For Baby and You




Having a healthy pregnancy is good for you and for your soon-to-be bundle of joy.It makes some women glow, others pale. It usually leads to joy, but also a lifetime sprinkled with stress and worry. Pregnancy is a transformative experience like no other, one that can make a mom-to-be's head spin - not from physiological changes, but from all the advice she receives, from her mom and Aunt Sally to strangers at the grocery store.Teasing out sound guidance from old wives' tales isn't always easy, and every pregnancy is unique, so the best route is to seek prenatal advice early from your doctor. But there are general, smart lifestyle choices women can make during a normal pregnancy that will increase the odds of having a healthier and more enjoyable pregnancy, birth and post-partum experience.To sweat or not to sweatOnce upon a time, pregnant women were told to rest and be pampered. While the idea of taking it easy is appealing and women should, in fact, take care not to overwork themselves, pregnancy these days is seen more as a time to be proactive and maintain (hopefully) good exercise habits, especially since obesity in America continues to earn top billing as a healthcare concern.Pregnant women should approach exercise wisely, given that, taken to an extreme, it can create its own risks, but a prudent workout routine during pregnancy can reap many rewards. Perhaps the most obvious payback from regular exercise is that it helps keep maternal weight gain in check, says Danielle T. Albushies, M.D., an obstetrician and gynecologist at Bedford Commons OB-GYN. "A lot of our patients find that if they exercise, they're able to stay somewhere between the 20-30 pound [weight gain] amount that is recommended for normal weight women," she says.Curbing weight gain is important for reasons beyond vanity. Pregnant women who have a high weight gain tend to have harder births, often with over-sized babies. A bigger baby raises the likelihood of delivering via cesarean section rather than vaginally, Albushies says. "Whatever we can do to help women maintain a healthy weight in pregnancy will help the baby," she says. "The birth, whether it's vaginal or c-section, will be more complicated if the mom's weight gain is higher, which is less likely to happen in women who are staying active," she says.Plus, exercise decreases the development and risks of gestational diabetes. Doctors often encourage women to get in the habit of exercise prior to conception, Albushies says, since "it's much easier to continue an exercise regimen than to start an exercise regimen," she says, especially during pregnancy.Other reasons to exercise during pregnancy include more restful sleep, increased energy, better muscle tone and strength and more endurance - physical conditioning that carries into labor, says Sonja N. Nelson, M.D., chief of obstetrics and gynecology at Portsmouth Regional Hospital and an obstetrician and gynecologist at Women's Health Associates of Portsmouth. "It makes sense that you will do better in the active, pushing part of labor if you've got better endurance," Nelson says.Need more convincing? Consider exercise's psychological benefits: it calms nerves and boosts mood. "A lot of our patients are balancing work and being pregnant, and that's a lot, so if you've got a way to burn some of that stress off, it's helpful," Nelson says.In addition, regular workouts offer some sense of control over a changing body. "Many patients find it really difficult to be in a situation where they're gaining weight," Nelson says. "Exercise gives them a way to feel like, even though their body is still changing, they're doing what they can to stay healthy and minimize their weight gain, so that after they deliver, it's going to be a lot easier for them to get back to where they were in square one."If you don't want to do it for yourself, do it for your baby. The physical and psychological perks that come with exercise are "absolutely real," says Albushies. "It's clear that moms who have better mental health do better, and there are better outcomes for babies whose moms are healthier in mind and body."Two for teaPrenatal vitamins help safeguard against nutritional deficiencies in the average American woman's diet and provide the essential folic acid that pregnant women hear so much about. (Folic acid decreases the risk of spinal cord malformation in the baby.) But how much food is enough for a pregnant woman?Well, think of it this way: the target amount of pregnancy weight gain depends, to a large degree, on the expectant mom's weight as she enters the pregnancy. Women who tip the scales significantly beyond the normal range prior to pregnancy should put on much less than a thin woman should, Nelson says. "Your weight gain and how much you eat is going to depend on who you are when you start your pregnancy," she says.In general, women who begin pregnancy with a normal weight only need an additional 300-500 calories per day, depending on the trimester, Albushies says, which doesn't amount to much - a few pieces of fruit can add up to 300 calories. The additional caloric requirement during pregnancy certainly is not a license to eat for two. "Some women take it as a ticket to eat whatever, whenever, but it really is a matter of just getting that many extra calories," Albushies says.Women should also be cautious of restrictive diets that can raise their risk of being nutritionally weak in certain areas. If you're a vegetarian or on a low-carb diet, for instance, be sure to discuss that with your doctor, Albushies says, because babies require a mix of protein and carbohydrates for proper growth and development. "It's important for women to have a balance," she says. "Women who don't have a lot of dairy have to compensate. The patients who are used to a low-carb diet need to get the carbs back - the right carbs."A balanced diet will also stabilize blood glucose, which promotes feeling healthier and lessens light-headedness. It will also provide more energy, says Nelson, whose patients sometimes complain of feeling sick and faint an hour or so after they eat breakfast. She says, "When I ask them what they had for breakfast, they say, 'Oh, a doughnut or something.' And I tell them, 'You didn't have any protein!'" Pregnant women must consume the right blend of complex carbohydrates and protein to nourish their pregnancy as well as their body, she says.A final dietary note: don't be overly afraid of fish. Pregnant women are warned not to eat certain types because of possible mercury exposure, but women don't need to eschew all fish for the nine-month duration, Albushies says. Tuna fish, for example, is on the "to be avoided" list, but expectant moms can eat certain amounts of chunk light tuna, she says. "Fish is a beautiful, lean source of protein. It's a low-calorie, great source of omega-3 fatty acids," she says. Talk to your doctor about which types of fish are OK and how much you can safely eat.

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