A new regular on the blog, Pregnancy Week by Week from NaturalChildbirth. Each week you’ll be taken through the stages of pregnancy, what to expect, what to avoid and, of course how to stay well. Click on the NaturalChildbirth link for more information about people, products and advice to help with a natural birth. I’ll hand you over to Dr. Lindsay Reid - Midwife writer, researcher and historian, to begin the series.
Finding out that you are pregnant can be a time of mixed emotions – joy, shock disbelief. It’s amazing to think that a full term baby begins with the joining together of two separate cells – one ovum and one sperm. It’s sometimes difficult to believe without outward signs.
Pregnancy however follows quite a definite pattern and it is useful for you to have an idea, at each stage of this before-birth journey, of how you might feel and what your baby looks like and what she can do. Pregnancy week by week: you and your baby is a series of articles featuring a week by week discussion on your pregnancy, and various aspects of baby’s growth and development. We will also be discussing symptoms you might experience at each stage, how you might feel, what you might expect to happen, and the people, for instance, your midwife, with whom you will meet along your journey of pregnancy.
This week we are looking at the two weeks immediately before you become pregnant. These are the weeks that begin with that significant day: your Last Menstrual Period (LMP).
Pre-pregnancy – but very important
Did you know that your pregnancy calculation begins before you even conceive?
Read on.
Timing of pregnancy
You may wonder why we are starting this series with pre-pregnancy weeks. It’s all to do with calculations.
Pregnancy officially lasts for 40 weeks or 280 days, calculated from the first day of your last period plus nine calendar months and seven days, or, plus 40 weeks. So, if you ovulate two weeks after your period and become pregnant then, the timing is still counted from the first day of your last period as a standard way of calculation. So, in working out when your baby is due, your midwife will count the weeks from the first day of your last period.
So the two weeks following your period can be seen as a time when your uterus is ‘preparing the nest’ for many weeks of giving your developing baby a safe home until the expected date of birth arrives.
Your preparation too…
Your health leading up to conception can have a lasting impression on the health of your baby. The early weeks of pregnancy are often missed as far as nutrition is concerned as many mothers do not even know that they are pregnant at this point.
‘You are what you eat’
It’s true. Try and start your pregnancy healthy with already a really good balanced diet and a spring in your step. Then carry this on into the first three months, or trimester, of pregnancy. This is a vital time for development of your baby and your good nutrition has a big part to play in your baby’s health as well as your own. So, even before you know whether or not you are pregnant, start consciously thinking about what you are eating so that your baby will receive the best. This will serve you both well: your baby will benefit and you will get into the habit (if not there already) of long-term healthy eating habits – after the first trimester comes the second and the third and then you need to be fit for being a mother…
What can you do to improve the quality of your diet?
Ideally, pre-conception diet planning should start as soon as you stop any contraception in preparation for pregnancy. But life is not always as smooth as that – however if you are hoping to conceive, you could start making positive changes.
Should I take folic acid ?
Folic acid supplements (400mcg per day) should be taken by all women hoping to conceive at an early date. You should take them daily until the 12th week of pregnancy. Doing this will help to prevent risk of neural tube defects such as spina bifida. If you have had a baby with neural tube defect before or have diabetes or take epilepsy drugs please talk to your midwife or GP about this as you should be able to receive a higher dose of folic acid on the NHS.
What about iron?
When you are pregnant your body will have to cope with more red blood cells, the needs of your growing baby and the growing placenta (afterbirth) which is linking your baby to you via the umbilical cord. Some women may need extra iron to help with this. However with a healthy diet this is not always required. Good sources of iron include dark green leafy vegetables, red meat, pulses, wholegrain bread, and breakfast cereals which are fortified with iron.
Tip: Drink fruit juice, high in Vitamin C along with your iron-rich food – this will help your body to absorb the iron.
Vitamin supplements
Supplements of Vitamins C and D are usually recommended in pregnancy and are easily available. Ask your midwife about this as some midwives keep a stock ready to give out.
What else can I do?
- Remember your ‘five a day’ fruit and vegetables. They provide fibre, vitamins and minerals.
- Eat lots of protein for growth – fish, at least two portions a week one of which should be oily, meat, eggs, nuts, pulses like lentils.
- Eat dairy foods – milk, cheese, yoghurt for calcium.
- And healthy carbohydrates for energy like wholegrain bread and rice, potatoes, pasta.
- Fibre – the wholegrain will have the added benefit of helping avoid constipation as will fruit and vegetables.
- Watch out for fatty sugary foods – you don’t want to be putting on too much weight.
Think about weight gain
It’s wise to think about weight gain very early on so that you can plan ahead. You don’t want to be ‘eating for two’ when it comes to quantity of food. The main emphasis is on healthy food.
We’ve all heard about the rise in obesity in the UK and other countries. Obesity is a danger in pregnancy and is linked with an increased risk of complications for mother and baby. It can be avoided.
Ideally, if you are very overweight before pregnancy, to lose some weight should be a serious pre-pregnancy aim. If you are overweight when you become pregnant then one suggestion is that you should aim to put on only 7 kg instead of the usual average pregnancy weight gain of 12 kg. However, it is not a good idea to attempt to lose weight whilst pregnant.
A few foods to avoid
There are certain bacteria in some foods which are potentially harmful in pregnancy and you should avoid them while pregnant.
Listeriosis: Paté, soft cheese like Camembert, ‘blue’ cheese like Stilton, some goats’ cheeses, unpasteurised dairy products, ready-meals which have not been cooked properly.
Salmonella: anything with raw or partially cooked eggs, raw shellfish, raw or undercooked meat of any kind.
Toxoplasmosis: raw and partially cooked meat, unpasteurised dairy products.
When you are pregnant avoid cats’ litter trays which may carry toxoplasmosis. Remember also that outdoor cats frequently litter in the soil.
What about alcohol in pregnancy?
There is no recognised safe limit for alcohol in pregnancy. The Department of Health recommends no alcohol. That is good enough for me – better be safe than taking any risk that can be avoided.
Caffeine
We tend to think that a cup of coffee is fine, but caffeine when you are pregnant should be kept to no more than 200 mg per day. This reduces risk of miscarriage and low weight babies. One mug of instant coffee contains 100 mg of caffeine. It soon mounts up. One mug of ‘brewed’ coffee contains 140 mg. Caffeine is in cola, ‘many energy drinks’, plain and milk chocolate, cold and flu medications and tea. I’m sure that there are more examples.
This time of preparation will end around 14 days after your LMP with conception.
As you wait, hopefully you are doing all the right pre-pregnancy things – that is, living life as usual but with all the added little conscious add-ons like getting enough sleep, not rushing, staying calm and relaxed, eating with the health of you and your baby in mind, enjoying work and play and life with your partner. No doubt if you are thinking ahead you will also be browsing the web and bookshops for information on all things to do with pregnancy, birth, babies and all the related subjects.
Next week, we’ll look at conception – when the ovum meets the sperm and starts to grow. In the meantime you can get advice from Sarah Buchanan, founder of NaturalChildbirth on Greatvine.
Reference: Phillips F, ‘Eating your words: getting the right messages across’, The Practising Midwife, 14:9:12-16.
All images kindly supplied by Thinkstock.