During your pregnancy there are lifestyle choices that can have a positive or negative impact on your pregnancy and birth journey. It’s important to consider how you can improve your health and keep your baby safer during pregnancy. Read on to find out more about specific issues, or have a look at LiveWell Dorset’s information on looking after yourself and your baby in pregnancy.
Maintaining a healthy weight throughout pregnancy is one of the most important things that you can do for your own health and your baby’s health. Being overweight or underweight can have a big impact on both of you.
If you are underweight (i.e. your body mass index (BMI) is below 18.5), this can impact your baby’s growth. It also increases your risk of miscarriage, premature birth and developmental issues for your baby such as gastroschisis (a condition where their stomach doesn’t develop properly). If your BMI is 18 or below at your booking appointment, you will be referred to a consultant for additional antenatal care and monitoring, such as additional growth scans. Your consultant can refer you to other services, such as a dietician or the perinatal mental health team, depending on your personal circumstances. Read more about being underweight during pregnancy.
If you are overweight and your BMI is over 30, this can cause additional complications for you and your baby. NHS UK recommends that you don’t try to lose weight during your pregnancy as this may not be safe, and there is no evidence that losing weight will reduce the risks.
Women across Dorset with a BMI of 35 or more at their 12-week scan will be offered additional help and support throughout their pregnancy. This varies depending on which hospital you are attending for your antenatal care.
Your mental health during pregnancy and after birth is very important to us. It is just as important to take care of your mental health as it is to take care of your physical health, but it can be harder to realise that there’s a problem or admit that you need some extra help.
In the UK, up to 1 in 5 women develop some form of mental health problem during their pregnancy or in the year after birth (sometimes called the “perinatal period”).
Most of us have heard of postnatal depression (PND), but you might not be aware that some women also suffer from antenatal depression (depression during pregnancy). This is a time of so much change, to your body and your hormones as well as to your life in general, so it’s understandable that lots of women struggle with their emotional during pregnancy.
It’s important to remember that depression and anxiety during pregnancy are common, and can be treated, but there are also lots of things you can do yourself to improve your emotional wellbeing. You could try:
- Meditation, relaxation and breathing exercises
- Asking family and friends for practical help
- Meeting up with friends for an activity you enjoy
- Take some time for yourself
- Talking to trusted family or friends
- Join a support group, such as PANDAS
If you find that these steps aren’t helping and you are still struggling, you can get help and advice from your midwife or GP.
If you experience any of the following symptoms, it’s best to talk to someone:
• Anxiety, worrying or feeling low most of the time for more than two weeks
• Loss of appetite
• Not wanting to get out of bed
• Having unpleasant thoughts that you can’t control
• Panic attacks
• Feelings of dread, guilt or worthlessness
• Finding that you need to repeat certain actions (e.g. washing your hands, turning lights on and off) to make yourself feel better
• Feeling so terrified of labour / birth that you feel unable to go through with it
• Losing interest in the things you usually enjoy
• Thinking you are a bad mother or cannot cope with a baby
• Thinking about hurting yourself or suicide
Lots of women feel embarrassed or worried about admitting that they are struggling with their emotional wellbeing, but there is no need to feel this way. Your midwife and your general practitioner (GP) will have helped lots of pregnant women with their mental health, and everyone involved in your care wants to help you.
You can also refer yourself to Steps 2 Wellbeing to access talking therapies if you’re feeling sad, anxious, low or stressed.
If your mental health issues are severe, your midwife may refer you to the perinatal mental health team for assessment and treatment
Some women suffer from a fear of labour and birth, also known as tokophobia. This happens more commonly in women who have had previous children, especially if they have had a traumatic birth experience, but it can also occur in your first pregnancy. Women who’ve had lots of gynaecological problems or a history of sexual abuse are also more likely to suffer from this issue. Tokophobia can get worse as your pregnancy progresses it’s best to speak to your midwife about this as early as possible in your pregnancy. They can refer you for help and support, and to the Birth Choices clinic if you need to discuss your birth options.
Take a look at the following links for more information and support:
- Tommy’s have a free wellbeing plan you can download from their website – this can help you think about how you’re feeling and what help you might need
- Wessex Healthier Together have lots of information about mental health issues during and after pregnancy, including antenatal depression, eating disorders, anxiety and much more
- MIND have some information on self-care during and after pregnancy, to help you to take good care of yourself
- Read more about maternal mental health from the Royal College of Obstetricians & Gynaecologists (RCOG)
Smoking during pregnancy has been linked to various health issues for both mum and baby.
The good news is, if you manage to quit smoking by the 15th week of your pregnancy and remain smoke free, the risks to your baby in terms of growth and development can be reduced to that of a woman who has not smoked. Find out more about the benefits of quitting smoking during pregnancy.
New guidelines mean that you will have your carbon monoxide levels tested at each midwife or consultant clinic appointment, to ensure that the staff can give you the help and support you need.
Throughout Dorset there are specialist Smoking in Pregnancy Support Services to help you quit. The services are run by qualified midwives who have completed specialist training to support you to give up smoking. The specialist one-to-one support and the treatments provided mean you are four times more likely to be able to quit, and to remain smoke free, than if you tried to quit alone. At your booking appointment, your midwife can refer you to the relevant service so they can offer you support right from the start of your pregnancy.
Taking illegal drugs, street drugs, legal highs or medications that have not been prescribed for you can be extremely harmful to you and your unborn baby. If you are using drugs or struggling to drug addition, it’s very important to speak to your midwife, GP or a specialist drug and alcohol service. Getting help early can protect your baby and keep you well.
You can contact the following organisations for help:
Some medications are safe to take during pregnancy, but others are not. If you are already taking any medications, speak to your GP about whether they are safe. Don’t stop taking any medications or reduce the dosage without speaking to your doctor.
If your GP or another doctor needs to prescribe any new medication for you during your pregnancy, they will check to make sure that it’s safe – make sure that they know you are pregnant. You can speak to your GP or pharmacist if you have any concerns.
For most women, it’s safe to continue to have sex throughout your pregnancy, unless you are advised not to by a healthcare professional.
Some women find sex very enjoyable during pregnancy and find that their sex drive increases. Others find that they suddenly don’t want to have sex at all. Changes to your sex drive are usually related to the changes in your hormones, but feeling uncomfortable or self-conscious, feeling sick, being in pain, or being concerned about the baby can all impact your sex drive.
Make sure you talk to your partner about how you’re feeling, as this will help you to maintain other types of intimacy in your relationship.
Be assured that your baby will not be aware of what’s happening, and you can’t hurt your baby.
If you are experiencing certain complications, you might be advised not to have sex for some or all of your pregnancy. If you receive this advice, you should follow it in order to keep your baby safe.
If you have any pre-existing health conditions, you should make an appointment to see your GP when you find out that you’re pregnant. This will give them the opportunity to review any medication you’re taking, and see whether you need additional care to keep you and your baby well. If you have been diagnosed with conditions such as high blood pressure, diabetes, epilepsy or thyroid issues, you should see your GP as early as possible in your pregnancy.
It’s also really important tell your midwife about any pre-existing conditions at your booking appointment, and any other healthcare professionals you see during your pregnancy. This includes allergies, conditions you’ve suffered from previously, and any previous surgeries (including cosmetic procedures). This will ensure they can give you appropriate care, and monitor your health more carefully if needed.
If you are under the care of a consultant for your condition, it’s a good idea to inform them about your pregnancy. They can discuss any potential impact of pregnancy on your condition, and vice versa, and they can be involved in putting together your care plan. If they do have specific advice, ask them to write a summary that can be put into your antenatal notes, as not all hospitals and departments in Dorset share notes automatically.
The hormonal changes during pregnancy can cause bleeding gums, so it’s really important that you brush your teeth well twice a day with a fluoride toothpaste to avoid tooth decay.
Dental care is free during pregnancy and until your baby is one year old. We recommend that all pregnant women visit a dentist during pregnancy, especially if you are suffering from sore or bleeding gums.
Eye tests are also free during pregnancy. Pregnancy itself can cause changes to your vision, as well as dry eyes. If you are having problems with your vision, you should arrange to see an optician.
Some infections or viruses can be harmful to you and / or your baby if you suffer from them during pregnancy. Please seek medical advice from your GP if you are concerned about any of the following:
Chicken pox is a virus which is highly infections and can be dangerous to your baby. If you have already had chicken pox, you will most likely be immune to the virus and you don’t need to worry about being around children or adults with chicken pox during your pregnancy. If you’re unsure whether you’ve had it or not, you may be able to get a blood test to check your immunity.
If you are unsure whether you are immune or not and you think you have come into contact with chicken pox during your pregnancy, you should contact your GP or your midwife. Don’t attend the maternity unit unless you are told to do so, as this may spread the virus to other pregnant women.
Slapped cheek syndrome (Parvovirus B19)
This virus usually affects children, but adults can catch it too. If you catch it during pregnancy, it can be harmful to your baby.
If you experience a blotchy, red rash on your face, usually with a mild temperature, headache or sore throat, you should call your GP or midwife for advice.
Sexually transmitted infections (STIs)
Rates of some sexually transmitted infections, such as chlamydia, herpes and gonorrhea are increasing, and they can be harmful to your baby’s health. Others such as human immunodeficiency viruses (HIV) can be passed to your baby without appropriate treatment. If you are suffering from symptoms of an STI during pregnancy, or you think that either you or your partner may have been exposed to one, it’s very important to get tested. Find your nearest sexual health screening service here by entering your postcode.
Toxoplasmosis is a dangerous virus that’s often found in cat faeces, contaminated soil or contaminated meat. If an adult catches it, they’ll usually experience flu-like symptoms and won’t realise have it. However, if you catch it during pregnancy, it can be harmful to your baby. It is rare so it is not tested for usually, but you should see your GP If you are concerned that you may have come into contact with toxoplasmosis. If you have a cat, ask your partner to handle the litter trays during pregnancy if possible, or use disposable gloves if you have to do it yourself. Avoid gardening if possible, or use gloves. It’s best to wash all fresh fruit and vegetables to remove any traces of soil.
Travelling can be more difficult during pregnancy, but there are things you can do to make it more manageable.
Although you may be able to cycle for much of your pregnancy, it’s best avoided if possible. Your joints are less stable, because of the hormone relaxin, and your centre of gravity changes as your bump grows. This can make cycling more difficult, and can increase the risk of you falling off your bike. A fall could hurt your baby, so we recommended not cycling, especially as your pregnancy progresses. If you usually cycle to work, see if you can find an alternative during pregnancy, such as public transport or getting lifts.
Make sure you have a bottle of water with you, especially when it’s hot. If you are struggling to stand or feeling dizzy, ask someone for a seat. If you have a long bus journey, consider where you might be able to get off to use the loo if you get desperate! Same train companies offer first class seats to pregnant women so it’s worth checking with the train lines you use.
It’s very important to wear your seatbelt so that the horizontal strap sits under your bump, and the diagonal strap is between your breasts. Make sure the seatbelt is not across your bump, as this could cause an injury to you or your baby if you have an accident.
Long car journeys can be really uncomfortable, especially in later pregnancy. Make sure you schedule lots of stops to stretch your legs and use the loo. Be sure to take a bottle of water with you so you don’t get dehydrated.
You can drive during pregnancy, but you should stop driving yourself if you can no longer do so safely and comfortably. Avoid making long journeys on your own if you can – have someone with you who can drive so that you can share the driving, and they can take over if you need it. As you get bigger you may find it more difficult to drive.
Flying isn’t harmful to your baby but you should always get advice from your GP or midwife before flying.
You need to consider how many weeks you are when you plan to travel and, crucially, when you fly to come back. Most airlines will refuse to let you fly after 37 weeks, but some airlines have much stricter rules and earlier deadlines, so it’s important to check the rules with the airlines you’re using.
Many airlines and some countries will insist that you carry a letter stating that you are safe to fly, and confirming your due date. Your GP can provide this for you and there is a usually a charge for this.
Airline travel increases your risk of deep vein thrombosis (DVT) so it’s important to discuss this with your GP or midwife before you fly. You can purchase compression stockings from a pharmacy which can help to prevent DVT and reduce swelling in your legs and feet. It’s really important to stay hydrated, do foot and ankle stretches, and keep moving around the plane when It’s safe to do so.
You will need to have vaccinations before visiting certain countries, and it’s important to check this before you book a trip. Some of these vaccinations contain live bacteria, and may not be suitable for use during pregnancy, so speak to your practice nurse about this.