Common pregnancy questions

"Pregnancy is a special time in a woman’s life but often women have many questions. We’ve answered some questions here but always talk to your GP, obstetrician or midwife if you are unsure. Most of all enjoy anticipating this wonderful event but get plenty of sleep, eat well, continue gentle exercise and relax, which will keep you and baby healthy." Dr Christine Bennett, Chief Medical Officer, Bupa Australia.

Are there certain foods that I should avoid during pregnancy?

Good nutrition during pregnancy will help to keep a developing baby and mother healthy. The need for certain nutrients, especially iron and folate, is increased at this time. But only a small amount of extra energy is needed.

Although it is not common some foods are more prone to contamination with listeria, a food borne bacteria, than others. Some experts recommend that you exclude these foods from your diet if you are pregnant:

Soft cheeses, such as brie, camembert and ricotta - these are safe if served cooked and hot
Precooked or pre-prepared cold foods that will not be reheated - eg pre-prepared salads, paté, quiches and delicatessen meats like ham and salami
Raw seafood such as oysters and sashimi or smoked seafood such as salmon (canned varieties are safe)
Unpasteurised foods
Soft-serve ice cream.

On the positive side it is suggested that pregnant women eat 2-3 serves of fish every week for the good health of themselves and their developing baby. Some types of fish should be limited because they might contain high levels of mercury, which is dangerous for the developing foetus.

Recommendations suggest, pregnant women should:

Limit to one serve (150g) per fortnight - billfish (swordfish, broadbill and marlin) and shark (flake), with no other fish eaten in that fortnight
Limit to one serve (150g) per week - orange roughy (deep sea perch) or catfish, with no other fish eaten that week.

What kind of exercise can I do during pregnancy?

Regular exercise during pregnancy can prepare your body for labour and the demands of a new baby. Caring for a newborn can be stressful and physically demanding, so it helps to be fit.

If you have high blood pressure, a twin or multiple pregnancy, increased risk of premature labour, pre-eclampsia or heart disease, you should seek advice from your doctor. You may be advised to limit or avoid physical activity.

Activities and exercises that are recommended for pregnant women include exercise in water (aquarobics), walking, swimming, stretching.

Exercises to avoid during pregnancy include contact sports, trampolining or activities that carry a risk of falling or contact.

Exercises to strengthen the pelvic floor are useful and involve squeezing your muscles slowly and holding for up to 10 seconds. Repeat 10 times. Abdominal exercises are also important particularly during the third trimester when the size and weight of your baby are rapidly increasing. Suggestions include concentrating on drawing your belly button towards your spine.

Pregnancy affects the way your body responds to exercise, including:

Hormones soften ligaments, so there is some increase in the risk of joint injuries
Balance is affected because of a larger belly
Weight gain during pregnancy puts extra strain on joints
Your blood pressure can drop, especially in the second trimester, so it is important to be careful if you participate in activities that involve fast changes of position
Your growing baby needs oxygen, so avoid exercise that takes you to the point of breathlessness.

Can I sleep on my back?

Lying on your back puts pressure on the main blood vessels that run up and down your spine so it is not ideal. But most women don’t like sleeping on their back after about 24 weeks anyway. The recommendation is to sleep on your side with a pillow behind you supporting your back and another one between your legs.

Can I get the flu vaccination while I’m pregnant?

It is actually recommended that pregnant women do get the flu vaccination. Before you get pregnant you should make sure you are up to date with your vaccinations.

Why do some women undergo skin pigmentation changes during pregnancy?

This is called chloasma and happens commonly - on nipples, face, midline and other parts of the body. These changes are caused by a temporary increase during pregnancy in the body's production of melanin, the hormone that increases pigmentation.

Are there cures for morning sickness?

There is no simple solution that works for everyone. Some women don’t have it at all and others are quite sick with it. Here are some things you can try yourself but if these don’t work, you need to see your doctor or midwife.

Small carbohydrate snacks (a sandwich or fruit) every two to three hours may provide some relief
Eat dry bread, biscuits or cereal before or when getting up in the morning. Get up slowly, avoiding sudden movements
Drink liquids between rather than with meals to avoid bloating as this can trigger vomiting
Avoid large meals and greasy, highly spiced foods
Suck something sour like a lemon
Relax and get fresh air as much as possible. Keep rooms well ventilated and odour free
Slowly sip a fizzy drink when feeling nauseated
Try food and drinks containing ginger as these sometimes relieve nausea.

Which vitamin supplements and medications are safe to take during pregnancy?

Drugs that you can take:

Women who have pre-existing conditions (such as diabetes or asthma) should continue their treatment according to doctor’s advice. Tell your doctor about any condition you have and any treatment you’re on, including natural or complementary medicines.
Nutritional supplements, complementary medicines and over-the-counter medicines should be taken only on the advice of a qualified medical professional
Try to deal with health problems through dietary modifications rather than medications, for example eating a high fibre diet to avoid constipation or eating frequent small snacks to avoid heartburn
Most vitamins in small doses are OK but don’t take lots of anything and avoid mixing supplements that have ingredients in common
Folate supplements before and in early pregnancy are recommended. Your doctor may suggest iron supplements

Drugs that you should be careful about/ avoid:

Drugs which are teratogenic or cause foetal distress, stillbirth or miscarriage
Tobacco increases the risk of miscarriage or stillbirth
Limit caffeine intake to two coffees per day but remember that some soft drinks, energy drinks and tea also contain caffeine
Illicit drugs such as cocaine, cannabis and amphetamines have shown to be associated with a higher incidence of birth defects, low birth weight and still birth. Mixing these drugs with alcohol can have dangerous effects.

Should I avoid certain ingredients in skin creams / make up?

The following products and beauty treatments are not safe to use while pregnant:

Accutane or retinoic acid - This is a medication that doctors prescribe for acne. It contains substances that will cause serious birth defects. If you become pregnant while taking this drug, it is important you stop taking it and contact your doctor immediately.
Many anti-aging products contain high doses of vitamin A , which can cause birth defects in babies. If you use any wrinkle creams, check the label and read the ingredients. If you are not sure about the ingredients ask your doctor.

What sort of tests might I have and why?

A number of tests are done during pregnancy to recognise potential problems early to treat them if necessary and to reduce risk for your baby and you. You might be tested for;

Infectious diseases: blood test at 10 weeks for HIV, syphilis, rubella, hepatitis B and C, varicella (chicken pox)
Urinary tract infection and chlamydia: urine test
Downs syndrome: the blood test is interpreted with a neuchal scan ultrasound at 13 weeks or so to measure the thickness of the babies neck, or the regular 17 week scan
If you are at higher risk you might be advised to have investigations for genetic or chromosomal abnormalities:
- CVS (chorionic villus sampling): biopsy of placental tissue to test for genetic abnormalities eg cystic fibrosis
- Amniocentesis: amniotic fluid is extracted from the amniotic sac that surrounds the baby
- - If you have a family history of a genetic disorder (other than downs syndrome) eg cystic fibrosis
  - Women with a family history or genetic carriers (both male and female) of chromosomal abnormalities
  - Women who have already had children with chromosomal abnormalities.
Organ abnormalities: morphology scan at 17-18 weeks looks for abnormalities in organs ie heart, brain, spina bifida
Diabetes: Testing blood sugar is one test and you may need a glucose tolerance test is used to test for gestational diabetes
Vaginal infection: swab at 36 weeks to look for infection in the birth canal that can be passed on to your baby during birth
Other tests: full blood count for anaemia, iron studies for deficiency and vitamin D for deficiency, thyroid function tests including urinary iodine.

Is it safe to have sex while pregnant?

Yes unless you have complications in pregnancy that may put you at higher risk of going in to labour early. With a normal pregnancy you can do it right up until the waters break. It will not hurt the baby even with your partner on top. For some women, the intensity of orgasm is decreased in pregnancy and for some it is increased. You may experience increased blood flow to the pelvic area and abdominal cramps which can be uncomfortable for some women.

Is dyeing my hair dangerous while pregnant?

There is no hard evidence but it is generally recommended to not dye your hair at least until after the first trimester, which is the most crucial time in the formation of the baby.

What is the risk/rate of miscarriage?

Each year in Australia, approximately one in four pregnancies is affected by miscarriage. Most of the spontaneous miscarriages occur in the first 12 weeks of pregnancy. Some women are at higher risk but this needs to be discussed with your doctor.

Is high blood pressure is a concern?

Very much. Pre-eclampsia is the name given to high blood pressure during pregnancy that may cause health concerns for the woman and her baby. For the woman, pre-eclampsia may affect the normal functioning of her kidneys, liver, brain and blood clotting system. For the baby, it may affect the functioning of the placenta.

Pre-eclampsia usually only occurs after about 20 weeks of the pregnancy. The precise cause of pre-eclampsia is still not clear, but it is thought that it may be due to an imperfect implantation of the placenta early on in the pregnancy.

Pre-eclampsia tends to be more common in women having their first baby and women having another baby with a new partner. It is also more common for teenage mothers and women over 35 years. Women with a family history of pre-eclampsia (mother or sister), women with diabetes and women having multiple births are also more likely to develop pre-eclampsia.

Up to 50% of women who have had pre-eclampsia with a previous pregnancy will develop pre-eclampsia again during a subsequent pregnancy, but it is usually milder.

Is there a need to avoid using mobile phones and microwaves while pregnant?

There is no evidence that these need to be avoided.

Which form of pain relief is the best during labour and what are their differences?

Firstly maintaining a healthy lifestyle during the pregnancy period is highly recommended and gentle exercise and a balanced diet will ensure your body is well prepared for birth. There are a few methods available to relieve labour pain. It is the mother’s choice whether or not to use these options and it is best to discuss these options with your obstetrician or midwife before going into labour.

Nitrous oxide gas, pethidine and epidural can be useful analgesics during labour, but many women prepare for labour with relaxation techniques that allow them to go through childbirth without the need for these interventions. Pethidine can cause nausea and there is a possibility of incomplete anaesthesia in epidural. There are pros and cons of all drugs and these should be discussed with your doctor or midwife in advance.

Is having a caesarean dangerous?

No. There are medical conditions where a caesarean section is preferable to a vaginal delivery. You as the mother or your doctor may have different views. There are circumstances when avoiding a caesarean section can be a risk- even an unacceptable risk and others when the small added risk of an operation and anaesthetic means it would be better to avoid it. Many people believe the rate of caesarean is too high in Australia.

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