Pregnancy

The neural tube closes by day 28, the organs are laid down by week 10. At that point many do not yet know they are pregnant. That is the whole reason folic acid is recommended before conception and not from the positive test.

It starts around week 6, is strongest at weeks 9 to 10 and stops for most around week 14. What is studied: small meals every two to three hours, something dry before getting up, 1–1.5 g ginger a day, acupressure at point P6. What does not help: drinking more with meals — that fills the stomach further.

Haemoglobin falls in pregnancy even without deficiency, because blood volume rises by 30–50 %. Only ferritin tells the dilution from a genuine deficiency. Iron on suspicion causes constipation and dark stool without achieving anything — with a proven deficiency, however, it matters, and uptake rises with vitamin C at the meal.

Two causes at once: progesterone relaxes the sphincter and the womb presses up against the stomach. What works: smaller portions, the last bite three hours before lying down, the head of the bed 15 cm higher, lying on the left rather than the right. What does not work: milk — it soothes for minutes and then prompts more acid.

Between weeks 24 and 28, because it usually does not show earlier and would be found too late afterwards. It causes no symptoms. For most, diet and movement are enough; it disappears after the birth but leaves a raised risk of type 2 diabetes over the following ten years — which is the reason for the follow-up check after six to twelve weeks.

From week 20. Blood pressure and protein in urine are therefore measured at every check. What belongs assessed the same day: sudden swelling in the face and hands, severe headache, visual flickering, pain in the right upper abdomen. With raised risk low-dose aspirin from week 12 lowers the frequency — that is decided medically.

Several values shift without anything being wrong: haemoglobin and albumin fall through dilution, alkaline phosphatase rises from the placenta, thyroid cut-offs are lower, and D-dimer rises markedly towards the end. Reading them by the usual limits finds results that are not findings.

Iron stores are often empty, especially after heavier blood loss — ferritin belongs in the follow-up. Iodine and DHA stay raised while breastfeeding, and the energy need is around 500 kcal above the usual. The thyroid can go out of step in the first months; lasting exhaustion after the birth is therefore not always what it is taken for.

Folic acid prevents neural tube defects if it is in the body before day 28 — afterwards it can no longer do so. Iodide covers a need, it does not make anyone cleverer. Iron works only with a proven deficiency and otherwise causes constipation. Ginger acts on the nausea, not on its cause; that stops by itself. And a multivitamin replaces neither fish nor vegetables — it fills gaps, it does not build a foundation.

40 weeks from the first day of the last period. Neural tube closed on day 28, organs laid down by week 10. Nausea weeks 6 to 14, peak at weeks 9 to 10, in about 70 %. Glucose test weeks 24 to 28. Pre-eclampsia from week 20. Folic acid 400 µg, four weeks before conception through week 12. Iodine 230 µg, iron 30 mg, DHA 200 µg extra a day. Caffeine up to 200 mg. Energy plus 0 / 250 / 500 kcal by trimester. Weight gain 11.5–16 kg with a normal starting BMI. Blood volume plus 30–50 %.

Affects about 70 % and starts around week 6, peaks at weeks 9 to 10 and usually ends around week 14. Small frequent meals and 1–2 g ginger powder a day are studied. Losing more than 5 % of body weight or keeping nothing down belongs looked at.

In the last trimester for more than half. Two causes at once: progesterone relaxes the sphincter and the womb presses from below. Smaller portions, the last bite three hours before lying down and a raised head of the bed all help.

Progesterone slows the bowel, iron preparations add to it. Fibre up to 30 g with 2–2.5 litres of fluid; psyllium is studied in pregnancy and well tolerated.

Common from the second trimester. Unlike in older people, individual studies found a benefit in pregnancy from 300–360 mg magnesium a day. The evidence remains mixed.

Water retention narrows the carpal tunnel — in up to a third. It usually recedes within weeks after the birth; a night splint bridges the time.

Normal and harmless up to a point. If sudden facial swelling, headache, visual flickering or pain in the right upper abdomen come with it, that belongs assessed the same day.

With a regular cycle this is the first and clearest pointer. A pharmacy test is informative from the missed period on.

Blood volume rises by 30–50 %, so haemoglobin falls arithmetically — that is the normal dilution and not a deficiency. Ferritin tells the two apart: below 30 µg/l it is a genuine iron deficiency.

The thyroid works harder in pregnancy and the cut-offs are lower than otherwise. An untreated underactive thyroid affects development — hence early measurement.

Between weeks 24 and 28. Gestational diabetes causes no symptoms and is found only this way; it usually disappears after the birth but raises the later risk of type 2 diabetes.

Together they signal pre-eclampsia, usually from week 20. That is why both are measured at every check — it can develop within days.

A low level is corrected. An influence on the course of the pregnancy is less clearly established than the one on the bone of mother and child.

400 µg extra as a supplement, started four weeks before conception through week 12. The neural tube closes by day 28 — usually before the pregnancy is noticed.

230 µg a day instead of 200. Iodised table salt is the main source in Switzerland; avoiding salt or using only sea salt loses it.

30 mg a day is the guide — twice the usual. Supplementation follows ferritin, not suspicion; extra iron without deficiency brings nothing and causes constipation.

200 mg a day extra, especially in the last trimester — when the brain grows fastest. Two portions of oily sea fish a week cover it; without fish, algae oil supplies the same fatty acids.

Must be supplemented on a purely plant-based diet. A deficiency in the mother leads to one in the breastfed child that only shows after months and then costs developmental steps.

1000 mg a day — the same as usual. The need does not rise because the body absorbs calcium better; if it is missing, it is taken from the mother’s bone.

Here an upper limit rather than a target: above about 3000 µg a day in the first trimester vitamin A can harm the child. Liver holds several times that per portion and is therefore left out.

400 µg a day, four weeks before conception through week 12. After an earlier child with a neural tube defect, in diabetes and on certain medicines the dose is higher — set by the caring team.

Recommended in Switzerland for the whole of pregnancy and breastfeeding, because iodised salt alone often does not cover the raised need.

200 mg DHA a day if no fish is eaten. Anyone eating oily sea fish twice a week needs no supplement.

Convenient but not always fitting: some contain vitamin A above the upper limit for the first trimester, others iron without a deficiency being present. Reading the back is worth more than reading the front.

Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.

Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.

Doubles about every two days in the first weeks and peaks around week 10 — nausea then eases for most.

Relaxes smooth muscle everywhere in the body. Hence heartburn, constipation and the more frequent need to pass water — one cause in three guises.

Rises strongly until the end. Thicker hair, more sensitive gums and the darker pigmentation come from it.

The need rises by about 30 % from early pregnancy. Anyone already taking thyroid hormone usually needs more — often before the first appointment.

Raw meat, raw milk cheese, smoked fish and raw eggs are the routes for listeria and toxoplasmosis. Thoroughly cooked and pasteurised, all of them are safe — it is about the preparation, not the food.

Two portions of oily sea fish a week supply the DHA. Large predatory fish — tuna, swordfish, shark, escolar — accumulate mercury and are limited to one portion a week or less. Salmon, herring, mackerel and sardine are the unproblematic ones.

Up to 200 mg a day is considered unproblematic — about two cups of filter coffee. Espresso is 60–80 mg, energy drinks 80 mg a can, and black tea and cola count too.

Alcohol crosses the placenta unhindered; the child breaks it down more slowly than the mother. No study has been able to establish an amount below which nothing happens — which is why the recommendation is zero rather than a figure.

Nothing extra in the first trimester, around 250 kcal in the second, around 500 in the third. “Eating for two” means two slices of bread with cheese, not two platefuls.

With a BMI below 18.5 the frame is 12.5–18 kg, at 18.5–24.9 it is 11.5–16 kg, at 25–29.9 still 7–11.5 kg, and from 30 about 5–9 kg. The starting value decides, not the number on the scales today.

The best-studied plant remedy for pregnancy nausea: 1–1.5 g of powder a day, split into several doses, for up to three weeks.

150 minutes a week at moderate effort remains the guide in pregnancy too. Studies show less gestational diabetes and less back pain. Sports with a risk of falling or impact are avoided, and from the second trimester lying flat on the back.

Against the constipation that progesterone and iron preparations cause together. 5–10 g a day in plenty of water; works in the bowel and is not absorbed.

Studied for nausea and pelvic pain with small effects. Acupressure at point P6 on the forearm has been tested in several studies and is low risk — wristbands for it are sold ready-made.

“Herbal” does not mean “without effect on the child”. Parsley in quantity, mugwort, sage in high doses and aloe taken internally do not belong in pregnancy. Culinary amounts are never meant — this is about teas and preparations over weeks.

Raspberry leaf tea is the best-known application of the final weeks — traditionally from week 37. The few studies show no clear benefit and no harm.

Here as a list of what does not belong: wormwood, mugwort, tansy and greater celandine are not intended in pregnancy. The reason is the same for all — they act on the womb or are toxic to the liver.

Common as a mild tea and drunk for centuries. Flushing courses with large amounts are still not the place for it in pregnancy.

Against morning nausea the citrus scent is the mildest thing there is — and better than nothing in a small study. On the skin only in the evening: citrus oils cause light sensitivity.

Here as a list of what does not belong: sage, clary sage, cinnamon, oregano, wintergreen and juniper are not intended in pregnancy. For some it is the effect on the womb, for others the salicylate or kidney connection.

The mildest oil there is and widely used in small amounts — in the room, in the bath, in a diluted massage. It stays sparing nonetheless.

The point traditionally avoided in pregnancy — an effect on the womb is attributed to it. Anyone going for acupuncture says they are pregnant, in the early time too.

The one point with solid studies: acupressure at the wrist eases pregnancy nausea in several investigations — the wristbands from the pharmacy work with it.

At the little toe, traditionally used with moxibustion for a breech position — one of the few TCM methods with controlled studies in obstetrics. The results are inconsistent.