What to Expect When You’re Expecting
by Heidi Murkoff
- Ashto =
- Jonesy =
What You Will Learn from What to Expect When You’re Expecting
What to Expect When You’re Expecting is one of the best go-to manuals for new parents around the world. In this book, Heidi Murkoff explains the week-to-week overview of pregnancy and touches on important points such as diet, self-care, and possibilities of complications. This book also prepares expectant parents by addressing problems and issues regarding today’s rapidly changing society and how it affects the use of alternative medicine, assisted conception, and various options for labour and delivery.
This week, Ashto and Jonesy learn the basic knowledge you need to have when you (or your partner) fall pregnant and a few basic do’s and don’ts about pregnancy that you may not have thought about before. Revised and adapted to meet best Australian practices, any expectant parent should consider reading What to Expect When You’re Expecting to understand the basics of pregnancy.
Lifestyle Do’s and Don’ts When You’re Expecting
Now that you’ve gone through the initial details of your pregnancy, here’s some of the important stuff you need to know about yourself and your risk profile.
Most overweight moms have completely safe pregnancies and completely healthy babies. But carrying a lot of extra weight while you’re carrying a baby increases the possibility of certain pregnancy complications, including miscarriage, birth defects, stillbirth, preterm birth, high blood pressure, and gestational diabetes (GD).
Being overweight poses some practical pregnancy problems, too. The extra layers of fat may make it trickier for a practitioner to determine a fetus’s size and position. And prolonged labor and difficult delivery can result if a baby is much larger than average, which is often the case when the mom is obese (particularly if she’s diabetic). If a cesarean delivery is necessary, obesity can complicate both the surgery and recovery from it. Then there’s the issue of pregnancy discomfort – unfortunately, as the pounds multiply, so do those uncomfortable pregnancy symptoms. Extra pounds of weight can cause extra backache, varicose veins, swelling, heartburn, and more.
You need to add roughly around 300 calories to your daily calorie intake while pregnant, so it’s not the right time to be losing weight during pregnancy. The ideal solution to this is getting to your ideal weight before falling pregnant. It will make everything about pregnancy a lot easier and less complicated.
Pregnancy Is definitely a time for eating well and gaining weight. If you’ve come into pregnancy on the super-skinny side (with a BMI of 18.5 or less), you’ll have to be filling up your plate even more. That’s because there are some potential risks (such as having a small-for-date baby and preterm birth) associated with being pregnant and extremely underweight, particularly if you’re also undernourished. Any added risk can be eliminated by eating well (getting plenty of calories and nutrients), taking a prenatal vitamin, and gaining enough weight. Most people are supposed to gain around 25-35 pounds (10-12 kgs) in pregnancy; so if you’re already skinnier it might be recommended to put on more like 30-40 pounds instead.
Around 15% of women of childbearing age battle bouts of depression, so you’re far from alone. Luckily, with the right treatment, women with depression can have perfectly normal pregnancies – and happy ones, too. However, when it comes to the use of medications, you should consult your mental health care provider and your prenatal practitioner to weigh the risks and benefits of taking meds (or not taking them).
Maybe it seems like a simple decision to make but it’s actually a lot more complicated than that. For starters, pregnancy hormones can heavily impact your emotional state. Women with a history of depression are especially at greater risk of having depressive bouts during pregnancy and are more likely to suffer from postpartum depression.
Untreated depression isn’t likely to affect only you (and those you’re close to) – it’s also likely to affect your baby’s health. Depressed moms-to-be may not eat or sleep well or pay as much attention to their prenatal care, and they may be more likely to turn to unhealthy lifestyle habits, like drinking or smoking. Any or all of those factors, combined with the debilitating effects of excessive anxiety and stress, have been linked in some studies to an increased risk of preterm birth, low birth weight, and a lower Apgar score for babies.
So what does all this mean? It means you should consult both with your prenatal practitioner and the doctor or therapist who has been treating you for depression before you decide what your next move should be.
Being over 35 years old
The risks of pregnancy are very small to begin with, and rise only slightly and gradually as you get older. If anything, most of the risks that do rise can be reduced, or even eliminated. The major reproductive risk faced by a woman over 35 (an age group perhaps unfairly referred to as ‘advanced maternal age’ or AMA) is that she might not become pregnant due to the slight and very gradual decline in fertility that begins once a woman has exited the optimum fertility window of her early 20s. If you conceive, you face a somewhat increased chance of having a baby with down syndrome.
It’s speculated that the gradual rise in this and other chromosomal abnormalities are most often linked to an older woman’s older eggs (women are born with a lifetime supply of eggs that gradually age along with her). However, an estimated 25% of down syndrome cases and other chromosomal abnormalities are the result of a defect in an older dad’s sperm. Because older moms are often married to older dads, it’s not always clear whether it’s mom’s age or dad’s age that’s implicated.
A handful of other pregnancy quirks related to older mums:
- Older moms are more likely to conceive twins (even if they’ve conceived naturally), thanks to an age-related predisposition to releasing more than one egg at a time.
- Increasing age also increases the risk of miscarriage (because of an older mom’s older eggs), preeclampsia, gestational diabetes, and preterm labour.
- Labour and delivery are longer and slightly more likely to be complicated (often because the pregnancy is higher risk, to begin with), with higher c-section rates in older moms, too.
Your Pregnancy Lifestyle
Of course, you’re expecting to make some adjustments in your everyday life now that you’re expecting. But you might also be wondering just how drastically your lifestyle will have to change now that you’re living for two. Does being pregnant really mean you have to think twice about all those things you’ve never given a second thought to – from letting your best friend smoke in your living room to zapping your dinner in the microwave?
Workouts are not only a can-do for most pregnant women but a definite should-do. In fact, the vast majority of workouts work well with the vast majority of pregnancies, which means you can almost certainly count on continuing your usual routine through your 9 months. Just make sure to check in with your practitioner for the all-clear on your current workout regimen or before beginning a new one. Also, remember this mama-to-be mantra: Listen to your body. Don’t exercise until you drop or until it hurts. Instead, make moderation your pregnancy workout plan.
There’s no need to give up your morning coffee completely. Most evidence suggests that drinking up to about 200 mg of caffeine (one cup of coffee) a day is perfectly safe for your little bean. However, different practitioners have different recommendations on caffeine consumption, so check in with yours for a bottom line on your coffee quota.
There’s no research to support that an occasional glass of wine (or beer, or cocktail) is a safe bet when you’re expecting. In fact, the Surgeon General, the CDC, ACOG, AAP, and many other experts advise that no amount of alcohol is safe for pregnant women. Nobody knows for sure whether there is a safe limit when it comes to alcohol consumption during pregnancy. But the alcohol that enters the fetal bloodstream is in about the same concentrations present in the mom-to-be’s blood, and it takes the fetus twice as long to eliminate the alcohol from its system.
There’s no clear evidence that any smoking you’ve done before pregnancy will harm the baby you’re now carrying. But smoking during pregnancy, particularly beyond the third month, is hazardous to your baby’s health (and yours as well). In effect, when a mom smokes, her fetus is confined in a smoke-filled womb. Its heartbeat speeds up and, worst of all, because of insufficient oxygen, it can’t grow and thrive as it should. The results can be devastating. The most widespread risks for babies of smokers are low birthweight, shorter length, and smaller head circumference, as well as cleft palate or cleft lip, and heart defects.
Smoking around the time of conception increases the risk of ectopic pregnancy and continued smoking can increase the risk of a wide variety of pregnancy complications, including abnormal implantation or premature detachment of the placenta, premature rupture of the membranes, and early delivery.
Moms-to-be definitely carry a heavy load—and most of the baby-nurturing responsibilities, at least until the baby’s born. The exception: When it comes to providing a smoke-free environment, mom can’t do it alone. If there is smoke in her environment, there’s smoke (and harmful tobacco by-products) in the baby’s surroundings. Doing your smoking away from your pregnant partner is better than smoking around her, but you’ll still be exposing her (and baby) to the toxins that stick to your clothes and skin.
All the research indicates that microwaves are completely safe to use during pregnancy (and at all other times). Just keep a couple of sensible precautions in mind:
- Use only cookware that is specifically manufactured for use in the microwave (look for a microwave-safe BPA-free container).
- Don’t let plastic wrap touch foods during microwaving. Instead, cover your food with an appropriate microwave-safe top or with a paper towel.
Toxoplasmosis from your pet cat
If you’ve had cats for a while, you’re likely to already be immune to toxoplasmosis (because you’ve probably already been infected with it as most cat owners have been). You can keep your pet cat around while considering the following rules to be extra safe:
- Have someone else handle the litter box. If you must do it yourself, use disposable gloves and wash your hands when you’re finished, as well as after you touch your cats. The litter should be scooped at least daily.
- Wear gloves when gardening. Don’t garden in areas where your cats may have deposited feces.
- Wash fruits and vegetables, especially those grown in home gardens, very thoroughly.
- Don’t eat raw or undercooked meat or unpasteurised milk or dairy products.
- Wash your hands thoroughly after handling raw meat.
Nine Months of Eating Well
Not surprisingly, a lot goes into making a baby. Happily, for babies and the parents who love them, the chances that your baby will be born not only perfectly cuddly but perfectly healthy, are already excellent. What’s more, there’s something you can do to help make those excellent chances even better (while helping yourself to a healthier and more comfortable pregnancy). A balanced, healthy diet – one that includes plenty of lean protein, calcium-rich foods, whole grains, a rainbow of fruits and vegetables, healthy fats, plus about 300 extra calories a day – will get the job done.
Eating Safely for Two
Here’s a food-safety reality check: a more immediate – and proven – threat than the chemicals in your food are the little organisms, bacteria, and parasites that can contaminate it. To make sure that the worst thing you’ll pick up from your next meal is a little heartburn, you need to start shopping, preparing, and eating with extra care. When in doubt, always throw out your food. When food shopping, avoid fish, meat, and eggs that are not well refrigerated or kept on ice. Toss jars that are leaky or don’t pop when you open them, and cans that are rusty or seem swollen or otherwise misshapen. Other tips that you can follow include:
- Wash can tops before opening (and wash your can opener frequently in hot soapy water or in the dishwasher).
- Wash your hands before handling food and after touching raw meat, fish, or eggs. If you use gloves, remember that unless they’re disposable, they need to be washed as often as your bare hands.
- Keep kitchen counters and sinks clean.
- Wash your cutting boards with soap and hot water or in the dishwasher.
- Wash dishcloths frequently and keep sponges clean (replace them often, wash them in the dishwasher each night, or periodically pop dampened ones into the microwave for a couple of minutes), since they can harbour bacteria.
- Use separate cutting boards for produce, fish, and meat.
- Serve hot foods hot and cold foods cold.
- Leftovers should be refrigerated quickly and heated until steaming before reusing. (Toss perishable foods that have been left out for more than 2 hours).
- Don’t eat frozen foods that have been thawed and then refrozen.
- Marinate meat, fish, or poultry in the refrigerator, not on the counter. Don’t reuse the marinade.
- Don’t eat raw or undercooked meats, poultry, fish, or shellfish while you’re expecting.
- Always cook meat and fish to medium (to 160°F) and poultry thoroughly (to 165°F). Fish should be cooked until it easily flakes with a fork, and poultry until the juices run clear (and the proper temperatures are reached).
- Eat eggs cooked through, not runny. The exception to this rule: pasteurised eggs.
- Wash raw fruits and vegetables thoroughly (especially if they won’t be cooked before eating or juicing). Even the freshest organic produce can wear a coating of bacteria.
- Avoid alfalfa and other sprouts, which can be contaminated with bacteria.
The Lowdown on Listeria
Some pregnancy diet restrictions may seem random and unfair, but they’re actually designed to protect you and your unborn baby from listeria. This bacteria can cause a serious illness (listeriosis) in high-risk individuals, including young children, the elderly, those with compromised immune systems, and pregnant women, whose immune systems are also somewhat suppressed.
Though the overall risk of contracting listeriosis is extremely low – even in pregnancy – the potential of it causing problems in pregnancy is higher. It’s important to prevent infection in the first place by staying away from the risky foods that might possibly carry listeria, including:
- Cold cuts (deli meats)
- Hot dogs
- Cold smoked fish
- Soft cheese – cheeses made from unpasteurised milk (including some mozzarella, blue cheese, Mexican cheese, brie, camembert, and feta – unless cooked until bubbly)
- Unpasteurised juice
- Raw or undercooked meat, fish, shellfish, poultry, or eggs
- Unwashed raw vegetables and salad
Conclusion of What to Expect When You’re Expecting
There are a whole bunch of other rules you need to follow during pregnancy, but those mentioned above are the basics. If you’re after a fuller overview, What To Expect When You’re Expecting on Up The Duff (in Australia) includes good overviews of pregnancy. But this book includes the initial stuff you need to know; you’ll be able to work out the rest when the time comes. If you’re looking for other books to improve your health, don’t hesitate to take a look at our reviews of The Easy Way to Control Alcohol and The Easy Way to Stop Smoking by Allen Carr or Mindless Eating by Brian Wansink.