The Public Health Agency of Canada has released a new, updated guide for a healthy pregnancy as of February 2021, Your Guide to a Healthy Pregnancy

Your Guide to a Healthy Pregnancy addresses:

Prenatal Nutrition

This section recommends:

o   Eat a variety of healthy foods each day

o   Choose foods with healthy fats instead of saturated fat

o   Choose fish low in mercury

o   Eat a little more food each day than you normally would

o   Make water your drink of choice

o   Be mindful of your caffeine intake

o   It answers common questions around healthy snacks, eating healthily within a budget, recommended weight gain, maintaining iron levels, and foods to avoid due to increased risk of food poisoning.

Folic Acid

This section explains the role and value of folic acid in pregnancy, and answers questions about how much to take, cautions around “natural folate”, and factors that can influence the amount of folic acid required, such as:

o   A previous pregnancy with an Neural Tube Defect (NTD)

o   A family history of other folic acid-related birth defects

o   A family history of an NTD or a male partner with a family history of an NTD

Alcohol

This section explains why the safest choice for a woman who is pregnant or planning to become pregnant is not to drink alcohol, and provides answers to common questions around how much drinking causes FASD, whether children will grow out of FASD, and whether a partner’s drinking can cause FASD.

Tobacco and Vaping

This section emphasizes that quitting smoking or vaping during pregnancy can have considerable positive health impacts for both mother and baby, and addresses the impact of small amounts of smoking, vaping while pregnant, smoking after the baby is born, and how to find help to quit smoking.

Cannabis

The key message in this section is that there is no known safe amount of cannabis use during pregnancy, noting that cannabis can affect birth weights, may affect brain, learning and physical development, and may also lead to behavioural issues later in life. Research is ongoing on these impacts. It addresses questions about using cannabis to treat morning sickness, using medical cannabis and CBD products during pregnancy, and recommends speaking openly with one’s health provider about one’s cannabis use.

Oral Health

This section talks about how hormone changes during pregnancy can increase the risk of gingivitis and periodontitis, which can also affect birth weights. It recommends having teeth cleaned and an oral health check in the first trimester, making sure one’s health provider knows about the pregnancy. It answers questions about pregnancy gingivitis, how to avoid tooth decay whilst pregnant, and oral care after morning sickness vomiting.

Physical Activity

This section emphasizes that exercise is safe and encouraged for healthy pregnant women who are receiving prenatal care, and recommends aiming for 150 minutes of moderate intensity physical activity each week, noting the importance of listening to one’s body, fueling the body, staying hydrated and avoiding overheating. It answers questions about best types of exercise during pregnancy, pelvic floor exercises, starting exercise for the first time whilst pregnant, and types of exercise to avoid.

Emotional Health

The key messages of this section are about how taking care of one’s physical health can help improve one’s emotional health, and the importance of sharing one’s thoughts and feeling with others, noting that one in ten women suffer from depression during pregnancy. It identifies symptoms to be aware of, especially if one experiences 5 or more of the symptoms for more than two weeks, and answers questions about mood swings, antepartum and postpartum depression, the importance of speaking with one’s health practitioner about continuing previously prescribed antidepressants whilst pregnant, and whether antepartum and postpartum depression are time-limited issues. Finally, it looks at ways that a partner can offer support during pregnancy.

Sexual Health

The key message in this section is that, if your pregnancy is healthy and progressing without problems, sex is safe for both mother and fetus. It offers reassurance that having sex will not cause a miscarriage, and when it would still be advisable to use protection while pregnant (e.g. avoiding risk of transmission of STDs).

Immunization

This section’s key message is to make sure vaccinations are up to date to give both mother and baby the best protection against vaccine-preventable diseases, noting that a woman should receive a DTaP vaccine during every pregnancy to protect against tetanus, diphtheria and pertussis to protect the baby against whooping cough after birth and before they can receive vaccines. This section offers reassurance about vaccination safety during pregnancy and breastfeeding, and explains why vaccines are given to children on a specific schedule.

Breastfeeding

The key message in this section is that breast milk is so complete it is the only food or drink one’s baby needs for the first six months, stressing:

o   It helps the baby fight off sickness and disease.

o   It reduces the risk that the baby will have diarrhea, ear or lung infections, die of SIDS, or be overweight when they are older.

o   It increases protection to the mother against breast and ovarian cancer, diabetes and heart disease.

o   The section answers questions about Vitamin D supplement, how partners/friends/family can offer support to a breastfeeding mother, how to know whether a baby is getting enough breastmilk, the value of skin-to-skin contact after birth in establishing breastfeeding, and offers an explanation and recommendation against consuming alcohol or cannabis whilst breastfeeding.

Common Complaints

This section looks at what causes common physical issues during pregnancy and offers recommendations to alleviate discomfort for:

o   Back, pelvic and hip pain

o   Bloating and gas

o   Breast changes (pain, tingling, tenderness)

o   Constipation

o   Fatigue

o   Heartburn

o   Increased urination

o   Insomnia (difficulty sleeping)

o   Leg cramps

o   Nausea and vomiting (morning sickness)

o   Skin changes

o   Swelling (edema)

o   Vaginal discharge changes

o   Varicose veins

Your Developing Baby

This section outlines the main elements of fetal development during each few weeks of pregnancy.

Preparing for Birth

This sections answers questions around practical and emotional preparations for delivery (support/birth preferences/childcare for older children/being prepared for going to hospital), early signs of labour, preterm labour, and skin-to-skin contact after delivery.

Postpartum

The key message in this section is that having a new baby is a physically and emotionally difficult time of life and to not be afraid to ask for support. It answers questions about vaginal care after delivery, recovery from caesarean section, postpartum bleeding, return of ovulation, and options for birth control.

Helpful Resources

This section provides links to resources on each of the sections above and information and links to CPNP project availability.