Melissa Murphy

Before you get pregnant…
There’s a lot you can do before you even get pregnant. Fertility expert Zita West says, “Give your whole lifestyle a review - how much do you drink? Do you smoke? Are you overweight? Do you eat natural foods, not junk?” West also recommends building up a good energy store. “In the first three months, your baby relies on your energy stores. It takes a while to build these, so take folic acid and omega-3, follow a good diet, and give up drinking and smoking at least three months before getting pregnant.” Midwife Claire Friars says, “Before trying for a baby, go and see your GP. They can tell you whether you need to lose weight or help you stop smoking.” Also check your rubella status as some women are finding the vaccines they had at school are not lasting through their child-bearing years. “If you aren’t immune, then you’ll a jab and should wait about three months before getting pregnant,” says Friars. Also need to be careful of toxoplasmosis, found in cat faeces and undercooked meat. Your GP can test to see if you have this or are at risk of it.

UP FOR DEBATE
PEANUTS

Eating peanuts in pregnancy is a hot topic, with experts now debating whether it increases or decreases the risk of allergy in later life. “At the moment, we tell mums-to-be that if they, their partner or siblings have an allergy, then they should avoid peanuts,’ says Claire Friars, a midwife from Tommy’s, the baby charity that promotes healthy pregnancies.“If there’s no history of allergies in your family, it’s fine to eat them.”

But early indications from research suggest that avoiding peanuts is not actually lowering the number of children being born with serious nut allergies. “There is a school of thought which asks whether small amounts of nuts could actually help to desensitise susceptible individuals. But we’ll have to wait for more evidence before the guidance changes,” explains Friars.

ALCOHOL

Another area subject to conflicting messages is drinking alcohol during pregnancy. Mums-to-be are now being told to stop drinking altogether and if they can’t do this, then one or two units a week is the absolute limit. Many experts believe one to two units a week is safe. But until there is a definitive answer, it’s best to abstain.

EXERCISE

The general consensus is that mums-to-be should be cautious about exercising in the first trimester. A recent study showed that strenuous exercise in the first trimester could increase the risk of miscarriage. The study identified ‘strenuous’ as exercising more than seven hours a week or doing high-impact exercises such as running, racket or ball sports. “Avoid any exercise where you could lose your balance and fall over or get hit by a ball,” says Friars. The best way to work out whether or not you are overexerting yourself is with the ‘talk test’. During exercise you should be able to talk easily. If you can’t, then you need to slow down.

So what is safe? “Stay active during the first trimester, but avoid anything strenuous,” says Friars. “If you’re inactive for three months, you’re going to find it hard to get going again.’ The best exercise during pregnancy is walking and swimming. See your midwife before starting to exercise to make sure it’s safe for you. If you’re a gym member, ask for a trainer to devise a suitable work-out for you. Yoga and Pilates haven’t been researched enough yet for medical practitioners to say they’re definitely safe, but many women practice them. Yoga and Pilates practitioners believe that both forms of exercise can help mums-to-be reduce stress, improve posture, prevent back pain and help you regain a flat stomach more quickly. “Always tell the teacher - don’t just join a normal class - or go to a special antenatal class as there are certain moves you shouldn’t do, such as lying flat on your back after 16 weeks,” Friars says.

OFFICIAL ADVICE
EATING FOR TWO

Thankfully there is a definitive list of food no-go areas. “Mould-ripened cheeses, pate, liver and liver products, any supplement with vitamin A, raw or partially cooked eggs, raw shellfish, shark, marlin and swordfish are all off the menu,” says Susan Price, a dietician from the British Dietetic Association. These foods carry a greater risk of getting food poisoning, salmonella or listeria. The main risk with food poisoning is dehydration and a high temperature. High temperatures during the first trimester have been linked with miscarriage, while dehydration can affect the growth of your baby. Salmonella isn’t harmful for your baby but very unpleasant to have while pregnant, and listeria can cause jaundice, eye problems, meningitis, pneumonia, premature birth, miscarriage and stillbirth. However, listeria is very rare and only affects one in 20,000 pregnancies.

Care also needs to be taken with meat, ready meals and fish. “Make sure ready meals are piping hot and meat is well-done, not pink,” says Price. Don’t go overboard on fish either. “Eat no more than one fresh tuna steak or other portion of oily fish a week. Tinned tuna is safer – two medium-sized cans of tuna a week is fine.” These types of fish contain high levels of mercury which can damage an unborn baby’s nervous system, but don’t give up on fish altogether. Fish oils such as omega-3 fatty acids are important for the development of your baby’s central nervous system.

CAFFEINE

“Drink no more than 300mg a day,” says Price. A mug of instant coffee has around 100mg and a cup of tea has 50mg. Watch your chocolate intake too - a 50g bar of milk chocolate has about 40mg of caffeine.

SMOKING

This is a definite no-no. There is a lot of evidence relating to its effects on a fetus. Some of the scariest risks include low birth weight, stillbirth, miscarriage and premature delivery. “Some women don’t think that a low birth weight or premature delivery is that serious,” says Friars. “But these babies are certainly more at risk of health and educational disabilities.” If you haven’t given up yet, call the NHS Pregnancy Smoking line on 0800 169 9169.

PILL POPPING

Take folic acid to prevent conditions such as spina bifida. “Folic acid is essential and ideally should be started before you are pregnant,” says Friars. The government recommends a minimum of 400 mcg per day. When it comes to everyday medications, pretty much everything is out of bounds! “Paracetamol is OK but look out for added ingredients such as caffeine. Nothing else should be taken without seeing your GP or midwife,” adds Friars.

STRESS

You may be used to high stress levels, but you have to slow down during pregnancy.Professor Vivette Glover from Imperial College London says, “There is strong evidence to show that if a mother is very stressed during pregnancy, this can increase the risks of ADHD, having an anxious child or a delay in language development. We believe that the stress hormone cortisol may have an effect on the baby’s brain.”

Research also suggests that severe stress can increase the risk of a premature birth. Mums living near the World Trade Center on 9/11 gave birth to a much higher rate of low-birth-weight babies in the following months. One journal reported that the rate was two-thirds higher than normal.

But don’t stress over stress. “Everyday stress is perfectly normal during pregnancy,” says Professor Glover. “The best thing to do is talk to a friend, family member or midwife. Don’t bottle things up and, if your stress is severe, you might need to seek counseling.” Fertility expert Zita West (www.zitawest.com) agrees: “Go with the flow and try to put aside 10-15 minutes every day just to relax.”

That seems to be the mantra - go with flow, relax and enjoy your pregnancy.