Health and Wellness

Nutrition During Pregnancy:

Eating well is one of the best things you can do during pregnancy. Good nutrition helps you handle the extra demands on your body as your pregnancy progresses. The goal is to balance getting enough nutrients to support the growth of your fetus and maintaining a healthy weight. The popular saying is that pregnant women “eat for two,” but now we know that it’s dangerous to eat twice your usual amount of food during pregnancy. Instead of “eating for two,” think of it as eating twice as healthy. If you are pregnant with one fetus, you need an extra 340 calories per day starting in the second trimester (and a bit more in the third trimester). That’s roughly the calorie count of a glass of skim milk and half a sandwich. Women carrying twins should consume about 600 extra calories a day, and women carrying triplets should take in 900 extra calories a day. Getting plenty of water during pregnancy is important as well. Aim for 8-12 8 oz. glasses per day.

Prenatal Vitamin:

Vitamins and minerals play important roles in all of your body functions. Eating healthy foods and taking a prenatal vitamin every day should supply all the vitamins and minerals you need during pregnancy. Take only one serving of your prenatal supplement each day. If your obstetrician–gynecologist (ob-gyn) thinks you need an extra amount of a vitamin or mineral, your ob-gyn may recommend it as a separate supplement.

Nutrient Needed and How Much	Why You and Your Baby Need it	Best Sources
Calcium (1000 mg)	Builds strong bones and teeth	Milk, cheese, yogurt, sardines, dark green leafy vegetables
Iron (27 mg)	Helps red blood cells deliver oxygen to your fetus	Lean red meat, poultry, fish, dried beans and peas, iron-fortified cereals, prune juice
Iodine (220 micrograms)	Essential for healthy brain development	Iodized table salt, dairy products, seafood, meat, some breads, eggs
Choline (450 mg)	Important for development of your fetus’s brain and spinal cord	Milk, beef liver, eggs, peanuts, soy products
Vitamin A (770 micrograms)	Promotes healthy gums, teeth, and bones	Citrus fruit, broccoli, tomatoes, strawberries
Vitamin D (600 IU)	Builds your fetus’s bones and teeth Helps promote healthy eyesight and skin	Sunlight, fortified milk, fatty fish such as salmon and sardines
Vitamin B6 (1.9 mg)	Helps form red blood cells, helps body use protein, fat, and carbohydrates	Beef, liver, pork, ham, whole-grain cereals, bananas
Vitamin B12 (2.6 micrograms)	Maintains nervous system Helps form red blood cells	Meat, fish, poultry, milk (vegetarians should take a supplement)
Folic acid (600 micrograms)	Helps prevent birth defects of the brain and spine Supports the general growth and development of the fetus and placenta	Fortified cereal, enriched bread and pasta, peanuts, dark green leafy vegetables, orange juice, beans. Also, take a daily prenatal vitamin with 400 micrograms of folic acid.

Weight Gain During Pregnancy

Body Mass Index (BMI) Before Pregnancy	*Rate of Weight Gain in the Second and Third Trimesters (Pounds Per Week)**	Recommended Total Weight Gain With a Single Fetus (in Pounds)	Recommended Total Weight Gain With Twins (in Pounds)
Less than 18.5 (underweight)	1.0 to 1.3	28 to 40	Not known
18.5 to 24.9 (normal weight)	0.8 to 1.0	25 to 35	37 to 54
25.0 to 29.9 (overweight)	0.5 to 0.7	15 to 25	31 to 50
30.0 and above (obese)	0.4 to 0.6	11 to 20	25 to 42

*Assumes a first-trimester weight gain between 1.1 and 4.4 pounds

Source: Institute of Medicine and National Research Council. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, DC: The National Academies Press.

Exercise:

Ideally, pregnant women should get at least 150 minutes of moderate-intensity aerobic activity every week. An aerobic activity is one in which you move large muscles of the body (like those in the legs and arms) in a rhythmic way. Moderate intensity means you are moving enough to raise your heart rate and start sweating. Monitor your heart rate, and avoid a sustained heart rate of higher than 140 beats per minute. Always have water available while exercising. If using weights, do not exceed 20-25 pounds.

Examples of moderate-intensity aerobic activity include brisk walking and general gardening (raking, weeding, or digging). You can divide the 150 minutes into 30-minute workouts on 5 days of the week or into smaller 10-minute workouts throughout each day.

If you are new to exercise, start out slowly and gradually increase your activity. Begin with as little as 5 minutes a day. Add 5 minutes each week until you can stay active for 30 minutes a day.

If you were very active before pregnancy, you can keep doing the same workouts with your ob-gyn’s approval. But if you start to lose weight, you may need to increase the number of calories that you eat.

Safe Exercises for Pregnant Women:

Walking—Brisk walking gives a total body workout and is easy on the joints and muscles.
Swimming and water workouts—Water workouts use many of the body’s muscles. The water supports your weight so you avoid injury and muscle strain.
Stationary bicycling—Because your growing belly can affect your balance and make you more prone to falls, riding a standard bicycle during pregnancy can be risky. Cycling on a stationary bike is a better choice.
Modified yoga and modified Pilates—Yoga reduces stress, improves flexibility, and encourages stretching and focused breathing. There are prenatal yoga and Pilates classes designed for pregnant women. These classes often teach modified poses that accommodate a pregnant woman’s shifting balance. You should avoid poses that require you to be still or lie on your back for long periods.

If you are an experienced runner, jogger, or racquet-sports player, you may be able to keep doing these activities during pregnancy. Discuss these activities with your ob-gyn.

Activities to Avoid

Please be careful and avoid:

Hot tubs, saunas, roller coasters, sky diving, horse-back riding, skiing, scuba diving, motorcycle riding
Changing cat litter boxes
Smoking, drinking, alcohol, or using illicit drugs
Any activity that put you at increased risk of injury, such as the following:
Contact sports and sports that put you at risk of getting hit in the abdomen, including ice hockey, boxing, soccer, and basketball
Skydiving
Activities that may result in a fall, such as downhill snow skiing, water skiing, surfing, off-road cycling, gymnastics, and horseback riding
“Hot yoga” or “hot Pilates,” which may cause you to become overheated
Scuba diving
Activities performed above 6,000 feet (if you do not already live at a high altitude)

What are warning signs that I should stop exercising?

Whether you’re a seasoned athlete or a beginner, watch for the following warning signs when you exercise. If you have any of them, stop and call your ob-gyn.

Bleeding from the vagina
Feeling dizzy or faint
Shortness of breath before starting exercise
Chest pain
Headache
Muscle weakness
Calf pain or swelling
Regular, painful contractions of the uterus
Fluid gushing or leaking from the vagina

Other Health and Safety Tips

Dental Care: Gum disease and bacteria in the gums is more common during pregnancy and can have potential harmful effects on your pregnancy. If dental care can be postponed until after you are 13 weeks, that is most preferable but if delay will cause further deterioration or damage, care should not be delayed.
Depression: Please inform your provider if you have in the past or if you are currently experiencing any signs or symptoms of depression.
Hair Coloring: hair coloring and nail care should be done in well-ventilated areas. Most practitioners will recommend that hair dye is avoided until after your 14^th week of pregnancy.
Seat belt: A seat belt should always be worn while in a vehicle. The shoulder belt should sit between your breasts and the lap belt below your belly but over your hips.
Sex: Sex during pregnancy is safe unless you are having bleeding, concern that you may be leaking amniotic fluid, preterm labor, or have been otherwise instructed not to by your provider.
Travel: Travel during pregnancy up to 34 weeks is fine. Consult with one of your providers prior to leaving, make sure to consume plenty of fluids, get up and stretch frequently to avoid any chance of a blood clot.