You won't have to switch to cold showers, but it's probably a good idea to stay out of the hot tub. Anything that raises the body temperature over 102F and keeps it there for a while-whether it's a soak in a hot tub or an extremely hot bath, or an overzealous workout in hot weather-is potentially hazardous to the developing embryo or fetus, particularly in the early months. Some studies have shown that a hot tub doesn't raise a woman's temperature to dangerous levels immediately-it takes at least 10 minutes (longer if the shoulders and arms are not submerged or if the water is 102F or less). But because individual responses and circumstances vary, play it safe by keeping your belly out of the hot tub. Feel free, however, to soak your feet.

If you've already had some brief dips in the hot tub, there is probably no cause for concern. Most women spontaneously get out of a hot tub before their body temperatures reach 102F because they become uncomfortable. It's likely you did, too. If you are concerned, however, speak to your practitioner about the possibility of having an ultrasound exam or other prenatal test to help put your mind at ease.

Lengthy stays in the sauna or steam room aren't smart, either. A pregnant woman is at greater risk for dehydration, dizziness, and lower blood pressure in general, and these are all symptoms that may be exacerbated by such extreme heat. And as with a hot tub, pregnant women should avoid anything that might potentially raise their body temperatures.

For more information on the safety of other types of spa treatments (massage, aromatherapy, and so on), see page 147 page 147.

Is Hot Stuff Not So Hot?

Considering cuddling up with an electric blanket when the winter chill sets in? Or easing that achy-breaky back with a heating pad? Too much heat isn't so hot when you're pregnant, since it may raise your body temperature excessively. So cuddle up to your sweetie instead of that electric blanket (or if his tootsies are as icy as yours, invest in a down comforter, push up the thermostat, or heat the bed with an electric blanket and then turn it off before you turn in). Still feeling the chill. Keep in mind that as the months pass, you'll probably be keeping yourself so warm-thanks to a pregnancy-boosted metabolism-that you'll be kicking off all your covers anyway.

As for that heating pad, wrap it in a towel before you apply it to your back, belly, or shoulders to reduce the heat it passes along (an ankle or knee can take the heat), keep it at the lowest setting, limit applications to 15 minutes, and avoid sleeping with it. Already spent some time under that electric blanket or heating pad? Not to worry-there's no proven risk.

The Family Cat "I have two cats at home. I've heard that cats carry a disease that can harm a fetus. Do I have to get rid of my pets?"

Don't send your feline friends packing. Since you've lived with them for a while, the chances are pretty good that you've already contracted the cat-related disease toxoplasmosis and have developed an immunity to it. It's estimated that up to 40 percent of the American population has been exposed, and the rates of exposure are much higher among people who have cats that spend time outdoors, as well as among people who frequently eat raw meat or drink unpasteurized milk, both of which can also harbor. and transmit the infection. If you weren't tested prenatally to see if you were immune, it's not likely you will be tested now, unless you show symptoms of the disease (though some practitioners run regular tests on all pregnant women and others test only those who live with cats). If you were tested prenatally and were not immune, or if you're not sure whether you are immune or not, take the following precautions to avoid infection: [image] Have your cats tested by a veterinarian to see if they have an active infection. If one or more do, board them at a kennel or ask a friend to care for them for at least six weeks, the period during which the infection is transmissible. If they are free of infection, keep them that way by not allowing them to eat raw meat, roam outdoors, hunt mice or birds (which can transmit toxoplasmosis to cats), or hang out with other cats. Have your cats tested by a veterinarian to see if they have an active infection. If one or more do, board them at a kennel or ask a friend to care for them for at least six weeks, the period during which the infection is transmissible. If they are free of infection, keep them that way by not allowing them to eat raw meat, roam outdoors, hunt mice or birds (which can transmit toxoplasmosis to cats), or hang out with other cats.[image] Have someone else handle the litter box. If you must do it yourself, use disposable gloves and wash your hands when you're finished, as well as after you touch your cats. The litter should be changed daily. Have someone else handle the litter box. If you must do it yourself, use disposable gloves and wash your hands when you're finished, as well as after you touch your cats. The litter should be changed daily.[image] Wear gloves when gardening. Don't garden in soil in which cats may have deposited feces. If you have children, don't allow them to play in sand that may have been used by cats or other animals. Wear gloves when gardening. Don't garden in soil in which cats may have deposited feces. If you have children, don't allow them to play in sand that may have been used by cats or other animals.[image] Wash fruits and vegetables, especially those grown in home gardens, rinsing very thoroughly, and/or peel or cook them. Wash fruits and vegetables, especially those grown in home gardens, rinsing very thoroughly, and/or peel or cook them.[image] Don't eat raw or undercooked meat or unpasteurized milk. In restaurants, order meat well done. Don't eat raw or undercooked meat or unpasteurized milk. In restaurants, order meat well done.[image] Wash your hands thoroughly after handling raw meats. Wash your hands thoroughly after handling raw meats.

Some practitioners are urging routine testing before conception or in very early pregnancy for all women, so that those who test positive can relax, knowing they are immune, and those who test negative can take the necessary precautions to prevent infection. However, public health officials believe the financial cost of such testing outweighs the benefit it may provide. Check with your practitioner to see what he or she recommends.

Household Hazards "How much do I really have to worry about household hazards like cleaning products and bug sprays? And what about tap water-is it safe to drink it while I'm pregnant?"

A little perspective goes a long way when you're expecting. Sure, you've read or heard that cleaning products, insecticides, drinking water, and other substances around the house can be dangerous to live with, especially when you're living for two. But the fact is that your home is probably a very safe place for you and your baby to hang out-especially if you couple a little caution with a lot of common sense. Here's what you need to know about so-called household hazards: Household cleaning products. Mopping your kitchen floor or polishing your dining room table may be tough on your pregnant back, but it's not tough on your pregnancy. Still, it makes sense to clean with care when you're expecting. Let your nose and the following tips be your guide: Mopping your kitchen floor or polishing your dining room table may be tough on your pregnant back, but it's not tough on your pregnancy. Still, it makes sense to clean with care when you're expecting. Let your nose and the following tips be your guide: [image] If the product has a strong odor or fumes, don't breathe it in directly. Use it in an area with plenty of ventilation, or don't use it at all (what better excuse for getting your spouse to scrub the toilet?). If the product has a strong odor or fumes, don't breathe it in directly. Use it in an area with plenty of ventilation, or don't use it at all (what better excuse for getting your spouse to scrub the toilet?).[image] Never (even when you're not pregnant) mix ammonia with chlorine-based products; the combination produces deadly fumes. Never (even when you're not pregnant) mix ammonia with chlorine-based products; the combination produces deadly fumes.[image] Try to avoid using products such as oven cleaners and dry-cleaning fluids whose labels are plastered with warnings about toxicity. Try to avoid using products such as oven cleaners and dry-cleaning fluids whose labels are plastered with warnings about toxicity.[image] Wear rubber gloves when you're using a really strong product. Not only will this spare your hands a lot of wear and tear, it'll prevent the absorption of chemicals through the skin. Wear rubber gloves when you're using a really strong product. Not only will this spare your hands a lot of wear and tear, it'll prevent the absorption of chemicals through the skin.

Lead. Exposure to lead isn't just potentially harmful to small children but to pregnant women and their fetuses as well. Fortunately, it's also pretty easy to avoid. Here's how: Exposure to lead isn't just potentially harmful to small children but to pregnant women and their fetuses as well. Fortunately, it's also pretty easy to avoid. Here's how: [image] Since drinking water is a common source of lead, be sure yours is lead free (see below). Since drinking water is a common source of lead, be sure yours is lead free (see below).[image] Old paint is a major source of lead. If your home dates back to 1955 or earlier and layers of paint are to be removed for any reason, stay away from the house while the work is being done. If you find paint is flaking in an older home, or if you have a piece of old painted furniture that's flaking, see about having the walls or furniture repainted to contain the flaking lead paints, or have the old paint removed-again, stay away while the job is being done. Old paint is a major source of lead. If your home dates back to 1955 or earlier and layers of paint are to be removed for any reason, stay away from the house while the work is being done. If you find paint is flaking in an older home, or if you have a piece of old painted furniture that's flaking, see about having the walls or furniture repainted to contain the flaking lead paints, or have the old paint removed-again, stay away while the job is being done.[image] Flea market fan? You might want to know that lead can also be leached from older earthenware, pottery, and china. If you have pitchers or dishes that are home-crafted, imported, antique, or just plain old (the FDA did not set limits on lead in dishes until 1971), don't use them for serving food or beverages, particularly those that are acidic (citrus, vinegar, tomatoes, wine, soft drinks). Flea market fan? You might want to know that lead can also be leached from older earthenware, pottery, and china. If you have pitchers or dishes that are home-crafted, imported, antique, or just plain old (the FDA did not set limits on lead in dishes until 1971), don't use them for serving food or beverages, particularly those that are acidic (citrus, vinegar, tomatoes, wine, soft drinks).

Tap water. It's still the best drink in the house-and in most houses, water is completely safe and drinkable straight from the tap. To be sure that when you fill a glass of water you'll be drinking to your-and your baby's-good health, do the following: It's still the best drink in the house-and in most houses, water is completely safe and drinkable straight from the tap. To be sure that when you fill a glass of water you'll be drinking to your-and your baby's-good health, do the following: [image] Check with your local Environmental Protection Agency (EPA) or health department about the purity and safety of community drinking water or a well, if that is the source of your tap water (go to Check with your local Environmental Protection Agency (EPA) or health department about the purity and safety of community drinking water or a well, if that is the source of your tap water (go to epa.gov/safewater/dwinfo/index.html). Or check with the EPA Water Safety Hotline at (800) 426-4791 or online at scorecard.org. If there is a possibility that the quality of your water might differ from the rest of the community's (because of pipe deterioration, because your home borders on a waste disposal area, or because of odd taste or color), arrange to have it tested. Your local EPA or health department can tell you how.[image] If your tap water fails the test, invest in a filter (what kind depends on what turns up in your water) or use bottled water for drinking and cooking. Be aware, however, that bottled waters are not automatically free of impurities; some contain more than tap water, and some are bottled directly from the tap (talk about throwing money down the drain). Many bottled waters also don't contain fluoride, an important mineral, especially for growing teeth (your baby's). To check the purity of a particular brand, contact the National Sanitation Foundation at (800) 673-6275 or If your tap water fails the test, invest in a filter (what kind depends on what turns up in your water) or use bottled water for drinking and cooking. Be aware, however, that bottled waters are not automatically free of impurities; some contain more than tap water, and some are bottled directly from the tap (talk about throwing money down the drain). Many bottled waters also don't contain fluoride, an important mineral, especially for growing teeth (your baby's). To check the purity of a particular brand, contact the National Sanitation Foundation at (800) 673-6275 or nsf.org. Avoid distilled waters (from which beneficial minerals have been removed).[image] If you suspect lead in your water, or if testing reveals high levels, changing the plumbing would be the ideal solution, but this is not always feasible. To reduce the levels of lead in the water you drink, use only cold water for drinking and cooking (hot leaches more lead from the pipes), and run the cold-water tap for about five minutes in the morning (as well as anytime the water has been off for six hours or more) before using it. You can tell that lead-free fresh water from the street pipes has reached your faucet when the water has gone from cold to warmer to cold again. If you suspect lead in your water, or if testing reveals high levels, changing the plumbing would be the ideal solution, but this is not always feasible. To reduce the levels of lead in the water you drink, use only cold water for drinking and cooking (hot leaches more lead from the pipes), and run the cold-water tap for about five minutes in the morning (as well as anytime the water has been off for six hours or more) before using it. You can tell that lead-free fresh water from the street pipes has reached your faucet when the water has gone from cold to warmer to cold again.[image] If your water smells and/or tastes like chlorine, boiling it or letting it stand, uncovered, for 24 hours will evaporate much of the chemical. If your water smells and/or tastes like chlorine, boiling it or letting it stand, uncovered, for 24 hours will evaporate much of the chemical.

Pesticides. Can't live with roaches, ants, and other yucky insects? Living with them, of course, often means eliminating them through the use of chemical pesticides. Fortunately, pest control and pregnancy can be completely compatible, with a few precautions. If your neighborhood is being sprayed, avoid hanging around outside for long periods until the chemical odors have dissipated, usually about two to three days. When indoors, keep the windows closed. If spraying for roaches or other insects is necessary in your apartment or house, be sure all closets and kitchen cabinets are tightly closed (so the chemicals don't seep in and settle on dishes and food) and all food-preparation surfaces are covered. Ventilate with open windows until the fumes have dissipated. Once the spray has settled, make sure food-preparation surfaces in or near the sprayed area have been thoroughly wiped down. Can't live with roaches, ants, and other yucky insects? Living with them, of course, often means eliminating them through the use of chemical pesticides. Fortunately, pest control and pregnancy can be completely compatible, with a few precautions. If your neighborhood is being sprayed, avoid hanging around outside for long periods until the chemical odors have dissipated, usually about two to three days. When indoors, keep the windows closed. If spraying for roaches or other insects is necessary in your apartment or house, be sure all closets and kitchen cabinets are tightly closed (so the chemicals don't seep in and settle on dishes and food) and all food-preparation surfaces are covered. Ventilate with open windows until the fumes have dissipated. Once the spray has settled, make sure food-preparation surfaces in or near the sprayed area have been thoroughly wiped down.

Whenever possible, try to take a natural approach to pest control. Pull weeds instead of spraying them. Eliminate some pests from garden and houseplants by spraying with a forceful stream from the garden hose or with a biodegradable insecticidal soap mixture (the procedure may need to be repeated several times to be effective). Invest in an infantry of ladybugs or other beneficial predators (available from some garden supply houses) that like to feed on the bugs that are bugging you.

Inside the house, use "motel" or other types of traps, strategically placed in heavy bug traffic areas, to get rid of roaches and ants; use cedar blocks instead of mothballs in clothes closets; and check an environmentally friendly store or catalog for nontoxic pesticides. If you have young children or pets, keep all traps and pesticide products out of their reach. Even so-called natural pesticides, including boric acid, can be toxic when ingested or inhaled, and they can be irritating to the eyes. For more information on natural pest control, contact your regional Cooperative Extension Service or a local environmental group. You may even have a "green" exterminator in your neighborhood.

Also keep in mind that brief, indirect exposure to insecticides or herbicides isn't likely to be harmful. What does increase the risk is frequent, long-term exposure, the kind that working daily around such chemicals (as in a factory or heavily sprayed field) would involve.

The Green Solution Looking for a way to breathe easier about the air you're breathing at home? Go green, filling your living space with living plants. Plants have the ability to absorb assorted pollutants in the air while adding oxygen to the indoor environment. In making your selections, however, be sure to avoid plants that are toxic when ingested, such as philodendron or English ivy. You won't likely be munching on shrubbery, but the same can't necessarily be said for your baby once he or she begins crawling around the house.

Paint fumes. In the entire animal kingdom, the period before birth (or egg laying) is spent in hectic preparation for the arrival of the new offspring. Birds feather their nests, squirrels line their tree-trunk homes with leaves and twigs, and human mothers and fathers sift madly through online design catalogues. And almost invariably, plans involve painting the baby's room (once you can settle on the color, that is). Fortunately, today's paints don't contain lead or mercury and are safe to use when you're pregnant. Still, there are plenty of good reasons why you should pass the paintbrush to someone else-even if you're trying desperately to keep busy in those last weeks of waiting. The repetitive motion of painting can be a strain on back muscles already under pressure from the extra weight of pregnancy. In addition, balancing on ladder tops is precarious at the least, and paint odors (though not harmful) can offend the pregnant nose and bring on a bout of nausea. In the entire animal kingdom, the period before birth (or egg laying) is spent in hectic preparation for the arrival of the new offspring. Birds feather their nests, squirrels line their tree-trunk homes with leaves and twigs, and human mothers and fathers sift madly through online design catalogues. And almost invariably, plans involve painting the baby's room (once you can settle on the color, that is). Fortunately, today's paints don't contain lead or mercury and are safe to use when you're pregnant. Still, there are plenty of good reasons why you should pass the paintbrush to someone else-even if you're trying desperately to keep busy in those last weeks of waiting. The repetitive motion of painting can be a strain on back muscles already under pressure from the extra weight of pregnancy. In addition, balancing on ladder tops is precarious at the least, and paint odors (though not harmful) can offend the pregnant nose and bring on a bout of nausea.

While the painting is being done, try to arrange to be out of the house. Whether you're there or not, keep windows open for ventilation. Avoid exposure to paint removers entirely, because they are highly toxic, and steer clear of the paint-removing process (whether chemicals or sanders are used), particularly if the paint that's being removed is older and might contain mercury or lead.

Air Pollution "Can city air pollution hurt my baby?"

Take a deep breath. Ordinary breathing in the big city is a lot safer than you'd think. After all, millions of women live and breathe in major cities across the nation and give birth to millions of healthy babies. Still, it's always sensible to avoid extraordinarily high doses of most air pollutants. Here's how: [image] Avoid smoke-filled rooms. Since tobacco smoke is one pollutant that's known to hurt the fetus, ask family, guests in your home, and coworkers not to smoke near you. That goes for cigars and pipes, too, because they release even more smoke into the air than cigarettes do. Avoid smoke-filled rooms. Since tobacco smoke is one pollutant that's known to hurt the fetus, ask family, guests in your home, and coworkers not to smoke near you. That goes for cigars and pipes, too, because they release even more smoke into the air than cigarettes do.[image] Have the exhaust system on your car checked to be sure there is no leakage of noxious fumes and the exhaust pipe isn't rusting away. Never start your car in the garage with the garage door closed; keep the tailgate on an SUV or minivan closed when the engine is running; keep your car's outside air vent closed when driving in heavy traffic. Have the exhaust system on your car checked to be sure there is no leakage of noxious fumes and the exhaust pipe isn't rusting away. Never start your car in the garage with the garage door closed; keep the tailgate on an SUV or minivan closed when the engine is running; keep your car's outside air vent closed when driving in heavy traffic.[image] If there is a pollution alert in your area, stay indoors as much as you can, with the windows closed and the air conditioner, if you have one, running. Follow any other instructions given by health officials for residents who are at special risk. If you want to work out, go to the gym or go for a long walk at an indoor mall. If there is a pollution alert in your area, stay indoors as much as you can, with the windows closed and the air conditioner, if you have one, running. Follow any other instructions given by health officials for residents who are at special risk. If you want to work out, go to the gym or go for a long walk at an indoor mall.[image] Don't run, walk, or bicycle along congested highways, no matter what the weather, since you breathe in more air-and pollution-when you're active. Instead, choose a route through a park or a residential area with little traffic and a lot of trees. Trees, like indoor greenery, help to keep the air clean. Don't run, walk, or bicycle along congested highways, no matter what the weather, since you breathe in more air-and pollution-when you're active. Instead, choose a route through a park or a residential area with little traffic and a lot of trees. Trees, like indoor greenery, help to keep the air clean.[image] Make sure fireplaces, gas stoves, and wood-burning stoves in your home are vented properly. Also, make sure the fireplace flue is open before lighting a fire. Make sure fireplaces, gas stoves, and wood-burning stoves in your home are vented properly. Also, make sure the fireplace flue is open before lighting a fire.[image] Try the Green Solution (see previous page). Plants, and the air-purification properties that they provide, can help you breathe easier both inside your home and out. Try the Green Solution (see previous page). Plants, and the air-purification properties that they provide, can help you breathe easier both inside your home and out.

Domestic Violence Protecting her baby from harm is every expectant mother's most basic instinct. But sadly, some women can't even protect themselves during pregnancy. That's because they're victims of domestic violence.

Domestic violence can strike at any time, but it's especially common during pregnancy. While having a baby brings out a new (or renewed) tenderness in many relationships, it rocks others, sometimes triggering unexpectedly negative emotions in a woman's partner (from anger to jealousy to a feeling of being trapped), particularly if the pregnancy wasn't planned. In some cases, unfortunately, those emotions play out in the form of violence against both the mother and her unborn baby.

Surprisingly, domestic violence is the leading cause of death among pregnant women, killing more often than pregnancy complications or car crashes. Even without the homicides, the statistics are just as alarming: Nearly 20 percent of women experience violence at the hands of their partners during pregnancy. This means, statistically, that pregnant women are twice as likely to experience physical abuse during their nine months than experience a preterm birth or preeclampsia.

Domestic abuse (emotional and physical) against pregnant women carries more than just the immediate risk of injury to the mother-to-be and her baby (such as uterine rupture or hemorrhaging). Being battered during pregnancy can lead to numerous negative health consequences for the mom-to-be, including poor nutrition, poor prenatal care, substance abuse, and so on. Its effects on the pregnancy can also include stillbirth or miscarriage, preterm labor, premature rupture of the membranes, or low birthweight. And once a baby is born into a physically abusive household, he or she can easily become a victim of direct violence as well.

Abused women come from all backgrounds and socioeconomic areas, every age, every race and ethnicity, and every educational level. If you're the victim of domestic violence, remember that it is not your fault. You have done nothing wrong. If you are in an abusive relationship, don't wait-get help now. Without intervention, the violence will only get worse. Keep in mind that if you're not safe in your relationship, your child won't be safe either.

Talk to your practitioner, tell your trusted friends and family, and call a local domestic violence hotline. Many states have programs that can help you with shelter, clothing, and prenatal care. Check out The Safety Zone, thesafetyzone.org; Violence Against Women, 4woman.gov/violence/index.cfm; Family Violence Prevention Fund, endabuse.org; National Coalition Against Domestic Violence, ncadv.org; or call the National Domestic Violence Hotline at (800) 799-7233.

If you are in immediate danger, call 911.

Complementary and Alternative Medicine The days when alternative medicine was about as welcome in traditional medical practice as old wives' tales (and regarded with about as much credibility) are over. Today, these seemingly unrelated branches of healing are no longer considered incompatible. in fact, more and more practitioners in both consider them complementary. Which is why complementary and alternative medicine (CAM) is more and more likely to find a place-in some form-in your life and the life of your family.

The practitioners who practice complementary medicine take a broad view of health and well-being, examining and integrating the nutritional, emotional, and spiritual influences, as well as the physical ones. CAM also emphasizes the body's ability to heal itself-with a little help from some natural friends, including herbs, physical manipulation, the spirit, and the mind.

Since pregnancy is not an illness but rather a normal part of life, it would seem that CAM might make a natural addition to traditional obstetrical care. And for an increasing number of women and their health care providers, it has. A variety of CAM practices are currently being used in pregnancy, labor, and delivery, with varying degrees of success, including the following: Acupuncture. The Chinese have known for thousands of years that acupuncture can be used to relieve a number of pregnancy symptoms-but it's only recently that the traditional obstetrical community has started to catch on. Scientific studies now back up the ancient wisdom; researchers have found that acupuncture triggers the release of several brain chemicals, including endorphins, which block pain signals. How is it done? An acupuncturist inserts dozens of thin needles at prescribed points along invisible paths (or meridians) on the body. According to ancient tradition, the paths are the channels through which chi, the body's life force, flows. Researchers have found that the points correspond to deep-seated nerves, so that when the needles are twirled (or electrically stimulated, in a procedure known as electropuncture), the nerves are activated, leading to the release of endorphins-and relief from back pain, nausea, and other symptoms, including pregnancy depression. Acupuncture may also be used during labor to relieve pain, as well as to help speed progress along. For those finding conception elusive, acupuncture may help with fertility issues. The Chinese have known for thousands of years that acupuncture can be used to relieve a number of pregnancy symptoms-but it's only recently that the traditional obstetrical community has started to catch on. Scientific studies now back up the ancient wisdom; researchers have found that acupuncture triggers the release of several brain chemicals, including endorphins, which block pain signals. How is it done? An acupuncturist inserts dozens of thin needles at prescribed points along invisible paths (or meridians) on the body. According to ancient tradition, the paths are the channels through which chi, the body's life force, flows. Researchers have found that the points correspond to deep-seated nerves, so that when the needles are twirled (or electrically stimulated, in a procedure known as electropuncture), the nerves are activated, leading to the release of endorphins-and relief from back pain, nausea, and other symptoms, including pregnancy depression. Acupuncture may also be used during labor to relieve pain, as well as to help speed progress along. For those finding conception elusive, acupuncture may help with fertility issues.

Acupressure. Acupressure-or shiatsu-works on the same principle as acupuncture, except that instead of getting poked with needles, your practitioner will use thumb or finger pressure, or will apply firm pressure with small beads, to stimulate the points. Pressure on a certain point just above your inner wrist can ease nausea (which is why Sea-Bands can also work; see Acupressure-or shiatsu-works on the same principle as acupuncture, except that instead of getting poked with needles, your practitioner will use thumb or finger pressure, or will apply firm pressure with small beads, to stimulate the points. Pressure on a certain point just above your inner wrist can ease nausea (which is why Sea-Bands can also work; see page 134 page 134). Acupressure on the center of the ball of the foot is said to help back labor. There are several acupressure points that are said to induce contractions (such as those in the ankle)-which is why they should be avoided until term (at which point, impatient moms-to-be might want to give them a try-at the hands of a professional, that is).

Biofeedback. Biofeedback is a method that helps patients learn how to control their biological responses to physical pain or emotional stress, and it can be used safely to relieve a variety of pregnancy symptoms, including headache, backache, and other pains, plus insomnia and possibly morning sickness. Biofeedback can also be used to lower blood pressure and combat depression, anxiety, and stress.

Chiropractic medicine. This therapy uses physical manipulation of the spine and other joints to enable nerve impulses to move freely through an aligned body, encouraging the body's natural ability to heal. Chiropractic medicine can help pregnant women battle nausea. back, neck, or joint pain; and sciatica (plus other types of pain), as well as help relieve postpartum pain. Be sure any chiropractic practitioner you see during pregnancy is familiar with caring for expectant women, using tables that adjust for a pregnant woman's body and using techniques that avoid pressure on the abdominal area. This therapy uses physical manipulation of the spine and other joints to enable nerve impulses to move freely through an aligned body, encouraging the body's natural ability to heal. Chiropractic medicine can help pregnant women battle nausea. back, neck, or joint pain; and sciatica (plus other types of pain), as well as help relieve postpartum pain. Be sure any chiropractic practitioner you see during pregnancy is familiar with caring for expectant women, using tables that adjust for a pregnant woman's body and using techniques that avoid pressure on the abdominal area.

Massage. Massage can help relieve some of pregnancy's discomforts, including heartburn, nausea (but only in some women; others may be more nauseated by massage), headaches, backache, and sciatica, while preparing muscles for childbirth. It can also be used during labor and delivery to relax muscles between contractions and reduce the pain of back labor. What's more, it's a great way to reduce stress and relax. Just make sure you're being massaged by someone who's trained in the art of prenatal massage (not all massage therapists are); see page 147 page 147 for more. for more.

Reflexology. Similar to acupressure, reflexology is a therapy in which pressure is applied to specific areas of the feet, hands, and ears to relieve a variety of aches and pains, as well as to stimulate labor and reduce the pain of contractions. Because applying pressure to certain areas on or near the feet and on the hands can trigger contractions, it's very important that the reflexologist you visit be well trained and aware of your pregnancy, and that he or she avoids these areas before term (afterward, again, they could be just the ticket to bring on a long-awaited labor). Similar to acupressure, reflexology is a therapy in which pressure is applied to specific areas of the feet, hands, and ears to relieve a variety of aches and pains, as well as to stimulate labor and reduce the pain of contractions. Because applying pressure to certain areas on or near the feet and on the hands can trigger contractions, it's very important that the reflexologist you visit be well trained and aware of your pregnancy, and that he or she avoids these areas before term (afterward, again, they could be just the ticket to bring on a long-awaited labor).

Hydrotherapy. This therapeutic use of warm water (usually in a whirlpool tub) is used in many hospitals and birthing centers to help relax a laboring woman and reduce her discomfort. Some women choose to give birth in water; see This therapeutic use of warm water (usually in a whirlpool tub) is used in many hospitals and birthing centers to help relax a laboring woman and reduce her discomfort. Some women choose to give birth in water; see page 24 page 24.

Aromatherapy. Scented oils are used to heal body, mind, and spirit and are utilized by some practitioners during pregnancy; however, most experts advise caution, since certain aromas (in this concentrated form) may pose a risk to pregnant women; see page 147 page 147.

Meditation, visualization, and relaxation techniques. All of these can help a woman safely through a variety of physical and emotional stresses during pregnancy, from the miseries of morning sickness to the pain of labor and delivery. They can work wonders on general expectant mom anxiety, too; see page 142 page 142 for a relaxation exercise you can try. for a relaxation exercise you can try.

Hypnotherapy. Hypnosis may be useful in relieving pregnancy symptoms (from nausea to headaches), reducing stress and easing insomnia, turning a breech birth (in conjunction with the more traditional external cephalic version), holding off preterm labor, and providing pain management during labor and delivery (hypnobirthing). It works by getting you deeply relaxed-and in the case of pain management, so relaxed that you're unaware of any discomfort. Keep in mind that hypnosis isn't for everyone; about 25 percent of the population is highly resistant to hypnotic suggestion, and many more aren't suggestive enough to use it for effective pain relief. Make sure any hypnotherapist you use is certified and experienced in pregnancy therapies. For more on hypnobirthing, see Hypnosis may be useful in relieving pregnancy symptoms (from nausea to headaches), reducing stress and easing insomnia, turning a breech birth (in conjunction with the more traditional external cephalic version), holding off preterm labor, and providing pain management during labor and delivery (hypnobirthing). It works by getting you deeply relaxed-and in the case of pain management, so relaxed that you're unaware of any discomfort. Keep in mind that hypnosis isn't for everyone; about 25 percent of the population is highly resistant to hypnotic suggestion, and many more aren't suggestive enough to use it for effective pain relief. Make sure any hypnotherapist you use is certified and experienced in pregnancy therapies. For more on hypnobirthing, see page 306 page 306.

Moxibustion. This alternative medicine technique combines acupuncture with heat (in the form of smoldering mugwort, an herb) to gradually help turn a breech baby. If you're interested in trying moxibustion to turn your breech baby, look for a practitioner who's experienced in the technique (not all acupuncturists are).

Herbal remedies. "Botanicals" have been used since humankind first began looking for relief from ailments, and they are today used by some practitioners to relieve pregnancy symptoms. Most experts, however, do not recommend herbal remedies for pregnant women because adequate studies on safety have not yet been done.

Clearly, CAM is making an impact in obstetrics. Even the most traditional ob-gyns are realizing that it's a holistic force to be reckoned with, and one to begin incorporating into ob-business as usual. But in making CAM a part of your pregnancy, it's wise to proceed with prudence and with these caveats in mind: [image] Make sure your traditional ob-gyn or midwife is aware that you're seeking a CAM treatment, so your care is truly complementary. Keeping your entire prenatal team in the know is important for your safety and that of your baby. Make sure your traditional ob-gyn or midwife is aware that you're seeking a CAM treatment, so your care is truly complementary. Keeping your entire prenatal team in the know is important for your safety and that of your baby.[image] Complementary medications (such as homeopathic and herbal preparations) are not tested or approved by the FDA. Because they haven't been thoroughly tested-as FDA-approved drugs are-their safety hasn't been clinically established. Which is not to say that there aren't complementary medications that are safe to use in pregnancy and possibly very beneficial, just that there is no official system in place to determine those that are and those that aren't. Until more is known, it makes sense to avoid taking any homeopathic, herbal medication, dietary supplement, or aromatherapy treatment unless it has been specifically prescribed by a traditional practitioner who is knowledgeable in CAM and who knows you're pregnant. (This is also true once the baby is born if you are breastfeeding.) Complementary medications (such as homeopathic and herbal preparations) are not tested or approved by the FDA. Because they haven't been thoroughly tested-as FDA-approved drugs are-their safety hasn't been clinically established. Which is not to say that there aren't complementary medications that are safe to use in pregnancy and possibly very beneficial, just that there is no official system in place to determine those that are and those that aren't. Until more is known, it makes sense to avoid taking any homeopathic, herbal medication, dietary supplement, or aromatherapy treatment unless it has been specifically prescribed by a traditional practitioner who is knowledgeable in CAM and who knows you're pregnant. (This is also true once the baby is born if you are breastfeeding.)[image] Complementary procedures that are usually benign-or even beneficial-for the nonpregnant may not be safe during pregnancy. From therapeutic massage to chiropractic maneuvers, special precautions must be observed when a patient is pregnant. Complementary procedures that are usually benign-or even beneficial-for the nonpregnant may not be safe during pregnancy. From therapeutic massage to chiropractic maneuvers, special precautions must be observed when a patient is pregnant.[image] CAM can still be strong medicine. Depending on how it's used, this potency can be therapeutic or it can be hazardous. Keep in mind that "natural" is not synonymous with "safe" any more than "chemical" is synonymous with "dangerous." Have your practitioner help you navigate through the potential pitfalls and steer you toward CAM practices that can help-not hurt-when you're expecting. CAM can still be strong medicine. Depending on how it's used, this potency can be therapeutic or it can be hazardous. Keep in mind that "natural" is not synonymous with "safe" any more than "chemical" is synonymous with "dangerous." Have your practitioner help you navigate through the potential pitfalls and steer you toward CAM practices that can help-not hurt-when you're expecting.

CHAPTER 5.

Nine Months of Eating Well THERE'S A TINY NEW BEING DEVELOPING inside of you-a baby in the making. Adorable little fingers and toes are sprouting, eyes and ears are forming, brain cells are rapidly growing. And before you know it, the speck of a fetus inside of you will come to resemble the baby of your dreams: fully equipped and suitable for cuddling. inside of you-a baby in the making. Adorable little fingers and toes are sprouting, eyes and ears are forming, brain cells are rapidly growing. And before you know it, the speck of a fetus inside of you will come to resemble the baby of your dreams: fully equipped and suitable for cuddling.

Not surprisingly, a lot goes into making a baby. Happily for babies and the parents who love them, nature's incredibly good at what it does. Which means that the chances that your baby will be born not only perfectly cute, but perfectly healthy, are already excellent. What's more, there's something you can do to help make those excellent chances even better-while helping yourself to a healthier and more comfortable pregnancy. It's something that's relatively easy to do (except maybe when you're feeling queasy)-and something that you probably already do at least three times a day. Yes, you guessed it: eating. But the challenge during pregnancy isn't just to eat (though that may be challenge enough during those early months)-it's to eat as well as you can. Think of it this way. Eating well when you're expecting is one of the first and best gifts you can give to your soon-to-arrive bundle of joy-and it's a gift that can keep on giving, handing out not just a healthier start in life but a healthier lifetime.

The Pregnancy Diet is an eating plan dedicated to baby's good health-and yours. What's in it for your baby? Among many other impressive benefits, a better chance for a bouncing birth weight, improved brain development, reduced risk for certain birth defects-and as a bonus, believe it or not, better eating habits as baby grows to be a potentially picky preschooler (a perk you'll really appreciate when broccoli's on the dinner menu). It may even make it more likely that your child will grow to be a healthier adult.

And your baby's not the only one who's likely to benefit. The Pregnancy Diet can also increase the chances that you'll have a safe pregnancy (some complications, such as anemia, gestational diabetes, and preeclampsia, are less common among women who eat well); a comfortable pregnancy (a sensibly selected diet can minimize morning sickness, fatigue, constipation, and a host of other pregnancy symptoms); a balanced emotional state (good nutrition can help moderate those crazy mood swings). a timely labor and delivery (in general, women who eat regularly and well are less likely to deliver too early); and a speedier postpartum recovery (a well-nourished body can bounce back faster and more easily, and weight that's been gained at a sensible rate can be shed more quickly). For more on the many benefits of a healthy diet during pregnancy, see What to Expect: Eating Well When You're Expecting. What to Expect: Eating Well When You're Expecting.

Luckily, scoring those benefits is a piece of (carrot) cake, especially if you're already eating pretty well, and even if you're not (you'll just have to be a little more selective before bringing fork to mouth). That's because the Pregnancy Diet isn't all that different from the average healthy diet. While a few modifications have been made for the pregnant set (not surprisingly, baby making requires more calories and more of certain nutrients), the foundation is the same: a good, balanced mix of lean protein and calcium, whole grains, a rainbow of fruits and vegetables, and healthy fats. Sound familiar? It should-after all, it's what sensible folks in the nutrition field have been touting for years.

And here's some more good news. Even if you're coming to your pregnancy (and bellying up to the table) with less than ideal eating habits, changing them to follow the Pregnancy Diet won't be that tough, especially if you're committed to making the changes. There are healthy alternatives for almost every less healthy food and beverage you've ever brought to your lips (see box, next page), which means there are nourishing ways to have your cake (and cookies and chips and even fast food) and eat it, too. Plus, there are countless ways to sneak crucial vitamins and minerals into recipes and favorite dishes-which means that you can eat well when you're expecting without your taste buds being the wiser.

Have It Your Way Have your doubts about diets? Not a fan of eating plans? Just don't like being told what to eat-or how much? No problem. The Pregnancy Diet is one way to feed yourself and your baby well, but it definitely isn't the only way. A balanced, healthy diet-one that includes plenty of protein, whole grains, and fruits and vegetables, plus about 300 extra calories a day-will get the job done, too. So if you'd rather not keep track-don't. Eat well, your way!

There is a very important point to keep in mind as you embark on making a diet change for the better: What's presented in this chapter is the ideal, the best possible plan for eating well when you're expecting. Something you should strive for, certainly, but nothing you should stress over (especially early in pregnancy, when your appetite for healthy foods may face a smorgasbord of suppressive symptoms-from nausea to food aversions). Maybe you'll choose to follow the diet closely, at least most of the time. Or you'll follow it loosely, all of the time. But even if your allegiance remains to burgers and fries, you'll still pick up in the pages that follow at least a few pointers that will help nourish you and your baby better during the next nine months (salad with that burger?).

Try These Instead Looking for healthy alternatives to your not-so-healthy favorite foods? Here are some ideas to get you started: Instead of...

Potato chips A bag of M&M's Before-dinner pretzels Fried chicken Hot fudge sundae Taco chips and cheese sauce French fries Anything on white bread A soft drink Sugar cookies Try ...

Soy chips Trail mix (with a few M&M's) Before-dinner edamame Grilled chicken Frozen yogurt with fruit and granola Veggies and cheese sauce Roasted sweet potato chips Anything on whole wheat A fruit smoothie Whole-grain Fig Newtons

Nine Basic Principles for Nine Months of Healthy Eating Bites count. Chew on this: You've got nine months' worth of meals and snacks (and nibbles and noshes) ahead of you-each one of them an opportunity to feed your baby well before he or she is even born. So open wide, but think first. Try to make your pregnancy bites count by choosing them (at least most of the time) with baby in mind. Remember that each bite during the day is an opportunity to feed that growing baby of yours healthy nutrients. Chew on this: You've got nine months' worth of meals and snacks (and nibbles and noshes) ahead of you-each one of them an opportunity to feed your baby well before he or she is even born. So open wide, but think first. Try to make your pregnancy bites count by choosing them (at least most of the time) with baby in mind. Remember that each bite during the day is an opportunity to feed that growing baby of yours healthy nutrients.

All calories are not created equal. Choose your calories with care, selecting quality over quantity when you can. It may seem obvious-and inherently unfair-but those 200 calories in a doughnut are not equal to the 200 calories in a whole-grain raisin-bran muffin. Nor are the 100 calories in 10 potato chips equal to the 100 calories in a baked potato served in its skin. Your baby will benefit a lot more from 2,000 nutrient-rich calories daily than from 2,000 mostly empty ones. And your body will show the benefits postpartum as well. Choose your calories with care, selecting quality over quantity when you can. It may seem obvious-and inherently unfair-but those 200 calories in a doughnut are not equal to the 200 calories in a whole-grain raisin-bran muffin. Nor are the 100 calories in 10 potato chips equal to the 100 calories in a baked potato served in its skin. Your baby will benefit a lot more from 2,000 nutrient-rich calories daily than from 2,000 mostly empty ones. And your body will show the benefits postpartum as well.

Starve yourself, starve your baby. Just as you wouldn't consider starving your baby after it's born, don't consider starving it when it's at home in your uterus. A fetus can't thrive by living off your flesh, no matter how much you're sporting. It needs regular nourishment at regular intervals-and as the sole caterer of your uterine cafe, only you can provide it. Even if you're not hungry, your baby is. So try not to skip meals. In fact, eating frequently may be the best route to a well-nourished fetus. Research showsthat mothers who eat at least five times a day (three meals plus two snacks or six mini meals, for instance. are more likely to carry to term. Of course, that's easier said than done, especially if you've been too busy hugging the toilet to even think about eating. And what if your heartburn has made eating a pain-literally? You'll find plenty of tips on how to eat around these pregnancy inconveniences on Just as you wouldn't consider starving your baby after it's born, don't consider starving it when it's at home in your uterus. A fetus can't thrive by living off your flesh, no matter how much you're sporting. It needs regular nourishment at regular intervals-and as the sole caterer of your uterine cafe, only you can provide it. Even if you're not hungry, your baby is. So try not to skip meals. In fact, eating frequently may be the best route to a well-nourished fetus. Research showsthat mothers who eat at least five times a day (three meals plus two snacks or six mini meals, for instance. are more likely to carry to term. Of course, that's easier said than done, especially if you've been too busy hugging the toilet to even think about eating. And what if your heartburn has made eating a pain-literally? You'll find plenty of tips on how to eat around these pregnancy inconveniences on pages 130 pages 130 and and 153 153.

Efficiency is effective. Think it's impossible to fill each of the Daily Dozen requirements (see Think it's impossible to fill each of the Daily Dozen requirements (see page 93 page 93) each and every day (let's see, six whole-grains means one every four hours ...)? Worried that even if you do manage to eat it all, you'll end up looking like a pregnant blimp? Think and worry no more. Instead, become an efficiency expert. Get more nutritional bang for your buck by choosing foods that are lightweights when it comes to calories, heavy hitters when it comes to nutrients. Need an example? Eating a cup of pistachio nuts at 715 calories (about 25 percent of your daily allotment) is a considerably less efficient way of netting a 25-gram protein serving than eating a 4-ounce turkey burger, at 250 calories. Another efficiency case in point: Eating a cup and a half of ice cream (about 500 calories; more if you've chosen the really good stuff) is a fun but far less efficient way of scoring a 300-mg calcium serving than eating a cup of nonfat frozen yogurt (still fun, but only about 300 calories). Because fat has more than twice as many calories per gram as either proteins or carbohydrates, opting often for lower-fat foods will step up your nutritional efficiency. Choose lean meats over fatty ones, fat-free or low-fat milk and dairy products over full-fat versions, grilled or broiled foods over fried. Spread butter lightly; use a tablespoon of olive oil for sauteing, not a quarter of a cup. Another trick of the efficient-eating trade: Select foods that are overachievers in more than one Daily Dozen category, thus filling two or more requirements at once.

Efficiency is important, too, if you're having trouble gaining enough weight. To start tipping the scale toward a healthier weight gain, choose foods that are dense in nutrients and calories-avocados, nuts, and dried fruits, for instance-that can fill you and your baby out without filling you up too much.

Carbohydrates are a complex issue. Some women, concerned about gaining too much weight during pregnancy, mistakenly drop carbohydrates from their diets like so many hot potatoes. There's no doubt that refined carbs (like white bread, crackers, and pretzels; white rice; refined cereals, cakes, and cookies) are nutritional slackers. But unrefined (complex) carbohydrates (whole-grain breads and cereals, brown rice, fresh fruits and vegetables, dried beans and peas, and, of course, hot potatoes in their skins) supply essential B vitamins, trace minerals, protein, and important fiber. They're good not only for your baby, but also for you (they'll help keep nausea and constipation in check). And because they are filling and fiber-rich but not fattening, they'll help keep your weight gain in check, too. Recent research suggests yet another bonus for complex carbohydrate consumers: Eating plenty of fiber may reduce the risk of developing gestational diabetes. Be careful to move from a low-fiber diet to a high-fiber diet slowly to avoid possible stomach upset (too much fiber too fast can pump you up with too much gas). Some women, concerned about gaining too much weight during pregnancy, mistakenly drop carbohydrates from their diets like so many hot potatoes. There's no doubt that refined carbs (like white bread, crackers, and pretzels; white rice; refined cereals, cakes, and cookies) are nutritional slackers. But unrefined (complex) carbohydrates (whole-grain breads and cereals, brown rice, fresh fruits and vegetables, dried beans and peas, and, of course, hot potatoes in their skins) supply essential B vitamins, trace minerals, protein, and important fiber. They're good not only for your baby, but also for you (they'll help keep nausea and constipation in check). And because they are filling and fiber-rich but not fattening, they'll help keep your weight gain in check, too. Recent research suggests yet another bonus for complex carbohydrate consumers: Eating plenty of fiber may reduce the risk of developing gestational diabetes. Be careful to move from a low-fiber diet to a high-fiber diet slowly to avoid possible stomach upset (too much fiber too fast can pump you up with too much gas).

The Six-Meal Solution Too bloated, queasy, heartburned, or constipated (or all four) to contemplate a full meal? No matter what tummy troubles are getting you down (or keeping food from staying down), you'll find it easier to spread your Daily Dozen (see page 93 page 93) into five or six mini meals instead of three squares. A grazing approach keeps your blood sugar level, so you'll get an energy boost, too (and who couldn't use that?). And you'll have fewer headaches-and fewer wild mood swings.

No More Guilt Willpower has its place, particularly while you're trying to eat well for two. Still, everyone needs to give in to temptation now and then, without feeling guilty about it. So lose the guilt, hold the deprivation, and allow yourself a treat every once in a while-something that doesn't add appreciably to your nutritional bottom line but makes your taste buds jump for joy. a blueberry muffin that's probably more sugar than blueberries but is also off-the-charts yummy, a double scoop of cookies-and-cream (when frozen yogurt just doesn't cut it), the fast-food burger you've been craving like crazy. And when you say "yes" to that occasional frosted brownie or candy bar, serve it up without a side of remorse.

But when venturing down the path of least nutritious, try to pump it up-add a slice of banana and some nuts to your ice-cream sundae; choose a candy bar that's filled with almonds; order your burger with cheese and tomato (and maybe a side salad). Keeping portions of these foods small is another good strategy: Share that serving of onion rings; take a slender slice of pecan pie instead of a hefty slab. And remember to stop before you get too carried away; otherwise, you might just begin to feel that guilt after all.

Sweet nothings are exactly that. There's no gentle way to put this: Sugar calories, sadly, are empty calories. And though empty calories are fine once in a while-even when you're pregnant-they tend to add up a lot more quickly than you'd think, leaving less room in your diet for nutritionally substantial calories. In addition, researchers are finding that sugar may not only be void of value, but in excessive amounts may potentially be harmful. Studies have suggested that in addition to contributing to obesity, heavy sugar consumption may be linked to tooth decay, diabetes, heart disease, and colon cancer. Perhaps sugar's biggest shortcoming, however, is that large quantities are often found in foods and drinks that are, on the whole, nutritional underachievers (candy and soda come to mind). There's no gentle way to put this: Sugar calories, sadly, are empty calories. And though empty calories are fine once in a while-even when you're pregnant-they tend to add up a lot more quickly than you'd think, leaving less room in your diet for nutritionally substantial calories. In addition, researchers are finding that sugar may not only be void of value, but in excessive amounts may potentially be harmful. Studies have suggested that in addition to contributing to obesity, heavy sugar consumption may be linked to tooth decay, diabetes, heart disease, and colon cancer. Perhaps sugar's biggest shortcoming, however, is that large quantities are often found in foods and drinks that are, on the whole, nutritional underachievers (candy and soda come to mind).

Refined sugar goes by many names on the supermarket shelves, including corn syrup and dehydrated cane juice. Honey, an unrefined sugar, has a nutritional edge because it contains disease-fighting antioxidants. Plus, it is more likely to find its way into more nutritious foods-particularly those whole-grain ones you'd find in the health food sections of your market. Try to limit your intake of all forms of sugar, however, since the calories you save can be spent on foods that pack a much more wholesome punch.

For delicious and nutritious sweetness, substitute fruit, dried fruit, and fruit juice concentrates for sugar when you can. Besides being sweet, they contain vitamins, trace minerals, and valuable phytochemicals (plant chemicals that may help the body defend itself against disease and aging), all absent in sugar. You can also find sweet revenge in the calorie-free sugar substitutes that appear to be safe for pregnancy use (see page 111 page 111).

Good foods remember where they came from. Nature knows a thing or two about nutrition. So it's not surprising that the most nutritious foods are often the ones that haven't strayed far from their natural state. Choose fresh vegetables and fruits when they're in season, or fresh-frozen or canned when fresh are unavailable or you don't have time to prepare them (look for ones that don't have added sugar, salt, or fat). And speaking of preparation, less is more when it comes to nutrients. Try to eat some raw vegetables and fruit every day, and when you're cooking, opt for steaming or a light stir-fry, so more vitamins and minerals will be retained. Nature knows a thing or two about nutrition. So it's not surprising that the most nutritious foods are often the ones that haven't strayed far from their natural state. Choose fresh vegetables and fruits when they're in season, or fresh-frozen or canned when fresh are unavailable or you don't have time to prepare them (look for ones that don't have added sugar, salt, or fat). And speaking of preparation, less is more when it comes to nutrients. Try to eat some raw vegetables and fruit every day, and when you're cooking, opt for steaming or a light stir-fry, so more vitamins and minerals will be retained.

And there's more nutritional know-how in nature's model. Avoid processed foods; not only have they picked up a lot of chemicals, fat, sugar, and salt on the assembly line, but they're frequently low in nutrition. Choose fresh roasted turkey breast over smoked turkey, macaroni and cheese made with whole-grain macaroni and natural cheese over that bright orange variety, fresh oatmeal made from rolled oats over the lower-fiber and super sugary instant varieties.

Healthy eating begins at home. Let's face it. It isn't easy to nibble on fresh fruit when your darling husband's diving headfirst into a half-gallon of ice cream-right next to you on the sofa. Or to reach for the soy chips when he's filled the cabinets with those orange cheese balls you can't resist. So enlist him-and other family members-in making your home a healthy food zone. Make whole wheat your house bread, stock your freezer with frozen yogurt, and ban the unhealthy snacks you can't help attacking when they're within reach. And don't stop after delivery. Research associates a good diet not only with a better pregnancy outcome but with a lower risk of many diseases, including adult-onset diabetes and cancer. Which means the family that eats well together is more likely to stay healthy together. Let's face it. It isn't easy to nibble on fresh fruit when your darling husband's diving headfirst into a half-gallon of ice cream-right next to you on the sofa. Or to reach for the soy chips when he's filled the cabinets with those orange cheese balls you can't resist. So enlist him-and other family members-in making your home a healthy food zone. Make whole wheat your house bread, stock your freezer with frozen yogurt, and ban the unhealthy snacks you can't help attacking when they're within reach. And don't stop after delivery. Research associates a good diet not only with a better pregnancy outcome but with a lower risk of many diseases, including adult-onset diabetes and cancer. Which means the family that eats well together is more likely to stay healthy together.

Bad habits can sabotage a good diet. Eating well is only part of the healthy prenatal picture. The best pregnancy diet in the world can be undermined by alcohol, tobacco, and other unsafe drugs. If you haven't done so already, change your other lifestyle habits to match. Eating well is only part of the healthy prenatal picture. The best pregnancy diet in the world can be undermined by alcohol, tobacco, and other unsafe drugs. If you haven't done so already, change your other lifestyle habits to match.

The Pregnancy Daily Dozen Calories. Technically, a pregnant woman is eating for two (rejoice, food lovers). But it's important to remember that one of the two is a tiny developing fetus whose caloric needs are significantly lower than mom's-a mere 300 on average a day, more or less (sorry, food lovers). So, if you're of average weight, you now need only about an average of 300 calories more than you used to eat prepregnancy-the equivalent of two glasses of skim milk and a bowl of oatmeal (not exactly the all-you-can-eat sundae bar you were envisioning). Pretty easy to spend (or overspend), given the extra nutritional requirements of pregnancy. What's more, during the first trimester you probably don't need any extra calories at all (that baby you're growing is only pea size), unless you're trying to compensate for starting out underweight. By the time your metabolism speeds up during thesecond trimester, you can aim for 300 to 350 extra calories. Later in pregnancy (when your baby is much bigger) you may even need more, or upward of about 500 extra calories a day. Technically, a pregnant woman is eating for two (rejoice, food lovers). But it's important to remember that one of the two is a tiny developing fetus whose caloric needs are significantly lower than mom's-a mere 300 on average a day, more or less (sorry, food lovers). So, if you're of average weight, you now need only about an average of 300 calories more than you used to eat prepregnancy-the equivalent of two glasses of skim milk and a bowl of oatmeal (not exactly the all-you-can-eat sundae bar you were envisioning). Pretty easy to spend (or overspend), given the extra nutritional requirements of pregnancy. What's more, during the first trimester you probably don't need any extra calories at all (that baby you're growing is only pea size), unless you're trying to compensate for starting out underweight. By the time your metabolism speeds up during thesecond trimester, you can aim for 300 to 350 extra calories. Later in pregnancy (when your baby is much bigger) you may even need more, or upward of about 500 extra calories a day.

Eating more calories than you and your baby need isn't only unnecessary, it isn't smart-and can lead to excessive weight gain. Eating too few calories, on the other hand, is not only unwise but also potentially dangerous as pregnancy progresses; women who don't take in enough calories during the second and third trimesters can seriously slow the growth of their babies.

There are four exceptions to this basic formula-and if any apply to you, it's even more important to discuss your caloric needs with your practitioner. If you're overweight, you can possibly do with fewer calories, as long as you have the right nutritional guidance. If you're seriously underweight, you'll need more calories so you can catch up weightwise. If you're a teen, you're still growing yourself, which means you have unique nutritional needs. And if you're carrying multiples, you'll have to add about 300 calories for each additional baby.

While calories count during pregnancy, keep in mind that they don't have to be literally counted. Instead of adding them up at every meal, step on a reliable scale every once in a while (once a week if you're really curious, once every two to three weeks if you're more scale-phobic) to check your progress. Weigh yourself at the same time of day, either naked or wearing the same clothing (or clothing that weighs about the same), so that your calculations won't be thrown off by a heavy meal one week or heavy jeans the next. If your weight gain is going according to schedule (an average of about one pound a week in the second and third trimesters), you're getting the right number of calories. If it's less than that, you're getting too few; if it's more than that, you're getting too many. Maintain or adjust your food intake as necessary, but be careful not to cut out nutrients you need along with calories.

Count 'Em Once, Count 'Em Twice Many of your favorite foods fill more than one Daily Dozen requirement in each serving, giving you two for the caloric price of one. Case in point: A slice of cantaloupe nets a Green Leafy and a Vitamin C in one delicious package. One cup of yogurt yields 1 Calcium serving and half a Protein serving. Use such overlappers as often as you can to save yourself calories and stomach space.

Protein foods: 3 servings daily. How does your baby grow? Using, among other nutrients, the amino acids (the building blocks of human cells) from the protein you eat each day. Because your baby's cells are multiplying rapidly, protein is an extremely crucial component of your pregnancy diet. Aim to have about 75 grams of protein every day. If that sounds like a lot, keep in mind that most Americans (including you, most likely) consume at least that much daily without even trying, and those on high-protein diets pack away a lot more. To get your share of protein, all you have to do is eat a total of three servings of Protein foods from the list that follows. When tallying your Protein servings, don't forget to count the protein found in many high-calcium foods: a glass of milk and an ounce of cheese each provide a third of a Protein serving; a cup of yogurt equals half a serving. Whole grains and legumes contribute protein, too. How does your baby grow? Using, among other nutrients, the amino acids (the building blocks of human cells) from the protein you eat each day. Because your baby's cells are multiplying rapidly, protein is an extremely crucial component of your pregnancy diet. Aim to have about 75 grams of protein every day. If that sounds like a lot, keep in mind that most Americans (including you, most likely) consume at least that much daily without even trying, and those on high-protein diets pack away a lot more. To get your share of protein, all you have to do is eat a total of three servings of Protein foods from the list that follows. When tallying your Protein servings, don't forget to count the protein found in many high-calcium foods: a glass of milk and an ounce of cheese each provide a third of a Protein serving; a cup of yogurt equals half a serving. Whole grains and legumes contribute protein, too.

Every day have three of the following (each is 1 Protein serving, or about 25 grams of protein), or a combination equivalent to three servings. Keep in mind that most of the dairy options also fill calcium requirements, which make them especially efficient choices.