When Rebecca Brandt's home pregnancy test came out positive, one of the first things she did was call her ob-gyn to schedule an appointment for the next day. "I couldn't wait to confirm the results, and I already had a lot of questions about diet, exercise, and whether it would be safe to take over-the-counter medicines," says the Portland, Oregon, mom, whose daughter was born 15 months ago. But to Brandt's surprise, her doctor wasn't in nearly the rush that she was; she was told that he wouldn't need to see her for another two weeks, when she'd already be two months into the pregnancy. "I asked the nurse if she at least had some guidelines to send me, but she had nothing. So I just stopped taking Advil for my occasional back pain and hoped for the best," says Brandt.
Indeed, many doctors wait to see moms-to-be until 8 or even 12 weeks into a pregnancy. Why not sooner? Home pregnancy tests are extremely reliable; also, before two months there's no fetal heartbeat and it's too early to do an accurate pelvic exam. But that doesn't mean you shouldn't start taking steps now to make your pregnancy - and the months following it - as healthy and seamless as possible.
Here's what you need to know and do as soon as you discover there's a baby on the way.
If there was ever a time to eat right, it's in the first weeks of pregnancy. This is when a baby's bones, organs, and nervous system begin to form, and a well-balanced diet helps them develop properly, according to Marcos Pupkin, M.D., chairman of the department of obstetrics and gynecology at Mercy Medical Center, in Baltimore. One way you can help yourself to the right mix of nutrients: Take prenatal vitamins. Your doctor can recommend a brand to you over the phone before your exam. If morning sickness is making you feel too queasy to stomach them, try taking them at a different time of day when you're feeling better.
But if you haven't taken any prenatal vitamins or paid attention to your diet until now, don't panic. "Most babies are born healthy even when Mom hasn't been sticking to a strict regimen," says Andrew Rubenstein, M.D., assistant clinical professor of obstetrics, gynecology, and reproductive science at Hackensack University Medical Center, in New Jersey.
Now and throughout the pregnancy, here's what to aim for in the foods you eat:
Protein 60 grams per day. That's one 4-ounce serving of cooked poultry, meat, or fish (about the size of your palm), two tablespoons of peanut butter, and three 8-ounce servings of milk or yogurt.
When I was pregnant, I munched on shelled sunflower seeds that I kept at my desk (one-quarter cup has eight grams of protein). Bonus: They settled my stomach.
Calcium At least 1,000 milligrams per day. Three to four servings of dairy products should do it. One serving is eight ounces of milk or yogurt, one ounce of hard cheese (such as cheddar or swiss), or one cup of yogurt.
Complex carbohydrates Six servings of fruits and veggies and at least six servings of breads, cereals, rice, or pasta per day. One serving of produce can be a cup of raw leafy greens, a half cup of cooked fruits or vegetables, one medium-size piece of fruit, or a half cup of juice. A slice of bread, a cup of cereal, or a half cup of cooked rice or pasta counts as one serving of grains.
Folate (or folic acid) At least 400 micrograms per day. One bowl of Cheerios provides 50 percent of what you need. Other good sources of this nutrient are enriched grain products, orange juice, and spinach.
Click ahead for Exercise and Food Safety Tips
Fatigue may make you feel like sitting out the next nine months on the couch, but exercise is a great way to energize. It also controls weight gain, keeps abdominal muscles toned (important for preventing backaches as your uterus expands), and helps prevent constipation and premature delivery. You'll also be thankful for the extra strength and stamina you've gained when it's time to push the baby out.
Stick with activities that are easy on the joints, such as walking, swimming, or cycling, since hormone changes make you more prone to strains and sprains. Thirty minutes of exercise three or four times a week is an ideal amount; though not if it means pushing yourself to the point of exhaustion.
Those same hormones that loosen your joints can do a number on your mouth as well. A mere week or two after sperm meets egg, your gums become more sensitive to plaque. If it's not removed regularly, you may develop gum disease, which can contribute to premature labor or low birth weight, according to several recent studies.
If you're not in the habit already, make sure you brush your teeth at least twice a day and after meals if possible, recommends Cindy Flanagan, a dentist in private practice in Houston. Floss daily as well, and follow that up by rinsing with an alcohol-free antiseptic mouthwash. If your gums start to become inflamed and tender, see your dentist. She may recommend more frequent professional cleaning while you're expecting.
Play It Safe
You already know to steer clear of alcohol and cigarettes, but you may not be aware of other behavior that might be risky.
While most ob-gyns say it's safe to take acetaminophen and many antacids, check with your doctor before using any drug; cough syrups, sleep aids, and other over-the-counter products may contain ingredients that can harm a developing baby. If you're on a prescription medication, don't wait until your first prenatal exam to talk to your doctor. He may want you to stay on course, or he may decide to reduce your dosage or switch you to a different medicine altogether.
The seemingly harmless task of changing your cat's litter box is actually potentially hazardous. Cat feces can contain the parasite that causes toxoplasmosis, an infection that creates flulike symptoms in grown-ups but potential hearing, vision, or even brain damage in unborn babies. The risk is highest if a woman gets sick during the first trimester. The parasite can also contaminate raw or underdone meat, so cook meat to at least 160 degrees before eating and always wash hands with soap and water after handling raw meat.
Foods to avoid: unpasteurized milk or juice, soft cheeses (such as brie, feta, and roquefort), and bagged salads. These may contain listeria, a type of bacteria that can cause miscarriage. Deli meats may also carry listeria, so even though they're cooked, heat to steaming before you eat them.
Cross raw seafood off your prenatal diet as well; it may contain the parasite that causes hepatitis A.
As for those caffeine-containing espressos, cappuccinos, and sodas, moderation is key. While recent studies have found no link between caffeine and birth defects, caffeine does draw fluid and calcium from your body. "It probably won't harm your baby," says Oliver Jones, M.D., an ob-gyn in private practice in Denver, "but it can't hurt to cut it out or limit yourself to one eight-ounce caffeinated drink a day."
Click ahead for more Pre-Baby To-Dos
Give Your Doctor a Checkup
Your ob-gyn may have handled your routine gynecological care for years - and perhaps even helped you through a previous pregnancy - but now's the time to decide whether she's the one you want for these nine months. Ask yourself, Are we on similar wavelengths on prenatal testing, episiotomies, and epidurals? Is the office staff friendly and accessible? Does she take the time to give clear, thoughtful responses to my questions?
"You should never have to walk out of your doctor's office with unanswered concerns," says Dr. Rubenstein. "If you're not comfortable with your doctor, now's a good time to switch. Check with friends for a recommendation, or call your local hospital and ask to speak to a nurse in the maternity ward. Labor and delivery nurses work with ob-gyns day in and day out - they know who's good."
Pay Down Debt
Having a baby costs a bundle. "The less you owe, the better," says Peter Finch, coauthor of How to Raise Kids Without Going Broke. Eliminate as much debt as possible by chipping away at loans and credit card balances or by transferring all of your balances to one low-interest-rate account, and begin paying it off.
Aim to bulk up your savings as well. The earlier you start, the more money you'll have stashed away come delivery day. The easiest, and surest, way to save a lot of money when you're in a hurry: Have a set dollar amount automatically deducted from each paycheck and deposited directly into your bank account or a mutual fund.
Look Into Leave
"Maternity leave may seem like a long way off when you're only a few weeks pregnant, but it's not too early to begin thinking about how much time off you'd like and can afford," says Carol Buckler, coauthor of Everything a Working Mother Needs to Know. "There's a lot to consider."
While you probably won't want to tell your supervisor about the pregnancy until you've reached the second trimester - when the risk of miscarriage is largely behind you - you can use this time to check out your company's maternity-leave policy. Read the employee handbook, or discreetly ask colleagues with young kids. "They should be able to explain how the employer managed their leave and give you the inside scoop on things they were able to negotiate, such as making the transition back to work on a part-time basis for a few weeks," says Ann Douglas, coauthor of The Unofficial Guide to Having a Baby. You may also discover that if you start storing up sick or vacation days now, you can use them for a longer leave later.
It goes without saying that you'll get plenty of pregnancy advice both from books and from your doctor, but you should also talk to the real pros - the women who've been there. Get to know new parents in your neighborhood, hook up with moms in your exercise class, or chat online. Parents will be eager to offer tips on everything from curbing morning sickness to shopping for maternity clothes. And when the baby arrives, you'll have a built-in playgroup and maybe even a sitter or two.
Pamela Kramer, mother of two, lives in Colorado.