Congratulations on your pregnancy!
Pregnancy can be an exciting and anxious time as you consider a range of issues and your body begins to change. You may have a range of questions already, or you may still be wondering what questions you should ask.
In the following web pages we have addressed some of the things you may like to know such as diet, exercise, vaccinations and choosing an obstetrician.
More than 60% of all pregnancies are unplanned. If you are pregnant and it was unplanned it does not necessarily mean that your health, or the health of your baby has been placed at risk. If you have any concerns, simply speak to your doctor.
You probably have many questions. The information below will help with some answers.
Diet during pregnancy
When women are pregnant they require more vitamins and minerals. A good diet will help ensure you and your baby are healthy.
What specific dietary requirements are there during pregnancy?
It is important to have a diet which:
- is rich in calcium, folate, iron, niacin, thiamine, vitamin C and zinc;
- is high in fibre and protein, and
- includes two litres of healthy fluids, including water, milk and fruit juice per day.
Should I make any dietary modifications during pregnancy?
A diet rich in folate may help prevent the risk of babies developing neural tube defects. During the first three months of pregnancy and if your pregnancy is planned at least one month before conception taking a folate supplement is recommended.
You should avoid excessive amounts of vitamin A.
Limiting your caffeine intake to 200 mg per day during pregnancy is recommended. This is approximately equal to two cups of coffee, four cups of tea, four cups of hot chocolate or four 375ml cans of cola.
Avoiding alcohol is also recommended. Alcohol can increase your risk of miscarriage and in later pregnancy can cause fetal alcohol syndrome.
If you or your partner smoke, you should consider quitting, as it can affect the health of your baby. It only takes approximately four days for your body to be free of nicotine.
Do women who have diabetes need a specific diet during pregnancy?
Women who have diabetes should have good diabetic control and follow a diet recommended by their doctor. Once a woman with diabetes is pregnant it is important that she has a diet consistent for a normal healthy pregnancy.
Are there other women who may need special dietary advice during pregnancy?
If you have a vegetarian or vegan diet during pregnancy you will need to ensure that you have an adequate intake of protein. People on vegan diets need to ensure they have enough vitamin B12 to prevent neurological risks to their baby. Please speak with your doctor about your dietary needs.
Women who have an eating disorder, such as anorexia or bulimia are at high risk of nutritional deficiencies which may put the health of their baby at risk. Please speak with your doctor about the best solution for you.
Should I take a multivitamin supplement during pregnancy?
It may be a good idea to take a multivitamin suitable for pregnancy. Taking a folate supplement is certainly recommended. Please speak to your doctor about what supplements you should take.
Listeriosis during pregnancy
What is listeriosis?
Listeriosis is an infection caused by the bacteria listeria moncytogenes. The bacteria may be found in dust, soil, animal faeces, water and some foods. Listeriosis may occur if the bacteria are ingested; it is very rare and only occurs in less than 0.7 per 100,000 people. Infection cannot occur through contact with people who have listeriosis. During pregnancy, women are immunosuppressed and may be more susceptible to infections of all kinds.
What are the symptoms of listeriosis?
Often people with listeriosis show no symptoms. Mild effects of the infection are consistent with food poisoning or the common cold, including headaches, fever, aches, pains and nausea. Serious effects of the disease may include severe cramping, meningitis and septicaemia, also known as blood poisoning.
How can listeriosis affect my baby?
An unborn fetus may not be affected by listeriosis. In rare cases it may affect the health of the baby, approximately two until 14 days after the mother has been infected. In extreme cases, listeriosis may lead to spontaneous miscarriage, stillbirth, premature labour or an ill newborn.
How can I avoid listeriosis?
Listeriosis can be prevented by taking a few simple precautions including:
- hygienic food preparation;
- thoroughly washing your hands;
- eating well cooked food;
- ensuring leftover foods are appropriately stored;
- not eating food that is close to the recommended used by date, and
- avoiding food from salad bars.
What food should I avoid?
Avoiding foods that may cause food poisoning can help prevent listeriosis. Please remember that listeriosis is very rare. Some foods you may want to avoid include:
- diary products made from unpasteurised milk;
- salads and pre-cut cold meats that may not be fresh;
- raw seafood including sashimi, and
- smoked seafood including smoked oysters and mussels.
Can listeriosis be treated?
Yes. People infected with listeriosis may be prescribed a course of antibiotics.
Nausea and vomiting during pregnancy
Nausea and vomiting is experienced by 50-80% of women during the first trimester of pregnancy. It can have a serious impact on the day-to-day lives of women and can usually be treated, with varying degrees of success.
What causes nausea and vomiting during pregnancy?
It is not known why women experience nausea and vomiting during the first 16 weeks of pregnancy. Nausea may be related to low blood sugar levels, low levels of vitamin B6, a hormonal imbalance, or an imbalance in potassium and magnesium. However, a well balanced diet should provide all of these vitamins and minerals.
Nausea is more common and severe in pregnancies with higher human chorionic gonadotrophin (HCG) levels. HCG is a hormone produced in pregnancy; pregnancy tests use this as a marker to indicate pregnancy. Higher HCG levels are common in multiple pregnancies and molar pregnancies. Molar pregnancies are very rare, approximately 0.1% of pregnancies and is basically when a pregnancy does not form properly and does not continue.
Generally the nausea occurs during the morning; hence it is also called morning sickness. Unfortunately some women will still experience nausea during the afternoon or evening.
Severe vomiting in pregnancy is very rare. It only occurs in about one in 1000 pregnancies and is called hyperemesis gravidarum.
How can I reduce nausea and vomiting?
Some practical ways to reduce nausea and vomiting during pregnancy include:
- not over-eating;
- eating smaller meals, more often, such as every two or three hours;
- having a snack of yoghurt, milk, juice bread or a sandwich before bed, can help reduce nausea in the morning. You may need to sit upright for 10 to 20 minutes after eating to prevent gastric reflux;
- having a biscuit or two whilst still in bed in the morning three hours;
- getting out of bed slowly to avoid sudden movement;
- drinking soups and other liquids between meals. Instead of drinking fluids with meals, drink them about half an hour after the meal. This may help reduce the distension and swelling of the stomach that can trigger vomiting;
- avoid greasy or fried food, they are hard to digest and can worsen nausea, and
- getting plenty of fresh air. Take a short walk or try sleeping with the window slightly open. To help get rid of odours, open the windows and use the exhaust fan when you are cooking.
Can taking ginger reduce nausea and vomiting?
Research has shown that half a capsule of Zinax, which is used for arthritis, taken four times a day, can reduce nausea. Each capsule contained 1.5 grams of dried ginger. Other studies have shown that one gram of dried ginger can reduce nausea. Ginger capsules are available from natural therapy stores.
Can acupuncture help?
Some trials have shown that acupressure and acupuncture, on the point known as pericardium 6 (p6) located on the underside of the wrist, were associated with significant improvements in nausea by the end of one week and dry retching by two weeks compared to no treatment. There was no improvement in vomiting.
Another trial of acupressure wrist bands, commonly referred to as sea-bands, demonstrated a considerable effect in reducing nausea and vomiting in early pregnancy.
There are also acupressure wrist devices which use an electrical current and have been shown to achieve positive results in reducing nausea and vomiting in patients who have undergone chemotherapy and in post-operative recovery.
What else can be taken to reduce nausea and vomiting?
There are several medications which can alleviate nausea and vomiting during pregnancy and your doctor can advise which may be suitable for you.
Two common medications which can be effective are:
- doxylamine succinate, the active ingredient found in anithistamines such as Dozile, and
- metoclopramide hydrochloride, the active ingredient found in Maxolon.
The antihestamine generally needs to be taken of a night due to its sedating effects. Many women find this medication helpful and it also assists in gaining a good nights sleep, which can help your body cope with the nausea.
Both of these medications are Category A, which means they have been taken by large numbers of people, including pregnant women, with no proven links to adverse impacts on the fetus.
Stemetil and Ondansetron (Zofran) may also be effective. Zofran can be taken as a wafer and placed under the tongue, which can be helpful for women who are finding it difficult to swallow anything.
I am unable to eat much due to nausea, if I am not reaching my dietary requirements could this harm my baby?
We have evolved so that pregnancies can survive famines, so the body copes very well if your food intake is restricted temporarily. The baby is able to absorb everything it needs from its mother’s body.
If you had a good diet before pregnancy, your body will generally have plenty of vitamins and minerals for the healthy growth and development of your baby. The nausea is generally confined to the beginning of the pregnancy and once alleviated you will be able to resume a well balanced diet.
If you are experiencing more extreme vomiting, you may need to be hospitalised and be placed on intravenous fluids. Please speak to your doctor if your nausea is severe.
This information is provided as general information only. It is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always see your doctor regarding your personal health matters. © National Association of Specialist Obstetricians & Gynaecologists 2010