Pre-Conception and Early Pregnancy - NHS Wales



Pre-Conception and Early Pregnancy

Diet

DO – eat a healthy diet with plenty of protein such as meat, fish, nuts, etc.. Eat plenty of vegetables rich in the vitamin folic acid (foliate) such as brussel sprouts, spinach, broccoli, green beans, potatoes, fortified cereals.

DON’T – eat liver during pregnancy. Although a healthy food in lots of ways, it contains too much Vitamin A which can cause problems in pregnancy.

DON’T – eat food which may have high levels of listeria. This bacteria (bug0 doesn’t cause problems in people who are not pregnant. However, pregnant women are more likely to catch it, and it sometimes causes miscarriage, stillbirth or infections in the baby after birth. Foods which are most at risk of carrying listeria are:

• Cooled/chilled foods like pre-cooked meats and pre-prepared meals bought from supermarkets or delicatessens.

• Soft veined cheeses such as brie or camembert. (Hard cheeses and processed cottage cheese are safe.)

• Pates

DON’T – ‘eat for two’ and overeat. Excess weight gain will increase the risk of problems later on in the pregnancy and is always difficult to lose after the birth. Avoid sugary, starchy foods, cakes and eating between meals. If you have an increase in appetite then some of the less fattening foods like fruit and vegetables are best.

Folic Acid

You should take extra folic acid for at least the first 12 weeks of pregnancy – even if you are healthy and have a good diet. If you take folic acid in early pregnancy you have less chance of having a baby born with a spinal cord problem such as spina bifida.

It is best to start taking the folic acid before becoming pregnant. If the pregnancy is unplanned then start taking folic acid as soon as you know you are pregnant. The recommended dose is small (400 micrograms or 0.4mg a day). You can buy folic acid tablets at most health food shops or pharmacies. The recommended dose is higher (5mg daily) if you already have a baby with a spinal cord problem, or if you are taking medicines for epilepsy.

Smoking

Tobacco smoke contains poisonous chemicals which pass into the baby’s blood and can slow its growth. The risks of having a miscarriage, premature birth or stillbirth are higher if you smoke. For many women, pregnancy is a good incentive to stop smoking, and is often a good time to persuade partners to give up too. Cutting down smoking is a good start. But, it has been shown that smokers who cut down tend to inhale more deeply and take more puffs resulting in the same amount of chemicals getting to the baby. So, it is best to stop completely.

Even after the birth, children of smoking parents are more likely to develop chest infections, asthma, and ‘glue ear’. Sudden infant death syndrome (cot death) is also more common in babies who have parents who smoke.

Alcohol

The amount of alcohol that is safe in pregnancy is not known. So, many women have little or no alcohol when they are pregnant.

Street Drugs

The effects of many drugs on pregnancy have not been fully studied, but it is safe to assume that it is best to stop taking any illegal or ‘street’ drugs. See your doctor for help if necessary.

Medication

The effects of some prescribed medicines have been studied very thoroughly and it is known that certain medicines are safe in pregnancy. For example, paracetamol is safe to take and useful for headaches and other aches and pains that occur during pregnancy such as backache. However, some medicines are not safe and they may affect the development of the baby, particularly if you take them in the early weeks of pregnancy.

Therefore, always tell a doctor or dentist who prescribes medicine for you that you are pregnant or intend to become pregnant. Also, don’t take remedies that you buy at the pharmacy unless they are known to be safe in pregnancy. The pharmacist will advise.

If you already take regular medication for example for epilepsy, ideally you should discuss this with a doctor before becoming pregnant. If you have an unplanned pregnancy, discuss medication with your doctor as early as possible.

Animals

Avoid contact with sheep and lambs at lambing time. This is because some lambs are born infected with the bugs that cause listeriosis, toxoplasmosis and Chlamydia. These may be passed on to you and your unborn baby. See below about cats and kittens.

Infections

Rubella (German Measles)

The rubella virus causes a mild illness in an adult but can seriously damage an unborn baby, especially in the early stages of growth. A routine blood test early in pregnancy is usually done to check if you are immune to rubella.

Most women are immune due to previous infection or immunisation as a child. However, immunisation is not 100% effective. So, if you plan to become pregnant for the first time you should check to see if you are immune becoming pregnant. See your practice nurse for a ‘pre-pregnancy’ check. If you are not immune you can be immunised. You should not become pregnant for 1 month after the injection and ideally not until your immunity has been confirmed by a further blood test.

Unless you know you are immune to rubella you should avoid anyone who has rubella, especially in the first 12 weeks of pregnancy.

Other virus infections

Most virus infections that you may get (such as coughs and colds) have no harmful effect on an unborn baby. However, certain viruses can occasionally affect the baby during pregnancy. For example chicken pox.

So, unless you know you are immune it is best to avoid any person with an infectious illness until they are better.

Toxoplasmosis

This bug is commonly found in raw meat and cat faeces. It can sometimes affect an unborn baby. To avoid it:

• Do not eat raw or undercooked meat.

• Wash your hands thoroughly after handling raw meat.

• Wash your hands after handling cats and kittens.

• If possible, get someone else to clean out any cat litter trays when you are pregnant.

• Always wear gloves when gardening.

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