The Dos And Don’ts During Pregnancy – Expert Advice

Dos And Don'ts During Pregnancy
(Last Updated On: January 18, 2023)

Are you a pregnant woman or planning for pregnancy and searching for the dos and don’ts during pregnancy? This article discusses pregnancy care, the topic is the dos and don’ts during pregnancy care. Let’s start briefly with pregnancy and then the common questions that are usually asked.

What Are The Dos And Don’ts During Pregnancy?

Pregnancy is a milestone, an important milestone in every woman’s life. At some point, to the other, every woman wants to become a mother. But it is also one of the most sensitive and very emotional journeys for a woman and it is always fought with a lot of worries. No matter whether it’s your first or your second pregnancy, you always have a lot of questions which you feel need to be answered. Let’s start with a brief introduction, not even interruption, just to take you through what we usually do in normal pregnancy care.

What is the ideal age for me to get pregnant?

A lot of people in their thirties say their parents are pressurising to have a baby and hence their question is what is the ideal age? There is no real ideal age for pregnancy though of course want the woman only after the age of 21 to go ahead and plan a family because before that your body is not very completely much. Would like the first pregnancy to happen before the age of 35 because, after the age of 35, there’s always a risk of an increased risk of the baby having some kind of chromosomal anomalies and the risk increases with increasing maternal age.

As the age increases the mother is also at risk of many medical comorbidities like diabetes, and hypertension.

From Pregnancy To Birth – How A Child Is Born?

Even practically speaking a 28-year-old mother is more able to give physically to her baby’s needs than when you have a baby at 35. Even because pregnancy, being a mother doesn’t end with delivering a live baby. A lot of other things are there. You have a baby at the same time handling everything in the family.

Stages Of Pregnancy – What To Expect During Pregnancy?

When to consult a doctor for pregnancy?

When do we start treating your mother ideally you should consult the doctor before you become pregnant. In India what happens is most patients visit a doctor when they miss their periods. They’ve done a pregnancy test at home and it tests positive. But if you go outside, a lot of people actually visit for preconception counselling and that is very important because we start off with what we call folic acid. It’s a vitamin D which decreases the rate of abortions by almost 96%.

We can also do a couple of blood tests like thyroid, and sugars just to make sure that you don’t have any of those complications and in case of any deficiencies, we can give you medicines and we can make sure that you enter the pregnancy in a much more healthy way.

Prenatal care – Dos And Don’ts During Pregnancy

What are the tests and care needed before pregnancy?

The US FDA is the regimen that all of us mostly follow. They have advised that every woman who is planning a pregnancy should take about 400 micrograms of folic acid per day. The dosage of folic acid increases to about 600 micrograms during pregnancy and the final micrograms during breastfeeding.

But in India, we also see a lot of women with anaemia, a large percentage of which is contributed by folic acid deficiency, we usually start to give folic acid 5 milligrams. It ideally starts three months before you plan a pregnancy. It’s a vitamin, it is water-soluble so it does not get stored in your body. You don’t have any major side effects with folic acid. So it is quite safe to start and it’s the same tablet which is used in the first three months of pregnancy.

What are the vaccinations required for pregnancy?

Chickenpox

The other thing that we want to talk to you about when you come for preconception counselling is what are the vaccinations you have got,? Have you ever had chickenpox as a child? Because then you become naturally immunized to chickenpox.

Rubella (German Measles)

One of the most important vaccines that we want to give before you plan a pregnancy is rubella which is also called German measles because if you contract rubella for the first time in pregnancy, 80 per cent of the time the fetus is affected and the problems could be varied from blindness to deafness to cardiac defects. And if the mother tests positive for rubella during pregnancy, we have no other option but to terminate the pregnancy and which is completely preventable by one shot of a vaccine.

Hepatitis B

The other thing is hepatitis B because hepatitis B is transmitted from mother to baby. So we also vaccinate the mother against Hepatitis B. The one good thing about hepatitis B is vaccination can also be given during pregnancy. Unfortunately, rubella and chicken pox vaccination and most of the other vaccines cannot be given during pregnancy.

PCOD

One more important point is that pcod so rampant in youngsters. We should also check their blood sugar and advise them to decrease their weight.

Activities And Food – Dos And Don’ts During Pregnancy

What are the activities and food that the pregnant lady should avoid as soon as she knows that she’s pregnant?

Foods to avoid during pregnancy

We will take food first and then exercise. The food ideally, all kinds of raw food are best to avoid during pregnancy. All raw food, raw meat, raw fish, and raw mushrooms most of them contain either Salmonella or Listeria. If the mother gets salmonella she contracts typhoid which could cause severe health problems in her and go forbid if it crosses the placenta Listeria screams at home.

Any kind of raw foods kind of really are a health hazard. Even street food in India really doesn’t know what kind of water they’re using, or whether the water is ideally sterilized. So that’s what one thing I tell my patient rule of thumb is you can eat whatever you want but just make sure they are cooked. It could be steamed, boiled, fry it, or whatever but if they are put into hot water or hot oil most of the germs are killed. So that is one thing about food.

Unpasteurized milk also should not be taken because there you have again a high risk of contracting Listeria and Toxoplasma which is another dreaded virus which can cause severe brain damage in the baby.

What else do we avoid during pregnancy?

Do not take too much caffeine because it is a psycho-tropic thing. So don’t take too much caffeine.

What about eating papaya during pregnancy?

Normally many pregnant women ask the question about eating papaya and sesame seeds. There’s nothing in the literature. There’s no sign, no basis for avoiding papaya and pineapple and a lot of cultures especially the Western population, I’ve seen them eating a lot of papaya and pineapple. I don’t think there’s any scientific, there’s no evidence to support that anything to say.

Some people say that they should not eat too much heat food like chicken or mangoes, but in Allopathy we don’t have any because the body lets this temperature no matter what you eat.

What activities to avoid during pregnancy

Then coming to the next point is activity. There are no restrictions on activity. You can do whatever you are comfortable with. We’ve had patients who are marathon runners and a lot of younger women nowadays are into extreme sports. So somebody who runs a 21 or 42 kilometres marathon can run two or three kilometres daily even during pregnancy. However, if you’re not used to that kind of exercise I don’t think pregnancy is the right time to start off the exercise regimen. So all kinds of exercises are allowed. In fact, we encourage people to do exercises especially yoga, Pilate, and low-intensity aerobics and all can be done.

Of course, any exercise like terrain, biking or cycling, they always associated with some risk of injuries you fall down. Those kinds of injuries could cause injury even to the pregnant uterus. Avoid those kinds of things, but otherwise, we need extraneous activities like icing, swimming, aerobics, yoga, and pilates, I think it is encouraged. In some places where they appear in fact, pregnant ladies have to be more active so that they don’t gain that excess weight and lean into complications.

Travel – Dos And Don’ts During Pregnancy

Can I travel during pregnancy?

One more question is what regularly we come across because many of our pregnant women are working women. Their question is can I travel? Can I travel from one place to another place? Can I travel from one town to another town? I don’t think anybody in any major city in the world can really avoid travel. All of us have travelled during pregnancy and travelling as per does not cause any problems.

What is the best mode of travelling during pregnancy?

I don’t think there is anything to choose from one mode of transport to another. Is it matter flight journey? Flights are a totally different thing because most flights allow travel only up to 32 weeks because, after thirty-two weeks especially, domestic flights they have very little space between the seats and most of the airlines don’t even want to take the risk of somebody getting into preterm labour or any kind of problems in flight. So they usually ask us. But train travel or bus travel I think should be okay till about thirty-six weeks. I don’t think we can really put a timeframe to travel and mode of travel as long as they’re comfortable. I think everything should be fine.

Nutritional -Dos And Don’ts During Pregnancy

What are the new additional nutritional needs of a pregnant woman?

Definitely, a pregnant woman needs additional nutritional needs. The initial study said that a pregnant woman would need about 1500 calories extra per day, and in breastfeeding also we would say 1500 to 2,000 calories. But now I think even that there has been a lot of talk about that. Because somebody who is a slender young woman would be okay to have an increase of 10 to 12 kg body weight all through the frequency. But if somebody is already entering pregnancy in an overweight condition we would really not want her to get on even more weight because everything then becomes difficult.

Delivery, if it’s a cesarean section that becomes difficult, with higher chances of diabetes, BP, and so many things. So again we don’t have any diet thing but the only thing is we want them to have a balanced diet and increase the number of proteins that they take because proteins are necessary for tissue and muscle development. And so protein intake should be higher and I think you get that a lot when you take your spices, dairy and stuff like that. And also there are lots of fruits and vegetables that need to include in their diet than be doing earlier.

How much water and milk intake recommend during pregnancy?

How much water intake and milk intake you would recommend during pregnancy? There is no fixed amount of water or milk that you take. The water, of course, everybody should be taking at least one and a half to two litres per day. It doesn’t really change during pregnancy because you’re pregnant you don’t have to take any extra water but you have to be adequately hydrated because a lot of in pregnancy in this normally a fall in high pee and people end up getting giddy. So I would suggest taking a lot of water. It also ensures that you pass a lot of urine and which is one of the best ways to prevent urinary tract infections.

Milk I’m not so sure because a lot of people get put off by the smell of milk sometimes. So milk basically contains a lot of calcium but we are already supplementing most of our patients with calcium. So I’m not very particular about them taking so much amount of milk. If they are happily taking it if they tolerate it. I don’t think need to force women to take milk if they are not really comfortable.

Protein supplements during pregnancy

What is your recommendation regarding protein supplements in the form of a powder? What regularly keeps taking and asking for us? Again I don’t think there is any evidence base for protein supplements. Yes, if the baby is showing signs of decreased growth, and potential in the uterus, or the mother is of low weight, then maybe we could add proteins. But then I would actually recommend they see a dietitian to make sure the dietitian knows what they’re really taking. What their normal dietary intake is and then you know let her make a very scientific chart That becomes more important because of any extra additional foods which they are not able to afford that matter a lot.

What are the superfoods to consume during pregnancy?

The omega-3 fatty acid is one superfood that is recommended. You get it a lot in cold water fish like Salman and tuna but again make sure that it is cooked properly because you could end up getting some other infection. For vegetarians, seaweed is very very strong. It has very strong concentrations of omega-3 fatty acids. You also get all omega-3 fatty acid capsules now over the counter.

Iron-rich foods like lean meat, and eggs. Many of them have a problem and they don’t know the importance of having the whole egg for that matter because many of them consume only the white whereas there are also a lot of important things. And also iodine-rich foods once they become pregnant they can have a lot of dry fruits.

Exercise – Dos And Don’ts During Pregnancy

Will exercise help to prevent weight gain during pregnancy and post-elevated?

Let’s take it as during pregnancy and post-elevated. Exercise no matter what you do, you are going to get weight gain during pregnancy because the weight gain in pregnancy is not only the amount of fat or muscle mass that is added to your body, the weight gain in pregnancy is also influenced by the weight of the baby, the growing placenta, the water around the baby, there’s a lot of water retention in your body. So no matter what exercise or diet you take you are going to increase weight and pregnancy.

Basically, pregnancy is not the time to diet and concentrate on weight loss. There are a lot of craving stories in pregnancy that happen. At least cut on your junk food because you don’t want to end up with a lot of weight during pregnancy. People who are not over on the leaner side still have the comfort of eating whatever they want.

But exercise in pregnancy is important not to lose weight but it’s important because it is proven to increase the chances of normal labour and delivery. It has been proven to have a very good effect on the cognitive movement variations of the mother as well as the baby. It is very well-known to control diabetes if you have abnormal sugars and also your BP and other stuff are also kept in control. So exercise is always great.

We have many of the doctors who are being trained in anti-metal exercises and also the Lamaze classes which we also have practice in are as to CMI hospital which would help them to take away take the pregnancy all through easily and if they are not in a position to go to the exercise classes.

What would be the basic recommendation for walking during pregnancy?

At least 30 minutes of walking but if somebody is not used to walking at all, let them start with 10 minutes and then slowly increase. Somebody who’s been really rigorous in their exercise regimen can continue but please listen to your body because your body gives you enough signals. So listen to your body and stop when you feel uncomfortable. But other than that the recommended 30 minutes of a walk would be good enough.

What about the post-delivery weight loss?

Exercise definitely helps in post-delivery weight loss, and toning of muscles, especially, because a lot of people come back with backache following delivery. You really need to do a lot of back-strengthening exercises too because you’ve already lost a lot of your anterior abdominal wall tone. So toning exercise will help your toning, it gives you releases endorphins, and you feel good. And also because they are feeding the poster of breastfeeding and restlessness.

Is wearing a seat belt at term gestation safe enough?

Yes, you must wear a seat belt but the important thing to remember is the seat belt has to be worn correctly. In a pregnant woman even at term because now we’re always on the go and so if you want to be independent there is absolutely no need to restrict yourself. You can drive your car but it’s absolutely necessary to wear your seat belt.

How to wear a seat belt properly?

The important thing about wearing a seat belt is to make sure that the seat belt should have a shoulder and a lap strap and the way you wear it. The shoulder strap should come over your shoulder, not your neck. It should come between the breasts on the breastplate. Now the lap, the belt is the most important. The lap belt should come below the baby bump and belt should sit on your thighs and the lock should be just near your hip joints. The problem arises when the lap belt is over your abdomen. Because when that happens got for with an accident, the strap can cause more damage. It’s like having a direct impact on your abdomen.

So the bump should be between your shoulder strap and your lap strap. Because what happens when you wear a lap strap below the baby bump is that the coalition, the effect of collision, and the whole impact are transmitted moot your hip joints which are the strongest joints in the body. So that is the most important thing. So if you’re driving late in your pregnancy make sure that you always wear a seat belt and make sure that the seat belt is worn properly.

Medicines – Dos And Don’ts During Pregnancy

Can I take medicines during the pregnancy?

Commonly all pregnant ladies have doubts can we take medicines during pregnancy if they get a headache, they get a cold or a fever or what tablets are recommended is what they always have a doubt.

Paracetamol and antihistamines like cetirizine are safe but antibiotics or any other antiepileptic, or diabetic medicines all have to be taken only under the supervision of a doctor. Those are to be taken only if needed. The dose, the duration everything has to be explained properly and they have to be taken only under a doctor’s advice. You can’t self-medicate especially, with BP medicines. You’ve seen people have high BP, they go back, they check at home and they realize the BP is less then they stop. So please do not self-medicate or just stop or start the medicines.

Whoever is being detected to be diabetic even before pregnancy and hypertensive or with any kidney problems or liver problems they have to consult a doctor as soon as they have a missed period or detected pregnancy because there has to be a conversion to a safer medicine during pregnancy.

What are the recommended scan durations during pregnancy?

Many are aware that how important are ultrasound scans during the whole pregnancy. But still, have some pregnant women coming and asking, is scanning in the first month or a second month important? What are the recommended scan durations?

Usually, the two most important scans are between 11 and 14 weeks and one between 18 and 22 weeks. Those are the two most important scans. But we also do a scan at 8 weeks because that tells us whether, or sometimes if the patient comes with bleeding or abdominal pain it is done earlier. But that is to find out whether the pregnancy is intrauterine. Because there are that 1 per cent of pregnancies are sometimes located outside the uterus and they have to be detected early so that we can manage them medically. Because otherwise so many people come with ectopic pregnancy which is ruptured and they have already bled into the abdominal cavity and then they need emergency surgery.

What Is Bleeding In Early Pregnancy And Its Causes?

What we usually do is do a scan early between 7 & 8 weeks so that we can confirm an intrauterine pregnancy and also detect the heartbeat well as we know life, it’s an alive and healthy pregnancy. Then we do a scan at the third month, and then at the fifth month just to make sure that the baby is healthy.

32 weeks scan, a growth scan may not be very necessary but if your doctor feels that the baby is either too big or not of the size expected during that gestation they might ask for a growth scan and also if they have developed a medical complication. And then of course we have one scan that most of us do just before delivery which helps us plan the mode of delivery and what to be aware of, what kind of things we should be ready for during the process of labour.

What about vaccinations during pregnancy?

What are the recommended vaccinations to be taken up? We’ve already given rubella, chickenpox and hepatitis B vaccines. In pregnancy, Tetanus is the only vaccine that we give. Recently we have started giving what we call a triple vaccine which contains tetanus, diphtheria, and pertussis so the woman needs to take only one shot after 29 weeks of pregnancy and that also prevents diphtheria and pertussis in the newborn because the newborns can take the first shot of DPT only at around six to eight weeks. So for six to eight weeks, because the mother has already taken this vaccine the babies are passively immunized.

The other vaccine that we usually now give is influenza because a lot of influenza cases and it is very difficult when a neonate gets it. The H1N1 vaccine is given to a newborn only after the first six months. So again if the mother takes it during pregnancy the baby has a benefit for the first six months. So we also give an influenza vaccine.

What about normal delivery and C-section?

Now having discussed pregnancy and all the important aspects coming the delivery, nowadays many of them come and ask us about normal delivery and C-sections. Many of them directly go opting for c-sections.

I think if we ideally wait till dates and maybe even a three-four dates post date or more, 96 of patients go into labour spontaneously. And once you go into some labour spontaneously almost 90 per cent of the time a normal delivery is assured. It’s only when we induce before dates which could be because of so many reasons, maybe the patient has diabetes or BP also matter or the baby’s not growing enough but whenever we induce labour the chances of having c-section rates go up a bit. But if you actually wait patiently and allow the patient to go into labour spontaneously most of them end up with normal delivery.

A lot of people are scared about the pain of normal delivery but now we have so many analgesic methods, you have an epidural which makes the whole process of labour so painless and Entonox analgesia. So there are so many things now that we can do to make your labour experience painless. Once we take care of the pain I think most patients are quite confident about going through the process. Also because of the pain, they are quite stressed out both physically and mentally and quite relaxed.

One thing I would add is not that every induction goes in for a c-section as most people think. They always have fear when the doctor says induction they think okay their planning process it’s not that way always.

Is the instrumental delivery safe?

One more question we have is whether the instrument will delivery is safe, whether it be a vacuum delivery or forceps delivery. It is very safe because instruments have been used for the last 100 years and there are huge pile of evidence saying that instrument delivery is safe. We have certain prerequisites that we make sure to tick off before we even put an instrument. So instrument deliveries are safe.

In fact, nowadays we put the instruments only when we see the head. It’s almost there, it’s just that over the whole period of labour. The mother is so exhausted that they’re unable to push or at the last minute the baby’s heartbeat drops we need to extract the baby immediately and that is the only reason so can avoid emergency sections. Instrument deliveries are absolutely safe and in a safe pair of hands, there is absolutely no need to worry.

How should a pregnant woman keep a watch on the baby?

Once a pregnancy is cross the period of viability which we usually take after 22 weeks in our country and in other countries 28 weeks of pregnancy how should a pregnant woman keep a watch on the baby and how can she have the alarming symptoms to come to a doctor?

One of the most important things that we say is the daily fetal moment compound. So the rule is that there are two ways of looking at the baby’s count either it is a chart of your baby’s movement over a whole 12 hours. Your waking up time and say if you have 10 movements in your whole day it’s a fair sign that the baby’s doing well. Most of us are working and we can’t keep counting the whole day. What we say after every major meal, that is after your breakfast, lunch, and dinner just keep a count for the next hour.

At least three movements in one hour are that it comes up to nine counts in the whole day. That itself is a good measure of good baby health. And the other things to look after are any intermittent painful contractions of the uterus, any vaginal bleeding, any abnormal foul-smelling discharge or even water you discharge from the vagina. It is always better to meet your doctor and just make sure that everything is okay.

Even if it is coming and going negative, we have to assure that everything is going fine by checking out the baby’s movements. checking about the baby’s heartbeat raising and making sure that everything is fine. Anytime the count is less, the pregnant woman has to visit the doctor.

Whenever a pregnant lady has some pain or bleeding they sometimes take it as a normal issue because the elders in the house may say okay this is the starting of your pain, still there is a lot of time to wait, we can wait.

That is where exactly what I say painless bleeding is one of the first signs that your placenta might be low lying and all initial bleeding which is kind of not serious could end up in torrential bleeding and major problems. Pain associated with bleeding could be the first sign of placental abruption which is premature separation of a not normally situated placenta which means that the oxygen supply to the blood to the baby is suddenly cut off because the placenta that is inside the uterus has separated.

So without you having signs of labour you could just have small abdominal pain or just a little bit of spotting. A lot of people just ignore the fact and then they come in very late when they’re dizzy or when they have really lost a lot of blood inside the uterus and their BP is falling and many times we have lost babies.

Because the placenta is the main connection for the supply of oxygen and nutrients to the baby. Once that gets detached there is a fraction of a minute or second with the baby may going for in trying fetal demise.

I think the rule of thumb is if anything is abnormal please visit the hospital, and please see your doctor. They are the best person to judge to find out whether this is normal or not. Let them have a look and everything is fine you can go back home. I don’t think nobody should be chasing a scare.

Sleep And Sleep Posture During Pregnancy

What are the important blood tests to be done and when?

I think at the first visit we do a blood grouping of both parents to see if there’s any incompatibility between the blood groups of the parents. We also do a sugar test because as an Indian population, we are prone to diabetes. So we do a sugar test. Thyroid abnormalities are rampant. So we also do a thyroid test because it can be easily set right. So these are quite important.

Hypothyroidism and lack of thyroid hormone supplementation for the baby are very important because the first three months are an important period for the baby’s brain development. Hypothyroidism is one of the most common causes of mental retardation in children. So these are the tests. Then, of course, we do all the serology because HIV, and HBsAg because they have the potential of being transmitted from the mother to the baby.

Now we have medicines with which we can completely prevent 100% mother-to-child transmissions. Serology is another thing that we do. The glucose challenge test is a screening test which tells us whether the mother is at risk of developing diabetes later on in pregnancy.

These are not very expensive tests, very basic tests. If we find there is less haemoglobin we could rule out the cause and treat them with some iron tablets and injections.

Is sexual contact permissible during pregnancy?

As long as the woman is comfortable sexual contact is permissible. Of course, as the uterus grows in size it becomes more difficult but then each one is old. Because they have the fear that the first three months of pregnancy are quite sensitive. Yes, of course, if you see the placenta is low or the patient has come with episodes of bleeding, then we would tell them to abstain from intercourse. But if not I think we have no restrictions on having sexual contact at any time all through the trimesters.

Expert Healthy Pregnancy Lifestyle Tips

Things To Remember – Dos And Don’ts During Pregnancy

What are all the things a woman should remember in the context of going through the pregnancy? There are a lot of financial issues, family issues everything burdens women. How do you think that they should cope with themselves?

Having a healthy diet, exercising as much as you can, making sure that you get some rest and then really discussing this. Pregnancy is another time when the partner should really be completely invested in the woman because this is one of the most susceptible points in a woman’s life. You feel very very vulnerable because you’re scared, labor pains are not easy, they are very very painful. And at that time all you really need is a lot of support from your partner as well as the family.

As a family, we should also be very open to what she needs. Because we have seen so many people who’ve gone through a long labour and we tell them that c-section is a good option. But then there’ll be so much family pressure of saying, no can we wait for another two hours when the patient is telling us I can’t hold on a minute longer. And that waiting is also not really going to change the outcome.

So they have a lot of psychological issues and they’re also going for a lot of depression. We have seen them going through psychological counselling. So a lot of support, emotional support from friends, family and especially, the partner will really go a long way in ensuring that her pregnancy is a wonderful experience for her.

Well, one thing I would say is if you can change, change it, otherwise leave it. You and your baby are the most important things also the nine months of your pregnancy. It’s easier said than done but yes. It’s true and especially in India, it’s very difficult I know. I do understand but women should be strong enough to take care of themselves and their babies though everyone may not support them.

Common Pregnancy Questions And Expert Answers

Final Thoughts

Hope that you could find the answers to most of your questions about dos and don’ts during pregnancy. It is very important not to ignore anything abnormal and always consult your doctor immediately. Always follow the dos and don’ts during pregnancy.

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References & Credits: Dr. Soumya Lakshmi T V, Aster CMI Hospitals, Bengaluru

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