You should take folic acid tablets for at least the first 12 weeks of pregnancy – even if you are healthy and have a good diet. Folic acid is a vitamin which occurs naturally in certain foods. However, you need a good supply of folic acid when you are pregnant. If you take folic acid tablets in early pregnancy you reduce the risk of having a baby born with a spinal cord problem such as spina bifida. You can buy folic acid tablets from pharmacies.
Advice from the the HSE is that you should not drink at all if you are pregnant or trying to become pregnant. It is known that if you drink heavily you have an increased risk of miscarriage, and it may cause serious harm to the baby’s growth and brain development. A condition called fetal alcohol syndrome develops in some babies born to mothers who drink heavily. A baby with this syndrome can have severe physical and mental problems.
However, the exact amount of alcohol that is safe during pregnancy is not known. This is why the advice is not to drink at all. If you do chose to drink when pregnant then limit it to one or two units, once or twice a week. And never get drunk. If you find it difficult to cut down or stop drinking alcohol, then seek advice and help from your practice nurse or GP.
If you smoke, you are strongly advised to stop smoking before getting pregnant. Tobacco smoke contains poisonous chemicals which pass into the baby’s blood and can slow the baby’s growth. The risk of having a miscarriage, premature birth, or stillbirth are higher if you smoke. Babies born to mothers who smoked when pregnant also have an increased risk of developing attention deficit hyperactivity disorder (ADHD) when they are older. Also, after the birth, children of smoking parents have an increased risk of developing chest infections, asthma, ‘glue ear’ and sudden infant death syndrome (cot death).
For many women who smoke, planning to become pregnant is a good incentive to stop smoking. It is often a good time to persuade partners to give up too. If you find it difficult to stop smoking then seek advice and help from your practice nurse, GP, or pharmacist.
Eat a healthy balanced diet
Aim to eat a ‘healthy diet’ (which everyone should be eating!) Briefly, the bulk of most meals should be starch-based foods (such as bread, cereals, potatoes, rice, and pasta), with fruit and vegetables. Eat protein foods such as meat, fish, pulses, chicken, etc, in moderation.
Don’t ‘eat for two’ and over-eat when you become pregnant. Too much weight gain increases your risk of developing problems later in the pregnancy. Also, extra weight is difficult to lose after the birth. If you are already obese or overweight, try to lose some weight before becoming pregnant to reduce the risk of pregnancy complications.
Include foods with plenty of iron, calcium and folic acid
A growing baby needs these nutrients right from the start of the pregnancy.
Foods and drinks to avoid
You should not eat the following if you are pregnant or trying to become pregnant.
Avoid contact with sheep and lambs at lambing time. This is because some lambs are born carrying the germs that cause listeriosis, toxoplasmosis and chlamydia. These may be passed on to you and your unborn baby. See below about cats and kittens.
The effects of some prescribed drugs have been well studied and it is known that certain drugs are safe in pregnancy. For example, paracetamol at normal dose is safe and useful for headaches, backache and other aches and pains that may occur during pregnancy. However, some drugs are not safe, and may be harmful to a developing baby, particularly if you take them in the early weeks of pregnancy.
Therefore, always tell a doctor or dentist who prescribes you medication that you are pregnant, or intend to become pregnant. Also, don’t take drugs that you can buy (including herbal remedies) unless they are known to be safe in pregnancy. The pharmacist will advise.
If you already take regular medication, (for example, for epilepsy), it is important to discuss this with a doctor before becoming pregnant. If you have an unplanned pregnancy, discuss any medication that you take with your doctor as soon as possible.
Rubella (German Measles)
If you plan to become pregnant for the first time, you should check that you are immune to rubella before becoming pregnant. See your practice nurse for a ‘pre-pregnancy’ blood test. Most women are immune to rubella as they have been immunised as a child. However, childhood immunisation does not work in every child and you may not be immune. If you are not immune, you can be immunised.
Note: you should not become pregnant for one month after the injection, and ideally until your immunity has been confirmed by a further blood test.
The rubella virus causes a mild illness, but can seriously damage an unborn baby, especially in the early stages of growth. So, until you know that you are immune (from the result of the blood test), you should avoid anyone who has rubella, especially in the first 16 weeks of pregnancy.
This germ is commonly found in raw meat, sheep, lambs and cat faeces. It can sometimes cause serious harm to an unborn baby. To avoid it:
Having chickenpox when pregnant can be a nasty illness, and there is some risk to the developing baby. A vaccine is offered to healthcare workers (doctors, nurses, etc) who have not previously had chickenpox and so are not immune and may catch chickenpox. (About 1 in 10 adults have not had chickenpox as a child.) Therefore, non-immune healthcare workers should consider having this vaccination before getting pregnant.
If you are not sure if you have had chickenpox, a blood test can check if you have previously had it.
A mother who is infected with hepatitis B has a high risk of passing it on to her new-born baby. If you are at high risk of catching hepatitis B you should be immunised against this virus before becoming pregnant. You are at increased risk and should be immunised if:
Screening blood tests
Ideally, you should have a blood test before you become pregnant to screen for hepatitis B, syphilis, and HIV. Ask your practice nurse for a ‘pre-pregnancy’ blood test.
Consider your working environment
If you think that your occupation may pose a risk to a pregnancy, then ideally you should discuss this with your employer before becoming pregnant. For example, if you work with chemicals, fumes, solvents, etc, which may pose a risk, or if you work with animals such as cats or sheep which may be carrying germs
Women with certain medical conditions may benefit from other advice before becoming pregnant. See your doctor if you have concerns about a medical condition which may affect pregnancy. For example:
Most pregnancies go well and without any major problems. But it is wise to reduce any risks as much as possible. So, a reminder of things to consider before becoming pregnant, or as soon as you realise that you are pregnant …
Sexually transmitted infections are common. Remember any sexually active person may be exposed to a sexually transmitted infection. If you suspect you have an infection get it checked out as soon as possible. Most treatments are simple and painless and you do not have to be admitted to hospital. Treatment is confidential, non judgmental and free. The staff in the clinic are trained to treat sexually transmitted infections in an understanding and helpful way so there is no need for you to feel embarrassed. If you are pregnant and think you may have picked up a sexually transmitted infection it is particularly important to get it checked out and treated as soon as possible.