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When you’re pregnant, it might seem like everyone wants to offer you advice. Although friends, family and co-workers are usually well-intentioned with their recommendations, it’s hard to know what advice is reliable and what isn’t, especially because the answer isn’t always straightforward.
Below, I’ve listed some of the more common misconceptions that my patients are concerned about and the answers I typically give them.
I hope some of this information helps. If you have any lingering questions after reading this post, please ask your care provider!
Can I travel by plane in pregnancy?
The short answer is, generally, women are allowed to fly during pregnancy. It’s safe, so do not avoid seeing your family at the holidays or heading to a warm destination in the winter, especially if travel falls during your 1st or 2nd trimester. Some airlines do require a doctor’s letter in order for you to travel late in your 3rd trimester (usually 4-5 weeks before your due date), but other airlines have no restrictions except a recommendation to consult with your clinician. It’s a good idea to know the airline’s policies before you make your travel plans.
It’s also important to know that in pregnancy you are at slightly higher risk for developing a blood clot. And since most plane travel involves sitting in one place for long periods of time, your risk during travel can be even higher. I encourage patients who are planning any long trips (by plane or even by car) to avoid keeping their legs crossed for long periods of time and to make sure they are changing positions in their seat and/or getting up frequently to stretch their legs and get the blood flowing!
To avoid any extra stress towards the end of pregnancy, I typically recommend that my patients avoid flying around 34 weeks and beyond and instead choose trips that are close enough to home that they can just hop in the car if any issues arise.
Should I really be “eating for two”?
This is a myth! A pregnant woman actually only needs to be taking in 300-400 extra calories per day, slightly more if she is carrying more than one baby.
An acceptable weight gain in pregnancy is anywhere from 25-35 pounds. However, please know that if your BMI is higher than 30 the weight gain expectation might be considerably lower.
Many women have a hard time digesting the idea of gaining 35 pounds in 40 weeks so I like to remind my patients that much of their weight gain comes from the growing placenta (1-1 ½ lbs), the increase in blood volume (3-4lbs), amniotic fluid (2lbs), the enlargement of your uterus (2lbs), and of course the baby (6-8lbs)! So the weight gain is coming from very essential changes in your body that support your pregnancy. Also, don’t forget that much of the weight you gain in pregnancy may naturally be lost with the birth of your baby. Exercise (both during and after pregnancy) and breastfeeding can aid you in getting back to your pre-pregnancy weight as well.
Weight gain is something we evaluate at each prenatal visit; however, it’s important to remember that weight does fluctuate based on things like the clothes you are wearing, the time of day, which scale you are using and how close we are to the holidays. I also want to reassure women that if you lose a couple of pounds in the first trimester due to nausea and/or vomiting, you will likely get back on track as you start to feel a little better.
I want to be clear that aside from caloric intake, it is very important for women to be getting enough nutrients in pregnancy, so I do recommend a healthy, balanced diet as well as a daily prenatal vitamin including adequate amounts of folic acid.
Am I hurting myself – or my baby – if I don’t lie on my left side?
I have many patients who come in with their left sides literally sore because they forced themselves to sleep on that side all night long. The reality is that either side is fine, and if you happen to be lucky enough to sleep through the night, you may even spend some time on your back, and that, too, is probably fine. As your belly and baby grow, there is more weight from the uterus that rests on important blood vessels that bring blood and oxygen to the baby and to the placenta. But those vessels also supply blood to you and your brain. So, if you are on your back and that blood vessel gets compressed, you will likely be very uncomfortable and naturally want to change positions. If you wake up and find yourself on your back, this is actually a good sign that the system is working and your body was smart enough to bring you back to consciousness so that you turn over.
Some of my patients have been so concerned about needing to sleep on their left side that they have their spouses or other family members wake them up if they are lying on their back or their right side – please don’t do that! Getting a good night’s sleep is far more important.
Can’t I have some coffee, please?!
Yes, you can! The current recommendations from the March of Dimes is that women who are pregnant or are trying to become pregnant consume no more than 200mg of caffeine a day. So I often tell patients that as long as they keep their intake to a small cup of coffee or tea a day, there is no significant risk to their pregnancy.
Don’t forget that caffeine is also a stimulant so limit your consumption of caffeinated beverages to before 1 or 2pm so as not to disrupt good sleep patterns. Caffeine can also be a trigger for urinary frequency as it is a diuretic.
Is exercise safe?
I definitely recommend exercise in pregnancy. It keeps weight gain in check and is generally great for your physical and emotional well-being. It’s not a bad idea to start to exercise before you become pregnant so it is already a natural part of your daily regimen. Regular exercise can also help to keep your BMI in a normal range and this is especially important because being overweight can make it harder to become pregnant and increase the level of complications during pregnancy.
Walking, biking, swimming, yoga and even aerobic classes like Zumba or running (although that might start to be uncomfortable at some point in the 2nd trimester) are fine as long as you feel good while engaging in these activities. Instead of continuously monitoring your heart rate while you exercise, my advice is to listen to your body– if you are feeling dizzy, crampy, or very short of breath, it’s time to stop, sit down, have some water and maybe call it quits for the day.
Pregnancy isn’t a time to push yourself in a way that you might when you are not pregnant. It’s a time to honor the intelligence of your body and the messages about fatigue and dehydration that it might be sending.
You may be short of breath or uncomfortable during activities that you had no problems with when you were not pregnant, so as your pregnant body changes, you may need to modify your regimen somewhat. Joints and ligaments can soften and become less stable in pregnancy, so using good body mechanics is of utmost importance. I’d also recommend avoiding activities in which you have a high risk of falling or injuring your belly.
Are there restrictions on sex when you’re pregnant?
Generally speaking, no. If your pregnancy is normal, there’s no restriction during any trimester and intercourse will not hurt you or your baby. That being said, many women find intercourse uncomfortable at various points during their pregnancy and their interest in sex can wax and wane throughout each of the trimesters.
If you are bleeding, if your amniotic sac (bag of waters) has broken, or if you’ve been monitored for PTL, your doctor or midwife will likely be advising you to avoid intercourse and/or orgasm.
For some of my patients who have gone past their estimated due date, I often encourage couples to have intercourse as there is some evidence that it can help start the labor process. For instance, semen is a natural prostaglandin which can soften the cervix and sometimes even initiate contractions. Your body releases oxytocin during orgasm and this can also cause the uterus to start to contract and stimulate the labor process to begin.
I thought seafood was good for me, but I’ve heard I should avoid it when I’m pregnant.
Some shellfish are actually excellent sources of calcium, and other fish like salmon are rich in omega-3 fatty acids which is also good for you. Pregnant women should limit or avoid the high-mercury fish – shark, tilefish, mackerel and tuna. For the sushi lovers– moderation is okay. I do suggest you stick to reliable sushi restaurants that you have been to a number of times and that you trust. It’s a good idea to avoid those high-mercury fish listed above to be the safest. However, since the fish is raw, even fish like salmon has concerns of bacteria, so if you want sushi but are also a little nervous, stick to the veggie-only varieties.
Do I have to cut out alcohol?
The Surgeon General of the United States recommends complete abstinence from alcohol in pregnancy because a safe level of prenatal alcohol consumption has not been determined. It is clear, though, that rates of fetal alcohol syndrome or other alcohol related birth defects increase as levels of alcohol intake go up. All the more reason to keep any alcohol consumption in pregnancy to a minimum.
The first trimester is when significant fetal development takes place so this is the most important time to abstain. That said, don’t freak out if you think you went overboard with alcohol before you realized you were pregnant. And the reality is that many women are turned off by the smell or taste of alcohol in their 1st trimester, anyway.
I certainly don’t condone moderate or heavy drinking at ANY point during your pregnancy. However, if your best friend is getting married, please toast to them. Having half a glass of wine or a half a beer once or twice during your pregnancy on a special occasion will likely not have negative effects on your baby’s development in-utero or after he or she is born.
My co-workers keep telling me that because I am carrying low I’m probably having a boy. Is there any truth to that?
My patients ask me about these types of myths all the time! I’ve heard that if a woman has frequent heartburn, her baby will be born with a lot of hair. And many women comment that they are probably having a boy if the fetal heart rate is on the lower end of normal or a girl if the heart rate is higher. I’m sorry to say, though it can be fun to make guesses, I haven’t found any truth to these beliefs. So much of pregnancy is unpredictable so perhaps this is a way that women try to gain some sense of control over the situation.
I have to stick to a perfect diet in pregnancy with no exceptions, don’t I?
Pregnancy is a time of great excitement but it also comes with some challenges. Food can often provide us with joy and comfort, so I hate to have my patients restrict themselves to the extent that they lose all the enjoyment and pleasure that delicious food can offer. Instead, focus on making healthy choices on a daily basis and make exercise a weekly, if not daily, ritual. That way, if you indulge in one of your favorite, high-calorie foods once in a while (which is fine!!) your regular exercise routine will burn away any unneeded calories.
I recommend healthy, protein-rich foods like baked, grilled or broiled chicken or fish, rice and beans, eggs, yogurt and nuts. If women feel daunted by this or if they aren’t used to eating like this, they can think about having different colored fruits and vegetables on their dinner plate or maybe attempt to pick one new and healthy food to try each week.
It’s easier to make good food choices when you aren’t hypoglycemic (low blood sugar), so having a healthy snack in the late morning or before dinner might help in making better choices for your bigger meals of the day. Some pregnant women find it helpful to stash a healthy snack in their purse for times when they are on the go and dinner is a few hours away.
I advise women to take a daily prenatal vitamin if they are pregnant or trying to become pregnant and to include enough iron-rich foods in their diet to avoid anemia, a common problem during pregnancy.
I do not automatically recommend an iron supplement but we do routinely check for anemia just before the third trimester and, if indicated, pregnant women may be advised to take an additional supplement up until delivery.