Maternal Health: 9 Ways Pregnant Women Can Stay Safe and Healthy
One of the first things you’ll learn about pregnancy and parenthood is that there are very few definitive rules. Just because your friend felt her baby kick at 17 weeks doesn’t mean you will too. And if TUMS cured your sister’s pregnancy heartburn—well, there’s no guarantee it’ll help curb yours. But there’s one thing that’s pretty much universal for excited moms-to-be: They want to stay as healthy as possible for themselves and their growing families.
Subjective experiences aside, there are plenty of science-backed steps you can take to boost your chances of having a safe and healthy pregnancy, as well as a smooth delivery. Ready to prioritize your well-being? Below, expert-provided tips on how to take care of your physical and mental health throughout the next nine+ months.
The Centers for Disease Control and Prevention (CDC) recommends three important vaccines during pregnancy: the flu shot, the COVID-19 vaccine (Moderna or Pfizer-BioNTech) and a Tdap shot (which protects against pertussis whooping cough). Compared to non-pregnant people, pregnant women are more likely to get severe illness and complications from infections like the flu and COVID-19, explains Renita White, MD, an ob-gyn at Georgia Obstetrics and Gynecology in Atlanta. “This is due to changes in the immune system in pregnancy,” she says. “Studies show that vaccination against influenza, COVID-19 and pertussis whooping cough significantly reduce the risk of respiratory infections, ICU admission and death.” There’s also the added benefit of protecting your developing baby from illness, White notes. Remember, they won’t be able to get vaccinated for several months to years (depending on vaccine type), so do it for yourself and your little one.
Instead of waiting to see if any potential complications or risks arise, White suggests addressing all health conditions as soon as possible, ideally bringing them up to your OB before you’re even pregnant. The best option is to schedule a preconception appointment with your ob-gyn to discuss ways to optimize your own health before getting pregnant. “Things like high blood pressure, diabetes and obesity can come with added risks to women when they become pregnant,” she notes. “High blood pressure during pregnancy, for example, can increase one’s risk of preeclampsia, preterm birth, placental abruption (where the placenta disconnects prematurely) or c-section.” However, working to address and improve existing medical conditions in advance of pregnancy will help decrease risks to you and your developing baby.
Additionally, you’ll want to talk to your doctor about any medications you’re taking; you might have to make some changes. “There are several blood pressure medications that can negatively impact the fetus, even before you find out you’re pregnant. Preconception appointments are a great way to address this,” explains White.
Of course, if you miss the opportunity to have a preconception appointment, it’s not too late to take your health into your hands. Just make sure you have these important conversations and consultations sooner rather than later.
When it comes to deciding on an OB or midwife, never settle. It’s not hyperbole to say that you’re potentially putting your and your baby’s life in their hands. “This is small, but probably the most important tip of all,” says White. Things don’t always go as planned, and unforeseen hurdles can be very scary. “Many decisions have to be made in a moment’s notice and can have a life-changing impact on Mom and baby.” Having confidence in your provider can make these instances a little less intimidating. What’s more, White emphasizes that it’s essential to find a doctor or midwife that makes you feel seen and heard—and there’s no harm in switching during your pregnancy if needed. Don’t be afraid to explore your options through references from friends, family and online reviews. “It’s okay to meet with several providers before selecting the doctor you end up going with,” adds White.
As soon as you find out you’re going to be a mom, you’ll want to try to befriend other parents and moms-to-be. If you think “mom friends” won’t come into play until after baby is born—or when they’re old enough to start having play dates—you’re mistaken. Kara Kushnir, MSW, LCSW, a psychotherapist at A Work of Heart Counseling in Allendale, New Jersey, explains that it’s helpful to start talking to other women who are currently pregnant or recently went through the experience. Pregnancy—especially during the time of COVID-19—can be both isolating and overwhelming. “Seeking support and connection during pregnancy and using those outlets to also brainstorm the support you’ll need postpartum can not only be helpful during pregnancy but also during the adjustment into motherhood,” Kushnir says. She adds that this can end up being even more important “if you find yourself as one of the one in seven women who experience a postpartum mood or anxiety disorder.”
This one is simple: Take those darn prenatal vitamins each and every day. As Kristen Hurley, MPH, PhD, a public-health nutritionist in Santa Barbara, California, explains, when a woman becomes pregnant, her vitamin and mineral demands increase in order to meet her nutritional needs as well as those of her developing baby. Plus, prenatal vitamins also help to reduce anemia and support a healthy immune system. “Many women don’t get enough nutrients through food alone,” she says. “The earlier in pregnancy a woman begins taking a multivitamin, the greater the impact the vitamins and minerals can have on her health and the health of her child.”
White adds that the brand of prenatal vitamins itself doesn’t really matter—it’s more about consistently taking them to get adequate amounts of folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins and vitamin C. She notes that the CDC recommends 400 micrograms of folic acid to decrease the risk of neural tube defects and that studies show that folic acid reduces the risk of birth defects of the brain, spine and spinal cord by 70 percent. “Brain and spinal cord development begins prior to a woman even knowing she’s pregnant, so it’s recommended to start taking [prenatal vitamins] one to three months before getting pregnant,” she says. Not taking a vitamin yet? Don’t panic. There’s no time like the present.
Experiencing all those new body changes can be disorienting. Still, it’s as important as ever to listen to your instincts. Even if this is your first pregnancy, trust that you know your body best. If your gut tells you something isn’t right, speak up. “Work with [your] doctor to know what symptoms are normal for pregnancy and what could indicate a bigger problem,” advises White. And if you still don’t feel heard, “it’s also okay to get a second opinion,” she says.
Greg Marchand, MD, an ob-gyn and founder of the Marchand Institute for Minimally Invasive Surgery in Mesa, Arizona, agrees that it’s essential to stay in tune with your body. “Fetal movement—learning to appreciate it and detect when it’s decreased is a critical part of pregnancy,” he says. “Your doctor will do their best to take care of your pregnancy, but there’s no substitute for a mother’s recognition of a baby that has stopped moving,” he adds. Ideally, you want to feel 10 movements within one hour. If drinking something sweet or cold doesn’t perk baby up, and you don’t count 10 movements within two hours, it’s best to head to the hospital to be sure they’re alright.
Oftentimes, when we talk about health in pregnancy, we think of the physical health of Mom and baby. But your mental health is of the utmost importance too. “Perinatal mood and anxiety disorders (PMADs) are the number one complication of pregnancy and childbirth,” says Shana Averbach, LMFT, a maternal mental health therapist in San Francisco, California. “And while they’re highly treatable, we need to be able to notice and name them in order to seek treatment.” Unfortunately, the mental health components of prenatal planning are often skipped over completely or only briefly touched on. “But anxiety and depression often start during pregnancy, if not before.”
Averbach notes that, per the American College of Obstetricians and Gynecologists (ACOG) recommendations, pregnant women should be screened during pregnancy and the postpartum period. If that’s not happening regularly, proactively ask to be screened. What’s more, be your own best advocate by doing the research and knowing the signs and symptoms to watch for. “If this is the last thing you want to think about, that’s totally understandable. After all, we are told everything should be joyous and glow-y,” she says. “But remember, being armed with information can only help, and if you don’t end up needing it for yourself, you may be able to share your knowledge with someone else.”
Don’t wait or hold back when it comes to sharing mental health or emotional wellness concerns with your doctor or therapist. “Many women are quick to disregard how they’re feeling or believe they have to just push through it because it would be unsafe to treat those symptoms during pregnancy,” Kushnir says. But this isn’t the case. In fact, waiting can be detrimental to your well-being. She stresses that avoiding the issue could set you up for more negative outcomes in terms of physical recovery and the overall transition into parenthood.
Heidi McBain, LMFT, a licensed perinatal mental health therapist in the Dallas area, also notes that there are multiple benefits to therapy during pregnancy in addition to lowering any anxiety or depression symptoms that may develop. It can also help you process feelings of grief or loss that may start to surface. “Pregnant moms are also often surprised that issues that they’ve worked through in the past, like trauma, may be showing up as they are transitioning into motherhood,” she says.
Starting therapy during pregnancy can also be considered a proactive and preventative measure if you’re worried about PMAD symptoms showing up after birth. It’s a way to “learn some skills while pregnant that can better prepare [you] for postpartum mental health symptoms,” McBain says.
Ready to put your swollen feet up and relax for the next nine+ months? A sedentary lifestyle may sound tempting when you’re expecting and exhausted, but it’s not the best choice for you or baby. “Exercise is good for most pregnant women,” says White. According to the US Department of Health & Human Services, pregnant women should get at least 150 minutes of moderate intensity aerobic activity each week. Try yoga, walking, swimming, using a stationary bike, doing Pilates or lifting light weights. If you’re an experienced athlete or active runner, you may be able to continue high-intensity exercises under the guidance of your doctor.
The benefits of exercise in pregnancy are plentiful. White says that physical movement can reduce back pain, improve diabetes and blood pressure complications, enhance general health and strength and potentially even help ease the labor process.
What’s more, physical activity can reduce the risk of depression in pregnancy, according to studies. “Exercise helps balance important neurochemicals associated with feelings of well-being, and when done outside—which has been a great option in the COVID era—it also provides the benefits of vitamin D,” Averbach says. “Since exercise is also associated with a decrease in physical complaints (like bloating, backaches, etc.) and helps with sleep, it’s a real power tool for supporting wellbeing.”
About the experts:
Shana Averbach, LMFT, is a maternal mental health therapist in San Francisco, California. She earned her master’s of science in counseling from San Francisco State University.
Kristen Hurley, MPH, PhD, is a public health nutritionist and senior vice president of nutrition at Vitamin Angels, a global public health nonprofit that distributes essential prenatal vitamins to over 60 million pregnant women at risk of malnutrition. She received her doctoral degree from The John Hopkins Bloomberg School of Public Health.
Kara Kushnir, MSW, LCSW, is a psychotherapist and clinical director at A Work of Heart Counseling in Allendale, New Jersey. She received her degrees from Rutgers University in New Brunswick, New Jersey.
Greg Marchand, MD, FACOG, FACS, is an ob-gyn and the founder of The Marchand Institute for Minimally Invasive Surgery in Mesa, Arizona. He earned his medical degree from Spartan Health Sciences University in Vieux Fort, St. Lucia.
Heidi McBain, LMFT, LPC, PMH-C, is a licensed perinatal mental health therapist outside of Dallas, Texas. She received her master’s degree from the University of San Diego, San Diego, California.
Renita White, MD, is a board-certified ob-gyn at Georgia Obstetrics and Gynecology in Atlanta and Alpharetta, Georgia. She earned her medical degree at the Ohio State University.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.