Health Promotion During

Pregnancy
Prepared by: Sarah Jane L. Racal
RN,MAN
Christian University of Thailand

BASIC NUTRIENTS
Key Nutrients for Mom and Baby
Calcium
Strong Bones and
Teeth
Milk, cheese,
yogurt, sardines
Iron
Oxygenation of red
blood cells
Lean red meat, dried
beans, peas
Vitamin A
Healthy
skin,eyesight, bone
growth
Carrots,dark leafy
greens, sweet
potatoes
Key Nutrients for Mom and Baby
Vitamin C
Healthy gums, teeth
and bones,
absorption of Iron
Citrus fruit, broccoli,
tomatoes,
strawberries
Vitamin D
Build babys bones
and teeth
Sunlight exposure, fatty
fish, fortified milk
Vitamin B6
Form RBC,helps use
CHON, fat, and CHO
Beef, liver,
pork,ham,whole grain
cereals, bananas
Key Nutrients for Mom and Baby
Vitamin B12
Maintains nervous
system,form RBC
Liver, meat, fish,
poulrty milk (only in
animal foods)
Folate
Produce blood and
proteins, help some
enzyme functions
Green, leafy vegetables,
liver, orange juice,
legumes, nuts
Extra Nutrients
Folic Acid
Vitamin B
Folate
0.4 mg/day
Reduce neural tube
defects
Green leafy
vegetables, citrus
fruits and beans
Iron
27 mg
Prevent anemia
Take in an empty
stomach or with
vitamin C
Neural tube defects
Neural Tube Defects
How Much Weight Should You Gain During
Pregnancy?
Prepregnancy
Weight Status
Body Mass
Index (BMI)*
Weight Gain
(pounds)
Underweight Less than 18.5 2840
Normal weight 18.524.9 2535
Overweight 25.029.9 1525
Obese 30 or more 1120
*You can find out your BMI by going to
https://www.yourpregnancyandchildbirth.com/topics.php?page=nutrition
Data from Institute of Medicine (US). Weight gain during pregnancy: reexamining the
guidelines. Washington, DC: National Academies Press; 2009.
Pregnancy and Weight Gain
Body Mass Index- a
measure of body fat
based on height and
weight.
Normal BMI:
Gain 25-35 pounds during
pregnancy

Overweight/obese:
Gain 11-20 pounds

BMI of 40 and above:
Weight loss
Pregnancy Risk for Obese/Overweight
Women
Gestational
Diabetes
High Blood
Pressure
Preeclampsia
Cesarean Delivery
Pregnancy Weight Gain
Where does the weight go?
Where does the weight go?
Baby 7.5 lbs
Breast growth 2 lbs
Maternal Stores 7 lbs
Placenta 1.5 lbs
Uterus 2 lbs
Amniotic Fluid 2 lbs
Blood 4 lbs
Body Fluids 4 lbs
Special Concerns
1. Caffeine
Moderate caffeine
intake
(200 mg/day: 2 8-
ounce cups of
brewed coffee)
does not appear to
lead to miscarriage
Excess caffeine:
Interfere with sleep
Cause nausea
Light-headedness
Increase urination
dehydration
Special Concerns
2. Vegetarian Diets
- Take enough
protein.
- Take supplements
probably,
especially iron,
Vitamin B12 and
Vitamin D
Special Concerns
3. Mercury
- do not eat
certain kinds of
fish ( shark,
swordfish, king
mackerel, tilefish)

- types of fish low in
mercury are:
shrimp, canned light
tuna, salmon,
Pollock, catfish.
You may safely eat
up to 12 ounces
(about two
meals/week)

Special concerns
4. Listeriosis
- An illness caused by
bacteria that occur in
unpasteurized milk and
soft cheese and
prepared uncooked
meats, poultry, and
shellfish.
Symptoms:
fever, chills, muscle
aches, and back pain.
May cause still birth
or miscarriage when
a woman is infected.
Special Concerns
5. Pica
- Strong urges to eat
nonfood items such as
clay, ice, laundry, starch
or cornstarch
- May lead to
constipation and
anemia.
Four Foods to avoid when you are
pregnant
Peanuts ( avoid eating
when you or your partner
has food allergy)
Unwashed fruits and
vegetables
Foods to avoid when you are pregnant
Raw and undercooked meat
may contain a parasite
which causes toxoplasmosis
Soft and blue veined cheese
harbor bacteria that may
cause listeriosis
Glossary
Anemia- Abnormally low
levels of blood or red
blood cells in the
bloodstream. Most cases
are caused by iron
deficiency , or lack of
iron.
Congenital: refers to a
condition that is present
in a baby when it is born.
Gestational diabetes:
Diabetes that arises
during pregnancy.

Macrosomia: a condition
in which a fetus grows
very large.
Miscarriage: Early
pregnancy loss
Neural Tube Defect: A
birth defect that results
from incomplete
development of the brain,
spinal cord or their
coverings.
Glossary
- Pica: The Urge to eat
nonfood items.
- Preeclampsia: A
condition of pregnancy
in which there is high
blood pressure and
protein in the urine.
-Stillbirth:
Delivery of a baby that
shows no sign of life.
Exercise during pregnancy
can help prepare you for
labor and childbirth.
Exercising afterward can
help you get back in shape.
Benefits of Exercise
Helps reduce backaches,
constipation, bloating,
and swelling.
May help prevent or
treat gestational
diabetes
Increase your energy

Improve your mood
Improves your posture
Promotes muscle tone,
strength and endurance
Helps you sleep better.
Changes in the Body
Joints
More mobile
More at risk for
injury.
Avoid jerky, bouncy or
high impact motions
that can increase
your risk of injury.
Changes in the Body
Balance
- You are carrying extra
pounds as much as 25-40
lbs at the end of
pregnancy.
- Extra weight shifts your
center of gravity and
places stress on joints and
muscles (lower back and
pelvis)00413
Changes in the Body
Heart rate
Heart rate may increase
since the extra weight
you are carrying will
make your body work
harder than before.
It increases the flow of
oxygen and blood to the
muscles being worked
and away from other
parts of the body.


No Exercise During Pregnancy for:
Risk factors for
Preterm Labor
Vaginal Bleeding
Premature Rupture
of Membranes
Pregnant women
with High Blood
Pressure
Choosing Safe Exercises
After first trimester of pregnancy, women
should not do exercises that require
them to lie flat on their backs.
Standing still for long periods of time also
should be avoided as much as possible.
Safe Sports
Walking
Swimming
Cycling
Aerobics
Other safe exercises if in moderation
Running
Racquet sports
Strength
training
Exercises to avoid during pregnancy
Downhill snow
skiing
Contact sports
Scuba diving

Your routine
First 24 weeks-
most practical
Last 3 months-
may be difficult
(normal)
Start slowly
5 min/day
+ 5 min each week until
you can still stay active
for 30 minutes/day.
Begin with a warm-up
period (5-10 min)
Cool down by slowly
reducing your activity
(5-10 min) + stretching
to avoid sore muscles.
Things to Watch
Avoid:
Jumping
Jarring motions
or quick
changes in
direction
Becoming
overheated during
pregnancy---loss
of fluids---
dehydration---
problems during
pregnancy.
General guidelines for a safe and
healthy exercise program
After the first trimester of
pregnancy, avoid doing
any exercises on your
back
Avoid brisk exercise in
hot, humid weather or
when you have a fever.
Make sure you consume
the daily extra calories
you need during
pregnancy.
Wear comfortable clothing
that will help you to
remain cool.
Wear a bra that fits well
and gives lots of support to
help protect your breasts.
Drink plenty of water to
keep you from overheating
and dehydrating.
Warning signs to stop exercising:
Vaginal bleeding
Dizziness or feeling
faint
Increased shortness
of breath
Chest pain
Headache
Muscle weakness
Calf pain or swelling
Uterine contractions
Decreased fetal
movement
Fluid leaking from
the vagina
Glossary
Cesarean Delivery:
Delivery of a baby
through an incision
made in the mothers
abdomen and uterus.
Gestational Diabetes:
Diabetes that arises
during pregnancy; it
results from the effects
of hormones and usually
subsides after delivery.
Premature rupture of
membranes:
A condition in which the
membranes that hold
the amniotic fluid
rupture before labor.
Sexual relationships and pregnancy
Sex during pregnancy
Sex is among the top most enjoyable
activities practiced by couples.

Why should this be any different
during the nine months of
pregnancy?
Questions in Pregnancy
Is it safe for the baby?
In a normal, low-risk pregnancy. Sex during
pregnancy will not harm the baby. The fetus is
protected by the amniotic sac ( a thin-walled bag
that holds the fetus and surrounding fluid) and by
the strong muscles around the uterus. There is a
also a thick mucus plug that seals the cervix and
helps guard against infection.
When is it not safe?
It is in unsafe in high
risk pregnancies. Some
cases in which you
should not have sex
during pregnancy are:
If you have a history or
threat of miscarriage.
If you have history or
signs indicating the risks
of preterm labor.
More than one fetus
(twins, triplets, etc)
Unexplained vaginal
bleeding, discharge or
cramping
Placenta previa ( a
condition in which the
placenta is situated so
low that it covers the
cervix)
When is it not safe?
Leakage of amniotic
fluid
Incompetent cervix ( a
condition in which the
cervix is weakened and
dilates prematurely
raising the risk of
miscarriage or preterm
delivery)
Amniotic Fluid

Can the Baby Feel It?
The cervix is protected
by a mucus plug. The
penis will not come into
contact with the fetus.
The baby may thrush
around a bit after
orgasm, but this is
simply because of the
mothers pounding
heart
And not because the
baby is feeling
discomfort or even
knows whats
happening.
Can sex during pregnancy or orgasm lead
to miscarriage or premature birth?
It should not lead to miscarriage in normal low
risk pregnancies. The contractions felt during
orgasm are perfectly different from the
contractions associated with labor.
Some doctors recommend, though, that all
mothers discontinue sex during the final
weeks. There is a chemical in semen that is
believed to stimulate contractions.
Is it normal for my desire for sex to
fluctuate during pregnancy?
Normal
Nausea, fatigue, breast
tenderness, increased
need to urinate- make
sex bothersome ( 1
st

trimester)
2
nd
trimester
heightened sex drive.


There is increased
blood flow to the pelvic
area, engorgement of
the genitals and
heightened sensation
Which positions are most favorable?
Lie sideways, with the man on top, can
become more and more difficult as the baby
grows.
Use the edge of the bed. The mother can lay
on her back with her feet and rear on the edge
of the bed, and the man kneeling or standing
in front.

Which positions are most favorable?
Lie side by side in the spoon position. This will
allow only for shallow penetration. Deep thrusts
can become uncomfortable as the months pass.
Have the woman on top. This allows her to
control the depth of penetration and will put no
added weight on her abdomen.
Oral sex can be safe in monogamous relationships
, where both partners are HIV-negative.