Ask an Expert: Ten tips for a healthy pregnancy

Q. "I'm pregnant! This will be my first child. In your expert opinion, what are the top 10 things I should do to ensure a healthy pregnancy and a healthy baby?"

Answer from Brian Drake, M.D., F.A.C.O.G., board-certified obstetrician/gynecologist with Rose City Women's Health: If I could go back in time and address your question before you became pregnant, the first thing I'd recommend would be pre-conception counseling. Most women wait until they're pregnant to see their obstetrician, but for those who are still in the planning stages, a pre-conception appointment is a great way to make sure you are prepared, mentally and physically, for pregnancy.

Now that you are pregnant (congratulations!), here's my top 10 list for the next nine months:
  1. Schedule a prenatal visit with your obstetrician.
    If you haven't done so already, schedule a prenatal visit right away. Talk with your doctor about any medical conditions you are being treated for, such as depression, diabetes, high blood pressure, etc. — you may need to change medications or dosages during your pregnancy to protect the fetus, so your doctor needs to know everything you are taking. Your doctor will probably talk to you about the rest of the issues on this top-ten list, as well. Before you leave the doctor's office, schedule your next visit; be sure to make it to all of your prenatal appointments.

  2. Make this the most important subject you've ever studied.
    Now is the best time to ask your pediatrician, your local librarian or the other moms in your life to recommend some good books on childbirth and parenting. I highly recommend signing up for a childbirth class, too — the more you learn now, the better prepared you'll be for the big day, and all the days that follow.

  3. Start eating for two.
    I'm not suggesting that you double the amount that you eat, but it is a good idea to eat a little bit more — about 300 extra calories a day — while you're pregnant. Make sure you are eating nutritious, well-balanced meals — that's always important, but even more so when you're pregnant with your future son or daughter. A few key points:
    • Eat several daily servings of foods that are rich in calcium, such as milk and yogurt.
    • Fish is good for you, but avoid varieties that may contain mercury
    • Avoid unpasteurized soft cheeses and raw meat.
    • Eat four to six small, healthy meals throughout the day to maintain even blood sugar levels.

  4. Take a daily prenatal vitamin.
    If you eat a balanced diet, you'll get most of the vitamins you need from the foods you eat. But as a precautionary measure, all pregnant women should take a prenatal vitamin that provides at least 400 to 800 micrograms of folic acid, plus calcium and vitamin D.

  5. Keep exercising.
    If you were a regular exerciser before you got pregnant, keep it up. If you don't usually exercise, start. All pregnant women should get regular aerobic exercise. In addition to the usual benefits, it helps regulate blood sugar, keeps babies from getting too big, reduces the stress of pregnancy, and builds strength and endurance that will help you during labor and delivery. Hold off on the extreme sports or high-intensity training programs (don't raise your heart rate higher than 150 beats per minute), but do try to get in a 20- or 30-minute walk, swim, bike ride or other form of physical activity on most days of the week.

  6. Get a flu shot.
    Some vaccines are not recommended during pregnancy because they could harm the mom or the baby. The flu vaccine, however, is perfectly safe during pregnancy, and is strongly recommended. Both the seasonal flu and H1N1/swine flu can cause serious problems for pregnant women. Get vaccinated for both, but be sure that the person administering the vaccine knows that you are pregnant - pregnant women should not receive the nasal form of the vaccine.

  7. Say no to alcohol and cigarettes.
    Is one drink safe? The American College of Obstetricians and Gynecologists is pretty strict on this one: Because the lower threshold of safety is unknown, there is no amount of alcohol that is acceptable during pregnancy.
    Smoking — even second-hand smoke — is a big "no," as well. Studies show connections between smoking and low birth weight, abruption (a very dangerous premature separation of the placenta from the wall of the uterus) and multiple other risks to mother and baby. Living with a smoker and breathing second-hand smoke carries the same risks as smoking the cigarettes yourself. If you or someone you live with smokes, talk to your physician right away about methods that can help you quit.
    Similarly, any illegal substance use during pregnancy puts a mother and her fetus at serious risk and should be stopped.

  8. Drink water.
    I recommend that pregnant women drink at least 72 ounces of water a day, mainly for vascular reasons. During pregnancy, your vascular system is less responsive to changes in position, which can make you feel dizzy when you go from sitting to standing. Drinking plenty of water will help you reduce this problem and avoid the risk of falls caused by dizziness.

  9. See your dentist.
    There are a lot of links between infections in the mouth and early labor, so if you have any dental problems, get them checked out. Make sure your dentist knows that you are pregnant before he or she treats you.

  10. Wear a seat belt.
    Whether you are driving or riding along as a passenger, always use both your lap and shoulder belts. Make sure you wear the lap belt below your belly, and the shoulder strap across your chest but away from your neck.
If you have questions about any of this advice, please discuss them with your doctor. Welcome to pregnancy — buckle up and enjoy the ride!