4. Your Nutrition

Some important vitamins you may need during pregnancy include vitamin A, vitamin B and vitamin E. Let’s examine each vitamin and how it can help you.

Vitamin A is essential to human reproduction. Fortunately, deficiency in North America is rare. What’s of more concern is the excessive use of the vitamin before conception and in early pregnancy. (This discussion concerns only the retinol forms of vitamin A, usually derived from fish oils. The beta-carotene form, of plant origin, is believed to be safe.)

The RDA (recommended dietary allowance) is 2700IU (international units) for a woman of childbearing age. The maximum dosage is 5000IU. Pregnancy doesn’t change these requirements. You probably get enough vitamin A from the foods you eat, so supplementation during pregnancy isn’t recommended. Read food labels to keep track of your vitamin-A intake.

B vitamins important to you in pregnancy include B6, B9 (folic acid/folate) and B12. B vitamins help regulate the development of baby’s nerves and formation of blood cells. If you don’t take in enough B12 during pregnancy, you could develop anemia. Taking enough may help prevent certain birth defects.

There are many good food sources of B vitamins. Some you may enjoy include milk, eggs, tempeh, miso, bananas, potatoes, collard greens, avocados and brown rice.

Vitamin E helps metabolize fats and builds muscles and red blood cells. You can usually get enough vitamin E if you eat meat. Vegetarians and women who can’t eat meat may have a harder time getting enough. If you don’t take in enough vitamin E, you increase the risk of your child developing asthma by age 5. But don’t take megadoses of vitamin E; studies show it could cause problems.

Foods rich in vitamin E include olive oil, wheat germ, spinach and dried fruit. You may want to check with your healthcare provider or read the label on your prenatal vitamin to see if it supplies 100% of the recommended daily allowance.

Be cautious with every substance you take during pregnancy. If you have questions, discuss them with your healthcare provider.


Many parents-to-be are now scheduling a babymoon before the end of pregnancy. A babymoon is a prebaby vacation—a trip for expectant parents to reconnect and to enjoy each other’s company before baby’s birth. It usually focuses on relaxing and pampering.

A couple can plan a weekend getaway close to home or take a trip farther afield. Some hotels and resorts now offer babymoon packages. Keep in mind it’s the time you spend together that’s important, whether you stay in a luxury hotel close by, find a mountain lodge to cuddle up in or relax in a cottage by the sea.

A babymoon is a time to take walks, sleep in, lay by the pool, shop, eat in nice restaurants, take pictures and build memories. It’s a time to enjoy each other’s company before your hectic life as parents begins. Some people look forward to a babymoon so they can pamper themselves with massages and other spa treatments. Whatever you choose to do, it’s a time to draw closer together.

Before You Make Plans. Be sure you discuss your plans with your healthcare provider before paying any deposits or buying any nonrefundable tickets. He or she may have valid reasons you shouldn’t travel.

Baby’s experiences inside the uterus impact its cognitive and sensory development.

If you get the OK to go, do some research. If you were thinking of going on a short cruise, check to see if the cruise line bans pregnant women from traveling after a particular time in pregnancy. If you’re thinking about going somewhere with activities you’d like to do, check to see if there are any restrictions on pregnant women. No matter what you plan, keep it simple and casual.

Often the best time in pregnancy to travel is during the second trimester. You’re usually past any morning sickness at this point, and you haven’t grown too large to enjoy moving around.

If you decide to take a babymoon, relax, share time together and enjoy the baby-free environment. It won’t be long until you’ll both be involved in the all-encompassing days and nights of being parents!


Lupus is an autoimmune disorder of unknown cause that occurs most often in young or middle-aged women. It is a chronic inflammatory disease that can affect more than one organ system. Those with lupus have a large number of antibodies in the bloodstream. These antibodies are directed toward the person’s own tissues and various body organs and may damage organs. Affected organs include joints, skin, kidneys, muscles, lungs, the brain and the central nervous system. The most common symptom of lupus is joint pain, which is often mistaken for arthritis. Other symptoms include lesions, fever, hypertension, rashes or skin sores.

Over 1½ million people in the United States have some form of lupus. Women have lupus much more frequently than men—about nine women to every man. Nearly 80% of the cases develop in people between the ages of 15 and 45. Lupus is 2 to 3 times more common in women of color, including Black/African Americans, Latina/Hispanics, Asian American/Pacific Islanders and Native Americans/Alaska Natives.

The term lupus actually applies to many different forms of the same disease. There are five types of the disease: cutaneous lupus (discoid lupus, ACLE, SCLE, CCLE, DLE), systemic lupus erythematosus (SLE), drug-induced lupus (DILE), overlap lupus and neonatal lupus.

Cutaneous lupus primarily affects the skin but may involve the hair and mucous membranes. Systemic lupus erythematosus (SLE) can affect any body organ or system, including joints, skin, kidneys, heart, lungs or nervous system. Most often when people speak about “lupus,” they are referring to this type; about 70% of all cases of lupus are SLE. SLE affects one in every 2000 to 3000 pregnancies. The effects of SLE on pregnancy are most often related to high blood pressure or kidney problems.

Drug-induced lupus can be a side effect of long-term use of some medicines. When it is stopped, symptoms often disappear completely within a few weeks. Overlap lupus is a condition in which a person has symptoms of more than one connective-tissue disease. In addition to lupus, a person may also have scleroderma, rheumatoid arthritis, myositis or Sjogren’s syndrome.

Neonatal lupus is quite rare. A mother-to-be passes her autoantibodies to her baby, which can affect baby’s heart, blood and skin. The condition is associated with a rash that appears within the first few weeks of life. It can last up to 6 months.

Lupus is diagnosed through blood tests, which look for the suspect antibodies. Blood tests done for lupus are a lupus antibody test and an antinuclear antibody test.

Treating Lupus. Steroids, short for corticosteroids, are generally prescribed to treat lupus. The most common medicines used are prednisone, prednisolone and methylprednisolone. A small amount passes to the baby. It may be unnecessary to take prednisone every day.

Dexamethasone and betamethasone pass through the placenta and are used only when it’s necessary to treat the baby as well. These medications are used in preterm labor and delivery to accelerate lung maturation. This is called antenatal corticosteroid administration.

If you use warfarin, contact your healthcare provider; it should be replaced with heparin as soon as possible. If you have high blood pressure, you may have to switch medicines. Don’t take cyclophosphamide during the first trimester. Azathioprine and cyclosporin may be continued in pregnancy.

Lupus during Pregnancy. All lupus pregnancies should be considered high risk, although most lupus pregnancies are completely normal. “High risk” means solvable problems may occur during the pregnancy and should be expected. More than 50% of all lupus pregnancies are completely normal, and most of the babies are normal, although babies may be somewhat premature.

About 35% of pregnant women with lupus have antibodies that interfere with the placenta’s function. These antibodies may cause blood clots to form in the placenta that prevent the placenta from growing and working normally. To deal with this problem, heparin therapy may be recommended; some healthcare providers also add a small dose of baby aspirin.

The risk of complications is slightly increased in a woman with lupus. Protein in the urine may get worse. It’s a good idea to see your rheumatologist every month during pregnancy. If you begin to have a flare-up or other symptoms, it can be dealt with.

If you had kidney damage from previous flare-ups, be on the lookout for kidney problems during pregnancy. Other common symptoms are arthritis, rashes and fatigue. Some women experience improvement in their lupus during pregnancy.

A “stress” steroid is often given to a woman with lupus during labor to protect her. After baby’s birth, some experts believe steroids should be given or increased to prevent a flare-up of lupus in the mom. A woman with lupus can breastfeed; however, some medications, including prednisone, may interfere with milk production.

5. Exercise for Week 27

While standing in line at the grocery store, post office or anywhere else, use the time to do some “creative” exercises. These exercises help you develop and strengthen some of the muscles you’ll use during labor and delivery.

• Rise up and down on your toes to work your calves.

• Spread your feet apart slightly, and do subtle side lunges to give your quadriceps a workout.

• Clench and relax your buttocks muscles.

• Do the Kegel exercise to strengthen pelvic-floor muscles.

• Tighten and hold in your tummy muscles.

You probably have to reach for things at home or at the office. When you do, make it an exercise in controlled breathing.

• Before you stretch, inhale, rise up on your toes and bring both arms up at the same time.

• When you’re finished, drop slowly back on your heels.

• Exhale while slowly returning your arms to your sides.


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