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    Pregnancy Day by Day: Count Down Your Pregnancy Day by Day with Advice from a Team of Experts
    Pregnancy Day by Day: Count Down Your Pregnancy Day by Day with Advice from a Team of Experts
    Pregnancy Day by Day: Count Down Your Pregnancy Day by Day with Advice from a Team of Experts
    Ebook1,674 pages13 hours

    Pregnancy Day by Day: Count Down Your Pregnancy Day by Day with Advice from a Team of Experts

    By DK

    4.5/5

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    About this ebook

    DK brings you an all-encompassing and illustrated guide to your pregnancy journey, from the moment of conception to the first two weeks of your newborn's life.

    Becoming pregnant is a beautiful moment in any person's life, and with this one-stop pregnancy guide by your side, you will be fully-equipped from beginning to end of your joyful journey.

    With day-by-day artworks and fetal images showcasing your baby's development, this comprehensive pregnancy book is perfect for both first-time mums and experienced parents alike.

    Dive right in to discover:

    - A day-by-day structure with unmatched detail for every step of the journey.
    - The day-by-day format is continued for the first two weeks of life with a new-born baby.
    - An hour-by-hour account of the crucial 12 hours post-delivery.
    - Illustrated artwork to show fetal development throughout the stages of pregnancy.

    As your due date approaches, this baby development book explores all the options available for your labour and birth so you can make the right choice with confidence, and also breaks down your delivery and the first 12 hours after childbirth. The day-by-day format continues for the first two weeks postpartum as you embark on life with your newborn.

    All the latest medical advice for mums-to-be is covered, including guidance on nutrition and exercise, so you'll understand how to keep you and your baby happy and healthy throughout pregnancy. Featuring Q&As with both experts and mums also provides extra support, answering common questions and offering reassurance for any questions or concerns you may have about pregnancy, from your pregnancy diet, to the first 40 days, this baby parenting book truly does have it all.

    The ideal gift for expectant mothers who are seeking a healthy and happy pregnancy every step of the way, and a must-have parenting book for those who seek a detailed account of labour, birth, and exploring all the options available during pregnancy care.

    With Pregnancy Day by Day by your side, we assure you will feel safe and supported during this special time in your life, as you count down the days to your new arrival!
    LanguageEnglish
    PublisherDK
    Release dateFeb 14, 2023
    ISBN9780744083002
    Pregnancy Day by Day: Count Down Your Pregnancy Day by Day with Advice from a Team of Experts

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      Pregnancy Day by Day - DK

      g Contents

      A HEALTHY

      PREGNANCY

      With an ever-growing body of knowledge on how a mother’s behavior in pregnancy impacts her baby’s immediate and long-term health, you have the opportunity to ensure that your lifestyle choices positively benefit your baby. Eating healthily, exercising regularly, and avoiding hazards will all help give your baby the best possible start in life.

      A Healthy Pregnancy | Contents

      Your pregnancy diet

      Exercising safely

      Sex and relationships

      Illnesses and medication

      Lifestyle hazards

      Skin, hair, and teeth

      Traveling in pregnancy

      g A HEALTHY PREGNANCY g Contents

      Your pregnancy diet

      You can optimize your own health and your baby’s future health by eating a nutritious, balanced diet throughout pregnancy.

      In recent years, much has been learned about what constitutes a healthy diet in pregnancy. In addition to the importance of nutrients such as folic acid, evidence is mounting that a person’s health may be influenced by the mother’s diet, including whether particular nutrients were received at certain times. Good nutrition in pregnancy may reduce a baby’s future risk of obesity, diabetes, and heart disease, as well as help you deal with the demands of pregnancy.

      DK

      Eating regular nutritious food, such as smoothies, is vital during pregnancy to keep your energy levels up, and to provide your growing baby with all he needs to develop well.

      A healthy diet

      Getting the right balance of protein, carbohydrates, and fats in pregnancy is simple, since the ratios are the same in pregnancy as at other times: 45–65 percent of your calories should come from carbohydrates; 20–35 percent from fats; and 10–35 percent from protein over the course of a week. A diet with plenty of vegetables, fruits, whole grains, and good proteins and fats automatically contains the proper mix of nutrients.

      Carbohydrates are an important source of fuel for you and for your baby since they are broken down into glucose, which passes easily across the placenta. Try to get six servings a day, a serving being equivalent to a slice of bread, 2 oz (60 g) of cereal, or five crackers.

      Carbohydrates are divided into two subgroups: refined and unrefined. Refined foods such as white rice and white breads are rapidly broken down and enter the bloodstream as a glucose spike that could produce larger babies with a future obesity risk. Unrefined carbohydrates such as in whole-wheat bread and pasta, and brown rice, break down more slowly and release glucose steadily, and are a good source of fiber. At least half of your carbohydrates should come from unrefined sources.

      Protein is essential for the growth of the baby and the placenta, as well as for your health. Pregnant women need around 2 oz (60 g) each day. Aim for two to three servings of protein-rich foods a day, a typical serving being 3 oz (85 g) red meat, or 5 oz (150 g) fish. Since most adults get about 3½ oz (100 g) of protein daily, there is usually no need to increase your intake, especially if you have protein at each meal. If you’re vegetarian, in addition to protein at each meal, you should have a snack that contains protein. If you’re having twins or more, ask your doctor how much protein to consume. When breast-feeding you’ll need 2½ oz (70 g) daily.

      Choose protein sources that contain less saturated fat, such as skinless chicken, lean beef and pork, tofu, low-fat cheese and yogurt, and skim milk. Fish, nuts, and seeds contain healthier unsaturated fats, although your intake of some fish should be limited since they contain mercury, which could be harmful to your baby.

      Fats contain vitamins and contribute to the healthy development of cells. However, although fats make a useful contribution to overall nutrition, their intake needs to be limited. Choose healthier unsaturated fats, found in foods such as fish and some types of oil, over unhealthy saturated fats found in whole-milk dairy products, meat, or trans fats found in processed foods.

      Studies suggest that the development of the baby’s nervous system may be boosted by omega-3 fatty acids, the richest source of which is found in fatty fish. Avoid fish high in mercury (see Know your fish); opt instead for fish such as salmon and anchovies, which are good, safe sources of omega-3 fatty acids. Wild salmon is very rich in omega-3, but farm-raised salmon is also a good source. Other sources include omega-3–enriched eggs, flaxseed, flaxseed oil, walnuts, canola oil, and omega-3 supplements and prenatal vitamins containing omega-3 fatty acids.

      Dairy products are an important component of the diet since they provide a good supply of proteins and fats, as well as calcium and some vitamins. Calcium is essential for the healthy development of bones and teeth. Opt for low-fat dairy products and low-fat or skim milk. Aim for 2–3 servings each day, a typical serving being 1 oz (30 g) of hard cheese, or 1 cup (200 ml) milk.

      Vitamins and minerals support the healthy functioning of body systems and provide antioxidants, which protect the body against harmful free radicals. See the table for more.

      A vegetarian diet, and vegan diets where dairy products are excluded, can be safe and healthy during pregnancy as long as you ensure a good balance of nutrients and sufficient protein (see Vegetarian mom-to-be). Babies born to vegetarians are in a healthy weight range, although vegans need to be vigilant in getting adequate protein, as well as reliable sources of B12 and zinc. Vegans can discuss with their doctors whether they can meet their B12 needs through diet alone. Since B12 is found primarily in animal sources, a supplement may be required. Non-animal sources may be unreliable.

      A low-GI diet: Glucose, the product of carbohydrates, serves as the primary fuel for your growing baby. A newer concept in nutrition is the glycemic index (GI), which looks at how much a food will raise the level of glucose in the bloodstream. Foods that release glucose gradually, such as unrefined carbohydrates, and thus have a low GI, appear to be healthier.

      Evidence suggests that a low-GI diet has health benefits for both the mother and baby. Maternal carbohydrate intake can affect glucose levels in the bloodstream, which in turn can affect the baby’s growth. Higher glucose levels, even those in the normal range, can make for a bigger baby—above the 90th percentile (the top end of a baby’s growth chart). There are health risks later in life linked to a high birth weight, such as obesity, diabetes, and heart disease. One study found that women who consumed a low-GI diet had infants that were a normal size, but had less body fat than those from women who consumed a high-GI diet.

      A low-GI diet can also help control glucose levels in mothers with gestational diabetes, in turn reducing complications of labor and birth associated with this condition.

      Your calorie intake: During pregnancy, most women need to increase their calorie intake by 100–300 calories a day for proper nutrition and weight gain. Your energy needs may vary depending on your pre-pregnancy weight and your activity levels.

      YOUR RECOMMENDED DAILY INTAKE

      A healthy, balanced diet is essential for dealing with the additional demands on your body and providing your baby with needed nutrients. Eating a wide variety of healthy foods ensures that you both receive the correct balance of nutrients. Include foods from each of the major food groups each day.

      DK

      Include 2–3 portions each day of protein-rich foods, such as fish, lean meat, chicken, legumes, hard cheeses, and nuts to ensure that body structures grow in a healthy way and that you have fuel to keep you going.

      DK

      Try to include 3 servings of dairy products in your diet each day. Ideally, your choices should be low-fat products, such as low-fat milk, low-fat cheese, and low-fat yogurt.

      DK

      Have 3 servings of whole-grain carbohydrates, such as brown rice and whole-wheat breads and pasta, to keep up energy levels and ensure a supply of fiber, which helps relieve constipation.

      DK

      4–5 servings of vegetables each day will ensure a good supply of essential vitamins and minerals. Try to eat produce from all colors of the rainbow and don’t overcook your vegetables.

      DK

      3–4 portions of fresh fruit every day will also provide a wide range of vitamins and minerals, many of which contain important protective antioxidants.

      DK

      1–2 servings daily of iron-rich foods such as eggs or dark leafy green vegetables will help maintain healthy iron levels during pregnancy when demands are increased.

      DIETARY PRECAUTIONS

      Certain foods should be avoided or their intake limited since they may pose a risk to your unborn baby. Simple cooking and hygiene measures are also important to limit the risks.

      Listeria is a food-borne bacteria to which pregnant women are more susceptible. It is found in unpasteurized dairy products, as well as refrigerated, ready-to-eat foods like meat, poultry, and seafood. To avoid it, thoroughly reheat hot dogs, lunch meats, or prepared deli foods and avoid unpasteurized dairy products; check labels of soft cheeses to be sure they’re made with pasteurized milk.

      Nearly all seafood contains at least trace amounts of mercury, which can affect the development of the fetal nervous system. Pregnant women should avoid swordfish, shark, king mackerel, and tilefish. To stay within safe limits, eat up to 12 ounces per week of lower-mercury seafood like shrimp, salmon, pollock, catfish, and canned light tuna.

      Toxoplasmosis is a parasite spread through cat feces or undercooked beef, pork, or lamb that can harm the fetus. Avoid changing cat litter and practice careful hygiene in the kitchen when preparing raw meat, being careful not to contaminate other foods such as lettuce or vegetables. Beef, pork, and lamb all need to be well cooked.

      Salmonella bacteria are found in chicken and eggs. Infection with salmonella can cause severe vomiting, but doesn’t directly affect the baby. Avoid any products containing raw or undercooked eggs, and make sure all poultry is thoroughly cooked through, since cooking kills the bacteria.

      HOW MUCH CAFFEINE?

      Recent research indicates that there is no absolute safe level of caffeine, so current advice is to limit caffeine consumption to less than 200mg a day, which is equivalent to 2½ cups of instant coffee. High levels of caffeine is associated with an increased chance of having a miscarriage or a small baby. Be aware of how much caffeine drinks and chocolate contain:

      7fl oz (200ml) instant coffee: 75mg

      7fl oz (200ml) filter coffee: 140mg

      8fl oz (225ml) latte: 75mg

      8fl oz (225ml) flat white: 150mg

      7fl oz (200ml) black tea: 33–50mg

      11½fl oz (330ml) regular cola: 32mg

      11½fl oz (330ml) diet cola: 42mg

      9fl oz (250ml) energy drink: 80mg

      1¾oz (50g) bar of plain (dark) chocolate: less than 25mg or milk chocolate: less than 10mg

      DK

      A Healthy Pregnancy | YOUR PREGNANCY DIET

      VITAMINS AND MINERALS

      This table shows why you and your baby need vitamins and minerals and the top dietary sources.

      A Healthy Pregnancy | YOUR PREGNANCY DIET

      g A HEALTHY PREGNANCY g Contents

      Exercising safely

      Staying fit in pregnancy has many benefits for you and your baby and increases your stamina for labor and birth.

      If you had an exercise program before you became pregnant, you can continue with this in the first trimester as long as you have the all clear from your doctor. As your pregnancy goes on, you may need to adapt your program.

      If you didn’t have a regular exercise program before, now is the ideal time to adopt a new, healthier way of life from which you will reap the rewards for years to come. If you do start exercising now, build up gently; listen to your body and do only what feels comfortable.

      Regular gentle exercise is much better than intense irregular bouts of exercise (which aren’t advisable in pregnancy), since your body responds more positively to consistent, moderate exercise.

      DK

      Stay well hydrated by sipping water before, during, and after your workout.

      How exercise helps

      In addition to increasing your energy levels, exercise helps you maintain a positive outlook and feel confident about your changing body image. Exercise can also ease common pregnancy discomforts such as nausea, leg cramps, swollen feet, varicose veins, constipation, insomnia, and back pain. By keeping muscles strong and toned, exercise makes it easier for your body to deal with changes in posture during pregnancy. There is also evidence that increased fitness helps shorten labor and your postpartum recovery time and lessens your overall anxiety about the birth.

      Food for fuel

      A nutritious, balanced diet is vital in pregnancy, and even more important when you’re exercising too. By drinking water and taking a snack such as nuts, fruit, or a yogurt with you when exercising, you’ll avoid being tempted by sugary snacks and drinks.

      EXERCISE GUIDELINES

      Follow these guidelines to exercise safely in pregnancy.

      Do:

      Warm up and cool down for at least 5–7 minutes before and after exercise.

      Drink enough water before, during, and after exercising.

      Wear loose, comfortable clothes that don’t restrict your rib cage.

      Try to exercise regularly for about 30 minutes, 2–3 times a week.

      Adjust your expectations; pregnancy is not a time to go for personal bests.

      Build your strength gradually. Do Kegel exercises. Breathe properly while exercising, especially when lifting weights.

      Protect your back when getting up from a lying position: roll onto your left side and sit up using your legs.

      Avoid exercises that feel awkward or uncomfortable or that make you feel unstable on your feet.

      Focus on posture and alignment when doing any exercise.

      Stop immediately and seek advice if you feel severe localized pain, especially in your abdomen; experience vaginal bleeding or dizziness; or if you just feel unwell.

      Eat frequent small meals and snacks to maintain energy and avoid having your blood-sugar levels fall.

      Don’t:

      Exercise in heat or humidity.

      Do jerky or bouncy moves and stretches or twist or rotate your abdomen.

      Lift weights that are too heavy. You should be able to lift weights easily for at least 10 repetitions.

      Do sports where you risk falling, such as skiing or horseback riding, or any high-impact movement.

      Overstretch: the pregnancy hormone relaxin can make you feel more supple than you are.

      Exhaust yourself. Decrease the intensity or duration and rest for an hour for each hour of exercise daily.

      g A HEALTHY PREGNANCY g Contents

      Sex and relationships

      You may find that you and your partner need to adapt to the emotional and physical changes that accompany pregnancy.

      In a low-risk pregnancy, sex is perfectly safe, although your levels of desire may fluctuate. Most women report that their interest in sex is the same or slightly reduced in the first trimester. In the second trimester, it varies from woman to woman, and in the third trimester libido often falls.

      Sex during pregnancy

      During the first trimester, the hormonal changes that cause nausea, vomiting, and fatigue can naturally result in a reduced interest in sex. However, other pregnancy changes may increase your desire, such as an increased blood flow, which produces swelling in the clitoris and labia, and extra vaginal secretions. In the second trimester especially, vaginal lubrication and intensity of orgasm can increase. This may be accompanied by gentle contractions; these are normal and are nothing to worry about. Many women find that their libido falls toward the end of pregnancy since a bigger belly makes sex more awkward and uncomfortable, and they may also feel increasingly anxious about the birth.

      How your partner feels

      Your partner may have a range of feelings towards sex in pregnancy. While some may find their partner’s new, fuller shape particularly sensuous, others may feel apprehensive about sex, fearing that they may harm the baby. Some men may feel a combination of these emotions. Unless there are concerns about your pregnancy (see An intimate pregnancy), it’s generally thought that sex won’t cause harm, since your baby is well protected by the amniotic fluid and your uterus.

      When to seek advice

      Some women experience vaginal bleeding after sex in pregnancy. This is most likely to be harmless and is often caused by the increased blood flow to the cervix in pregnancy, which can cause it to bleed on contact with the penis. If this is the cause, the bleeding should resolve after the birth. However, since there are other possible causes, report any bleeding to your doctor.

      In addition to the size of your belly causing discomfort during sex, some women experience pain during sex toward the end of pregnancy as the baby moves farther into the pelvis; or they may find that the contractions during an orgasm cause discomfort. These symptoms are unlikely to be a cause for concern, but speak to your doctor if you need reassurance.

      Intercourse in late pregnancy may not be safe if you’ve had a previous premature labor or risk factors for premature labor, such as a weak cervix, or if you have placenta previa (see Low-lying placenta), or leakage of amniotic fluid. If you have any concerns, don’t be afraid to ask your doctor for advice.

      Being able to enjoy sex in pregnancy will help you and your partner feel close. Psychologists have found that couples who enjoy sex in pregnancy are more tender toward each other and communicate better after the birth.

      DK

      You may both feel differently about having sex during pregnancy, so keep communicating.

      AN INTIMATE PREGNANCY

      During pregnancy, fatigue, feelings of insecurity about your new shape, and concerns about the safety of sex can all take their toll on your relationship. Allowing yourself time to adjust and keeping the channels of communication open will help you and your partner enjoy this new stage in your relationship.

      Talk to each other about your feelings and be aware that, for both of you, levels of interest may fluctuate.

      If your belly makes some positions uncomfortable, experiment with alternative ones that accommodate your size, such as side-by-side, rear entry, or woman-on-top positions.

      Enjoy other ways to maintain intimacy besides intercourse, such as touching and massage.

      g A HEALTHY PREGNANCY g Contents

      Illnesses and medication

      Knowing how to manage illness and what medications are safe to take is important to protect your own and your baby’s health.

      If you have an existing medical condition, seek advice from your doctor before you conceive as some medications may need to be changed before becoming pregnant.

      Preexisting conditions

      If you have a condition such as high blood pressure, asthma, epilepsy, or diabetes, your pregnancy will be classified as high risk and you’ll need to be monitored carefully. Women with high blood pressure, kidney disease, diabetes, systemic lupus erythematosus, previous preeclampsia, a BMI greater than 35, or a maternal age over 40 may be advised to start taking low-dose aspirin between 12 and 16 weeks of pregnancy. If you become pregnant while taking medication for a condition, don’t stop taking the medication; consult your doctor as soon as possible. Your medication may be safe, or you may need to change to another type of medication. The most important thing is to control your condition during pregnancy to minimize the risks to you and your baby, which will usually mean continuing with medication.

      Diabetes If you have diabetes and are planning to conceive, discuss with doctor the best way to control your blood sugar levels and how you will manage diabetes in pregnancy. Women with diabetes are advised to take a prenatal vitamin with folic acid before trying to conceive and for the first three months of pregnancy. Diabetic women who are overweight may be advised to lose weight before getting pregnant, and they’ll likely be told to monitor their blood sugar more frequently and take their medications on time during their pregnancy. Babies born to diabetic women also have a greater risk of higher birth weight, respiratory problems at birth, jaundice, and low blood sugar at birth.

      As soon as you’re pregnant, you should be referred to an obstetrician who specializes in pregnancy and diabetes, where you’ll receive extra care. You will have more frequent prenatal visits, additional scans, and extra blood tests to monitor your blood sugars. You may need diabetes medication and/or insulin injections each day; the dose usually changes throughout pregnancy and needs to be monitored. The better your blood sugar control, the less likely you or your baby is to experience problems during pregnancy.

      Since diabetic women have an increased risk of late pregnancy problems such as preeclampsia and premature labor, you may be advised to have an induction of labor before your due date. The exact timing will depend on factors such as your blood-sugar control during pregnancy and the size of the baby. Once in labor, your blood sugar levels will be closely monitored, and you will probably be given an insulin and glucose IV. After the birth, your baby’s blood sugar levels will be closely monitored, too, for 24 hours. If you’re planning to breastfeed, your insulin dose may need to be changed after the birth.

      DK

      If you have diabetes and become pregnant, talk to your doctor about how to best monitor your blood sugar levels and manage medications.

      Epilepsy If you have epilepsy, it’s very important to discuss pregnancy with your doctor before you conceive, as certain drugs carry a small risk of causing harm to the developing baby. Nonetheless, it’s also important that your epilepsy be controlled. Your doctor will ensure that you are on the lowest possible effective dose of medication before you get pregnant. Women with epilepsy are advised to take 5mg of folic acid for three months prior to conception and for the first 12 weeks of pregnancy. Most maternity units will assign a specialist team to look after women with epilepsy in pregnancy and you will have regular scans to confirm the baby is growing normally. The anomaly scan will check for problems such as cleft palate, which are slightly more common with certain medications. Most women with epilepsy have an uncomplicated pregnancy. If you have concerns, contact your maternity unit.

      Systemic lupus erythematosus This is an autoimmune disorder that can affect many parts of the body, including the kidneys, joints, skin, nervous system, heart, and lungs. The condition is more common in women, and particularly in those of childbearing age. Some women find that the symptoms for this condition ease during pregnancy; however, for some, they can worsen. It’s important to control the condition during pregnancy since it can affect the developing baby, with an increased risk of miscarriage, poor growth, premature labor, and stillbirth. Most medications for lupus are safe to use during pregnancy, but some aren’t, so you need to check with your doctor about whether you need to change your current medication. From around 32 weeks, your baby will be closely monitored and their growth and well-being will be checked. If there are concerns about you or your baby, labor may be induced early, or you may have a planned Cesarean.

      High blood pressure Check with your doctor that the medication you are on is safe to use during pregnancy. It’s important to continue your medication so that your blood pressure is controlled, because high blood pressure can be dangerous for both you and your baby. Your doctor will frequently check your blood pressure, and will test your urine for protein, because high blood pressure and protein in the urine are symptoms of preeclampsia. Your doctor may also recommend additional scans to check that your baby is growing well.

      Thyroid problems If you have an underactive thyroid gland for which you are taking thyroxine, you’ll need to have a blood test to ensure that your thyroid is functioning well and that the dose is correct, as thyroxine requirement can increase in pregnancy. It’s important that you are not lacking in thyroxine, because this may affect the baby. If you are being treated for an overactive thyroid gland, check with your doctor that you’re taking a thyroid medication that is safe in pregnancy. Your thyroid function will be monitored to check that your medication doesn’t need to change.

      Bowel disease Women with inflammatory bowel conditions, such as ulcerative colitis or Crohn’s disease, usually find that their condition improves during pregnancy, although you may relapse after the baby is born. Although it’s unusual for bowel conditions to cause major problems during pregnancy, it is important to check that you are not anemic, which can be a side effect of some bowel conditions, and your doctor may recommend extra scans to check that the baby is growing well.

      ASK A DOCTOR

      I’m asthmatic. Can I use my inhalers during pregnancy?

      It’s essential that you keep asthma under control in pregnancy, which means continuing to use your inhalers, since the risks from uncontrolled asthma are greater than any risk from taking asthma medication. If asthma is uncontrolled, it can mean that not enough oxygen gets to the baby, leading to a low birth weight or other problems. One of the best ways to control asthma, in addition to taking medication, is to avoid asthma triggers such as pet fur and dust mites. Use air filters, vacuum often, and damp dust; and use duvet, mattress, and pillow protectors. Sometimes, pregnancy reduces the severity of asthma, but if you feel wheezier than usual, talk to your doctor about reviewing your medication.

      Homeopathy seems to be a popular form of therapy. How effective is it and is it safe?

      Homeopathy works on the principle of treating like with like to stimulate the body’s natural healing mechanisms. There has been debate about the efficacy of homeopathy, and the scientific opinion is that there is insufficient evidence to show that it has any effect beyond that of a placebo. But talk to your doctor before using any homeopathic products or remedies during pregnancy, since homeopathy is an area of complementary and alternative medicine that’s associated with much debate and scientific controversy. If your doctor gives you the okay, a certified homeopath may be able to provide treatment.

      What’s the verdict on taking herbal remedies and teas during pregnancy?

      The US Food and Drug Administration does not regulate herbs and other dietary supplements, and there’s not much research about the health effects of many herbs on pregnant women, so it’s best to avoid them while you’re pregnant, including herbal teas. Decaffeinated black teas are your best bet, but if you want a fruit or ginger tea, read the ingredient label on the package carefully to be sure that no herbs are present. If you want to use an herbal remedy, talk to your doctor first.

      Infections during pregnancy

      When you’re pregnant, your immune system is slightly suppressed. This is necessary to stop you from rejecting the baby. This means that you may be slightly more susceptible to colds, coughs, sore throat, or food poisoning, and the illness may last longer.

      DK

      If you’re laid low with an illness during pregnancy, take time to rest and recuperate since pregnancy can exacerbate everyday symptoms.

      Colds and coughs Most pregnant women get a cold at some stage. However, cold medications can contain ingredients not safe in pregnancy, so avoid taking them, especially in the first trimester (see Taking medications during pregnancy). Steam inhalations and saline nasal sprays can ease congestion, and hot honey drinks help soothe a sore throat.

      Flu If you get the flu during pregnancy, call your doctor. Drink lots of liquids and get plenty of rest. Don’t take any flu or medications without talking to your doctor first. Flu complications can include dehydration and pneumonia and are more common in pregnant women. The US Centers for Disease Control and Prevention (CDC) recommends that all pregnant women get flu vaccinations. However, the nasal-spray flu vaccine is not approved for pregnant women.

      Food poisoning and stomach upsets It’s vital to practice good kitchen hygiene (see Careful cooking) to avoid getting food poisoning. If you do develop food poisoning or a stomach upset during pregnancy, try to drink plenty of fluids, and if it continues for more than 24 hours, see your doctor (see also Gastroenteritis).

      Yeast If you have a thick, white discharge and itching inside or outside the vagina, it is likely that you have yeast (candidiasis). This is common in pregnancy and nothing to be concerned about, but since the itching can be intense, it is worth a trip to your doctor. A swab may be taken to confirm the diagnosis, and an appropriate local antifungal treatment prescribed. Eating plain yogurt may help restore the bacterial balance in your vagina. Wearing cotton underwear and avoiding tight clothing is also recommended.

      Urinary-tract infections (UTIs) Many pregnant women get UTIs because the hormone progesterone relaxes all the smooth muscle, allowing the bacteria that normally live in your vagina to travel up the urethra (the tube that leads to the bladder) where they may cause an infection. The symptoms may be slightly different in pregnancy. Classic symptoms include burning when urinating and frequent urination; back pain, lower abdominal pain, nausea, or vomiting. These are usually easily treated with antibiotics, most of which are safe in pregnancy.

      COVID-19 While there is still a lot of research to be done regarding the effects of COVID-19 in pregnancy and the virus is rapidly evolving, pregnant women are at increased risk of complications from infection. The best way to protect yourself, and your baby, from COVID-19 infection is to get vaccinated. If you test positive for COVID-19 during pregnancy, discuss your symptoms with your doctor. Current treatments including monoclonal antibodies and antiviral medications can be used in pregnancy and may be offered to you.

      EXPOSURE TO CHICKENPOX OR RUBELLA

      Chickenpox in pregnancy can be severe, possibly leading to pneumonia, and can cause problems both for you and for your baby. If you contract rubella for the first time in early pregnancy, it can cause miscarriage or severe problems in the fetus.

      If you encounter chickenpox, contact your doctor who can check your immunity. If you aren’t immune, your doctor may advise an injection to protect you from severe chickenpox.

      Your rubella status is checked at the start of pregnancy. If you aren’t immune, you can be vaccinated after the birth. Meanwhile you need to be extra careful.

      If you develop chickenpox or suspect rubella because of a rash, contact your doctor immediately, but don’t go to the doctor’s office, where you may spread the infection to other pregnant women.

      TAKING MEDICATIONS DURING PREGNANCY

      During the first three months of pregnancy, it’s best to avoid all over-the-counter medications. Take the lowest possible dose. After the first trimester, some other medications are considered safe, but consult your doctor if in doubt. The following provides guidance on medications used for treating common pregnancy complaints and minor illnesses.

      Antacids Heartburn and indigestion are common, particularly during the third trimester when the increased size of the baby puts pressure on your stomach. Some antacids are safe to use during pregnancy, although you should avoid sodium bicarbonate because it may increase fluid retention. Consult your doctor or pharmacist about which ones are recommended.

      Antibiotics Many antibiotics used to treat infection are safe for use during pregnancy. These include antibiotics containing penicillin, although there are safe alternatives if you’re allergic to penicillin. The following antibiotics should be avoided during pregnancy:

      Streptomycin. This can damage the ears of the fetus as it develops and may result in hearing loss in the baby.

      Sulfonamides. These can cause jaundice in the newborn baby.

      Tetracyclines. These drugs shouldn’t be taken because they can affect the development of the baby’s bone and teeth and can cause discoloration in the teeth.

      Antiemetics If you have severe nausea and vomiting and natural remedies such as gingersnaps or ginger tea don’t relieve the problem, your doctor may recommend an antiemetic medication that is safe to use during pregnancy.

      Antifungal remedies You should avoid over-the-counter antifungal remedies, including oral and local remedies, for treating yeast. Consult your doctor, who can recommend an antifungal medication that is appropriate for use in pregnancy.

      Cold remedies Remedies for coughs and colds often contain a range of ingredients, such as caffeine, antihistamines, and other decongestants, many of which aren’t safe in pregnancy. Ideally, avoid all cold remedies and instead have steam inhalations and hot caffeine-free drinks. If you need relief, talk to your doctor before using any over-the-counter treatments.

      Diuretics It’s normal to experience some swelling in the hands and feet during pregnancy, and you shouldn’t attempt to deal with this by taking diuretics, including herbal diuretics. If you have sudden swelling in the face, hands, or feet, you should consult your doctor immediately because this can be a sign of preeclampsia.

      Laxatives The first step in dealing with constipation is to take dietary measures by increasing your intake of fiber and drinking plenty of fluids. If this isn’t enough to ease constipation, then some over-the-counter laxatives may be safe to take during pregnancy, including laxatives that contain bulking agents. Those containing castor oil may cause uterine contractions. Check with your doctor before taking any laxatives.

      Analgesics The general advice is to avoid all analgesics during pregnancy, especially during the first trimester. Before using pain medication for a common problem, such as a headache or backache, first try natural remedies; massage or a warm bath are often effective in relieving aches and pains. If these aren’t sufficient, call your doctor for advice. High-dose aspirin and anti-inflammatories such as ibuprofen should be avoided throughout pregnancy. The pain medicine codeine can sometimes be used for a short period to treat specific pain, but should only be taken on the advice of a doctor.

      Rehydration solutions If you have a stomach upset resulting in a severe bout of diarrhea that lasts for an extended period, your doctor may recommend a rehydration solution that is safe to use in pregnancy.

      Steroids If you have eczema, or find that this condition develops or worsens during pregnancy, your doctor may prescribe a steroid cream such as hydrocortisone. Corticosteroids, which are used to treat eczema, aren’t associated with birth defects, but they are known to cross the placenta, so both topical and oral corticosteroids aren’t recommended during pregnancy. Your doctor will provide advice and guidance on safe usage.

      Steroid inhalers used to treat asthma are safe in pregnancy, and it’s important to control your asthma while you’re pregnant.

      Oral steroids may also be prescribed for certain other conditions, and these may be safe to continue with under the guidance of your doctor. Anabolic steroids should not be taken during pregnancy.

      DK

      Making your own natural cold remedies from honey and lemon is preferable to taking over-the-counter remedies.

      g A HEALTHY PREGNANCY g Contents

      Lifestyle hazards

      Pregnancy can be beset with anxiety about potential hazards. Being aware of exactly what to avoid will help to allay fears.

      Whether you’re pregnant or are planning to conceive, now is the time to do a safety check on your social habits and home and work environment. Anything that could affect your well-being could affect your baby too, especially in the first trimester. Don’t become overanxious, but arm yourself with the facts so that you can avoid hazards and enjoy your pregnancy.

      Your social habits

      The decision to have a baby may inspire you to review your social habits and, if necessary, make changes.

      Alcohol consumption You should stop drinking alcohol while trying to get pregnant and once you’re pregnant according to the US Surgeon General. There is no known safe consumption level for pregnant women, so abstaining from drinking is the safest option. What isn’t in doubt is the damage caused to the fetus by excessive alcohol intake and could lead to fetal alcohol syndrome. The effects include retarded growth, facial and joint abnormalities, and heart problems.

      If you drank in the weeks before you knew you were pregnant, try not to worry, but stop now. Many women also decide to give up alcohol while they’re trying to conceive to optimize fertility.

      Smoking Ideally, stop smoking before you get pregnant. If you’re still smoking once you conceive, stop right away. If your partner or friends smoke, ask them not to smoke in your home or near you. Inhaled cigarette smoke interferes with the supply of oxygen to the baby, which can lead to a low birthweight and increases the risk of stillbirth or the death of a baby in the first month of life. If you smoke in pregnancy, you will be advised to take low-dose aspirin and offered smoking cessation classes. The doctor will also monitor your carbon monoxide levels, which is especially dangerous as it reduces the amount of oxygen available to the baby and may affect the baby’s growth.

      Recreational drug use In addition to damaging your own health, recreational drugs are not advised in pregnancy since some pose dangers for the fetus and other hazards.

      Heroin and cocaine are damaging to both a pregnant woman and her unborn baby. These drugs stunt fetal growth, affect the placenta, and can cause miscarriage or premature birth, as well as health problems in the newborn. Babies born to women who use heroin often show drug withdrawal symptoms. A report on ecstasy linked the use of this in pregnancy to a rise in birth defects. The specific effects of amphetamines and LSD are unclear, but it’s safest to avoid them.

      Although marijuana may be legal in some states, use of marijauna in pregnancy and breastfeeding is not safe for your baby. Using marijuana, in any of its forms, can cause problems with your baby’s developing brain as well as low birthweight.

      Hazards at home

      Many people use chemicals daily in and around the home, contained in toiletries and cleaning products. When products are used in accordance with the manufacturers’ instructions, there is little chance of them causing harm in pregnancy. However, minute traces of chemicals can enter the bloodstream, either through the skin or by inhalation, and cross the placenta. No hard evidence shows that this has an ill effect, but it makes sense to minimize the chances of chemicals reaching the baby.

      When using products, wear rubber gloves to prevent skin contact and ventilate rooms. To avoid inhaling mists or vapors, choose nonaerosol products. Also, choose products recommended for their low environmental impact, which contain fewer chemicals. Where possible, use natural alternatives to chemicals.

      DK

      Wearing rubber gloves when using household cleaning products will reduce your exposure to chemicals.

      Painting and decorating Don’t climb up ladders or stand on tables to reach high places since your belly alters your center of gravity. Also avoid skin contact or inhalation if you use oil-based paints, spray paints, paint strippers, floor varnishes, and sealant adhesives. Make sure rooms are well ventilated while decorating. Ideally, get someone else to do the decorating.

      Pets and infections Certain infections that could harm the fetus can be picked up from pets. The parasitic infection toxoplasmosis is spread through contact with cat feces. It may produce flulike symptoms, or no symptoms at all, and many unknowingly acquire immunity through previous exposure. However, although it rarely happens, contracting toxoplasmosis for the first time in pregnancy can cause serious problems, such as miscarriage or birth defects. Other pets, such as dogs, caged birds, and turtles, can carry salmonella bacteria. Salmonella infection doesn’t directly harm the baby, but can make a pregnant woman ill.

      Being scrupulous about hygiene helps you avoid such infections. Wear rubber gloves when handling a cat litter box, cleaning cages where animals are kept, or disposing of dog feces, then wash your hands (and the gloves) afterward. Wear gloves also for digging or weeding in case animals have defecated in the garden. Or get someone else to do these tasks.

      Toxoplasmosis and salmonella can also be contracted from eating undercooked or raw meat or eggs, so be careful with kitchen hygiene and cooking (see Dietary precautions).

      Workplace hazards

      It’s the legal responsibility of your employer to provide a safe environment. Being aware of your rights can help protect you and your baby.

      In recent decades, women worried about whether working at a computer screen put their babies at risk. It’s now clear that using a VDT (as well as photocopiers and printers) is safe. Some environments do pose possible dangers. If you work in a health-care setting with ionizing radiation or cancer-treatment drugs, inform your department that you’re pregnant. Hospital regulations will ensure that you are given alternative duties.

      Women employed in places such as hairdressers, manicure salons, labs, and craft workshops may be exposed to toxic chemicals. Working around some dry cleaning solvents has been linked to miscarriage. It’s up to employers to ensure protection from hazards. Talk to your boss or HR manager.

      Standing on your feet all day and physical work that involves heavy lifting can be exhausting in pregnancy. Ask if it’s possible to switch to less tiring tasks.

      DK

      If your job involves handling chemicals, ensure that a risk assessment is done and that you are able to avoid harmful substances.

      ASK AN EXPERT

      Is it safe to use a cell phone during pregnancy? I’ve read that phones emit radiation.

      The radiation emitted by cell phones is non-ionizing. This is not the same as the radiation received from X-rays, which can be harmful in large doses. There is no evidence to show that using a cell phone is a health risk to either you or your baby.

      I go swimming twice a week and love it, but is the chlorine in the pool bad for my baby?

      In the past there has been some debate about whether it’s safe to swim in chlorinated pools during pregnancy. However, now most experts believe that swimming in chlorinated water does not pose any health risks for pregnant women and their developing babies. You may find that the smell of chlorine might add to your nausea if you are suffering from morning sickness, although this is less of a problem in an outdoor pool. Try not to swallow the water. If you do, drink fresh water after your swim. Shower thoroughly afterward. Swimming has great benefits during pregnancy. It has a low risk of injury while providing a good cardiovascular workout and improving muscle tone, so don’t be put off by unnecessary worries.

      Is it OK to use nicotine patches or gum while I’m pregnant?

      Nicotine is known to decrease the blood supply to the fetus. This could affect the baby’s growth, especially in early pregnancy. Although tobacco substitutes such as patches, gum, and lozenges deliver less nicotine to your body than smoking, you should never use them without a doctor’s advice. Ask your doctor for information on safer ways to beat cigarette and nicotine cravings.

      g A HEALTHY PREGNANCY g Contents

      Skin, hair, and teeth

      In addition to affecting what happens to you internally, hormonal changes in pregnancy can also affect your external appearance.

      Many women look and feel better than ever during pregnancy, while those less fortunate report that there is a downturn in their appearance. However pregnancy affects you, the changes will be temporary and you’ll be back to your normal self soon after the birth.

      Skin

      You may find that your skin looks better in pregnancy due to hormonal changes, mild fluid retention, and increased blood flow. These can all result in smoother skin and are responsible for the famous pregnancy glow. On the other hand, you may find that your skin gets drier and more pimply and you may need to take extra care of it during pregnancy.

      Skin also tends to darken during pregnancy. The reason for this is unknown, but may be explained by the increased levels estrogen and melanocyte-stimulating hormone, which stimulate skin pigmentation.

      DK

      Applying moisturizing creams to relieve dry, itchy skin, or ones recommended to reduce stretch marks, is safe during pregnancy.

      Stretch marks (striae gravidarum) Many women develop stretch marks during pregnancy, which can occur on bellies, breasts, hips, or legs. These initially appear as pink or purple lines and may be quite itchy. After pregnancy they fade into pale wrinkles. Nobody knows for sure why these occur, but they probably result from a combination of pregnancy hormones and your skin stretching. You’re more likely to get stretch marks if you’re very young, if you gain a lot of weight in pregnancy, or if you have a very big baby. There is less agreement about the role of other factors such as a family history, being very overweight before pregnancy or belonging to a particular ethnic group.

      Many creams, lotions, and oils have been marketed for the prevention or treatment of stretch marks but none has been proven to work. Studies performed on such products are inconclusive. Commercially produced creams, lotions, and oils are safe to use and may help to minimize stretch marks by maintaining the elasticity of the skin; unfortunately, however, there is no guarantee that they will prevent them.

      Chloasma This describes the increased pigmentation of the cheeks, nose, and chin that affects around 50–70 percent of pregnant women. Using a protective sunscreen and avoiding the use of any photosensitizing skin-care products may reduce chloasma. A recent study found that using a highly protective sunscreen (SPF 50 and UVA-PF 28) prevented most pregnant women from developing chloasma.

      Hair and nails

      Hair stays longer in the growth phase during pregnancy, meaning that your scalp hair is likely to grow and thicken. Not so welcome is the fact that facial and body hair may also increase. After the birth, many women find that they suddenly lose a lot of hair as the growth phase stops. You should find that your hair is back to normal within six months.

      Fingernails may also change, often becoming stronger, although some find that they become softer and brittle. Nails may develop white spots or transverse grooves, but these are rarely anything to worry about and don’t mean that you’re lacking in vitamins.

      Teeth

      Pregnant women are more prone to tooth decay (dental caries), bleeding gums, and chronic gum infection (periodontal disease). Poor dental health not only affects you but can also have an impact on your baby. Studies have linked infection of the gums in pregnant women to premature birth, and if a woman has ongoing tooth decay after the birth, her baby may acquire bacteria directly from her saliva, leading to tooth decay in the child later on. It’s therefore important that you take care of your teeth during pregnancy and visit your dentist and dental hygienist regularly.

      To keep your mouth healthy during pregnancy, brush twice a day with fluoride toothpaste and floss every day. Routine dental treatment and some local anesthetics are safe in pregnancy, although it’s better to postpone elective dental treatments until after pregnancy or take care of them before pregnancy. Many women worry about having their teeth X-rayed in pregnancy. The radiation exposure from dental X-rays is minimal and the risk to your baby probably negligible. However, dentists will take every precaution to minimize your radiation exposure, covering you with a leaded apron before the X-rays.

      ASK AN EXPERT

      I am 18 weeks’ pregnant and due to go on a beach vacation. I have become uncomfortable with my facial and body hair. How can I safely remove it?

      You can safely tweeze, wax, and shave new stray hair. Skin bleaching and hair removal creams are probably safe during pregnancy, but there has been insufficient research to clear them since they can be absorbed through the skin and their effects on the baby are unknown. Permanent hair-removal techniques, such as laser and electrolysis, are thought to be safe in pregnancy. Both techniques penetrate the skin no deeper than a few millimeters. Consult your doctor to see if this is okay.

      I’ve been using topical cream to treat acne and I’ve just found out that I’m pregnant. Will it harm my baby?

      Tretinoin belongs to a group of medications called retinoids that contain vitamin A and may be associated with birth defects. Studies have looked at the effects of this cream in pregnancy and have found that babies whose mothers used it, even in the first trimester, had no increase in birth defects. However doctors recommend avoiding tretinoin cream in pregnancy. Another similar medication, isotretinoin, which is taken orally, may increase the risk of birth defects and is therefore contraindicated in pregnancy.

      I’m in the first trimester and will be going to my sister’s wedding. Can I have highlights put in my hair?

      Although the research into the safety of hair dyes if used in the first trimester may seem conflicting, the amount of chemicals used is small and it’s unlikely that hair dyes cause harm. Also, if your hairdresser uses foil, the dye is kept off your skin.

      I’ve heard that nail polish needs to be removed if you have a cesarean. Why is this?

      Previously, women were encouraged to remove nail polish before surgery. One of the reasons was that the pulse oximeter, a device attached to your finger to measure the oxygen in your blood during surgery, may give lower readings if placed over nail polish. However the device works as intended with nail polish or long nails if it’s mounted sideways on a finger. Therefore there’s no need to remove your polish.

      BEAUTY TREATMENTS AND COSMETICS

      Hair and nail products Shampoos, conditioners, manicures, and pedicures are safe. Minute amounts of hair dye may be absorbed through the skin, but there’s no evidence that this affects the baby. Chemical hair straighteners and curlers are also thought to be safe.

      Piercing Facial piercing or piercing the belly button, nipples, or genitalia isn’t advised since you’re at a higher risk of infection. If you have a navel piercing already, you can change a metallic ring for a flexible plastic retainer made from PTFE (polytetrafluoroethylene). Nipple rings can affect breast-feeding, so remove a ring before birth so the skin can heal. Vaginal or vulval piercings are best removed to avoid damage at birth.

      Tanning Tanning beds aren’t advised because of harmful UV rays. Tanning beds can cause your body to overheat, which can harm your baby, and UV rays may break down folic acid. Tanning lotions are safe.

      Body wraps/ Hot tubs These raise body temperature, which is unsafe for you and your baby. Heat exposure from a hot tub in the first three months can increase the risk of a baby developing spina bifida.

      Facials The cosmetics used for facials are thought to be safe.

      Botox The Food and Drug Administration recommends that women who are pregnant or breastfeeding should not use Botox. Although it’s used for cosmetic reasons, it is a drug and should be considered as such. Doctors also advise against having Botox during pregnancy.

      g A HEALTHY PREGNANCY g Contents

      Traveling in pregnancy

      Your growing belly shouldn’t put a stop to travel plans. Just a bit of extra planning is required to help your vacation run smoothly.

      Provided your pregnancy is normal, going to faraway places is perfectly possible. However, discomforts such as extreme heat, high altitude, and makeshift accommodations may be less tolerable and, in some cases, may compromise the safety of your baby.

      The best time to travel

      In the first trimester, you may find that morning sickness and fatigue lessen your enthusiasm for travel. Most women feel at their best in the second trimester, and this is also seen as the safest time to travel since your risk of miscarriage is low, energy levels are increased, and your due date is still some way off. After 28 weeks, the size of your belly, fatigue, and the looming birth date are likely to make home seem the best place to be.

      DK

      The best time to travel is often during the second trimester when nausea has abated and your belly size is not yet uncomfortable.

      Making plans

      A little extra planning is the key to successful travel in pregnancy. Think carefully before you book. How will you get there and how long will it take? Pregnancy adds to the stress of a long-haul trip. If you want to fly, check with the airline about its policy. Some require a current letter from your doctor confirming your due date and your fitness to fly after 36 weeks, largely because of the possibility of going into labor.

      Find out about the medical facilities in case you have any health problems while on vacation. Unless you have no choice, avoid visiting countries where disease is a high risk factor. Many doctors agree that protective drugs, such as certain vaccines and antimalarial pills, are not advisable in pregnancy or when trying to conceive. Check the internet for information about an area’s health hazards and local hospitals. If you have a condition such as diabetes that could cause complications, make sure you can get treatment while away.

      Take out travel insurance. Some companies consider pregnancy a preexisting condition and won’t provide coverage for your trip.

      ADVANCE PLANNING

      You’ve found your passport and put the tickets in your bag. However, when you’re pregnant, you may also need to take the following items:

      A note from your doctor stating your due date and giving you the all-clear to travel (helpful if you’re over 28 weeks).

      Any special medical records regarding your pregnancy or general health.

      A list of numbers for health-care facilities at your destination.

      Remedies for heartburn or other minor pregnancy problems, such as hemorrhoids. You may not be able to buy your usual products abroad.

      TRIMESTER-BY-TRIMESTER TRAVEL GUIDE

      Think about the implications of traveling at different times in your pregnancy when planning a trip.

      1st trimester (weeks 1–12)

      Period of highest risk for miscarriage and development problems in the baby. Be extra careful to avoid extremes of temperature and overly vigorous activities.

      Motion sickness could make morning sickness worse.

      Flying is allowed, provided you have no pregnancy complications.

      Insurance is unlikely to be a problem.

      2nd trimester (weeks 13–25)

      You are likely to be feeling your best, and the chances of miscarriage or fetal development problems are greatly reduced.

      Flying is allowed, but check to see whether you need to carry a doctor’s letter stating your due date.

      Check with individual travel insurance companies to see if you can get coverage—policies vary.

      3rd trimester (weeks 26–40)

      Your belly is huge and travel may be very uncomfortable now.

      Some airlines may not allow you to fly after 36 weeks without a letter from your doctor written within 72 hours of your flight that includes your due date and confirms your fitness to fly.

      Avoiding bugs

      Pregnancy reduces the efficiency of your immune system, increasing your risk of an infection. When you’re traveling, stomach bugs caused by contaminated food and water are more likely to strike.

      If you’re unsure about local tap water, buy bottled water (make sure the seal is unbroken) and use it when brushing your teeth as well as for drinking. Avoid drinks with ice and don’t eat salads or fruit you can’t peel since they may have been washed in contaminated water. A less obvious danger is fruit such as melon, which may have been injected with water to increase its weight.

      Avoid outdoor stalls or cafés where food might have been prepared hours in advance. Try to find restaurants where food is freshly cooked and standards seem high. Be scrupulous about hygiene, and carry moist wipes in case hand-washing facilities are inadequate.

      On the trip

      If you’re traveling by car, stop regularly to stretch your legs, have a snack, or find a bathroom. On a train or plane, keep your circulation moving with foot and ankle exercises, and every so often walk down the aisle. Stay hydrated by drinking lots of water or juice. Carry a bag of dried fruit or nuts with you on trips. Comforts, such as a cushion and a cooling water spritzer, can make a trip more bearable.

      Vacation activities

      Forego water skiing and horseback riding, as a fall could harm your baby. Scuba diving is dangerous because of the risk of air bubbles forming in the bloodstream and the potential lack of oxygen. Avoid going on white-knuckle theme park rides.

      If you’re used to exercising, there is no reason not to go swimming or walking, just don’t overdo it—hiking up hills under a blazing sun could send your temperature soaring, In the first trimester especially, extreme heat can affect fetal development. You might also become dehydrated, which, later on, can increase the risk of premature labor.

      Hot tubs and saunas should be avoided since the heat could make you feel faint and may be harmful to your baby. Some aromatherapy oils may be toxic to the baby, especially in the

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