Advice on health and lifestyle
In early pregnancy, people start to think through how their own health and lifestyle is affecting their unborn baby. Parents valued early contact with their GP or midwife to get advice, and many also found useful information in books, magazines and the Internet. (See also 'Finding information and support' and 'First contacts with services').
People were already well informed on some issues, for example that taking folic acid reduces the risk of spina bifida, and that smoking and alcohol are bad for the baby (for advice on vitamins and supplements in pregnancy see National Childbirth Trust and NHS Choices). Some were pleased that becoming pregnant helped them give up smoking. If the pregnancy was unplanned, some mothers worried they might have harmed the baby by drinking or smoking, not realising they were pregnant. People knew that smoking was harmful, but were less sure whether there was a 'safe' level of drinking during pregnancy. It can be difficult to know what to believe about a whole range of issues, including diet and exercise, given conflicting media reports. One mother worried that people could feel guilty if their lifestyle was not perfect, and disliked the way one doctor talked to her about her weight.
It was easier to give up smoking when she became pregnant, and she has not started smoking again.
How much did you smoke before you became pregnant?
I used to smoke, I wasn't a heavy smoker, about 10, 15 a day. I've given up completely now, so.
So did you give up when you found out you were pregnant?
The day I found out I was pregnant I gave it up.
Tell me about that, was that hard?
No, it wasn't because I've wanted to give up for ages and to actually have a reason to give up smoking was a good thing, definitely. And yeah, yeah, it was good because, obviously, I don't smoke now either so it's brilliant. And, and also giving up drinking, that was the hardest bit [laughing]. I mean you can have a glass of wine here and there but that's, that's it, so, that wasn't too bad, really.
She worried whether smoking and drinking before she realised she was pregnant had harmed the baby...
Before I became pregnant I used to smoke and drink a lot and when I found out I was pregnant it all stopped straight away. And it was, because I drank a lot as a student I used to think, well it was, almost, it was a good thing because it meant that I had to take control of my life, which I hadn't done for years, and I did. And I just, and I found it amazing that I suddenly felt this new responsibility and I was capable of giving up smoking and of cutting my drinking down to a bare minimum. And in the early stages the thing that worried me the most, it was probably what, what damage I'd done by smoking and drinking through the first bit of the pregnancy, before I knew I was pregnant; what that would have done to the development of the child. And so I wanted to find out lots of information about how it might have affected him.
She had heard conflicting advice about drinking alcohol in pregnancy. It can be difficult to know...
So how do you decide what to believe and what not to believe?
It [sigh] it's tricky. I think trusting your instincts is quite a good one. I just do not feel like drinking alcohol. The most I've had is a really, really weak Pimms. I mean, it was literally that much Pimms and, you know, a full glass of lemonade. And that's all I've had, so, I suppose it's about, in some ways, it's about trusting your body about what it says you fancy. But also just cutting yourself some slack, that you know, you don't get any prizes for being, kind of, the super mother of the year, you know. I think it's about getting through the pregnancy, making sure you don't get too tired, drinking plenty - I've never drunk so much water in my life, I'm always thirsty, always hungry, but trying to make sure that I'm eating apples and oranges, and not M&Ms, Twix bars and what have you. But then again, you know, having chips once a week because, sometimes that's the only thing you really, really fancy. And I, you know, think a lot of pregnant women really beat themselves up about these kind of lifestyle issues. You know, lots of the books say you should be doing exercises and yoga, and all sorts of things. I mean I'm lucky if I'm awake by the time I get home [laughs]. So quite where you're meant to get the energy to do all of these other things from I'm not sure really. So I think it is about just being, being gentle to yourself, really, and you know, I had two lovely walks over the weekend, which were great and I felt so much better for them, but that was probably the first time since I've been pregnant that I've fancied, you know, taking the dog for more than a walk round the block. So I think waiting until you're ready for these things.
She did not like the way one doctor talked to her about her weight in pregnancy.
I suppose there - there was one. When I was first seen at the hospital that's going to deliver my antenatal care, and I had my kind of roughly twelve week scan there, and I saw a midwife, and I also saw some medical staff, and initially it was a very sweet student doctor. And it was quite funny actually, because we went and sat down in a room, and we could hear him talking to the nurse outside, saying, "Right, What do I do? What do I do next?" It's like, "You take her history". "But she's already seen the midwife, she's already had her history taken", and they were saying, "You're a doctor, you do it again", [laughs] so by the time he came in we were trying really hard not to laugh. But he was - no, he was charming and - my one question was that I'd, at that point, because I wasn't quite twelve weeks, I was still taking my metformin [a drug to induce ovulation], and I wanted to check what this hospital's policy was about me continuing, or discontinuing the drug, and he wasn't sure about that, so he said he'd go and talk to his - I presume it was his registrar, or equivalent, and after about five, ten minutes the registrar came back, and, you know, quickly reviewed my notes and was very I suppose dismissive actually, of the advice I'd been given about taking metformin, and said, "In this hospital we, we do things on a needs basis, and you've been fine so far, so you've no need to take it. We do things in an evidence based manner here", kind of thing, which didn't help because you go on the advice you're given. So, and then [sigh] he, and this is going to sound awful but he was frankly clinically obese. He was a massive man, and he started referring to me as a larger mother, and going on about my weight, and it was just really hard to take from somebody who was frankly four times my size, and it was just really difficult. And I'd also lost a huge amount of weight over the last couple of years. I'm not, you know, thin by any stretch of the imagination, but I felt kind of quite comfortable about where I was, and that was quite hard. You know, partly you just felt, "Where do you get off telling me, you know, lecturing me?" You know, saying, "We'll have to see you at thirty weeks because, you know, you're on the larger side", and all the rest of it.
What was his point?
Because allegedly - well, presumably - he said it's very difficult to visualise the baby, so we'll need to check at thirty weeks that we can still see it clearly. Which seems quite strange really, because, you know, women far larger than me have had very successful pregnancies, so that was, that was the only kind of sour note, really, that it just, it was quite difficult. Because I suppose I'd had a lot of support from my fertility consultant, who understood how ha- one of the things about PCOS [polycystic ovary syndrome] is it's really difficult to lose weight, because it alters your metabolism and, you know, it is really a struggle. But, you know, I had lost a lot of weight, so that felt quite hard.
Most people knew they should avoid medicines in pregnancy that might harm the baby. One woman was upset that her GP prescribed an antihistamine for a rash, having earlier told her to avoid them.
She was upset that her GP advised her to avoid antihistamines in pregnancy but then prescribed...
And one of the things that I'd asked about previously was antihistamines. Well, the funny thing is she'd prescribed antihistamines for this rash. And so I just thought, 'Well, she'd said previously that antihistamines were not a good idea, which is fine by me, and I can then make an informed choice about what I want to take and what I don't want to take during my pregnancy.' And so that sort of made me think, 'Well, mm. I don't really trust what she's saying now, because of what happened in, in my previous appointment.' So, my father-in-law is a GP and when I got home I had these tablets that she'd given me and I rang him up and said, 'Please could you find out, well, are these, what these tablets are?' And he looked in his index that he still has, gets every year, and apparently these, these particular tablets were contraindicated in pregnancy. And that just really upset me and I just thought, 'How could she just prescribe these knowing that I've already talked to her about antihistamines, she knows that I'm pregnant.' I think I was about 14 weeks pregnant at the time. And, you know, 'How can she just prescribe these and not even give me any information about them to say, 'Well, you know, they are contraindicated, it's a low dose, you know, take them if you want to, really need to take them but otherwise...?'
And did she say whether there was anything else that you could do with the rash? Was this the only possible treatment or... ?
Mother' Well, she did give me hydrocortisone creams or - which is 1 per cent, and she - because it was very, very itchy and not very comfortable - and she said, 'Oh, put this on if you need to' but I...
Father' Did we use calamine at all?
Mother' I think...
Father' I remember daubing it all over you.
Mother' I did, I put calamine on because it was so itchy. But in the end I decided not to put anything on at all, apart from a bit of calamine, because I just thought, 'Well, I just don't want to, you know, take anything while I'm pregnant.' I think the only thing I did take while I was pregnant was paracetamol, but every so often, if I really needed to, otherwise I didn't take anything at all. But I think it's just the fact that I felt that she'd taken choices away from me again, and that's what made me quite annoyed about it.
For people with conditions such as diabetes and epilepsy, taking drugs in pregnancy can be essential (see 'Pregnancy with another condition or disability').
Knowing what foods to avoid mattered to people; some had received conflicting advice from professionals. (Useful advice on diet in pregnancy, including alcohol, caffeine and vitamins and other supplements, is available from NHS Choices and National Childbirth Trust).
She was given conflicting advice about whether it was safe to eat bio-yoghurt; her midwife gave...
Family and friends can also offer conflicting opinions. One woman from a Pakistani background asked her midwife for advice about diet. Traditional advice from her family was to avoid foods such as eggs, which are considered in many South Asian communities to generate heat in the body. (Such 'hot' foods are not necessarily warm or spicy in themselves, but it is their effect on the body that matters. 'Cool' foods may be recommended to neutralise the 'hot' state of pregnancy). Another Pakistani woman explained how she felt hot in pregnancy.
She asked the midwife for advice on diet, to help her assess traditional advice from her family....
And did you get any kind of advice or any support from family? I mean, you've mentioned your friends, but any family members who were particularly supportive?
Yeah, my sisters, and my Mum, yeah. Because my sisters are, they've all got like three kids each and they're forever ringing me with advice, because obviously, “Don't eat this, don't do this, don't go for.” And Mum would say, “Don't go for long walks now, and don't do this, don't pick this, don't carry this.”
What kind of things were they saying? Don't eat what?
You know like warm, we call them warm things, and so it's like
Eggs and hot foods
And things like that, not to eat that. But having said that, I know some of it is just like old wives' tales, “You can't eat this, you can't eat that”, so I did get some information from the midwife as well, on what to do.
And what was the difference between what the midwife was saying and what your family was saying?
Well, she was saying more like mayonnaise and not anything with raw egg in it.
So if I say, “Well, can I have whatever mayonnaise?” She goes, “Well, you can, because that's powdered egg, but you can't have that one.” So it's more, I suppose to explain more in detail the information about what you can and can't eat. And then again I just got it from magazines as well.
Mmm, I suppose the midwife was talking about kind of salmonella and things like that?
Whereas the hot foods, can you say a bit more about what the thinking is behind that?
No [Laughs] I can't really. You know, it's something like that you've just sort of grown, [laughs] grown up with. Yeah, so I just, I really don't even know that much at all. It's just they said, “Don't eat warm food.” And I go, “Okay.” So that's your eggs.
Eggs, and honestly I can't even remember because it just went over the top of my head and I was just going, “Okay.”
So it's warm, warm foods?
Yeah, the idea is that they have a warm effect on your body. Or they heat up your body, so it's a different kind of way of...
...thinking about it, but [laughs].
That's all I know, and I was just going, “Okay.”
[Laughs] And did you ignore that advice then?
Well no, because I don't really eat eggs anyway, so [laughs] I wasn't really, I wasn't really bothered, actually. So, because I think when I found out I was about, I was one and a half, coming on to two months, so I'd eaten whatever I wanted to eat anyway by that time, so I just didn't sort of realise. But I was careful about what I wasn't supposed to eat, but
She felt hot and anxious in pregnancy. Family members advised her to drink juice and eat cold...
It was the change that was a bit of a problem more than anything else, I had a great deal of anxiety - I could not vomit so I felt very hot.
Did you feel like vomiting?
No. I did not feel like eating much, but I felt very anxious that something hot was moving inside.
I felt as if smoke was coming out of my ears - I was full of anxiety every day, and thought how difficult it was, and was worried about what would happen in the coming days.
So, did you talk to any one about what was happening to you?
Yes, I discussed things with Aunty and Sister and told them how it was, they told me to drink juice or eat cold things or fruit.
Did they tell you not to eat hot things?
I did not feel like eating anything hot myself - I used to drink four or five cups of tea but then I stopped it. I used to feel hot just by looking at tea.
Good, hot inside anyway-
Yes it was hot.
Some people say that you should not eat hot things in this condition anyway-
You do not feel like eating anything for two or three months in any case.
Did anyone advise you to stay away from hot food?
No, they told me to eat what I felt like, but not to force myself, because if you are sick then that is not a lot of good.
Right, so you do not feel sick but just anxious?
Yes too much anxiety, it was really bad for three months but now I feel a bit better.
[Some foods are considered in many South Asian communities to generate heat in the body. Such 'hot' foods are not necessarily warm or spicy in themselves, but it is their effect on the body that matters. 'Cool' foods may be recommended to neutralise the 'hot' state of pregnancy.]
A fitness instructor, also from a Pakistani background, was keen that women from her own community should be better informed about the value of exercise in pregnancy. Another woman thought keeping fit had helped her recover from her caesarean section. Gentle exercise such as walking, yoga and swimming were commonly recommended; one woman thought her GP's advice was too cautious. NICE guidelines (National Institute for Health and Clinical Excellence- Antenatal screening CG62) recommend women can continue or start moderate exercise in pregnancy, but advise against contact sports, high-impact sports, vigorous racquet sports and scuba diving.
As a fitness instructor, she is keen to encourage pregnant women to continue exercising,...
Well, it's what we're trained as fitness instructors for, as well, to give advice out, you know, and generally you've - I mean I don't, I don't get much with sort of like, say, the Caucasian women, English women. I don't have the problem with them. It's the Asian women, because part of my work is also to deliver classes and, and exercise classes to Asian women, and you generally, what I've found is that some of the Asian women who fell pregnant just stopped exercising. And I said, “Look, you know, unless your doctor's advised you not to exercise for any problems that might harm you and the baby, you're actually okay to keep going. It'll actually help, you know, in terms of getting back into shape afterwards. And even the, the delivery itself, will help, you know, in terms of having your muscles supple and strong.” And so I sort of kept it in mind that I would carry on exercising.
She felt keeping fit in pregnancy helped her recover from her caesarean section.
Earlier in the pregnancy, what other sorts of fitness things were you doing?
I went swimming quite a lot [laughing] until it got to the stage that I could only swim on my back because my bump kept turning me round. And I had done aerobics up until the impact of the exercise was probably just too much, probably when I was about 4 months, I think, I had to give up my aerobics. But I carried on swimming until I was probably about 8 months pregnant, but certainly walking I carried right up to, yeah, until a few days before or so.
Do you think that being fit was helpful?
I think it, certainly being fit contributed to the quick recovery time after my section. I was able, you don't want to push yourself too quickly, I think, after you've had major abdominal surgery, which having a section is. You really do have to take things pretty easy for the first couple of weeks, certainly, afterwards. But I was able to go out walking probably, you know, 3 weeks after having had my section, I was able to push [baby's name] in her pram and things like that.
She felt one GP's advice about exercise in pregnancy was too cautious but another was supportive...
And then I'd actually spoken to, as I said, the people at the gym and when I saw my own GP the next week, I'd said that she had said this and she said, 'But all the research that's been done shows that exercise is good for you, that - as I had thought - that at that stage because there's so much sort of lining of the uterus and it's so small that you're not doing anything that's silly. You know, you're not going abseiling or going skiing or horse-riding or anything like that, you're doing sensible exercise.' She said, 'As you get further through you'll probably feel it's uncomfortable for you if you do high impact exercise and you can cause yourself damage to pelvic muscles and things if you carry on doing too much of that.' But she said, 'No, I don't see any reason.' And she said, 'You know, you can't wrap yourself up in a sort of a plastic bubble for the next 9 months. You have to live your life and if something happens then maybe it wasn't meant to be or, you know, there was something wrong.' So she made me feel better, because I'd just this feeling that, you know, 'Okay, I shouldn't be doing anything, running up the stairs or something.' You know, it was very, very bizarre.
What about discussions with midwives, has that been different to your relationship with the GPs?
No, the midwife, again, was, on the exercise thing was particularly positive and said that the more, not the more exercise I could do, but the longer I could do exercise the better. And as long as I was sensible, and not to get too overheated and too out of breath because that would have an effect.
Some women had to stop exercising because of aches and pains, including one who developed symphysis pubis disorder (pelvic joint pain) (see also 'Pain and discomfort'). Some simply felt too tired or sick to do much exercise, and stressed the importance of trying to rest and relax - not always easy if they had a toddler already. Women who have complications in pregnancy or previous problems such as miscarriage may be advised to rest a lot, and perhaps take time off work.
She was disappointed she had to stop exercising because of symphysis pubis disorder.
I think probably my lowest point was when the pelvic thing kicked in and I, I had had visions of myself going swimming. I'd only learned to swim this year and I felt very proud of myself. And I've been going swimming in the local pool - there's an outdoor pool and I could go most mornings before work, and I did that for the first three or four months of pregnancy. And I felt extremely healthy and very fit, and I enjoy things like going, going walking and so on. And suddenly at about four months to realise that those sorts of things had to come to an abrupt halt did make me feel quite resentful, I think. Because I had these expectations of how I was going to manage my pregnancy, and they didn't really come off.
After severe nosebleeds at 18 weeks, she had to stay off work and avoid strenuous activity for...
What has nosebleed got to do with pregnancy?
The nosebleeds they thought were a result of just simply the hormonal changes, and that I had a really particularly bad reaction. They could find no other reason - there was no blood pressure change or anything, and just they think that hormonal changes and the volume of blood in your body means that if there's pressure points, then these build up, and you, you get nosebleeds. And I just unfortunately had a really bad one that just wouldn't, wouldn't stop. And I, I lost quite a lot of blood, so had to get to hospital, so.
Okay, so you spent ten days in hospital dealing with the nosebleed. It sounds an awfully long time?
It was. It was [laughs]. It just, the nosebleeds kept happening, over and over again. Every time they packed it and every time you moved, then the nosebleeds would start again, so you were effectively just completely immobilised in your bed when that happened, so they could have a chance to heal, and the blood vessels had a chance to heal before I got home. So'
Okay, so you were signed off work?
Yes I was.
And then you had to rest a lot?
I was signed off work for the rest of my pregnancy after that eighteen weeks, that was me signed off work. And then I had to - I had to take quite a lot of rest, no heavy lifting and things like that. I could still do things around the house, and, but no heavy lifting, and obviously no decorating with nurseries and things like that. No doing these sorts of things, but, because later on they did come back, but not as bad, and they weren't as severe after that.
She gave up work in one pregnancy to reduce the risk of another miscarriage. With her second...
With my first one because I'd had a miscarriage and because it had, the miscarriage was still fresh in my mind, it, I didn't want to risk anything, you know. But I'm not the kind of person that kind of can sit at home and do nothing. And so, with my first, because the miscarriage was still fresh in my mind I decided, 'No, you know, I'm going to relax, rest and do everything I can.' With my second I took time off only when I experienced problems, because I'd, it was planned and because, you know, I thought I was prepared to, you know, even - you know, because I'd experienced such severe sickness I was prepared to go through everything again to have another child, and I thought I was mentally prepared. I felt that my body had recovered after my first child, and I left it two and a half years, and I was ready to have another child. But I thought I'll carry on with work and see how it goes. And I, and I did, but once I experienced problems I took about a month off, and that month was, carried me through to the end of my third month of pregnancy and into my fourth, so I thought once that's out of the way, it shouldn't be too bad. But what I did was I changed my hours at work, so I was working late evenings instead, instead of early mornings. And you know, I kind of took measures to kind of slow things down a bit, and make it a bit easier on myself, yeah.
Last reviewed May 2017.
Last updated August 2014.