Should I take a multivitamin during my pregnancy?

Yes. Most doctors recommend that pregnant women or those trying to get pregnant take a multivitamin or prenatal vitamin every day. This ensures that you and your baby get enough important nutrients like folic acid. Folic acid helps prevent serious birth defects of your baby’s brain and spine. These birth defects often happen before most women know they are pregnant.

Even women who plan carefully to eat healthy every day sometimes fail to get important nutrients. Taking a daily multivitamin or prenatal vitamin will guarantee you daily dose of needed nutrients. But don’t overdo it. Taking more than one multivitamin daily can be harmful.

What about other supplements?

Folic acid: Pregnant women need 400 micrograms (400 mcg) of folic acid every day to help prevent birth defects.

Folic acid is important for any woman who could possibly become pregnant. Folic acid is a B vitamin that helps prevent serious birth defects of a baby’s brain or spine called neural tube defects. Getting enough folic acid can also help prevent birth defects like cleft lip and congenital heart disease.

Getting enough folic acid is most important very early in pregnancy, usually before a woman knows she is pregnant. So, at least one month before you try to become pregnant you should make sure you’re getting enough folic acid. Women who are already pregnant need to get enough folic acid every single day.

An easy way to get enough folic acid is to take a multivitamin every day. Most multivitamins sold in the U.S. contain enough folic acid for the day. But be sure to check the label! Choose a multivitamin that contains 400 mcg or 100% of the Daily Value (DV) for folic acid.

Another way to get enough folic acid is to eat a serving of breakfast cereal that contains 100% DV for folic acid, every day. Check the nutrition label on the box of cereal to be sure. It should say “100%” next to folic acid. Orange juice, spinach and legumes are also good sources of folic acid.

Iron: Pregnant women need twice as much iron — 30 mg per day — than other women.

The Centers for Disease Control and Prevention (CDC) recommends that pregnant women start taking a low-dose iron supplement (30 mg/day) or a multivitamin with iron beginning at the time of their first prenatal visit. Ask your doctor what she recommends. Prenatal vitamins prescribed by your doctor or those you can buy over-the-counter usually have the amount of iron you need. But be sure to check the label to make sure. Pregnant women should also eat lots of iron-rich foods. Some good sources of iron include lean red meat, fish, poultry, dried fruits, whole-grain breads, and iron-fortified cereals.

Pregnant women need extra iron for the increased amount of blood in their bodies. Iron helps keep your blood healthy. Plus, your baby will store iron in his body to last through the first few months of life.

Too little iron can cause a condition called anemia. If you have anemia, you might look pale and feel very tired. Your doctor checks for signs of anemia with the routine blood tests taken at different stages of your pregnancy. If your doctor finds that you have anemia, she will give you a special iron supplements to take once or twice a day.

Calcium: Pregnant women aged 19 to 50 years should get 1,000 mg/day of calcium. Younger pregnant women need even more — 1300 mg/day.

Most women in the U.S. don’t eat enough calcium. So many pregnant women will have to change their diets to get their fill of this important mineral. Low-fat or non-fat milk, yogurt, cheese or other dairy products are great sources of calcium. Eating green leafy vegetables and calcium-fortified foods like orange juice and breakfast cereal can also provide calcium. If your diet is not providing 1,000 mg/day of calcium, talk to your doctor about taking a calcium supplement.

What role does water paly in nutrtion?

Water: Pregnant women should drink at least six eight-ounce glasses of water per day. Plus, pregnant women should drink another glass of water for each hour of activity.

Water plays a key role in your diet during pregnancy. It carries the nutrients from the food you eat to your baby. It also helps prevent constipation, hemorrhoids, excessive swelling, and urinary tract or bladder infections. Drinking enough water, especially in your last trimester, prevents you from becoming dehydrated. Not getting enough water can lead to premature or early labor.

Juices also contain water. But juice also has a lot of calories that can cause you to gain extra weight. Coffee, soft drinks, and teas with caffeine actually reduce the amount of fluid in your body. So caffeinated drinks do not count towards the total amount of water you need every day.

While you are pregnant, you will need additional nutrients to keep you and your baby healthy. But, that does not mean you need to eat twice as much. You should only eat an extra 300 calories per day. A baked potato has 120 calories. So getting these extra 300 calories doesn’t take a lot of food.

Fruits and Vegetables — Pregnant women should try to eat 7 or more servings of fruits and vegetables combined (for example: 3 servings of fruit and 4 of vegetables) daily.Fruits and vegetables are rich sources of fiber, vitamins and minerals. Fruits and vegetables with vitamin C help you and your baby to have healthy gums and other tissues. Vitamin C also helps your body to heal wounds and to absorb iron. Examples of fruits and vegetables with vitamin C include strawberries, melons, oranges, papaya, tomatoes, peppers, greens, cabbage, and broccoli. Fruits and vegetables also add fiber and minerals to your diet and give you energy. Plus, dark green vegetables have vitamin A, iron, and folate, which are important nutrients during pregnancy.

Whole-grains or Enriched Breads/Cereals — Pregnant women should eat 6 to 9 servings of whole-grain or enriched breads and/or cereals every day. Whole-grain products and enriched products like bread, rice, pasta, and breakfast cereals contain iron, B vitamins, minerals, and fiber. Some breakfast cereals are enriched with 100% of the folic acid your body needs every day. Folic acid has been shown to help prevent some serious birth defects. Eating breakfast cereals and other enriched grain products that contain folic acid is important before and during pregnancy.

Dairy Products — Pregnant women should try to eat 4 or more servings of low-fat or non-fat milk, yogurt, cheese or other dairy products every day. Dairy products provide the calcium you and your baby need for strong bones and teeth. Dairy products are also great sources of vitamin A and D, protein, and B vitamins. Vitamin A helps growth, fight infection, and vision. Pregnant women need 1,000 milligrams (mg) of calcium each day. If you are 18 or younger, you need 1,300 mg of calcium each day. Try to eat low-fat or non-fat milk and milk products to lower your fat intake. Other sources of calcium include dark green leafy vegetables, dried beans and peas, nuts and seeds, and tofu. If you are lactose intolerant or can’t digest dairy products, you can still get enough calcium. There are several low-lactose or reduced-lactose products available. In some cases, your doctor might recommend a calcium supplement.

Proteins — Pregnant women and their growing babies need 10 grams of protein more than non-pregnant women. Pregnant women should eat 60 grams of protein every day. Two or more 2-3 ounce servings of cooked lean meat, fish, or poultry without skin, or two or more 1 ounce servings of cooked meat contain about 60 grams of protein. Eggs, nuts, dried beans, and peas also are good sources of protein. But don’t rush out and buy high protein drinks! Women in the United States regularly eat more protein than they need. So you probably won’t have to make an effort to eat the needed 60 grams of protein a day. Don’t eat uncooked or undercooked meats or fish. These can make you sick and may harm your baby. Pregnant women should also avoid deli luncheon meats. Protein builds muscle, tissue, enzymes, hormones, and antibodies for you and your baby. Protein-rich foods also have B vitamins and iron important for your blood.

Most women develop mild swelling in the face, hands, or ankles at some point in their pregnancies. As the due date approaches, swelling often becomes more noticeable. If you have rapid, significant weight gain or your hands or feet suddenly get very puffy, call your doctor as soon as possible. It could be a sign of high blood pressure called preeclampsia or toxemia.

To keep swelling to a minimum:

• Drink 8 to 10 eight-ounce glasses of fluids (water is best) daily.
• Avoid caffeine.
• Try to avoid very salty foods.
• Rest when you can with your feet elevated.
• Ask your doctor about using support hose.

Teeth and Gums Problems

A pregnant woman’s teeth and gums need special care. Pregnant women with gum disease are much more likely to have premature babies with low-birth weight. This may result from the transfer of bacteria in the mother’s mouth to the baby during pregnancy. The microbes can reach the baby through the placenta (a temporary organ joining the mother and fetus which supplies the fetus with blood and nutrients), through the amniotic fluid (fluid around the fetus), and through the layer of tissues in the mother’s stomach.

Every expectant mother should have a complete oral exam prior to or very early in pregnancy. All needed dental work should be managed early, because having urgent treatment during pregnancy can present risks. Interventions can be started to control risks for gum inflammation and disease. This also is the best time to change habits that may affect the health of teeth and gums, and the health of the baby.

Remember to tell your dentist that you are pregnant! You can ease bleeding gums by brushing with a soft-bristled toothbrush and flossing at least twice a day. Get more details on taking care of your teeth and gums during pregnancy.

Digestive Difficulties

Constipation

Many pregnant women complain of constipation. High levels of hormones in your pregnant body slow down digestion and relax muscles in the bowels leaving many women constipated. Plus, the pressure of the expanding uterus on the bowels boosts the chances for constipation.

Try these tips to stay more regular:

• Eat fiber-rich foods like fresh or dried fruit, raw vegetables, and whole-grain cereals and breads daily
• Drink eight to ten glasses of water everyday.
• Avoid caffeinated drinks (coffee, tea, colas, and some other sodas), since caffeine makes your body lose fluid needed for regular bowel movements.
• Get moving. Mild exercise like walking may also ease constipation.

Hemorrhoids

Up to 50% of pregnant women get hemorrhoids. Hemorrhoids are swollen and bulging veins in the rectum. They can cause itching, pain and bleeding.

Hemorrhoids are more common during pregnancy for many reasons. During pregnancy there is a huge increase in the amount of blood in the body. This can cause veins to enlarge. The expanding uterus also puts pressure on the veins in the rectum. Plus, constipation can make hemorrhoids worse. Hemorrhoids usually improve after delivery.

Follow these tips to help prevent and relieve hemorrhoids:

• Drink lots of fluids
• Eat plenty of fiber-rich foods like whole grains, raw or cooked leafy green vegetables, and fruits
• Try not to strain for bowel movements
• Talk with your doctor before taking any laxative.

*Talk to your doctor before using witch hazel or ice packs to soothe hemorrhoids.

Sleeping Troubles

During your pregnancy, you might feel tired even after you’ve had a lot of sleep. Many women find they’re particularly exhausted in the first trimester. Don’t worry, this is normal! This is your body’s way of telling you that you need more rest.

In the second trimester, tiredness is usually replaced with a feeling of well being and energy. But in the third trimester, exhaustion often sets in again. As you get larger, sleeping may become more difficult. The baby’s movements, bathroom runs, and an increase in the body’s metabolism might interrupt or disturb your sleep. Leg cramping can also interfere with a good night’s sleep.

Try these tips to feel and sleep better:

• When you’re tired, get some rest.
• Try to get about eight hours of sleep every night, and a short nap during the day.
• If you feel stressed, try to find ways to relax.
• Sleep on your left side. This will relieve pressure on blood vessels that supply oxygen and nutrients to the fetus.
• If you have high blood pressure during pregnancy, always lay on your left side when you’re lying down.
• Avoid eating large meals three hours before going to bed.
• Get some mild exercise like walking.
• Avoid long naps during the day.

Weight gain

The amount of weight you need to gain during pregnancy depends upon how much you weighed before you became pregnant. According to the American College of Obstetricians and Gynecologists (ACOG) women who have a normal weight before getting pregnant should gain 25 to 35 pounds. Women who are underweight before pregnancy should gain 28 to 40 pounds. And women who are overweight should gain 15 to 25 pounds.

Research shows that women who gain more than the recommended amount during pregnancy have a higher chance of being obese 10 years later. Ask your doctor how much weight gain during pregnancy is healthy for you.

When to Call the Doctor

When you are pregnant you should not hesitate to call your doctor or midwife is something is bothering or worrying you. Sometimes physical changes can be signs of a problem.

Call your doctor or midwife immediately if you:

• are bleeding or leaking fluid from the vagina
• have sudden or severe swelling in the face, hands, or fingers
• get severe or long-lasting headaches
• have discomfort, pain or cramping in the abdomen
• have a fever or chills
• are vomiting or have persistent nausea
• feel discomfort, pain or burning with urination
• have problems seeing or blurred vision
• feel dizzy
• sense a change in your baby’s movement
• suspect your baby is moving less than normally after 28 weeks of pregnancy ( if you count less than 10 movements in 2 hours or less)

Body Changes

Aches, pains, and backaches
As your uterus expands pains in the back, abdomen, groin area, and thighs often appear. Many women also have backaches and aching near the pelvic bone due the pressure of the baby’s head, increased weight, and loosening joints.

To ease some of these aches and pains try:

If you are worried or the pains do not get better, call your doctor.

Breast Changes

A woman’s breasts increase in size and fullness during pregnancy. As the due date approaches, hormone changes will cause your breasts to get even bigger in preparation for breastfeeding. Your breasts may feel full and heavy, and they might be tender or uncomfortable.
In the third trimester, some pregnant women begin to leak colostrum from their breasts. Colostrum is the first milk that your breasts produce for the baby. It is a thick, yellowish fluid containing antibodies that protect newborns from infection. If leaking becomes embarrassing, put nursing pads inside your bra.

Try to these tips to stay comfortable:

Dizziness

Many pregnant women complain of dizziness and lightheadedness throughout their pregnancies. Fainting is rare but does happen even in some healthy pregnant women. There are many reasons for these symptoms. The growth of more blood vessels in early pregnancy, the pressure of the expanding uterus on blood vessels and the body’s increased need for food all can make a pregnant woman feel lightheaded and dizzy.

To feel better follow these tips:

Call your doctor as soon as possible if you faint. Dizziness or lightheadedness can be discussed at regular prenatal visits.

Leg Cramps

At different times during your pregnancy, you might have cramps in your legs or feet. They usually happen at night. This is due to a change in the way your body processes, or metabolizes, calcium.

Try these tips to prevent and ease leg cramps:

Nasal Problems

Nosebleeds and nasal stuffiness are common during pregnancy. They are caused by the increased amount of blood in your body and hormones acting on the tissues of your nose.
To ease nosebleeds blow gently when you blow your nose. Stop nosebleeds by squeezing your nose between your thumb and finger for a few minutes. If you have nosebleeds that do not stop in a few minutes or happen often, see your doctor.

Drinking extra water and using a cool mist humidifier in your bedroom may help relieve nasal stuffiness. Talk with your doctor before taking any over-the-counter or prescription medicines for colds or nasal stuffiness.

Shortness of Breath

As the baby grows, your expanding uterus will put pressure on all of your organs, including your lungs. You may notice that you are short of breath or might not be able to catch your breath.

Tips to ease breathing include:

Use an extra pillow and try sleeping on your side to breathe easier at night

Causes, incidence, and risk factors

An ectopic pregnancy occurs when baby starts to develop outside the womb (uterus). The most common site for an ectopic pregnancy is within a fallopian tube. However, in rare cases, ectopic pregnancies can occur in the ovary, the stomach area, and the cervix.

An ectopic pregnancy is usually caused by a condition that blocks of slows the movement of a fertilized egg through the fallopian tube to the uterus. This may be caused by a physical blockage in the tube.

Most cases are a result of scarring caused by a past infection in the fallopian tubes, surgery of the fallopian tubes, or a previous ectopic pregnancy. Up to 50% of women who have ectopic pregnancies have had inflammation of the fallopian tubes (salpingitis) or pelvic inflammatory disease (PID).

Some ectopic pregnancies can be due to birth defects of the fallopian tubes, endometriosis, complications of a ruptured appendix, or scarring caused by previous pelvic surgery. In a few cases, the cause is unknown.

Sometimes, a woman will become pregnant after having her tubes tied (tubal sterilization). The risk of an ectopic pregnancy due to this procedure may reach 60%. Women who have had successful surgery to reverse tubal sterilization in order to become pregnant also have an increased risk of ectopic pregnancy.

Taking hormones, specifically estrogen and progesterone (such as those in birth control pills), can slow the normal movement of the fertilized egg through the tubes and lead to ectopic pregnancy.

Women who have in vitro fertilization or who have an intrauterine device (IUD) using progesterone also have an increased risk of ectopic pregnancy.

The “morning after pill” (emergency contraception) has been linked to some cases of ectopic pregnancy.

Ectopic pregnancies occur from 1 in every 40 to 1 in every 100 pregnancies.

Symptoms

• Lower abdominal or pelvic pain
• Mild cramping on one side of the pelvis
• Amenorrhea (missed period)
• Abnormal vaginal bleeding (usually spotting)
• Breast tenderness
• Nausea
• Low back pain

If the area of the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include:

• Severe, sharp, and sudden pain in the lower abdominal area
• Feeling faint or actually fainting
• Referred pain to the shoulder area

Internal bleeding due to a rupture may lead to shock. This is the first symptom of nearly 20% of ectopic pregnancies.

Signs and tests

The health care provider will perform a pelvic exam, which may reveal tenderness in the pelvic area. A pregnancy test is usually positive (says you are pregnant).

Tests that may be done include:

• Hematocrit (may be normal or high)
• White blood count (may be normal or high)
• Culdocentesis (to check for blood in the pelvic/abdomen area)
• Transvaginal ultrasound or pregnancy ultrasound (shows an empty uterus)

A laparoscopy, laparotomy, or D and C may be needed to confirm the diagnosis.

An ectopic pregnancy may affect the results of a serum progesterone test.

Prevention

Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. However, a tubal pregnancy (the most common type of ectopic pregnancy) may be prevented in some cases by avoiding conditions that might scar the fallopian tubes. The following may reduce the risk of a tubal pregnancy:

• Avoiding risk factors for pelvic inflammatory disease (PID), such as multiple sexual partners, intercourse without a condom, and sexually transmitted diseases (STDs)
• Early diagnosis and treatment of STDs
• Early diagnosis and treatment of salpingitis and PID

Get 400 micrograms (or 0.4 mg) of folic acid daily. Eat foods fortified with folic acid, take a multivitamin, or take a folic acid pill to get your daily dose. Taking folic acid in a pill is the best way to be sure you’re getting enough. Including 0.4 mgof folic acid (or folate) in your diet before you get pregnant and in the first three months of pregnancy can help prevent some birth defects. If you don’t get enough folic acid, your baby’s spine may not form right. This is called spina bifida (spy-nuh bif-uh-duh). Also, your baby needs folic acid to develop a healthy brain. Many doctors will prescribe a vitamin with folic acid. But you also can buy vitamins or folic acid pills at drug and grocery stores. Some foods rich in folate include: leafy green vegetables, kidney beans, orange juice and other citrus fruits, peanuts, broccoli, asparagus, peas, lentils, and whole-grain products. Folic acid is also added to some foods like enriched breads, pastas, rice and cereals. Get more details on folic acid.

One half of all pregnancies are not planned!
And many women don’t realize they are pregnant for at least a few weeks. So you should always take care of your health. Your baby is counting on you for the best start at life!

Start watching what you eat. Load up on fruits, vegetables, and whole-grains (such as whole-wheat breads or crackers). Eat plenty of calcium-rich foods such as non-fat or low-fat yogurt, milk, and broccoli. Your baby needs calcium for strong bones and teeth. When fruits and vegetables aren’t in season, frozen vegetables are a good option. Avoid eating a lot of fatty foods (such as butter and fatty meats). Choose leaner foods when you can (such as skim milk, chicken and turkey without the skin, and fish). Find out more about what to eat and what to avoid for a healthy pregnancy.

Tell your doctor if you smoke or use alcohol or drugs. Quitting is hard, but you can do it.

Ask your doctor for help.
Get enough sleep. Try to get seven to nine hours every night.
Take steps to control the stress in your life. When it comes to work and family, figure out what you can and can not do. Set limits with yourself and others. Don’t be afraid to say NO to requests for your time and energy.

Move your body. Once you get pregnant, you can’t increase your exercise routine by much. So it’s best to start before the baby is on the way.

Get any health problems under control. Talk to your doctor about how your health problems might affect you and your baby. If you have diabetes, monitor your blood sugar levels. If you have high blood pressure, monitor these levels as well. If you are overweight, talk to your doctor about how to reach a healthy weight.
Ask your mother, aunts, grandmother or sisters about their pregnancies. Did they have morning sickness? Problems with labor? How did they cope?

Find out what health problems run in your family. Tell these to your doctor. You can get tested for health problems that run in families before getting pregnant (genetic testing).
Make sure you have had all of your immunizations (shots), especially for Rubella (German measles). If you haven’t had chickenpox or rubella, get the shots at least three months before getting pregnant.

Get checked for hepatitis (hep-uh-tie-tus) B and C, sexually transmitted diseases (STDs), and HIV. These infections can harm you and your baby. Tell your doctor if you or your sex partners have ever had an STD or HIV.
Go over all of the medicines you take (prescription, over-the-counter, and herbals) with your doctor. Make sure they are safe to take while you’re trying to get pregnant or are pregnant.

Ask your partner to stay healthy too!

Ask your partner to limit how much alcohol he drinks. If he uses illegal drugs or smokes, encourage him to quit. Studies show that men who drink a lot, smoke, or use drugs can have problems with their sperm. These might cause you to have problems getting pregnant.