Parenting: Pregnancy

So, you've just taken the test and it came back with those unmistakable lines. Congratulations, you're pregnant! Whether you've been trying to conceive for months and months or if you and your partner have been given a surprise, you may think your job is over now that you have become pregnant. Think again.

Pregnancy takes each mother-to-be on an emotional and physical journey filled with ups and downs, so it is of the utmost importance for Mom to keep herself healthy. Here are a few tips to help achieve a fit and healthy pregnancy:

1. Take Your Vitamins
Right now, you are working on one of the most important jobs you'll ever undertake. You are growing a baby, and you need to take in the right kinds of nutrients, vitamins and minerals to keep you and your little one healthy.

The March of Dimes and the United States Public Health Service both recommend that a pregnant woman consume approximately 400 micrograms of folic acid every day prior to and during pregnancy.

Folic acid supplements have been shown to significantly decrease the incidence of neural tube defects (such as spina bifida). Natural sources of folic acid include orange juice, peas and green leafy vegetables.

"Folic acid is a water soluble vitamin and does not build up in tissues," says Dr. Marguerite Lisa Bartholomew, maternal-fetal medicine specialist at Cedars Sinai Medical Center in Los Angeles, Calif. She says that folic acid should be in the woman's system prior to pregnancy, at conception and during the first three to four weeks of gestation.

2. Eat Healthily
Pregnancy is a great time to eat delicious, balanced foods. According to the March of Dimes, an expectant woman needs only 300 extra calories per day in order to support her unborn baby's growth and development.

"A well-balanced diet and a daily prenatal vitamin are usually sufficient to supply the extra nutrients required for pregnancy," says Dr. Bartholomew. "The Food and Drug Administration recommends between 6 to 11 servings of complex carbohydrates (whole grain bread, sugar-free cereal, pasta), three to five servings of vegetables, two to four servings of fruit, three servings of dairy and two to three servings of proteins per day. Fats, oils and sugars should be used sparingly."

3. Gain Weight Sensibly
Dr. Marjorie Greenfield, associate professor of obstetrics and gynecology at University Hospitals of Cleveland and Case School of Medicine and who recently updated Dr. Spock's Pregnancy Guide (Simon Schuster, 2003), advises the "ideal weight gain is 25 to 35 pounds during the pregnancy, with 7 to 10 pounds in the first half of the pregnancy, and 1/2 pound a week after that. Many women tend to gain more than that, and women who start off their pregnancy being overweight can probably gain slightly less and still do well."

Some of the biggest obstacles that a pregnant woman faces with an excess amount of weight gain are the serious medical conditions that she puts herself at risk for. "Excess weight gain can lead to excessively large babies, with some increase in the risk of complications of childbirth," says Dr. Greenfield, who adds that a mom-to-be may also experience a struggle in losing the weight after she has given birth.

4. Break the Caffeine Addiction
Caffeinated beverages offer no nutritional value. Caffeine contains a stimulant that can increase heart rate and metabolism that may in turn cause stress to a developing baby.

"Ideally, a mom should try to decaffeinate before she gets pregnant, since many caffeine drinkers get withdrawal headaches if they stop cold turkey," says Dr. Greenfield. She suggests that it may be best to avoid caffeine in the first trimester and to use it sparingly after that.

Dr. Bartholomew, however, feels that some caffeine intake is OK. "A woman does not have to give up her morning coffee during pregnancy," she says. "One or two cups of coffee per day does not pose a problem during pregnancy. The recommendation is to limit caffeine intake to less than 300 milligrams a day."

5. Up Your Water Intake
Most expectant women need approximately eight 8-ounce glasses of water per day during the course of their pregnancies. "We encourage pregnant women to meet that recommendation for many reasons, since dehydration can cause water retention, preterm contractions, constipation, headaches, irritability and urinary tract infections," says Dr. Bartholomew.

Drinking water may also ease constipation. "Hydration is important in softening the stool, which eases constipation," says Dr. Ashi Daftary, assistant professor of obstetrics and gynecology at the University of Pittsburgh Medical Center in Pennsylvania.

6. Make Sure You Get a Flu Shot
Most prenatal care specialists recommend that a woman have all of her vaccinations up to date prior to conception. "Live or live attenuated vaccines are usually avoided during pregnancy because of a theoretical risk of transmitting the virus to the fetus," says Dr. Bartholomew.

Unfortunately, an expectant woman cannot always avoid becoming sick at least once during her pregnancy. "Pregnant women have slightly impaired immune systems and this makes them more susceptible to getting very sick if they get infected with a cold," says Dr. Greenfield. "It is always an issue about how to treat symptoms of a cold or flu, since we don't like to have pregnant women exposing their babies to a lot of medications."

The American College of Obstetrics and Gynecologists (ACOG) recommends that all pregnant women receive a flu vaccination after they have completed their first trimesters if they are going to be pregnant during the flu season (which runs from October to March). "Pregnant women who get the flu have an increased risk of developing serious complications," says Dr. Bartholomew. She says the vaccine is inactivated and is considered safe for both pregnant women and their fetuses.

7. Get Up and Move
Unless a mother-to-be has specific medical conditions that advise against it, expectant women should exercise moderately during the course of their pregnancies. The ACOG's newest guidelines recommend moderate exercise for at least 30 minutes on most days.

"Although the best time to begin an exercise program is before pregnancy, moderate exercise during pregnancy is important," says Dr. Bartholomew. Not only can exercise help relieve stress, it can build up the strength and stamina an expectant mom will need to deliver her baby. Also, according to the March of Dimes, there has been evidence that exercise may help to prevent gestational diabetes (a form of diabetes that can develop during pregnancy).

Be cautious, however, about the type of exercise routine that you choose (pregnant women should avoid activities that may put themselves and their unborn baby at risk, including horseback riding, skiing, ice hockey, kickboxing and/or soccer.) Always be on the lookout for telltale signs that suggest that you may be overdoing it.

"Notify your physician if you experience any type of injury, vaginal bleeding or leaking, shortness of breath, dizziness, chest pain, muscle weakness and regular contractions during exercise or at any time," says Dr. Bartholomew.

8. Keep Up With Self Breast Exams
Since the majority of breast cancers have been detected through self breast exams, they are recommended monthly for all women.

Self breast exams are usually best performed right after your monthly period has ended. However, during pregnancy, the rules change.

Dr. Bartholomew recommends that a pregnant woman notify a health care provider about any findings that may be of concern. "Breast discharge can be normal during pregnancy, but you should always be evaluated by a care provider," she says. "A breast exam is usually performed by your care provider during the first prenatal visit and may be repeated at your postpartum visit. Mammograms, breast ultrasounds, MRIs and breast biopsies can be safely performed in pregnancy, if needed."

9. Be an Active Participant in Your Care
It is vital that an expectant mom find a health care provider who will make her feel comfortable and will listen to her concerns during pregnancy. "The importance of getting involved in your own pregnancy cannot be stressed enough," says Dr. Bartholomew. She says that every expectant mom-to-be, owes it to herself to be her own advocate. "Be honest about your history, learn the names of your medications and ask questions if you don't understand something," she says.

Most specialists concur that they too want to make sure each woman is an informed and satisfied patient during her precious months of pregnancy. "I appreciate a patient with an interest in her health and who kindly tells me what is on her mind, even if she is unhappy with what is going on," says Dr. Bartholomew. "Doctors are people too, and we want you to be informed. You must have a sense of trust in your physician and be comfortable with the care plan."