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Not your mama’s pregnancy Prenatal Care

Not your mama’s pregnancy

Today’s best practices are a bit different from those of yesteryear. Stay abreast of the latest advice for the healthiest pregnancy possible.

My mom is amazing. She delivered five healthy babies, one of them naturally (me!), and breastfed every one of us. She believes that motherhood is a lifelong calling (she’s right), and she continues to be a loving, capable mom and nana to her clan today. I would not hesitate to ask my mom for advice on a myriad of subjects; however, there are some changes that have taken place in the world of obstetrics since her time at the rodeo.

If your mama’s maternity know-how is also a little outdated, don’t sweat it—just get a second opinion. Fortunately, your OB or midwife can keep you up to speed on the latest recommendations for pregnancy and delivery, and your friends here at P&N have a few tips for you, too. So out with the old advice, and in with the new!

OLD ADVICE: Wait three months to tell people you’re pregnant.
NEW ADVICE: Tell them when you’re ready.

In today’s world of sharing (and honestly, sometimes over-sharing) via Facebook, Instagram, blogs and beyond, not much is kept private for long—and that includes pregnancy. Women once kept their impending bundles of joy hush-hush for at least the first three months, showed ultrasound images only to close family members, and didn’t publicly reveal the sex of their babies-to-be (if they knew it). But times have changed. Because any pregnancy has a chance of ending in miscarriage, it’s still smart to protect your own feelings by suppressing the news until you’ve at least had an ultrasound and heard a heartbeat. However, it’s now acceptable to announce your pregnancy at any time you choose. And speaking of ultrasounds, they’ve come a long way even since the early ’90s! It now makes more sense to show them off. Viewers can make out baby’s profile pretty clearly in modern ultrasounds, and visual gender predictions are much more accurate than they used to be (which is really nice when you’re planning a baby shower). Even if you do announce a pregnancy that later ends in miscarriage, we tend to be fairly open now about sharing our experiences with failed pregnancies and infertility, too. So many people have faced these challenges that, culturally, we’ve decided to share our feelings and help each other rather than hide.

OLD ADVICE: Limit exercise, and focus on rest.
NEW ADVICE: Keep moving.

Back in the day, pregnancy was treated more like an illness than anything else. Women were expected to rest and relax, putting little strain on their bodies. While this sounds pleasant in a way, 40 weeks of rest and relaxation can get old— just ask anyone who has been put on bed rest long-term.

Beginning in the 1980s, women experiencing healthy pregnancies were allowed—and eventually encouraged—to exercise. The benefits of fitness are many: better controlled weight gain, improved circulation, stronger heart and lungs, greater endurance (which can help during labor and delivery!) and a more positive mental state.

Because your balance is off and your joints are loose, certain activities are still discouraged during pregnancy. Stay away from contact sports, horseback riding, skiing, biking and scuba diving. (For a more complete list, see your doctor.) Drink lots of water, and stop any activity that is causing you pain or making you feel dizzy or lightheaded. Above all, listen to your body!

Some health care providers will recommend continuing only activities you were already practicing before the pregnancy. Others are OK with starting new exercise programs after conception (especially if they’re low-impact activities like walking or swimming). Discuss your exercise plans with your practitioner, and make sure you have the green light to work out. Certain pregnancy complications could stand in the way of your fitness goals, but baby comes first. If you have to put the workouts on hold until after delivery, so be it.

OLD ADVICE: Stop drinking coffee—or caffeine in any form.
NEW ADVICE: Limit coffee to a cup a day.

In 1980, the U.S. Food and Drug Administration advised pregnant women to stay away from caffeine, based on the results of studies conducted on animals.

In the 21st century, we’ve taken a more casual approach toward caffeine consumption. Although turning down caffeine certainly won’t hurt (except maybe to leave you tired), recent studies have failed to prove that small amounts of caffeine are harmful to a pregnancy. Where coffee drinking was once thought to be linked to intrauterine growth restriction and miscarriage, it’s now considered safe for daily use in appropriate quantities.

What are these appropriate quantities, you ask? It’s generally advised that women take in less than 200 milligrams of caffeine per day while pregnant. Here’s how that plays out: a cup of coffee has 76-137 milligrams of caffeine, tea has 26-48 milligrams, caffeinated sodas contain about 37 milligrams, and 1.45 ounces of dark chocolate has 30 milligrams. In other words, if your day calls for a cup of joe and a piece of chocolate, don’t feel guilty for indulging.

OLD ADVICE: A glass of wine a day is A-OK.
NEW ADVICE: No alcohol. Period.

The debate went on for years: Is it OK to have a drink now and then, or even once a day, while expecting? How much alcohol is too much during pregnancy?

Then, in October 2015, the American Academy of Pediatrics (AAP) released a report that finally laid to rest the question of alcohol use during pregnancy. The report states, “There is no known absolutely safe quantity, frequency, type or timing of alcohol consumption during pregnancy.” Fetal alcohol spectrum disorders (FASDs) can have devastating, lifelong consequences for the children affected; for this reason, the AAP insists that consuming any amount of alcohol during pregnancy poses too great a risk.

Now, does this mean you are doomed if you drank during the first weeks of your pregnancy, before you knew you were expecting? Absolutely not. This is a common occurrence and, chances are, your child will be just fine. It is important, however, that you stop drinking completely the moment you find out you have a baby on the way. (Ideally, it’s wise to abstain from alcohol even while you’re trying to get pregnant, but it’s not always something you can see coming!)

OLD ADVICE: Smoking during pregnancy is no big deal.
NEW ADVICE: Absolutely no smoking! Before, during and after pregnancy, smoking is highly discouraged.

It’s hard to imagine a time when the sight of a pregnant woman smoking a cigarette was commonplace. However, rewind to the early 1960s, and she wouldn’t have turned heads. At the time, there was no official stance against smoking during pregnancy (or smoking in general, for that matter). Although various studies had been conducted worldwide that linked smoking to lung cancer, it wasn’t until 1964 that the U.S. Surgeon General published findings that definitively outlined the harmful effects of smoking and began to change the public perception of the habit.

The 1964 “Smoking and Health” report detailed several dangers of smoking, including a finding that women who smoke during pregnancy are more likely to deliver underweight infants.

Now we know that smoking carries many risks for pregnant women and their unborn babies besides low birth weight. Pregnant women who smoke have a higher likelihood of premature delivery, ectopic pregnancy, miscarriage and stillbirth. Baby has a higher chance of being born with certain birth defects and of passing away from sudden infant death syndrome (SIDS) during the first year.

OLD ADVICE: Keep your weight gain as low as possible.
NEW ADVICE: Gain a reasonable amount of weight based on your prepregnancy size.

In decades past, doctors shamed patients for gaining too much weight during pregnancy, believing they were putting themselves and their babies at risk. My own grandmother, who delivered her first child in 1960, remembers following a strict diet during pregnancy. She would often eat only cottage cheese as a “meal,” and as a result, gained very little weight.

Gradually, the medical industry came to see that mothers gaining too little weight led to babies weighing too little at birth and facing unnecessary health challenges. By the 1970s, weight restriction began to ease up. Today, most doctors are fairly relaxed about weight gain—not too much, not too little—unless additional risk factors are at play. As of 2009, the American College of Obstetricians and Gynecologists (ACOG) recommends the following pregnancy weight gain guidelines:

If you’re …
Underweight: 28-40 pounds
Normal weight: 25-35 pounds
Overweight: 15-25 pounds
Obese: 11-20 pounds

OLD ADVICE: Hide that bump with baggy clothes.
NEW ADVICE: Show off your curves!

It’s obvious that maternity fashion has come a long way since my mama’s day. Maternity clothes used to resemble tents more than fashionable garments. Frumpy dresses and baggy tops were used to hide any evidence of a baby belly. And there weren’t a whole lot of options when it came to shopping for your maternity wardrobe.

Today, we are spoiled rotten with a plethora of maternity designers offering all sorts of styles. In stores or online, fun pregnancy duds are not hard to find. And with celebrity mamas showing off their curves in form-fitting runway gowns, the rest of us feel a little more comfortable toting our own baby bumps about. It’s more proof that today, more than ever, pregnancy is something to be celebrated.

OLD ADVICE: The hospital staff will tell you how to deliver.
NEW ADVICE: Give birth lying down, in a squat, with or without drugs—you call the shots.

Birthing trends come and go with the decades, from the 1950s when women were practically unconscious and strapped to gurneys; to the 1970s when Lamaze was all the craze; to the 1990s when you could expect an epidural, IV and constant monitoring. In recent years, HypnoBirthing and birthing tubs have gained popularity among those hoping to deliver without anesthesia. (PSA: In 2014, the AAP and ACOG officially advised against giving birth while in water, but they do advocate for laboring in the tub. Just hop out before baby arrives!)

Today, hospitals and birth centers let you choose your method of delivery. Want to birth naturally? Great. Prefer an epidural? No problem. Require a C-section? Let’s do it. If labor is progressing normally and baby appears to be doing fine, then mom is free to walk around, sit on a birthing ball or hop in the shower.

In the 10 years since my first pregnancy, there has been more emphasis on delivering with fewer interventions. Anesthesia is available (and usually very effective) if mom wants it, but she does not have to lie down in a bed attached to straps and tubes. In 2007, inductions and C-sections were often scheduled purely for convenience. Not so much today. In 2013, ACOG revised the definition of a “full-term pregnancy” to begin at 39 weeks, discouraging women and doctors from inducing labor any earlier unless medically necessary.