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Health Promotion During

Pregnancy
Christian University of
Thailand

Pregnancy
Nutrition

Exercise and Relaxation


Sexual Relationship

BASIC NUTRIENTS

Proteins Fats
Carbohydrates
Minerals
Vitamins

egnancy and Nutrition

Key Nutrients for Mom and


Baby
Calcium Strong Bones
and Teeth
Iron

Oxygenation of
red blood cells

Vitamin AHealthy
skin,eyesight,
bone growth

Milk, cheese,
yogurt,
sardines
Lean red meat,
dried beans,
peas
Carrots,dark
leafy greens,
sweet potatoes

egnancy and Nutrition

Key Nutrients for Mom and


Baby
Vitamin C Healthy gums,
teeth and bones,
absorption of
Iron babys
Vitamin DBuild
bones and teeth

Citrus fruit,
broccoli,
tomatoes,
strawberries
Sunlight
exposure,

fatty fish, fortified


milk
Beef, liver,
Vitamin B6
Form RBC,helps
pork,ham,whole
use CHON, fat,
grain cereals,
and CHO
bananas

egnancy and Nutrition

Key Nutrients for Mom and


Baby
Liver, meat, fish,
Vitamin B12
Maintains
poulrty milk
nervous
system,form RBC (only in animal
foods) leafy
Folate
Green,
Produce blood
vegetables, liver,
and proteins,
orange juice,
help some
legumes, nuts
enzyme
functions

egnancy and Nutrition

Extra Nutrients
Folic Acid Reduce neural
Vitamin B tube defects
Folate
0.4 mg/day
Iron
27 mg

Prevent anemia

Green leafy
vegetables,
citrus fruits and
beans
Take in an empty
stomach or with
vitamin C

egnancy and Nutrition

Neural tube defects

Neural Tube
Defects

ow Much Should You Ea


Normal
weight
- Extra 300
calories/day
Overweight/o
bese
-Smaller weight
gain/weight loss

egnancy and Nutrition

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
https://www.yourpregnancyandchildbirth.com/topics.php?page=nutrition
Data from Institute of Medicine (US). Weight gain during pregnancy: reexamining th
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

egnancy and Nutrition

Pregnancy Risk for


Obese/Overweight Women

Gestational
Diabetes
High Blood
Pressure
Preeclampsia
Cesarean
Delivery

egnancy and Nutrition

Pregnancy Weight
Gain

Where does the weight go?

Where does the weight


go?
Baby
Breast growth
Maternal Stores
Placenta
Uterus
Amniotic Fluid
Blood
Body Fluids

7.5 lbs
2 lbs
7 lbs
1.5 lbs
2 lbs
2 lbs
4 lbs
4 lbs

egnancy and Nutrition

Special Concerns
Excess caffeine:
1. Caffeine
Interfere with
Moderate caffeine
sleep
intake
Cause nausea
(200 mg/day: 2 8 Lightounce cups of
headedness
brewed coffee)
Increase
does not appear
urination
to lead to
dehydration
miscarriage

egnancy and Nutrition

Special Concerns
2. Vegetarian Diets

- Take enough
protein.
- Take supplements
probably,
especially iron,
Vitamin B12 and
Vitamin D

egnancy and Nutrition

Special Concerns
Mercury
- do not eat
certain kinds of
fish ( shark,
swordfish, king
mackerel,
tilefish)

3.

- 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)

egnancy and Nutrition

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.

egnancy and Nutrition

Special Concerns
5. Pica
- Strong urges to eat
nonfood items such
as clay, ice,
laundry, starch
or cornstarch
- May lead to
constipation and
anemia.

egnancy and Nutrition

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.

egnancy and Nutrition

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.

egnancy and Nutrition

Exercise during
pregnancy can help
prepare you for labor
and childbirth.
Exercising afterward
can help you get back
in shape.

egnancy and Exercise

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.

egnancy and Exercise

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.

egnancy and Exercise

Changes in the Body


Balance
- You are carrying extra
pounds as much as 2540 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

egnancy and Exercise

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.

egnancy and Exercise

No Exercise During
Pregnancy for:
Risk factors for
Preterm Labor
Vaginal Bleeding
Premature Rupture
of Membranes
Pregnant women
with High Blood
Pressure

egnancy and Exercise

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.

egnancy and Exercise

Safe Sports

Walking
Swimming
Cycling
Aerobics

egnancy and Exercise

Other safe exercises if in


moderation

Running
Racquet
sports
Strength
training

egnancy and Exercise

Exercises to avoid during pregnancy

Downhill
snow skiing
Contact
sports
Scuba diving

egnancy and Exercise

Your routine
First 24 weeksmost practical
Last 3 monthsmay 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.

egnancy and Exercise

Things to Watch
Avoid:
Jumping
Jarring
motions or
quick
changes in
direction

Becoming
overheated
during
pregnancy---loss
of fluids--dehydration--problems during
pregnancy.

egnancy and Exercise

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.

egnancy and Exercise

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

egnancy and Exercise

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.

egnancy and Exercise

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?
gnancy and Sexual Relationship

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.

gnancy and Sexual Relationship

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)

gnancy and Sexual Relationship

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)

gnancy and Sexual Relationship

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.

gnancy and Sexual Relationship

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
gnancy
andcontractions.
Sexual Relationship

Is it normal for my desire for sex to


fluctuate during pregnancy?
Normal
Nausea, fatigue,
breast tenderness,
increased need to
urinate- make sex
bothersome ( 1st
trimester)
2nd trimester
heightened sex
drive.

There is increased
blood flow to the
pelvic area,
engorgement of
the genitals and
heightened
sensation

gnancy and Sexual Relationship

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.

gnancy and Sexual Relationship

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 HIVnegative.

gnancy and Sexual Relationship