Most women know that when they get pregnant they are supposed to cut out smoking and drinking and take folic acid supplements.
But several pregnancy myths still abound. For example, some women may think they have to stop any sports or exercise and that they shouldn’t take any form of medication.
Now, newly updated NHS guidance has shed more light on the dos and don’ts of pregnancy, including several recent recommendations that may be less well known.
Women on long-term medications who want to conceive are advised to discuss with their doctor beforehand whether they are safe to take in pregnancy, says the report, called Saving Babies’ Lives. In some cases, women may be able to switch to a less risky drug.
Half of pregnancies are unplanned, though. “We don’t want people to panic and stop taking their medication, because in some conditions, that could be really serious,” said Kate Marsh, head of midwifery for the pregnancy charity Tommy’s. “We just say speak to a GP as soon as possible or they can call us at Tommy’s.”
For instance, painkillers such as ibuprofen are not usually recommended in pregnancy, although a short course may be prescribed for some illnesses. Paracetamol is generally seen as safe, if used just for as long as needed.
In recent years, health professionals have become more open to prescribing medicines to treat severe nausea or vomiting. “We do not want people becoming really unwell,” said Marsh. “There are plenty of options that women can take.”
Vitamin D
Taking a vitamin called folic acid is recommended for the first three months of pregnancy and ideally for three months before conception too.
Less well known is that women should also take vitamin D throughout the pregnancy, as this supports growth and function of the placenta, the organ that supplies oxygen and nutrients to the baby. “The placenta is what goes wrong in a number of different pregnancy complications,” said Professor Alex Heazell, an obstetrician at the University of Manchester.
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Vitamin D is also made by skin exposed to sunlight. So it is good for pregnant women to make the most of any sunshine, as long as they do not get burned said Heazell.
One of the major risks in pregnancy is a condition called pre-eclampsia, which can cause dangerously high blood pressure, potentially leading to heart attacks and strokes.
Women at higher risk – for instance, those with diabetes or who are having their first baby aged 40 or over – may be prescribed a daily low-dose aspirin tablet to thin the blood. “Pre-eclampsia is a major cause of death. And to a great extent it can be predicted,” said Professor Kypros Nicolaides, an obstetrician at King’s College London. “Aspirin is cheap and safe.”
But at some hospitals, not all women in higher-risk groups are offered aspirin, he said.
Side sleeping
In the last three months of pregnancy, women should try to avoid sleeping on their back, because this is linked with twice the risk of stillbirth, several studies have found. “There’s a logical anatomical reason,” said Heazell, who was involved in the research. “It reduces the amount of blood going to the baby.”
Women should try to go to sleep on their side, and could use pillows to help them stay in position – but should not worry if they do end up shifting on to their back while asleep, said Heazell. “You just need to roll over and go back to sleep on your side,” he said.
Regular check-ups can identify problems in good time (Photo: Janie Airey/Getty Images/Image Source)
Women who attend all their antenatal appointments are more likely to stay well through their pregnancy and birth, says the NHS report. The first visit, the booking appointment, at around 10 weeks, is crucial, as this is where midwives can check if the woman has any special risks, said Marsh.
Later visits are also vital for regular checks on blood pressure and urine, which can identify if pre-eclampsia or diabetes are developing. “Sometimes people can have high blood pressure and have no symptoms and not even be aware,” said Marsh. “Those risks for that woman and the baby are still there, even if that person feels well.”
Cytomegalovirus
Some viruses and bacteria pose particular risk in pregnancy. One is a virus called CMV or cytomegalovirus. Most people catch it in childhood and have no symptoms. But if a woman gets infected for the first time when she is pregnant, it can pass to the baby and cause blindness or brain damage.
The most common source of CMV is young children’s saliva and urine, so women who already have a young child, or work in childcare, are more at risk. Pregnant women are advised to follow good hygiene practices, such as handwashing after changing nappies and feeding children and not to put their child’s dummy in their own mouth.
Good handwashing is important in pregnancy (Photo: Mykola Sosiukin/Getty Images/iStockphoto)
Germs are all around us and it is impossible to completely avoid them. But pregnant women are advised to, where possible, avoid those with signs of infectious illness, such as diarrhoea, vomiting, fever or a rash. If a mum-to-be catches the infection, it could cause a stillbirth.
For the same reason, pregnant women should also try to avoid children with common illnesses, like chicken pox, measles or slapped cheek syndrome.
Vaccines
Pregnant women are offered vaccines against flu, covid, whooping cough and RSV, a virus that can be serious in young babies.
“We would always encourage women, if they do have uncertainties about taking a vaccine in pregnancy, to speak to their healthcare professional and have a balanced conversation about why it’s being offered,” said Marsh.
Women may feel cautious about sports and exercise in pregnancy, but they are advised to stay physically active if possible to help maintain a healthy weight.
NHS guidelines say: “As a general rule, you should be able to hold a conversation as you exercise when pregnant. If you become breathless as you talk, then you’re probably exercising too strenuously.” But women are advised to use caution about anything with a risk of falls, like horse riding or cycling.
Focus on teeth
Tooth care becomes more important in pregnancy as hormone changes leave women more prone to gum disease. Check-ups are free on the NHS for women who are pregnant and for up to a year after birth.
The Saving Babies’ Lives report was written by doctors in the Government’s Office for Health Inequalities and Disparities, along with Sands, a charity for preventing stillbirths and baby deaths.
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