Physical health in pregnancy

A healthy varied diet is recommended in pregnancy including plenty of fruit, vegetables, carbohydrates, protein and dairy. You do not need to ‘eat for two’, but you may need to have regular healthy snacks as your body works to support the growing baby. There are some foods that you should avoid during pregnancy because they could make you unwell or harm your baby. Guidance around which foods to avoid can change as new evidence or research is found. Ask your midwife, or check on the websites listed below. Normal weight gain in pregnancy is between 10 -12.5kg (22-28lb). If you start your pregnancy with a high or low body weight your midwife or GP may give you special dietary advice about weight gain or loss.

The point at which alcohol consumption becomes dangerous to an unborn baby is unknown. The safest way to protect against the effects of alcohol is to avoid it completely. Babies born to mothers who drink alcohol when pregnant can be affected by a range of disorders known as Fetal Alcohol Spectrum Disorder. Talk to your midwife or GP if you have concerns about alcohol in pregnancy.

Smoking and inhaling passive smoke causes harm to you and your baby. Pregnancy is an ideal time to quit smoking for good. Your midwife or GP can refer you to local smoking cessation services or you can self-refer via the NHS Smoking Helpline on 0300 123 1044. Some nicotine replacement therapies are safe to use in pregnancy. Your stop smoking advisor should be able to support you in finding the right method to help you quit smoking whilst pregnant. Although considered less harmful than smoking tobacco, E-cigarettes do contain chemicals that could be dangerous for you and your baby’s health; therefore they should be used with caution and only under the advice of a specialist smoking cessation advisor.

Use of illegal or street drugs when pregnant can seriously harm you and your baby. If you (or someone close to you) are using drugs, it’s important to seek help straight away. You can talk to your midwife, GP or any of the specialist treatment services that are available. For 24 hour immediate help and support contact FRANK by: Phone: 0300 123 600 Text: 82111

If you are taking medications for any long term conditions, do not stop taking them or change the dose without talking to your GP first. If you’re not sure about the safety of certain medications, talk to your GP or local pharmacist. If you want to breastfeed, discuss any medications you take with your doctor before you give birth - to see if they are safe for breastfeeding, and if not, what alternatives you might be able to take.

It is safe to have sex in pregnancy, unless your care provider has advised you not to. Some couples find sex very enjoyable during pregnancy, whereas some find their sex drive changes and they don’t feel like they want to as often or at all. If you don’t feel like having sex, think about other ways you could feel intimate and close with your partner. Talk about your feelings with your partner and make adjustments if you need them. Your breasts may be sore and tender, and as your bump grows certain positions become more difficult. Having sex cannot harm your baby, and he or she will not be aware of what is happening.

Exercise is an important part of maintaining a healthy lifestyle, and is known to be safe in pregnancy. Pregnancy is not the time to start a challenging new fitness regime, but it is good to maintain your pre-pregnancy level of activity with some adjustments if needed, or to try something gentle like swimming or pregnancy yoga. Some women feel exercise helps them adjust to the physical changes taking place in their body, promoting a sense of wellbeing and reducing feelings of stress, anxiety and depression. Exercise may help prevent some pregnancy complications and can help with swollen ankles/feet. Avoid exercise where you could lose your balance and hurt yourself. Ensure you drink plenty of water during exercise and remember that hormonal changes preparing you for birth can make you more flexible so it’s important to avoid deep twists of the spine. It is important to warm up and cool down when exercising to avoid strain or injury. If you are taking a class, remember to inform the trainer you are pregnant. If you experience anything unusual, you should not continue to exercise, and contact your midwife or doctor.

During pregnancy and after birth it’s important to have regular dental check-ups. Hormonal changes in pregnancy may cause bleeding gums. It is important to keep a good level of dental hygiene to prevent tooth decay and gum disease. It is recommended that you brush twice a day with fluoride toothpaste (this is safe to use in pregnancy). After consuming sugary products, use a mouthwash containing fluoride (0.05%) or brush your teeth. Drinking water after eating sugary foods can also be of benefit to preventing dental decay. NHS dental care is free for pregnant women and for one year after the birth of your baby. It is recommended that all pregnant women see their dentist during pregnancy. It is especially important to see your dentist if you have persistent sore or bleeding gums.

During pregnancy you may experience slight changes in your vision and/or dry eyes. Eye tests are recommended every two years and are free when you are pregnant. Contact your local optician to book an appointment. Your GP can provide you with a signed form for a maternity exemption certificate. This will entitle you to free NHS prescriptions up to one year after the birth of your baby, and free NHS dental care.

Chicken pox Chicken pox is caused by the varicella zoster virus. Chicken pox is highly infectious and can be dangerous to your baby. If you had chicken pox as a child, it is likely that you are immune; you do not need to worry. If you are unsure whether you have had chicken pox before, you may be offered a blood test to confirm your immunity. If you think you may have come into contact with someone with chicken pox and you know that you are not immune, please phone your GP or midwife for advice. Do not attend the maternity unit for advice unless advised to by your midwife/doctor. Sexually transmitted infections (STIs) STIs such as chlamydia, herpes and gonorrhoea are becoming increasingly common and when left untreated in pregnancy can be dangerous to your baby. If you are concerned that you or your partner may have been exposed to STIs please attend your local sexual health service clinic for full sexual health screening. Parvovirus B19 (slapped cheek syndrome) Parvovirus is very infectious and usually affects children. The main symptom is a red blotchy rash on the face. It can also be accompanied by mild fever, headache and sore throat. If you contract parvovirus in pregnancy it can be harmful to your baby. Please speak to your GP or Midwife if you think you may have been in contact with parvovirus. Toxoplasmosis Toxoplasmosis is an infection caught by direct contact with cat faeces (poo), contaminated soil or contaminated meat. Most people don’t realise they have it, but it can cause flu like symptoms and it can harm your unborn baby. Pregnant women are advised to wear gloves when gardening or handling cat litter and to thoroughly wash fruit and vegetables to remove all traces of soil. We don’t test for toxoplasmosis routinely as it is very rare. Group B Streptococcus (GBS) GBS is a transient bacterial infection, commonly found in the gut, occasionally spreading to the vaginal and rectal tract. GBS causes no symptoms and is harmless to adults. It can however be harmful to babies of infected mothers if they are born vaginally. GBS can be detected via urine tests or by taking swabs of vaginal and rectal mucosa. GBS is not routinely tested for in pregnancy, however if it is detected or if you have been infected with GBS in the past, it will be recommended that you have intravenous antibiotics in labour, to protect your baby from infection.

It is currently recommended that all pregnant women have flu and whooping cough vaccinations during pregnancy. Ask your midwife or GP about this early in pregnancy. Flu vaccine The flu vaccine is available in winter every year and is safe at every stage of pregnancy. The flu vaccine is recommended because catching flu when pregnant can cause serious complications for both you and your baby. Whooping cough (pertussis) vaccine The whooping cough vaccine is recommended for all pregnant women and can be given from 20-32 weeks. Whooping cough can cause pneumonia and brain damage in young babies but having a booster vaccine will help protect your baby. Travel vaccinations If you are travelling to countries that require specific vaccinations please speak to your practice nurse. Some vaccines that use live bacteria or viruses are not recommended during pregnancy because of concerns they could harm the baby in the womb. Inactivated vaccines are safe in pregnancy.

Always take your maternity notes with you if travelling away from home. If travelling far from home in the middle/later stages of pregnancy, it may be worthwhile looking up the local maternity unit in case you need any urgent care whilst away. Cycling Riding a bicycle in pregnancy should be approached with caution, due to the risk of falling which may harm you or your baby. Because your joints are less stable, your centre of gravity is altered (the bump tends to overbalance you) and your reactions are slower. It might be best to avoid cycling unless you are used to doing it regularly but take extra care when doing so. Car On longer car journeys it is important to stop regularly for a break and to stretch your legs. Wear your seatbelt with the cross strap between your breasts and the lap strap across your pelvis under your bump, not across your bump. Road accidents are among the most common causes of injury in pregnant women. Avoid making long trips on your own and share the driving with others when possible. Flying Flying is not harmful to you or your baby, but it is important to discuss your pregnancy with your midwife or doctor before flying. The likelihood of going into labour is higher after 37 weeks and some airlines will not let you fly towards the end of pregnancy. Check with the airline directly about this. After week 28 of pregnancy, the airline may ask for a letter from your GP confirming your due date, and that you aren’t at risk of complications. Long-distance travel carries a small risk of blood clots (known as deep vein thrombosis or DVT). Discuss any long haul travel with your doctor as you may require DVT preventative medication, particularly if you have other risk factors. If you fly, drink plenty of water and move around the cabin regularly. You can buy a pair of compression stockings from the pharmacy, which will help reduce the risk of DVT.