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Month 4

Alcohol Use

Alcohol can hurt your baby’s brain. Your baby’s brain grows and changes the whole time you are pregnant. Protect him and his brain by avoiding alcohol.

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Drinking alcohol when you are pregnant can hurt your baby.

Alcohol is a teratogen. A teratogen can cause a disability. A teratogen harms your baby before she is born.

Your baby is joined to you by your umbilical cord and placenta. The umbilical cord and placenta help move food, water, and oxygen from you to your baby. Anything that goes into your blood goes to your baby. This includes alcohol. Your baby’s body takes longer to get rid of alcohol than your body does. This makes alcohol affect the baby longer.

Drinking alcohol when you are pregnant can cause Fetal Alcohol Spectrum Disorder (FASD). FASD affects a baby for his whole life. You may not notice FASD until your child is in school.

Alcohol can affect the brain, spinal cord, and organs (e.g., heart) of your baby. It can cause many disabilities.

It can affect:
  • his size
  • how he learns
  • what he remembers
  • how he pays attention
  • how he fixes problems
  • how he gets along with other people
  • how he feels about himself
  • how he sees
  • how he hears

Alcohol can hurt your baby at any time while you are pregnant. It is healthier for your baby if you don’t drink while you are pregnant. If you stop drinking alcohol or cut down, your baby has a better chance to be born healthy.

It is never too late to stop drinking.

Do you want to stop drinking? Talk to your healthcare providers. There are people who can help and support you. Call HealthLine at 811 and speak to an Addictions/Mental Health Counsellor. This is free and open 24 hours a day. You can also visit HealthLine Online.

It is not easy to stop drinking alcohol. Drinking alcohol is common. It can be hard to tell people that you don’t want to drink. Look for friends who can help you. You can be the designated driver. Your partner may stop drinking to support you.

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Complications

See your healthcare providers as soon as you can if you have heavy bleeding. This can be a sign that there is a problem. You can also call Health Line (811) for support and information.

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If you are experiencing any of the following symptoms, contact your healthcare providers or Health Line (811) for support and information.

Bleeding

It is normal to have spotting during pregnancy. Heavy bleeding might be a symptom of:
  • abruptio placenta
  • cervical incompetence (Delisle,M., Brown., & Gagnon, R.,2013)
  • miscarriage
  • placenta previa
  • premature labour

Abruptio placenta usually happens after the 20th week of pregnancy. Abruptio placenta happens when the placenta separates from the wall of the uterus too early. It can cause bleeding. Your baby may have problems getting enough oxygen and nutrients he needs to grow. Abruptio placenta can cause problems during labour. It can cause your baby to be born dead.

Cervical incompetence happens when your cervix starts opening before your 9th month of pregnancy. This can cause premature birth or miscarriage.

Miscarriage means that your baby has died inside of you. You will still need to deliver your baby or you can get very sick.

Placenta previa is about the placement of the placenta in the uterus. Usually the placenta attaches to the top part of the uterus. When it attaches to the bottom of the uterus, it is called placenta previa. This can cause the placenta to cover the birth canal. It can also cause bleeding and complications during labour. Placenta previa can cause the mother to die.

Premature labour is labour that starts before your 37th week of pregnancy.

Chronic Disease Symptoms

Diabetes

Your blood sugar levels may change during pregnancy. Monitor your sugar levels carefully. See your healthcare providers, including your dietician, if you need help staying healthy.

Insulin is not harmful to your baby. It is safe whether you are using a pump, needles, or pills.

Diabetes increases your risk of having a big baby. This can make it harder to deliver your baby. You may need to have an induced labour or a caesarean section. Diabetes can also increase the risk of your baby dying before she is born.

Epilepsy

Pregnancy may increase the number of seizures you have. It might also make the seizures more severe. Severe seizures may be fatal for you and your baby.

Seizures during labour and delivery may be harmful to you and your baby. Work with your healthcare providers to create a delivery plan.

Keep taking your epilepsy medications and follow the advice of your healthcare provider. Your medications may be changed.

Asthma

If you have asthma, you may see an increase in your symptoms during your pregnancy. Work with your healthcare providers to make sure your asthma is under control. It is safe to use asthma medication during pregnancy. Avoid smoke; it may make your asthma worse.

If your asthma cannot be controlled, it may increase the risk that your baby will be born underweight.

A common symptom of pregnancy is acid reflux. This can cause heartburn. Acid reflux can make asthma worse.

Many chronic diseases, like diabetes, epilepsy, and asthma, can get worse during pregnancy. If your symptoms are not controlled by your medication, call your healthcare providers.

Fever

Fevers are signs of infections. Infections during pregnancy can affect the way your baby grows and develops.

Headache

Headaches during pregnancy can be a symptom of pre-eclampsia. Pre-eclampsia is a complication that usually occurs after the 20th week of pregnancy. Symptoms are headaches, high blood pressure, swelling in your feet or hands, vision problems, and protein in your urine (pee). If you smoke and get pre-eclampsia, you can have more complications than if you don’t smoke. If left untreated, pre-eclampsia can be very dangerous for you and your baby.

High Blood Pressure

High blood pressure can be a symptom of pre-eclampsia. Pre-eclampsia is a complication that usually occurs after the 20th week of pregnancy. Symptoms are headaches, high blood pressure, swelling in your feet or hands, vision problems, and protein in your urine (pee). If you smoke and get pre-eclampsia, you can have more complications than if you don’t smoke. If left untreated, pre-eclampsia can be very dangerous for you and your baby.

Premature Labour

If labour starts before your 37th week of pregnancy, you may show these symptoms:
  • Contractions
  • Vaginal pressure
  • Frequent urination
  • Diarrhea
  • Tightness in lower stomach

Protein in Urine (pee)

Protein in urine can be a symptom of pre-eclampsia. Pre-eclampsia is a complication that usually occurs after the 20th week of pregnancy. Symptoms are headaches, high blood pressure, swelling in your feet or hands, vision problems, and protein in your urine (pee). If you smoke and get pre-eclampsia, you can have more complications than if you don’t smoke. If left untreated, pre-eclampsia can be very dangerous for you and your baby.

Swelling in Feet or Hands

Some swelling of the feet and hands is normal during pregnancy. If it does not decrease or becomes uncomfortable, this can be a concern. Swelling can be a symptom of pre-eclampsia. Pre-eclampsia is a complication that usually occurs after the 20th week of pregnancy. Symptoms are headaches, high blood pressure, swelling in your feet or hands, vision problems, and protein in your urine (pee). If you smoke and get pre-eclampsia, you can have more complications than if you don’t smoke. If left untreated, pre-eclampsia can be very dangerous for you and your baby.

Vision Problems

Loss of vision or dots in vision can be symptoms of pre-eclampsia. Pre-eclampsia is a complication that usually occurs after the 20th week of pregnancy. Symptoms are headaches, high blood pressure, swelling in your feet or hands, vision problems, and protein in your urine (pee). If you smoke and get pre-eclampsia, you can have more complications than if you don’t smoke. If left untreated, pre-eclampsia can be very dangerous for you and your baby.

Vaginal Discharge and Itchiness

Some vaginal discharge is normal during pregnancy. Heavy discharge and itching may be a sign of an infection. Ask your healthcare providers to be tested for sexually transmitted infections (STIs). Many of these infections can be treated during pregnancy. If left untreated, some sexually transmitted infections can be harmful to your baby.

Vaginal discharge might also be a sign of cervical incompetence. This happens when your cervix starts opening before your 9th month of pregnancy.

Heavy discharge can be a sign of premature labour.

If your discharge is clear and a lot of liquid is coming out, your amniotic sac’s membranes may have broken early. This is also known as your water breaking. This should not happen until you are in labour. If it happens early, it is called Preterm Premature Rupture of Membranes (PPROM). It can cause infections that can hurt both you and your baby.

Vomiting and Nausea

It is normal to feel sick and vomit during pregnancy. If you haven’t been able to eat or drink in the last 12 hours, contact your healthcare providers. There is medication that can help control severe vomiting during pregnancy.

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Growth of Your Baby

Your baby can hear your voice. Talk and sing to your baby.

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During your ultrasound, you may be able to find out if your baby is a girl or a boy. It is your choice if you want to find out.

Your baby’s bones continue to grow bigger and stronger.

Your baby’s hair begins to grow.

Your baby’s fingernails and toenails are growing.

Your baby’s first teeth have formed below the gum line.

Your baby’s brain has been growing throughout your whole pregnancy.

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Healthcare Provider

Your healthcare providers are there to help. Make a list of questions to bring with you to your next appointment.

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Find healthcare providers to give you and your baby the care that you need. Healthcare providers can be doctors, midwives, or nurse practitioners. Midwives are available in some Saskatchewan health regions. Midwives are experts in normal pregnancy, birth, and newborn care. They can provide support, monitoring, and assessment throughout your pregnancy, labour, and delivery, including performing invasive procedures and prescribing medications. For low risk pregnancies, midwives are trained to help women deliver their babies at the hospital as well as at home. For more information about midwives, click here.

Doulas can support you as well. However, they are not healthcare providers. If you have a doula, you also need to see a healthcare provider.

During your first visit, your healthcare provider will:
  • ask about your health
  • ask about your lifestyle
  • talk about having a healthy baby
  • offer to do medical tests
  • find out your due date

A healthcare provider can also answer your questions. Before you visit a healthcare provider, write down your questions. Ask these questions during your visit. Take your time and ask as many questions as you need to.

  • Do you provide care for pregnant women?
  • Will I be able to be your patient through my whole pregnancy?
  • Will you be available for the birth of my baby?
  • Where can I give birth to my baby?
  • Can I visit the place I will be giving birth before my due date?
  • What support can you give to me during my pregnancy?
  • How can I make sure I am getting the right foods for me and my baby?
  • Can I still exercise while pregnant?
  • Should I change any of my medications?
  • Will any illnesses I have now affect my pregnancy or baby?
  • Why should I take prenatal vitamins? Where can I get them?
  • How much weight should I gain during pregnancy?
  • How can I find support to stop smoking?
  • How can I find support to stop drinking?
  • How can I find support to stop using street drugs?

Medications

Some medications, even herbal products, can harm your baby. Talk to your healthcare providers, pharmacist, medSask, or MOTHERISK at 1-877-439-2744. These experts will help you make healthy choices.

Acetaminophen (e.g., Tylenol) is safe during pregnancy for short-term use. It is not recommended for long periods of time. Ibuprofen (e.g., Advil) is not safe in the first or third trimester. For more information, talk to your healthcare provider or pharmacist.

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You may be taking prescribed medication. You may be taking vitamins or medicine you buy at a drug store, like pain relievers or antacids. You may also be taking herbal products.

Some of these products are safe to take when you are pregnant. Some are not. Ask your healthcare providers or pharmacist which ones are safe. You may need to take something different during your pregnancy.

If you get a cold during pregnancy, check before taking any medication. Some cold medications are not safe to use during pregnancy. You can ask you healthcare provider or pharmacist for more information.

You can contact MOTHERISK at 1-877-439-2744 for more information or medSask These experts will help you make healthy choices.

Herbal Products

Some herbal products are taken in strong (concentrated) amounts. They are not used the same way you use herbs for cooking. Some of these may cause birth defects and early labour. More research is needed to know how dangerous certain products are. Discuss the use of herbal products with your healthcare providers before beginning or continuing use.

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Medical Tests

An ultrasound can tell your due date and the size of your baby. It can also tell you how well the baby’s heart and other organs are working and growing.

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A healthcare provider will need to do some tests when you are pregnant. These tests check the health of you and your baby. They are safe for both of you.

Tests this month include:
  • glucose screening
  • physical exam
  • blood tests
  • a urine test
  • electronic fetal heart monitoring
  • special testing
  • ultrasound

Each time you see a healthcare provider, your blood pressure and your weight will be checked. It is important to be weighed because gaining too much or too little weight can hurt your baby. Your healthcare professional may ask you to take your blood pressure outside of your regular prenatal visits. This can be done at home if you have a blood pressure machine. This can also be done at a pharmacy or drug store if they have a blood pressure machine for public use.

Special tests can also be done to see if your child has certain conditions. These tests do not tell you if your child has a condition. They will tell you if your child has a chance of having a condition. These tests are optional. You do not have to have them done.

Some medical tests, like some X-rays, are not safe during pregnancy. Always tell healthcare providers that you are pregnant.

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Healthy Families BC: Check Ups and Tests during Pregnancy

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Electronic Fetal Heart Monitoring

Fetal heart monitoring is a simple test that is used to listen to your baby’s heart beats. Your baby’s heart rate is a good way to tell whether your baby is doing well or may have some problems. During the test, a probe is passed over your belly until you and the healthcare provider can hear your baby’s heart rate. The probe is then held in place to listen. The healthcare provider will assess the baby’s heart rate.

Human Immunodeficiency Virus (HIV) Testing

HIV is a virus that damages the immune system and can lead to AIDS. People can live a healthy, long life being HIV positive if they get treatment and care.

HIV can be passed from mother to baby during pregnancy, delivery, or after birth.

Mothers living with HIV can pass the virus to their babies in three ways.
  1. The placenta joins the mother and baby. Food and oxygen reach baby through the placenta. HIV can pass through the placenta from the mother to baby.
  2. The baby can come into contact with his mother’s blood while being born.
  3. HIV is found in breast milk. The virus can be passed to the baby during breastfeeding.

HIV testing is part of your prenatal blood tests. You can refuse the test. However, HIV does not discriminate. If you have had sex, you are at risk. If your healthcare provider does not offer the test, you can ask for it.

If a mother with HIV gets good medical care and treatment, there is less than a 2% chance of passing HIV onto a baby. A mother with HIV can have a healthy baby.

If you are HIV positive, you can stay healthy when you are pregnant.
  • Find a healthcare provider who knows about HIV and pregnancy.
  • Follow the advice of your healthcare provider.
  • Stay on all medications given to you.

One of the ways that HIV can be passed from you to your baby is through breast milk. If you are HIV positive, it is recommended that you do not breastfeed. It is not recommended that another woman breastfeed your baby.

Free formula is available in Saskatchewan for women living with HIV. You can call the numbers listed below to ask questions about the Saskatchewan Infant Formula program.

  • Prince Albert: 306-765-6535
  • Regina: 306-766-3915
  • Saskatoon: 306-665-1477

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Physical Exam

A pelvic exam may be done. During a pelvic exam, the healthcare provider will examine your vagina, uterus, and ovaries. This can help confirm you are pregnant.

Your healthcare provider may do a pap test. A swab will be used to scrape cells from your cervix. A pap test checks the health of your cervix and vagina.

Your healthcare provider will check your blood pressure at each visit during your pregnancy.

Special Testing

There are two types of genetic tests: screening and diagnostic. These tests look at the chance that your baby may have a certain condition, like Down syndrome or spina bifida. Both types of tests are optional. You do not have to have them. If you want more information, talk to your healthcare providers about these tests.

Screening Tests

These tests do not tell you for sure if your baby has a condition. These tests tell you whether your baby has an increased risk of having a condition. Screening helps you decide if you want to do further testing.

If your screening results show that there is an increased risk that your baby may have a condition, you may want to have a diagnostic test to know for sure. Diagnostic tests are more exact than screening tests. They can diagnose a condition.

There are a lot of questions to ask yourself before you choose genetic screening.
  • How do I feel about having my baby screened for a condition?
  • Will the results change my feelings about my pregnancy?
  • Will I want to continue with diagnostic testing?
  • If I have a diagnostic test that tells me my baby has a condition, will I want to continue the pregnancy?
  • Will the results of the tests help me prepare for the future?

Prenatal Maternal Serum Screening

Prenatal Maternal Serum Screening is a blood test. This test is done between the 11th and 20th week of pregnancy. It is usually done more than once.

There is no risk to you or your baby.

The cost of this test is covered by Ministry of Health, Government of Saskatchewan.

Nuchal Translucency Measurement

Nuchal Translucency Measurement is a type of ultrasound. It measures the clear (translucent) fluid in the tissue at the back of your baby’s neck. Babies with certain conditions have lots of fluid in the back of their necks.

This test is done between 11th and 14th weeks of pregnancy.

There is no risk to you or your baby.

The cost of this test is covered by Ministry of Health, Government of Saskatchewan.

Non-Invasive Prenatal Test

Non-Invasive Prenatal Test is a more accurate screening test than Prenatal Maternal Serum Screening and Nuchal Translucency Measurement.

When you are pregnant, your blood has your baby’s DNA in it. DNA carries genetic information. Our genes give instructions to our bodies about how to develop. This test analyzes your baby’s DNA that is found in a sample of your blood.

This test is done at 10th weeks or later. You will have blood taken from your arm just like a regular blood test.

The test costs about $800.00 and is not covered by Ministry of Health, Government of Saskatchewan.

There is no risk to you or your baby.

The screening tests are Prenatal Maternal Serum Screening, Nuchal Translucency Measurement, and Non-Invasive Prenatal Test. You can have all three tests.

Diagnostic Tests

If your screening results show that there is an increased risk of your baby having a condition, you may want to know for sure.

The diagnostic tests you can have are Amniocentesis and Chorionic Villus Sampling (CVS). These tests look for chromosome abnormalities found in conditions such as Down syndrome.

Chromosomes are the structures in our bodies that hold our genes. Genes give instructions to our bodies about how to develop. We have 46 chromosomes that form into 23 pairs. There are several ways that chromosome abnormalities can occur. For example, abnormalities can occur when there are more than 23 pairs or less than 23 pairs. Abnormalities can also occur if there is a pair that has 3 instead of 2 chromosomes.

Chorionic Villus Sampling

CVS is done between 11th and 14th weeks of pregnancy. A thin needle is passed through the abdomen or cervix into the placenta. A sample of your placenta is taken to be tested.

There is a small chance of miscarriage after this test.

This test is not currently offered in Saskatchewan. If you wish to have this test, you have to travel to either Edmonton or Calgary.

The cost of this procedure and genetic testing is covered by Ministry of Health, Government of Saskatchewan.

Amniocentesis

An amniocentesis looks for chromosomal abnormalities. This test is done between 15th and 18th weeks of pregnancy. A needle is passed through the abdomen and uterus into the amniotic sac. A small amount of fluid is removed from the amniotic sac and tested.

There is a small chance of miscarriage after this test.

The cost of this procedure and genetic testing is covered by Ministry of Health, Government of Saskatchewan.

Both Chorionic Villus Sampling and Amniocentesis will give you the same results. Only one test is needed.

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Prenatal Glucose Testing

Your doctor will check the amount of glucose you have in your blood. If you have a high amount of glucose, you may have gestational diabetes.

Gestational diabetes is a type of diabetes that can happen during pregnancy. It occurs because your body is not able to make enough insulin to control the amount of sugar in your blood. This makes your blood sugar level high.

If you have gestational diabetes, the following are risks for your baby.

  • High birth weight
  • Increased change of having a Caesarean Section (C-Section)
  • Low levels of blood sugar
  • High risk of developing diabetes in his lifetime.”

If you have gestational diabetes, your doctor will want to continue to monitor your glucose levels after pregnancy. For most women, these levels return to normal. However, some women will require ongoing medical care.

Urine Test

During a urine test, a sample of urine (pee) is taken. Follow the instructions of the medical professional. A urine test is done to check for a urinary tract infection, diabetes, and high blood pressure. These conditions can all occur during pregnancy.

Ultrasound

The purpose of an ultrasound is to see if your baby is growing and developing normally. The technician will put gel on your stomach and run a probe over it. The probe sends sound waves that will bounce off your baby and form a picture. An ultrasound cannot hurt you or your baby.

The first ultrasound is usually done in the fourth month. This ultrasound can determine your due date and tell you if you are carrying more than one baby.

In the first trimester, your doctor may want to get an ultrasound to see if there are any problems with your pregnancy. Some common reasons for an early ultrasound are if you have pain in your stomach or pelvic area, or if you are bleeding. This early in pregnancy, your baby may be too small to see clearly using ultrasound. You will be asked to lie on your back with your knees bent. A probe covered with gel will be placed in your vagina. The probe sends sound waves through your vaginal wall. These bounce off the baby and form a picture.

Mental Health and Support

When you are pregnant, you will have many feelings. Your family, friends, and partner can support your mental health. Talk to them about what you need.

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Your feelings and moods may change quickly during pregnancy. This is normal.Some people have depression during pregnancy.

Talk to someone you trust about the way you feel. A friend, family member, or partner can support you.

When to talk to your healthcare provider
  • You feel down, sad, or worried for longer than seven days.
  • The things that used to make you happy don’t make you happy anymore.

Click here for information about maternal mental health.

Maternal Mental Health

Having a baby is often a time of joy and excitement for a new mother, but this is not the case for all women. 1 in 5 women experience mental health concerns during or after pregnancy. Do not to be ashamed if you experience mental health concerns. There is help available.

Learn about maternal mental health. Talk to your family and friends about the symptoms to watch for. They might be the first to recognize your symptoms. It is important to get help as soon as possible. Contact your regional mental health office.

For more information about mental health services in Saskatchewan, please contact Government of Saskatchewan, Community Care Branch, (306) 787-7239 or info@health.gov.sk.ca
Having several of the following symptoms for more than two weeks could mean you have a mental health concern
  • Have less interest in normal activities.
  • Cry for no reason.
  • Feel grumpy, angry, or sensitive.
  • Feel more tired than usual.
  • Have more energy than usual.
  • Have problems sleeping or sleep too much.
  • Have problems concentrating.
  • Have difficulty coping.
  • Feel anxious or panicked.
  • Think about hurting yourself, your baby, or others.
  • See things or hear voices.
Maternal mental health concerns can be serious. They affect the health of the mother, baby, and others around them. Maternal mental health concerns will not go away by themselves. Get help as soon as possible.

Past Mental Health Concerns

If you have had mental health concerns in the past, tell your healthcare provider. You may be at risk of developing further mental health concerns during and after pregnancy. Your healthcare provider can help you. He may refer you to someone who can meet with you and support you.

Don’t be afraid to talk to your healthcare provider. Mental health concerns are normal. Your healthcare provider will help you develop a plan to spot early warning signs. The earlier you are treated, the faster you will recover.

If you are on medication for mental health concerns, do not stop taking it. Talk to your healthcare provider. She may need to switch you to a medication that is safer in pregnancy or change your dose.

  • Talk with you about your feelings.
  • Celebrate your pregnancy with you.
  • Massage sore and stiff areas of your body (back, legs, feet).
  • Exercise with you.
  • Help you avoid drugs and alcohol.
  • Help you eat healthy foods.
  • Attend doctor and other medical appointments with you.

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Nutrition

Eating healthy foods is always important. Add another healthy snack to your day. This will help your baby get the nutrition she needs.

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Eating healthy foods will help your baby grow and keeps you and your baby healthy.

Healthy foods include:
  • vegetables and fruit (broccoli, bananas, apples, carrots, berries)
  • grain products (whole wheat bread, cereal, pasta, muffins)
  • milk products and alternatives (milk, cheese, yogurt, soy milk)
  • meat and alternatives (beans, lentils, eggs, fish, chicken)

Are you craving certain foods? It is fine to feed your food cravings, but try to eat small amounts if the food you are craving is unhealthy. If you crave something salty, instead of potato chips, try popcorn. Top it with a bit of butter and salt. Try fruit to satisfy your sweet tooth.

Are you low on money? If you are having problems buying enough food to eat well, there may be help. Talk to your healthcare provider or social worker. Some communities have programs to help pregnant women.

Now that you are in your second trimester, you will need to add about 340 calories to your diet every day. Two of Canada Food Guide serving equal approximately 340 calories. Some examples of a 340 calorie snack are:

  • 1 cup plain yoghurt with ¾ cup berries and ½ cup granola
  • 1 ½ cup bran cereal with 1 cup of skim milk and an apple

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Folic Acid (Folate)

Folic acid and folate are important for your baby’s brain and spinal cord to grow right. Getting enough folic acid and/or folate decreases the chance that your baby will be born with a disability. Folate is found in food such as:

  • dark green, leafy vegetables (spinach, broccoli, asparagus, brussel sprouts)
  • citrus fruit (oranges)
  • whole grains (lentils, chickpeas, fortified breads and grains)

When pregnant, it is hard to get enough folate from eating foods alone. Folic acid is the synthetic form of folate found in supplements such as prenatal vitamins. In addition to eating the foods above, it is important to take a multivitamin containing folic acid every day.

Try to eat foods with folic acid:
  • before you are pregnant (ideally 3 months before getting pregnant)
  • while you are pregnant
  • while you are breastfeeding your baby
All pregnant women do not need the same amount of folic acid. Talk with your healthcare provider about how much folic acid you should be taking.

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Food Safety

Food poisoning can be harmful to you and your baby. To protect you and your baby, some foods should be avoided. Other foods need to be cooked until steaming.

Foods to cook or heat until steaming
  • Eggs: Cook until the yolk is firm. Cake batter, cookie dough, or other items with raw eggs should not be eaten until cooked.
  • Fish: Fish is good to eat. Eat fish every week to help your baby grow. Make sure the fish is cooked. Do not eat raw fish. Some fish have high levels of chemicals that can hurt you.
    • Safe fish
      • white fish
      • salmon
      • rainbow trout
      • canned light tuna (slipjack, yellowfin)
      • sardines
      • tilapia
      • sole
      • haddock
      • shrimp
  • Hot Dogs: Heat hot dogs until the middle is steaming.

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Foods to Avoid

To protect you and your baby, some foods should be avoided.
  1. Caffeine: Caffeine passes from you to your baby. Your baby’s body is not made to get rid of caffeine. Limit your caffeine intake to 300 mg per day (1 cup of coffee) or less. Caffeine is found in:
    • coffee
    • tea
    • chocolate
    • pop/cola/soda
  2. Herbal Teas: Ask your healthcare providers which herbal teas to avoid.
  3. Fish: Some fish have high levels of chemicals, such as mercury, that can hurt you. Fish to avoid or eat less often:
    • tuna (fresh or frozen)
    • canned white (albacore) tuna
    • shark
    • swordfish
  4. Wild meat killed with lead pellet
  5. Kidney and liver from older moose

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Morning Sickness

You may often feel sick to your stomach and you may vomit. This is called morning sickness. However, it can happen at any time of the day. Avoid long periods of time without food. Eating small amounts frequently can help you feel better. Drinking water can also help relieve your morning sickness.

For some pregnant women, drinking water makes them feel sick to their stomach and vomit. It is important to stay hydrated. Try taking small sips of water at a time instead of trying to drink a full glass. Some women find that eating before they have a drink of water helps. Other ideas are drinking ginger ale, or sucking on ice chips. If you are choosing to drink herbal teas, talk to your healthcare professional first. Some herbal teas are not safe during pregnancy.

Talk to your healthcare providers if morning sickness is severe.

Prenatal Vitamins

Take a multivitamin each day that is meant for pregnant women. This is called a prenatal vitamin. Prenatal vitamins should contain folic acid and iron.

Taking a prenatal vitamin each day will help you and your baby get all the nutrients you both need. Talk to your healthcare providers if you need help getting prenatal vitamins.

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Water

Drink 10-12 glasses of water a day. Water keeps you from becoming dehydrated. Dehydration can cause symptoms like headaches. Water carries nutrients to your body and to your growing baby. Water can help you stay cool. It can also prevent constipation and reduce swelling. You will know you are getting enough water when your urine (pee) is pale yellow.

For some pregnant women, drinking water makes them feel sick to their stomach and vomit. It is important to stay hydrated. Try taking small sips of water at a time instead of trying to drink a full glass. Some women find that eating before they have a drink of water helps. Other ideas are drinking ginger ale, or sucking on ice chips. If you are choosing to drink herbal teas, talk to your healthcare professional first. Some herbal teas are not safe during pregnancy.

Ongoing Healthcare

Are you HIV positive? You can have a healthy baby. Take care of yourself. Eat healthy foods. Take your medication.

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During pregnancy, don’t forget to see your healthcare provider for ongoing concerns, like chronic illnesses. Chronic illnesses include asthma, epilepsy, and diabetes.

Influenza Vaccination (flu shot)

Influenza is the flu. It spreads from one person to another through sneezing or coughing. There are several different types (strains) of flu.

The flu causes symptoms that include feeling tired, fever, sore throat, cough, headaches, chills, nausea, vomiting, and diarrhea.

The influenza vaccination (flu shot) is free in Saskatchewan. Click here to learn about clinics in your region. Influenza vaccines are different every year. Even if you had a vaccination last year, you still need one this year.

During pregnancy, your immune system is weaker than usual. Your immune system is what fights illnesses in your body. Pregnant women are at risk of complications due to flu. These complications may cause them to have their babies too early.

Babies under the age of six months cannot get the influenza vaccination. If you get the influenza vaccine when you are pregnant, both you and your baby are protected.

It is safe to get the influenza vaccine any time during pregnancy. Those who will be in contact with your baby should also be immunized.

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Chronic illnesses

If you are living with a chronic illness (e.g., epilepsy, diabetes), talk to your healthcare provider. She will help you manage your illness and medications during your pregnancy. During pregnancy, she may need to see you often. Your medications may need to be changed.

Asthma

If you have asthma, you may see an increase in your symptoms during your pregnancy. Work with your healthcare providers to make sure your asthma is under control. It is safe to use asthma medication during pregnancy. Avoid smoke; it may make your asthma worse.

If your asthma cannot be controlled, it may increase the risk that your baby will be born underweight.

A common symptom of pregnancy is acid reflux. This can cause heartburn. Acid reflux can make asthma worse.

Diabetes

Your blood sugar levels may change during pregnancy. Monitor your sugar levels carefully. See your healthcare providers, including your dietician, if you need help staying healthy.

Insulin is not harmful to your baby. It is safe whether you are using a pump, needles, or pills.

Diabetes increases your risk of having a big baby. This can make it harder to deliver your baby. You may need to have an induced labour or a caesarean section. Diabetes can also increase the risk of your baby dying before she is born.

Heart Disease

If you have heart disease, ask your healthcare providers for a referral to a cardiologist.

Epilepsy

Pregnancy may increase the number of seizures you have. It might also make the seizures more severe. Severe seizures may be fatal for you and your baby.

Seizures during labour and delivery may be harmful to you and your baby. Work with your healthcare providers to create a delivery plan.

Keep taking your epilepsy medications and follow the advice of your healthcare provider. Your medications may be changed.

High Blood Pressure

If you already have high blood pressure, it is important to keep it under control during pregnancy. Talk to your healthcare provider about monitoring your blood pressure.

HIV

HIV can be passed from mother to child. However, it is possible to have a healthy baby.

Mental Health Concerns

If you have a history of mental health concerns, tell your healthcare provider. You may be at risk of developing mental health concerns during and after pregnancy. Your healthcare provider may refer you to someone who works in this area and can help.

Do not be afraid to talk to your healthcare provider. Mental health concerns are common. Your healthcare provider will help you develop a plan so you can spot the early warning signs. This plan should be shared with those close to you. The earlier you seek care, the better your recovery.

If you are on medication for mental health concerns, do not stop taking it. Talk to your healthcare provider. They may need to switch your medication. They might also need to change your dose.

Obesity

If you are obese, you have an increased chance of having problems with your pregnancy. One of the risks includes having your baby too early. Talk to your healthcare provider about your risks.

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Human Immunodeficiency Virus (HIV) and Pregnancy

HIV is a virus that damages the immune system and can lead to AIDS. People can live a healthy, long life being HIV positive if they get treatment and care.

HIV can be passed from mother to baby during pregnancy, delivery, or after birth.

Mothers living with HIV can pass the virus to their babies in three ways.
  1. The placenta joins the mother and baby. Food and oxygen reach baby through the placenta. HIV can pass through the placenta from the mother to baby.
  2. The baby can come into contact with his mother’s blood while being born.
  3. HIV is found in breast milk. The virus can be passed to the baby during breastfeeding.

HIV testing is part of your prenatal blood tests. You can refuse the test. However, HIV does not discriminate. If you have had sex, you are at risk. If your healthcare provider does not offer the test, you can ask for it.

If a mother with HIV gets good medical care and treatment, there is less than a 2% chance of passing HIV onto a baby. A mother with HIV can have a healthy baby.

If you are HIV positive, you can stay healthy when you are pregnant.
  • Find a healthcare provider who knows about HIV and pregnancy.
  • Follow the advice of your healthcare provider.
  • Stay on all medications given to you.

One of the ways that HIV can be passed from you to your baby is through breast milk. If you are HIV positive, it is recommended that you do not breastfeed. It is not recommended that another woman breastfeed your baby.

Free formula is available in Saskatchewan for women living with HIV. You can call the numbers listed below to ask questions about the Saskatchewan Infant Formula program.
  • Prince Albert: 306-765-6535
  • Regina: 306-766-3915
  • Saskatoon: 306-665-1477

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Vaccinations

Some diseases can be harmful to you and your baby when you are pregnant. Vaccines can protect you and your baby from these diseases. Early in your pregnancy, make sure your vaccinations are up-to-date. Your immunity to diseases during pregnancy protects your baby until he is 6 months of age. Breastmilk also provides some immunity for your baby.

Many vaccines are safe to get during pregnancy. Your healthcare providers will know which are safe. Be sure to tell your healthcare provider that you are pregnant before getting a vaccination. All vaccines are safe to get while breastfeeding.

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Oral Health

It is safe to get dental work done during pregnancy. This will not hurt you or your baby. Let your dentist know that you are pregnant.

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During pregnancy oral health is very important. Oral health means the health of your gums, teeth, and jaw.

Schedule a dentist appointment during your first trimester. Dental work is safe during pregnancy. Your dentist will clean your teeth and give you a checkup. X-rays should be avoided, if possible. If you need them, your healthcare provider will put a lead vest over your stomach to protect your baby.

Your hormones change during pregnancy making you at risk for oral health diseases.Morning sickness can also hurt your oral health. Vomit has acid in it. Acid can wear down the outside layer (enamel) of your teeth. This can cause cavities.

Oral disease can be prevented and treated. You can take these simple actions to protect the health of you and your baby.
  • Take prenatal vitamins.
  • Use toothpaste with fluoride.
  • Brush your teeth two times a day.
  • Brush your tongue.
  • Floss daily.
  • Eat healthy foods.
  • Limit sugary foods and drinks.
  • Rinse your mouth with water or mouth wash if you throw up.

Studies show that pregnant women with severe gum disease may be more likely to deliver a baby that is too early or comes too soon.

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Physical Activity

Being active will keep you and your baby healthy. However, some things are not safe when you are pregnant. Talk to your healthcare providers about this.

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Being physically active during pregnancy is good for you and your baby.

Physical activity can help in many ways.
  • Increase feelings of happiness
  • Decrease stress
  • Increase energy
  • Improve sleep
  • Decrease constipation
  • Decrease swelling in your feet, legs, and hands
  • Help you keep a healthier weight
  • Speed up recovery after labour

Do light activities, like walking and swimming. Find someone to exercise with to make it more fun. Start with 5 minutes a day. Slowly increase your time to 30 minutes a day. Drink lots of water before, during, and after your activity.

Slow down if you are out of breath. You should be able to talk normally while you exercise.

You may find that some exercises you used to find comfortable are not anymore. Listen to your body. Adjust your exercise until you feel comfortable. Mayo clinic.

Yoga is an excellent exercise during pregnancy. Yoga is a good way to develop strength. It is also a good way to learn about breathing. Learning to control your breathing will help you during labour. Ask your yoga instructor about positions that are safe for you.

Controlled breathing is important when you are exercising. Count your breaths in and your breaths out. They should be the same. Breathe slowly. If you get breathless, take a deep breath and try to slow your breathing.

When you are pregnant, some types of exercise are not safe. Talk to your healthcare providers for more information.

Avoid doing exercises flat on your stomach or back. Change them so you can do them on your side or sitting or standing.

Avoid jumping, bouncing, and jolting. This includes doing aerobics and riding horses.

If you are using weights, keep them light or moderate. Do not lift heavy weights.

If you have any of these symptoms while exercising, see your healthcare provider.
  • Contractions that do not stop
  • Bleeding
  • Back, stomach, or pelvis pain that keeps getting worse
  • Sudden swelling in your face, ankles, and hands
  • Dizziness
  • Breathlessness
  • Extreme tiredness
  • Difficulty walking
  • Changes in your body’s movements
  • Swelling, pain, or redness in your lower legs

Have you heard of Kegels? Kegels are pelvic floor exercises. Kegels strengthen the muscles in your vagina. Your pelvic floor muscles support your uterus, bladder, and bowels. Doing Kegels can help you to prevent leaking urine (pee). They can also help you during labour and delivery. To do a Kegel, squeeze the muscles that you use to stop the flow of your pee. Hold these muscles for 5-10 seconds, and then relax. Do this 10 times and repeat 3 times a day. Work on breathing in while you let your pelvic floor relax. Breath out while you go a Kegel.

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Sex During Pregnancy

It is safe to have sex during pregnancy, but you may be tired, sick to your stomach, or uncomfortable. This may affect your feelings about sex. Talk to your partner about this.

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During your entire pregnancy, it is usually safe to have sex. In some special cases, your healthcare provider may tell you it is not safe to have sex when you are pregnant.

Your baby is protected during sex by your own body. The amniotic sac, the muscles of your uterus, and a mucous plug in your cervix protect your baby. As well, proper hygiene and the use of condoms will decrease the risk of infections.

As your pregnancy progresses, you may find that certain positions are uncomfortable. Talk to your partner and together experiment until you are both comfortable. If sex is painful, talk to your healthcare providers.

You may have a range of feelings about sex. Changes to your feelings about sex during pregnancy are normal. You may want to have sex more. You may want to have sex less. Talk to your partner about the way you feel and your needs.

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Street Drug Use

All street drugs, like heroin, can hurt you and your baby. If you want to quit heroin, your healthcare provider may give you methadone. It will cut your cravings and stop your withdrawal symptoms. Methadone is safe for you and your baby.

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Drugs can hurt you or your baby. Do you want to stop using drugs or cut down on the amount that you use? Talk to your healthcare providers. There are people who can help and support you. Call HealthLine at 811 and speak to an Addictions/Mental Health Counsellor. This service is free and open 24 hours a day. You can also visit HealthLine Online.

Intravenous drug use (shooting up, using needles) puts you at high risk for human immunodeficiency virus (HIV) and hepatitis C (HCV). Without proper care, these infections can be passed to your baby.

HIV

HIV can be passed to your baby during pregnancy, childbirth, and breatfeeding. However, women with HIV can have healthy pregancies and healthy babies. Treatment and care can reduce the chance of a baby being infected with HIV to less than 2%. If you have HIV and are pregnant, talk to your healthcare provider early in your pregnancy or before you become pregnant about reducing the risk for your baby.

Hepatitis C

Hepatitis C is a serious liver disease caused by a virus. Hepatitis C is spread through blood to blood contact. If you have hepatitis C, your baby may become infected during child birth. Some drugs that are given for hepatitis C are not recommended during pregnancy. Talk to your doctor before your become pregnant or early in your pregnancy, to discuss ways to keep yourself and your baby healthy.

Click here for more information on HIV and Hepatitis C.

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    Alcohol, Nicotine, Substance Use

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    Information about Prescriptions, Over-the-Counter Medications and Herbal Remedies

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    Drug Use and Pregnancy

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Cocaine can cause:

  • you to go into early labour
  • your baby to have a birth defect
  • your baby to be born too small (low birth weight)
  • your baby to die before he is 28 days old

Using cocaine when you are pregnant can increase your baby’s risk of dying from Sudden Infant Death Syndrome.

SIDS

Sudden Infant Death Syndrome (SIDS) is the leading cause of death in healthy infants up to one year of age. SIDS occurs when a healthy baby dies suddenly during sleep.

Cocaine use can also cause your placenta to break away from the wall of your uterus. This is called abruptio placenta. This is dangerous for you and your baby.

Abruptio Placenta

Usually happens after the 20th week of pregnancy. Abruptio placenta happens when the placenta separates from the wall of the uterus too early. It can cause bleeding. Your baby may have problems getting enough oxygen and nutrients he needs to grow. Abruptio placenta can cause problems during labour. It can cause your baby to be born dead.

Heroin (brown sugar, dope, China White, or smack)

Using heroin during pregnancy can cause your baby to die.

Heroin use can also cause the placenta to break away from the wall of the uterus. This is called abruptio placenta. This is dangerous for you and your baby.

Heroin withdrawal during pregnancy can be dangerous. Using heroin during pregnancy can cause your baby to have withdrawal after birth. To prevent the baby’s withdrawal, your healthcare provider may put you on methadone. Methadone is safe to use during pregnancy. Methadone prevents withdrawal symptoms. It will also decrease your cravings for heroin.

Get help to stop using heroin.

Inhalants (glue, paint thinner, gas, and aerosols such as hairspray)

Using inhalants during pregnancy can cause your baby to die. Your baby may be born with a birth defect. Using inhalants can cause your baby to have mental health or behaviour problems.

Marijuana (dope, ganja, grass, pot, weed)

Using marijuana during pregnancy can cause your baby to be born early. Marijuana use can cause your baby to have a learning problem.

Methamphetamine (meth, speed)

Using Methamphetamine can cause your baby to die before he is born. This is called miscarriage.

Miscarriage

A miscarriage means that the baby has died inside of you. You will still need to deliver the baby or you can get very sick. See your healthcare providers right away.

Methamphetamine can cause the placenta to break away from the wall of the uterus. This is called abruptio placenta.

Using Methamphetamine is dangerous for you and your baby.

Tobacco Use

Smoking can hurt your baby. Protect your health and your baby’s health. Make your home and car 100% smoke-free. Ask your friends and family not to smoke around you.

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Smoking tobacco when you are pregnant can hurt you and your baby. When someone else smokes around you, you breathe in harmful chemicals. There are more than 4,000 harmful chemicals in tobacco smoke. These include nicotine, tar, ammonia, carbon monoxide, arsenic, cyanide, and lead.

The chemicals from tobacco smoke stay in the air for a period of time. They also stay on surfaces around your house as well as on your hair and clothes. These chemicals are passed through the uterus to the baby. Talk to your healthcare providers for help to quit smoking.

As much as possible, keep your environment smoke-free. Talk to your friends and family about keeping your house and car smoke-free. Avoid situations where people are smoking.

Risks from tobacco smoke during pregnancy

  • Losing your baby
  • Having your baby too early
  • Having a baby who is too small
  • Having a baby born with health, learning, emotional, and behavioural problems
  • Miscarriage
    • Miscarriages happen when a baby dies in the mother’s uterus.
  • Ectopic Pregnancy
    • An ectopic pregnancy happens when a fertilized egg implants outside of the uterus. The fetus cannot survive. This condition can cause the mother to die.
  • Placenta Previa
    • Usually the placenta attaches to the top part of the uterus. When it attaches to the bottom of the uterus, it is called placenta previa. Placenta previa can cause bleeding and complications during labour. It can cause the mother to die.
  • Abruptio Placenta
    • This condition happens after 20 weeks of pregnancy. Abruptio placenta happens when the placenta separates from the wall of the uterus too early. It can cause bleeding. Your baby may have problems getting enough oxygen and the nutrients he needs to grow. Abruptio placenta can cause problems during labour. Abruptio placenta can cause your baby to be born dead.
  • Pre-term premature rupture of membranes
    • When the amniotic sac breaks before 37 weeks, it is called Pre-term premature rupture of membranes. It can cause infection for mother and baby. This can also cause your baby to be born early. It can also lead to death of both mother and baby.
  • Preeclampsia
    • Preeclampsia is a condition that may occur during pregnancy after the 20th week. Symptoms include headaches, high blood pressure, swelling in your hands or feet, vision problems, protein in your urine (pee), upper stomach pain, shortness of breath, and sudden weight gain. If left untreated, preecplampsia can be very dangerous for you and your baby.
  • Delayed Wound Control
    • Smoking causes wounds to heal slower and increases risk of infections after a caesarean.

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Your Body

Some moms feel there baby move as early as 13-16 weeks. At first you may mistake your baby’s movements for gas. After a while, you will know it is your baby moving. First time moms may not feel their babies moving until 19-20 weeks.

Your body is working hard. Put your feet up to help reduce swelling in your ankles and feet.

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Discomfort and Pain

You may have pain in your back, hips, and legs. This can make it hard to sleep. Try sleeping on your side with a pillow between your legs. Massages and stretching can help. Be sure to find a massage therapist certified in prenatal massage.

Your feet, ankles, and hands may swell. Rest and put your feet up. Avoid wearing tight clothing, rings, watches, and socks with elastic tops.

Morning Sickness and Other Stomach Concerns

You may feel sick to your stomach and you may vomit. This is called morning sickness but it can happen at any time of the day.

For some women, drinking water makes them feel sick to their stomach and vomit. It is important to stay hydrated. Try taking small sips at a time instead of trying to drink a full glass. Some women find that eating before they have a drink helps. Other ideas are drinking ginger ale, herbal tea, or sucking on ice chips. If you are choosing to drink herbal teas, talk to your healthcare professional first. Some herbal teas are not safe during pregnancy.

There may be smells or foods that make you feel sick or vomit. You may have indigestion, bloating, or heartburn.

Avoid going without food for long periods of time. Find out which foods make you nauseous and which foods you can tolerate. Eating often can help you to feel better.

You may be constipated and have gas. Drink lots of water. Eat foods that are high in fiber.

You may have heartburn. The changes in your hormones make the top of your stomach relax. This means that stomach acid can come back up. If this happens to you, sleep with your back propped up. It can also help to avoid eating and drinking right before bed if possible. Drinking milk can help soothe your stomach. Your healthcare provider can recommend medications that may help with the symptoms.

If you have not been able to eat or drink in the last 12 hours, contact your healthcare provider. There is medication that can help control nausea and vomiting during pregnancy.

Physical Changes

Dark veins may appear on your breasts. Your nipples and the area around them (areola) will get darker and bigger. Your breasts will become larger and heavier.

A dark line may appear between your belly button and pubic hair. This is normal.

You may get varicose veins in your legs. Don’t worry; these will likely go away after pregnancy.

You may have bleeding gums. You may also have a stuffy nose. Sometimes you may get nose bleeds. While these symptoms are common, talk with your healthcare providers about them.

Pets

Your immune system lowers when you are pregnant. This means you can get sick easier than before so you need to take extra care.

If you have a cat, have someone else change the litter box for you while you are pregnant. If you cannot find anyone to help you, wear gloves and wash your hands carefully after you clean it.

There is a parasite that can be found in cat feces (poop) that can make you sick. The illness it causes is called toxoplasmosis. Even though you may not feel sick, the illness can cause miscarriage and birth defects. Miscarriage is when a baby dies before birth.

Weight Gain

When you are pregnant, you will gain weight. This helps your baby grow. Underweight women need to gain more weight. Overweight women need to gain less weight.

Find out what is best for you. Talk to your healthcare providers about how much weight you should gain.

If you gain too much weight during pregnancy, you are at an increased risk of developing gestational diabetes. Your baby could be at an increased risk for:

  • Being born to large
  • Being born to early
  • Being overweight later in life

If you gain too little weight during pregnancy, your baby could be at risk of:

  • Being born to small
  • Being born to early
  • Problems breastfeeding

Pregnancy weight is spread throughout your body. For example, the amniotic fluid and placenta weigh about 2 pounds.

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Eat a variety of healthy foods to help you gain the right amount of weight. Healthy foods include:
  • vegetables and fruit (broccoli, bananas, apples, carrots, berries)
  • grain products (whole wheat bread, cereal, pasta, muffins)
  • milk products and alternatives (milk, cheese, yogurt, soy milk)
  • meat and alternatives (beans, lentils, eggs, fish, chicken)

Exercise will also help you to maintain a healthy weight.

Working During Pregnancy

Be sure to check with Employment Insurance Benefits to find out the rules about getting parental benefits.
In some jobs, you may be exposed to chemicals, fumes, radiation, and solvents that are unhealthy during pregnancy. Check with Motherisk. They will know if something might cause health problems. Ask your healthcare provider for a letter stating that for pregnancy-related reasons, you need to stay away from unhealthy exposures in the workplace. Work with your boss to make a safe work environment during your pregnancy.

Some jobs can be hard on your body. Do you do shift work? Do you work more than 40 hours a week? Do you climb ladders or stairs a lot? Do you stand for more than 4 hours a day? Talk to your healthcare providers. They can share ideas that keep you safe at work during your pregnancy.

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