Pregnancy dos and don’ts for each trimester, from a gynae

First Trimester

This is one of the most important and crucial phases. The first trimester begins on the first day of your last period and lasts until the end of week 12. This means that by the time you know for sure you’re pregnant, you might already be five or six weeks pregnant. A lot happens during these first three months. During this trimester, your baby grows faster than at any other time. By six weeks, a heartbeat can usually be heard and by the end of week 12, your baby’s bones, muscles and all the organs of the body have formed. At this point, your baby looks like a tiny human being and is now called a foetus.

Some of the “Dos” of the First Trimester are as follows:

• An early consultation with the obstetrician and regular follow-up is essential during the first trimester for a weekly progress on the development of the foetus.
• Choose the obstetrician and hospital with care. Avoid frequent changes as this leads to conflicting opinions during consultations.
• Increase the intake of folic acid supplements as it’s a type of vitamin B that is needed for the formation of blood cells. It’s extremely helpful for the development of the baby’s nervous system. The dosage will depend on the physician’s advice. Folic acid is prescribed pre- pregnancy and throughout pregnancy as it prevents neural defects in the developing foetus.
• Do consume more of organic and homemade food, since this is rich in minerals and essential vitamins and proteins. Eat a variety of healthy food that is rich in iron, calcium and folate.
• Small frequent meals at regular intervals, along with an adequate liquid intake, are essential during the first trimester. Drink at least eight glasses (1.5 litres) of fluid every day, mostly water. It’s very important to stay hydrated.
• Do choose foods with antioxidants throughout pregnancy such as dark green spinach, oranges, carrots, red apples, yellow bananas, blueberries.
• Pursue normal daily activities unless advised otherwise by the treating consultant.
• Walking plays a critical role and is considered to be the best exercise for pregnant women. It helps to keep your muscles toned and, most importantly, keeps you active. Walking helps control blood sugar levels, thus reducing the risk of gestational diabetes.
• Do take plenty of rest .
• Do ensure that you always wear a seatbelt when driving or travelling by car.

Don’ts for the First Trimester

• Do not take any self-medication as there could be a health-risk for the mother and child.
• Do not consume any junk foods as they lead to an increased risk of gestational diabetes since they are high in sugar and calorific content.
• Smoking, alcohol and caffeine consumption should be avoided. If you’re pregnant, whatever you put into your body reaches your baby too. Smoking, drinking alcohol or drugs may be detrimental to your baby’s growth, development and health, so it’s important for you to change your habits.
• Do not consume street foods to avoid gastrointestinal
• In first trimester, there is no need to add any extra diet.
• Do not consume raw papaya and raw pineapple.
• Avoid foods with preservatives and pesticides.
• Avoid dehydration and stress.
• Avoid over exertion and aggressive exercises.
• Prevent weight gain till 16 weeks of pregnancy.
• Do not consume foods that lead to constipation.
• Don’t get into the sauna or steam room or overheat in the bath.

Second and Third Trimesters

The second trimester is from week 13 to the end of week 26 and one of the safest and the best time during the entire phase. The discomfort that an expecting mother experiences during the first trimester will ease in the second though certain other discomforts surface. It is during the second trimester that the mother will start feeling the baby’s first movements. Things must have started settling down and now you are more comfortable.

The third trimester is from week 27 to the end of the pregnancy. During this phase, a woman may experience more aches, pain and swelling as she carries around her baby. A pregnant woman may also begin to become anxious about her delivery.

Do’s of the second and third trimester

• Do regular and timely check-ups with your physician.
• Do get a flu vaccine. According to the World Health Organization (WHO), women who are pregnant during the flu season should receive the vaccine. There is sufficient evidence showing that the vaccine is safe for a mother and baby at any stage of pregnancy, as it offers protection from what could be a severe illness in pregnancy. A flu vaccine does not contain the live virus which means it cannot infect you, but does cause your body to build up antibodies that protect you when you’re exposed to the live virus.
• Do take a high protein diet with adequate milk and milk products. A balanced diet is very essential to ensure there is no weight gain.
• Stay hydrated. Ensure a regular intake of fluids.
• Do regular exercises such as Yoga and Lamaze. Join prenatal classes at the hospital or antenatal classes. During the third trimester, expecting mothers can look out for childcare classes, which are a very good idea.
• Do moisturise. Use creams and oils over the abdomen to prevent stretch marks. A pregnant woman’s belly stretches a lot in a short span of time during the second trimester. Keeping the belly moisturised helps reduce stretch marks and itching that may result due to stretching.
• Do get a dental check up to prevent dental infections.
• Prepare bags for hospital.
• Prepare your home to receive the new member.
• Identify people who can help you in an emergency.

Don’ts for the second and third trimester

• Avoid alcohol, smoking, excessive intake of caffeine.
• Dental visits are linked to diagnostic procedures. It is better to avoid all dental procedures until after delivery as dental x-rays and some dental medication can be harmful for the foetus.
• Avoid undercooked meat to prevent diseases like Toxoplasmosis and Listeriosis.
• Avoid hot sauna baths.
• Avoid cleaning of the litter box to prevent infections.
• Avoid any kind of sexual contact in the third trimester.

Travel during pregnancy

For most women, travelling during pregnancy is safe. As long as you and your foetus are healthy, you can travel safely until you are 36 weeks pregnant. The best time to travel is the middle of your pregnancy—between week 14 and week 28. Most common pregnancy problems happen in the first and third trimesters. During mid-pregnancy, your energy has returned, morning sickness usually is gone, and it is still easy to get around. Paying attention to the way you feel is the best guide for your activities.

Flying is not contraindicated in an uncomplicated pregnancy. You must be well with no abdominal pain or bleeding. Domestic travel is usually permitted until 36 weeks gestation whereas international travel may be curtailed after 32 weeks of pregnancy. This is due to the risk of preterm delivery.

When travelling in a car, always wear a seatbelt to protect you and your unborn baby. A seatbelt should be worn correctly.

Travel is not recommended if you have certain pregnancy complications, including preeclampsia, premature rupture of membranes, and preterm labour. Travel also may not be a good idea if you are pregnant with more than one foetus. Before travelling, schedule a check-up with your obstetrician–gynaecologist (ob-gyn) before you leave. Know your estimated due date. If you have a problem while you are travelling, your caregivers will need to know how far along you are in your pregnancy.

It is important that all expecting mothers buy comfortable clothing and flats for the entire phase. It is important that every expecting mother avoids extreme stress during all the three trimesters. It can cause abnormalities in the baby early in pregnancy and result in premature labour later on.

Most of these prohibitions span throughout the pregnancy, but care needs to be taken according to the most important don’ts based on the foetal development. Pregnancy is a wellness and not an illness and it’s a life-changing event for expecting parents. The arrival of this little bundle of joy is definitely worth all the trouble.

(The writer is Director, Department of Obstetrician and Gynaecology, Cloudnine Group of Hospitals, Noida.)