How do I stay healthy during my pregnancy?

Quitting smoking is the single most important thing you can do for your health at any time – but especially when pregnant. Protect your baby from tobacco smoke to give them the healthiest start in life. This includes second hand smoke (breathing in other people’s smoke) – which poses a serious risk to you and your baby, before and after birth.

The sooner you can give up smoking the better. There are lots of benefits: 

• You will reduce the risk of having complications during your pregnancy and birth. 
• You will have a healthier pregnancy and healthier baby. 
• You will reduce your risk of stillbirth. 
• Your baby is less likely to be born early, which will avoid them having health problems that often go with being born too early (premature). 
• Your baby is less likely to be born with a low birth weight. A low birth weight can cause problems during and after labour, for example your baby might have problems keeping warm and are more likely to get infections. 
• You will reduce the risk of sudden infant death syndrome, also known as ‘cot death’. 

You can get assistance from a specialist midwifery support worker who is trained and experienced in helping pregnant people to quit smoking:

Bolton NHS Foundation Trust – 07827992883
Manchester University NHS Foundation Trust – 07971115482
Northern Care Alliance NHS Foundation Trust – 07966 240892
Stockport NHS Foundation Trust – 0161 419 4734 or 07876351391
Tameside and Glossop Integrated Care NHS Foundation Trust – 0161 922 5989 or 07425096374
Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust – 07786 501322

There are also some self-help resources available out there for you. Visit the NHS website or call the National Smokefree Pregnancy Helpline on 0300 123 1044. 

For those around you

Encourage your partner – or those close to you – to stop smoking too. 

We’ve mentioned that second hand smoke is also harmful to you and your baby. This includes not smoking in the house or the car.  

Partners can also get support by calling the National Smokefree Pregnancy Helpline on 0300 123 1044. 

Food and drink

There is lots of evidence to show that the nine months of pregnancy – and the first two years of a baby’s life – are the important opportunities to get food and nutrition right.  

Eating healthily during pregnancy will not only help your baby to grow and develop but help your body cope with the additional demands that come during pregnancy, so that your nutrition needs and those of your baby are met. 

It’s good to eat a variety of foods. Use the NHS Eat Well guide to help you make healthy choices.

You can also use the NHS guide to have a healthy diet in pregnancy.

Vitamins and supplements

Most of the vitamins and minerals you need during pregnancy will come from foods, however, it is advised to: 

• Take 400 micrograms folic acid every day before you’re pregnant and until you’re 12 weeks pregnant. 
• Take 10 micrograms (400 International Units) of vitamin D every day during pregnancy (and if you are breastfeeding) 
• From birth to one year of age babies should have between 8.5 to 10 micrograms of vitamin D daily (if breastfed or having less than 500mls/17.5oz of infant formula per 24 hours). 
• All children aged one to four years should have a daily vitamin supplement containing 10 micrograms of vitamin D as well as containing vitamins A and C. 

The Healthy Start Scheme is available if you need help to buy vitamins, food, or milk. Find out more on the NHS Healthy Start. 

Looking after your teeth and gums is important for everyone, especially when you’re pregnant.  

To keep your mouth healthy when you’re pregnant: 

• Before brushing, clean daily between the teeth to below the gum line using floss or tape to remove small bits of food from between your teeth. 
• Brush your teeth at least twice a day for twice minutes. 
• Brush last thing at night and at least on one other occasion. 
• Use a toothpaste that has 1350 – 1500 parts per million (ppm) of fluoride in it (this will be on the ingredient list). 
• Spit out after brushing but don’t rinse (this is to keep the fluoride on your teeth). 
• Use an alcohol-free fluoride mouthwash once a day at a different time to brushing. 

Healthy lifestyle habits such as avoiding alcohol, not smoking, and eating a balanced diet will also help to protect your teeth and gums. 

Whilst you are pregnant – and for 12 months after giving birth – you are entitled to free NHS Dental care. 

Your midwife, GP, Practice Nurse, or Health Visitor must apply for your Maternity Exemption Certificate for you. They may ask you to sign Form FW8 or they can apply for your Maternity Exemption Certificate online. If they apply for a digital certificate, you will receive it by email. Otherwise, you will receive it by post within ten days. 

If you need support to access dental care visit our service finder. 

Staying active during pregnancy is so important for your physical and mental health. It will also help you to cope with labour (giving birth) and to recover in the months after giving birth. Look online for some good videos – there are pregnancy yoga sessions and other exercise classes online. 

Exercise is not dangerous for your baby. There is evidence that those who are active are less likely to experience problems in later pregnancy and labour. 

Activities like walking and swimming are good to do, but avoid starting new intensive exercise during your pregnancy.

Visit the NHS website for exercise in pregnancy information and advice.

Pregnancy yoga

Yoga is a great way to stay active and look after your wellbeing during and after pregnancy.  

Visit the NHS prenatal and postnatal yoga video page for more information. 

Tommy’s (the pregnancy and baby charity) also has a page of information and resources about yoga. 

If you’re pregnant or planning to become pregnant, do not drink alcohol. This will keep any risk to your baby to a minimum. 

Drinking alcohol whilst you are pregnant can harm your baby, and the more you drink, the greater the risk.  

Drinking alcohol during pregnancy also increases the risk of having a miscarriage, premature birth or your baby having a low birth weight.  

If you drink alcohol during your pregnancy your baby could develop a serious life-long condition called fetal alcohol spectrum disorder (FASD). The NHS has more information about FASD and the services available to help you stop drinking if you need them 

If you’re pregnant and continuing to drink alcohol during your pregnancy, please speak to your midwife or doctor as soon as possible. Help and support is available to you. 

You can have caffeine in pregnancy, but no more than 200mg per day. Caffeine is found in coffee, tea, soft drinks, energy drink and chocolate.  

Regularly drinking more than this amount can increase your risk of pregnancy complications, such as low birthweight, and even miscarriage. 

There is: 

• 100mg in a mug of instant coffee 
• 140mg in a mug of filter coffee 
• 75mg in a mug of tea (green tea can have the same amount of caffeine as regular tea) 
• 40mg in a can of cola 
• 80mg in a 250ml can of energy drink 
• less than 25mg in a 50g bar of plain dark chocolate 
• less than 10mg in a 50g bar of plain milk chocolate 

Visit Tommy’s  to calculate your daily caffeine intake and for more information about caffeine.

Heartburn

Indigestion – or heartburn – is common in pregnancy.   

Up to 70% of people report being affected by heartburn, which seems to get worse towards the end of pregnancy. This is probably caused by pressure from your growing baby on your stomach and also hormonal changes affecting your digestive system.  

Speak to your midwife if you’re struggling with heartburn.  

Eating little and often rather than one large meal could help.  

Some antacids are safe to take – ask your midwife and pharmacist for advice.  

Stretch marks

Stretch marks are narrow, streak-like lines that can develop on the surface of your skin. 

80% of people will experience stretch marks during pregnancy.  

They occur due to rupturing of the collagen under your skin caused by the stretching of your skin as your baby grows. It’s nothing to worry about and totally normal. 

Some people may feel proud of their stretch marks as they show how strong their body has been to grow a baby. But other people can feel self-conscious and buy creams to help them fade. In time, stretch marks will face from the red purple colour to a silver skin-tone colour.  

Haemorrhoids and constipation

When you’re pregnant, the progesterone hormone relaxes your muscles in the digestive system, causing food to move more slowly.  

Haemorrhoids are swollen veins in the bottom part of your bowel near the opening (your anus). They can be painful and bleed when you are having a poo, especially when if you’re constipated.  

There are things you can do, like having more fibre in your diet and drinking lots of water to soften the food in your gut and make it easier to poo.  

You’ll find fibre in fruits and vegetables, cereals, and brown bread. Increasing the amount of these types of food you eat should help your constipation and reduce any pain caused by haemorrhoids.  

Sleeplessness

Being unable to sleep whilst pregnant is a common complaint. As your pregnancy progresses, you might feel more tired but might find it difficult to get comfortable at home.  

Some people might experience strange dreams about labour and birth – which is normal – it could be your bodies way of adjusting to this big lifestyle change. 

Our advice is to sleep on your left side, and not on your back, to ensure you and your baby get plenty of oxygen – especially later in your pregnancy.  

A pregnancy pillow could also help you find a more comfortable sleeping position and relaxation music might also help.  

If you have the time and opportunity for a nap in the day, go for it, as it will also help you to prepare for sleeping during the day when your baby is born. 

Backache

Backache is common in pregnancy, especially in the early stages.  

When your pregnant, your ligaments become softer and stretch to prepare for your labour. This can put a strain on the joints in your back and pelvis, which might cause pain. 

There are things you can do to ease backache such as wearing flatter shoes to help distribute your weight, keeping your back supported when sitting, getting enough rest and not lifting any heavy objects. 

Doing antenatal yoga or aqua natal classes can also help to build your muscles to better support your back.  

If your backache is very painful, talk to your midwife or healthcare professional; they may refer you to a physiotherapist who can give you some helpful exercises to support your back. 

If you have any of the following symptoms alongside substantial back pain, please contact your midwife or maternity team as soon as possible so they can check you don’t have an infection, premature labour, or pre-eclampsia.  

• Bleeding from your vagina. 
• Pain when you have a wee. 
• Pain that moves to your side and under your ribs. 
• Swelling. 
• Fever. 

Water retention (Oedema) 

When your pregnant, it’s common for your legs, ankles, feet and fingers to swell due to your body holding more water than usually. This particularly symptom usually develops later in your pregnancy and can get worse by the end of the day. 

Whilst this is normal, you should seek immediate medical help if you are experiencing sudden onset of swelling, bad headaches, flashing lights or blurry vision, several abdominal pain or severe pain below your ribs, or vomiting. These symptoms could be a sign of pre-eclampsia, and you would need treatment as soon as possible. 

There are things you can do to ease your swelling such as keeping your feet up and wearing comfortable shoes, keeping yourself hydrated and moving your feet in circles, up and down to ease the discomfort.  

Carpal Tunnel syndrome

Some people report feeling pain or tingling in their wrist or hand during pregnancy. This is caused by swelling or water retention (oedema) putting pressure on the nerve in the wrist. 

Some people experiencing this might not be able to use their hand as normal. If this happens to you, please speak to your midwife as she could refer you to a physiotherapist who can help you manage the pain and may give you a wrist splint to help.  

Pelvic girdle pain

Pelvic girdle pain is a collection of uncomfortable symptoms caused by a stiffness or looseness in your pelvic joints. It can cause your joints to move unevenly at the back or front of your pelvis. 

One in five pregnant people report pelvic pain. Whilst it’s not harmful to your baby, it can be disruptive to your life and make it difficult to get around. 

The exact cause of this type of pain is uncertain, but it’s thought to be due to the hormonal changes that cause your ligaments to relax.  

If your pain is in the front of your pelvis, you might hear it called ‘Symphysis Pubis Dysfunction’, named after that painful joint.   

The pain can be severe for some people and if this happens to you, please speak to your midwife who could refer you for physiotherapy. You could be given exercises, a support belt or potentially crutches to help.