Your stay-calm pregnancy guide

Get ten tips to put your brain—and your baby—at ease

Who knew that the most common pregnancy symptom isn’t nausea or fatigue, but worry? There I was, a positive pregnancy test still in my grasp, convinced that a gnawing pain in my right side was sure proof of something wrong. When a seven-week ultrasound assured me that the baby was fine, I sighed with relief. Then I moved on to fretting about a million other things, such as the safety of sushi, sex, prenatal tests. Yup, pregnancy anxiety seems to start at conception and continue for the whole 40-odd weeks. (And yes, that is longer than nine months!) Worries are understandable given pregnancy surprises: untimely bouts of gas, a nosebleed just as you’re serving up dinner or your belly doing the wave in aisle 7 of the supermarket. The outpouring of well-meaning advice, warnings and old wives’ tales from friends and family doesn’t help, either. So, we asked the experts and some real women who’ve been through it—names changed to encourage maximum candour—for advice on your top 10 pregnancy concerns. Here’s what you need to know to take control, gain peace of mind and enjoy the healthiest of pregnancies:

Worry 1: What the heck can I eat?

Go ahead, dig into that peanut butter jar Rumour has it that pregnant women should avoid eating everything from peanuts to caffeine. But with nausea and heartburn already sucking the joy out of eating, you don’t need to whittle down your menu to 10 allowable items, too. “I gave up my beloved peanut butter for an entire pregnancy, only to find out that the latest evidence suggests it’s OK to eat,” complains Rebecca, a 39-year-old mother of one. Don’t fret about increasing your child’s risk of food allergies unless you’re breastfeeding, agrees Leslie Beck, Toronto-based registered dietitian and author of Leslie Beck’s Nutrition Guide to a Healthy Pregnancy (Penguin). That’s when certain proteins can get into breast milk and trigger infant allergies, especially with early and prolonged exposure.

Besides, you’ll miss out on vital nutrients by boycotting certain foods during pregnancy. For example, oily fish such as salmon, trout and sardines contain a fatty acid essential for your baby’s brain and preventing postpartum depression. (Skip higher-mercury fish such as swordfish, tilefish, shark, canned albacore tuna and tuna steaks.) But what about raw or unpasteurized foods that may carry listeria bacteria or toxoplasmosis parasites? Yes, the potential harm of foodborne illness is higher in pregnancy. But the risk is still relatively low, says Dr. Joanne Stone, co-author of Pregnancy for Dummies, 2nd Edition (Wiley). Avoid these foods, but don’t fear if you’ve eaten some. As for caffeine, Beck suggests just one calcium-rich latte or small (8-oz/250-mL) coffee a day. Also, consider prenatal vitamins with folic acid, calcium and iron.

Worry 2: I went on a bender and didn’t know I was pregnant!

Stop drinking and stop worrying, too “Alcohol consumption occurs in one-quarter of pregnancies, since half of pregnancies are unplanned, so many women drink unknowingly,” explains Dr. Gideon Koren, director of the Motherisk program at the Hospital for Sick Children in Toronto. Yet, most deliver healthy children. “I drank a lot on a trip to Cancún, and I felt bad when I found out I was pregnant. It wasn’t until my first ultrasound that I finally relaxed,” recalls Nalini, a 30-year-old mother of one. Dr. Koren is a pragmatist: “No doctor should tell women it’s OK to drink during pregnancy, but it’s also irresponsible to tell women one drink is harmful. No research has shown this, and misinformation may lead women to terminate a pregnancy.”

If you’re trying to conceive or know you’re pregnant, though, put away the martini shaker. Heavy alcohol consumption during pregnancy has been linked to neurological, cognitive and behavioural problems, low birth weight and malformation in children. Research is inconclusive about moderate drinking, but it’s best to abstain. There is no “safer” trimester, either, because the baby’s brain develops throughout.

Worry 3: I’m bleeding—will I lose the baby?

Don’t panic Penny, a 34-year-old mom, says she was terrified when she noticed some bleeding during her first trimester. “My family doctor said it was normal, but my OB/GYN was less than reassuring,” she says. About one-third of women have vaginal bleeding in early pregnancy—it’s even more common with twins—yet the majority of women go on to have healthy babies. For example, light or brownish blood for a day or two around the time of your period can result from implantation—when the fertilized egg nestles into the uterine lining, says Sheila Evans, a perinatal epidemiologist at the University of Calgary. The risk of miscarriage (which occurs in about 15 per cent of pregnancies) decreases significantly after the first trimester. Although experts still haven’t identified hard and fast reasons why miscarriages occur, Evans says you don’t have to worry about having sex, exercising lightly or straining on the toilet, unless you have been identified as having an at-risk pregnancy.

Worry 4: What if tests show the baby isn’t healthy?

Take test results with a grain of salt Medical advances in prenatal screening can be a mixed blessing, since they sometimes allow us to find out more than we want to know. Although new non-invasive testing can predict Down syndrome and other chromosomal abnormalities 85 to 90 per cent of the time tests may still suggest something is wrong with your baby when there isn’t. For a definitive diagnosis, you need to have an amniocentesis or chorionic villus sampling, two invasive procedures sometimes recommended for women older than 35 or those with at-risk pregnancies. The challenge? Amniocentesis increases miscarriage risk slightly. Rita was 36 when she got pregnant, so she went ahead with the amnio. “Anticipating the procedure was awful,” she says. “You never breathe easy until it’s over with no complications and, of course, normal results—which we got.”

The question is, what are you going to do with the results, asks Dr. Elaine Herer, an assistant OB/GYN professor at the University of Toronto and Sunnybrook and Women’s College Health Sciences Centre in Toronto. If you’re not willing to terminate your pregnancy, you may worry needlessly and put your baby at risk, she says. Severe abnormalities are unlikely if your pregnancy continues past the first trimester.

Worry 5: Are medications unsafe during pregnancy?

Taking meds may be safer than not Laura, a 44-year-old mother of two, agonized over whether to take antibiotics and Tylenol when she developed pneumonia eight months into her pregnancy. “Then I realized that I had to recuperate quickly to be ready for the birth.” Many medications are safe during pregnancy, says Dr. Koren. Quitting or cutting back on prescription drugs can be risky, as uncontrolled asthma, blood sugar or blood pressure, depression and bacterial infections can all trigger adverse effects in mother and baby. Women may even need higher doses in late pregnancy due to their increased weight and enhanced ability to eliminate drugs. But Accutane, ACE inhibitors, cholesterol-lowering statins and anticonvulsants such as Tegretol and Dilantin should be avoided, as they could seriously harm the baby. Most over-the-counter drugs and smoking-cessation aids are safe, says Dr. Koren, but never self-prescribe.

Worry 6: Will morning-sickness meds hurt my baby?

No, it’s easy to deal with the queasies More aptly called “anytime-of-day sickness,” nausea doesn’t just happen upon waking or end with the first trimester. “I had morning sickness throughout the entire pregnancy,” says 28-year-old mother of one Jaclyn, who still experienced some nausea even with drugs. “Without treatment, I would have been hospitalized.” Why suffer? asks Dr. Koren. The most-prescribed anti-nauseant, Diclectin, has a safe track record spanning more than four decades, and new research suggests it has no long-term cognitive or behavioural effects. Meanwhile, excessive vomiting can result in malnutrition, dehydration and liver damage. To manage nausea without medication, try eating smaller meals more frequently or avoiding triggering foods and smells. If you take ginger, stick to less than 250 milligrams, four times a day.

Women who don’t get the heaves, meanwhile, may wonder if something is wrong with their baby. One recent British study found that morning sickness is associated with larger placentas and higher birth weights, hinting at a healthier baby. However, many women lucky enough to skip the queasies have perfect babies.

Worry 7: Will my workout hurt the baby or me?

Keep moving, just exercise caution Staying fit can strengthen muscles you’ll need for labour, promote better sleep and help prevent diabetes, pre-eclampsia, constipation and excessive weight gain. “I was in good shape prior to the pregnancy, so I just kept going according to my energy level and abilities,” says Brenda, a 43-year-old mother of four. “Because I remained active, I recuperated quickly.” But this is no time to make a leap from couch potato to Olympic athlete. “Only women who’ve been medically pre-screened by their health-care provider and found to have a low-risk pregnancy should exercise,” says Dr. Michelle Mottola, director of the exercise and pregnancy lab at the University of Western Ontario in London. Sedentary women shouldn’t start any exercise other than walking until the second trimester, even if they get a doctor’s thumbs-up.

Increasing body weight, lax joints and a shifting centre of gravity all make you more injury-prone than usual, so opt for workouts that are lighter or specifically designed for pregnant women. (This isn’t the time to pick up weight training, Mexican wrestling or other contact sports, for example.) Skip exercise if you’ve previously experienced a miscarriage or premature labour. Stop exercising and call your doctor if you experience abdominal pain, bleeding or dizziness while working out.

Worry 8: Will the doctors honour my labour requests?

They’ll try, but there are no guarantees Some women have visions of natural drug-free births, while others want labour pain eased with medication or even a C-section. “If you have strong feelings about C-sections, epidurals or the use of forceps, tell your physician in advance,” says Dr. Jan Christilaw, head of specialized women’s health at BC Women’s Hospital & Health Centre in Vancouver. But remember: you may change your mind about what you will or won’t accept once you’re in labour, whether it’s a matter of relieving fatigue or pain, or making things safer for the baby. “I can’t describe labour pain except to say that I am deathly scared of needles and when the admissions nurse came by, I was already begging for an epidural,” says Jaclyn. “I didn’t care how big the needle was or where they stuck it.”

It helps to do some research beforehand—no need to make uninformed decisions while in the throes of a contraction. For example, while most physicians try to avoid episiotomies these days, it’s worth asking about your hospital’s take on them. And will that be a vaginal birth or C-section? Medical necessity will decide the matter, but a C-section isn’t necessarily preferable. Urinary incontinence can occur after either delivery method, says Dr. Christilaw, and a C-section is still major surgery with potential risks such as infection, blood clots or respiratory distress for the baby. Whatever your birth experience, try not to feel badly about it. Keiko, a 30-year-old mom of two, doesn’t regret her epidural for an instant. She remembers peacefully reading while the woman in the next room screamed for hours. “It was the last bit of spare time I’ve had in two years, and every day I thank the goddess of anesthesia for it.”

As for me, I was all ready for a vaginal birth. But two days past my due date, my baby did a somersault and was breech. I was whisked to the hospital for a C-section. It seems Mother Nature scripts her own labour plan. Whatever happens, it’s worth it—as every mom says—to finally hold that little bundle in your arms.

Worry 9: Am I gaining too much weight?

Well, it probably wasn’t the baby who ordered that large, double-cheese pizza “Perpetuating the myth that you should be eating for two has contributed to more pregnant women putting on too much weight,” says Kristine G. Koski of McGill University’s School of Dietetics and Human Nutrition. Overeating during pregnancy increases the risk of becoming overweight and obese a year later, according to a recent U.S. study. Gaining substantially more than the recommended 25 to 35 pounds (the baby and placenta account for about 50 per cent of weight gained) can also lead to hypertension, diabetes, pain and varicose veins during pregnancy, labour complications and a bigger baby. “I wish my doctor had told me that weight gain increases your chance of having a C-section and a big baby. I also wouldn’t have so much to lose now,” says Nalini. Don’t count on breastfeeding as a magic weight-loss plan, either. Research shows the most you stand to lose by nursing for six months is about four to nine pounds.

Just don’t try to lose weight while you’re pregnant, says Koski. Instead, focus on healthy eating and not gaining too much. How much really depends on your pre-pregnancy weight, so get your doctor’s two cents’ worth. Generally, aim to add 100 calories per day (equal to a slice of pumpernickel bread) during the first trimester, and about 300 to 400 calories per day (equal to a cup-and-a-half of low-fat yogurt) during the second and third trimesters. A study in the International Journal of Obesity found that mothers retained less postpartum weight if they gained a larger portion of pregnancy weight in the second half of pregnancy.

Worry 10: Were those baths a bad idea?

No—enjoy a warm soak! “I wish I had taken more baths,” sighs Nalini. How cruel that just when your body needs more pampering than ever, a relaxing soak is off-limits for fear of raising your body temperature too high. Or is it? Actually, Dr. Stone says the risk of miscarriage and neural-tube defects like spina bifida from raising your core body temperature above 39 degrees Celsius (102 F) for 10 minutes or more—think hot tubs, extremely hot baths and saunas—typically only happen in the first seven weeks of pregnancy. Soaking in a warm bath is safe and may help relieve backache and pelvic pressure, she adds. Keep in mind that if you end up having a C-section, you won’t be able to take a bath for weeks afterward, so enjoy one while you can!