Part C: Lifestyle considerations

This section discusses lifestyle factors that contribute to the health and wellbeing of a woman and her baby during pregnancy. Recommendations are based on evidence about the health risks and benefits associated with a range of lifestyle factors.

The summary of advice on lifestyle considerations during pregnancy considered a priority for inclusion in these Guidelines. Advice on immunisation during pregnancy is included in the Australian Immunisation Handbook ATAGI 2017.

Summary of advice for women about lifestyle considerations during pregnancy

Health behaviours

Nutrition

• Healthy dietary patterns are characterised by high intake of fruits, vegetables, legumes, wholegrains, fish, seafood, unprocessed meats, dairy foods and water. 
• Diets with high intake of sweetened foods and drinks, foods high in saturated fats (eg fried foods), processed meats and refined grains are associated with poorer outcomes. 
• The Eat for Health website provides further details.

Physical activity

• Usual physical activity during pregnancy has health benefits and is safe.

Tobacco smoking

• Smoking and passive smoking can have negative effects on the pregnancy and the baby.

Alcohol

• Not drinking alcohol is the safest option for women who are pregnant.

Substance use

• Illicit substances and non-medical use of medications (eg opioids) have negative effects on the pregnancy and the baby.

Preventive health interventions

Folic acid

• Dietary supplements of 400 µg folic acid a day, ideally taken from 1 month before conception and throughout the first 3 months of pregnancy, reduce the risk of a baby having neural tube defect.

Other vitamins

• In the absence of identified deficiency, supplements of vitamins A, C and E are of little or no benefit during pregnancy and may cause harm.

Iron

• The need for iron supplementation is assessed through a blood test at 28 weeks.
• If an iron supplement is necessary, weekly supplementation (80-300 mg elemental iron) is as effective as daily supplementation (30-60 mg elemental iron) in preventing (but not treating) iron-deficiency anaemia, with fewer adverse effects.

Calcium

• Calcium supplements are recommended for women at high risk of pre-eclampsia.

Iodine

• Iodine requirements increase during pregnancy and a supplement of 150 micrograms a day is advised.

Omega-3 fatty acids 

• Supplementation with omega-3 long-chain polyunsaturated fatty acids (800 mg docosahexaenoic acid [DHA] and 100 mg eicosapentaenoic acid [EPA] per day) may reduce the risk of preterm birth among women who are low in omega-3. 

Herbal preparations 

• The effectiveness and safety of herbal preparations varies according to the herbal preparation and the condition being treated. 

Medicines

Medicines

• Use of medicines should be limited to circumstances where the benefit outweighs the risk.

General advice

Oral health 

• Good oral health is important to a woman’s health and treatment can be safely provided during pregnancy.

Sexual activity

• Sexual intercourse in pregnancy is not known to be associated with any adverse outcomes.

Travel

• Correct use of three-point seatbelts during pregnancy is to have the belt ‘above and below the bump, not over it’.
• Long-distance air travel is associated with an increased risk of venous thrombosis.
• Pregnant women should discuss considerations such as air travel, vaccinations and travel insurance with their midwife or doctor if they are planning to travel overseas.
• If a pregnant woman cannot defer travel to malaria-endemic areas, she should use an insecticide-treated bed net.
• Some medications to prevent malaria can be safely used in pregnancy.