Can’t get pregnant? A few lifestyle changes may be in order.

Like we said, it’s never really as simple as have sex, get pregnant. Even a few lifestyle factors can mean boost or bust if you want to have a baby. If you’ve decided you’re ready to be a parent, consider our fertility don’ts. If you want to get pregnant and have a healthy head-start for your baby, time to start kicking some bad habits — or a least practice some self-control.

Here are our pre-pregnancy don’ts:

Cigarettes

We all know cigarettes are bad for our health, but you may be surprised that it can also diminish your fertility. Cigarettes bring toxins to your body that can damage your eggs — interfering with fertilization and implantation. They can also cause ovaries to age prematurely. Dr. Robert Barbieri OB-GYN at Brigham and Women’s Hospital Boston and co-author of the book 6 Steps to Increased Fertility explains, “the ovaries of a 35-year-old smoker function as if they belong to a 42-year-old and are therefore less fertile.” The good news is, when you quit smoking, ovarian function can normalize or improve.

Alcohol

More research indicates that alcohol over consumption diminishes a woman’s chances of getting pregnant. Alcohol can affect estrogen levels and also interfere with egg implantation. A glass of wine over dinner every so often shouldn’t be cause for concern, but binge drinking can lower your chances of getting pregnant. And of course, too much alcohol can definitely harm a growing fetus in the event that you find yourself already pregnant.

Caffeine

You should also consider cutting back on caffeine while trying to conceive and during your pregnancy. A recent study published in the American Journal of Obstetrics and Gynecology found that women who drank the equivalent of caffeine found in two cups of coffee were twice as likely to miscarry as those who didn’t consume any. The bottom line: If you’re thinking about getting pregnant, limit your daily caffeine fix. Consider that caffeine can also be found in soda and chocolate… so limit where you’re getting your fix for the day.

His health matters too. The same things that harm your fertility can do a number on your husband’s reproductive health as well. Cigarettes, alcohol, a poor diet — any of these can contribute to lower sperm count or motility — the sperm’s ability to swim to fertilize an egg. Studies have traced chromosomal damage in sperm to cigarettes and heavy alcohol intake. Getting enough nutrients every day — particularly vitamins E and C and the mineral selenium — helps men produce healthy sperm. Dr. Christopher Williams, reproductive endocrinologist and author of The Fastest Way to Get Pregnant Naturally says, “it takes almost three months for a man to make new sperm, so he needs to think ahead too.”

What’s good and safe about pregnancy massage?

Massage offers many benefits for pregnant women. Done properly by a trained therapist, prenatal massage can help alleviate the aches and pains of pregnancy, improves circulation and relieves tension and fatigue. You might hear people tell you to skip massages while pregnant because it can harm your baby. That’s a misconception!

The truth is, wether you are pregnant or not, massage can only be as good as the person giving it to you. If you need to de-stress and think you could use a massage while pregnant — ask for referrals for properly trained massage therapists. An OB-gynechologist, midwife or a friend who’s had it before can point the way.

Here’s more reason why indulging in that massage can be good for you:

• Pressing certain acupuncture pressure points can minimize or completely relieve first trimester nausea.
• Stress relief on weight bearing joints such as ankles, neck, lower back and pelvis.
• Reduces swelling in hands and feet by stimulating blood and lymph circulation.
• Helps with relaxation and insomnia. Even if you don’t have insomnia, massage helps you get better quality sleep.
• Helps eliminate lactic acid from the body, helping your body’s circulatory and lymphatic systems.

I had regular weekly massages when I was pregnant and for me the best part… it just felt good and relaxing. I’m a believer in touch therapy.

There are still misconceptions that should be cleared concerning prenatal rubs. Massage, done properly, does not cause miscarriages. Rubbing the lower back or stomach will not dislodge the placenta. However, there are some guidelines to follow to make a prenatal massage session safe for you and your baby:

• Do not massage open wounds, areas with rashes or distended varicose veins.
• After 20 weeks of pregnancy, never lie on your back for a massage as this can compromise blood flow to the uterus. Note: you’re not even supposed to be sleeping on your back anymore at this stage.
• Massage of the abdomen must strictly be done by a professional massage therapist trained in prenatal massage.
• Avoid applying pressure between the ankle bone and heel. There are pressure points here that are connected to the uterus and can induce labor.

Go ahead and indulge on a pregnancy massage. But do note, now more than ever, it’s important that you get one from a professional massage therapist.

What’s true and what’s an old wives’ tale?

When you announce you’re pregnant, the unsolicited advice and information pours in. It can get confusing and overwhelming. You can even be misled to do the wrong thing. We can be worried about what we shouldn’t be bothered with. We know more about medicine and health these days, but myths still abound. We sort out what’s fact and what’s fiction.

Pregnant women should eat for two. The old belief is that women should gain at least 25 pounds when we’re get pregnant. That is false. A woman just has to eat properly during pregnancy. All that’s required is to eat a good balance of food — protein, good carbs, fiber and vitamins with not too much fat and sugars. Pregnancy is not an excuse to eat whatever we want  – and as much as we want — because we are “eating for two.”

There is no set formula for how much pregnant women must gain. Generally, in the last trimester, the baby gains half a pound a week. If during this time, a pregnant woman is not gaining more than that, her doctor may be concerned and her diet should be re-evaluated.

Pregnant women shouldn’t eat fish. This is false. When we’re pregnant, certain fish must be avoided due to high mercury levels and possible food poisoning when eaten raw. However, pregnant women should not stop eating fish. Fish oil contains Omega 3 fats, which enhance the development of the baby’s brain, improve the baby’s IQ, make the baby a better sleeper after birth, prevent premature contractions and premature labor, prevent high blood pressure during pregnancy, and act as an anti-inflammatory that prevent infection. Just avoid those types of fish that are known to have high levels of mercury. We have a list of safe fish in a previous post.

Pregnant women shouldn’t take baths. Again, false. What you should avoid when pregnant is taking hot baths over 98 degrees. That level of heat is not ideal for the baby. Besides, you’ll notice you tend to be sensitive to heat or get hot easily when you’re pregnant. Warm baths are fine and safe. They can even help you relax, decrease swelling in the arms, legs and feet as well as help increase amniotic fluid. So dip in!

Pregnant women always have morning sickness. False! The nausea, lethargy and vomiting typical in the first trimester happens because of overactive hormones. But pregnancy hormone levels vary from woman to woman. Some women may also be more sensitive to hormonal changes, some not so much. Morning sickness is typical, but it doesn’t strike every pregnant woman. In the same vein, the symptoms can run from mild to severe depending on the woman.

Pregnant women shouldn’t carry heavy stuff. Yes, true especially anything weighing more than 25 pounds. The pregnant body is already carrying extra weight which throws off a woman’s balance and makes her more likely to fall. This and other things that cause a diminished sense of balance should be avoided. A hard fall after the first trimester may be dangerous to the pregnancy and always requires immediate medical attention.

Pregnant women shouldn’t drink alcohol. This one’s true. Alcohol is considered feto-toxic. The term “fetal alcohol spectrum disorder” (FASD) describes the range of alcohol effects on a child. It can damage and affect the growth of the baby’s cells. Brain and spinal cord cells are most vulnerable. Too much alcohol consumption during pregnancy can cause a child to have physical or mental problems that may last all of his life. If you had a little to drink before you found it you were pregnant, you shouldn’t worry. But soon as the test turns positive, hold off on the alcohol.

Some expectant mothers are more prone to depression than others. A University of Michigan study reports that factors such as stress, mental health history, social support and whether a pregnancy was planned contribute to putting a woman at risk for depression during pregnancy.

This is important because women who are depressed have higher risk for dangerous complications during pregnancy. In fact, attending doctors are being encouraged to identify depression and its risk factors to minimize pregnancy complications.

Dr. Christie Lancaster, the study’s lead author and lecturer at the University of Michigan Department of Obstetrics and Gynecology says, “Depression has been associated with adverse outcomes for both mom and baby, including pre-term delivery, pre-eclampsia, sleep disturbances for both mom and baby, and maternal-infant attachment effects, in addition to its impact on the mother’s daily quality of life.”

Depression is experienced by almost 13 percent of pregnant women. Good news is, this complication can be treated during pregnancy. What is vital is that depression is identified early, so treatment can be administered.

Dr. Lancaster and her team of researchers had set out to study risk factors that could help doctors evaluate a patient’s risk factor for depression while pregnant. Most studies have focused on post-partum depression, but theirs is among the few that closely examine depression during pregnancy.

Their results show that maternal anxiety, stress, previous depressive episodes, lack of social support, domestic violence, unplanned pregnancy and relationship factors have a high correlation with depressive symptoms among women who are expecting.

Doctors caring for pregnant women are being urged to learn how to identify depression in pregnant women, so steps can be taken to cure their depression. This has a significant impact on the mother’s health as well as the health and outcome of the baby she is carrying.

Results of the study were published last week by the University of Michigan Health System.  At their health facility, all pregnant patients are screened for depression during pregnancy even though not all women with a positive screening test will have or develop clinical depression.

Dr. Lancaster says, “We are hoping that providers (doctors) can use the presence or absence of risk factors such as those identified in our study to enhance their assessments for depression in addition to the information that they obtain from the screening test.”

Dealing with those pregnancy dizzies.

As we had tackled previously, it is typical for women to experience nausea and vomiting during the early stages of pregnancy. These symptoms may be unpleasant, but the American Pregnancy Association considers morning sickness as indicative of healthy placenta development. It’s a sign your body is doing its work to grow your baby! Still, we have more ways to deal with the discomfort. No need to suffer too badly.

Snack away.

Your appetite may have gone pffft form the nausea, but you still have to get some food into your stomach. Avoid big meals and turn yourself into a snacker. Spread out your eating to six small snacks a day. Bland carbs like crackers, wheat toast, dry cereal, and pretzels have seen many pregnant women through morning sickness. Have some hard cheese for some protein. Ice cold treats like watermelon and frozen berries are good for hydration and a good dose of vitamins. Note that fatty and spicy foods tend to upset iffy stomachs, so you may want to avoid such foods.

When it comes to eating, many women find that grazing all day settles their stomach. Heidi Murkoff, author of What to Expect when You’re Expecting explains, “When your tummy is empty, the stomach acids have nothing to feast on but your stomach lining, compounding nausea. On the other hand, eating too much can overtax the digestive system, also leading to quease. Keeping your tummy a little bit full all day and all night is the best defense against morning sickness.”

Distract Yourself.

Nausea’s not easy to ignore, so you have to find something – anything  - to take your mind off it. See what works for you. Maybe reading a book, doing the crossword or going for a walk? Yoga is said to be helpful too – great for the body and mind. Some moms claim that exercise relieves their nausea, but make sure to check with your doctor first.

Lie Down.

Sometimes the best solution is just to lie down, close your eyes and take a few deep breaths. Many doctors and moms attest that sleep is a great way to escape morning sickness – and your body could use those extra zzzs! If you already have a young child or two, bring a babysitter in so you can catch up on some much needed rest. Remember, your body is working overtime growing that baby.

Try unusual remedies.

Sour lollipops or candy help some pregnant mothers. Others swear by seasick wristbands. These acupressure bands apply light pressure to a spot located inside the wrist believed to control nausea and vomiting — whether motion, sea, or morning sickness induced. Lollipops or sea bands…. Who knows? It might just make you feel a bit better. No harm in trying.

Consult a doctor.

Consider going to your doctor if the vomiting becomes frequent or contains blood or a mere drink of water makes you vomit. Abnormal heart beat, dark or very little urine also warrant a doctor’s check up. Sometimes, women have to be given medication or may need assisted feedings to survive extreme morning sickness symptoms.

Dr. Robert Atlas, chair of the Department of Obstetrics and Gynecology at Mercy Medical Center, says women should not shun all medicine during pregnancy, nor should they avoid medical intervention altogether. He explains, “It’s important not to let morning sickness go too far in the interest of avoiding medication at all costs because the dehydration, calorie deprivation, and starvation state is really unhealthy for the baby.”

I’m pregnant and I feel sick!

Actually, morning sickness is somewhat of a misnomer. The nausea, fatigue and vomiting that may accompany pregnancy can happen anytime of the day or night. I can attest to that. Mine would come in waves, during the afternoon and in the evening. Just found out you’re pregnant and not feeling too good? Welcome to your first trimester!

Dr. Marjorie Greenfield, ob-gyn and author of The Working Woman’s Pregnancy Book, says 70 percent of women experience nausea early in pregnancy and about 50 percent experience vomiting. “It’s very, very common, but it’s also incredibly varied,” Greenfield adds. “Lots of people are sick all day, some are sick mostly in the evening, and others are sick if they haven’t gotten enough sleep.”

Morning sickness can start as early as six weeks into pregnancy and tends to peak around the eighth and ninth weeks. But this too shall pass. Typically, pregnancy-induced nausea lifts when you hit the second trimester at 12 to 14 weeks.

In the meantime, we have advice on how to manage those unpleasant pregnancy symptoms.

Take a break

Early in your pregnancy you may often feel tired and dizzy. Your head hurts. You may feel so fatigued that it’s hard to get yourself to work. Your body is making a baby and this is why it’s working overtime and making you feel less energetic than usual. Consider taking some much needed rest. Maybe even ask for a leave during your seventh to eighth week, which is when morning sickness tends to peak. Your body is going through major changes and if you’re not feeling too good, it’s asking you to slow down. Give in.

Identify triggers

Maybe it’s your husband’s soap or cologne that makes you feel like hurling. Your coworker’s cologne may also set off a dizzy spell. Whatever odor it is, remember that morning sickness is often smell-associated.

Miriam Erick, author of Managing Morning Sickness: A Survival Guide for Pregnant Women explains, “estrogen is the hormone that’s responsible for the sense of smell, and if you’re a high estrogen hormone person – like when you’re pregnant – you have the radar nose of pregnancy. Ugly smells, smells you can’t get away from, and potent smells will make you nauseous.”

Identify what smells bother you and simply avoid them. Ask hubby to change to unscented soap. Bring around a bottle of lemon extract to take a whiff when you can’t open a window or leave the area. Citrus smells are great for counteracting strong odors.

Drink up

Staying hydrated is standard advice, but it becomes even more important when you’re pregnant and in the throes of morning sickness. Dehydration aggravates nausea. It may be hard to drink up when you can hardly keep anything down in your stomach, but you have to find ways to keep the fluids coming in. Take small sips. If water tastes like metal to you – like it did for me when I was pregnant – then put in some lemon juice to make it more palatable. Drink it iced, warm or hot, whichever way helps it go down, enjoy your drinks that way. Some women manage by crunching on ice chips. I found that ginger ale helped settle my stomach. To avoid the sugar that goes with that, try good old ginger tea. For some reason, many pregnant women claim ginger ale or ginger tea is very helpful for counteracting morning sickness.

Be sure to come back tomorrow for more pregnancy symptom soothers!

You’ve decided to take the plunge. Now what?

Deciding to have a baby before it actually happens is a great opportunity. Take advantage of having the chance to prepare yourself – and your body – for a healthy pregnancy and a healthy baby at the end of it. Go though our pre-pregnancy checklist and get a good, healthy start.

Stop Smoking. If you have this nasty habit, now would be a good time to kick it. It takes time and effort to quit. Let future baby be a major motivation. The effects of smoking have been proven to be bad for buns in the oven. If your family has a history of allergies or asthma, smoking seals the deal for your baby to get it too.

Convince him to stop smoking. Second hand smoke is harmful to pregnant women and babies. If you’re ready to stop, it would be a good idea to go through the transition together. Again, a new human being around can be good motivation.

Exercise. Women who weigh too much or too little can have problems conceiving. Start a moderate exercise routine you can carry-out through pregnancy. Pregnant women who exercise moderately have less birth complications, lose post-pregnancy weight faster and generally produce healthier babies.

Control your caffeine. Too much caffeine intake has been linked to higher risk of miscarriage. Coffee, tea and cola drinks are usual caffeine culprits. Limit intake to no more than two cups of coffee a day.

Switch to a prenatal vitamin. Yes, even if the stick hasn’t turned pink yet, you need extra folic acid found in vitamin supplements for pregnant women. Folic acid levels should be sufficient even before baby comes – to ensure little he or she develops a healthy nervous system. Eat more leafy greens too!

Find an OB-GYN you trust. Ask for recommendations. Check credentials and reputation. Is the doc someone you can get along with and easily talk to? Look for a doctor near your home. Proximity is important.

Have a thorough check-up. Make sure you have no medical issues that need to be addressed before baby comes. Have your MD review all prescription and OTC drugs you take regularly. Anything you should avoid now that you’re trying to have a baby? Consider genetic testing – if that’s for you. Update your vaccinations – there are some you cannot take while already pregnant.

Do some math. Call your insurance provider and get the full rundown on how they can cover prenatal care and hospital birth. You may want to talk to a financial planner about childcare or other expenses you need to anticipate.

Think about work. If you or your husband decide that one of you needs to stay home with a baby for the early years, start making plans and examining your options.

Nutritious or poisonous? The real score on fish for pregnant moms.

When it comes to eating fish during pregnancy, experts seem to be giving conflicting advice. Some say fish contains mercury which could lead to abnormal brain development. Others tell us, fish is rich in omega fats that are crucial for brain development. So what’s a pregnant woman to eat?

When I first became pregnant, I was forced to turn nutrition expert overnight. After all, I wasn’t just eating for myself anymore. What I eat, my baby grows on too. If there was anything really confusing during my frenetic food research, it was advice about eating fish and seafood. We have a guide that finally makes sense.

Common knowledge is that fish is good – packed with protein and iron that are crucial nutrients for baby’s growth and development. You even get these nutrients without the fat and cholesterol of meat. What is especially good about fish are omega-3 fatty acids that promote a baby’s brain development.

Studies have proven that inadequate sea food intake during pregnancy has resulted in children having developmental delays, poor verbal skills and behavioral problems.

Then again, fish are also known to contain mercury. The mercury contaminant is common among large, predatory fish such as swordfish, king mackerel and shark. For most adults, mercury doesn’t really pose a problem. Doses are too small to impact our health. But for a growing fetus, the contaminant builds up quicker to damage the developing brain and nervous system.

So what’s an expecting mom to do? You can have your fish and eat it too! Provided you follow these guidelines courtesy of the experts from The Mayo Clinic:

• Avoid large, predatory fish. To reduce your exposure to mercury, don’t eat shark, swordfish, king mackerel, marlin or tilefish.
• Avoid raw fish and shellfish. To avoid ingesting harmful bacteria or viruses, avoid raw fish and shellfish — especially oysters and clams — and anything you know was caught in polluted water. Refrigerated smoked seafood, such as lox, also is off-limits.
• If you eat fish from local waters, pay attention to local fish advisories. Larger game fish contaminated with chemical pollutants may potentially harm a developing baby. If advice isn’t available, limit consumption of fish from local waters to 6 ounces a week and don’t eat other fish that week.
• Cook seafood properly. Cook fish to an internal temperature of 145 F (67 C). The fish is done when it separates into flakes and appears opaque throughout. Cook shrimp, lobster and scallops until they’re milky white. Cook clams, mussels and oysters until their shells open. Discard any that don’t open.

Bottom line is, pregnant women must be vigilant about how much mercury they may be taking in from fish or any other foods. Tuna can be eaten, even if it contains some mercury – as long as you do not eat more than three 6oz. servings in a month. Carp, salmon, mahi mahi, cod and monkfish are also safe – and packed with those vital omega-3s. More good choices for fish include:

• anchovies
• catfish
• sole
• tilapia
• sardines
• sturgeon
• trout

Do your kids have asthma? Then they’re at higher risk for H1N1 complications.

Young children have always been a high-risk group for contracting the pandemic H1N1 virus. Now, a new study shows that if your child has asthma the risk for serious H1N1 complications also rises significantly. Read on for more reason to take steps to protect your family from the virus.

The new study published by the Canadian Medical Association Journal is the second largest done on the asthma-H1N1 link, as of today. Researchers examined charts of 58 flu cases admitted to Toronto’s Hospital for Sick Children.

They found that among kids infected with the typical seasonal flu, only six percent had asthma. Among children with confirmed H1N1 flu, a much higher 22 percent were asthmatics. Another red alert for asthma sufferers: Nearly half of all H1N1 admissions to intensive care units were children with asthma.

Lead researcher Doctor Dat Tran found that the severity of asthma did not have a bearing on wether or not a child would contract the H1N1 virus. From severe to mild asthmatics – all asthmatic kids were high risk.

Dr. Upton Allen from the Hospital for Sick Children notes that “the most striking finding in our study was the high prevalence of asthma among children admitted with pandemic H1N1 influenza compared with those admitted in previous influenza seasons.”

The American Centers for Disease Control (CDC) has always recommended that vaccination efforts prioritize target groups at higher risk for H1N1 complications or who could transmit the virus to others at risk. These groups include pregnant women, people who live with or care for infants younger than 6 months, health care and emergency medical services personnel, people 6 months through 24 years of age, and people 25 years through 64 years of age who have certain medical conditions that put them at higher risk for influenza-related complications. Asthma is one such condition.

Perhaps it’s just me, but I do notice many kids these days have a history of this respiratory illness – my daughter included.  Now we know if you or any of your kids have a history of asthma, getting vaccinated and practicing good disease preventive hygene is very important. These latest studies and health statistics should not be ignored.

But here’s some news that’s a bit troubling. According to an ABC News/Washington Post survey, nearly four in ten parents do not plan to have their children vaccinated against H1N1, despite evidence the virus is having a bigger impact on the young than on other priority groups identified by the CDC. The stats are also sobering for adults. Only 35 percent of American adults indicated they plan to be vaccinated.

In a November 2009 report by federal health officials, at least 22 million Americans have come down with the H1N1 swine flu since the virus surfaced April this year. So far, 3,900 people have died including 540 children.

Have your kids been vaccinated against H1N1? How about you?

So what’s to expect – in the bedroom – when you’re expecting?

Even with that growing belly occupying more space, there should be room for romance. Sex during most pregnancies is safe. On top of that, those extra hormones can even give your sex life a boost. Multiple orgasms anyone? It’s a hot topic, and questions about sex and pregnancy abound. We have the answers… uncensored!

Is it really okay to have sex? My husband thinks he might hurt the baby.

If your doctor has determined no pregnancy complications, you can continue to have an active sex life. A penis won’t harm or traumatize the fetus. No matter how well-endowed, it won’t even reach your uterus! Your husband also can’t break your water bag. Thrusting motions will not disturb your little bun. These are all common misconceptions.

If you notice some bleeding after sex, consult your doctor as soon as possible. But do note that pregnancy increases blood flow in the cervix and sometimes this can cause light spotting after intercourse.

When should sex be avoided?

Here are some typical reasons why doctors will advice a pregnant woman not to have sex:

• a history of premature birth or labor;
• placenta previa – when the placenta is covering the cervix;
• when there is spotting (blood on your underwear) and a cause has yet to be determined;
• when the mother or her partner have a sexually-transmitted disease.

How about oral sex and masturbation?

If your doctor says you’re okay to have intercourse, you’re clear for oral sex and masturbation. You should skip cunnilingus  if your husband has a mouth sore – it might be the herpes virus. He should also avoid the blowing-into-the vagina move. This can lead to an air embolism. Women are more prone to this when pregnant since blood circulation is stronger in the cervix.

I found out we were pregnant a month ago. My friends say sex was good when they were pregnant. Not for me. I’m tired most of the time and I feel fat. What’s wrong?

In the first 3 months of pregnancy, most women face nausea, dizziness and fatigue. You are dealing with major changes inside and outside your body. It’s common to feel overwhelmed and not-in-the-mood. But there’s good news from Lou Paget, author of Hot Mamas: The Ultimate Guide to Staying Sexy Throughout Your Pregnancy and the Months Beyond, “Once you hit your second trimester, the nausea lifts and estrogen kicks in, which jump-starts your sex drive.” This is the time your friends were talking about. Many women say it’s during pregnancy when they experience multiple orgasms. Un-orgasmic women suddenly turn orgasmic. If you’re not there yet, your husband should understand that kissing and cuddling is all you can handle, for now.

My big belly makes our favorite position feel awkward. Any suggestions?

Here’s where you can get creative, maybe even kinkier than usual. The missionary position may not be ideal with your big belly. Besides, women should not be lying on their backs when their stomachs are already heavy. There are other options. Try woman-on-top, side-lying, spooning with rear-entry, or get on your hands and knees. Enjoy experimenting to see what works for you. You may end up having new favorite positions!

Talk About It

It’s important to communicate with your husband and make him understand what you’re going through. Same goes for him. You are about to have a child, your life – sex life included – is about to change. It doesn’t have to be for worse. Sometimes the bedroom acrobatics may stall, but when it revs up again, it could be for the better!