Frequently Asked Questions, Part Two

FAQ's continued:

While pregnant, you're eating for two, as the old saying goes -- but just what are you two supposed to be eating?

• Get all essential vitamins and minerals daily. That means sticking with the prenatal vitamins you started prior to becoming pregnant, as well as eating a healthy diet.
• Fill your plate with leafy greens, fruits, veggies, and whole grains (like wheat breads and cereals). Get plenty of calcium-rich foods like broccoli and low-fat milk and yogurt, to help build your baby's bones and teeth. Stick to lean meats like chicken and turkey.

Foods to avoid during pregnancy include:

• Fish with lots of mercury. High levels of mercury can damage a baby's developing brain. But don't cut out fish completely -- they give you important omega-3 fatty acids. Cut out fish like swordfish, tilefish, and shark. If you love your tuna and snapper, you can still eat it -- just cut back to no more than one serving a week. You can eat up to two servings of fish like salmon, catfish, mahi mahi, and cod, along with shellfish like shrimp, crab, and scallops. For a more detailed list of fish and their mercury levels, go to http://www.americanpregnancy.org/pregnancyhealth/sushimercury.htm.
• Raw fish. Sorry, sushi and sashimi lovers.
• Unpasteurized soft cheeses like brie, Camembert, feta, gorgonzola, and Roquefort. They may contain bacteria called listeria that can cross the placenta, potentially causing miscarriage or leading to a life-threatening infection.
• Unpasteurized milk, which can also contain listeria.
• Cold ready-to-eat meats, like hot dogs and luncheon meats; these can also contain listeria. Reheat these foods until they are steaming.
• Uncooked or cured eggs and meats, like prosciutto, runny eggs, and sauces made with raw eggs (like some hollandaises).
• Alcohol. There is no known safe level of exposure to alcohol for a fetus. Prenatal exposure to alcohol can interfere with healthy development and lead to fetal alcohol syndrome, one of the most common causes of mental retardation and the only one that is completely preventable.
• Caffeine. While some studies show that moderate caffeine intake during pregnancy is OK, others have found a link to miscarriage, so it's particularly important to steer clear of caffeine during the first trimester. Large amounts of caffeine have been linked to premature birth and low birth weight, so do your best to switch to decaf. If you can't cut it out entirely, limit intake to 300 milligrams per day or less (1-2 cups of coffee).

Are there other activities I should steer clear of while pregnant? Do more of?

Here are some key dos and don'ts:

DO:

• Exercise. Light to moderate exercise during pregnancy is good for you, strengthening your back and abdominal muscles, improving your balance and helping to speed your recovery after delivery. (See more about this in question 4 below.)
• Have sex. Unless you have a high-risk pregnancy and your doctor has advised you against it, sex during pregnancy is safe. The baby is protected by your amniotic fluid. Especially in later pregnancy, though, avoid lying flat on your back during sex; the uterus can compress the veins in the back of your abdomen and leave you lightheaded or nauseous.
• Wash your hands before preparing food, before meals, after handling raw meats, and after using the bathroom.
• Clean house. Sorry, most household cleaning products, including bleach, are safe for use during pregnancy. Just be sure the room is well ventilated, read warning labels, and avoid mixing chemicals (like ammonia and bleach) -- good advice for cleaning safety whether you're pregnant or not.
• Travel by airplane -- sometimes. The American College of Obstetricians and Gynecologists (ACOG) says that the second trimester is the safest time for air travel, when you're at the lowest risk of miscarriage or premature labor. Generally, if you have a healthy, uncomplicated pregnancy, there's no special risk posed by commercial air travel. (ACOG recommends that pregnant women stop flying at 36 weeks' gestation.) Be sure to stay hydrated during the flight by drinking plenty of fluids, and keep your seat belt on! And no matter whether you're traveling by car, train, bus or plane, get up and move around every so often, and be sure to stretch your legs and back.
• See your dentist. Preventive cleanings and annual exams are a very good idea during pregnancy, as your rising hormone levels can cause bleeding gums and irritation. Since gum infections have been associated with preterm births, keeping your mouth healthy is important.

DON'T:

• Change the cat's litter box. No, this isn't just an excuse to get out of an icky task; cat feces can transmit an infection called toxoplasmosis, which can lead to severe problems in newborns, including low birth weight, jaundice, mental retardation, and convulsions.
• Use saunas, hot tubs, and tanning booths. Excessive heat can be harmful to the baby, and has been linked to spinal malformations.
• Paint. Let somebody else paint the baby's room; pregnant women shouldn't be exposed to toxic substances and chemicals, which include paint and cleaning solvents.
• Get an X-ray. Unless you absolutely have to, avoid tests like X-rays and mammograms while pregnant, which can be dangerous to your growing baby. If you absolutely must have an X-ray, make sure that your doctor or dentist knows you are pregnant so they can take extra precautions.
• Ride the Great American Scream Machine or the Tower of Terror. Though no studies have been done to document this, there is concern that the rapid stops and jarring forces of rides like this could cause placental abruption (premature separation of the placenta from the uterine wall). Play it safe and stick to the Ferris wheel until the baby's born.

What can I do to relieve or stave off pregnancy symptoms like nausea and vomiting, heartburn, leg cramps, and hemorrhoids?

Pregnancy may come with a host of uncomfortable symptoms, but you don't have to suffer in silence. Here are some tips for preventing some of the most common symptoms of pregnancy -- or at least easing some of the discomfort.

• Nausea and vomiting: Get up slowly in the morning; movement can make nausea worse. Don't let your stomach completely empty: eat five or six small meals throughout the day. Drink plenty of fluids, get lots of fresh air, and avoid fatty foods that are hard to digest. And trust your instincts. If something smells good to you and the thought of it doesn't make you nauseous, you can probably eat it.
• Leg cramps: Exercise regularly, get plenty of fluids, and avoid sitting in the same position for a prolonged period of time. Stretch your legs before going to bed by straightening your leg heel first and wiggling your toes. Massage your legs and apply heat to relieve a cramp.
• Heartburn: Avoid greasy or fatty foods, garlic, spicy foods, and drinks containing caffeine. Eat smaller meals, and avoid bending or lying down right after a meal.
• Hemorrhoids: Drink plenty of liquids, eat a high-fiber diet, exercise regularly, and avoid long periods of standing or sitting. To relieve hemorrhoid pain, take periodic sitz baths, apply cold compresses, and ask your doctor which OTC creams are safe to use.
• Backache: Wear low-heeled shoes with good arch support to avoid straining your lower back muscles. Avoid lifting heavy objects or standing for long periods of time. Make sure your mattress is firm, and that chairs you sit in have good back support (a small pillow placed in the small of your back can help). Don't take medications for back pain unless OK'd by your doctor. Try a heating pad, warm water bottle, or cold pack instead.

How much weight should I gain during pregnancy?

Pregnancy doesn't equal a get-out-of-jail-free card for a caloric spending spree. Weight gain during pregnancy is a lot like Goldilocks and the Three Bears: you don't want too much, you don't want too little -- you want "just right." If you gain too much weight, you're at risk for conditions like gestational diabetes; too little, and your baby may be born at a low birth weight. What's "just right" for you?

• If you're at a normal weight before pregnancy, gain between 25 to 35 pounds during pregnancy.
• If you are overweight before pregnancy, gain 15 to 25 pounds.
• If you are underweight prior to pregnancy, gain 28 to 40 pounds.
• For multiple births, consult your doctor (usually, you should gain about 35 to 45 pounds for twins).

The average woman should gain about 2 to 4 pounds during her first three months of pregnancy, and 1 pound a week for the remainder of her pregnancy.

How can I make a birth plan for labor and delivery?

A birth plan for labor and delivery is a clear, one-page statement about how you want the birth of your baby to go.

Ask your obstetrician, midwife, hospital, or birthing center what the policies are for deliveries. Then, think about the areas that you'd like to mention in your birth plan. Some questions to ask yourself:

• Who do you want present at the birth?
• What do you want for pain relief? (Epidural or other medications, hypnobirthing /self-hypnosis , massage, guided imagery, and breathing exercises are options you can consider.)
• What position or positions do you want to be in to give birth? Would you like to have the option to stand, walk around, squat, or get on your hands and knees?
• Do you want an episiotomy? If not, what would you like done to help avoid one?
• What do you want for the baby's care after the birth? Will your baby be in the room with you? What are your preferences about feeding and sleeping?

Keep in mind that this is a birth plan, not a birth mandate. Be positive about stating what you want, but understand that things can change during the course of labor, and be prepared for the unexpected. Include in your birth plan notes about what you would like if complications arise, such as if a caesarean becomes necessary.

All of these FAQ plus more can be found at webmd.com