Do’s and Don’ts in pregnancy

Stages of pregnancy are measured in the following ways:

  • The first day of your last period is first to be known.
  • Assume you became pregnant after your last period started.
  • Your due date is approximated based on the measurements done at your first ultrasound.
  • Measurements in months are counted from the date of conception which means that if you are 10 weeks pregnant or two months pregnant you conceived 8 weeks ago.
  • Pregnancy measurement is also referred to in trimesters.
    • First trimester includes up to 13 weeks pregnancy
    • Second Trimester is from 13 to 26 weeks
    • Third trimester is from 26 weeks till delivery
  • Exact date of conception is difficult to estimate and hence one or two weeks out is normal in the measurement.

Most women deliver close to the due date estimated by the doctors.  The variables are:

  • Normal delivery takes place 40 weeks after the last period.
  • 10% women deliver before the 37th week
  • Delivery is likely to be over the due date for the first delivery.
  • It is safe to deliver 2 weeks over the due date
  • Induction is recommended at 41 weeks if over due
  • C Section, if recommended, is scheduled in the 37th week
  • For twins, the C section is recommended at 37 weeks

Announcing your pregnancy depends entirely up to you.  There is a general fear that pregnancy may end up in a miscarriage so the announcement is delayed till the chances of miscarriage reduce.  The facts and statistics are:

  • 15% of pregnancies result in miscarriage while 85% do not
  • Once heartbeat is determined in the fetus the risk of miscarriage is much lower
    • Risk of miscarriage is less than 5% if heartbeat is determined at 8 weeks
  • After 12 weeks the risk of miscarriage is less than 1%.

What you should eat is given below:

  • Only 300 extra calories per day are required during pregnancy
  • Weight gain target for the first 12 weeks should be 0 to 5 pounds and half or one pound per week thereafter.
  • Frequent small meals are recommended to avoid heartburn and hypoglycemia
  • Eat healthy food and avoid sugars and starches
  • No smoking or alcohol is permitted during pregnancy so that you can have a healthy baby
  • Avoid fish which contain high levels of mercury like shark, tilefish, swordfish and king mackerel
  • Avoid highly processed meat as it may contain bacteria which will be harmful to the baby
  • Avoid unpasteurized milk products for the same reasons
  • Limit intake of caffeine.

It is quite safe to have sex during pregnancy.  The only precaution to be taken is to avoid sex if there is some complications like bleeding, preterm contractions or a low lying placenta.

The portion of hair that is outside the scalp is dead tissue and does not absorb anything into the bloodstream.  Hence if color is limited to only the hair and not the scalp it is totally safe.  However, if the scalp is exposed to chemicals, which are there in a large number of dyes, than those chemicals could enter the blood stream and may affect the baby.  Hence if you have to color your hair then it is safer to use only herbal dyes from reputed manufacturers.

Paints need to be checked for lead content which is poisonous if the fumes are inhaled.  Hence it is safer not to play around with lead based paints while you are pregnant.  Using paints which have no lead content is safe as along as proper ventilation is maintained.

Exposure to hot water for prolonged periods carries the risk of spina bifida during the first 2 months of pregnancy.  Hence it is better to take showers than to immerse yourself in hot water (103 deg F) for long periods in a bath tub

If your cat is confined to the house and does not mingle with any other cat there is no risk in looking after it during pregnancy.  However please note that outdoor cats can be exposed to Toxoplasmosis and this can be passed on to humans through the feces.  Hence you are at risk if you clean the litter box or are in anyway exposed to feces of your cat which has in turn been exposed to this parasite.  Dogs are not affected

Your doctor is the best judge of what vitamins or supplements are required to be taken during pregnancy.  However the general guidelines during different stages of pregnancy are as follows:

  • One month prior to pregnancy and two months after pregnancy
    • 1000 micrograms or 1 mg of Vitamin B or folic acid to reduce risk of spina bifida
    • More Vitamin B if there is a history of spins bifida
  • Continuing with 800 to 1000 micrograms of general multivitamin with folic acid, calcium and iron is recommended during prenatal period along with a well balanced diet.
  • If you are on a well balanced diet than stopping of prenatal vitamins can be considered after two months of pregnancy.
  • After twelve weeks of pregnancy as the baby starts developing bones, 1000 to 1500 mg of calcium is recommended. Do not take calcium and iron supplements at the same time as they offset each other’s absorption.
  • Eating fish at least three times a week is required for EFAs (essential fatty acids). If you do not eat fish then a supplement for essential EFAs is recommended as this will contribute to fewer complications like pre-term labor and pre-eclampsia.  It will also contribute to fetal eye, brain development and healthier hair and nail growth for the moms.

There are large blood vessels that run close to the spine and can get compressed by the pregnant uterus.  This decreases blood flow to the baby as well as to the head causing light headedness and dizziness. Though there is no medical evidence to suggest that lying on the back will be harmful to the baby, it is apparent that lying on the side, left or right will maximize blood flow to the baby.  Hence the following conclusions can be drawn:

  • Till the third trimester, as the baby bump is small, it does not matter if you sleep on the left side or right side or on your back.
  • In the third trimester it is better if you sleep on the left or right side rather than on your back.
  • Choose the position that gets you the most comfortable sleep as sleep is also very important.

Down syndrome is a genetic defect.  There are various reasons for women to have a tendency and these are normally checked by your doctor when your medical profile is generated.  Hence, if the chances for your baby to have this defect or other genetic defects may be more than your doctor may recommend genetic screening tests. If the medical profile does not warrant this than taking these tests is your own option.  It is important to note that practically nothing can be done even if the defect is confirmed other than opt for an abortion

Obstetric ultrasound has been extensively studied and found to be safe for the baby. However it is recommended that this be used only when required and recommended by your doctor and not indiscriminately.

It is necessary to look after your teeth at all times and especially during pregnancy.  Treatment of dental infections of a severe nature is treated by antibiotics which may not be safe during pregnancy.  Dental visits are ok and if any medication is required to be taken than it is better for your dentist to discuss this with your obstetrician.

The C section delivery leaves a scar on the uterus.  There is a very low (1%) chance that during normal delivery this scar could open up leading to expulsion of the baby and the placenta into abdomen.  This is called uterine rupture and leads to a major emergency which could result in death of the baby and cause serious complications to the mother with severe blood loss and hysterectomy.  Hence most doctors would not take the risk and would recommend a C section again instead of a normal delivery.

Presently there is no such banking system to collect and preserve blood from the baby’s cord.  This blood contains stem cells which have a great many current and more future medical uses.  You would need to contact a private company that does this storage of stem cells on payment basis