What to expect when you're expecting (49 page)

For tips on when to break the news at work, see
page 188
.

“Should I be taking vitamins?”

Virtually no one gets a nutritionally perfect diet every day, especially early in pregnancy, when round-the-clock morning sickness is a common appetite suppressant, or when the little nutrition some women manage to get down often doesn’t stay down (sound familiar?). Though a daily vitamin supplement can’t take the place of a good prenatal diet, it can serve as some dietary insurance, guaranteeing that your baby won’t be cheated if you don’t always hit the nutritional mark you’re aiming for, especially during the early months when
so much of your baby’s most crucial construction occurs.

And there are other good reasons to take your vitamins. For one thing, studies show that women who take a vitamin supplement containing folic acid and vitamin B
12
during the first months of pregnancy (and even prior to pregnancy) significantly reduce the risk of neural tube defects (such as spina bifida) in their babies, as well as help prevent preterm birth. For another, research has shown that taking a supplement containing at least 10 mg of vitamin B
6
before and during early pregnancy can minimize morning sickness (and who needs a better reason than that?).

Good formulations designed especially for expectant mothers are available by prescription or over-the-counter. (Ask your practitioner for a recommendation and see
page 103
for details on what the supplement should contain.) Don’t take any kind of dietary supplements other than such a prenatal formula without your practitioner’s approval.

Some women find that taking the typical horse-size prenatal supplement increases nausea, especially early in pregnancy. Switching vitamin formulas or pill types may help, as may taking your pill with food (unless you usually throw up after eating) or taking it during the time of day when you’re least likely to be nauseous. A coated pill is often easier to tolerate, as well as easier to swallow. If even that bothers you, you might consider a chewable supplement or a slow-release one. If your nausea is particularly bad, look for a formulation that’s higher in vitamin B
6
(ginger is another good addition for the queasy set). But be sure any formula you select approximates the requirements for supplements designed for pregnancy and doesn’t contain any extras that might not be safe (such as herbs). If your practitioner prescribed your supplement, check with him or her before switching.

In some women, the iron in a prenatal vitamin causes constipation or diarrhea. Again, switching formulas may bring relief. Taking a pregnancy supplement without iron and a separate iron preparation (your doctor can recommend one that dissolves in the intestines rather than in the more sensitive stomach—or one that is a slow release) may also relieve symptoms.

“I eat a lot of cereals and breads that are enriched. If I’m also taking a prenatal supplement, will I be taking in too many vitamins and minerals?”

You can get too much of a good thing, but not usually this way. Taking a prenatal vitamin along with the average diet, which includes plenty of enriched and fortified products, isn’t likely to lead to excessive intake of vitamins and minerals. To take in that many nutrients, you’d have to be adding other supplements beyond the prenatal ones—which an expectant mother should never do unless advised by a physician who knows that she’s pregnant. It’s wise, however, to be wary of any foods (or drinks) that are fortified with more than the recommended daily allowance of vitamins A, E, and K, because these can be toxic in large amounts. Most other vitamins and minerals are water-soluble, which means any excesses that the body can’t use are simply excreted in the urine. Which is, by the way, the reason why supplement-crazy Americans are said to have the most expensive urine in the world.

“Now that I’m pregnant, I’m tired all the time. Sometimes I feel as if I won’t even be able to get through the day!”

Can’t lift your head off the pillow each morning? Dragging your feet all day? Can’t wait to crawl into bed as soon as you arrive home at night? If it seems like your get-up-and-go has left the building—and doesn’t plan to be back anytime soon—it’s not surprising. After all, you’re pregnant. And even though there might not be any evidence on the outside that you’re busily building a baby, plenty of exhausting work is going on inside. In some ways, your pregnant body is working harder when you’re resting than a nonpregnant body is when running a marathon—only you’re not aware of the exertion.

So what exactly is your body up to? For one thing, it’s manufacturing your baby’s life-support system, the placenta, which won’t be completed until the end of the first trimester. For another, your body’s hormone levels have increased significantly, you’re producing more blood, your heart rate is up, your blood sugar is down, your metabolism is burning energy overtime (even when you’re lying down), and you’re using up more nutrients and water. And if that’s not enough to wear you out, just toss into the enervating equation all the other physical and emotional demands of pregnancy that your body is adjusting to. Add it all up, and it’s no wonder you feel as if you’re competing in a triathlon each day—and coming in dead last (or at least, dead tired).

Happily, there is some relief headed your way—eventually. Once the herculean task of manufacturing the placenta is complete (around the fourth month) and your body has adjusted to the hormonal and emotional changes pregnancy brings, you’ll feel a little peppier.

In the meantime, keep in mind that fatigue is a sensible signal from your body that you need to take it easier these days. So listen up, and get the rest your body needs. You may also be able to recapture some of that get-up-and-go with some of the following tips:

Baby yourself.
If you’re a first-time expectant mother, enjoy what will probably be your last chance for a long while to focus on taking care of yourself without feeling guilty. If you already have one or more children at home, you will have to divide your focus (see next page). But either way, this is not a time to strive for supermom-to-be status. Getting adequate rest is more important than keeping your house spotless or serving four-star dinners. Let the dishes wait until later, and turn the other way as the dust bunnies breed under your dining table. Order your groceries (and anything else you can think of) online instead of dragging yourself to the stores. Be a regular on the take-out circuit. Don’t book activities—or take care of chores—that aren’t essential. Never been a slacker? There’s never been a better time to try it on for size.

Let others baby you.
You’re doing enough heavy lifting these days, so make sure your spouse is doing his fair share (right now, that should be more than half) of household chores, including laundry and grocery shopping. Accept your mother-in-law’s offer to vacuum and dust the house when she’s visiting. Have a pal pick up some essentials for you while she’s going on a shopping run anyway. That way, you might actually have enough energy left to drag yourself out for a walk (before you drag yourself into bed).

Chill out more.
Exhausted once the day’s over? Spend evenings chilling out (preferably with your feet up) instead of stepping out. And don’t wait until nightfall to take it easy. If you can squeeze in an afternoon nap, by all means go for it. If you can’t sleep, lie
down with a good book. If you’re a working mom-to-be, a nap at the office may not be an option, of course, unless you have a flexible schedule and access to a comfortable sofa, but putting your feet up at your desk or on the sofa in the ladies’ room during breaks and lunch hours may be possible. (If you choose to rest at lunch hour, make sure you make time to eat, too.)

Be a slacker mom.
Have other kids? Fatigue may be more pronounced, for obvious reasons (you have less time to rest, more demands on your body). Or it may be less noticeable, since you’re already accustomed to exhaustion—or too busy to pay attention to it. Either way, it’s not easy babying yourself when you have other babies (and older children) clamoring for your attention. But try. Explain to them that growing a baby is hard work and it’s leaving you beat. Ask for their help around the house, and their help in letting you get more rest. Instead of running around playgrounds during the day and chasing children at night, spend more time at quiet pursuits—reading, doing puzzles, being the patient in a game of “hospital” (you’ll get to lie down), watching DVDs. Napping when you’re mothering full-time may also be difficult, but if you can time your rest with the children’s naptime (if they still nap), you may be able to swing it.

Get some more sleep.
It may be stating the obvious, but just in case: Getting even an hour more sleep at night can pick you up come morning. Skip the
Late Show
and turn in earlier; ask your spouse to fix breakfast so you can turn out later. But don’t overdo. Too many z’s can actually leave you feeling even more exhausted.

Eat well.
To keep your energy up, you need a steady supply of premium fuel. Make sure you’re getting enough calories each day (which may be easier said than done if morning sickness has you down—but is definitely worth the effort), and focus on long-lasting energy boosters, such as protein, complex carbohydrates, and iron-rich foods. Caffeine or sugar (or both) may seem like the perfect quick fix for an energy slump, but they’re not. Though that candy bar or those jolt-in-a-can energy drinks might pick you up briefly, that blood sugar high will be followed by a free-falling crash, leaving you more beat than ever. (Plus, some canned energy drinks may contain dietary supplements that aren’t safe for pregnancy use.)

Eat often.
Like so many other pregnancy symptoms, fatigue responds well to the Six-Meal Solution (see
page 91
). Keeping your blood sugar on an even keel will help keep your energy steady, too—so resist meal skipping, and opt for frequent mini meals and snacks (the sustaining kind, comprised of protein and complex carbs).

Take a hike.
Or a slow jog. Or a stroll to the grocery store. Or do a pregnancy exercise or yoga routine. Sure, the couch has never looked more inviting—but paradoxically, too much rest and not enough activity can heighten fatigue. Even a little exercise can be more rejuvenating than a sofa break. Just don’t overdo it—you want to finish up your workout feeling energized, not enervated—and be sure to follow the guidelines starting on
page 218
.

Though fatigue will probably ease up by month 4, you can expect it to return in the last trimester (could it be nature’s way of preparing you for the long sleepless nights you’ll encounter once the baby has arrived?).

“I haven’t had any morning sickness. Can I still be pregnant?”

Morning sickness, like a craving for pickles and ice cream, is one of those truisms about pregnancy that isn’t necessarily true. Studies show that nearly three quarters of all expectant women experience the nausea and vomiting associated with morning sickness, which means that a little more than 25 percent of moms-to-be don’t. If you’re among those who never have a nauseous moment, or who feel only occasionally or mildly queasy, you can consider yourself not only pregnant but also lucky.

Your Nose Knows

Have you noticed, now that you’re expecting, that you can smell what’s on the menu before you even set foot in the restaurant. That heightened sense of smell you’re experiencing is actually a very real side effect of pregnancy, caused by hormones (in this case estrogen) that magnify every little scent that wafts your way. What’s worse, this bloodhound syndrome can also ramp up morning sickness symptoms. Smell trouble? Here are some strategies you can try to give your poor nose a break:

If you can’t stand the smell, get out of the kitchen. Or the restaurant. Or the perfume aisle of the department store. Or anywhere odors that sicken you hang out.

Open your windows whenever possible to banish cooking or musty odors. Or run the exhaust fan on the stove.