Is it safe to get the COVID-19 vaccination during pregnancy?

COVID-19 in pregnancy: An overview

The government ruled that the third phase of vaccination for adults between 18 and 44 years would start soon. May 1, 2021, saw its effective outset. One of the most crucial questions at this juncture is, whether pregnant women can take it or not. Initial studies were unclear about the risk of COVID-19 in pregnancy. The studies went ahead to establish, however, that pregnant women may be at a more raised risk of severe COVID-19 than non-pregnant ones. Pregnant women may develop severe symptoms including COVID-19-specific illness warranting immediate hospitalization and ICU transfer. Details about COVID-19, the effect of the disease on pregnancy and details about COVID-19 vaccines under progress are evolving in swift phases. 

COVID-19 vaccination, pregnancy and lactation:

Pregnant and lactating women heaved a sigh of relief after the Federation of Obstetrics and
Gynaecology Societies in India (FOGSCI) unveiled their stance on how pregnant and lactating women
should plan for COVID-19 vaccination. The details by FOGSCI shed light on COVID-19 development
and vaccine safety in maternity health. The guidelines suggest that every pregnant and lactating
woman has the right to vaccinate herself. Nonetheless, it should be her wish and not something out
of subtle psychological pressure. The robust clinical benefits of vaccination for pregnant and
lactating women outweigh the presupposed risks of vaccination.

Women who are lactating also present themselves as suitable candidates since the vaccine doesn’t seem to endanger the neonate who is breastfeeding. Women should receive proper consultation and counselling. They should receive optimal emotional support from their caregivers and next of kin. Both acceptors and exempts should receive equal and fair treatment. The guidelines recommend that obstetricians and gynaecologists should promote vaccination drive in pregnant and lactating women with clinical preparations to tackle any adverse or contraindicative responses (if any).

For women who are planning to get pregnant:

Guidelines rule that women planning for pregnancy may consider administering the vaccine at any
time before confirming the pregnancy as per their convenience. No scientific literature lays any
foundations to postpone the pregnancy or treatment for taking the vaccine. The scientific literature
hasn’t yet found concrete evidence demonstrating the possibility of infertility or miscarriage due to
vaccine administration.

Menstruation:

May 1, 2021, saw the centre ruling that everyone above 18 years of age can take the vaccination.
Soon after the judgement of the centre, several women asked whether it was suitable to take
COVID-19 vaccination in pregnancy or not. Various social media platforms were thronged with
questions and comments on the subject. Women should avoid taking COVID-19 vaccines 5 days
before and after their period. The reason behind the guideline is the immune system’s futility. The
immunity in women tends to be less in periods. Their periods last for 5 days. The same 5 days
witness the endometrium shedding. The menstrual cycle is the period which witnesses the
endometrial growth to a bulky and glandular tissue layer full of blood vessels. The immunity and
everything sensitive in the female body remains healthy afterwards. And the period except 5 days
before and after periods may be safe for women to inoculate themselves.

How would the healthcare facilities address COVID-19 and its possible effects on pregnancy?

Healthcare setups should assess the contraindications of the COVID-19 vaccine in pregnancy or breastfeeding. Pregnant women may be offered vaccinationat any point in pregnancy if there are no contraindications. Individual woman’s consent and the overall knowledge that the hazards of COVID-19 infection and morbidities from COVID-19 exceed the hypotheses and presupposed risks of vaccination in pregnancy and while breastfeeding. Therefore, pregnant women shouldn’t be dissuaded from vaccination under the pretext of pregnancy or breastfeeding

COVID-19 and its effects on pregnancy:

The majority of pregnant women infected with COVID-19 may develop mild-to-moderate symptoms
with many remaining asymptomatic. International data, however, suggests that approximately 7-
11% of pregnant women need hospitalization for COVID-19-specific morbidities with about 1-4% of
them needing ICU. In comparison with non-pregnant counterparts, pregnant women with COVID-19
may be in increased need of hospitalization, intensive care and invasive ventilation.

The perils of COVID-19 in pregnant women associate itself with various risk factors. They may
include Asthma, Obesity, Existent Hypertension, Existent Diabetes and Heart Diseases. Studies even
denote that in the event of an increase in the risk of preterm birth associated with COVID-19
infection in pregnancy, it may cause increased morbidities in the premature infant.

COVID-19 vaccination in pregnancy and while breastfeeding:

Various vaccines obstetric experts administer during pregnancy suggest that we may witness an
identical efficacy for the COVID-19 vaccines in pregnant women in comparison with non-pregnant counterparts. Vaccines may generate a good immunogenic response with a good degree of efficacy
in pregnant women. While primordial clinical details on the safety and efficacy of COVID-19 vaccines
in pregnant populations are still under scrutiny, resolute surveillance finds no signs of unfavourable
prenatal or neonatal outcomes related to the administration of COVID-19 vaccines. Nonvaccinated
pregnant women may be at raised risk of COVID-19 infection and a higher risk of morbidities in the
event of infection in comparison with non-pregnant women.

Infection of COVID-19 may complicate maternal, foetal and neonatal health. Pregnancy doesn’t raise the risk of COVID-19 infection. But pregnant women who are active in sensitive areas like healthcare or social care during pandemics may be vulnerable to COVID-19 infection. Advanced maternal age, conditions that underlie and pregnant women below the poverty line may face severe COVID-19 risk. Studies denote that the COVID-19 vaccine may be the right choice provided that a proper risk assessment is done. If analysis confirms that the benefits outweigh the risks for pregnant women and foetal health, it may be recommended. 

Healthcare experts and women should consider the factors below as they set out to vaccinate themselves:

  • Time of vaccination in pregnancy
  • Perils and potential risk of any existent maternal condition (if any) which may include the possible effects of the disease on the foetal health and new-born
  • Availability of data about the administration of a vaccine in pregnancy
  • level of infectivity of the virus in the vicinity/local community.

I am pregnant. Am I at the risk of testing positive for COVID-19?

COVID-19 and its transmission:

COVID-19 was first identified in Wuhan, China by the end of the year 2019. A healthcare professional may diagnose COVID-19 based on signs, symptoms and purported exposure, or using a positive test for SARS-CoV-2 even when there are no palpable symptoms. 

Infectivity and transfer

The majority of cases involving COVID-19 transmission denote the evidence of human-to-human transfer. The virus is readily isolable from respiratory droplets faeces, fomites or bodily secretions. Close or accidental contact with an infected person or an infected surface may transmit the virus. When it comes to the possibility of vertical transmission, evidence suggests that it may be uncommon for a pregnant lady to transmit the virus prenatally. In the event of a transmission of the virus from mother to her child, it suggests various possibilities. It may be least affected by the factors such as delayed cord clamping, skin-to-skin kangaroo care, breastfeeding or colocation (rooming-in). 

Possible risk of catching COVID-19 in pregnancy

At present, there’s no concrete evidence to conclude whether pregnant women are more prone to COVID-19 infection than the nonpregnant counterparts. However, it may be noted that pregnancy involves various physiological changes. The changes even include alterations in the immune system. The alterations in the immune system may make a few women more prone to infections with a marked reduction in the body’s defences against virulent microbes. However, there may be a group of women more prone to severe complications from COVID-19 infection. Certain complications may even require hospitalization. Therefore, precautions and preventive measures against exposure to the virus are important. 

Is it safe to continue with prenatal care in the COVID-19 pandemic?

Of course, it’s safe and important. Obstetricians worldwide are striving to make the most out of healthcare availabilities. They are busy making all the possible changes and help patients and healthcare staffs prevent COVID-19 exposure. Most obstetric setups and firms dedicated to obstetric care are converting traditional antenatal care to tele-healthcare. However, it doesn’t mean the traditional visits will no longer be available. Most setups treat common symptoms using telephonic consultations or video consultations.

Various pregnancy-specific tests may continue based on your consent and your obstetrician’s decisions. Your obstetrician may guide you about how to count the kick and ascertain that the baby is healthy and hale and hearty. You might consider buying something like a blood pressure cuff and a scale. It will make it easy for you to produce your blood pressure and other parameters during telehealth sessions. 

Steps to safeguard yourself from COVID-19 in pregnancy:

  1. Most guidelines to ensure personal safety during the COVID-19 pandemic for pregnant women are the same as those for nonpregnant counterparts.
  2. Stay home, stay safe.
  3. Wear a mask while moving out.
  4. Observe healthy social distances and restrict your social interactions with others.
  5. Use a sanitiser preferably recommended by your obstetrician.
  6. Use a handwash recommended by your obstetrician and wash hands regularly, and specifically after an interaction with an outsider.
  7. Avoid visiting places with rush and crowd.

What is the risk of preterm birth with COVID-19?

Owing to the lack of knowledge on the virus and its interventions in obstetric health, people have less awareness about COVID-19 impact on pregnant women. Studies worldwide haven’t concluded anything on the possible rise in the risk of spontaneous abortion in pregnant women with COVID-19. Women with a certain medical history and health status may be more prone to COVID-19 complications.

If a pregnant woman develops severe symptoms with COVID-19 infection, she may need ICU attention and early delivery. Nonetheless, the data available about the correlation between the virus and preterm delivery is less. Therefore, it may be unwise to conclude that COVID-19 can be the direct cause of preterm delivery. 

Is it true that pregnant women may transmit the virus to their baby during pregnancy and childbirth?

Respiratory or saliva droplets of an infected person are the main modes that may infect a healthy person with COVID-19. Few cases of COVID-19 are reported in neonates. The good news is that most pregnant women infected with COVID-19 gave birth to healthy neonates. Studies are yet to find any traces of coronavirus in cord blood, breastmilk or amniotic fluid. The evidence available on the overall infectivity is unclear. 

Alterations in prenatal care to minimize the risk of COVID-19

The healthcare setups should consider crafting alterations for low-versus-high-risk pregnancies. Women with pregnancy-specific disorders or pre-existing conditions like Hypertension, Diabetes mat require special attention. Healthcare departments should restrict the number of visitors and enhance the quality of care based on various parameters. 

What are the symptoms of COVID-19 infection in pregnancy?

Most pregnant women infected with COVID-19 remain asymptomatic. Most women with symptoms may develop flulike signs alongside mild to moderate cold. The other uncommon symptoms may include diarrhoea, loss of taste and smell, myalgia and dyspnoea. Pregnant women infected with COVID-19 may be more prone to myalgia and fever than the nonpregnant counterparts. 

Severe complications of COVID-19 infection in pregnant women

About two-thirds of pregnant women infected with COVID-19 are asymptomatic. But women with COVID-19 are more likely than the nonpregnant counterparts to get admitted to the Intensive Care Unit (ICU). Most reliable surveys show that women with COVID-19 aren’t at a raised risk of death from COVID-19. But compared to pregnant women without COVID-19, some of the pregnant counterparts with symptomatic COVID-19 may encounter worse clinical outcomes. 

What are the risk factors associated with COVID-19 infection in pregnancy?

  1. A BMI of 25kg/m2 or more
  2. pregnancy-specific morbidities
  3. Pre-existent conditions such as diabetes and hypertension 
  4. Advanced maternal age
  5. Residence in high-risk areas of the areas of high prevalence

What are the effects of COVID-19 on foetal health?

COVID-19 positive women who are symptomatic may have to face certain challenges ahead. Nonetheless, the studies or data available on the risk of COVID-19 on the foetus are scarce. Symptomatic maternal COVID-19 may be linked to an increase in the risk of iatrogenic preterm birth. Besides preterm birth, COVID-19 infection may not leave any harmful effects on the foetal health or neonatal outcomes.

The evidence denoting any possibility of congenital anomalies isn’t yet available. There is no concrete evidence to date showing any possibilities of neonatal mortalities or stillbirth in response to maternal COVID-19 infection. There is no evidence even suggesting that spontaneous abortion is possible in the wake of maternal COVID-19 infection. 

Are you getting enough vitamins during pregnancy?

Pregnancy care involves a balance of nutrition and optimum personal hygiene. Enjoying a healthy and vivid diet in pregnancy allows you to make the most out of the three trimesters. Pregnancy includes physiological changes resulting in increased plasma volume. The other physiological changes in pregnancy are a rise in red blood cells and a decrease in the concentration of proteins and micronutrients that bind nutrients. Nutrition in pregnancy starts always with taking the necessary steps. The steps may include taking prenatal vitamins and designing a balanced diet. Pregnancy tips on safety and nutrition may mainly include a full-fledged dietary regimen. It may follow clinical guidelines depending upon various factors. 

Many women prefer attending pregnancy exercise class or aerobics. In a few geographical regions, undernutrition or deficiency may affect the physiological changes of pregnancy. During pregnancy, a baby receives necessary nutrition from the mother. A pregnant woman needs more nutrition from the day she conceives. Make sure that the prenatal vitamins you include have folic acid, calcium and iron in them. Ask your obstetrician/gynaecologist to round off a diet supplying ample vitamin D, DHA and iodine each day. 

Prenatal vitamins:

As the name suggests, prenatal vitamins are the multivitamins for pregnant women or those willing to conceive. Contrary to regular vitamins, prenatal vitamins contain major ingredients you need for a healthy pregnancy. It’s great to follow the multivitamin prescribed by an obstetrician or midwife. 

Your body thrives on the nutrients, minerals and other nutritional availabilities in the food. If you are a vegetarian or prone to food allergies, your healthcare provider may prescribe a suitable supplement. Some supplements will help you get the most out of the nutritional availabilities. 

How does your nutritional journey start with prenatal vitamins?

Prenatal vitamins allow you to get the right nutrition throughout the pregnancy.

The ideal prenatal vitamins are:

400 mcg of folic acid

400 IU of vitamin D

2mg of riboflavin

3mg of thiamine

6mcg of vitamin B12

10mg of vitamin E

15mg of zinc

17mg of iron

150 mcg of iodine

200-300 mg of calcium

70 mg of vitamin C

20mg of niacin

  • Folate:

Folate is a B vitamin aiding the process of DNA synthesis, foetal growth and development and red blood cell production. Folic acid is the synthetic form of folate available in various supplements. The body receives an active form of folate with folic acid. The active form of folate the body gets is called L-methyl folate. Expert obstetricians recommend at least 400 mcg of folate or folic acid to cut the risk of neural tube defects and congenital malformations. Folate is essential to prevent the abnormalities such as heart defects and cleft palate. 

  • Iron:

The iron requirement of pregnant women rises drastically due to the rise in maternal blood volume by 45%. Iron is irreplaceable in pregnancy for various reasons. Iron promotes oxygen transport and the healthy development of your baby and placenta. Various health issues are linked to the lack or scarcity of iron in pregnancy. Maternal depression, infant anaemia and preterm delivery are the 3 main health issues due to lack of iron in pregnancy. 17mg of iron per day is enough to meet the nutritional requirement. Your obstetricians may recommend higher doses of iron if you are suffering or have suffered from anaemia. Don’t exceed the dosage recommended by your obstetrician. An excessive dose of iron may cause nausea, constipation and abnormally high haemoglobin. 

  • Vitamin D

Vitamin D deficiency in pregnancy may increase the risk of caesarean section, preeclampsia, gestational diabetes and preterm birth. Vitamin D is a fat-soluble vitamin aiding various functions such as immune responses, bone health and cell division. The recommended intake of vitamin D in pregnancy is 400 IU per day. Many experts recommend extensive doses of vitamin D in pregnancy. However, you mustn’t exceed the dose recommended without consulting your obstetrician. 

  • Calcium

Calcium is a mineral aiding the development of a baby’s bones, heart, muscles, teeth and nerves. The requirement for calcium rises in pregnancy. You may require 200-300 mg of calcium every day when you are pregnant. You may optimise the calcium intake by following the dietary recommendations. You may consider taking more calcium by introducing certain foods to your platter. They may be Broccoli and kale, orange, milk, yoghurt and cheese. 

  • Iodine:

Iodine is a mineral aiding the synthesis of thyroid hormones. Thyroid hormones allow the body to reserve and utilize energy from food. Pregnant women require iodine in pregnancy to aid the growth of their baby’s nervous system. The brain, nerves and spinal cord form the nervous system. The nervous system helps the baby to move, feel and think. Pregnant women may seek their obstetrician’s guidance to determine how much iodine they need in pregnancy. Not every prenatal vitamin contains iodine. The total amount of iodine needed in pregnancy may differ from person to person. Make sure that you are regularly consuming the foods that contain iodine. 

  • Thiamine:

Thiamine usage is recommended based on the obstetrician’s guidance. The recommended daily allowance (RDA) for thiamine in pregnancy is 1.4mg/day regardless of the pregnant woman’s age. Some obstetricians may recommend 3mg of thiamine in pregnancy. Women carrying more than one foetus may require a higher dose of thiamine. 

  • Zinc:

Women trying to conceive should try to increase the intake of zinc. Both the partners should introduce zinc to their regular diet. It’s unlikely for you to suffer from a deficiency of zinc provided your diet is healthy and balanced. The recommended intake of zinc is 8mg per day for adult women. Your obstetrician may recommend an intake of up to 12mg or 15mg of zinc per day in pregnancy and lactation.

  • Vitamin E:

Vitamin E helps in the production and nourishment of red blood cells, eyes and healthy skin. It promotes a healthy immune response. It’s best to include a healthy amount of vitamin E in your platter based on your obstetrician’s guidance. The recommended daily intake of vitamin E in pregnancy is 3mg. A healthy and balanced diet should suffice. If your medical history denotes higher doses of vitamin E, your obstetrician may recommend a dose of up to 10mg.  

  • Riboflavin:

Riboflavin is vitamin B2. Riboflavin is essential in the maintenance of various tissues of the body. Riboflavin is used to treat or prevent deficiency of vitamin B2. Ask your obstetrician if it’s safe for you to administer riboflavin in your regular diet. Your obstetrician may study the medical history. If you have a history of cirrhosis or other liver disease or any gallbladder issues, riboflavin should be carefully used. Don’t use riboflavin without your obstetrician’s advice. 

  • Niacin:

Niacin or Nicotinic acid (Vitamin B3) is a water-soluble chemical. Nicotinamide is another form of Vitamin B3 available for human consumption. Niacin plays a crucial role in the growth and development of the foetus. Niacin may help prevent birth defects and miscarriage. It may be essential in the baby’s brain development. It energizes us. It provides optimum nutrition for the skin and other organs. It helps reduce nausea and improve digestive power. Niacin is also linked to a reduction in migraines. The recommended intake of niacin is 20mg. 

  • Vitamin B12:

Vitamin B12 is vital in the production of red blood cells. It may help nourish the nerve tissue. The deficiency of vitamin B12 may lead to anaemia, nerve damage and brain damage. 6mcg of vitamin B12 may be essential in pregnancy. If you need higher doses of vitamin B12, your obstetrician may recommend them based on your medical history and current health status.

  • Vitamin C:

Proper intake of vitamin C helps reduce the risk of placental abruption. Vitamin C alone helps reduce the risk of preterm labour and prelabour rupture of membranes (PROM). However, some studies suggest that vitamin C in combination with vitamin E raises the risk of PROM. Pregnant women should be careful while including vitamin C in the platter. We recommend that you seek your obstetrician’s guidance on the amount of vitamin C to include in your platter. 

What care should be taken during first three months of pregnancy?

precautions during first three months of pregnancy
Author: Dr. Shefali Tyagi MBBS,DGO, FRCOG, MRCOG, PGDMLE, PGDPC, FRANZCOG
Consultant – Obstetrician & Gynaecologist at Motherhood Hospitals, Sarjapur

By the time a woman conceives, her body prepares itself for various changes. These changes are important to help a pregnant lady carry her pregnancy to term. A list of changes occurs in the first three months of pregnancy. These occurrences are a precursor to signs that develop throughout all the trimesters. 

The first trimester of pregnancy:

The first trimester of pregnancy starts the day a woman conceives and lasts till the 12th week. The need for first-trimester care strikes right here as the first trimester involves crucial changes and challenges. The pregnant lady may gain weight or feel apathetic followed by the common episodes of morning sickness. Various other symptoms associate themselves with the first trimester. It’s a phase that involves quick foetal growth. This is when various vital organs of the foetus develop phenomenally. They include the spine, nervous system and digestive tract. The foetus obtains a human form by the end of the first trimester. A healthy lifestyle is a mandate during the first trimester. Pregnant women may have to maintain dietary control throughout the pregnancy. Pregnant women should seek an obstetrician’s advice early in pregnancy for better outcome (healthy child).

Below are the precautions to take as a crucial part of pregnancy care:

  • Hydration – marking your healthy pregnancy:

A rise in blood volume is a significant part of the first trimester. The blood volume increases to actively contribute to the oxygen and nutritional requirements of the foetus. The expectant mother needs more fluids throughout the pregnancy. Various sudden changes in the body warrant a steep rise in the demand for fluid intake. Fresh juices and clean water support you like never before in the pregnancy. 

  • Stay away from smoking:

Pregnancy is the time when all kinds of addictions negatively influence foetal growth. Smoking in pregnancy raises the risk of miscarriage, premature labour, and ectopic pregnancy. The inhalation of the unhealthy vapours hinders the foetal development risking the overall success of the pregnancy. Practice a lifestyle free of addictions and especially smoking to ensure the safety of yourself and your munchkin.?˜

  1. Hb electrophoresis test
  2. Screening tests may be needed to find out if the baby is at risk for certain inheritable health issues.
  3. Blood type and antibody screen
  4. Complete Blood Count (CBC) to check if you have Anaemia or low platelet count. 
  5. RPR tests to detect any exposure to Syphilis
  6. Fasting glucose checks for diabetes(HbA1c)
  7. Prenatal vitamins:

Vitamins play a crucial role in determining the overall status of health. Take prenatal vitamins based on your doctor’s recommendation. The early phase or first-trimester health remains crucial for both mother and her unborn. Folic Acid is the most important supplement as it helps prevent birth defects. Iron helps in the prevention of Anaemia. 

  • Avoid hot baths and sauna:

High temperatures may interfere with healthy foetal development. Avoid hot showers. Consult your orthopaedic doctor or general physician if you have a history of back pain or joint pain. Some pregnant women can use pads wrapped in a towel to treat their pain. However, it’s important to keep the temperature of the pad below 100-degree F or 37-degree. 

  • Avoid or restrict seafood:

Seafood is widely accepted as a source of dozens of essential nutrients. Various seafood items contain abundant proteins and fats. But shark, swordfish and other similar fish species contain high levels of mercury. Some seafood items may lead to growth deficits in kids. The first trimester is the best phase to avoid seafood. It’s even better to avoid seafood throughout pregnancy. And if you feel like eating any seafood items in pregnancy, consult the right dietician or your obstetrician.?˜

  • Avoid processed foods:

Majority of the processed foods are dangerous in pregnancy. They contain additives and substances detrimental to foetal development. Many food additives contain traces of sodium nitrate and carcinogenic substances. Pesticides are also known to leach into processed foods. It’s, therefore, essential that you stick to organic foods and avoid packaged items. Make sure that the fruits and vegetables in your kitchen are properly washed and sanitized. 

  • Be choosy while zeroing your search for the right diet:

Effective weight management and healthy metabolism are the two essential parts of a well-defined pregnancy. And healthy food choices facilitating a balanced diet give you all you expect from a healthy lifestyle. Make sure you are getting abundant vitamin D, mostly from the sunlight. Incorporate more nuts and seeds that fulfil your need for omega-3 fatty acids. Omega-3 fatty acids aid the healthy development of your baby’s brain, eyes, and nerves. Include more calcium through spinach, tofu and broccoli. Dairy products are rich sources of Calcium. 

  • Exercise:

Start with the mild sessions of warm-up or leisurely walks. Avoid brisk walks in the pregnancy. Yoga forms the irreplaceable part of a healthy lifestyle, specifically in pregnancy. Avoid heavy or strenuous exercises that may interfere with your baby’s healthy growth. Some exercises may even lead to preterm labour. Activeness and metabolism are the two essentials of a healthy pregnancy. Light exercises serve the purpose to the fullest, especially during pregnancy. 

  • Be cautious about prescription medications:

Your obstetrician may scrutinize you for at least 30 minutes if you have a sensitive medical history. He or she may ask you about the prescription medicines you are taking when you are in the first trimester. Some medications may contain teratogens – substances causing birth defects. Antibiotics like streptomycin and tetracycline, anticonvulsants like Coumadin, and Acne medication Accutane are some detrimental medications in pregnancy. It’s better to avoid a different doctor or physician prescribing any medication for you in pregnancy. If you have no other choice, it’s better to consult your midwife/obstetrician.

  • Occupational hazards:

If your occupation involves anything risky like handling chemicals such as mercury, it’s better to inform your immediate supervisor. It’s difficult for pregnant women, irrespective of their trimester, to pursue a job that demands strenuous physical effort. Consider taking early maternity leave or cut back on your routine.

  • Practice mindful eating during pregnancy:

Practicing mindful eating is a key component of maintaining a healthy and nutritious diet. Mindful eating involves being present and fully engaged in the eating experience, paying attention to hunger and fullness cues, and making conscious choices about the foods you consume. To ensure healthy eating during pregnancy, focus on a balanced diet that includes a variety of nutrient-rich foods. This means incorporating ample amounts of fruits, vegetables, whole grains, lean proteins, and healthy fats into your meals. To alleviate nausea during pregnancy, it is advisable to avoid foods that trigger discomfort.

What happens if you don’t eat enough while pregnant?

Pregnancy care and maternal nutrition:

Maternal nutrition is an irreplaceable part of a healthy pregnancy and childbirth. Effective prenatal care may include various things from taking prenatal vitamins to regularizing on physical exercise. Maternal nutrition offers unique opportunities to address and overcome concurrent health problems. Prenatal nutrition plays a crucial role not just in foetal development and growth but also in the health the offspring carries throughout his/her life.

A balanced prenatal regimen contributes to foetal health and prevention of congenital malformations, low birth weight and premature birth. Pregnancy is often reckoned as the right time to facilitate a healthy diet. Evidence shows that a high body mass index (BMI) before pregnancy, obesity and malnutrition in pregnancy may raise the risk of noncommunicable diseases (NCD). Your obstetrician may ask you to join an aerobics or pregnancy exercise class. 

Optimal nutrition in pregnancy… What’s that?

Optimal nutrition in pregnancy is vital for a healthy pregnancy and childbirth. A healthy diet in pregnancy minimizes the chances of your baby developing some dreaded illnesses later in life. They may be diabetes, heart disease and obesity. Studies even denote that a healthy diet in pregnancy is the secret to drastically minimize the chances of your baby acquiring eczema, hay fever and asthma after childbirth. A conceiving diet allows you to enhance your fertility and carry the pregnancy to term. 

How would you start?

Give a zestful start to your pregnancy diet by including whole foods. Prefer minimally processed foods and those close to the natural form. Avoid packaged foods, especially if the packaged foods contain any unfamiliar ingredient.

  • Protein:

Most women need about 80gm of protein in pregnancy. Seek your obstetrician’s help to calculate the recommended daily dose of protein.

  • Healthy fats:

Fats are known to interfere with weight management programs. But research shows that healthy fats may be necessary for all types of body systems. Adequate fat plays a crucial role in the growth of a baby’s organs and brain. Avocado, seeds, eggs and nuts may help satiate your fat requirements in pregnancy. 

  • Fresh vegetables and fruits:

All of us know how important vegetables and fruits are in our dietary regimen. Fruits and vegetables form some of the richest sources of minerals, fibres and vitamins. A fibrous diet is known to aid in a healthy lifestyle free of dyspepsia and constipation. Enjoying a good variety of fruits and vegetables will help you obtain a majority of the dietary essentials. Take green leafy vegetables and increase your intake of folate every day. 

  • Medium intake of starch and grains:

Brown rice, whole-grain foods like whole-grain pasta and whole oats are a few of the beneficial choices. Avoid high consumption of carbohydrates including sugars and refined carbohydrates. These are the ingredients that dysregulate the blood sugar levels raising the risk of gestational diabetes. Foods containing starches are essential in medium quantity. However, make sure your obstetrician is okay with your decisions on grains and starches. If you are allergic to grains, it’s best to avoid them. If you find them beneficial for your overall health, make sure you render them digestible. Making the grains more digestible by various techniques like soaking may add value to your diet. Digestible grains also increase the nutritional availability in them.

  • Reasons to avoid processed and high sugar foods:

 Processed and high sugar foods contain below average nutrition. They often contain chemicals harmful to your health and your baby’s future. Replace every food as such with something more nutritious. It will help you feel satiated and contented all day long. 

  • Now it’s about fluids:

Morning sickness and constipation tend to haunt pregnant women more often. Various changes in hormones and the overall system make every day different from days before conception. A rise in the blood volume in pregnancy makes it mandatory to increase daily water intake. Adequate levels of water support pregnant women’s digestive health. They are even essential to replenish the amniotic fluid of the baby. Most fluids come from water, juices and herbal teas. Fluids are essential to effectively tackle dietary essentials. But it’s more important to avoid fluids containing caffeine. Avoid soft drinks, alcohol, tea, coffee, soft drinks and soda. Conceiving Healthy foods help a healthy conception. And fluids provide the proper support throughout the pregnancy.

  • Multivitamins:

The spinal cord of a foetus tends to develop 4 weeks after conception. Folic acid aids a healthy pregnancy like no other vitamin. Most obstetricians recommend 400mcg folic acid. Folic acid helps prevent neural tube defects in the foetus. Make sure you start administering folic acid right after knowing that you are pregnant. If you have realized that you have an MTHFR gene mutation, start supplementing Leucovorin. Conceiving foods help raise fertility levels. And maintaining nutrition throughout pregnancy takes some smart efforts. 

  • Magnesium:

Magnesium plays a crucial role in foetal bone health and teeth development. Magnesium allows the muscles to relax. Muscular relaxation directly helps prevent constipation. It even contributes actively to tissue growth and promotes sound sleep. Magnesium may help prevent premature contraction of the uterus. 

  • Omega-3:

Omega-3 fatty acids contribute to the neurological and visual development of the foetus. Omega-3s are linked to the production of breast milk. Studies denote many positive outcomes of omega-3 fatty acids. Supplements containing omega-3 fatty acids in pregnancy help boost the baby’s IQ. They are vital for the cognitive development of the foetus. Some studies show that omega-3 fatty acids may effectively tackle the risk of allergy development in the baby. Reduction in premature labour, lower risk of maternal depression and low risk of preeclampsia are the other health benefits of adequate omega-3 fatty acids. However, the requirement of omega-3 fatty acids in pregnancy may differ from woman to woman. Seek your obstetrician’s opinion on the appropriate level of intake. 

  • Probiotics – What about them?

Parental history of allergies may interfere with the baby’s health later in life. If you both or either one of the partners has a history of allergies, your obstetrician may guide you on which probiotics can benefit your pregnancy. Some probiotics may help prevent the risk of the babies developing allergies. 

Foods to avoid in pregnancy:

  1. Salad bars
  2. Soft cheeses
  3. Raw fish
  4. Fish containing mercury
  5. Cuts of cured meat 
  6. Unwashed fruits and vegetables
  7. High levels of caffeine
  8. Raw eggs
  9. Undercooked meats

How does a mother’s nutrition affect the foetus?

Impact of a mother's nutrition on fetal development - Motherhood Hospital India

Almost everyone close to an expectant mother motivates her to eat for two. How does it apply to pregnancy and pregnant women? Although it implies that pregnancy is a license to enjoy overeating, maternal nutrition is much above plenty of food. It means ample calories and proper nutrients are vital to a healthy pregnancy. Consuming the right foods and choosing the right diet allows full-fledged foetal development. The mother needs to gather the right bits of information on prenatal diet and supplements. The mother should plan her diet and ensure that the unborn is getting the proper nutrients. And certain tips for new mothers are a key to assuring health throughout all the trimesters.

Prenatal nutrition Ÿ?? An overview:

Nutrition is known as the most significant factor in healthy foetal development. The availability of the nutrients for the foetus depends on various factors. The factors may include nutritional stores, diet and maternal body composition. Prenatal nutrition stands as the most important determinant of various developments. It impacts foetal growth, physiological functionality and Gestational Weight Gain (GWG). Gestational Weight Gain (GWG) is a complex phenomenon contributing to active foetal growth and development. Maternal metabolism, maternal physiology and placental metabolism influence the GWG. The changes in maternal homeostasis interfere with the placental structure and function thereby influencing the growth of the foetus. 

How to count calories for pregnancy?

Exceptions may exist even in terms of maternal health as they do elsewhere. Many pregnant women feel perplexed that they don’t require any additional calories in the first trimester. The second trimester, however, may mark the onset of about 340 additional calories per day. The third trimester involves the consumption of about 450 additional calories every day. 

Weight gain remains a normal change in pregnancy. Most obstetricians view weight gain as a normal development in pregnancy. Maternal weight gain influences the growth of the foetus. Poor growth and shortened gestation may raise the risk of babies with low birth weight.?˜

How does pre-pregnancy nutrition affect foetal growth?

The maturation of sperm and oocytes mark the onset of the periconceptional period that occurs before fertilization. The period extends until the fertilized egg implants. The overall process completes relatively faster (about 9 days in humans) than expected. But various developmental, metabolic and genetic changes render the process different. The embryonic genome sees epigenetic changes. More formally, the changes to the DNA don’t alter the genetic code, they instead affect how a gene gets expressed by turning the expression on or off. 

 Such modifications are sensitive to environmental conditions and prominent nutrients. They might adjust to facilitate survival under available conditions. Nonetheless, the gene pattern may be deleterious in environmental conditions outside the uterus. It may ultimately contribute to ailments later in life. 

Epigenetic changes prevail throughout one’s lifetime. The periconceptional period, however, remains unique as only a small number of cells are present in the period. Complete exposure to the environment facilitates the overall cell population to consolidate a genetic program that prevails throughout the development. 

Does it influence the present situation? And how so if it does?

The concept doesn’t stand as a new trend. Previous analyses have studied the impact of periconceptional maternal nutrition on the disease and development of offspring. Maternal obesity or maternal overeating can negatively influence the metabolic regulation in a child. Various factors including undernutrition may raise the risk of metabolic disease in the offspring. 

Essential nutrients for pregnant women:

Various nutrients vital for maternal health determine the foetal health throughout the development of the foetus. Various nutrients shape foetal nutrition and development throughout pregnancy.

Below are the essential nutrients:

  • Iron:

Iron is an irreplaceable mineral carrying oxygen to the maternal and foetal organs and tissues. The dietary iron needs tend to double in pregnancy due to various reasons. Blood volume increases both for the mother and her unborn in pregnancy. The recommended iron dose for pregnant women is 27mg. Most dieticians and obstetricians recommend an iron-fortified prenatal vitamin. Red meats, leafy greens, oats, fortified grains, lentils and beans offer opulent iron content. Citrus fruits, peppers, tomatoes and strawberries in combination with iron-fortified vitamins or supplements will aid in iron digestion and absorption. 

  • Folate:

Healthcare professionals worldwide recognize folate as an essential nutrient for foetal growth. Folate stands as a vital nutrient for foetal brain development and spinal cord development. The folate deficiency is often linked to neural tube defects. Women should consider administering folate before they conceive. 

Pregnant women need at least 600 mcg of folate a day. Nuts, seeds, eggs, leafy green vegetables, broccoli and fruits are the rich sources of iron. Confide in your doctor while you are expecting. It’s best to openly discuss your medical history with your obstetrician. It helps your obstetrician to recommend the right dosage of folate and other nutrients. 

  • Calcium:

Calcium plays a crucial role in foetal bone development and teeth. It has a role even in maternal orthopaedic health. The scarcity of calcium in prenatal health leads to the exhaustion of the maternal calcium stores. Mother’s bones may suffer as a result. Calcium intake in expectant women may aid in dozens of healthy developments. 3-4 cups of dairy may suffice the daily requirement of 1000mg calcium. Soy products, broccoli, canned salmon, dark leafy vegetables are recommended in the absence of dairy. 500mg calcium may aid in better absorption of calcium. Various calcium supplements are available today in the marketplace.

  • Choline:

Choline is a dietary essential helping the brain and spinal cord maturation in pregnancy. Eggs, beans, nuts and animal products offer rich choline content. 

  • Vitamin D:

Vitamin D works in collaboration with calcium towards the healthy development of foetal bones and teeth. Therefore, most obstetricians maintain that Vitamin D is a must for pregnant women. The recommended dose of Vitamin D in pregnancy is 15 mcg. Sunlight, fatty fish, eggs, fortified milk and mushrooms are various sources of Vitamin D. 

  • Fibre:

Fibre always remains one of the most integral dietary essentials. Many pregnant women complain about developing constipation during pregnancy. Various fruits and vegetables rich in fibre are recommended right from the first trimester of pregnancy. Water is another natural resource that helps prevent constipation. 

What are the first 1000 days in pregnancy?

What is ‘the first 1000 days?’

Pregnancy care remains one of the most important aspects of obstetrics and gynaecology. The first 1000 days signify the period that spans 1000 days from the conception of a child. It’s a period that denotes the children’s experiences throughout the first 1000 days of their life – from conception to age 2. The concept of ”First 1000 Days” involves a period of swift physical growth and quick mental growth.

The foetal health depends upon the mother for nutrition and various other aspects. Mother’s nutrition plays a crucial role in the mental, emotional and physical growth of the foetus. The first three months of pregnancy are referred to as the first trimester. 

‘The first 1000 days… Why are they so important?

Statistics suggest that about 155 million children worldwide suffer from stunting. Stunting or stunted growth involves a low birth weight for the age of such children. 52 million kids are wasted. It signifies that 52 million kids have a low birth weight for their height. A population of about 41 million kids grapple with obesity or being overweight. As many as 50% of pregnant women worldwide suffer from anaemia due to poor diet. The same issue contributes to anaemia even in the babies born to anaemic ladies. Millions of children are unable to get the nutrition they require for healthy growth and development. 

Nutrition in pregnancy and infancy:

Do you wonder how you can facilitate proper trimester care? You may consider various methods to ensure sufficient nutrition for your infant during the first 1000 days. The first step towards full-fledged pregnancy care starts during the first three months of pregnancy. The first step is to eat a varied diet full of vitamins and minerals. Breastfeeding is the best way to start strengthening the baby soon after he/she is born. Breastmilk is known for various health benefits. It promotes higher intelligence, IQ scores, and motor function skills. Breastmilk is essential for healthy brain development. Breastmilk protects the baby from various health issues. They may include eczema, abdominal issues, SIDS, various allergies and viruses. Breastfeeding betters the overall senses and emotional processes in the babies. 

As you are done with breastfeeding, stockpile your kitchen with natural ingredients and wholesome foods. Make sure that your baby is getting a list of items full of micronutrients. They should be free of allergens. It’s time you allow your baby to pamper his/her taste buds. Informed parenting and nutritional diet are the backbones of those healthy 1000 days. 

Nutrition in the first 1000 days:

Parents play a crucial role to identify the kid’s nutritional requirements. Babies require ample proteins, calories and nutrients- as a foetus and as a child – for a healthy life. Below is a list of nutrients essential for the babies during the first 1000 days.

  • Vitamin A:

Major organs, vision and cells depend on Vitamin A. The deficiency of Vitamin A may be rare. But now, it’s occurring as a global challenge.

  • Long-Chain Polyunsaturated Fatty Acids (Like DHA):

DHA, more formally, long-chain polyunsaturated fatty acids are essential in the healthy development of the brain. DHA aids the overall immunity and immune function. This is probably the reason why most obstetricians ask pregnant women to stay away from fish contaminated by mercury. 

  • Calcium:

No other nutrient replaces Calcium in the way it aids bone function. Calcium is an irreplaceable part of a kid’s diet as it addresses bone health. Calcium forms a major part of the nutrition required for healthy blood clot function, muscles, teeth and nerves. 

  • Folate:

Folate is essential for the health of both mother and her baby. Folate plays a crucial role in the development of the brain and spinal cord. Fruits, grains, prenatal vitamins and leafy green vegetables promise ample supply of folate. 

  • Iodine:

Iodine actively contributes to healthy brain development. Lack of iodine or scarcity of iodine may impair brain development. 

  • Iron:

Around one in 10 kids grapple with iron deficiency in some phase. The deficiency of iron may cause impairment of social behaviour, disabilities while learning and irritability. Every baby is born with some quantity of iron. The overall amount of iron naturally depletes in 4-6 months. And therefore, iron supply is important throughout the 1000 days of a baby’s life. Iron is also linked with depression in later life. Even if you address the deficiency of iron in the first 1000 days, it may influence adulthood. It’s important to ensure ample provision of iron from pregnancy through the age of two. 

Baby’s brain in the first 1000 days:

The first 1000 days are crucial for the baby’s brain to develop quickly. The baby’s brain develops quicker than ever during these first 1000 days. The way the brain of the baby develops and accustoms itself to its environment determines the kind of personage the baby will grow into. A dietary regimen you introduce to your platter in pregnancy will contribute to your baby’s intelligence. Similarly, the diet in early childhood allows your baby to learn, adopt physical skills and foster good emotional health.

Being famished or exposed to distress during the first 1000 days will leave lifelong impacts on your baby’s healthy growth. The brain is an organ that associates itself with many other parts of the body. Therefore, if it’s exposed to unsafe or unhealthy circumstances in the first 1000 days, it hampers physical growth as well. 

Distress and trauma during the first 1000 days:

Baby’s nervous system and healthy growth is an unavoidable aspect of a healthy pregnancy and childbirth. Researches denote that a mother exposed to distress or depression in pregnancy may end up complicating the overall pregnancy and childbirth. High blood pressure, obesity, diabetes and heart ailments may threaten the baby later in his/her life. 

Domestic violence or emotional neglect in pregnancy may leave lifelong impacts on the baby. Parents who lack composure before the baby is born may fail to establish a good emotional rapport with the baby. It’s not your fault if you encounter any emotional neglect in pregnancy. But speak to a counsellor or a life coach if you need a kind hand. 

What best can you do to achieve the maximum benefits from the first 1000 days?

  1. Enjoy a healthy and balanced diet when you are pregnant
  2. Seek psychological support if you feel that you are facing emotional neglect. 
  3. Avoid smoking, caffeine, alcohol and drugs
  4. Breastfeed the baby at least for the first 6 months.
  5. Make sure that the baby is on a healthy and balanced diet
  6. Give your baby the love and attention and make her feel secure
  7. Manage your stress by getting involved in various playful and funny activities 
  8. Form an affable relationship with your baby
  9. Relationships are the bonds that your baby learns to develop from you.
  10. Let them learn how to view the world and how to fit into a healthy society with healthy relationships. 

How long can I go without eating while pregnant?

How long can I go without eating while pregnant?

Author – Dr. Shefali Tyagi MBBS, DGO, FRCOG, MRCOG, PGDMLE, PGDPC, FRANZCOG
Consultant – Obstetrics & Gynaecology at Motherhood Hospital, Sarjapur

Pregnancy is the phase where your body undergoes various changes. You start knowing these changes better as your delivery date gets closer. For a few people, these changes may be worrisome. If you begin to gain weight, you must realize that there are food items to keep you healthy. There may be many alternatives to opt for. Conceiving foods are those that help you maximize your fertility.

Most religions consider fasts as a ritual of gratitude towards god. And even atheists may practice fasts as a trend. But do you think it’s safe to observe fasts when you are pregnant or breastfeeding? Fasts you observe for religious causes are different from those observed to manage weight. 

How much weight gain is in a healthy range in pregnancy?

Mothers should always rely on a healthy and balanced diet plan as they plan to conceive or attain the conception. A healthy weight is mandatory to ensure that both mother and baby are in good health. 

  • The women with a normal body weight should aim for an increase of around 11kg to 16kg.
  • Women who are obese before their pregnancy shouldn’t gain above 7kg to 11kg as they become pregnant.
  • Women who are underweight before their pregnancy should seek their obstetrician’s advice. 
  • The obstetrician may consider checking your medical history.
  • Your obstetrician may recommend an increase of around 12kg to 18kg.

What conceiving foods should you add to your platter?

The day you prepare to conceive is perhaps the day that makes you more diet-conscious than ever. If you are preparing a platter that makes you fertile, here are the foods to add.

  • Beets:

Beets are perhaps the most underrated foods. Beetroots may help improve blood flow to the uterus. It ultimately aids embryo implantation.

  • Sweet potatoes:

Sweet potatoes contain beta-carotene, an ingredient best known to aid the production of progesterone.

  • Berries:

Folate and zinc are the two antioxidants known to deactivate the free radicals. Raspberries, blueberries and strawberries contain antioxidants that enhance fertility. Just add berries to your platter along with some healthy fat and proteins.

  • Walnuts:

If you enjoy a snack that spices up your evening, walnuts will be the best bet. Walnuts are an excellent source of Vitamin E and omega-3 fatty acids. They even contain B vitamins and protein. Apart from being turbocharged fibres, they are the only vegetarian foods containing omega-3 fatty acids. 

  • Sunflower seeds:

Male fertility is unquestionably as important as female fertility. Sunflower seeds improve sperm motility and boost the male libido by increasing the sperm count. Sunflower seeds make one of the best garnishes for your favourite delicacies.

  • Leafy green vegetables:

Green leafy vegetables are an all-time favourite for many. They are the evergreen boosters of health. But they are especially important when you are planning to get pregnant. Leafy green vegetables are a rich source of iron, folate, calcium and many other essential nutrients.

Is it safe to observe fast when you are pregnant?

Carrying a baby tends to increase your nutritional needs by about 300 calories per day. Fasting in pregnancy may be difficult. Some researches show that staying away from food or fasting for any length of time in pregnancy may contribute to the production of ketone bodies. Ketone bodies are the molecules produced by the liver in periods of low food consumption. They may leave adverse effects on the foetal health. These are the factors that predispose pregnant women to risks. You must abstain from fasts while carrying.

Most religious disciplines exempt pregnant and lactating women from fasts. Hydration is often the key to maximize your prenatal health naturally. Water plays a crucial role in the healthy growth of a baby. Therefore, it’s essential to stay hydrated in every phase of pregnancy. Many studies link dehydration to various health issues such as preterm labour, birth defects and low amniotic fluid. It’s best to seek your obstetrician’s guidance and stay under a midwife’s observation. Ask your dietician/obstetrician about how to round off a ‘conceiving diet’/pregnancy diet plan.

You should ask your obstetrician if it’s safe to observe a fast in pregnancy. Most obstetricians will ask you to drink at least 8 glasses of water a day. You may be asked to stay away from any strenuous physical activity. No two pregnancies are the same. If your obstetrician confirms that it’s safe to observe a fast, you may proceed. Your obstetrician may consider many other factors before allowing you to fast. The factors may be the trimester you are in, your medical history, previous deliveries and the medical conditions underlying. Your obstetrician may ask you to prevent loss of fluids.

How safe is it to observe fasts while breastfeeding?

Breastfeeding adds more to the nutritional requirements. You may need at least 450 to 500 extra calories per day. You may gradually start feeling better and decide how you can start or continue fasting. Almost every religious discipline would exempt mothers who are breastfeeding from fasting. 

Most reputable obstetricians agree that fasting for a day doesn’t affect milk production or the mother’s health or baby’s health. The only condition for a fast in breastfeeding is that both mother and baby should be in good health. Moms should seek an obstetrician’s advice. Obstetricians may advise you to increase your fluid intake before fasting.

The other condition for a safe fast is your abstention from strenuous exercises. Fasts tend to burn too many calories. And if you are fasting, strenuous exercise may complicate the overall health. If you feel thirsty, it’s a likely sign redirecting you to increase your water intake. Moms who are breastfeeding should habituate themselves to regular water intake. A few additional glasses every day while nursing may elevate your overall approach.

However, your obstetrician may not want you to extend your fast on any grounds. Extending fasts while breastfeeding may hamper the milk quality. It may affect your baby’s health. Your obstetrician may even prevent you from observing a fast soon after the childbirth. The reason why you should abstain from fasting instantly after childbirth is exhaustion. Your body and your baby are recovering from exhaustion after delivery. Your body is busy establishing the maternal milk routine. A healthy breastfeeding diet is as important as healthy conceiving foods. Therefore, extending a fast in pregnancy or breastfeeding isn’t always a good idea. 

At Motherhood Hospitals, we have a team of experienced super specialists backed by the latest in infrastructure and facilities. We have the best fetal medicine specialists in Sarjapur Road, Bangalore. We are experts in handling complex deliveries, gynecological, and other surgeries including a range of laparoscopic surgeries.

Do take an appointment with the best maternity hospital in Sarjapur Road, Bangalore at a center closest to you. Meet with our doctors who will carry out the required investigations, diagnose the issue and recommend the most appropriate treatment, enabling you to lead an active life.

If you wish to get in touch with Dr. Shefali Thyagi, please book your appointment here.

How can I take care of myself during pregnancy?

Taking care of yourself and your baby is important. And the extensive care starts the day you realize that you are pregnant. Pregnancy care is easier than expected, specifically when you start it at the earliest. The concept of pregnancy care or prenatal care may include various healthy lifestyle choices. Right from taking prenatal vitamins to scheduling appointments with your obstetrician, a healthy pregnancy denotes all you can start methodically. 

How much weight gain is normal or essential in pregnancy?

Your obstetrician or midwife will guide you about healthy weight gain. It happens to be different for everyone. Nonetheless, most women gain about 25 to 30 pounds. Underweight women may have to gain more weight as directed by their obstetrician. Being overweight or underweight demands different dietary interventions. It may further depend upon various parameters like your BMI and medical history.

How do you wish to begin your journey?

A journey that starts with the first trimester spans 9 months of ecstasy and a bit of nervousness. Start with an appointment with your obstetrician. Schedule an appointment immediately as you find that you have sprained your ankle. Your obstetrician will start with knowing about your medical history. Doctors may ask you about the symptoms you developed after your pregnancy began. Your obstetrician may subsequently give you some invaluable pregnancy tips on safety and nutrition. 

  • Start with quitting smoking:

That’s the best thing you can ever do for yourself and your baby. Countless studies worldwide show that women exposed to smoke are less likely to conceive. They may not carry their pregnancy to term even if they conceive. And smoking predisposes you to grave complications in labour. Studies associate smoking with an increased risk of having a premature baby or stillbirth. It’s perhaps the best time to kick the butt. 

  • Enjoy a diet that balances your nutritional requirements:

Eat plenty of vegetables and fruits. Carbohydrates may fulfil your nutritional requirements. Beans, cheese, meat, fish, pulses and eggs are those dietary essentials you should start counting on. Based on your pre-pregnancy health, you may consider including an additional meal in your diet. Both perennial and seasonal fruits help you maintain a healthy regimen. Green leafy vegetables are jampacked with iron and folic acid. Start eating nuts and make yourself full of vigour and vitality throughout the pregnancy.?˜

  • Start practising a lifestyle full of hygiene and sanitation:

Wash your hands frequently. Use a soap preferably recommended by your obstetrician or midwife. The importance of hygiene and sanitation is growing day by day. Make sure that your hands are thoroughly sanitized before and after every meal. Trim your nails frequently. Personal hygiene helps you prevent infections and transmitting them to the baby.

  • Mild physical activity in pregnancy:

You may consider joining a pregnancy exercise class. Many yoga classes held today will give you the right knowledge on exercise in pregnancy. It’s great to exercise every day unless you have issues regularizing your exercise. Exercise helps you thrive on a healthy lifestyle and avoid tedium. Try to exercise for 30 minutes every day. Enjoy slow walks in the garden or lawn instead of brisk walks. Swimming is another choice that makes your day. Hydrating yourself is mandatory to assure that you don’t suffer from heats or dehydration. Dehydration is a common concern in the second trimester. Avoid any exercises causing a fall or skid. Wear skid-proof footwear. 

It’s best to contact your GP or obstetrician if you develop the following symptoms while exercising:

  1. Backache
  2. Chest pain
  3. Dizziness
  4. Blurred vision
  5. Loss of orientation 
  • It’s better to jot down all:

You may have many things to consider as you conceive and start nearing childbirth. You may take many things into account. Think about your medical history, your preferences, your current health status and your immediate surroundings. Write down all you wish to follow and include.

Following are the things you may consider including in your diary:

  1. How would you include pain medications?
  2. Special clothes you wish to wear
  3. Your favourite music/tracks
  4. Positions you prefer for labour and childbirth
  5. If you wish to avoid any procedures
  6. Plans to cope with complications if you have a medical history as such

How would you avoid or cope with the common pregnancy concerns?

  • Morning sickness:

Nauseous sensations are common mostly in the broad daylight during pregnancy. It’s better to plan small meals and eat them exactly as planned. Avoid anything that tastes spicy or acidic. Acidic foods may complicate your morning sickness in various ways. It’s better to confide in your obstetrician or midwife if your morning sickness lasts longer than 3 months. Morning sickness and weight loss may be the signs that foretell complications. Bring those to your obstetrician’s notice if weight loss accompanies 3 extensive months of morning sickness. 

  • Muscle cramps:

Muscle cramps or leg cramps may not be there to stay. If mild physical activity accompanies your midwife’s suggestions, you may avoid leg cramps easily. Stretch the calves of your legs by flexing your feet towards your knees. Drink plenty of water as directed by your obstetrician.

  • Tiredness:

Nothing is as common as tiredness and doldrums when you are pregnant. Take naps each time you feel overridden by doldrums. Make sure you aren’t anaemic. If you are anaemic, take every necessary precaution as your obstetrician guides you. 

  • Constipation:

Fibre happens to be the best natural source available if you feel constipated. Drink plenty of water. Fruits, vegetables and cereals may suffice. Laxatives can be dangerous in pregnancy. Don’t take any laxatives unless your obstetrician asks you. Prefer stool softeners over hard laxatives.

  • Haemorrhoids:

Constipation can be a precursor to Haemorrhoids. Avoid straining while passing the stool. Use stool softeners instead of any laxatives. 

  • Varicose Veins:

Don’t use tight clothes around your waistline or legs. Rest with your feet facing the ceiling. Don’t sit in an uncomfortable posture for a long time. Avoid standing for an extended period. 

  • Downright moodiness:

Hormonal changes are prevalent in pregnancy. It’s not new for a pregnant lady to develop moodiness in pregnancy. Life is all set to welcome a pleasant change. Get set for it with open arms. Avoid being rough on yourself. Consult the right psychiatrist if you feel overridden by nervousness or depressive thoughts. 

Hypothyroidism and its effect on unborn child By Dr Tulika, Motherhood Hospital, Noida

In India, thyroid diseases are quite prevalent in expecting women. It has been found that the occurrence of hypothyroidism, a condition in which the thyroid gland doesnŸ??t produce certain crucial hormones in the body, in pregnant women in India is between four and six per cent on an average. However, the similar condition affects only two to three per cent of pregnant women in western countries.

Unchecked or untreated hypothyroidism during pregnancy leads to preterm birth and low birth weight in the babies. So, itŸ??s important that a woman should get herself checked for thyroid especially during pregnancy because the fetus relies on the mother for thyroid hormones in the first few months of conception.  The thyroid hormones present in the motherŸ??s body essay an essential role in normal brain development of the unborn child and thus, deprivation of the maternal thyroid hormone due to hypothyroidism can have unalterable effects on the fetus.

Even studies have presented that those children, who were born out of hypothyroidism mothers during pregnancy, have lower IQ and impaired psycho-motor (mental and motor) development. But, fret not!  If the condition is properly controlled and treated well, then those women with hypothyroidism can also have healthier babies.

Effect of Hypothyroidism on unborn child and mother

Since the thyroid gland of the unborn child takes time to function on its own, itŸ??s completely dependent on the mother for the thyroid hormones.  Development and functioning of baby’s thyroid gland do not take place until about the end of the first trimester of pregnancy. Therefore, it’s suggested that women should start getting their thyroid disorder managed before conceiving so that impaired neurological functioning, stunted growth and physical deformities in the children can be avoided.

There is always best to plan for pregnancy and to consult with your physician to ensure your thyroid status and treatment are optimized prior to becoming pregnant and monitored throughout your pregnancy. However, if this does not happen and you find out you are pregnant, you should contact your physician immediately to arrange for increased testing of your thyroid functions and a potential change in your medication.

Untreated or poorly controlled hypothyroidism can also lead to:

Miscarriage

Premature birth

Pre-eclampsia

Stillbirth

So, it is vital for pregnant women with hypothyroidism to take the recommended thyroid medication consistently.

How is hypothyroidism treated during pregnancy?

The treatment of hypothyroidism in pregnant women is similar to that of who are non-pregnant. Doctors recommend synthetic T4 so that it compensates the presence of essential hormones in the body. The medication should be taken regularly so that a steady blood level of thyroid hormone gets adjusted within the normal range as the requirement of thyroid hormones increases during pregnancy. Therefore, it is a routine practice to monitor the blood level of the thyroid stimulating hormone (TSH) during pregnancy. Hyperthyroidism women can have healthy pregnancy by getting early prenatal care and working with their healthcare providers in the management of their disease.