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

Mother & Baby (Australia) - - Your well being -

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.”

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