The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Continuing to nurse likely is safe for you, your son and your baby in utero. A few caveats: Since breastfeeding burns calories and requires more fluids, you must eat and drink enough to stay well-hydrated and nourished and gain adequate weight. Also, breast stimulation in the last six weeks of pregnancy can lead to uterine contractions, so if there are concerns about preterm labor, your obstetrician may want you to stop nursing.
No one really knows. While there is no evidence that these supplements cause problems for a woman or her baby during pregnancy, there has not been enough scientific research to tell us with any certainty that they are safe.
As an obstetrician, I advise all my patients to eat a healthy, well-balanced diet and to avoid taking any medications or supplements that are not absolutely necessary during pregnancy. But since I'm not familiar with the specifics of your joint health, you'll need to speak directly with your doctor about this issue.
No. Many natural barriers in your body, including the cervix and amniotic sac, protect your baby from external substances such as chlorine in a pool or even soapy bath water. In fact, swimming is one of the most beneficial and comfortable forms of exercise you can do during pregnancy, as the water imparts a weightlessness that many women find soothing. That said, I recommend that you check with your doctor before beginning (or continuing) any exercise program.
I don't recommend using this product during pregnancy. Not enough studies have been done on salicylic acid (commonly known as aspirin) or hydroquinone to determine whether their topical use during pregnancy can harm a fetus. (Aspirin should never be taken orally during pregnancy because of potential risks to the fetus.) While not associated with risks to the fetus, the third ingredient, glycolic acid, can make your skin excessively dry, particularly during pregnancy. If acne continues to be a concern, speak with your doctor about a safe alternative to the cream you are using.
Walking is the perfect exercise for almost anyone at any time--especially pregnant women: It provides a cardiovascular workout without jarring or stressing your joints, ligaments, growing belly and breasts. In fact, it's so gentle that even sedentary women can start walking while pregnant. "Walking is fantastic for so many reasons, including the fact that most of us can walk with ease no matter how big we get," says Danielle Symons Downs, Ph.D., assistant professor of kinesiology and director of the exercise psychology laboratory at Pennsylvania State University.
If you're not having any complications, you can and should exercise every day for about 30 minutes, according to the American College of Obstetrics and Gynecology. You can exercise at a similar intensity to your prepregnancy level as long as you stay well-hydrated and avoid overheating. A good rule of thumb is to not increase intensity or duration beyond what you are used to doing so you don't overexert yourself. Stop immediately if you feel lightheaded or have contractions or bleeding. Using the "talk test" is an easy way to monitor your intensity while exercising.
"Scuba diving is a major no-no because of the oxygen considerations. With other activities, you need to weigh the benefits versus the potential risks," says Renee Jeffreys, M.S., an exercise physiologist in Cincinnati, and personal trainer with Fitness for Women (www.fitnessforwomenonline.com). After 15 weeks, the risks of falling and abdominal trauma become dangerous, so an aggressive game of basketball--where elbows are being thrown--wouldn't be a good idea.
It's better than OK: Swimming and other water-based activities are among the best things a pregnant woman can do for herself. Because you are suspended in water, the activity is easy on your joints and muscles, and you can maintain a fairly high level of intensity without straining, Downs says. Of course, you should feel comfortable in the water; if you're at all hesitant, use a flotation device and stay in the shallow end of the pool. Avoid water that's too hot or cold; a temperature between 80° F and 84° F is ideal.
Since the ligaments attached to your uterus are being stretched from all sides, don't be alarmed if you feel pulls and twinges in your groin, side or lower back while exercising or just going about your daily activities. It's also natural to feel more out of breath than usual--just back off the intensity a bit. But heed these warning signs: lightheadedness, contractions or cramping to the point of pain and bleeding. If you experience any of these, contact your doctor immediately.
"Strength training is not only safe, it is actually very important during pregnancy," Shashoua says. "Women who stay fit and strong during pregnancy are able to get through the 1 to 3 hours of pushing that is sometimes required to deliver a baby better than those who aren't as strong," he explains. "It also helps women feel better about themselves." Regardless of her strength-training experience, a pregnant woman may initiate or continue a program, Shashoua adds.
Even if you have no favorite exercise from your past to offer inspiration, there's no time like the present to get off the couch and integrate motion into your life. Start by taking a 15- to 30-minute walk each day. If this sounds daunting, do what you need to make it a more attractive proposition--enlist a friend to join you or listen to a book on tape. If it still doesn't appeal to you, try swimming--it's one of the most beneficial activities for pregnant women. Also consider taking a prenatal exercise or yoga class.
Pregnant women are at higher risk of suffering from pneumonia and other complications of the flu, so you are specifically encouraged to get the influenza vaccine (so are the elderly, health-care workers and people with compromised immune systems). Getting immunized also may help protect your baby: The antibodies generated by the vaccine cross the placenta, so it's likely that the baby will have some degree of protection following birth. Ask your doctor about thimerosal-free vaccines.
Overheating has been associated with pregnancy loss and birth defects, but using an electric blanket at a comfortable setting has not been shown to be unsafe for you or your baby. That said, if you were to become so warm that you perspired a great deal, you would be at risk for dehydration. To avoid any risks, the American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women use their electric blankets to heat up their beds prior to bedtime, then turn them off when sleeping, to avoid any risk of overheating.