By two weeks after conception, a developing baby is hooked into the mother’s blood supply. By this time, the mother is expecting her period and likely does not yet know that she is pregnant. A great deal happens in the first eight weeks after conception. All of the baby’s organ systems form, from heart, kidneys and bony structures right down to the hair follicles. This is the most critical period of development where, in general, the baby is most at risk from harmful agents. Once the first two months have passed, the baby continues to grow and mature. The baby’s brain grows and develops throughout pregnancy and into childhood. It continues to be at risk for damage.
These days, many couples delay pregnancy. They may wait until they can afford a house and a car, hoping to raise children in good financial circumstances. Some want to establish careers, travel and have other experiences first. Each couple is unique and must decide what is best for them. However, delaying pregnancy can make it more difficult to conceive and have a healthy pregnancy and baby.
Although there is no perfect age for pregnancy, women in their twenties tend to have the best outcomes. As you age, the chances of becoming pregnant drop while the risk of complications increases.
Half of all pregnancies are not expected or planned. As a result, many women have not prepared adequately for pregnancy.
To get ready for pregnancy, a woman should try to be at her healthiest. It is best if she is as close to her ideal body weight as possible. She should be physically active or exercising regularly, and have good sleep habits. Her diet should be balanced, including all food groups, and she should not be skipping meals.
She should also avoid anything harmful to a developing baby, such as smoking, alcohol and certain chemicals including illegal drugs.
A woman with chronic medical conditions such as asthma, epilepsy or diabetes should see her doctor to make sure her condition is stable. She will want to be taking medications appropriate for pregnancy. Ideally every woman should talk with her doctor before conception (when pregnancy begins).
All women planning a pregnancy, or who could become pregnant, should take folic acid supplements of at least 0.4 milligrams each day. Folic acid occurs naturally in leafy green vegetables and has been added to flour products. Most multivitamins and all prenatal vitamins have folic acid. There are benefits from the many other nutrients in these multiple vitamins. It is wise to take them daily before conceiving and throughout pregnancy. Vitamin D supplements are also recommended at higher doses than those found in multivitamins. The dosage ranges from 1000-4000 IU per day depending on the woman’s race, body weight and lifestyle.
During pregnancy, a woman needs about 300 more calories each day. She does not need to ‘eat for two.’ In early pregnancy many women crave certain foods, perhaps because their diet is inadequate in that area.
Developing babies need all the nutrients found in a quality diet. They need essential fatty acids for brain development as well as the calcium found in milk and dairy products or substitutes. They need calories and vitamins found in whole grains and minerals from vegetables and fruits. Pregnancy is not a time to go on a diet that limits these food groups. Prenatal vitamins help ensure that vitamins and minerals most needed in pregnancy are available, but vitamins cannot replace a good diet.
In early pregnancy, women tend to prefer foods least likely to be contaminated. Beef, pork and fish often do not appeal early in pregnancy. These foods come from animals high on the food chain. These animals will have eaten grains and possibly animal proteins that may have been contaminated with pollutants. Such pollutants will be concentrated in the meat.
Early in pregnancy, women often like to eat small amounts of carbohydrate-rich foods such as breads, cereals, pastas and rice. It is not as critical to eat all the food groups early on if nausea is a problem. There will be plenty of time later in pregnancy to balance the diet.
Many food scare stories have been aimed at pregnant women. Unfortunately, it is difficult to tell whether women should be overly concerned with these issues.
Fish – Fresh tuna, shark and swordfish have been identified as sources of mercury contamination, which is harmful to a baby’s developing brain. As these are big fish, they are high on the food chain, and can concentrate mercury in their flesh if their environment is contaminated. Still, since mercury levels in canned light tuna are well within acceptable guidelines, canned light tuna is safe to eat in pregnancy. Other possible contaminants include PCBs and dioxins. Local advisories about fish should be observed.
Limit fresh large fish to one meal per month. Fresh sport fish caught in freshwater lakes should be limited to four meals each month, and should be listed as safe in the provincial fish guides. Salmon is considered safe in pregnancy.
Other seafood – Raw seafood such as sushi and raw shellfish like oysters may carry infections that can be harmful in pregnancy. Buy seafood from a reliable source such as a major food chain and eat it soon after purchase. This food will have met Canadian standards that reduce the risk of infection and may be considered safe in pregnancy.
Listeriosis – Listeria is a rare bacteria found in unpasteurized milks, soft cheeses and deli meats. Pregnant women are much more likely to get sick when exposed to Listeria, and the infection can be deadly for the baby. If you have these foods during pregnancy, eat them steaming hot to avoid any risk. As with seafood, Canadian food safety standards ensure that soft cheeses and deli meats purchased from reliable sources, properly handled and stored, and eaten soon after purchase can be considered safe.
Food poisoning – E. coli, salmonellosis and toxoplasmosis are all infections spread through foods that have not been cooked adequately. Raw eggs, meat and poultry can all be sources. Avoid eggnog and caesar salads made with raw eggs or even partially cooked soft eggs unless you are sure these eggs were pasteurized. Cook ground meat until no pink is left. When preparing raw meats, be careful to wash hands and kitchen surfaces well. Raw sprouts and unwashed fruits and vegetables can also cause infection.
Evidence suggests that unborn babies may be able to actually taste the amniotic fluid in which they float. It is possible that the types of food a mother eats in pregnancy prepare her baby’s tastebuds for that food. This is very early role modeling indeed!
Smoking can lead to higher chances of miscarriage, growth disturbance, preterm birth (when the baby is born too early), stillbirth (when the baby is born dead) and crib death (SIDS), among other things. Problems with the placenta, which the baby uses to take in oxygen and get rid of carbon dioxide and other waste, can also develop. Cutting down or, better still, quitting at any time in pregnancy is best for the health of both baby and mother.
Alcohol is one of the strongest toxins (poisons) around. It can cause damage throughout the entire pregnancy. The more you drink, the greater the chance of damaging your baby’s developing brain and other organ systems. Drinking during pregnancy can cause fetal alcohol spectrum disorder, a lifelong condition that can devastate your baby’s future. There is no known safe level of alcohol in pregnancy. However, do not worry if you had a drink or two before realizing you were pregnant. Just take care to avoid further alcohol in pregnancy.
Understandably, illegal substances such as marijuana, cocaine and crystal meth are all hazardous to pregnancy. Avoid them completely.
Many other toxins are present in our environment, including dry cleaning fluids, cleansers, and industrial solvents. If you are exposed to fumes or chemicals at work, record the information from the chemical label and discuss it with your doctor or midwife, preferably before pregnancy. If fumes make you nauseous or sick, listen to Mother Nature’s instincts and avoid exposure. If someone else in the family works with chemicals such as pesticides, it may be wise to wash work clothes separately to keep the unborn baby safe.
Medications include prescription and over-the-counter medications available without prescription. Pills, elixirs, lotions and patches are all types of drugs. Although many people think any medication is unsafe in pregnancy, a large number of medications are considered safe.
Some medications have known ill effects, but may still be used if the condition they treat could cause worse problems. For instance, untreated depression can mean lost appetite, disturbed sleep, reduced activity and exercise, and in severe cases, attempted suicide. All of these can be unhealthy for the baby. Each medication and medical condition must be assessed for potential benefits and risks. Consult your doctor or midwife about all medications taken in pregnancy.
Herbal products and teas are a separate topic, as they are not regulated like medications. They may not be pure, may vary in concentration, and can be a hazard to baby even though they are ‘natural.’ Echinacea, garlic (in normal cooking amounts) and ginger are probably all safe to use in pregnancy. Discuss all other products with your pregnancy care provider.
It may be surprising to learn that women with good dental health have the best pregnancy outcomes. Although ideally all dental care should be done before pregnancy, do not be afraid to have routine dental check-ups. It is probably best to wait until the back of the teeth can be brushed without gagging to make the dental visit tolerable. Avoid routine dental x-rays at this time.
Women are often too tired to keep exercising during early pregnancy. However, they should resume activity once energy returns. Avoid activities that could lead to trauma (such as rock climbing or contact sports), speed up or slow down suddenly (like bungee jumping or carnival rides), or involve dramatic pressure changes (as with scuba diving and paragliding).
Exercise should not be overly strenuous. A target heart rate of 140 beats per minute or the talk test can be used to keep the level appropriate. To pass the talk test, you should be able to carry on a conversation or talk aloud during exercise without feeling winded or short of breath. As well, air circulation is necessary to avoid overheating during physical activities. Avoid using hot tubs and saunas. For the last half of the pregnancy, try not to exercise in positions that involve lying flat on the back for long times, as this may interfere with the blood supply to the baby.
A woman should make sure she is immune to certain diseases before trying to conceive. The illnesses include rubella (German measles) and varicella (chickenpox). Vaccinations are available for these conditions, and ideally should be given before pregnancy begins. Tests for CMV (cytomegalovirus) and toxoplasmosis can also be done, to discover if she is at risk for these infections. Since toxoplasmosis is often spread in the litter of outdoor cats, changing litter boxes should be avoided.
In pregnancy, testing for sexually transmitted infections (STIs), HIV and hepatitis B is done. A woman can still develop an STI while pregnant, and condoms should be used if her sexual partner could possibly pass on an STI.
Other infections in the community can be harmful to a developing baby. In general, pregnant women should stay away from anyone with a fever and those undergoing radiation therapy for cancer treatment.
Most pregnancies go very well. Listen to Mother Nature when she tells you what and when to eat, what to avoid and when to sleep, and you will be well on your way to the healthiest pregnancy possible. From the moment of conception, aim to give your child the best start possible. Consider it the beginning of true parenting – supply healthy food, remove waste (just like changing diapers), and protect your baby from the hazards of the world.