby isn't going to let you do that for a while. Until she sleeps through the night, you can limit your sleep deprivation by taking turns with your partner in getting up with the baby.
Tip: During the day, don't try to catch up on chores while the baby sleeps. Lie down and rest.
You'll Have Too Many Visitors
You know that family and friends will want to see the new baby. When they do, they'll bring endless stories about raising their kids and endless advice about raising yours. If you feel up for it, it could be fun.
Tip: If you're feeling overwhelmed with all you have to do, it's OK to say "Let's make it another time." Good friends will understand.
You Need Help
The constant attention that babies demand is exhausting. Ask for help from your partner. Each of you should have time each day while the other is taking care of the baby to do something that's just for you. Watch a favorite TV show, read a book, go for a walk, take a bath.
Tip: If you're a single parent, don't be afraid to ask for help from a friend or relative. Time away will let you recharge.
Babies Are Expensive
The average middle class family spends $225,000 in the first 17 years of a child's life. That's just to provide food, shelter, and other necessities. It doesn't include things like increases in health insurance. Nor does it include saving for college, which is best started early. Babies necessitate a lot of financial planning.
Guilt Is Part of Parenthood
You told yourself you were going to be a top-notch parent – a calming, happy presence. But there are times when you simply don't want to do it anymore. Now you feel guilty that you aren't enjoying every second of parenthood. Don't. It's natural to want a break from baby.
Tip: Ask for help. When the baby's safe in his crib, call a friend. And notice all the things that are going right.
You'll Make Mistakes
All those how-to books you read about parenting, and all those things you swore you would never do ... Maybe in a perfect world there are perfect parents. In the real world, the rule of thumb is you do what works. If your child's too old for a pacifier but it helps him sleep, you'll probably make the "mistake" of letting him keep it. Relax. That's not the kind of mistake that's going to hurt him. When in doubt, ask your pediatrician.