To be truly "preventive", prenatal care should begin even before pregnancy as preconception care.
Prenatal care has been shown to lead to more successful pregnancies, births and recovery. The most critical period is the first weeks of pregnancy. Usually, by the time of the first prenatal visit, the major development of the fetus has occurred.
Before Getting Pregnant:
- Quit smoking and avoid alcohol
- Take a folic acid supplement (.4mg every day) at least 2 months before conception
- Make sure immunizations for rubella, varicella and hepatitis B are up to date
- See a health care provider for pre-existing medical conditions (such as diabetes mellitus, high blood pressure, etc.) to make sure these conditions are under good control.
- See a genetic counselor if there are any concerns of genetically linked diseases, especially if they run in the family.
Nutrition/Diet For Pregnancy
Your daily diet should consist of:
- 6 to 11 servings of carbohydrates (bread, cereal, pasta)
- 3 to 5 servings of vegetables
- 2 to 4 servings of fruits
- 3 servings of dairy (milk, yogurt, cheese)
- 2 or 3 servings of meat, poultry, fish, beans and eggs
Avoid the following:
- Undercooked meat, poultry, seafood and hot dogs
- Unpasteurized milk and juices
- Soft-scrambled eggs or foods made with raw or lightly cooked eggs
- Raw sprouts, especially alfalfa sprouts
- Herbal supplements and teas unless discussed with your health care provider
- Swordfish, shark, king mackerel and tilefish, which may contain high levels of mercury
- Raw fish, especially shellfish (oysters, clams)
Fish that are ok to eat include shrimp, salmon, Pollock, catfish, bluegill, sunfish, black and white crappie, yellow perch, bullheads and canned light tuna with limit of 6 ounces a week, or about 1 meal a week. One meal a month of bass, walleye, northern pike, perch or crappie is allowed during pregnancy.
Check with local authorities about mercury levels in other fish caught locally.
Other Things to Avoid During Pregnancy
- Hot tubs or hot baths, because increased temperature can cause spina bifida or other neural tube defects
- Exposure to toxoplasmosis by avoiding raw and undercooked meat, wearing gloves when gardening and avoiding exposure to cat feces (Do not change the litter box.)
- Exposure to cytomegalovirus by washing hands thoroughly when around children and immunocompromised people
- Drinking caffeine (limit to 12 to 24 ounces a day)
- Cigarette smoking, drinking alcohol and street drugs, or those drugs not approved by your health care provider
Cigarette smoking is the most significant modifiable cause of adverse pregnancy results. When inhaling a cigarette, the smoke is in effect clamping the umbilical cord and depriving the developing fetus/baby of oxygen and blood. Lack of oxygen can cause your baby to grow slow and gain less weight in the womb. Smoking during pregnancy has been linked to miscarriage and preterm labor.
Medications To Avoid During Pregnancy:
- Androgens and testosterone by-products
- Angiotensin-converting enzyme (ACE)inhibitors
- Coumadin by-products (warfarin)
- Anti-folic acid drugs (methotrexate)
- Streptomycin, kanamycin, and tetracycline
- Valproic acid
- Vitamin A and its by-product (isotretinoin, etreticnate or retinoid)
Medications That Can Be Used During Pregnancy
- Acetaminophen (Tylenol®)
- Antacids (Mylanta®, Maalox®, Tums®, Rolaids®)
Milk of Magnesium®
Common Genetic Diseases in Certain Ethnic Groups
- Ashkenazi Jews - Tay-Sachs disease
- African Americans - sickle cell anemia
- Mediterranean - Β-thalassemia
- Southeast Asian and Chinese - α-thalassemia
- Northern European - cystic fibrosis
You and your provider should schedule visits every 4 to 6 weeks, for the first 28 to 30 weeks. Visits should be more frequent after 30 weeks. Your health care provider will schedule visits to meet your individual needs (usually 10 to 12 visits during your pregnancy).
A total of 25 to 35 pounds is gained during a normal pregnancy. If you are underweight to start with, you may gain up to 40 pounds. If you are overweight to start with, 15 to 25 pounds or less needs to be gained. A woman usually gains 3 to 6 pounds in the first trimester, then gains 1/2 to 1 pound per week during the second and third trimesters.
Tips To Make Pregnancy Easier
- Ease morning sickness by eating frequent small meals, crackers before getting out of bed and avoiding greasy or spicy food
- Get as much rest as possible, especially during the first and third trimesters, when you usually are the most tired
- Elevate your feet when possible and lay on your left side, especially near the end of your pregnancy
- Do not sit longer than 90 minutes when travelling; walk and stretch to prevent blood clots. Only travel for a maximum of six hours per day
Call your health care provider if you have any concerns during your pregnancy. Call immediately if you notice any of the following:
- Vaginal bleeding
- Steady or heavy discharge of watery fluid
- Chills or fever
- Sudden swelling
- Vomiting more than 2-3 times per day; unable to keep fluids down for more than 24 hours
- Visual disturbances
- Painful urination
- Severe or persistent headaches