Pregnancy & health


Being the healthiest you can be when you are pregnant includes having a healthy and nutritious diet and including key nutrients like calcium and folate. Taking care of your pelvic floor muscles is another important aspect of pregnancy and future health.

Many very good websites are dedicated to information on the stages and development of pregnancy. See our list of resources for reputable websites to visit if you want more specific information on your pregnancy.

Pregnancy is a time of great change and one of the most important things you can do is look after your own health. This includes eating well before (if possible), during and after pregnancy, and understanding the key nutrients to help you and your baby. Understanding how to help strengthen your pelvic floor muscles will not only help during pregnancy but is important for your future health and wellbeing. You will find information on nutrition and pelvic floor health in the following pages.

Nutrition before pregnancy

When you are planning a pregnancy it is an ideal time to think more about your food choices. Is the food you are eating providing you with all the nutrients required during pregnancy? Eating a healthy diet (as described in the dietary guidelines) will help you to meet your nutritional requirements more easily.

In addition, a new study[1] has found that a healthy diet in the year prior to getting pregnant is linked to a lower rate of birth defects. If you are planning to become pregnant, try to:

What to do What this means

Make sure you're getting enough folate (folic acid)

  • Take folate supplements (recommended for all women prior to and during pregnancy)
  • Eat folate-rich foods – present in a variety of vegetables and fruits as well as legumes, nuts and yeast extracts
  • Choose foods that have been fortified with folate – this includes some breakfast cereals and fruit juices, and most bread
Make sure you are getting enough iodine The National Health & Medical Research Council (NHMRC) recommends that all women planning a pregnancy or who are pregnant or breastfeeding take a 150µg (microgram) iodine supplement each day.[2]
If taking multivitamins, check they are specifically for pregnancy or preconception Vitamin A (retinol) is harmful in large amounts in pregnancy, so if you are taking a multivitamin check that it does not contain retinol.
Avoid eating fish with higher mercury levels Eat fish 2-3 times a week but limit fish with higher mercury levels e.g. shark (flake), ray, swordfish, barramundi, gemfish, orange roughy, long and southern blue fin tuna – to less than once per fortnight.

The best way to make sure you are getting enough nutrients is to have a healthy well-balanced diet rather than relying on vitamin supplements. For more information on a well-balanced diet visit the Nutrition Australia website or see our webpages on healthy living.

Nutrition during pregnancy

Women should not be dieting when they are pregnant. There are certain nutrition needs that must be met during pregnancy and very strict dieting puts that at risk.

Nutrition & pregnancy

Important nutrients

Calcium

Calcium is one of the essential nutrients necessary for healthy bone development.  Not only is calcium important to bones, it is also important for the function of various organs within the body and a certain amount of calcium circulates within the blood. If blood calcium levels fall, the body will compensate for this by drawing calcium out of bones and putting it into the blood. Calcium is also excreted by the body daily.

This means it is important to have an adequate daily intake of calcium through your diet, so your bone mineral strength is not compromised. The best sources of calcium are milk, yoghurt and cheese but other foods also provide calcium.

In pregnancy, the increased calcium requirement (to provide for skeletal growth in the foetus) is met through increased absorption in the mother's gastrointestinal system.

Women who breastfeed also have higher requirements for calcium, which is provided mainly from the mother's skeleton.

Normal pregnancy and breastfeeding is associated with a certain amount of bone mineral loss, which generally recovers 6-12 months after delivery and/or breastfeeding. 

Due to adaptation made by the body to obtain more calcium during pregnancy and breastfeeding, the calcium requirements are the same as for non-pregnant women. The calcium requirements for pregnant and lactating women are:

[3] Age (years) Recommended Daily Intake of calcium
Pregnant and lactating women

 
14-18 1,300mg/day
19-30 1,000mg/day
31-50 1,000mg/day

Iron

During pregnancy the body requires a greater amount of iron due to the gradually increasing blood volume of the mother and the formation of the baby's blood. The best sources of iron are red meat, chicken and fish but iron is also found in many other foods. It is important to include adequate amounts of iron in your diet throughout pregnancy to prevent anaemia and ensure the baby has adequate iron stores when born.

Folate

Folate (also called folic acid) is a B vitamin needed for healthy growing, in particular for the nervous system. Folate helps:

  • form red blood cells which carry oxygen around the body
  • cell growth in the body
  • in the development of the nervous system of babies both in the womb and while being breast fed
  • to reduce the risk of neural tube defects such as spina bifida in babies

Adequate intake of folate during pregnancy and breastfeeding is crucial, and requires a high quality diet. However, large surveys show women who are pregnant and breastfeeding often have a poor intake of folate through their diet. 

All women who are pregnant or planning a pregnancy are recommended to take a folate supplement.

Pelvic floor

In Australia, up to 42% of women aged 24-80 years have or have had urinary incontinence or 'leakage' [4]. Many women also experience bowel incontinence.

It is also possible to have pelvic floor muscles that are working too hard. In this case, women may experience pelvic pain and discomfort during intercourse.

About the pelvic floor

female pelvic floorThe pelvic floor is a very important group of muscles and one that is not talked about or exercised enough. Pelvic floor muscles are the layer of muscles spanning underneath the pelvis. 

Along with abdominal and back muscles, the pelvic floor helps to stabilise and support the spine, digestive system, pelvic and reproductive organs (including bladder, bowel and uterus) and plays an important role in preventing incontinence and supporting the pelvic organs. The pelvic floor is also important for sexual function in women, with voluntary contractions contributing to sexual sensation and arousal.

One of the risk factors for pelvic floor weakening is pregnancy and childbirth particularly:

  • multiple births
  • large birth weight (over 4kg)
  • instrument-assisted births
  • severe perineal tearing
  • long labours and/or rapid second stage of labour

More information on pelvic floor exercises is available here.

Other effects on pregnancy health

Fibroids

Sometimes fibroids cause problems in pregnancy or they interfere with labour and delivery. The number and position of the fibroids will determine if there is a problem. Fibroids can increase the risk of:

  • miscarriage
  • premature labour and delivery
  • wrong position of the baby (malpresentations) so the baby may not be positioned with its head down and the crown presenting
  • caesarean section, because the fibroid obstructs the baby moving down into the birth canal
  • reduced placental flow because the fibroids put pressure on the placenta
  • severe bleeding after childbirth

References

  1. Arch Pediatr Adolesc Med. 2012;166(2):121-126 http://archpedi.jamanetwork.com/article.aspx?articleid=1107698

  2. Iodine supplementation for Pregnant and Breastfeeding Women; NHMRC 2010 www.nhmrc.gov.au/guidelines/publications/new45

  3. Nutrient reference values for Australia and New Zealand; NHMRC 2006 www.nrv.gov.au/nutrients/calcium.htm

  4. Botlero r, Davis SR et al. Age specific prevalence of and factors associated with different types of urinary incontinence in community dwelling Australian women assessed with a validated questionnaire.  Maturitas. 2009 Feb; 62(2):134-9.

Last updated 03 July 2017 — Last reviewed 01 March 2014

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at March 2014.

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