7. Your Nutrition

You need about 30mg of iron a day to meet the increased needs of pregnancy. Baby draws on your iron stores to create its own stores for its first few months of life. This helps protect baby from iron deficiency if you breastfeed.

Your prenatal vitamin contains about 60mg of iron, which should be enough for you. If you must take iron supplements, take your iron pill with a glass of orange juice or grapefruit juice to increase its absorption. Avoid drinking milk, coffee or tea when taking iron supplements; they prevent the body from absorbing the mineral.

If you feel tired, have trouble concentrating, suffer from headaches, dizziness or indigestion, or if you get sick easily, you may have iron deficiency. An easy way to check is to examine the inside of your lower eyelid. If you’re getting enough iron, it should be dark pink. Your nail beds should also be pink.

Only 10 to 15% of the iron you consume is absorbed by the body. You need to eat iron-rich foods on a regular basis to maintain those stores. Foods rich in iron include chicken, red meat, organ meats (liver, heart, kidneys), egg yolks, dark chocolate, dried fruit, spinach, kale and tofu. Combining a vitamin-C food and an iron-rich food ensures better iron absorption. A spinach salad with orange sections is a good example.

If you eat a well-balanced diet and take your prenatal vitamin every day, you may not need additional iron. Discuss it with your healthcare provider if you’re concerned.

8. You Should Also Know

Chronic Fatigue Syndrome (CFS)

Chronic fatigue syndrome (CFS) is a condition in which a person experiences long periods of severe fatigue not directly caused by another condition. Resting doesn’t help relieve symptoms. We don’t know a lot about CFS and pregnancy. CFS affects about 1 million Americans; 80% are women.

Other problems may also be present. Research suggests about 65% of all people diagnosed with the problem also have symptoms of fibromyalgia.

CFS often affects women during childbearing years. Many women with chronic fatigue syndrome have had successful pregnancies and healthy babies. Symptoms improve in some pregnant women. Improvement usually occurs after the first trimester and may be due to pregnancy hormones. Some pregnant women experience no change, and some worsen. A woman may also feel worse during subsequent pregnancies.

If you have CFS and are pregnant, you will probably need extra rest during pregnancy. Some women may need bed rest.

Within weeks of delivery, about 50% of all new mothers relapse or feel worse than before pregnancy. This may be caused by the demands on a woman taking care of a newborn, along with the loss of pregnancy hormones. We don’t know if women with CFS pass the condition to their babies during pregnancy or breastfeeding.

Talk to your healthcare provider about any over-the-counter or prescription medicine you take. Some medicine may need to be stopped or dosages reduced. Folic acid has been shown to be beneficial before and during pregnancy.

Avodart and Propecia

You may have heard on TV or read in magazines that pregnant women shouldn’t handle certain medications, especially Avodart and Propecia. Should you take these warnings seriously? Can you harm your growing baby by just touching them?

You shouldn’t handle either of these pills during pregnancy because of possible problems if pills are crushed or broken, then handled. Medication could be absorbed into your body. If contact is accidentally made, wash the area immediately with soap and water. Let’s examine each medication more closely.

Avodart (dutasteride) is used to treat benign enlargement of the male prostate. This potent hormone can pass through the skin, so don’t handle it, even if it’s not broken. Handling it may cause a birth defect in a baby boy. Men shouldn’t donate blood while taking Avodart because blood could be given to a pregnant woman and cause a birth defect.

If UTIs are a problem, try eating less poultry and pork. These foods may contain an antibiotic-resistant form of E. coli.

Research also found dutasteride is present in the semen of a man taking Avodart, so don’t have unprotected sex during the first trimester, when baby is forming. Use a condom during sex.

Propecia (finasteride) is used to treat male-pattern baldness. Propecia tablets are coated, but it’s probably a good idea not to handle them at all. It could cause problems for a baby boy. No birth defects have been found in baby girls if a mother-to-be accidentally comes in contact with finasteride.

Bladder Infections

A urinary-tract infection (UTI) is the most common problem involving your bladder or kidneys during pregnancy. As the uterus grows, it sits directly on top of your bladder and the tubes leading from the kidneys to the bladder. This can block the flow of urine. Other names for urinary-tract infections are bladder infections and cystitis.

Keep Your Urinary Tract Healthy

• Don’t hold your urine—go when you feel the urge.

• Drink at least 100 ounces of fluid every day to flush bacteria from the urinary tract; include cranberry juice.

• Urinate immediately after sexual intercourse.

• Don’t wear tight underwear or slacks.

• Wipe from the front of the vagina to the back after a bowel movement.

Symptoms include the feeling of urgency to urinate, frequent urination and painful urination, particularly at the end of urinating. A severe UTI may cause blood in the urine.

Your healthcare provider may do a urinalysis and urine culture at your first prenatal visit. He or she may check your urine for infection at other times during pregnancy and when bothersome symptoms arise.

You can help avoid infection by not holding your urine. Empty your bladder as soon as you feel the need. It also helps to empty the bladder after having intercourse.

Drink plenty of fluid. Cranberry juice may help. Don’t take cranberry supplements without first asking your healthcare provider.

If you have a UTI during pregnancy, call your healthcare provider. Bacteria could pass through the placenta and affect baby. If left untreated, UTIs may cause other pregnancy problems.

There are many safe antibiotics available to treat a UTI infection, but some antibiotics may not be safe during pregnancy. Your healthcare provider can advise you.

Take the full course of any antibiotic prescribed for you. It may be harmful to baby if you don’t treat the problem!

Other Kidney Problems. A more serious problem resulting from a bladder infection is pyelonephritis. This type of infection occurs in 1 to 2% of all pregnant women. Symptoms include frequent urination, a burning sensation during urination, the feeling you need to urinate and nothing will come out, high fever, chills and back pain.

Pyelonephritis may require hospitalization and treatment with intravenous antibiotics. If you have pyelonephritis or recurrent bladder infections during pregnancy, you may have to take antibiotics throughout pregnancy to prevent reinfection.

Another problem involving the kidneys and bladder is kidney stones (renal calculi; nephrolithiasis). They occur about once in every 1500 pregnancies. Kidney stones cause severe pain in the back or lower abdomen and may cause blood in the urine.

Pain with kidney stones may be severe enough to require hospitalization. A kidney stone can usually be treated with pain medication and by drinking lots of fluids. In this way, the stone may be passed without surgical removal or lithotripsy (an ultrasound procedure).

Some women have chronic kidney disease, which raises risks during pregnancy. Research has shown a greater risk of various problems in women with chronic kidney disease.

Some Information May Scare You

In an effort to give you as much information as possible about pregnancy. The information is not included to frighten you; it’s there to provide facts about particular medical situations that may occur during pregnancy.

If a woman experiences a serious problem, she and her partner will probably want to know as much about it as possible. If a woman has a friend or knows someone who has problems during pregnancy, reading about it might relieve her fears. We also hope our discussions can help you start a dialogue with your doctor, if you have questions.

Nearly all pregnancies are uneventful, and serious situations don’t arise. However, please know we have tried to cover as many aspects of pregnancy as we possibly can so you’ll have all the information at hand that you might need and want. Knowledge is power, so having various facts available can help you feel more in control of your own pregnancy. We hope reading information helps you relax and have a great pregnancy experience.

If you find serious discussions frighten you, don’t read them! Or if the information doesn’t apply to your pregnancy, just skip over it. But realize information is there if you want to know more about a particular situation.

9. Exercise for Week 18


Stand with your feet flat on the floor and your arms by your sides. As you lift your arms straight in front of you and over your head, lunge forward with your right leg. Step back into the starting position as you lower your arms to your sides. Repeat 7 times, then lunge with your left leg. Tones and strengthens arms, upper back, back of legs and buttocks muscles.


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