Everyone seems to have an opinion about what you should and should not do while you’re pregnant. Don’t worry too much; most of these opinions are wrong! We get questions surrounding these topics all of the time.
Follow the links below to learn more specific information:
Here are the common “Dos and Don’ts” Questions:
Yes.
It is a myth, sometimes perpetuated by massage therapists themselves, that massages can be so relaxing that they might stimulate preterm labor. This is completely untrue. Some massage therapists may want a note from your doctor stating that a massage is safe, and we can’t think of a good reason why your doctor wouldn’t give you such a note.
At your first visit, review medications that you regularly take with your doctor, even over-the-counter medications, including herbals and supplements.
Sometimes you will have a problem develop during pregnancy and you'll wonder if you can take an over-the-counter medicine or remedy. Click here for a list of acceptable drugs. If you don't see what you're interested in on the list, check with your doctor.
A lot of women ask this question because they’ve been told to never sleep on their backs, particularly in the third trimester. Most advice on the Internet and in books about pregnancy recommends against sleeping on your back. There is no good scientific evidence that sleeping on the back increases the risk of stillbirth, even in the third trimester. There have been studies that show that fetuses have some fetal heart rate changes in different sleep patterns while the mother is sleeping on her back, but these changes have not been definitively associated with an increased risk of stillbirth. Studies of observed sleeping habits show that women roll around a lot and likely have little control how they lie during sleep.
Women in the third trimester are unlikely to sleep on their backs naturally due to their belly size, so they will tend to sleep on one side or the other anyway. If they do sleep on their backs, there is little to do about it since women have no control over how they turn and roll during sleep. Since there has been no definitive connection between back sleeping and stillbirth, women should not lose too much sleep (pun intended) worrying about how they sleep.
Yes, please do.Good dental hygiene is associated with good pregnancy outcomes. A severely infected tooth, on the other hand, may lead to problems for the pregnancy. There are no routine practices at the dentist’s office that are unsafe during pregnancy. This includes pulling teeth and getting dental x-rays. A pregnant woman can undergo many tens of thousands of shielded dental x-rays during pregnancy without fear of delivering a harmful amount of radiation exposure to the pregnancy.
Local anesthetics, antibiotics, and pain medicines that are commonly used by dentists are all also safe during pregnancy. If your dentist has a question about a particular antibiotic or other medicine, have them ask your doctor.
Yes! There are some rare reasons for a woman to abstain from sex during pregnancy. These rare cases where the risks may outweigh the benefits include certain cases of preterm labor with advanced cervical dilation; preterm, premature rupture of membranes; or placenta or vasa previa. Also, women who have had a cervical cerclage during pregnancy should probably abstain. Otherwise, have fun!
Most women find sex during pregnancy more satisfying and pleasurable than outside of pregnancy. Sex during pregnancy is not associated with an increased risk of miscarriage, preterm labor, or any other complications of pregnancy. Even in cases where penetration may not be the best idea, such as the situations listed above, orgasms during pregnancy are still perfectly fine. If you have a cervical cerclage and don’t need penetration to orgasm, then feel free to have fun!
As your uterus gets bigger during pregnancy, different sexual positions may help both with comfort and satisfaction. If you are having trouble with comfort during sex, ask your doctor about it.
Yes!
The Internet is full of advice recommending that you don’t dye your hair while pregnant, at least in the first trimester. This is born out of ignorance and a fear of everything during the first trimester. There is no scientific data that says that dying your hair is associated with any adverse problems, even in the first trimester. If you think about it, most female beauticians and hair stylists also become pregnant at some time, and they are exposed to these chemicals hundreds or thousands of times more than what you are exposed to when getting your hair dyed. We don’t recommend to those women that they should change their occupation while pregnant.
Yes!
Because of high levels of mercury in some big fish, pregnant women should avoid shark, swordfish, king mackerel, and tilefish. Smaller fish are usually safe, such as light tuna, salmon, pollock, and catfish. Up to 12 ounces per week of these fish is considered safe.
In fact, regular consumption of fish (and their omega fats) has been associated with lower rates of preterm labor and other complications of pregnancy. Recent evidence suggests that even the recommendation about avoiding the larger fish is likely unnecessary. So don’t stress too much unless you happen to eat these larger fish multiples times per week.
Yes!The best way to protect your baby during pregnancy is to protect yourself. Seatbelts are the best way to do this while driving. It is a myth that seat belts add extra or unnecessary risks to your baby; on the contrary, they may save your life and your baby’s life.Buckle up!
Well, you’ll think we’re biased for saying it, but the answer is no. While birth can be and usually is a very benign event, the truth is that the safest place for you to deliver your baby is in a hospital. It is the safest option for your and your baby’s health, in case anything were to go wrong. We cannot completely predict who will have issues at the time of delivery, or leading up to it. We know of certain risk factors that increase the chance of serious events happening, but ultimately, a number of things could happen to even the healthiest people.
The biggest risk factor for issues at delivery, believe it or not, is being nulliparous (a woman who has not delivered a child before). The reasoning behind this is because we do not know if you have an adequate pelvis for childbirth and you are at the greatest risk for shoulder dystocia and stalled labor. In the next section, we discuss some complications that can arise during pregnancy. One thing that all of these complications have in common is that the quicker we identify them and come up with a plan to treat them, the better it is for you and baby. That identification and treatment is best facilitated if you are in a hospital under the care of nurses and physicians that can monitor for these things.
The bottom line is that studies consistently show that even with low-risk and well-selected patients, home birth is consistently more dangerous for mom and baby.
There’s no quality scientific evidence that suggests that this is beneficial. Some women who are anxious about breastfeeding may gain confidence by doing this, but just as many women suffer pain, frustration, and unnecessary anxiety by attempting to hand express before the baby is born. The highest quality studies have found no health benefits to baby from having colostrum or milk already available by birth.
A general rule is to only bathe or soak in water that is comfortable to you. To be specific, we ask that you keep your water temperature below 100-102°F. The goals of this are:
- Don’t burn your skin and
- Don’t send yourself into heat stroke/exhaustion.
You should be able to gauge if the temperature of the water you’re getting into is going to cause either of these things. No thermometer is needed. If you do like hot baths or showers, just remember that you can get dehydrated quickly and maybe keep a cold water and a chair or stool by the tub. Also, get yourself a non-slip bath mat!
Many hot tubs might be set to 104°F or higher. One study from the 1990s showed that soaking in a hot tub at this higher temperature during the first trimester may be associated with neural tube defects in babies. Because of this study, we recommend to avoid temperatures that high for long periods of time, especially in the first trimester. The research is weak, but it is certainly something to consider. Hot tubs are different that most baths because the water is maintained at that higher temperature and your body is typically submerged with little opportunity to cool off. But with baths in your home, the water starts to cool immediately after its drawn so it doesn’t raise your core body temperature in the same way or to the same extent as a hot tub might.
Glycol ethers are a type of chemical used in some clearning products and these should be avoided. Examples of glycol ethers are 2-butoxyethanol (EGBE) and methoxydiglycol (DEGME). Glycol ethers are solvents that have been linked to miscarriage and birth defects. Check the ingredients of the products listed below before you buy them. A list of products that may contain a glycol ether:
- Resins, lacquers, house paints
- Dyes, inks, some water based paints
- Hydraulic fluids
- Degreasing cleaning agents
A general thing to avoid, not just in pregnancy, is the combination of ammonia and bleach when cleaning. This creates a poisonous gas that can be very harmful to you.
Paints that contain lead or the above mentioned glycol ethers should be avoided, but modern paints don’t have these substances. Keep the area well ventilated no matter what paints you are using. Other recreational paints for artistic use are generally safe, including watercolors, acrylic, and tempera paints.
You shouldn’t be worried about lifting general items around the house, the store, or work. This being said, if you work on an assembly line in a factory or in some other job that requires routine repetitive heavy lifting, it may be best to ask your doctor about your specific situation. But for the most part, occasional and recurrent lifting of any amount you normally lift in the course of your home or work life is not usually going to be a problem. This includes any babies or small children you have at home.
Still, lifting the right way is very important: bend at your knees, try to keep your back straight, and lift up with your legs. This will help prevent unnecessary strain or sprain on your muscles and joints which are already a bit overworked when you are pregnant.
It’s unclear if repetitive heavy lifting is associated with adverse pregnancy outcomes, but it certainly can make the normal aches and pains of pregnancy much worse. At the gym, light weights and repetitions are fine, but it’s probably not the time to set your new personal records for lifting. At work, it depends on how far along you are and how much lifting you do. Click here for a graphic that shows a very conservation approach to limiting problems associated with repetitive lifting while you’re pregnant.
This is not an uncommon situation. Many women don’t realize they are pregnant and consume alcohol during those early weeks of gestation before they realize it. Unfortunately, there is no way to diagnose fetal alcohol syndrome until the baby is born. In some severe cases it can be diagnosed right at birth, but most cases are not detected until early childhood, and some very mild cases may not be detected at all.
No amount of alcohol during pregnancy has been deemed safe, and the amount of alcohol consumed is a poor predictor of outcomes. The only way we can determine the effects of any alcohol consumption you might have had is by assessing the child during their development and seeing how they are doing with their cognitive, behavioral, and other developmental milestones. It is best to try and avoid alcohol when you are thinking about conceiving. Once you find out you are pregnant, cut out alcohol and avoid it for the rest of the pregnancy if you have not already done so.
Good question. The truth is, you can eat just about anything you want. Click here for a full explanation. The short answer is to not eat:
- Big fish with high levels of mercury (shark, swordfish, king mackerel, and tilefish)
- Unpasteurized milk and soft cheeses
- Raw or undercooked meats
- Cold cuts (lunch meat, salami, etc.)
Finally, make sure you wash your fruits and vegetables well before eating them. The absolute risk of the anything that happening from eating any of these foods is incredibly low. So you shouldn't worry too much; but pregnancy isn't the time to explore strange and new foods from uncertain sources.
Normal weight women (BMI of 18.5-24.9) should gain about 25-35 pounds during their pregnancies. Underweight women (BMI < 18.5) may need to gain more and overweight women less. For obese women (BMI > 30), dieting is safe and beneficial during pregnancy. Most weight gain comes in the second half of pregnancy and often women have gained no weight or even lost weight by their 20th week; this is healthy and okay.
We check your weight at every visit, but please don’t focus on how much you gain. We are usually not worried about you gaining too little weight but instead gaining too much weight. Excess weight gain increases the risks of several pregnancy complications, including the risks of preeclampsia, diabetes, fetal macrosomia (a big baby), and Cesarean delivery.
Many overweight women can gain no weight for the entire pregnancy or even lose some weight if they’re actively dieting. This is not a bad thing. Maternal weight gain, if it is excessive, is associated with a larger fetal size; but that doesn’t mean that gaining too little weight during pregnancy will not make your baby too small if you are overweight at the start of the pregnancy. The goal is to have a healthy baby and a healthy mom. Talk with your doctor or midwife about what your weight journey should look like throughout pregnancy based on your pre-pregnancy weight.
Yes, you can.
As with most things in life, moderation is the key. Scientific studies have not demonstrated any problems with caffeine consumption during pregnancy until a woman consumes over 700 mg per day. That’s a lot of caffeine! To be safe, and to make sure that a woman never approaches that amount of caffeine consumption, we recommend that women limit themselves to 350 mg of caffeine per day.
Click here to find out how much caffeine is in your favorite beverage.
Nausea and vomiting during pregnancy is no one’s idea of a good time. Unfortunately, it affects about two-thirds of pregnant women. The good news is, nausea and vomiting are not associated with risks to the pregnancy; the bad news is, you are nauseated and throwing up.
What can you do?
- Eat several small meals per day and avoid high-fat foods.
- Eat more bland foods and avoid smells that are noxious.
- Increase the protein and liquid content of your food.
- Ginger ale, ginger teas, or ginger capsules can help (three 250 mg capsules a day and one before bed).
- Taking a vitamin B6 supplement (25mg) 2-3 times per day alone or in combination with Unisom SleepTabs (doxylamine) at night may be beneficial.
Your doctor may need to prescribe an anti-nausea medicine for you if these remedies don’t resolve the issue. There are several drugs that are safe in pregnancy to choose from, including ondansetron (Zofran), metoclopramide (Reglan), promethazine, haloperidol, and a few others.
Make sure that your acid reflux and constipation are treated since both of those can contribute to nausea and vomiting as well.
In bad cases, you may need to be hospitalized for IV fluids and other treatments if you are unable to keep anything down and experiencing signs of severe dehydration/malnutrition. Hopefully, you should feel better by the end of the first trimester. If you don’t, or if the above remedies are not working, your doctor may need to investigate other causes of your nausea and vomiting apart from pregnancy. Typically, you shouldn’t be concerned as long as you can maintain your body weight and stay hydrated during the first trimester. If you lose a few pounds from the nausea and vomiting, it isn’t too concerning; but, more significant losses should be investigated further.
In most cases, the answer is no.
There is a whole industry that markets supplements and other products to pregnant women. Even among prenatal vitamins, for most women the only ingredient that is actually required is folate, and folate is only necessary until the baby’s neural tube is closed, which happens early in the first trimester. The truth is, prenatal vitamins are best taken beginning at least two to three months before pregnancy and provide little to no benefit past the first half of the first trimester. In fact, if you are beyond six weeks and prenatal vitamins are making you nauseous or constipated, there’s no reason for you to keep taking them.
Aside from the folate in a prenatal vitamin, the other ingredients often found in these vitamins are not science-based. Don’t get caught up in buying the most expensive prenatal vitamin because the company says it will make your child smarter or reduce the risks of pregnancy; this simply is not true.
In some cases, due to restrictive diets or preexisting anemia or other risk factors, your doctor might ask you to take an additional supplement or medication, most commonly iron.
If you failed your 1-hour glucose screen AND your 3-hour glucose tolerance test, then you have gestational diabetes.
Hopefully, you’ll get a chance to talk to a dietitian. In the meantime, try to cut down (if you can, cut them out completely) the simple sugary items from your diet: sodas, cookies, cakes, candies, and other sources of sugary carbs. Paying attention to portion size is the best thing you can do. Try to make your plate ½ greens, ¼ grains, and ¼ protein for every meal. If you’re not already, add in four to five 20 minute walks or other cardiovascular exercise sessions per week.
You’ll need to check your blood sugar several times per day, at least initially. You should check your blood sugar first thing in the morning (a fasting blood glucose), and then check it two hours after each large meal – breakfast, lunch, and dinner. Your fasting blood sugars should be below 95 and your blood sugars after meals should be below 120. If your blood sugars are running higher than this, you may need to take medicine to help lower your blood sugars.
Is also helpful, in the beginning at least, to track what you are eating. This can help your dietitian and your doctor decide if there are some things you should do differently in your diet. It can also help you understand why your blood sugar might spike – for example, after delicious pizza.
Yes!
Because of high levels of mercury in some big fish, pregnant women should avoid shark, swordfish, king mackerel, and tilefish. Smaller fish are usually safe, such as light tuna, salmon, pollock, and catfish. Up to 12 ounces per week of these fish is considered safe.
In fact, regular consumption of fish (and their omega fats) has been associated with lower rates of preterm labor and other complications of pregnancy. Recent evidence suggests that even the recommendation about avoiding the larger fish is likely unnecessary. So don’t stress too much unless you happen to eat these larger fish multiples times per week.
No! Alcohol does pass easily into breastmilk, but it’s also absorbed from milk much like it is from the bloodstream. Basically, if you are sober enough to drive, you’re likely sober enough to breastfeed. A rough average is about two to three hours after one drink. If you breastfeed a little early, it’s unlikely the baby will receive enough to be harmful. Only a very small percentage is actually passed on to the baby in breastmilk. Of course, if you had more than one or two drinks and will need to wait longer than usual between feeds, pumping and dumping may make you more comfortable! Also, bear in mind that current research suggests that “moderate” alcohol use (generally meaning less than one drink per day) is not considered harmful to babies. More than that and you could be putting baby at risk; there is no known “safe” amount of alcohol in breastmilk, and some research suggests frequent alcohol use during breastfeeding may put babies at risk for slowed development and poor weight gain.
Yes. The short answer is that exercise is a beneficial activity throughout pregnancy and virtually all pregnant women should exercise. Almost every limitation to exercise that you heard or read elsewhere on the Internet is not based in science. Women who exercise have better pregnancies in every aspect.
In general, the answer is yes. Under normal circumstances, travel during pregnancy is safe until the last 5 weeks or so of pregnancy. This includes flying. Most cruise ships will not allow you onboard if you are pregnant past a certain gestational age. Be sure to drink plenty of fluids, walk, and stretch your legs on long trips.
You should take normal precautions while traveling, such as wearing seat belts. The lap belt should be below your belly so that it fits snugly across your hips and pelvic bone; the shoulder belt should be across your chest (between your breasts) and over the mid-portion of your collarbone (away from your neck). Never place the shoulder belt under your arm or behind your back; also, ensure there is no slack in the belt and that your airbags are turned to “on.” Keep 10 inches between the steering wheel and your breastbone. You may need to angle the steering wheel toward your breasts, not your belly or head.
There is nothing inherently dangerous about traveling by ground, sea, or plane during pregnancy. However, you do have to consider how long you will be separated from the ability to seek medical care, and how far away that medical care might be. This is more important in the third trimester, particularly in the late third trimester when labor is more likely. It’s for this reason that many cruise ships will not allow you to embark after 24 weeks’ gestation. They do not want any liability related to premature delivery when the baby has a chance to survive preterm. It’s not that sailing isn’t safe, it’s only that it is many hours away from a hospital.
Planes do not often limit travel by gestational age, but you should consider how long your flight is. There is a big difference between flying from Atlanta to New York versus flying from New York to Melbourne. In general, many doctors recommend avoiding flying after 35 weeks’ if the length of the flight is particularly long. Some people worry about traveling by car due to the concern of increased risk of blood clots secondary to the immobilization of sitting in a car. This is probably not a valid reason to avoid travel by car, particularly when you consider that pregnant women will be taking pit stops every two or three hours anyway. When you stop for a potty break, be sure to walk around for a couple of minutes.