Pregnancy - Know about diet, care, and precautions:

Pregnancy - a unique period: Pregnancy is a period of happy moments, rapid growth, and development. Accordingly, a pregnant woman is required to have a sufficient amount of nutrients, etc. Various changes in the body and mind during pregnancy are quite natural. We should monitor them. Some of the changes, needs, and precautions are listed below:
Changes: During pregnancy, many changes occur and we may feel it. Some of the changes are listed below:
A pregnant woman can lose her balance very easily.
The body temperature of a pregnant woman will be higher than her normal temperature before pregnancy.
As the fetus grows, pregnant women need more oxygen and may feel short of breath.
Since the body of the pregnant woman is working hard to take care of the fetus, the pregnant woman may feel less energy.
Since the heart of the pregnant woman beats faster to fulfill the demand for more oxygen due to pregnancy, her heart (pulse) rate will be higher.
Due to hormonal changes,  joints and ligaments get loosened. It will stretch the body and prepare for delivery. It may also cause pain and instability in the joints, especially in the pelvis, hips, knees, and ankles. Therefore, avoid any jerky movements which are likely to hurt your joints.
Weight gain: Steady weight gain is normal and important for both the mother and baby. However, excess weight gain could be harmful.  What should be the graph of increasing the weight?  Advice from a healthcare provider or specialist is needed. Excess weight gain may cause certain health issues. Some are listed below:
Gestational diabetes. Type-2 diabetes at a later age.	High blood pressure
It may be difficult to reduce the excess weight gain after pregnancy.
Pregnant women who are already overweight or obese have a higher chance of the above health issues and baby birth by cesarian (C-section).
Healthy weight gain supports easy pregnancy and delivery. It also supports the original weight after delivery. It supports the baby by having little chance of becoming obese or overweight or a victim of weight-related issues.
What is a healthy weight? Body Mass Index (BMI) can help identify whether a person's weight is healthy. It depends on a person's weight and height. In this way, estimated body fat is measured. However, in some cases, it is not true. Online BMI calculators are available. However, it can be manually calculated as per the following formula:
In matric units:	In imperial (U.S.) units:
Divide the weight in (Kg.) by the square of height in meters.	Step-I Divide the weight in (pounds) by the square of height in inches. Step-II Multiply the result of Step-I by 703.
Example: If weight is 70 Kg. and height is 1.6 meters. Divide the 70 by 2.56 (1.6x1.6). BMI = 27.3	Example: If the weight is 175 pounds and the height is 65 inches. (i) Divide the 175 by 4225 (65x65) = 0.041 (approximately) (ii) Multiply 0.0414 by 703. BMI = 29.1
Continuous monitoring of weight during the pregnancy is needed. Depending on BMI (Body Mass Index) at the start of the pregnancy, a healthy weight gain range during the pregnancy is given below:
Healthy weight gain range during pregnancy:  Note - Kg - pounds conversion is done in approximation only.
BMI  <18.5 (Underweight):
Weight gain for single baby:	Weight gain for twins baby:
12.5 to 18 Kg (28 to 40 pounds)	22.5 to 28 Kg (50 to 62 pounds)
BMI 18.5 to <25 (Healthy weight)
Weight gain for single baby:	Weight gain for twins baby:
11.5 to 16 Kg (25 to 35 pounds)	16.8 to 24.5 Kg (37 to 54 pounds)
BMI 25 to <30 (Overweight)
Weight gain for single baby:	Weight gain for twins baby:
7 to 11.5 Kg (15 to 25 pounds)	14 to 22.7 Kg (31 to 50 pounds)
BMI 30 to <35 (Class-I obesity), 35 to <40 (Class-II obesity), and 40 or >40 (Severe obesity)
Weight gain for single baby:	Weight gain for twins baby:
5 to 9 Kg (11 to 20 pounds)	11.3  to 19 Kg (25 to 42 pounds)
A healthy weight gain range as above is important for the growth and development of the baby. However, an expert consultation is needed to know the individual weight gain.
Weight gain should be slow.
In the first trimester (3 months), the baby's size is like a walnut. Therefore, an extra high intake of calories is not needed.
During the entire pregnancy, compared to normal intake, a high intake is needed but don't eat equal to the diet of 02 persons.
A normal weight gain during the pregnancy should be like below:
01 to 04 pounds (450 grams to 1.8 Kg)	Total weight gain during the first trimester (3 months)
02 to 04 pounds  (900 grams to 1.8 Kg)	Each month from 04 months until delivery
Need for extra calories:
The need for extra calories (energy) before, during, and after pregnancy (during breastfeeding) depends on various factors like age, health, and weight of the individual. Only, an expert can advise the exact amount of energy needed in different months. However, a general recommendation for a healthy woman is listed below:
Period	Amount of extra calories (energy) needed:
First trimester	No extra calories.
Second trimester	Approximately 340 calories per day.
Third trimester	Approximately 450 calories per day.
In the last week of pregnancy	No extra calories.

A healthy diet during pregnancy: Indeed, a healthy diet is needed for the well-being of pregnant women and the growth/development of the fetus. In addition, a healthy diet during pregnancy plays an important role in the baby's later stage of life. Lack of a healthy diet may develop some of the following problems:
Spina bifida	Preterm birth
Low birth weight	Cleft lift and palate in the baby
Gestational diabetes	Asthmatic problems in the baby
A pregnant woman should follow the customized diet plan made by the dietitian or healthcare provider for the individual.  However, it is worth mentioning that all the following five food groups should be included in the healthy and balanced diet:
Food Group I (Vegetables, legumes, and seeds) Daily 5 serves of different varieties and colors: Examples: 1/2 cup cooked vegetables. 1/2 cup cooked or canned peas, beans, or lentils. 1 cup green leafy or raw salad vegetables.  1/2 cup sweet corn. 1/2 medium potato or other starchy vegetables. 1 medium potato.
Some of the recommended vegetables are listed below:
Carrot	Pumpkin
Spinach	Sweet Potato
Cooked green vegetables	Red sweet peppers
Tomato	Broccoli
Beets	Okra
Peppers	Jicama
Know more about dark green, and  leafy vegetables: Dark green and leafy vegetables like broccoli, spinach, and kale have many useful nutrients as given below:
Fiber	Vitamin C
Vitamin A	Vitamin K
Calcium	Iron
Folate	Potassium
Such vegetables help to reduce low birth weight and constipation.
Many people do not like such vegetables due to specific flavors. However, such flavors can be suppressed by adding such vegetables to soups, pasta sauces, etc. Some other combinations like Kale eggs florentine recipes, and spinach in a smoothie also hide the flavor of such vegetables.
Know more about Sweet potato: Sweet potatoes are a rich source of beta-carotene and fiber. Beta carotene is converted into vitamin A by our body. Vitamin A is essential for the development of the baby. However, too much vitamin A from organ meats (especially liver) can cause toxicity. Sweet potatoes are a good source of fiber, and they keep our stomachs full for longer periods, reduce blood sugar spikes, improve digestive health, and reduce constipation. There are several methods to use sweet potatoes like base for avocado toast, etc.
Food group II (Fruits of different varieties and colors ): Daily 2 serves: Example: 1 medium-sized fruit like apple, banana, or orange. 2 small fruits like apricots, ber, or kiwi. 1 cup diced or canned fruit.   Or on rare occasions:  1/2 cup (125 ml) fruit juice with no added sugar.  30 grams dried fruit like 4 apricots halved, 1.5 tablespoons sultanas.
Some of the recommended fruits for potassium, etc. :
Apricot	Banana
Cantaloupe	Red or pink grapefruit
Honeydew	Mango
Orange	Prunes
Avocado
Know more about dried fruits: Most of the dried fruits are rich in vitamins, minerals, fiber, and calories including folate, Iron, and Potassium. The main difference between fresh fruit and dried fruit is the percentage of water content. Dried fruits contain no or little water content, however, fresh fruits have a good amount of water.
Prunes contain high amounts of Fiber, Potassium, vitamin K, and natural laxatives.
Dates are rich in fiber, potassium, Iron, natural sugar, etc.
Many dried fruits are high in natural sugar contrary to candies which contain added sugar.
For protein and fiber-filled snacks, a trail mix with nuts and seeds is a good option.
Intake of dried fruits should be limited to avoid any harmful effects.
Know about berries: Most of the berries are good sources of water, antioxidants, folate, vitamin C, healthy carbohydrates, and fiber. They have a low glycemic index and do not cause any significant spikes in blood sugar levels. Berries are healthy snacks including blueberry smoothies, with a pleasant flavor, good nutrients, and relatively low calories. Some of the berries  useful in pregnancy are listed below:
Blueberries	Raspberries
Goji berries	Acai berries
Food group III (Whole grains and cereals with high fiber) Daily 8-9 serves:  Examples: 1 slice of bread, 1/2 medium roll or flat bread (40 grams). 1/2 cup cooked rice, pasta, noodles, barley, buckwheat, semolina, polenta, burghul or quinoa. 1/2 cup cooked porridge, 2/3 cup wheat cereal flakes, 1/4 cup muesli. 3 crisp breads. 1 crumpet, small English muffin, or scone.
Know more about whole grains: Whole grains are loaded with fiber and other nutrients. We can use various types of whole grains, and  some are listed below:
Oats/oatmeal	Quinoa
Brown rice	Wheat berries
Barley	millets
Brown rice	Bulgur
Whole wheat bread
In addition to fiber, some whole grains like oats and quinoa contain some amount of protein, vitamin B, and Magnesium.
A combination of quinoa and roasted sweet potato may be a healthy and tasty food.
Please remember that refined products ( white bread, pasta, white rice, etc.)  from whole grains do not contain such amounts of fiber, and other nutrients.
Food group IV: (Lean red meats, poultry, fish, eggs, tofu, nuts/seeds, and legumes/beans) Daily 3-4 iron-rich serves: Examples: 65 grams of cooked lean meats (from 90-100 of raw meat)  of beef, lamb, goat, veal, pork, or kangaroo. 80 grams of cooked lean poultry (from 100 grams of raw poultry) like chicken or turkey. 100 grams of cooked fish fillet (from 115 grams of raw fish) or one small canned fish.  2 large eggs. 1 cup cooked or canned legumes/beans like chickpeas, split peas, and lentils. 170 grams of tofu. 30 grams of nuts/seeds or nut/seed paste.
Food group V: (Low-fat milk, Yoghurt, hard cheese, and/or low-fat Calcium-rich alternatives) 2-3 Serves of Calcium rich food: Examples: Low-fat Milk: 1 cup (250 ml) fresh, UHT long-life, reconstituted powdered milk or buttermilk. 1/2 cup (120 ml) evaporated milk. 2 slices (40 grams) of hard cheese like cheddar cheese. 3/4 cup (200 grams) yogurt. 1 cup (250 ml) soy, rice, or other cereal drink, with at least 100 mg of added Calcium per 100 ml.
Know more about dairy products:  During pregnancy, extra protein and Calcium are needed, and dairy products like milk, cheese, and yogurt are good sources of such nutrients. In addition, it also gives Phosphorus, vitamin B, Magnesium, and Zinc. Dairy products have two types of protein (Casein and whey). If someone has lactose intolerance, may try yogurt (especially probiotic yogurt), Yogurt smoothies, parfaits, and lassi. Some of the best options for dairy products/alternatives are listed below:
Skimmed, semi-skimmed, 1% fat, or reduced-fat milk	Fromage frais
Low-sugar, fat-free or low-fat yogurt	Reduced fat hard-cheese
Fortified soy products  (milk, yogurt, cheese, etc.)	Unsweetened calcium-fortified alternatives.
Lactose-free milk/milk products
Unpasteurized dairy products are harmful to pregnant women.
Need for protein during pregnancy: Every cell in the human body has protein. It is required to grow new cells and repair old cells. Protein plays a crucial role in the health of pregnant women and babies. It is needed throughout the pregnancy. As per U.S. data, the average protein intake should be 71 grams daily, however, an expert can guide for the exact amount of protein needed for an individual depending on her health parameters.
Good sources of protein (Amino acids): Many natural sources give us the required protein during pregnancy.   Some good sources of protein are listed below:
Beans, lentils, and Peas.	Legumes, and pulses
Unsalted nuts and seeds	Dairy products like Cheese.
Skin-peeled poultry/chicken	Lean meat like beef
Seafood	Eggs
Tofu, Soy, and soy products	Nut butter
Poultry like chicken	Fish
Plant-based protein powder like peas protein powder.
Animal-based protein contains all types of protein (essential amino acids).
As per the U.S. data, protein content in some of the foods is listed below:
Food and serving size	Protein content
1 cup (226 grams) low-fat or 1% fat milk cottage cheese	28 grams
Poultry: 3 oz. (86 grams) boneless, skinless grilled chicken breast	26 grams
3 oz. (85 grams) canned pink salmon fish with bones	17 grams
1/2 cup (99 grams) boiled lentils	9 grams
1 cup (237 ml) skimmed milk	8 grams
2 teaspoon full (27 grams) peanut butter	7 grams
1 large hard-boiled egg (50 grams)	6 grams
Know more about legumes: Legumes are plant-based sources of fiber, protein, Iron, folate, and Calcium, Magnesium, and Potassium. Some of the members of the Legumes family are listed below:
Lentils	Chickpeas
Peas	Beans
Soybeans	Peanuts
It is good for health by adding the diet with meals like hummus on whole grain toast, black beans in tako salad, or a lentil curry.
Know more about eggs, fish, and meat:
Eggs: Eggs are a good source of all nutrients (little or more). A large egg gives the following nutrients and benefits:
Around 70 calories	3.6 grams protein
Fat	Multivitamins
Minerals	Around 145 mg of Choline
Eggs may be enjoyed in various ways like with spinach feta wraps, chickpea scramble, etc. Pregnant women should not eat raw and partially cooked eggs even in mousse, mayonnaise, and souffle, because such eggs may cause salmonella infection. The eggs should be hard-boiled i.e. white and yolk should be hard. However, eggs produced under the British Lion code (red lion logo stamped on the shells) are safe to eat raw or partially cooked (soft-boiled) because such eggs are produced from flocks vaccinated against salmonella.
Fish: Some Fish are perfect for health like Salmon, Trout, Herring, Sardines, Anchovies, and Pollock. They are rich in omega-3 fatty acids, and helpful in the development of the brain, eyes, and gestational length. The fresh salmon fish may be the best choice. 2 portions of fish should be taken in a week, of which 1 portion should have oily fish like salmon, trout, sardines, herring, or mackerel. Smoked on whole wheat bagel, teriyaki grilled, or served with pesto may be good ideas for enjoying. Avoid more intake of oily fish, because it can have toxins or pollutants. Some fish like sharks, swordfish, king mackerel, bigeye tuna, tilefish from the Gulf of Mexico, and marlins should be avoided during pregnancy and before conceiving due to the high content of mercury and other contaminants.
Meat and poultry: Lean meat without liver like Lamb, beef,  Pork, and chicken are good source of high-quality protein, iron, choline, Vitamin B, and other nutrients. Various foods like burgers, poultry, sausages, and whole cuts of meat (lamb, beef, pork, etc.) are required to cook properly and thoroughly.  It should not have pink meat or red/pink juice. Add no (or barely minimum) fat and salt.
High intake of healthy fluid: It also plays an important role in healthy pregnancy.  Some of the liquid intakes are listed below: Plenty of water. Recommended quantity of juices and soup. Alcohol in any form is not allowed during pregnancy.
Know more about water: Water is good for everyone because it keeps us hydrated. We get some amount of water from vegetables, fruits, coffee, tea, etc. However, we should drink plenty of water to prevent dehydration. During pregnancy blood volume increases by 45%, therefore a pregnant woman needs a high intake of water for the well-being of herself and her baby. A high intake of water reduces constipation also. It also reduces the chances of Urinary Tract Infections (UTIs) which are commonly observed during pregnancy. Dehydration causes headaches, anxiety, tiredness, bad mood, and loss of memory. The amount of water to be taken by a pregnant woman can be advised by an expert. However, it may be around 8 to 12 cups equivalent to 2 litres to 3 litres (or 64 to 96 ounces). A good idea is to always carry a water bottle on the go to drink the same as and when required.
Need for Complex carbohydrates (starchy food) during pregnancy: Starchy foods (Complex carbohydrates) give energy and some amount of vitamins, and fiber which is important during pregnancy. It also gives a feeling of being full with little calories. Instead of refined starchy food, it is better to take whole-grain or high-fiber options. Some of the starchy foods are listed below:
Bread	Potato (preferably skin peeled)
Sweet potato	Butternut squash
Whole grains like faro, buckwheat, maize (corn), oats, millet, etc.	Breakfast cereals
Cornflakes or cornmeals	Rice (preferably brown rice)
Pasta  (preferably whole wheat)	Noodles
Legumes like beans, and chickpeas.
The chips containing low fat and low salt may be taken occasionally.
Don't prefer refined carbohydrates like white bread, pasta, rice, etc.
Diabetic pregnant women should consult with an expert to fix the dose of carbohydrates.
Healthy snacks during pregnancy: If pregnant women feel hungry between meals, intake of healthy snacks should be taken, instead of regular snacks (sweets, biscuits, chips, chocolates, etc.)  which are high in fat, and/or sugar. Some of the healthy snacks are listed below:
Small sandwiches, Pitta bread with grated cheese, Lean ham, Mashed tuna, Salmon, or sardines with salads.
Vegetable salads such as carrot, celery, and/or cucumber.
Unsweetened breakfast cereals, or porridge with milk.
Slice of malt loaf	Fruited tea cake
Toasted fruit bread	Baked potato
Baked beans on toasts	Fresh fruit
Milky drinks	Soup of vegetables or beans
Ready to eat prunes, figs, or apricots	Fromage frais with fruits.
Yogurt with fruits. Choose fat-free or low-fat plain yogurt. Add low or no sugar.	Whole grain crackers with peanut butter.
Carrot with hummus
Note: Food labels (green, amber, or red) help choose the healthy snacks.

Importance of folic acid (folate) during pregnancy: It protects against neural tube defects and other abnormalities in the developing fetus. They are the birth defects of the brain, and spinal cord (like spina bifida). Neural tube defects may cause mild to serious paralysis, incontinence, and intellectual disability. Therefore pregnant women should take a sufficient amount of food naturally rich in Folate, and/or supplements fortified with folic acid. When folate is added as a fortified supplement to the food, it is called Folic acid. It is also known as vitamin B9. Folate is found in various vegetables, fruits, nuts/seeds etc. Sufficient intake of folate (naturally or supplements) helps to prevent premature birth and low birth weight babies. The liver is rich in folate, but due to the high content of vitamin A, is not recommended for pregnant women or women planning for pregnancy. How much folic acid supplement is needed before and during the pregnancy? It depends on your health and needs which should be judged by  a doctor, gynecologist/obstetrician, specialist, or healthcare provider. We should not decide the dose of the folic acid supplements. Since most of the neural tube defects occur during the first 28 days of pregnancy. Therefore, it must be started before conception. Therefore the dose of folic acid supplements before, during, and after pregnancy (during breastfeeding) may be  400 to 1000 mcg.  Its dose may vary as per the individual health conditions. However general recommendation is given below:
Period	Intake of folic acid supplements per day
Before pregnancy	400 mcg, In addition to folate received from food and drinks.
During pregnancy	600 mcg. In addition to folate received from food and drinks.
After pregnancy  (during breastfeeding)	500mcg. In addition to folate received from food and drinks.
Women taking anti-epileptic drugs may require a higher dose of folic to avoid neural tube defects.
Folate or folic acid content as per the U.S. data in some of the foods are listed below:
Food and serving size	Content of Folate of folic acid
3/4 cup (15 to 60 grams) ready-to-eat cereals	100 to 700 mcg (select 50% to 100% fortified)
1/2 cup (95 grams) boiled Spinach	131 mcg
1/2 cup (89 grams) of boiled Great Northern beans	90 mcg
4 boiled spears (60 grams) of Asparagus	89 mcg
1 small orange (96 grams)	29 mcg
1 ounce (28 grams)  Unsalted and dry roasted Peanuts	27 mcg
Some more folate-rich foods are listed below:
Broccoli	Bran flakes
Cabbage	Brussels sprouts
Cauliflower	Leeks
Parsely	Potato
Tomato	Lentils
Chickpeas	Dried beans
Peas	Vegemite
Orange juice	Wheat germ
Whole grain bread	Parsnips
Strawberries	Walnuts
Hazelnuts	Salmon
Fortified bread
Most of the berries, dark green leafy vegetables, nuts, dried beans, citrus fruit, peas, lentils, fortified breakfast cereals,  and specific dietary supplements are good sources of folate or folic acid.

Importance  of Iron during pregnancy: Iron makes the hemoglobin in the body. It (hemoglobin) is one type of protein in the blood cells which carries oxygen to the tissues in the body.  During pregnancy double amount of iron is required because the fetus draws iron from the mother during the developing stage. Even after the baby's birth, a high iron intake is required for 5-6 months. Pregnant women indeed save some iron due to the discontinuation of menstruation, but it is not sufficient for the developing fetus. Therefore, they need to eat more amount of an iron-rich diet every day compared to nonpregnant women, especially in the third trimester. As per the data available, the Recommended Daily Intake (RDI) of iron for pregnant women is around 27mg per day.  Anemia causes headaches, tiredness, irritability, depression, and fatigue. Acute deficiency of iron can cause premature birth, low-birth-weight babies, stillbirth, and postpartum depression. It can also increase the risk of excess bleeding during baby birth. Many pregnant women suffer from iron deficiency (anemia) and in such cases, iron supplements are needed. However, it is needed to consult with an expert to prescribe the dose of iron supplement,  because an excess amount of iron in the body may be toxic. Some of the iron-rich foods are listed below:
Animal-based iron-rich foods: It is easily absorbed by the body. However, combination with vitamin C food is a good idea for better absorption. Accordingly, Vitamin C-rich tomato slices with turkey burger,  and steak with mango salad may be enjoyed. Some of the animal-based iron-rich foods are listed below:
Lean red meats	Poultry/Chicken
Seafood	Fish like salmon
Plant-based  iron-rich foods: Animal-based iron-rich foods are easily absorbed by our bodies, but plant-based iron-rich foods are not easily absorbed by our bodies, therefore plant-based iron-rich foods should be taken along with vitamin-C-rich foods/juice like lemon, orange, tomato, strawberries, bell peppers, etc. Vitamin C helps in the absorption of iron. Iron supplements should not be taken with juices fortified with Calcium because Calcium reduces the absorption of Iron.  In case of need of Calcium supplements, it should be taken separately. Some plant-based iron-rich foods are listed below:
Dried beans	Legumes and Lentils
Dark green, and  leafy vegetables
Iron-fortified breakfast cereals are also available in the market.
Iron content in some of the foods as per the U.S. data is listed below:
Food and serving size	Iron content
Cereals: 1/2 cup (40 grams) quick oats fortified with Iron	20 mg
Meat: 3 oz. (85 grams) roasted lean beef tenderloin	3 mg
1/2 cup (90 grams) boiled spinach	3 mg
Beans: 1/2 cup (88.5 grams) boiled kidney beans	2 mg
Poultry: 3 oz. (85 grams) roasted dark turkey	1 mg
Importance of fat or fatty acids during pregnancy:
Fats play an important role during pregnancy, but not all types of fats.
Omega-3 is a type of Poly Unsaturated Fatty Acid (PUFA), and it is very much essential before conceiving, and during pregnancy.   It supports the overall health of pregnant women and their babies. It reduced the risk of preterm birth. Therefore, It should be taken in sufficient amounts for good health.
A low intake of saturated fat is good for health but a high intake of saturated fat is not recommended, as it can cause weight gain and complications during pregnancy.
Some of the foods rich in PUFA are listed below:
Fatty fish like salmon, trout, and herring.	Flax seeds and sunflower seeds.
Nuts like walnuts	Fruits like Kiwi, berries, avocado, and orange
Yogurt	Olive oil
Fish liver oil	Oil in seafood
Know more about fish liver oil: Fish liver oil is made from the oil liver of fish like cod, sardines, canned light tuna, pollock, or salmon. It is rich in the following nutrients:
Omega-3 fatty acids (EPA and DHA): Good for the eye and brain development of the baby. Reduce the risk of premature delivery.
Rich in vitamin D, and helpful for bones.
In addition to omega-3 fatty acids, a teaspoonful (4.5 grams) of fish liver oil gives 11 mcg of vitamin D and 1350 mcg of vitamin A.
Always consult with an expert before taking fish liver oil, because excess amounts of vitamins A, and D are toxic. High levels of omega-3 fatty acids may also give a blood thinning effect.
Know more about avocado: Avocado contains various healthy nutrients, some of which are listed below:
Healthy MUFA (Mono Unsaturated Fatty Acids)	Healthy PUFA (Poly Unsaturated Fatty Acids)
Fiber	Protein
Magnesium	Potassium
Vitamin C	Vitamin E
Vitamin K	Carbohydrates
Folate	Antioxidants
Copper
Since it has healthy fats and folate which are essential during pregnancy. Healthy fats make the skin, brain, and tissues of a baby. It has more Potassium than banana. Potassium helps to reduce the leg cramps. Avocado is a good substitute for mayo or sour cream. It can be used as guacamol in salads, and smoothies.
Need for fiber during pregnancy: Fiber is helpful in gut health. Fiber intake gives a feeling of a full stomach for a longer time.  Sufficient intake of fiber helps to reduce constipation and hemorrhoids during pregnancy.
Some of the fiber-rich sources of food are listed below:
Whole grains like oats, oatmeal, etc.	Beans
Lentils	Fruits
Vegetables	Brown rice

Need for Iodine during pregnancy: Iodine produces thyroid hormone which is needed in a sufficient amount for pregnant women because it plays an important role in the growth and development of the baby. Deficiency of Iodine in pregnant women may cause mental impairment and congenital hypothyroidism (Critinism) in the baby. A good intake of Iodin-rich foods is also needed for breastfeeding women. In case of need, a doctor, healthcare provider, or gynecologist and obstetrician may recommend Iodine supplements @150mcg per day for women planning for pregnancy, pregnant women, and breastfeeding women. Some of the Iodine foods are listed below:
Seafood	Seaweed including Nori and Kelp
Eggs	Meat
Dairy products	Iodized salt.
Bakery salt (famous in the Netherlands)

Role of vitamin D during pregnancy: Vitamin D is necessary for both i.e the good health of pregnant women and the growth and development of the baby.  It is essential for bone health and it provides optimum output for pregnant women and babies. Vitamin D with calcium works well for baby bones and teeth. Most of the vitamin D, we get from the Sun. It is the best natural source. Ultraviolet rays from the Sun produce vitamin D in the skin. A little amount of vitamin D, we get from eggs, fatty/oily fish like salmon, margarine, and milk/orange juice fortified with vitamin D. Before pregnancy or at the initial stage of pregnancy, the doctor, healthcare provider, gynecologist, and obstetrician may recommend a blood test to know the vitamin D level in the body. In case of deficiency, Vitamin D supplements may be advised.   The normal dose of vitamin D, as per the U.S. data is 600 IU (International Units) per day, and it is equal to 15 mcg per day. However, some other experts believe that vitamin D dose per day should be high like below:
Near to 4000 IU per day during pregnancy	Near to 6400 IU per day During lactation (breastfeeding)
Please keep in mind that an excess level of vitamin D in the body may be toxic. Therefore, it is needed to consult with an expert to fix the dose before, during, and after pregnancy as per the individual health.
Some of the reasons for the deficiency of vitamin D are listed below:
Dark color skin
Little content of UV rays from the Sun to the skin due to the covering of most of the body parts by clothes, vehicle body, etc.
Little exposure to the Sun due to indoor stay most of the time.	Non-availability of sunlight due to climatic conditions.
Vitamin D content in some of the foods/supplements as per the U.S. data is given below:
Food and serving size	Vitamin D content
3 oz. (85 grams) cooked sockeye salmon fish	570 IU
1 cup (237 ml) skimmed with added vitamin D	115 IU
8 OZ. (237 ml)  Calcium and vitamin D added to orange juice	100 IU
1 large hard-boiled egg  (50 grams)	44 IU
Need of Calcium:  An excess amount of Calcium is required for pregnant/breastfeeding women and babies to strengthen their bones and teeth. It also supports the functions of the circulatory, muscular, and nervous system.   During the third trimester of the pregnancy, a high amount of Calcium is needed for the development and strengthening of the bones of the baby. During such a period, the capacity of pregnant women to absorb the Calcium from the diet increases naturally. The amount of Calcium needed for a pregnant woman or nonpregnant woman may be the same as below:
Age group	Calcium intake
Age- 19 to 50 years	1000 mg a day
Age > 50 years	1300 mg a day
Adolescents (teenagers)	1300 mg a day
Some of the Calcium-rich foods are listed below:
Dairy products like milk, cheese, and yogurt are the best source of Calcium because it absorbs easily.
Nondairy products like broccoli and kale also provide Calcium.
Many fruit juices, Soy milk, breakfast cereals, and supplementary powder fortified with Calcium are also available in the market.
The content of Calcium in some foods as per U.S. data is given below:
Food and serving size	Calcium content
1 cup (20 to 60 grams) calcium-fortified ready-to-eat cereals	100 to 1000 mg
1 cup (237 ml) calcium-fortified orange juice	349 mg
1.5 oz. (43 grams) semi skimmed morezzela cheese	333 mg
1 cup (237 ml) skimmed milk	299 mg
6 oz. (170 grams) low-fat fruit yogurt with low-calorie sweetener	258 mg
3 oz. (85 grams) canned pink Salmon fish with bones	181 mg
1/2 cup (95 grams) boiled spinach	123 mg

Need for Dietary (nutrients) supplements during pregnancy:   Almost all or most of the water and fat-soluble nutrients are needed during the pregnancy. Practically, it may not be possible to get all the required nutrients (protein, vitamins, minerals, and fiber) from natural sources of food.
Some of the reasons for deficiencies are listed below:
Deficiencies found in blood tests.	Vegans and vegetarians.
Misusers of drugs, tobacco, and alcohol.	Overweight pregnant women.
Pregnant teenagers.
Therefore, Doctors, healthcare providers, specialists, gynecologists, and obstetricians may advise taking prenatal supplements before, during, and after pregnancy (during breastfeeding) to support the health of women and babies. Prenatal supplements provide all necessary nutrients, and some are listed below:
Folate (folic acid)  - vitamin B9	Iron
Vitamin B12	Vitamin D
Magnesium	Iodine
Protein (Amino acids)	Fiber
Vitamin C	Calcium
Fat, especially omega 3 - Poly Unsaturated Fatty Acids (PUFA)	Carbohydrates (starchy food)
Fluid	Potassium
Zinc: It is needed @ 11-12 mcg per day for a pregnant woman. It helps to avoid preterm birth.
Choline: Some experts treat it like Vitamin B4. Most of the prenatal supplements do not contain it. Its recommended dose is 450 mg per day. It is important for the health of pregnant women and their babies. It supports the development of various functions of the brain, spine, and nervous system like memory, mood, muscle, etc. It also forms the membrane around the body cells. Naturally, it is found in eggs, caviar, lean meats, nuts, cruciferous vegetables, potatoes, legumes, beans, lentils, wheat germs, low or fat-free dairy products, seafood, and shiitake mushrooms.
Vitamin A: It is also called retinol. It is essential during pregnancy, but high intake is harmful also. The recommended dose of vitamin A  is around 750-770 mcs per day of retinol or Ratinol Activate Equivalents (RAE). Vitamin A is found in various forms. RAE measures the relative amounts of vitamin A in these forms which is summarized below:
One RAE is equal to:
1 mcg of retinol	12 mcg of beta carotene from food.
2 mcg of beta carotene from  supplements	3.33IU of vitamin A
Need for physical activity: Under the guidance of an expert, physical activities (exercise, meditation, yoga, etc.) before, during, and after the pregnancy are necessary for good physical and mental health. It helps to get appropriate weight gain for pregnant women and their babies.
Regular physical activity reduces:
Leg cramps	Backache
Bloating	Risk of gestational diabetes
Postpartum depression	Risk of high blood pressure (Preeclampsia)
Length of labor	Postpartum recovery.
Chances of C-section delivery.	constipation
stress	Swelling in legs, ankles, and feet.
Sleeping problems	Preeclampsia
Chances of preterm birth	Uncomfort during labor and delivery.
Be alert, that during some pregnancy-related problems, physical activities may not be suitable. Some of the problems are listed below:
Preterm labor	Bleeding  or fluid leaking from the vagina
Pregnancy with twins or more.	Cervical insufficiency or a cerclage
Gestational hypertension or preeclampsia	Placenta previa after 26 weeks of pregnancy
Severe anemia or certain heart or lung conditions.	Chest pain, breathing problems, and fast heartbeat.
Fell of dizziness or unconsciousness	Headache
Trouble walking,  swelling in lower legs. It may be a problem of Deep Vein Thrombosis (DVT).	Regular painful contractions.
No movement of the fetus	Regular painful contractions
During pregnancy, if you are facing any complications as above, immediately consult an expert for further course of action.
Safety tips during physical activities:
Do: Light, moderate, and easy activities that are not likely to hurt. Take limited drinks before, during, and after the activity. Wear comfortable and suitable clothes to protect the breast. Immediately stop the activity if dizziness, shortness of breath, tiredness, or discomfort in the stomach occurs.
Don’t Don't attend sports (like football, soccer, ice hockey, basketball, water skiing, Skydiving or scuba diving, surfing or diving) prone to injury, especially in the abdomen. Avoid brisk exercise, especially in hot weather. Don't use a sauna, hot tub, steam room, etc. Don't do exercise at high altitudes like 6000 feet and above. Avoid exercise that requires lying down flat, especially after 12 months of pregnancy. Avoid jerky and bouncing movements. Avoid activities or yoga that raise your temperature too high.
What is a healthy diet for vegetarian or vegan pregnant women? Extra care is needed to get the right amount of nutrients from natural foods, and natal supplements. Some of the important nutrients are listed below:
Protein	Iron
Vitmain B12	Folate (vitamin B6 = folic acid)
Calcium	Vitamin D
Iodine
Such nutrients are available in the following vegan foods:
Tofu	Legumes
Dark green and leafy vegetables	Fortified foods
Nuts and seeds	Whole grains
Fresh and dried fruits	Unsweetened soy drinks
Yeast flakes

List of foods/drinks to be avoided during pregnancy: Some foods are harmful to healthy pregnancy and cause bacterial infections like listeria, salmonella, etc.  Some foods are needed in limited quantities. Some foods may cause unwanted weight gain, constipation, etc. Such foods should be avoided.  Some of the harmful foods are listed below:
Foods high in sugar, fat, or both: Most of the sugary foods or drinks are high in calories. Intake of such foods can increase body weight and tooth decay. Similarly, intake of foods high in saturated fat will also increase body weight and cholesterol.  Heart diseases may develop due to high cholesterol in the blood. High intake of food containing saturated fat and sugar, will cause multiple problems. Therefore, Minimal intake of food/drinks containing high saturated fat, and added sugar should be taken as some of them are listed below:
All spreading and solid fat like butter, lard, and shortening.	Cooking Oils
Salad dressings	Cream
Chocolate	Crisp
Biscuits	Pastries
Ice cream	Cake
Puddings	Fizzy drinks
soda	Sport drinks
sweets	Sugar-sweetened drinks
High intake of salt should be avoided	Sushi made with raw fish should be avoided
Soft mold-ripened cheeses such as Feta, Queso Blanco and fresco, Camembert, Brue/Brie, or blue-veined cheeses, etc. It can cause listeria infection which is fatal for pregnant women and babies.
High intake of vitamin A is harmful.
Any type of alcohol like wine, beer, or hard liquor is not allowed.
Uncooked(raw) and undercooked (partially cooked)  fish and seafood (like sushi, and oysters), eggs, meats, and poultry. Instead, opt for thoroughly cooked (steaming out, and/or as recommended) foods.  Eating raw shellfish can cause bacterial or viral infections.
Raw sprouts like alfalfa and mung beans may spread certain foodborne infections like E.coli, and salmonella.
The below foods/drinks are also harmful:
Refrigerated pate, meat spread, smoked seafood, etc.
Reheated hotdogs	Reheated luncheon meats
Other unheated meats	Raw or unpasteurized milk & its products, cider, juice, cheese, etc.
Untreated water	Raw dough
High intake of processed food
Lunch or deli meats smoked seafood, and hotdogs should be heated until steaming hot.
High intake of vitamin A is harmful. Therefore avoid liver and liver products.
Avoid foods containing licorice root (Liquorice, and tea).
Avoid foods that become dark brown or black after cooking, because they produce harmful substances.
Limit the consumption of tea made from aniseed, tarragon, fennel, basil, allspice, nutmeg, cinnamon, sassafras, dong quai, mace, and pepper.  Avoid dietary supplements that have high concentrations of these ingredients. However such ingredients used in the kitchen are not harmful.
Avoid calabash chalk because of its high levels of lead and dioxin.
Avoid excessive intake of isoflavones from soya products and do not take supplements containing these phytoestrogens.
Some pregnant women may crave some nonfood items like clay, laundry starch, ashes, or paint chips.  It shows that they are not getting sufficient nutrients. Avoid eating such items, instead consult with an expert to take the healthy diet and dietary/prenatal supplements.
How to avoid mercury in the fish? Eating 2-3 servings of fish every week is good for the well-being of pregnant women and babies. However, be careful; some fish have a high mercury content, which harms the fetus's development. Pregnant women and those likely to be pregnant within 6 months should avoid such types of seafood or fish like shark, swordfish, white (albacore) tuna,  king mackerel, orange roughy, tilefish, and marlin. Occasional intake of fish containing high levels of mercury is not harmful, but regular intake of such fish can be harmful. Therefore some of the precautions for eating the fish are listed below:
Only 1 serve (150 grams) per fortnight from the following: Billfish like swordfish, broadbill, and marlin. Shark (Flake) No other fish in this fortnight.                          Or Only 1 serving (150 grams) per week from the following: Orange roughy-like deep sea perch Catfish White (albacore) tuna No other fish in this week.                   Or Only 2-3 serves per week from the following:  Any other fish or shellfish Seafood like cod, shrimp, salmon or tuna. Note- 1 serving (150 grams) may be considered equal to approximately 2 frozen crumbed fish portions.
High  intake of caffeine should be avoided: High intake of caffeine during pregnancy can cause miscarriage, low weight of baby, and complications in fetal development. Therefore, a bare minimum intake (200 mg per day) of caffeine, and artificial sweeteners should be taken during pregnancy. The following foods/drinks have caffeine contents:
Coffee	some sodas
Energy drinks	Teas
Some cold and flu medicines	Diet drinks
Decaf coffee or tea, drinks with no sugar, or water with a dash of juice may be taken.

Is dieting is good during pregnancy to control the weight gain: The answer is No. Fasting and dieting will adversely affect the health of the pregnant woman and the baby.
Extra care for pregnancy in adolescents: In adolescent pregnancy, a very high intake of nutrients is needed compared to pregnancy in adult women. Because the growth and development of both (the adolescent and her baby) is going on simultaneously. Adolescents may give birth to a baby with a smaller size because nutrients taken by adolescents are distributed in both, which results development of the baby on the lower side. Therefore, they need a high intake of nutrients including Iron and Calcium. Since Adolschent’s bones are still growing and demanding Calcium for strength and growth. Any lack of Calcium may develop osteoporosis in the later stage of life of adolescents. To meet the demand for Calcium, adolescents need each day around 3.5 servings of milk, yogurt, cheese, or alternatives fortified with Calcium.
How to reduce constipation during pregnancy? Most of the pregnant women feel constipation during pregnancy. It may be reduced  by adopting the following habits: Include the varieties of foods containing high fiber like vegetables, legumes, fruits, prunes, whole grain cereals, brown rice, beans, and whole grains. Drink plenty of water.  May add fruit or herbs for fresh flavor. Do the physical activities regularly.
How to reduce nausea and vomiting during pregnancy? Most of the pregnant women feel nausea, vomiting, and morning sickness, especially during the first trimester of pregnancy. It may be reduced by adopting the following habits: Before getting up, try to eat dry bread, whole-wheat dry toast, whole-grain crackers biscuits, saltines, or dry cereal. You can take the rest of the breakfast (fruit, oatmeal, hot or cold cereal, or other items) later in the morning. Get up in slow motion and avoid fast movements. Take breakfast every day. Please don't drink liquid with a meal. Take the water half an hour before the meal or after 02 hours. In case of need, a small amount of water with a meal by sipping may be taken, it will burping and gassiness. If a pregnant woman takes a good amount of water or liquid with a meal, it may cause bloating and vomiting.  Do not take large amounts of meal at a time, instead may increase the frequency with small amounts of meal. Avoid spicy and oily food. Suck the citrus or sour item like lemon. Take frequent rest and get relaxed. Try to take fresh air as much as possible, and keep the room well-ventilated. Food containing Ginger or ginger tea may be helpful to reduce the nausea.
How to avoid heartburn during pregnancy? Due to the continuous growth of the baby, Pressure on the abdomen increases. It causes heartburn. The heartburn may be reduced by adopting the following habits: As mentioned in the last para, take small amounts of meal spread throughout the day, instead of large amounts of meal at a time.  Eat slowly. Avoid spicy, and fatty food like hot peppers, and fried chicken. Keep a sufficient gap ( say 2 hours) between dinner and bedtime. Avoid bending and laying down after the meal. Use the pillow under the head during the night to keep the head in the raised position. Avoid excess consumption of tea and coffee.
Avoid OTC Medications, Substance Use, and Toxic exposure during pregnancy:
OTC Medications: Over-the-counter (OTC) medications should be avoided or should be taken with the consultation of an expert.  If any pregnant woman is under any prescribed medications, should share the same with her healthcare provider for proper adjustment and advice.
Alcohol: Alcoholic consumption even in a small dose can not be recommended before conceiving or during pregnancy. Consumption of alcohol in any form including wine and beer may cause the following problems:
Miscarriage	Negative impact on baby's IQCongenital
Congenital deformities
A baby can born with a fetal alcohol spectrum disorder. This will cause vision and hearing problems, issues with attention, ion, and low body weight.
Caffeine: A maximum of 1 cup of coffee per day can be taken.
Tobacco, smoke, secondhand smoke, cannabis, and illicit drugs should be avoided.
Women with substance use disorder must consult with an expert to deal with the issue.
Pregnant women should also avoid the following :
Direct handling of cat litter may cause toxoplasmosis. It is an infection that can damage the fetus’s brain. Therefore direct handling of cat litter should be avoided.
Avoid excess exposure to the hot temperature like sauna or hot tub bath.
Avoid contact with people who have infections like rubella (German measles), chickenpox, or shingles. Otherwise, it can cause birth defects and serious complications to the fetus.
Avoid exposure to toxic chemicals and paint fumes. Exposure to toxic environment ( like lead, pesticides, solvents, Phthalates, etc.) before, during, or after pregnancy can cause the following problems:
Infertility	Miscarriage
Preterm birth	Low weight birth
Childhood cancer	Neurodevelopmental delay
Therefore during pregnancy, cosmetic/personal care products having toxic chemicals like phthalates, parabens, fragrances, scents, oxybenzone, or tricloson should not be used.
How to avoid listeria infection during pregnancy? The food infected with the bacteria known as Listeria Monocytusgenes causes the listeria (listeriosis) infection during pregnancy. Though the Listeria infection does not pose any health problems to a healthy person, it results in serious risk to a preborn baby.  Some of the risks are listed below:
Miscarriage	Stillbirth ( death of the fetus before or during birth)
Premature labor
This infection can be treated with antibiotics drugs but prevention is better than cure. Some foods are prone to infection with bacteria, parasites, and viruses like listeria, E-coli. Such foods should be avoided or consumed with precautions as listed below:
Soft cheeses (made from raw or unpasteurized milk) like brie, camembert, and ricotta should be consumed cooked and hot only.
Nonheatable precooked or preprepared cold foods like salad, pate, quiches, and delicatessen meats  (ham, salami, etc.) should be avoided.
Undercooked meat, eggs, and seafood. Chilled precooked meats and meat spread should be avoided.
Raw seafood (oysters, sashimi, etc.) and smoked seafood like salmon should be avoided. However, canned varieties are safe.
Avoid consuming unpasteurized food/milk.
Pre-prepared or pre-packaged cut fruits and vegetables should be avoided.
Avoid raw cookie dough.
Avoid soft-serve ice cream.
Avoid prepared meat or seafood salads like ham salad, chicken salad, and tuna salad. Avoid deli salad also.
Note- Properly cooked foods do not cause listeria infections.
Risk of salmonella infection during pregnancy: It is a bacterial infection (salmonellosis) caused due to food poisoning. It infects humans due to the consumption of raw eggs and undercooked meat and poultry. Due to this infection, the risk of miscarriage increases.
General hygiene: Make a habit of maintaining good hygiene around you to reduce infections like salmonella, toxoplasmosis, listeria, etc. Some of the hygienic practices are listed below: Rinse all raw foods thoroughly with running water before cutting, cooking, and eating. During rinsing of raw fruits and vegetables, remove all traces of soil, because soil may contain the toxoplasm which is a parasite and causes toxoplasmosis. It is harmful to the unborn baby. Wash and clean all cooking utensils/items to be used, and countertop before preparing food, and after using it. Use separate knives and chopping boards for raw meats. Wash your hands with some good quality handwash before and after preparing or eating the food. Heat ready meals till the vapors come out and as recommended, especially in the case of poultry. Make sure to store the cooked food, raw food, and ready-to-eat food separately to avoid the spread of contamination. Always check the use-by date ( expiry date or best-before date) for packaged food, and consume safe food. Irrespective of use-by date, don’t consume if its smell, color, or taste is not normal. The pets should not be allowed in the kitchen. Eggs, whole cuts of meat (like Beef, lamb, and pork), poultry, burgers, sausages, and other required foods should be cooked at the recommended internal temperature or until steaming, which should be verified by the food thermometer. The perishable items should be stored in the fridge as soon as possible. We should wear the gloves while handling with pea and poo of pet animals.
Preventive care during pregnancy: Pregnant women should have regular prenatal checkups under the guidance of an expert. Some of the preventive care problems that can create complications in the pregnancy are listed below:
High blood pressure	Preeclampsia
Diabetes	Sexually Transmitted Diseases (STD)
Urinary Tract Infections (UTI)	Genetic mutations. It can cause birth defects.
Chromosomal abnormalities
Rh(D) blood incompatibility. It can cause hemolytic disease.
Placental and other abnormalities due to exposure to blood tests, ultrasound, or other testing.

Vaccination during pregnancy: Timely immunization/vaccination before, and during pregnancy can prevent serious diseases and complications for pregnant women, fetuses, and newborns. Different countries may follow different vaccination plans as needed, depending on the health condition of pregnant women, etc. For any vaccination plan, pregnant women should follow the guidelines of their healthcare professionals, doctors, obstetricians, and gynecologists. However, some of the vaccines needed before, during, or after the pregnancy are listed below:

Covid-19 vaccine: It can be given at any stage like before conceiving, during pregnancy, and after pregnancy. Otherwise, it can affect the pregnant woman and fetus's health.

Whooping cough vaccine: The effect of whooping cough may be life-threatening. Its vaccine protects the babies till the age of their vaccinations. This vaccine may be given in the third trimester, preferably between 27 to 36 weeks of pregnancy. Other adults who are regularly in contact with the baby, can also be taken this vaccine.

The flu shot: It is needed for pregnant women. Otherwise, flu may cause serious problems like early labor and delivery that will also affect the baby's health. The Flue shot benefits will be passed on to the newborn baby. The child will not suffer problems like pneumonia (lung infection). The flu shot can be given in any trimester of the pregnancy.

RSV vaccine: Respiratory Syncytial Virus (RSV) infects the nose, throat, and lungs and it is common in babies. RSV vaccine during pregnancy helps protect to baby from such diseases. It protects the baby up to 6 months after the birth. Its vaccine (Pfizer Abrysvo only) is recommended during gestational weeks (32 to 36).

Tdap/ DTap/Td: Tdap (Tetanus, Diphtheria, and Pertussis), Tetanus and Diphtheria (Td), and DTap ( Diphtheria, Tetanus, and Pertussis) vaccines: Tdap or DTaP (pertussis-containing vaccine) should be given as per age. Tdap should be given between 27 to 36 weeks of gestation preferably earlier in that time frame.  Tdap should be given irrespective of the interval since the last Tdap/Td is given. Tdap is better than Td for wound recovery during recovery. Therefore Tdap is preferred over Td. Three doses should be given to those pregnant women who never received a primary Td series. Td/Tdap doses should given at 0,1 and 6 months. One of the three doses should be Tdap which should be given between 27 to 36 weeks.

Mpox (Monky pox) vaccine: Mpox is an infectious disease caused by a virus and spread through mainly close contact, similar to smallpox. Its vaccine may be given after considering the benefits and risks.

Inactivated Influenza Vaccine (IIV) or Recombinant Influenza Vaccine (RIV) may be recommended seasonally. It can be taken before, during, or after delivery.

Except for smallpox, no vaccine is contraindicated for household contacts or the children of a pregnant woman.

Meningococcal ( ACWY), Rabies, and Tickborne-cephalitis vaccines may be given if it is advised by the expert.

The polio (PIV) vaccine may be given after considering the benefits and risks.

Hepatitis A vaccine may be given to the HAV-infected pregnant woman if she is at risk.

Anthrax vaccine may be used only for high-risk exposure.

Cholera, Ebola, Japanese Encephalitis, Yellow fever, Polio (IPV), Meningococcal (B), and Dengue vaccines may be given only if the benefits outweigh the risks.

The following vaccines are Contraindicated during pregnancy, however, the decision of an expert is final: Varicella vaccine: Varicella is also known as Chickenpox. Smallpox for pre-exposure. Influenza (LAIV - Live Attenuated Influenza Vaccine).  Measles, Mumps, Rubella (MMR) Adenovirus Live vaccine Typhoid (Ty21a) -  (Vi polysaccharide vaccine may be given if needed).

Prenatal Serology (Antibody) test: Under this category, the following two tests are important:

Rubella immunity test: Rubella during pregnancy can cause serious birth defects, death before birth, or lifelong diseases to the child. If susceptible, a postpartum vaccine can be given. At least a month gap is needed between the rubella vaccination and getting pregnant. If a woman has taken all three MMR (Measles, Mumps, and Rubella) during his childhood, no further testing and vaccination is required.

Hepatitis B infection test: If the pregnant woman is infected with Hepatitis B, it will be passed on to the baby at birth and cause serious health problems for the baby. If susceptible and at risk, vaccination can be done. HBsAg (Hepatitis B surface Antigen) positive means active Hepatitis B Virus (HBV) is there, and the woman is contagious. In general, If already not vaccinated with the hepatitis B vaccine, pregnant women should get the vaccine. However, Heplisav-B and PreHevbrio vaccines are not recommended in pregnancy. Instead, Engerix-B, Recombivax HB, or Twinrix vaccine can be given.

Travel vaccines and travel precautions: If a pregnant woman is planning to travel to another country or region, it is advisable to contact an expert to get any travel vaccine if needed.  If a pregnant woman is traveling in an airplane, car, or other vehicle, should have the following precautions: Wear the seat belt with comfort and support to expand the abdomen and hips area. She should stretch and straighten the legs and ankles periodically. She should get up and walk around periodically.

Protection of newborn babies by vaccination: Vaccinated pregnant women pass the antibodies to the fetus, and such antibodies protect the newborn babies for a few weeks/months after birth. After that, they are protected by their vaccinations. Always consider the importance of childhood immunization, and it can be started by giving the hepatitis B vaccine within 24 hours of birth.

The vaccines for the following viruses/diseases are generally not recommended: Haemophilus influenza type b. HPV ( Happilo Papilloma Virus) Pneumococcal Conjugate Virus (PCV) Pneumococcal Poly Saccharide Virus (PPSV23) Zoster vaccine, also called shingrix vaccine is not recommended during pregnancy. However, it protects from shingles which is caused by varicella zoster virus (VZV). This virus also causes chickenpox.

Need for mental healthcare during pregnancy: A pregnant woman has mixed feelings. It depends on individual nature/health, past health history, and family environment.
Worry is a common problem for all pregnant women, especially during the first pregnancy or an unplanned pregnancy.
Pregnant women who are already suffering from depression, and anxiety may feel a much harder form of worry. They should understand that they are not alone.
Many pregnant women suffer from worry, sadness, or nervousness. They should get sound sleep, and contact an expert to deal with such a situation. Some of the common problems are listed below:
Worry	sadness
Anxiety	Depression
Mood swing	Nervousness
Stress	Bipolar disorder
Post Traumatic Stress Disorder (PTSD)	Panic attack
Obsessive Compulsive Disorder (OCD)	Eating disorder
Always consult with an expert, doctor, healthcare professional, Gynecologist, obstetrician, or Psychiatrist to deal with the situation.

Sexual activities during pregnancy: Sexual activities are generally safe during pregnancy if such activities are comfortable and have mutual consent. However extra precautions should be taken for comfort. In case of vaginal bleeding, pelvic or vaginal pain, leakage of amniotic fluid, or uterine contractions, sexual activities should be avoided. For any assistance, always consult with an expert.

Final words:
A higher intake of nutrients, including iron, iodine, vitamin D, and folate, is needed before, during, and after pregnancy (during breastfeeding).
With the help of an expert, doctor, healthcare provider, gynecologist, obstetrician, and/or dietitian, a customized diet and pre-natal (nutrients/dietary) supplements should be taken. It varies, depending on individual health.
During pregnancy, the following healthy lifestyle is good for health:
Appropriate weight gain	A balanced, healthy, and nutrient-rich diet
Timely intake of recommended nutrient supplements.	Regular physical activity
Include the intake of recommended nutrients from the balanced and healthy diet of protein, fresh & dry fruits, vegetables, and whole grains. Keep the minimum intake of sweets and fat. A balanced and healthy diet will help to reduce the constipation and nausea during the pregnancy.
Maintain the proper hygiene during pregnancy. It will reduce the risk of infections like listeriosis (listeria) and Salmonella.
Healthy food from all food groups should be included in the daily diet to get all the required nutrients.
Prenatal vitamins, minerals, especially folic acid foods, and supplements should start at least 3 months before conceiving and continue during the pregnancy as recommended by an expert.
As per the advice of a healthcare professional, some blood, urine, radiology, or Ultrasound tests may be needed to know the health condition of the mother and preborn baby.
Always consult with a doctor, healthcare provider, specialist, gynecologist, and obstetrician, before taking any supplements.
For an obese person, during pregnancy, it is not good to reduce the weight and go for dieting and fasting.
Any kind of restricted eating, or crash dieting during pregnancy will adversely affect the health of the woman and baby.
Reduce the intake of discretionary food and drinks. Such food and drink have little nutrients and high energy. They are added just for taste. Discretionary foods and drinks contain high amounts of saturated fat, added sugar, salt, and/or alcohol.
Maintain an active life during pregnancy.
A pregnant woman should indeed take more food, rich in nutrients for her and her baby's health, but the amount of food should not be so high that equals the diet for two persons.
Pregnant Adolescent needs more nutrients than pregnant adult women.
Consumption of fish by pregnant women or those who are planning for pregnancy within 6 months should be carefully chosen to avoid the high-level content of mercury in the fish.
Pregnant women should have heavy breakfasts, it will avoid the temptation of snacks containing high levels of sugar and fats.
During pregnancy, starchy food is also required to get the carbohydrate.
A daily diet for pregnant women does not mean that it should be taken exactly as per data. However, an average for a week of daily diet should be almost the same.
Ready-to-eat breakfast cereals and cooked cereals are good for Iron and Folic acid.
Before conceiving, during pregnancy and the lactation period, sufficient intake of water and fat-soluble nutrients including folate, choline, Vitamin  A, D, and B12 are needed. As per the need, experts recommend required supplements for the entire period as mentioned above.
Most of the pregnant women in the U.S., do not get the recommended dose of Choline (some experts treat it like vitamin B4). Each year in the U.S., as per an estimate, 58000 to 60000 children under the age of 5 years suffer from RSV (Respiratory Syncytial Virus). 90% of the U.S. population does not take the required amount of fruits and vegetables. It is required to fill the gap, especially through whole fresh or frozen fruits rather than juices.
Some women may be allergic to some foods like soy, milk, nuts, nuts, and seeds. They may take alternatives with the advice of an expert.
Pregnant women should take prenatal multivitamins containing iron and folate daily, even if their diet is adequate.
Select canned food/juice/paste with no added sugar or salt. Vegan people can take alternatives of meats, poultry, fish, and eggs with the advice of a dietitian, specialist, or healthcare provider.

Disclaimer: The best efforts are made to write the blog with the help of self-knowledge, following, and similar websites. However, the author does not have any responsibility (legal or otherwise) for its completeness or correctness. This blog is not A.I. generated and typed manually. Therefore, any typographical error is regretted. The author is not a medical professional. This blog is written for information purposes only, it does not replace the advice of healthcare providers,  or specialists. Therefore, it is recommended to consult with a registered medical professional before using any information from this blog. The author is not responsible for any consequences. https://www.betterhealth.vic.gov.au https://www.hopkinsmedicine.org https://www.nhs.uk https://www.mayoclinic.org https://www.medicalnewstoday.com https://www.niddk.nih.gov https://www.healthline.com https://odphp.health.gov https://www.health.state.mn.us https://www.hhs.gov https://www.cdc.gov https://kidshealth.org https://www.msdmanuals.com https://www.marchofdimes.org http://www.healthcouncil.nl

Welcome in advance for a happy birthday. =The end=