Healthy Living
The months before you get pregnant is the best time to take steps to be healthier.
These steps may include: Eating a healthy diet and taking a prenatal vitamin.
In general, a healthy lifestyle predating pregnancy and throughout pregnancy is associate with a healthy outcome.
- Getting regular exercise
- Reaching and maintaining a healthy weight
- Stopping unhealthy substances (tobacco, alcohol, marijuana, illegal drugs, and prescription drugs taken for a nonmedical reason)
- Keeping your environment safe
Pre-Pregnancy Weight
Abnormally high or low BMI is associated with infertility and maternal and fetal complications during pregnancy.
Women who are obese prior to becoming pregnant have an increased risk of having babies with certain birth defects than women who are a normal weight.
Among the most common obesity-related birth defects are NTDs, heart defects, and cleft palate. If you are planning a pregnancy, the best way to prevent problems caused by obesity is to be at a normal weight before you get pregnant.
- Keep in mind that losing even a small amount of weight may improve your overall health. This can be done through physical activity and diet.
- Regular physical exercise improves cardiovascular health, reduces obesity and associated medical comorbidities, and improves longevity. Patients should exercise moderately at least 30 minutes a day, 5 days a week, for a minimum of 150 minutes of moderate exercise per week.
- The benefits of exercise in pregnancy increases the chance of a successful vaginal delivery in addition to lowering the risk of developing gestational diabetes, hypertension, and preterm delivery.
BMI
There are four categories of weight that are based on BMI:
- Underweight—BMI of less than 18.5
- Normal weight—BMI of 18.5 to 24.9
- Overweight—BMI of 25 to 29.9
- Obese—BMI of 30 or greater
Nutrition
You should base your diet on healthy Mediterranean foods.
The best way to lose weight is by making changes in your diet and by being more physically active.
Healthy eating is important at every age, as well as during your pregnancy. Avoid “eating for two” approach. When deciding what to eat or drink, choose options that are full of nutrients. It’s important to eat a variety of fruits, vegetables, grains, protein foods, and dairy or fortified soy alternatives.
Portions control is Key.
Cutting back on your daily calories is a good first step.
An easy wat to calories is to avoid sugary drinks such as sodas and to pay attention to the amount of food you eat.
You’ll want to limit sugar-sweetened beverages, such as soda or sweet tea, which are very high in added sugar. Fruit juice would be OK to include in moderation, but you’re better off choosing whole fruits to get the benefit of fiber.
Water should be your go-to beverage on a Mediterranean diet.
During pregnancy you should drink 8 to 12 cups (64 to 96 ounces) of water every day. Water has many benefits. It aids digestion and helps form the amniotic fluid around the fetus. Water also helps nutrients circulate in the body and helps waste leave the body.
Coffee and tea are also healthy beverage choices on the Mediterranean diet. Be mindful of adding lots of added sugar or cream.
Caffeine
Research suggests that moderate caffeine consumption (less than 200 milligrams per day) does not cause miscarriage or preterm birth. That’s the amount in one 12-ounce cup of coffee. Remember that caffeine also is found in tea, chocolate, energy drinks, and soft drinks.
Caffeine can interfere with sleep and contribute to nausea and light-headedness. Caffeine also can increase urination and lead to dehydration.
Recreational Drug Use and Alcohol
Use of substances—tobacco, alcohol, marijuana, illegal drugs, and prescription drugs taken for a nonmedical reason—can cause serious problems for your pregnancy and your fetus, including:
- Birth defects
- Low birth weight
- Preterm birth
- Stillbirth
Alcohol can interfere with the normal growth of the fetus and cause birth defects.
When a woman drinks during pregnancy, her fetus can develop physical, intellectual, behavioral, and learning disabilities that can last a lifetime.
Using illegal drugs early in pregnancy can cause birth defects and miscarriage.
During the later weeks of pregnancy, illegal drugs can interfere with the growth of the fetus and cause preterm birth and fetal death.
Infants born to women who used illegal drugs during pregnancy may need specialized care after birth.
Recreational marijuana used during pregnancy is associated with attention and behavioral problems in children. Marijuana may increase the risk of stillbirth and the risk that babies will be smaller than babies who are not exposed to marijuana before birth. Medical marijuana also should be avoided.
Vaccination
The preconception period offers a unique opportunity to find your immunization records and review them with your primary care provider. Some vaccines should be considered for all women who are hoping to conceive. Others are recommended based on additional medical issues.
Vaccines recommended in pregnancy have proven to be safe in all trimesters. Since 2004 the CDC and ACOG have recommended vaccinations such as influenza during any trimester.
Getting your flu shot in anticipation of pregnancy will help protect you during flu season. Flu shots are generally available each year from late August through March to correspond with the influenza season (though timing may vary by region). If you could be pregnant, ask for the inactivated influenza vaccine.
- An influenza vaccine during flu season can protect women from severe medical and obstetrical complications, and provide protection for babies during early infancy. It can be safely given any time during pregnancy.
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Even healthy pregnant women can become severely ill and die from influenza infection.
“The flu shot makes me sick.”
While some patients may feel achy or fatigued after the flu shot, this is a sign that your immune system is working in response to the vaccine. Because the flu vaccine is made from a killed virus, you can’t get the flu from the vaccine.
The nasally administered live vaccine (LAIV, Flumist) is not recommended for women who may be pregnant, although children in your home can safely have this version of the vaccine.
Given the ongoing global measles outbreak, the Centers for Disease Control and Prevention (CDC) and American College of Obstetrics and Gynecology (ACOG) recommend assessing measles immunity before a woman becomes pregnant. A blood test can be ordered to evaluate your immunity and to see if a booster shot is needed.
The MMR booster shot is a live-attenuated (weakened) virus vaccine. After a woman receives it, the CDC recommends waiting four weeks before attempting pregnancy because of theoretical risks to the fetus with live vaccines. However, if a pregnancy occurs within the four-week window, do not worry! This recommendation is based on theoretical risks. In fact, there have been no reports of harm to a fetus due to this type of exposure.
Many women of childbearing age have either had chickenpox (varicella) or received the vaccine during childhood. Because chickenpox can harm a pregnant woman and her fetus, assessing your immunity to chickenpox is a good idea before conceiving. If you’re not immune, this is a good time to have the vaccine. Similar to the MMR booster, the VZV vaccine is a live-attenuated virus vaccine. A woman should have this vaccine at least four weeks before attempting to conceive, due to the theoretical concern for fetal exposure.
- A tetanus, diphtheria, and pertussis (Tdap) vaccine can be given during the third trimester. This protects against pertussis (whooping cough) in pregnant women who might pass it to their babies during delivery, and also protects babies during early infancy when pertussis can be life-threatening. Additionally, Tdap is recommended for anyone who has not received the vaccine and will be in close contact with infants less than a year old, such as grandparents or childcare providers.
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Vaccination during pregnancy gives newborns passive immunity, which protects them from pertussis until they are able to get their vaccination at 2 months.