Folic acid is recommended as it can help prevent birth defects including neural tube defects such as Spina Bifida.
If you are not already taking a folic acid supplement you should start taking this straight away (400mcg a day) most supermarkets and chemists stock it.
However, sometimes you require a higher dose of 5mg a day which can be obtained on prescription from your GP
- If your BMI (body mass index) is above 30,
- You or your partner have had a neural tube defect
- You have had a previous pregnancy with neural tube defect
- You are diabetic
- Some women taking anti – epileptic drugs may require a higher dose you will need to speak to your GP.
Folic acid should ideally be started three months before getting pregnant and continued for the first 12 weeks.
Eating well and keeping healthy during pregnancy
A healthy diet is important throughout life but it is especially important during pregnancy. This is because your developing baby receives all the nutrients it needs from what you eat whilst you are pregnant.
You do not need to “eat for two” during your pregnancy. Be guided by your appetite, as this should give you an idea of when you may need to eat more, but be sensible about the amount you are eating. You only need 200 more calories in the 2nd trimester i.e slice of wholemeal toast, low fat yoghurt.
Weight gain recommendations depend on each individual and your BMI – ask your Midwife how much they would recommend.
Unless you have been advised against exercise keeping fit in pregnancy is an excellent way of preparing for the birth and the physical demands that this brings.
Not only will it physically help with the strenuous demands of labour and looking after new baby but can help lift your mood.
During exercise the body releases endorphins or happy hormones ( think chocolate and sex!) this can help you feel relaxed and good about yourself, whilst getting a bit of that “me” time!
Did you know all pregnant mums should exercise for 30 mins 5 times a week?
Eat plenty of fruit and vegetables as they provide you with the vitamins and minerals as well as the fibre which helps digestion and prevents constipation. Eat them lightly cooked in a little water or raw to get the most from them. Frozen, tinned and dried fruit and vegetables are good too. You should aim to have five portions of fruit and vegetables a day.
Starchy food like bread potatoes, rice, pasta, chapattis, yams and breakfast cereal are an important part of your diet and should be the main part of your meals.
Lean meat, fish, poultry, eggs, cheese, beans and pulses are all good source of nutrients. It is important to eat some of these every day.
Dairy foods like milk, cheese and yogurts, which contain calcium, are a good source of protein and calcium which is needed for your baby’s bone and teeth development. When choosing, look for low fat yogurts or semi-skimmed or skimmed milk.
What foods should I cut down on?
Sugar and sugary foods. You should cut down on sweets, biscuits, cakes and sugary drinks as these only contain calories and not nutrients. This will add to tooth decay.
Fat and fatty foods. Fat is very high in calories and too much fat can increase our risk of heart disease. Most of us eat more fat than we need. It also will contribute to being overweight.
Obesity during pregnancy has implications for both mother and baby. There is an increased risk of a complications during pregnancy, delivery and after the baby is born. Especially for women who have a body mass (BMI) of >30.
For more information on managing your weight in pregnancy have a look athttp://www.tommys.org/
Whilst you are pregnant your immune system functions at a slightly lower level than normal, so you can be at risk from infections passed on through food.
For full information about your diet in pregnancy have a look at
What meat can I eat?
You can eat: Meat and poultry that has been cooked thoroughly all the way through. Cold cured meats include salami, parma ham, chorizo and pepperoni are safe . Smoked fish includes smoked salmon and smoked trout.
Some countries advise that pregnant women should avoid eating cold cured meats or smoked fish as there’s a small risk of these foods harbouring listeria or the parasite that causes toxoplasmosis Currently in theUK pregnant women aren’t advised to avoid these products.
What milk can I drink?
You can drink: Pasteurised and UHT milk. You don’t need full fat milk – semi and skimmed has just as much calcium.
Avoid: Unpasteurised sheep and goat’s milk unless it has been boiled for two minutes
What cheese can I eat?
Cheese is a great source of calcium. However, some cheese can carry the risk of listeria, a bacteria that can cause serious problems for the mother and baby.
You can eat: Hard cheeses such as cheddar, parmesan, mozzarella, gruyere and soft processed cheeses like cottage cheese, cream cheese and cheese spreads.
Avoid: Ripened soft cheeses like Brie or Camembert and blue-veined cheeses such as Stilton. Also avoid cheese from unpasteurised sheep or goat’s milk
What fish can I eat?
Fish can contain high levels of mercury, which can affect the development of a baby’s nervous system.
You can eat:
Oily fish such as Salmon and tuna steaks are rich in omega -3 in pregnancy it is recommended you have up to 2 portions a week.
White fish such as cod, haddock , plaice, , Pollack, Dover sole can be eaten as many times as you like there are no restrictions regarding number of portions.
Sushi and pregnancy
It’s fine to eat raw or lightly cooked fish in dishes such as sushi when you’re pregnant as long as any raw wild fish used to make it has been frozen first. This is because occasionally wild fish contains small parasitic worms that could make you ill. Freezing kills the worms and makes raw fish safe to eat. Cooking will also kill them.
Certain farmed fish destined to be eaten raw in dishes like sushi, such as farmed salmon, no longer need to be frozen beforehand. This is because farmed fish are very unlikely to contain parasitic worms due to the rearing methods used. If you’re unsure contact the Food Standards Agency for advice.
Lots of the sushi sold in shops is not made at the shop. This type of sushi should be fine to eat, because if a shop or restaurant buys in ready-made sushi, the raw fish used to make it will have been subject to an appropriate freezing treatment. If you’re in any doubt, you might want to avoid eating the kinds of sushi that contain raw fish such as tuna.
The safest way to enjoy sushi is to choose the fully cooked or vegetarian varieties, which can include:
- cooked seafood, for example fully cooked eel (unagi) or shrimp (ebi)
- vegetables, for example cucumber (kappa) maki
- avocado, for exampleCaliforniaroll
- fully cooked egg
If a shop or restaurant makes its own sushi on the premises, it must still be frozen first before being served. If you’re concerned, ask the staff.
If you make your own sushi at home, freeze the fish for at least four days before using .
Avoid: shark, swordfish and marlin. Limit your consumption of tuna to one fresh steak, or two cans a week..
Shellfish carries a risk of bacteria that can cause food poisoning – which can put you and your baby at risk. So avoid raw or undercooked shellfish like oysters, mussels, uncooked prawns and crab. Cold pre-cooked prawns are fine.
Can I eat eggs?
You can eat well-cooked eggs (so that the egg-white and yolk are solid).
Avoid: Raw or runny eggs, mayonnaise made with raw egg (shop bought mayonnaise is fine, but restaurants often make homemade mayonnaise with raw egg, so always ask first) and mousses made with raw egg.
Can I eat liver products?
NO do not eat liver, liver pate or liver sausages. Liver can contain high-levels of the retinol form of vitamin A, which can be harmful to your developing baby.
Can I eat peanuts or foods containing peanuts?
Peanuts are a good source of fibre and protein although peanuts can be dangerous if you or your partner’s family has a history of peanut or otherallergies, asthma, eczema or hayfever.
Avoid: eating peanuts or peanut products (e.g. Satay chicken, peanut butter, peanut oils, some snacks etc) during pregnancy and breast feeding.
Do I need to cut out caffeine?
Caffeine has been associated with the risk of miscarriage and your baby runs the risk of not growing properly. The government’s advice is to limit your caffeine consumption to 300 mg a day. (This is roughly 3 mugs of coffee (3 x 100mgs), or 6 cups of tea (50mg x 6).
Avoid: drinking too much caffeine, but a small amount is fine. Remember caffeine can also be found in energy drinks – up to 320mg may be in a can!.
- Wash your hands before and after handling food
- Wash all fruit and vegetables and salads thoroughly to remove all traces of soil which may contain toxoplasma.
- Avoid: packaged salads, unless you wash them first.
- Cooked-chilled foods can carry the risk of listeria.
- You can eat: Cooked-chilled foods that have been thoroughly heated all the way through.
- Avoid: unheated cooked-chilled foods.
- Do not reheat food more than once.
- Store raw and cooked foods well away from each other in the fridge to avoid contamination (for example place raw food on the bottom shelf of you fridge)
- Use separate boards for preparing meat and other foods and wash carefully after use.
- Use rubber gloves and wash them and then your hands thoroughly after gardening, handling soil or after clearing out pet litter trays.
Vitamin D should be taken throughout pregnancy and whilst breast feeding.It is recommended you take 10 micrograms of vitamin D daily.
Vitamin D regulates the amount of calcium and phosphate in the body, these are needed to keep bones and teeth healthy
You can obtain Vitamin D from either a multi vitamin for pregnancy or free if you are entitled to Healthy start. In some areas you can purchase healthy start vitamins – ask your Midwife.
Do I need extra iron?
The need for iron is increased during pregnancy especially during the later stages. Anaemia can be common whether you are vegetarian or not. It can be helpful to have an iron rich diet.
Good sources of iron: red meat, pulses, bread, green leafy vegetables, dried fruit, wholegrain cereals like weetabix, nuts
Is vitamin C important?
Vitamin C will help with iron absorption. Food rich in vitamin C include citrus fruits, tomatoes, broccoli, peppers, blackcurrants and potatoes. Some fruit juices are also high in vitamin C.
Vitamin and fish oil supplements to avoid in pregnancy
Don’t take high-dose multivitamin supplements, fish liver oil supplements or any supplements containing vitamin A.
Sex in pregnancy
It’s perfectly safe to have sex during pregnancy. Your partner’s penis can’t penetrate beyond your vagina, and the baby cannot tell what’s going on. It is normal for your sex drive to change during pregnancy though. Don’t worry about this, but do talk about it with your partner..
Later in pregnancy, an orgasm or even sex itself can set off contractions (known as Braxton Hicks contractions). If this happens, you’ll feel the muscles of your womb (uterus) go hard. This is perfectly normal and there’s no need for alarm. If it feels uncomfortable, try your relaxation techniques or just lie quietly until the contractions pass.
Travel in pregnancy
For most women without complications it is safe to travel in pregnancy although some women choose not to travel in the first 12 weeks when tiredness and nausea are a problem.
Flying in pregnancy
Flying is not harmful to you or your baby, but discuss any health issues or pregnancy complications with your midwife or doctor before you fly.
The likelihood of going into labour is naturally higher after 37 weeks (around 34 weeks if you’re carrying twins), and some airlines will not let you fly towards the end of your pregnancy. Check with the airline for their policy on this.
After week 28 of pregnancy, the airline may ask for a letter from your doctor or midwife confirming your due date, and that you aren’t at risk of complications.
Long-distance travel (longer than five hours) carries a small risk of blood clots (deep vein thrombosis, or DVT). If you fly, drink plenty of water and move about regularly – every 30 minutes or so. You can buy a pair of support stockings in the pharmacy over the counter, which will reduce leg swelling.
It is recommended that all pregnant women have a Flu vaccine as you are more at risk of developing serious complications whatever stage of pregnancy.The Flu vaccine will protect you and your baby.
The vaccine is available from October to February from your GP .The vaccine is not ‘live’ so you will not get Flu from the vaccine.
Why are pregnant women advised to have the whooping cough vaccine?
Getting vaccinated while you’re pregnant may help to protect your baby from developing whooping cough in their first few weeks of life. The immunity you get from the vaccine will pass to your baby through the placenta. Babies are not routinely vaccinated against whooping cough until they are two months old.
It is recommended you have the vaccine between 28- 38 weeks of pregnancy for more information discuss with your Midwife or GP.
Smoking in pregnancy
It is harmful to your baby and can affect your pregnancy. It is linked to miscarriage, premature birth, cot death and having a small baby. It can also cause breathing problems for baby.
For free advice and nicotine replacement therapy designed to help you or partner quit contact 0800 915 5959. or www.readytostopsmoking.co.uk
You are 4 times more likely to quit with the support service.
If you use recreational drugs
Most illicit street drugs are unlikely to cause serious congenital birth defects but can have a long term effects on your baby. Cocaine use in particular, can create a number of problems in pregnancy as it reduces the blood flow to your baby.
Other risks include: slow growth, premature baby, withdrawal problems for baby, Cot death and stillbirth particularly if you use cocaine and crack cocaine.
If you have a drugs worker tell them you are pregnant so they can help you and let the Midwife at your booking interview know so we can ensure you have the correct carer for you and baby.
It is best to avoid alcohol altogether, particularly in the first three months because there is uncertainty about a safe level. Heavy alcohol use is often associated with birth defects or later developmental problems in your baby.
If you would like to talk to someone locally, about you or your partners alcohol intake you can contact Action for Change 01482 321594
Very few medicines are thought to be safe to use in pregnancy, please seek advice before taking from your GP.
If you would like to speak to a midwife before your booking appointment: please telephone 01482 682658 or 01482 604390leave your details and a midwife will contact you within a few days. This is an answer phone service so please do not use it for urgent queries. Alternatively you can contact a midwife via the ‘Midwife Hull’ facebook page
The Goodwin Volunteer Doula Project is a voluntary project set up. The word ‘doula’ is a Greek word meaning ‘woman servant’ but has now come to mean a woman who offers emotional and physical support to women before, during and after childbirth. If you feel you may benefit from a Doula and live in Hull please speak to your Midwife or have a look at http://www.goodwindoulas.org/