What should I do if I am already pregnant?
Congratulations! You have embarked on a rewarding and growth-filled journey, but it will be accompanied by some hard work. Feelings of ambivalence or worry might accompany feelings of happiness. All are normal.
If you haven't already, please read the section above on preparing for pregnancy. The information about nutrition, exercise, medications, drugs and alcohol, and personal support are even more important now that you are pregnant.
Many people assume that prenatal care is what you get at your appointments with your midwife or physician, and certainly, this care is important. (Click for a schedule of prenatal visits. See also a discussion of many of the tests offered during pregnancy.)
The most beneficial prenatal care will be the care that you give yourself and your baby everyday. Although the causes of a few pregnancy complications are unknown, and a few cannot be controlled, many complications can be avoided or minimized by taking good care of yourself. By staying low-risk and healthy, you maximize your options for childbirth.
Good nutrition is essential for a healthy pregnancy and for the growth of the baby. Other than a folic acid supplement of 400 micrograms, most women can get their required nutrients from carefully chosen food and do not need to take vitamins. However, if you are anemic, your midwife or doctor may recommend an iron supplement. Some pregnant women do have a difficult time obtaining enough calcium, iron, protein, and green leafy vegetables.
Other important nutrients include essential fatty acids (especially Omega 3 fatty acids) and choline, both of which help the baby's developing brain and nervous system. If these nutrients are in short supply in your diet, you may wish to add a supplement. Click for sources of key nutrients. More resources about nutrition can be found under Additional Readings. You might need to make adjustments if you have significant nausea or vomiting in your pregnancy.
chart showing extra calories needed during pregnancyWeight gain is expected during pregnancy, but the amount of weight you gain is important. Check a BMI calculator and determine whether you are of normal weight or over or underweight. If you have started out your pregnancy at a normal weight, plan to gain between 25 and 35 pounds. If you are overweight, plan to gain about 15 pounds. If you were underweight, plan to gain between 28 and 40 pounds. The amount of extra food a pregnant woman needs is not large. If you are of average weight and are moderately active, you need the same amount of calories in your first trimester as you did before you were pregnant. In your second trimester, you need 350 calories more a day; and in your third trimester, only 500 extra calories are needed per day. (Three hundred calories is the equivalent of three glasses of non-fat milk or a peanut butter sandwich.)
Exercising and eating well can help keep your blood sugar in a normal range and can help you avoid having a very large baby. Exercise also helps you build strength and endurance, which are important for coping with labor. Resources about exercise are listed under Additional Readings.
pregnant woman meditatingIt is also important to pay attention to your emotional health during pregnancy. Stress is very common in our society; and, women often experience additional worry and fear during pregnancy. You might find that you worry about the baby, becoming a mother, finances, the change in your family, or many other things. Our system of healthcare, which often focuses on problems, may add to these worries with the various screening tests offered in pregnancy. It is a good idea to find a stress-reduction technique that you like and start practicing early in your pregnancy. Some good options include guided imagery, breathwork, meditation, or yoga with an instructor who is experienced in teaching pregnant woman. See the Mind-Body Therapies topic for more information on these and other helpful therapies and practices. A great book on self-care and growth by Jennifer Louden is included below under Additional Readings.
You should avoid most environmental toxins during pregnancy. A brief list of things to avoid is included below:
Toxoplasmosis: Wear gloves when gardening, do not consume raw meat products, have someone else change a cat litter box if you have one, and wash your hands after playing with your cat.
Lysteria: Avoid unpasteurized milk.
Mercury: Avoid tuna and other large fish.
Hot tubs/saunas: Excessive heat can affect the developing baby's central nervous system.
Alcohol: No amount of alcohol is safe during pregnancy and can contribute to fetal alcohol syndrome.
Tobacco: Tobacco use can affect the baby's growth and adversely affect your blood pressure. Even cutting back helps, if you are unable to stop completely.
Most medications: Discuss any medications, supplements, and herbs that you take with your health care provider to discuss safe alternatives.
Viruses: Regular handwashing is important for everyone, but especially important if you work with young children (to help prevent exposure to Fifth's disease, cytomegalovirus, chicken pox, and rubella).
Home products: Switch to the least toxic products you can find. Wear gloves, keep the area well ventilated, and wash your hands when you are finished.
The workplace: Some jobs present specific risks to the developing baby. For example, you might be exposed to lead or other chemicals. Discuss your work with your care provider to help identify any potential risks. You can also ask your employer for the Material Safety Data Sheet for any substances that you might be exposed to at work, and bring a copy of this to your care provider.