How to ensure a healthy pregnancy

Have a Healthy Pregnancy - MyHealthfinder

The Basics
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The Basics

Overview

Health care during pregnancy is called prenatal care. Getting prenatal care can help you have a healthier baby. It also lowers the risk of your baby being born too early, which can lead to health problems for your baby.

During prenatal care, your doctor or midwife can find any health problems that may come up. A midwife is a health professional who provides health care during pregnancy and helps pregnant people during childbirth.

Get regular prenatal checkups.

Schedule a visit with your doctor or midwife as soon as you know you're pregnant — or if you think you might be. You'll need many checkups with your doctor or midwife during your pregnancy. Don't miss any of these appointments — they're all important.

Be sure to get all the medical tests that your doctor or midwife recommends. Early treatment can cure many problems and prevent others.

Take steps to have a healthy pregnancy.

To keep you and your baby healthy, it's important that you:

Don’t smoke or drink alcohol
Eat healthy and get enough folic acid
Stay physically active

Get more tips for a healthy pregnancy:

If you just learned that you're pregnant, find out what to do next
Check out these tips for staying healthy and safe during pregnancy

Topics to Discuss

Make the most of each visit with the doctor or midwife.

Talk with your doctor or midwife about:

Your personal and family health history, including any chronic (long-term) health problems or surgeries you've had
When you need to get medical care for issues that can come up — like high blood pressure, dizziness, swelling, pain, bleeding, or contractions
When and where to go for emergency care during your pregnancy
Any prescription and over-the-counter medicines that you take — as well as vitamins, supplements, and herbs
Healthy weight gain during pregnancy

These visits are also a great time to discuss:

Questions you have about pregnancy, childbirth, and breastfeeding
How to get help buying food if you need it — including how to get help from a program called WIC (Women, Infants, and Children)
Anything that’s bothering or worrying you

If you're worried about your health during pregnancy, don't wait to ask for help. Learn more about pregnancy complications and when to call your doctor or midwife.

Make a birth plan.

A birth plan describes what you want to happen during childbirth and after your baby's birth. It can include:

Where you'd like to give birth — for example, at a hospital or birthing center
Who you want with you for support (like your partner, family member, or close friend) before, during, and after childbirth
How you want to manage pain during childbirth
Who you want to help you make important medical decisions during childbirth
Your plan to breastfeed after your baby is born

Talk with your doctor about depression.

Many people experience depression during and after pregnancy. Talk with your doctor about your risk for depression and whether you need counseling to help prevent it.

Medical Tests

Get important medical tests.

During your pregnancy, your doctor or midwife will recommend medical tests that all people need as part of routine prenatal care. You’ll need to get some tests more than once.

These tests give your doctor or midwife important information about you and your baby. The tests will check your blood or urine (pee) for:

Rh factor (a protein some people have in their blood)
Hepatitis B [PDF - 859 KB]
Urinary tract infection (UTI)
Syphilis
HIV
Signs of past rubella infections (German measles)
Group B strep

If you're younger than age 25 or have certain risk factors, your doctor or midwife may also check for other sexually transmitted diseases (STDs). Learn more about STDs during pregnancy.

Your doctor or midwife will also check your blood pressure regularly during your pregnancy. They may recommend that you check your own blood pressure at home using a monitor you can buy at a drug store. High blood pressure during pregnancy can be a sign of preeclampsia, a health problem that some pregnant people develop. Learn more about preventing preeclampsia.

Talk about your family history.

Share your personal and family health history with your doctor or midwife. This will help you and your doctor or midwife decide whether you need any other tests, like genetic testing. Find out more about genetic testing.

Diabetes Testing

Get tested for gestational diabetes.

All pregnant people need to get tested for gestational diabetes between 24 and 28 weeks of pregnancy. Gestational diabetes is a type of diabetes that some people develop during pregnancy.

Pregnant people at high risk for type 2 diabetes may need to get tested earlier than people at normal risk. Find out about your risk for type 2 diabetes.

What do I need to know about gestational diabetes?

Gestational diabetes can lead to health problems for moms and babies — both during and after pregnancy. It’s important to get tested so that you and your doctor or midwife can take steps to protect you and your baby.

You're at higher risk for gestational diabetes if you:

Are overweight or have obesity
Have a family history of diabetes
Are over age 25
Are African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander
Had gestational diabetes during an earlier pregnancy
Have had a baby weighing over 9 pounds
Have polycystic ovary syndrome (PCOS)

You can reduce your risk for gestational diabetes by eating healthy and staying active during pregnancy.

Learn more about gestational diabetes
Ask your doctor about getting tested for gestational diabetes

Cost and Insurance

What about cost?

Under the Affordable Care Act, insurance plans must cover routine prenatal tests. Depending on your insurance plan, you may be able to get these tests at no cost to you. Check with your insurance company to find out more.

To learn more, check out these resources:

Free preventive care for women covered by the Affordable Care Act
How the Affordable Care Act protects you
Understanding your health insurance and how to use it [PDF - 698 KB]

If you don’t have health insurance, you can still get help paying for medical care during pregnancy:

Get connected with free or low-cost services in your state by calling 1-800-311-BABY (1-800-311-2229)
Find a health center near you and ask about prenatal care

Learn more about health insurance options for pregnant people.

Take Action

Get Prenatal Care

There are lots of things you can do today to help you have a healthy pregnancy and a healthy baby.

Get regular prenatal care.

Plan on getting a prenatal checkup at least once a month for the first 6 months (through week 28) — and more often during the last 3 months of your pregnancy (after week 28). Learn more about prenatal care.

Get important vaccines.

All pregnant people need whooping cough and flu vaccines (shots). Talk to your doctor or midwife about getting other vaccines to help protect you and your baby. Learn more about vaccines for adults.

Take charge of your health care.

Speak up and ask questions when you're with your doctor or midwife. When you play an active role in your health care, you help make sure that you and your growing family will get good care. Find out how to take charge of your health care.

Keep track of your baby’s movement.

Sometime between 16 and 28 weeks of pregnancy, you'll probably start to feel your baby move. Keep track of how often your baby moves. If you think your baby is moving less than usual, call your doctor or midwife.

Don't Smoke, Drink Alcohol, or Use Drugs

Don’t smoke, drink alcohol, or use drugs.

One of the best ways to protect you and your baby is to stop smoking, drinking alcohol, and using drugs before you become pregnant — or as soon as possible during your pregnancy.

There's no safe amount to drink or smoke while you're pregnant. Both can harm your baby’s health. Talk with your doctor or midwife about ways to help you quit.

Quitting all forms of tobacco products, including e-cigarettes (vapes), is best for you and your baby. Secondhand smoke (smoke from other people’s cigarettes) can also put you and your baby at risk for health problems. Stay away from cigarette smoke during your pregnancy.

Using drugs during pregnancy — including opioid pain medicines and marijuana — can also put your baby’s health at risk. If you’re pregnant and using drugs, talk with your doctor right away.

Learn more:

Pregnant? Don’t Smoke!
Quit Smoking
Alcohol Use in Pregnancy
What You Need to Know About Marijuana Use and Pregnancy
Pregnancy and Opioid Pain Medications [PDF — 0.99 MB]

Eat Healthy and Stay Active

Get the nutrients you need.

Making healthy food choices and taking supplements as needed can help you gain weight in a healthy way, feel good while you're pregnant, and have a healthy baby.

Check out these tips on healthy eating during pregnancy
Ask your doctor or midwife if you need to take a daily prenatal supplement during pregnancy
Take a daily supplement with 400 to 800 micrograms (mcg) of folic acid — folic acid is a vitamin that can prevent birth defects

Gain weight in a healthy way.

Gaining a certain amount of weight during pregnancy is important for both you and your baby. Learn how much weight is healthy for you to gain during pregnancy.

Even if you're overweight, you still need to gain some weight for your baby to grow. Ask your doctor or midwife how much weight is healthy for you to gain.

Stay active.

Being physically active can help you have a healthier pregnancy. Aim for at least 150 minutes a week of moderate-intensity aerobic activity — like walking, dancing, or swimming.

If you haven’t been active before, start slow and do what you can! Even a 5-minute walk has real health benefits, and you can add more activity over time.

Get more information about physical activity during pregnancy from these resources:

Stay Active During Pregnancy: Quick Tips
Move Your Way: Pregnancy

Prevent Infections

Take steps to prevent infections.

Follow these tips to prevent infections and help keep your baby safe:

Wash your hands often with soap and water
Make safe food choices and prepare food safely
If you have a cat, learn how to protect yourself from toxoplasmosis (a disease spread by dirty cat litter)
Get vaccines to protect you from whooping cough and the flu
Avoid traveling to an area with Zika virus — and if you have to travel to an area with Zika, learn how to protect yourself from Zika virus

Learn more about preventing infections during pregnancy.

Get Support and Plan Ahead

Ask for help if you need it.

Being pregnant may be tiring or stressful at times. Extra support from loved ones can help. For example, family members or friends can:

Provide emotional support so you feel less stressed
Visit the doctor or midwife with you
Go with you to a breastfeeding or birthing class
Change the litter box if you have a cat
Help prepare for the baby’s arrival by setting up furniture

Think about what you need, and don’t be afraid to ask for help.

Plan ahead for the first year with your new baby.

Having a new baby is exciting, but it can be stressful. Take steps to help you prepare for your new baby:

Create a safe sleeping area for your baby, without soft objects in the crib.
Talk with your doctor or midwife about newborn screening tests.
Learn how to breastfeed your baby.
Know the signs and symptoms of postpartum depression. About 1 in 8 women experience depression after they have a baby. Talk to your doctor or midwife if you have any questions or concerns.
Make sure to keep up with postpartum visits to your doctor or midwife.
Talk to friends and family about helping out after the baby arrives. If you don't want visitors, people can support you in other ways, like dropping off food.

Read more about preparing for your baby.

Before You Get Pregnant

Not pregnant yet? Plan ahead.

Planning ahead can help you have a healthier pregnancy. For example:

Take a daily supplement with 400 to 800 micrograms (mcg) of folic acid. Taking folic acid before and during early pregnancy can help prevent certain birth defects. Most multivitamins have 400 mcg of folic acid — check the label to be sure.
Stop drinking alcohol when you start trying to get pregnant.
If you smoke, quit smoking when you start trying to get pregnant.

Read about more things you can do to plan ahead.

Schedule an appointment with a doctor or midwife.

Get your blood pressure checked. If you have high blood pressure, ask your doctor how you can control it before and during your pregnancy.
If you have a chronic (long-term) health condition, like diabetes, ask your doctor how you can control it before and during your pregnancy.
Ask about getting vaccines before you get pregnant.
Talk with your doctor about your family health history, including any medical conditions you have that could affect a pregnancy.
Talk with your doctor about your risk for depression during pregnancy and whether you need counseling to help prevent it. Learn about depression during and after pregnancy.
Talk with your doctor about any medicines you’re taking — both prescription drugs and over-the-counter medicines. Some medicines may not be safe to take while you’re pregnant.
If you take opioid pain medicine, talk with your doctor about how to protect yourself and your baby. Learn more about opioids and pregnancy.

The Basics

12 Ways to Stay Healthy During Pregnancy

Audra Meadows, MD, MPH, an obstetrician at Brigham and Women’s Hospital, helps patients optimize their health before, during and after pregnancy. Here are 12 tips from Dr. Meadows to help you increase your chances of having a healthy pregnancy and a healthy baby.

1. Eat healthy foods.

Eating healthy foods is especially important for pregnant women. Your baby needs nutrients to grow healthy and strong in the womb. Eat plenty of colorful fruits and vegetables, whole grains, calcium-rich foods and foods low in saturated fat.

2. Take a daily prenatal vitamin.

Taking a daily prenatal multivitamin can help ensure you get the right amount of the key nutrients you and your baby need during pregnancy. These include folic acid, iron and calcium.

3. Stay hydrated.

A pregnant woman’s body needs more water than it did before pregnancy. Aim for eight or more cups each day.

4. Go to your prenatal care checkups.

Women should get regular prenatal care from a health care provider. Moms who don’t get regular prenatal care are much more likely to have a baby with low birth weight or other complications. If available, consider group prenatal care.

5. Avoid certain foods.

There are certain foods that women should avoid eating while pregnant. Don’t eat:

Raw or rare meats
Liver, sushi, raw eggs (also in mayonnaise)
Soft cheeses (feta, brie)
Unpasteurized milk

Raw and unpasteurized animal products can cause food poisoning. Some fish, even when cooked, can be harmful to a growing baby because they’re high in mercury.

6. Don’t drink alcohol.

Don’t drink alcohol before and during pregnancy and while breastfeeding. Drinking alcohol increases the risk of having a baby with fetal alcohol spectrum disorder (FASD). FASD can cause abnormal facial features, severe learning disabilities and behavioral issues.

Alcohol can impact a baby’s health in the earliest stages of pregnancy, before a woman may know she is pregnant. Therefore, women who may become pregnant also should not drink alcohol.

7. Don’t smoke.

Smoking is unhealthy for you and your unborn child. It increases the risk of sudden infant death syndrome (SIDS), premature birth, miscarriage and other poor outcomes.

8. Get moving.

Daily exercise or staying active in other ways can help you stay healthy during pregnancy. Check with your doctor to find out how much physical activity is right for you.

9. Get a flu shot.

The flu can make a pregnant woman very sick and increase risks of complications for your baby. The flu shot can protect you from serious illness and help protect your baby after birth, too. Ask your doctor about getting a flu shot.

10. Get plenty of sleep.

Ample sleep (7 to 9 hours) is important for you and your baby. Try to sleep on your left side to improve blood flow.

11. Reduce stress.

Reducing stress is crucial for improving birth outcomes. Pregnant women should avoid, as much as they can, stressful situations. Recruit your loved ones to help you manage stress in your life.

12. Plan the right time to get pregnant.

“If you are choosing to become pregnant at a time when you know that you’re at your healthiest, that increases your chances of having a healthy pregnancy and a healthy birth,” says Dr. Meadows.

This not only means that women should make sure that they are healthy before they become pregnant, but they also should consider their age before getting pregnant. Mothers who have children early in life (earlier than 16-years-old), or late in life (older than 40) are at greater risk for having a premature birth. Also, women who become pregnant again too soon (less than 18 months in between births) are even more likely to have a premature baby.

Audra Meadows, MD, MPH

Audra Meadows, MD, MPH is an obstetrician at Brigham and Women’s Hospital (BWH).

Before you go,

If you’re thinking about pregnancy, managing a pregnancy complication or looking for tips on newborn care, our experts can help support you at every step in your journey. Read more pregnancy and childbirth articles.

Learn more about the Department of Obstetrics and Gynecology

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How to prepare for conception?

Pregnancy planning is really necessary, especially in our time, when a healthy woman is the exception rather than the rule. Not to mention the fact that pregnancy is a serious test for the body of even a perfectly healthy woman.

It can be said that entering into a pregnancy without prior preparation for it is the same as flying on an airplane that has not been checked in advance: maybe it will cost, or maybe not. Of course, aircraft are tested before each flight. So why does a woman, ready to give birth to a new human being, not always conduct a similar check of her body? After all, the price of her neglect of herself and her health can be the life of the unborn child.

The process of preparing for pregnancy is quite complex and includes several stages. It is worth starting planning a few months (at least three) before the time when the couple intends to conceive a baby.

And at the stage of pregnancy planning , it is necessary to understand that the bearing and birth of a baby is not a woman's business, but a married couple's. Therefore, the active participation of the father in planning pregnancy is extremely necessary and important for himself, and for his wife, and for the unborn baby.

Without the help of doctors, it will not be possible to manage even at this stage. A visit to the gynecologist will allow you to identify possible diseases and treat them in a timely manner. After the first appeal, future parents undergo several examinations and pass certain tests in order to find out how ready their bodies are for conceiving a baby, as well as to prevent possible problems when carrying a child. The gynecologist will tell you what to do if, before planning a pregnancy, a woman was protected with hormonal contraceptives. It is necessary to stop taking hormonal contraceptives 3 months before the planned pregnancy.

It is important for a future mother to understand that only a healthy woman can bear and give birth to a healthy baby. In this regard, you need to start taking care of your own health long before conception. Good physical shape, the absence of diseases, proper nutrition and the rejection of bad habits, hygiene and a measured lifestyle - all this has a beneficial effect on the female body and subsequently makes it easier to endure pregnancy. However, not all vitamins can be obtained from food. For example, the body can only obtain folic acid in an artificial form, since its counterpart (folate), found in green vegetables, beans, asparagus, and citrus fruits, is much less absorbed. Folic acid is very important for the development of the baby to take place correctly, and the need for its intake exists throughout pregnancy. If the mother's body during the bearing of the child receives a sufficient amount of this substance, then the risk of pathology from the nervous system is minimized.

What tests should a married couple undergo

before planning a pregnancy?

Gynecological examination, colposcopy for women.
Blood type, Rh factor for both spouses. If a woman has a positive Rh factor, there is no problem. If a woman has a negative Rh factor - antibodies to the Rh factor (even if a man is also negative). If they are positive, pregnancy is not currently possible and needs to be corrected. If negative - repeat this analysis once a month, starting from 8 weeks of pregnancy. If a woman has 1 group, and a man has any other group, incompatibility by blood types is possible. An analysis for group antibodies, as well as an analysis for antibodies to the Rh factor, is carried out once a month, starting from 8 weeks of pregnancy.
Tests for infections: routine smear, PCR for latent infections - both spouses.
Blood test for TORCH-complex. Antibodies to rubella, toxoplasma, herpes, CMV, chlamydia - quantitative analysis (with titer). The presence of IgG antibodies means immunity to these infections, and is not an obstacle to pregnancy. The presence of IgM means an acute stage, planning in this case must be postponed until recovery. If there are no IgG antibodies to rubella, it is necessary to be vaccinated and protected for another 3 months after it.
A trip to the dentist, a therapist, chest x-ray is a must for both spouses. By appointment of the therapist - consultation of narrow specialists (ENT doctor, urologist, endocrinologist, cardiologist, gastroenterologist).
Spermogram. Desirable, but not required. It is done to determine the quality of spermatozoa and identify a hidden inflammatory process (a much more informative analysis than any smears and PCR).
Ultrasound of the pelvic organs - at least 2 times per cycle: after menstruation and before menstruation. For the first time, the general condition of the pelvic organs is assessed, in the second, the presence of a corpus luteum and endometrial transformation, indicating that ovulation has occurred. Ideally, an intermediate third ultrasound on the eve of the expected ovulation is to detect the dominant follicle.
Blood test for hormones of the reproductive system, thyroid gland, adrenal glands - according to indications.
Ultrasound of the thyroid gland, mammary glands - according to indications.
Hemostasiogram, coagulogram. - according to indications.
General clinical blood test (hemoglobin, erythrocytes, leukocytes, platelets, ESR, color index, leukocyte formula). Finger blood. General urinalysis (morning portion of urine - completely collected, it is important that the analysis does not include discharge from neighboring organs).
Blood tests for syphilis, HIV, hepatitis B and C - for both spouses.
If there was a case of hereditary diseases in the family, miscarriages, spontaneous miscarriages, seek advice from a medical genetic consultation (Krasnoyarsk Regional Consultative and Diagnostic Center for Medical Genetics, Krasnoyarsk, Molokova St. 7, t. 55-99-20).

How to endure and give birth to a healthy child

Dear parents, I would like to start my publication with these wonderful lines that carry a very deep meaning.

“When a man does not know to which pier he is on his way, not a single wind will be favorable to him” (Seneca).

Have you ever thought about what your child's health depends on and what you have done to shape it.

Already from the moment you plan your pregnancy, you begin to lay brick by brick the foundation called "HEALTH" for your unborn child.

Every woman planning a pregnancy should be examined by a gynecologist, as well as other narrow specialists (depending on the diseases she has). Important at the stage of pregnancy planning is the refusal of a woman, and preferably both future parents, from bad habits. Many women who smoke do not even think about what their love for a cigarette can lead to. Smoking a woman before pregnancy, and subsequently during pregnancy, increases the risk of having a premature baby, the presence of congenital malformations, or even intrauterine death of the fetus. Such children often suffer from bronchial asthma in the future.

I would like to say a few words about drug use at the planning stage and during pregnancy. Using drugs and having a healthy baby is next to impossible. Not many people know that drug use affects the activity of sex hormones and pregnancy may not occur at all. If pregnancy occurs, then the child may be born with signs of drug addiction, congenital malformations, low body weight, and in the worst case, may die in utero. These children are characterized by the presence of severe mental and neurological diseases, up to disability.

The second more important stage for you begins from the moment of fertilization, when a new life begins to develop in your body.

Arriving in this wonderful state of mind and body, you should not forget that right now the "HEALTH" of your child depends on you to a greater extent.

Be sure to eat well, walk in the fresh air. Avoid unreasonable use of medications, occupational hazards (especially in the first trimester of pregnancy).

Remember, even an uncomplicated pregnancy requires the supervision of an obstetrician-gynecologist. To do this, it is necessary to register for pregnancy no later than the 12th week of pregnancy.

From this moment begins the joint work of the doctor and the expectant mother on the formation of the health of the baby.

Throughout the pregnancy, a woman should be regularly observed by an obstetrician-gynecologist, control general tests, undergo an ultrasound scan of the fetus in a timely manner. A special examination for the presence of infections should also not be ignored, so as not to expose the fetus to the risk of intrauterine infection. Many infections are successfully treated if detected early.

Such well-coordinated work of an obstetrician-gynecologist and a pregnant woman makes it possible to prevent the development of various pathologies in the fetus and preserve the woman's health.

Unfortunately, quite often one hears that a pregnant woman was not registered for pregnancy, was not observed by an obstetrician-gynecologist, did not take tests, did not have an ultrasound of the fetus and was not at all aware of her interesting situation until the very birth.

But an even more irresponsible act on the part of a pregnant woman is the decision to conduct childbirth at home.

- Why does a woman refuse to provide qualified medical care in the digital age? - it's hard to say...

Perhaps the internet is to blame?

Now you can find a large number of forums where mothers enthusiastically share their experiences, talk about the benefits of home birth in colors, describe everything: up to the step-by-step birth control. And it would seem: “Why a medical education?”, If you can give birth to a healthy child so easily with the help of GOOGLE!!!

Recently, however, there have been frequent reports in the media about home births that resulted in the death of a child and even a woman in labor.

One such incident happened a few years ago.

A 29-year-old woman was admitted to the intensive care unit of one of the central district hospitals in the Minsk region. During the examination of the patient, doctors found traces of recent childbirth. Within hours, the woman dies. As it turned out, the woman was taken to the hospital forcibly. And at the place of residence in the bathroom were found two newborn girls with no signs of life. As it turned out, the woman was not registered for pregnancy, she was not examined by an obstetrician-gynecologist.

An equally horrific case of home birth occurred in Vitebsk in February 2017. As it turned out, our former compatriot from St. Petersburg in November 2016 turned to the antenatal clinic of the Vitebsk Regional Maternity Hospital and said that she was going to give birth in Vitebsk at home, as well as her first child. Doctors warned about the possible risks and consequences of childbirth at home, but the woman did not take this into account. In February 2017, an ambulance team delivered a newborn girl in serious condition to the Vitebsk City Clinical Emergency Hospital, who soon died. During the investigation, it was found that the death of the child was due to the aspiration of amniotic fluid during childbirth at home.

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