CALUMET - Every expectant mother wants to give birth to a healthy, happy baby, and while a perfect pregnancy and delivery cannot be guaranteed, there are many things pregnant women can do to make the nine-month process as smooth as possible.
According to local obstetricians, the starting point for pregnant women is to simply be proactive about their own health and the health of their baby.
"One thing, unfortunately, that I don't often get a chance to tell women is that it's really best if they behave intentionally when it comes to pregnancy," said Aspirus Keweenaw OB/GYN Dr. James Feeley, who often does not see women until the end of the first trimester. "A lot of damage from environmental exposures has already happened by the time I meet them."
While Feeley said some pregnant women are ambivalent or oblivious and don't quit unhealthy habits such as drinking and smoking, others are hyperanxious and overanalyze what can be harmful.
A happy medium can be reached by being informed, and Feeley recommends the website OTISpregnancy.org to find medically supported advice.
Nutrition is often an area of concern among pregnant women, and there are many common misconceptions about how much to eat and what to eat.
"I always like to tell patients, 'You're definitely not eating for two.' It's not double your meals, it's only about an extra 300 calories per day," said Portage Health OB/GYN Dr. Rebecca Baudoin. "That's really only a few more bites during a meal or an extra snack in the afternoon or evening. ... Otherwise women can start to gain a lot of extra weight, then it's that much more difficult to lose after the baby comes."
In the early stages of pregnancy, Baudoin said appetite is decreased so it can take a conscious effort to eat extra calories, but later on the effort may need to be on limiting intake. It's common to only gain two to four pounds in the first trimester, but for a normal-weight woman, gaining 25 to 30 pounds during the pregnancy is common.
Gaining only 15 pounds may be normal for already overweight women.
As far as what to eat, Feeley and Baudoin both warn against undercooked meat, unpasteurized dairy and mercury-carrying products such as fish - large predator fish are particularly dangerous.
Small servings of basic seafood such as shrimp and tuna are fine but should be consumed in moderation.
"Mercury is something else we don't like pregnant women to get too much of," Baudoin said. "None of us should have too much, but pregnant women especially, because too much mercury can lead to abnormalities in the neurologic development of the baby and in severe cases can lead to mental retardation or fetal death."
Many pregnant women are unsure of how to continue taking prescribed medications, and they need to be evaluated on a case-by-case basis with a doctor. Some medications and vaccinations, though risky, would create greater risks by not taking them.
Exercise is another topic that can be confusing for pregnant women, but regular exercise during pregnancy is both normal and encouraged, even into the third trimester - of course, with the exception of contact sports.
"Exercise is good for them, but if they start off as a couch potato, don't expect to be a marathon runner,"?Feeley said. "If they're a marathon runner, don't become a couch potato while pregnant."
Feeley also suggested pregnant women avoid too much time in hot tubs, particularly those with temperatures more than 102 degrees, and Baudoin advised staying away from cat litter, which can carry a bacteria that can cause pregnancy complications.
Ultimately, even for pregnant women who do everything correctly, there are no guarantees.
"Women have to have realistic expectations. Even with a perfect diet and optimizing everything, it doesn't guarantee that the baby will go to Harvard. People have to realize there are a whole lot of different factors," Feeley said. "Pregnancy is one of those situations where people hope for and wish for a sense of control, and we just don't have absolute control. ... It's not a matter of absolutes, it's about trying to reduce the risk factors."
Between 20 and 25 percent of pregnancies end in miscarriage, but by taking the proper precautions and avoiding dangerous habits, women can increase their chances of giving birth to a healthy baby.
"Much like all things in life, you can't worry yourself thinking about the what ifs because you'll worry yourself non-stop about things that are beyond your control,"?Baudoin said. "I always tell patients just be as healthy as you can and take care of yourself."