As a pre-school teacher, 30-year-old Amanda Doll spends all day with babies and young children. But the baby she is most excited to spend time with is due this summer—she and her husband, Ian, are expecting their first child in August.
“We’re so ready,” Amanda says. “We knew it was time to expand our family. Ever since we made that decision, I’ve been trying to make healthy choices so my body would be ready. It took several months for us to get pregnant, so I had time to get those good habits in place.”
Amanda’s doctor, Ivy Lee, MD, an obstetrician and gynecologist with Indiana University Health Physicians – Women’s Health on the Indiana University Health West Hospital campus, says the prep time can be valuable in setting the stage for a healthy pregnancy.
“Ideally, we like to see our patients get started on their prenatal vitamins, particularly folic acid, as much as six to eight months before they conceive,” Dr Lee explains. “There is consensus among physicians that folic acid can reduce the chance of spina bifida by half, and can also reduce the chance of pre-term labor.”
Amanda says she didn’t have any major vices to deal with going into her pregnancy—she’s never been a smoker and rarely drank alcohol. One of the biggest changes to her diet has been giving up her Diet Coke habit, which she says has also helped mitigate her chronic migraine headaches.
“I just drink water all day now,” she says. “I really haven’t missed it at all.”
“I recommend reducing the amount of daily caffeine to what would be in two regular cups of coffee,” says Dr. Lee. “And of course, the sooner a smoker can quit, the better. Smoking during pregnancy can lead to low birth weight newborns and pre-term labor. The toxins in cigarettes can also interfere with the functioning of the placenta.”
Morning sickness was a challenge for Amanda in her first trimester, so she was more concerned with keeping something—anything—down rather than monitoring her calories. But going forward, she says managing her pregnancy weight gain is a priority.
“I don’t want it to be a situation where I put on 80 pounds and then struggle with it after the baby arrives,” Amanda explains. “It’s definitely a motivator. Some people will still tell you to eat anything you want, but that’s just not how it works.”
Dr. Lee says Amanda’s approach, both to her first trimester nausea and her plan to monitor her weight gain for the duration of her pregnancy is right on target.
“Now that she’s feeling better, we’ll want her to increase her normal caloric intake just a bit—the recommended increase is just under 15 percent. My suggestion is to decrease white carbs and the empty calories in soda and lots of juices, and focus on adding calories through foods such as lean protein and vegetables,” says Dr. Lee.
In addition to keeping up with 15 toddlers at work every day, Amanda is continuing to get exercise using a dance game on her X-Box with friends. She expects to transition to lower impact walking and yoga as her pregnancy progresses.
“Ian and I are house hunting now. We’re looking for a neighborhood with nice sidewalks and green space, which I think will help both of us stay fit after the baby arrives. That way, we can involve the baby in getting out and getting the weight off.”
Dr. Lee says the best advice she can give to busy moms-to-be like Amanda is simple: “Give yourself a break—especially early in your pregnancy. Slowing down is OK. You need sleep and rest. Feeling fatigued, and even morning sickness, is your body trying to protect you. If that laundry doesn’t get done today, it won’t matter five years from now. Women sometimes feel guilty about that, and they shouldn’t.”
Dr. Lee recommends the American Congress of Obstetricians and Gynecologists website for helpful, evidence-based information about pre-pregnancy, pregnancy and delivery. The site covers dozens of topics with reliable, easy-to-understand facts. And, she says women should always feel comfortable talking openly and honestly with their physician.
“Patients are sometimes worried about being judged—worrying ‘if I tell you I do this or don’t do that, you’ll think I’m a bad mom.’ Our goal is the same as yours: A healthy pregnancy. Let us know what you’re doing and how you’re feeling so we can anticipate any challenges,” says Dr. Lee.
For Amanda Doll, the biggest and most welcome challenge of her life is just ahead: Adding “Mother” to her long list of accomplishments.