Health and Safety During Pregnancy

It is important to talk to your health-care provider before you start or stop taking any medication while you are pregnant or breast/chestfeeding.

While some medication is safe during pregnancy, other medication may harm your baby if it passes through the placenta or through your milk. The effects of many types of medication during pregnancy remain unknown. Your health-care provider can help you evaluate the risks and benefits of a medication that you need. 

Even if a medication is not recommended during pregnancy, it might be safe to take while breast/chestfeeding. It is best to check with your health-care provider before taking any medication while breast/chestfeeding.

For more information on medication safety during pregnancy, please visit the following resources:

• NIH: Drugs and Lactation Database 
• Mother to Baby
• Pregnancy Info

Our pregnancy care team recommends the following immunizations during pregnancy.

The flu shot

The flu is contagious and causes symptoms such as fever, sore throat, tiredness, sneezing, coughing, watery eyes, nausea, vomiting and muscle pain. Complications of the flu can result in trouble breathing, seizures or pneumonia. Pregnant people are at an increased risk of complications. 

The influenza (flu) vaccine is safe during pregnancy and recommended by the Society of Obstetricians and Gynaecologists of Canada (SOGC).

Tdap (tetanus, diphtheria, pertussis) vaccine

Pertussis (whooping cough) is a serious illness that can be dangerous for infants younger than one year of age. 

The SOGC and Canadian Pediatric Society recommend all pregnant people get the pertussis vaccine between 21 and 32 weeks of pregnancy. The vaccine protects your baby until they can get their own shots. 

Everyone who cares for your baby is also encouraged to receive this vaccine. Many adults have not had a booster shot for this illness since they were a teenager.

Learn more about the Tdap vaccine from the Ministry of Health.

COVID-19 vaccine

COVID-19 is a respiratory illness that affects your breathing and can be serious in pregnancy.

The COVID-19 vaccine is safe to take throughout pregnancy and breast/chestfeeding. Getting the booster shot is also recommended if you are eligible for it.

Our pregnancy care team recommends that you stop using substances such as marijuana, tobacco, illicit drugs, or alcohol during pregnancy. This may also include the misuse of prescription drugs. These substances can harm your baby's development. 

If you are struggling with stress, please ask your health-care provider about programs and resources that can help you cope in a healthy way. 

Our pregnancy care team recommends avoiding exposure to harmful chemicals before and during pregnancy. Stay away from pesticides, lead, and fumes from household cleaners, paint and cosmetics like nail polish and hair products. Also, limit eating fish that is high in mercury.

We recommend avoiding excessive heat during pregnancy. This means not spending more than 10 minutes in the sun, sauna or hot tub.

Falls during pregnancy are common because your changing body makes it harder to keep your balance. Try to avoid icy walkways, wet floors and carrying heavy things.

It is a good idea to make some changes to your work area and in your daily activities to stay comfortable during pregnancy. Take breaks to stretch, eat healthy snacks and be careful to avoid injury.

We also suggest taking precautions when travelling while pregnant. Always wear a seatbelt in the car and take frequent breaks to stretch your legs and use the washroom. If you are flying, wearing compression stockings can help reduce leg swelling.

Avoid travelling to areas with Zika or malaria outbreaks and use mosquito repellent with DEET if there are mosquitos around. It is a good idea to get travel insurance and know where you can find medical help at your destination.

To reduce your chances of getting sick, wash your hands often and stay up to date with your vaccinations.

It is important to eat a healthy diet with enough vitamins and minerals during pregnancy. Our pregnancy care team recommends following Canada's Food Guide and including a variety of foods from each food group, such as fruits and vegetables, grains and starches and proteins. 

In the second and third trimester, you will need more calories to support your growing baby. If you are having twins or triplets, your energy needs are even higher. We suggest having snacks between meals to provide energy and keep you from feeling overly hungry.

Getting enough iron is also important during pregnancy. Iron helps your body make more blood to supply oxygen and nutrients to your baby. You can find iron in foods like lean meat, chicken, fish, eggs, beans, peas, lentils, pumpkin seeds, cashews, whole grains and dark leafy greens like spinach. Pairing iron-rich food with vitamin C-rich foods such as fruit and vegetables will help your body better absorb the iron. However, eating calcium-rich foods like dairy products at the same time can reduce iron absorption.

If you are low in iron, supplements may be recommended by your health-care provider. Learn more about iron deficiency in pregnancy.

Health Canada recommends taking prenatal multivitamin pills that contain folic acid (0.4 mg) and iron (16-20mg). Not all prenatal multivitamins are the same, so talk to your health-care provider to make sure the one you are taking meets your specific needs. When buying supplements, look for a Natural Product Number (NPN) on the label, which shows that the supplement has been approved by Health Canada and found to be safe, effective, and of high quality. 

If you are concerned about your diet, ask your health-care provider to refer you to our dietitian.

Residents of Ontario can also connect with a registered dietitian for free nutrition advice by visiting Health811 or phoning 811.
 

Food poisoning can be harmful to you and your baby. Our pregnancy care team recommends preparing and storing food safely to decrease your risk of food poisoning.

Limiting high-mercury fish like tuna and swordfish during pregnancy is also recommended.

Herbal supplements and some herbal teas (such as chamomile) should also be avoided during pregnancy. It is safe to drink the following teas in moderation: citrus/orange peel, ginger, lemon balm, peppermint, red raspberry leaf and rose hip.

Completely avoid alcohol and limit caffeine to 300 mg per day, which is equivalent to about 16 oz. (500 mL) of coffee or 48 oz. (1500 mL) of black coffee.

Learn more from Health Canada about food safety during pregnancy.

It is normal and healthy to gain weight during your pregnancy. Your weight gain will include the weight of your baby, your uterus, your amniotic fluid and more.

The amount of weight you should gain depends on your specific circumstances. Talk to your health-care provider to determine a healthy weight goal for you.

A healthy diet and regular physical activity will help you gain weight gradually throughout your pregnancy. Weight gain tends to be slow during the first trimester and then becomes steadier during the second and third trimesters.

Health Canada has a pregnancy weight gain calculator to discover how much weight gain is healthy for you.

If you are pregnant with multiple babies (twins or more), it is important to have a healthy diet, active lifestyle and adequate rest.

The amount of weight you should gain depends on your specific circumstances. In general, expect to gain more weight than someone with a singleton pregnancy (one baby), averaging between 37-55 pounds.  You may also need to modify the level of physical activity to meet your specific needs during pregnancy.

Talk to your health-care provider about how much weight gain and how much exercise is healthy for you.

Constipation is common during pregnancy. The following suggestions can help treat or prevent constipation.

Stay well-hydrated by drinking plenty of fluid every day. Any non-alcoholic drink counts, including tea, soup, milk and smoothies. Water is the best choice for hydration.

Eat high-fibre food such as beans, peas, lentils, nuts, seeds, whole grains, fruit and vegetables. We recommend getting 28g of fibre each day.

Stay active. Participating in movement that feels good like walking or swimming can help ease constipation too. Your health-care provider can help you find activities that are safe for you in pregnancy.

Heartburn is a burning sensation in the chest caused by stomach acid backing up into the throat. It is common in pregnancy because of changing hormones and the pressure of the growing baby on the stomach.  

To ease or prevent some of the symptoms of heartburn:

• Eat slowly and chew food well
• Sit up for at least one hour after eating
• Drink less while eating and drink more between meals
• Have smaller, more frequent meals (about five to six times a day) instead of larger meals
• Avoid or limit food that worsens heartburn such as spicy foods, onions, garlic, citrus fruits, deep-fried and fatty foods
• Keep track of which foods trigger your heartburn

If your heartburn does not improve, talk to your health-care provider for guidance. 

Hormone changes during pregnancy can cause swelling and bleeding of your gums. It is important to brush your teeth twice a day and floss every day to avoid tooth decay, gum disease and infections.

It is a good idea to see a dentist early in your pregnancy. You can then plan to have any dental work that needs to be done during the second trimester or as indicated by your health-care provider. 

Physical activity during pregnancy can help reduce the risk of complications. Current guidelines from the SOGC and Canadian Society for Exercise Physiology (CSEP) recommend:

• At least 150 minutes of moderate-intensity physical activity such as walking or swimming each week
• Moderate-intensity activity at least three days a week and daily activity is even better
• A variety of activity including aerobic exercise (such as walking) and resistance training (such as strength exercises or yoga)
• Pelvic floor exercises (as described below), which can be done daily
• Listening to your body and discussing your exercise plans with your health-care provider 

The pelvic floor is what we call the layers of muscles that support your bladder, bowel and uterus. These muscles hold your pelvic organs in place and help control the release of urine or stool. 

Sometimes the pelvic floor muscles will get weaker after pregnancy or childbirth. (Other causes of weak pelvic floor muscles include injury, lack of exercise or aging). Some people can experience leaking urine during pregnancy or after birth.

Pelvic floor exercise like Kegels can make these muscles stronger and help improve your bladder control. You can do pelvic floor exercises each day or as directed by your care provider.

Learn more about the pelvic floor during and after pregnancy and about pelvic floor exercises.