Dos and don'ts for a safer pregnancy

Congratulations on your pregnancy! This page covers the evidence-based recommendations from midwives of things to do and not do in pregnancy

The page covers things (activities, foods, medicines etc) in life that may carry a risk to your developing baby. Following the recommendations on this page will reduce your risk of pregnancy complications or loss. All of the information is based on research evidence.

Do take folic acid and vitamin D

Folic acid reduces your baby’s risk of neural tube defects to almost nil. It is ideal to start taking it three months before conception but if it’s too late for that, don’t worry but start taking the recommended daily amount now and continue taking it until the end of the first trimester (week 12 of your pregnancy). Read more about folic acid here.

Vitamin D helps your baby develop healthy bones, teeth and muscles. It helps to regulate the levels of calcium and phosphate in your body. You need these to keep your bones and teeth healthy. Read more about vitamin D here.

Taking a daily vitamin D supplement is even more important if you are at risk of vitamin D deficiency:

  • if you have darker skin
  • if you get less sunlight, for example you stay inside a lot, or if you usually cover your skin for cultural reasons.

These two supplements are the only ones you need in pregnancy unless your doctor or midwife diagnoses a deficiency, such as iron deficiency.

You can buy them cheaply in high street chemists or supermarkets (if you buy own brand supplements individually they can be cheaper than the branded packs of pregnancy vitamins).

If you are receiving benefits or are under 18 you might be able to get free vitamins with the government Healthy Start scheme.

Do stay active

Being sedentary (sitting down a lot) is not healthy for you or your baby.

It puts you at higher risk of too much weight gain, gestational diabetes, pre-eclampsia and varicose veins and you are more likely to have shortness of breath and lower back pain.

If you did exercise before you became pregnant, you can continue at the same level but listen to your body and slow down when you feel uncomfortable. 

If you didn’t exercise before you became pregnant, you don’t have to take up organised exercise classes, the important thing is to be active. There are tips here to help you build exercise into your day

The recommended amount of activity for pregnant women is 30 minutes a day four times a week. Read all about exercise and pregnancy here.

Do think about what you eat

Some foods carry a small risk of infections, such as toxoplasmosis or listeriosis. Others can give you food poisoning, such as salmonella. Others have too much vitamin A or mercury, which can harm your developing

Listeria infection is rare but if you get it can severely damage your unborn baby. Foods that are more likely to carry listeria:

  • mould‑ripened soft cheese, such as Camembert or Brie, and soft blue‑veined cheese (there is no risk with hard cheese such as cheddar, parmesan or stilton, or with cottage cheese or processed cheese)
  • pâté (even vegetable pâté)
  • unpasteurised milk

Salmonella food poisoning is unlikely to harm your baby, but it can give you a severe bout of diarrhoea and vomiting. Foods that are more likely to carry salmonella:

  • unpasteurised milk
  • avoid eating raw or partially cooked eggs or food that may contain them (such as mayonnaise) unless they are produced under a food safety standard called the British Lion Code of Practice

Toxoplasmosis infection is rare but if you get it can severely damage your unborn baby. Foods that are more likely to carry the toxoplasma parasite:

  • uncooked or undercooked ready‑prepared meals
  • raw or partially cooked meat, especially poultry
  • unwashed vegetables and salad
  • cured or fermented meat (these can made safe by freezing or cooking before eating)

Too much vitamin A can affect your developing baby.

Foods that have high doses of vitamin A are:

  • liver and liver products
  • high-dose multivitamin supplements, fish liver oil supplements, or any supplements containing vitamin A.

Too much mercury and other pollutants, such as dioxins and polychlorinated biphenyls (PCBs)

If you eat the following you are at risk of eating too much mercury and other substances that may harm your growing baby:

  • shark, swordfish or marlin
  • more than two tuna steaks a week (about 140g cooked or 170g raw each)
  • more than four medium-sized cans of tuna a week
  • more than two portions of oily fish a week, such as salmon, trout, mackerel and herring.

Do eat fish within the limits above though as it's a good source of nutrition for your baby.

Read all about nutrition in pregnancy here.

Do monitor your baby’s movements

Your baby’s movements are a sign that they are well. They settle into a regular pattern at around week 24. Start monitoring the pattern at this point and if you notice a reduction in movement seek help immediately. Read important information here about what to look out for and what to do if you notice a difference. 

Do go to sleep on your side in the third trimester

Going to sleep on your back in the third trimester doubles your risk of stillbirth. You may wake up in all sorts of positions during the night, and that’s OK, but if you go to sleep on your side you will be sleeping safely for your baby

Do remember your mental health

1 in 10 women suffer mental ill-health when they are pregnant. Don’t write off negative, unusual or unexpected bad feelings as part of your pregnancy, especially if they last longer than expected. Read more about the difference between mood swings and deeper anxiety/depression here.

Do consider taking the vaccinations that are offered

In pregnancy you will be offered two vaccinations:

You’ll be offered the whooping cough vaccine by your GP or midwife from week 20 of your pregnancy, or soon after your 20 week scan. You will be offered this vaccination to boost your antibodies. These antibodies will be passed to your baby through the placenta. Having the vaccination between weeks 16 and 32 of will mean your baby has a higher chance of being protected from birth. 

You’ll be offered the flu vaccine between September and February. There is evidence that pregnant women can be more at risk of developing complications if you get flu during pregnancy. 

Read more about vaccinations in pregnancy here.

Do carry your pregnancy notes

It is recommended to carry your antenatal notes everywhere you go as they contain all your medical and pregnancy history. This is particularly important if you need to go to the maternity unit, especially at short notice, as this is the only way health professionals will have access to all your history and what has been happening in your pregnancy.

Do take any overseas holidays before 37 weeks

Women have said that the best time in pregnancy for overseas holidays is the middle of pregnancy. Nausea and tiredness are common in the first 12 weeks of pregnancy, and the risk of miscarriage is also higher in the first three months (this is not linked to travelling). Travelling in the final months of pregnancy can be tiring and uncomfortable.

If you decide to travel later in pregnancy:

  • check your plans with airline. The likelihood of going into labour is higher after 37 weeks and some airlines will not let you fly. After week 28 of pregnancy, the airline may ask for a letter from your doctor or midwife confirming your due date, and that you aren't at risk of complications
  • check your plans with your travel insurer. Is pregnancy covered in the event of an accident
  • bring your maternity notes with you.

Long-distance travel (five hours or more) also carries a small risk of deep vein thrombosis (DVT or blood clots) so drink plenty of water and try and move around during the flight.

Do be aware of these symptoms

There are some symptoms that should always be checked with a midwife or doctor as they could be a sign that the baby is unwell.

You should also contact your midwife if you feel that something is wrong with you or the baby, even if you don't know exactly what it is. It's important to trust your instincts in pregnancy.

Don’t do these in pregnancy

Don’t ‘eat for two’

There’s no need for extra calories in the first or second trimesters. In the third trimester, you should have an extra 200 calories if you are active. This is the equivalent to half a sandwich. 

What does 200 calories look like? Find out here

Read about the recommended weight gain in pregnancy here

Don’t smoke

Smoking is a major modifiable risk factor (something you can change) for all sorts of health problems for your baby. It’s never too late to stop. Think about getting support, as this has been shown to make staying off cigarettes more likely.

Get support to quit smoking here.

Don’t drink alcohol

Don’t drink alcohol, especially in the first trimester when the baby’s brain is going through a period of intense development. Find out more about how alcohol affects pregnancy and where you can get support here.

Don’t take drugs

Cocaine, meta-amphetamines, cannabis, psychoactive substances (so called ‘legal highs’) are all likely to increase risks of health problems.

If you are taking illegal drugs it is really important to talk to your midwife or doctor. They will not judge you and can give you the right care and support during your pregnancy. The more they know, the more they can help you and your baby to get the right treatment.

You can also get confidential (they will not speak to anyone else about your drug-use) extra support from Talk to Frank. There is a live chat on the website. You can text 82111 or call 0300 123 6600

Don’t go diving or playing rugby

Most exercise is safe and healthy, but a handful of activities could cause injury to the baby. Read about activities that might harm your developing baby here

Don’t drink (or eat) too much caffeine

More than 60% of women who checked their caffeine intake on our caffeine calculator were surprised to find that they were over the limit. High levels of caffeine during pregnancy can result in low birth weight babies, which can increase the risk of health problems in later life. Too much caffeine has also been linked to miscarriage.

Check your caffeine intake here.

Don’t diet in pregnancy

Cutting out food groups may deprive your baby against nutrients they need for growth. Instead of dieting, it is best to have a healthy balanced diet.

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Sources

Sources

Tommy's (2015) Folic acid in pregnancy: https://www.tommys.org/pregnancy-information/im-pregnant/nutrition-pregn.... Published 11 April 2015. Review date 11/April 2018.

Tommy's (2015) Vitamin D in pregnancy:https://www.tommys.org/pregnancy-information/im-pregnant/nutrition-pregn... 11 April 2015. Review date 11/April 2018.

Tommy's (2015) 10 tips for staying active in pregnancy https://www.tommys.org/pregnancy-information/im-pregnant/exercise-pregna... reviewed on February 1st, 2015. Next review date February 1st, 2018.

Tommy's (2015) All about exercise in pregnancy https://www.tommys.org/pregnancy-information/im-pregnant/exercise-pregna... reviewed on February 1st, 2015. Next review date February 1st, 2018.

Tommy's (2015) Nutrition in pregnancy https://www.tommys.org/pregnancy-information/im-pregnant/nutrition-pregn... reviewed on June 27th, 2017. Next review date June 27th, 2020.

Tommy's (2016) Reduced fetal movements https://www.tommys.org/pregnancy/symptom-checker/baby-fetal-movements Last reviewed on April 1st, 2016. Next review date April 1st, 2019.

Tommy's (2017) Sleep position and pregnancy https://www.tommys.org/pregnancy-information/im-pregnant/pregnancy-calen... reviewed on November 20th, 2017. Next review date November 20th, 2020.

Tommy's (2015) How stressed or anxious should I be before I get help? https://www.tommys.org/pregnancy-information/im-pregnant/mental-wellbein...Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

Tommy's (2015) Vaccinations in pregnancy https://www.tommys.org/pregnancy-information/im-pregnant/antenatal-care/...Last reviewed on April 1st, 2015. Next review date April 1st, 2018.

Tommy's (2015) https://www.tommys.org/pregnancy-information/im-pregnant/weight-manageme...Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

Tommy's (2015) https://www.tommys.org/pregnancy-information/im-pregnant/smoking-and-pre...Last reviewed on April 1st, 2015. Next review date April 1st, 2018.

Tommy's (2015) https://www.tommys.org/pregnancy-information/im-pregnant/drinking-alcoho...
Last reviewed on June 27th, 2017. Next review date April 27th, 2020.

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Last reviewed on November 22nd, 2017. Next review date November 22nd, 2020.

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