Dos and don'ts in pregnancy
Pregnancy is generally a lovely time, but the list of things to avoid or things you MUST do if you're pregnant can feel very long indeed – not least because the advice seems to change so often.
Common sense is the best yardstick – and in the grand scheme of things, nine months isn't that long to give up or avoid a few things (though it may feel like forever). Here are the things you should try and avoid when pregnant and a few things it's worth remembering to do, as well.
Things to avoid during pregnancy
From prosecco to paté, there are a few things you need to steer clear of in pregnancy. It doesn't mean a total ban on “fun” but it's worth brushing up on the list of prenatal no-nos.
Foods to avoid if you're pregnant
There is a small chance that some foods could be harmful to you or your baby – so get acquainted with the full list of foods to avoid in pregnancy. Basically, you're trying to avoid foods containing bacteria that can cause infections and might (note, might) lead to miscarriage, stillbirth or infection in your newborn. Here's a brief list:
- Soft and mould ripened cheeses such as brie, gorgonzola and camembert. Things like feta and mozzarella are fine.
- Any milk or cheese that is unpasteurised.
- Raw or rare shellfish and meats as well as cured meats such as salami.
- Liver and products containing it need to be avoided as they contain high levels of Vitamin A, which can cause birth defects.
- Shark, swordfish and marlin contain high levels of mercury so they're on the “no” list, too.
Luckily, most women aren't nipping home from work once a week to sit down to shark or liver and mash, however, so hopefully neither of those will cause you nine months of woe.
“I was really unknowingly evil and ate about a million raw oysters when about five months pregnant with my boys and on holiday. I'd read the dos and don'ts, but somehow missed the shellfish embargo. Good grief – they were tasty though!”
There is some good news: in recent years, both Stilton and runny eggs (so long as they have the Lion quality mark on them) have been cleared as OK to eat during pregnancy – moving, therefore, from the “not for you, lady” list to the “knock yourself out, love” list. Bring on the cheesy omelettes.
Smoking during pregnancyMaybe seeing it from your baby's point of view and wanting to be around to see your baby grow up will give you the incentive to kick the habit.
This is one area where there's no disagreement, and the advice doesn't tend to change: smoking is not good for your baby or you. Cigarettes increase the risk of babies having a low birth weight, being born prematurely and/or with respiratory problems, and maternal smoking is linked to miscarriage and also sudden infant death syndrome (SIDS) after birth.
For some women who smoke (and most of those who don't), pregnancy is the ultimate aversion therapy – one whiff of tobacco can often bring on nausea or sickness. Others can find it a real struggle to give up, especially with the added stresses of pregnancy.
Remember though, it's no longer just your health you need to worry about. Both nicotine and carbon monoxide – two of the many toxic elements in cigarettes – are particularly harmful to your baby. Nicotine narrows the blood vessels, so your baby gets less oxygen-filled blood – while carbon monoxide pushes out even more of the oxygen that he or she needs to survive. As a consequence, the chance that a baby will be born prematurely doubles – and smoking while pregnant more than doubles the risk of stillbirth. Bottom line: every cigarette you don't smoke is good news for your baby.
“Every time you manage to go without a cigarette you should praise yourself, and every time you give in at least know that you tried. I took up chewing gum – I'm totally obsessed with it, keep it in pockets, in my bag, all over the house.”
Is it safe to drink when pregnant?
Current guidance is to avoid all alcohol, and that it's particularly important in the first three months – but if it took you a while to discover you were pregnant and give up the booze, don't panic. You are by no means alone, and many believe the occasional glass probably does no harm. Many women avoid all alcohol in the first trimester, but feel happy enjoying the occasional glass after that.
NHS Choices recommends: “If you're pregnant, or planning to become pregnant, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum. Drinking in pregnancy can lead to long-term harm to the baby. The more you drink – the greater the risk.”
The advice may be vague, but it's there for a reason: drinking during pregnancy is potentially dangerous because the alcohol crosses the placenta and your baby's developing liver can't process it as fast as your body can.
Too much alcohol raises your risk of miscarriage and your baby's chance of having a low birthweight. Drinking large amounts can also lead to foetal alcohol spectrum disorder, which causes serious health problems for your baby, such as heart defects and behavioural disorders.
“I suspect the reason they say no alcohol whatsoever is because if they said 'x amount of units' people would go over because lots of people don't know much much makes up a unit.”
“It's all a balance of risks, like most things in pregnancy. I choose to drink, since I don't think that the risk of harm from one small glass a week/fortnight is high enough to warrant the hysteria around drinking that amount.”
Taking drugs during pregnancy
If you're using cannabis, ecstasy, ketamine, cocaine or other illegal drugs, then so is your baby, because drugs cross the placenta. This increases the risk of pregnancy complications and foetal abnormalities – so don't worry about what you've done in the past, but do concentrate on stopping in the present.
Talk to your doctor as soon as you think you might be pregnant – he or she will be able to help.
Should I avoid dental x-rays?
Make sure you tell your dentist you're pregnant – for a start, you'll get free dental treatment on the NHS, and they can help answer any questions you might have about looking after your teeth and gums during pregnancy.
Although x-rays are thought to be safe, your dentist will probably suggest waiting until after your baby is born if one is required. X-rays cause no increase in the risk of miscarriage, birth defects or developmental problems, but there’s a very small increased risk of childhood cancers. For this reason, if you do have to have an x-ray which can't be delayed, the dentist may cover your abdomen with a lead apron.
Is it safe to change the cat's litter tray when I’m pregnant?
Cat faeces can carry a parasite that causes toxoplasmosis, an infection that isn't serious for you but can be for your baby. It's also carried by some birds and other animals, and found in undercooked meats. Cats get it by eating dirt and raw meat (usually rodents).
Cleaning the cat litter can't figure high on many women's 'chores I enjoy' list, so pregnancy is a good excuse to get out of it.
Your odds of contracting toxoplasmosis are low, and if you've had it already – fairly likely if you've had an outdoorsy childhood – you can't get it again. But to err on the safe side, if your moggy is not allowed outside, get someone else to clean the cat litter. If you have to do it, wear rubber gloves and wash both your hands and the gloves thoroughly afterwards.
If you don't have a cat, but neighbours' felines regard your garden or children's sand pit as a toilet, wear gloves when you're gardening and handling soil or sand.
Is it dangerous to sunbathe while pregnant?
Your skin is more sensitive during pregnancy, so if you're venturing out into the sun, be sure to slap on the factor 50, and don't be lying out on a beach frying yourself (not that that's ever a good idea anyway).
Overheating is very dangerous for your baby, especially in the first few months. Saunas, hot baths, sun beds and the like are best avoided for your whole pregnancy – and it's important to stay hydrated, since dehydration can cause premature labour.
In hot weather, stick to the shade and carry a bottle of water, particularly when travelling by bus or train – try freezing some half-filled bottles at home, ready to grab as you go out the door. Take regular sips, and don't wait until you're thirsty to drink. When the temperature rises there are lots of ways to stay cool when pregnant – but you can start by slowing right down!
Should I avoid people with infectious diseases when pregnant?
Your immune system is lower when pregnant so you will tend to pick up every cold and bug doing the rounds.
It's best to try and avoid anyone you know has any of the following (or has a child currently suffering with it) but it's not something to panic about if you discover only afterwards that you've had contact. Give your midwife a call and they'll be able to advise you on whether you need to take any further action or not.
Chicken pox and shingles
If you haven't had chicken pox before, avoid people with both of these (chicken pox can also be caught from someone with shingles). Pregnant women are at increased risk of developing pneumonia from chicken pox and while the risk to a baby is quite small, there is a tiny chance of them contracting foetal varicella syndrome, which can cause learning difficulties and birth defects. If you encounter chicken pox in the seven days before birth, your baby could get it as a newborn, which can be nasty, too.
Rubella (German measles)
Most people are immunised against this now so it's unlikely to be a problem. The most dangerous time to contract it is in the first trimester, when it can cause miscarriage. Later on it can cause problems including deafness in the baby.
Fifth disease (Slapped cheek)
Most of us are immune to this by adulthood but if you're in contact with a toddler who has it see your midwife so they can check all is well. If you do get it during pregnancy there is a small risk of miscarriage.
Lots of women unknowingly carry the Group B Strep virus which can occastionally cause problems in pregnancy or be passed to the baby during birth.
“Pregnancy can be trying enough without beating yourself up. None of us can escape exposure to ALL potentially harmful substances, but remember the vast majority of babies are born perfectly healthy. Our grandmothers and mothers smoked and drank through pregnancy, and doubtless our kids, in turn, will be scandalised by our reckless disregard for their health in utero.”
Things to be careful around in pregnancy
With some things, you just need to relax but employ a bit of common sense. These are all things that aren't outlawed exactly but you need to be cautious about.
Should I avoid chemicals when pregnant?
Lots of women are concerned about environmental chemicals in everyday items such as food and drink packaging, cleaning products, pesticides and paint. Try not to worry too much – you'd never leave the house if you avoided all risks, and the truth is that you're likely to come into contact with at least some environmental chemicals throughout your pregnancy, just like millions of other women who've gone on to give birth to perfectly healthy babies.
The effect of many chemicals on foetal development isn't yet known, though – and even though the risks are likely to turn out to be negligible, it's probably a good idea to avoid them if you can. If something has a strong chemical pong, it can't do you harm not to linger – good news for anyone who's dreading painting the hall ceiling or cleaning the mould off the grout in the bathroom. Anything in an aerosol spray can is probably best given a body swerve, too.
Paint and decorating products
Try to avoid using oil-based paints, turpentine, or finishes for floors that contain polyurethane and paint-strippers. It might be best to avoid removing old paint by any method, as some old paints contain lead.
Bug spray and pesticides
Insecticides are best avoided, though experts say that use of insect spray is OK. Many contain small levels of DEET but you'd need to absorb quite a lot for it to be dangerous. The dangers of being bitten by mosquitoes while abroad, however, outweigh the risks of the insect spray. As much as possible though, try to avoid fungicides, pesticides and anything else you might spray around the house or garden in the name of eliminating pests.
Phthalates and bisphenol A (household and cleaning products)
Also known as “plasticers” and BPA, these chemicals are found in lots of household products, such as lotions, some PVC flooring, but also in toys and some baby cups, plates and bowls. The chemicals are used to make plastics longer-lasting and more flexible.
The Royal College of Obstetricians and Gynaecologists says pregnant women should “play safe” and avoid exposure to products and foods that may contain chemicals such as bisphenol A and phthalates, which could harm your unborn baby. So you should avoid heating food in plastic containers and read labels carefully on plastic products, lotions and household items like mattresses and flooring, which may have been treated with such chemicals to make them flame retardant. Check product labels for “bisphenol A” (BPA) and any ingredients ending with the word “phthalate”.
Make-up and body products
Most of these are absolutely fine, but avoid anything containing retinol and accutane (often found in creams for acne and phthalates (see above). Read labels carefully and it's also worth checking whether essential oils in skincare products are safe for use in pregnancy.
Chemicals at work
Ask your employer to do a risk assessment, particularly if your work involves using solvents. It's your employer's responsibility to ensure you are safe at work during pregnancy, so let them know you are pregnant as soon as you need to.
With a few precautions, it's fine to colour your hair during pregnancy – the chemicals in both permanent and semi-permanent hair dye are not very toxic, and only really huge doses of the chemicals used in semi-permanent and permanent hair dyes would cause your baby harm.
Some women decide to wait until they're in their second trimester, just in case – and if you're doing it yourself at home, you can reduce the risk further by wearing gloves and opening a window for ventilation, as well as leaving the dye on for the minimum time. Highlighting your hair means that dye is less likely to be absorbed through your scalp, too, since it comes into contact mainly only with your hair.
Because your hormones are all over the place, you might be more susceptible to an allergic reaction from a dye (even ones you've used before), so do a patch test 24 hours before application. Being pregnant can affect your hair's overall condition – making it suddenly frizzier or less absorbent, for example – so a patch test is a good idea on all counts, particularly if you’re off to a wedding the next day.
How much caffeine is safe in pregnancy?
You don't need to cut out all caffeine, but you should limit yourself a bit. Current research indicates that high levels of caffeine can result in miscarriage or low birth weight, so government health advice is not to exceed 200mg of caffeine a day (even if you feel so tired you know six double espressos is the only thing that will get you through).
200mg is roughly one Americano and a small bar of chocolate, or a couple of cups of tea and a can of cola, per day. To reduce your intake, try substituting your daily cuppas with decaffeinated options or herbal teas. You’ll be surprised at how quickly you’ll get used to it – and cutting it out altogether can be easier than you think.
Which over-the-counter and prescription medicines are OK in pregnancy?
Current advice is that paracetamol can be taken sparingly after the first trimester. Lots of the remedies you'll usually take, including many decongestants, are a no-go area in pregnancy – but speak to your doctor or pharmacist and they'll be happy to advise you on alternatives, or other ideas to cope with your symptoms.
Are underwired bras safe during pregnancy?
Do get measured for a maternity bra and make sure it's comfortable to wear. At the back of your mind, you may recall something about underwired bras being bad for pregnant women because they can interfere with milk production. It's no longer thought to be the case, and the only important thing is that whichever bra you choose fits you well – so wires shouldn't be digging in. They shouldn’t be digging in if you’re not pregnant, to be frank – so use this as a good moment to say goodbye to restrictive scaffolding forever!
As hormones cause your breasts to grow larger (for which read: “balloon like a couple of airships”), you'll need to be re-fitted to make sure you're getting the right support. It's worth getting measured every couple of months – and, pregnant or not, it's good to know how a good-fitting bra should feel.
Things you SHOULD do in pregnancy
There are plenty of positive things you can do to keep you and your baby safe and healthy during these nine months.
What foods should I be eating in pregnancy?
You'll hear a lot about all the foods you need to avoid, but it's probably even more important to ensure you are getting enough of all the vital things your body needs to do its job in pregnancy.
There are lots of things on the “do eat” list, including plenty of starchy foods (wholegrains, pasta, rice, pulses, fruit and vegetables) for the usual reasons, but also to prevent, or at least limit, constipation – a bane of pregnancy.
You need plenty of calcium (milk, yoghurt, cheese – the right kinds), protein (pulses, lean meat, chicken, fish and eggs – all well-cooked) and iron (fortified cereals, red meat, pulses, bread, green veg).
And don't forget to keep your water levels topped up. Your blood volume increases dramatically during pregnancy and lots of water is needed to fuel this, as well as to help your body keep all its other vital functions working nicely.
Now is no time for dieting but you should keep an eye on your pregnancy weight gain as putting on too many pounds can put you at greater risk of complications such as gestational diabetes.
Food safety in pregnancy
It's not something to become obsessed with, but it's a good plan to be aware of the risks of bugs such as listeria when you're pregnant. You should also observe tip-top kitchen hygiene:
- Wash fruit and veg thoroughly
- Be careful with bagged salads – they’re best eaten on the day of purchase
- Store meat, fish and dairy separately and at the correct temperature
- Wash your hands after handling raw food, particularly meat
Do I need to keep taking folic acid once I’m pregnant?
Yes. A folic acid supplement should be taken every day from the time you start trying to conceive up until 12 weeks. It helps protect your growing baby from neural tube defects such as spina bifida.
Is it safe to exercise in pregnancy?
Absolutely. In fact, exercise during pregnancy is recommended by midwives to keep you healthy, happier and fit for birth. It’s thought to help ward of postnatal depression but will also keep you flexible, keep bodily functions (yes those) regular and will help keep weight gain at a safe level. An all-round winner.
Should I be doing pelvic floor exercises?
Yes – it's never too early to start practising pelvic floor exercises. They'll help guard against “leakage” both during pregnancy and after the birth, too. Your future self will thank you.
Get your care and support in place
Do make sure you book in with the midwives by visiting your GP or midwife team. It's amazing how many women (particularly with a second or subsequent baby) overlook this small detail – your antenatal team are not psychic (though it will sometimes feel like they are). Once you've told them you're pregnant, they can get the ball rolling with antenatal appointments
Pay a visit to the dentist. Your teeth and gums need extra care in pregnancy. You're entitled to free dental care throughout pregnancy and up to your child's first birthday.
Go on tours of the local maternity units and hospitals early on, so you can have a think about where you'd like to give birth.
Don't forget to book your antenatal classes too. In some areas these can get booked up pretty quickly and they are a great way to find out about labour and birth and make some new friends who’ll have babies the same age as you, too. You could also find your Mumsnet antenatal club for the month your baby is due.
Do I need to rest more in pregnancy?
Pregnancy tiredness can really take it out of you, whether it's that hormonal, draining tiredness of the first trimester, or the sort of knackeredness that takes over closer to birth, when the sheer exhaustion of just carrying around that extra weight all day gets a bit much.
Take it as easy as you can. You're growing someone else's EYEBROWS in there for goodness' sake. You need a break or two. Take naps in the daytime if possible and if not, catch up by heading to bed early in the evening.
I didn't know I was pregnant – should I be worried?
It's worth remembering that unborn babies are remarkably hardy – if they weren't, the human race would long since have dwindled into extinction.
Women in France don’t give up smelly cheese, women in Japan continue to nibble sushi – and all over the world women who had no idea they were pregnant have dyed their hair, sipped G&Ts and lifted heavy objects, and still given birth to perfectly healthy babies. So while it's important to know what's what and do your best, there's no need to fret too heavily about it.
Do join Mumsnet, if you haven't already, for advice and support from our forums – to help throughout your pregnancy, and beyond.