What to Eat During Pregnancy First 3 Months

WARNING: Content may be distressing for some readers.

The last three months of pregnancy can be an exciting and nerve-wracking time.

In the vast majority of cases, pregnancies that have reached 27 weeks end with a healthy baby, Melbourne obstetrician Stefan Kane says.

Tragically, stillbirths are not uncommon and every day in Australia six babies are stillborn. A stillbirth is the loss of a baby from 20 weeks gestation or, when gestation is unknown, weighing about 400 grams.

There is still a lot unknown about the causes of stillbirth and about 20 per cent of stillbirths remain unexplained.

However, there are some things you can do with your treating team to ensure the best possible outcome for you and your baby and reduce the risk of stillbirth.

Here are five things to consider:

1. Side sleeping

The main reason sleeping on your side is recommended late in pregnancy, is because the growing uterus can put pressure on the inferior vena cava (IVC), which is a big blood vessel that brings blood back to the heart, Dr Kane says.

"If the uterus presses on the IVC when you are lying flat on your back, then less blood will go back to the heart and therefore less blood can be pumped back around the body," he says

"This could limit the amount of blood and oxygen getting to the baby."

In the first two trimesters, when the baby and uterus are smaller, the IVC isn't at risk of being pressed — therefore side sleeping isn't as important.

If you go to sleep on your side but wake up on your back, Dr Kane says there is no need to worry.

"For the vast majority of women, how you sleep won't impact the baby, but for a small proportion it will — so we recommend all women go to sleep on their side."

A pregnant woman sleeping on her side with a support pillow

Side sleeping is recommended after 27 weeks to help encourage good blood circulation.( Adobe stock: Natalia Deriabina )

2. Monitor your baby's movements

While there is no set amount of movement that is normal or healthy, a noticeable change in your baby's movement during the third trimester is worthy of investigation.

Dr Kane recommends getting to know how your baby typically moves and if you are concerned, or the pattern changes, go to your doctor or midwife to get it checked.

"Most of the time it isn't a problem, but sometimes we may need to act," he says.

"Particularly if the movements have reduced or stopped completely."

3. Healthy habits

Eating well, exercising and quitting smoking is sound health advice at any time in your life and during pregnancy it is no different.

Dr Kane says it's never too late to quit smoking.

"There are benefits even in the third trimester," he says.

He also recommends talking to your maternity clinicians about appropriate exercise.

"Regular exercise makes a big difference to preparedness for labour and birth and recovery afterwards," Dr Kane says.

As well as a healthy diet, your doctor and midwife may recommend dietary supplements like a pregnancy multivitamin or iron.

To look after your own health and the health of your baby, Dr Kane says being vaccinated against COVID-19, the flu and whooping cough is important.

If you aren't already fully vaccinated against COVID, mRNA vaccines like Pfizer are recommended to protect you and your baby during any stage of pregnancy.

A young male doctor in a suit stands in a hall with a briefcase

Dr Stefan Kane is a Maternal Fetal Medicine Specialist and Acting Director of Maternity Services at the Royal Women's Hospital in Melbourne.( Supplied: Royal Women's Hospital )

4. Attend antenatal visits

During the last trimester of pregnancy, you can be asked to attend appointments every fortnight or more frequently depending on your personal situation.

These visits are an opportunity for doctors and midwives to monitor your psychological wellbeing, personal safety and blood pressure, as well as your baby's movements and growth.

"The key overarching principle here is ensuring women and their families identify risk factors and manage them for the very rare, but tragic outcome of stillbirth," Dr Kane says.

One of the most common maternal conditions in late pregnancy is pre-eclampsia, which is high blood pressure accompanied by signs of damage to another organ system such as the liver or kidneys.

"Historically, that is why we started doing antenatal care," Dr Kane says.

"So we could identify high blood pressure and bring labour on if the mother's blood pressure was too high."

Once picked up, pre-eclampsia can be managed with blood pressure medication.

Those third-trimester appointments may also prompt discussions about the support systems in place at home.

Dr Kane says there can be a greater risk of family violence and deteriorating mental health in late pregnancy.

"Maternity hospitals have very clear pathways to support women's safety and mental health," he says.

"Seeking care earlier rather than later can help ensure women are supported after birth."

5. Have a conversation about the timing of birth

While in the past clinicians might have informed a patient about the best course of action, Dr Kane says recently there has been a shift towards shared decision-making in medicine.

This can be particularly important when making decisions about the timing and type of birth, and your wishes for pain medication.

During your third trimester, it is important to have a conversation with your doctor so you can assess your personal situation and make a joint decision about the birth.

"There is sometimes a disconnect between what women read about having a birth without interventions and the reality of giving birth," he says.

"It's important to have a realistic picture of what is involved in birth and the potential role of induction of labour in preventing stillbirth."

A baby is said to have been born at full term anywhere from 37-41 weeks' gestation.

"Most of the time, most babies will do better if they are born as late in the pregnancy as possible, but a significant minority will do better if they are born earlier in the pregnancy," Dr Kane says.

Risk factors like pre-eclampsia or fetal growth restriction could prompt a discussion about planning an early-term birth via induction or caesarean section.

If you are 10 days or more overdue, your maternity care provider might also discuss the benefits of inducing labour.

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What to Eat During Pregnancy First 3 Months

Source: https://www.abc.net.au/everyday/five-things-you-can-do-in-your-third-trimester-pregnancy/100634942

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