The (new) rules... NOW THAT YOU’RE pregnant
The earlier you start to make your health a top priority, the greater the benefit. Here’s what you need to know about staying fit and well while waiting for baby
You’ve seen both lines come up on your pregnancy test and the excitement has started to sink in… closely followed by worry. What should you eat? What should you avoid? Can you still exercise? Learning you’re pregnant opens up a whole new world of concerns about what you need to be doing (or not doing). So we’ve outlined some of the biggest must-knows for mums-to-be.
1 TICK THE HEALTH CHECK BOXES
Brisbane obstetrician Dr Gino Pecoraro says while at-home pregnancy tests are extremely accurate, you’ll still need to see your doctor by the time your pregnancy is six to seven weeks to have it confirmed and have a health assessment. The first visit will involve a general check-up, urine test, blood pressure check, breast exam and a Pap test, if you’re due for one. Blood tests can also identify infections, clotting disorders, diabetes, thyroid problems and vitamin deficiencies that can influence your pregnancy. Your GP can also provide a referral to an obstetrician.
Whenever you have a health check, it’s a good idea to be prepared by taking a list of questions and details of any medications, dietary supplements or herbal remedies.
“Pregnancy brain is real – many women have trouble keeping track of numbers, facts and dates,” says Gino. “Write things down and take someone with you to your appointments as you might have trouble recalling everything that your doctor says.”
If your pregnancy is low-risk, you can book monthly check-ups for the first 28 weeks, fortnightly for weeks 28 to 36 and then weekly until your baby arrives. Other recommended tests include the following.
SCANS Some women have seven or eight over the course of their pregnancies, but an ultrasound at 18 to 20 weeks is important to check your baby’s heart and brain, as well as the placenta.
BLOOD TESTS After your first visit, you’ll have blood tests at 28 and 36 weeks.
ORAL HEALTH CHECK This is because some dental conditions increase your risk for miscarriage or premature labour.
IMMUNE STATUS You’ll be offered a flu shot and whooping cough vaccine for both you and your close family members.
GLUCOSE TOLERANCE TEST A check for gestational diabetes occurs at 28 weeks.
BLOOD PRESSURE Expect this at every antenatal check-up as high blood pressure can be a sign of pre-eclampsia, a form of hypertension that can be life-threatening to you and your baby if left untreated.
2 PLAN AN EXERCISE SCHEDULE
Exercise is important during pregnancy and increasing your fitness can improve your endurance for childbirth, too. Always check with your health care professional before starting any new physical activity. But, says Liz Lush, a
3 STAY HYDRATED
During pregnancy your body needs eight to nine litres of extra fluid, comprised largely of amniotic fluid and extra blood. Most of it happens in the first trimester, but over the course of your pregnancy you’ll also lose more fluid than usual in urine and sweat.
Sydney obstetrician Dr Rob Buist, creator of aquamamma, a hydration beverage specifically designed for pregnant women and breastfeeding mums, says you need to drink more fluids when you’re pregnant.
“Australasian authorities recommend pregnant women drink 2.3 litres of fluid per day,” he says. “This figure should increase if you are vomiting, exercising or are in labour.”
Your hydration status also affects amniotic fluid volume. The amniotic fluid performs many functions and is critical for bub’s lung development.
“It acts as a buffer to prevent compression of the umbilical cord, so it plays a critical role in supporting the delivery of oxygen and nutrients to the baby,” Rob says. “Low amniotic fluid levels can cause compression of the umbilical cord which can – in rare circumstances – be harmful for bub.”
physiotherapist specialising in obstetrics and fitness at mummyandco.com.au, as long as you’re healthy and medically stable, you should include some form of exercise on your daily schedule.
If exercise isn’t usually your thing, start off slowly and increase gradually, aiming for 20 to 30 minutes of moderate intensity exercise on most days. Moderate intensity means you find the activity challenging but you can still talk while doing it, Liz says. If you’re already physically active, the latest guidelines allow you to continue at a similar intensity throughout your pregnancy – with a few conditions.
“Contact sports, hot yoga, scuba diving or activities with a high risk of falling are on the definite ‘no’ list during pregnancy,” Liz says. “And when you’re exercising, be aware that you will burn more kilojoules and lose more fluid when you’re pregnant, so stay hydrated and have a healthy snack 20 minutes before your workout to avoid low blood sugar while you exercise.”
Prolonged holds in deep lunges, squats, planks or prolonged lying on your back can cause injury, so opt for smooth, controlled movements. Comfortable activities include water-based exercise, pregnancy Pilates or using equipment like the stationary bike and elliptical trainer. “Some women find using an elliptical trainer with a backwards movement more comfortable,” says Liz. “Make sure it’s first adjusted to your stride.” A women’s health physio can show you how to modify workouts for pregnancy.
4 EATING FOR TWO?
Actually, it’s more like eating for 1.2, so you don’t need to eat much more than you would normally. Dietitian Sharon Rochester, from babyarrivals.com.au, says during the first trimester, there are no added kilojoule/ energy increases. In the second and third trimesters this gradually increases to a total of about 1900kJ/day – the equivalent to a couple of extra nutritious snacks.
“We do suggest pregnant women increase their vitamin and mineral intake to include more folate and iodine though, so a daily pregnancy-specific multivitamin is recommended,” Sharon says.
A healthy, protein-rich diet with plenty of fresh fruit and veg will provide the right nutrition for you and your baby. Some foods are off the menu, however, to avoid a bacterial infection from listeria, which can pass through the placenta and put your baby in danger. These foods include soft cheeses and processed meat products. ”Also, make sure you consume any leftovers within 24 hours and ensure they’re thoroughly reheated,” says Sharon.
5 PREPARE YOUR PELVIS
If you’ve never done pelvic floor exercises before, now is the time to start. During pregnancy, your pelvic ligaments will soften in preparation for childbirth. Urine leakage is common during pregnancy, especially as your baby grows bigger and pushes on your bladder.
Strengthening your pelvic floor muscles can help but it’s important to make sure you’re doing the exercises right, says Liz. “One in three women aren’t doing their pelvic floor exercises correctly and could actually be making the problem worse.”
A physio can assess your pelvic floor strength and check you’re doing the right thing. The muscles you’re targeting are the same ones you’d use to stop yourself weeing but it is possible to overdo it – if you’re a ‘constant clencher’, you could end up weakening your pelvic floor. Liz advises gently squeezing those muscles, holding for the count of three breaths and then gently relaxing your pelvic floor, repeating eight to 10 times. Do this three times a day and you’ll strengthen your pelvic floor.
“We know the pelvic muscles take a pounding during childbirth and at times during pregnancy,” says Liz. “These include baby growth spurts and if you cough a lot, vomit violently or become constipated and have to strain on the toilet.”