Prenatal article - April 2023 (2023)

How to optimise nutrition for your developing baby, while overcoming pregnancy symptoms

by nutritional therapist Kyla Newcombe MSc, BSc, DipION

With a whirlwind of hormones stirring up your emotions, and feelings of nausea challenging your every move, your next meal may not be at the forefront of your mind. But in the early stages of pregnancy, your baby is at its most vulnerable, and key development depends on your nutrition.

While your growing baby is, quite literally, taking everything it needs from you, it is time to get clued up on nutrient-dense foods. Knowing which nutrients to focus on can really help; although only around 10% extra calories are needed during the last trimester, nutrient requirements are significantly higher, at around 50% more.

Although it is probably quite high on your priority list to concentrate on the health of your developing baby, as a mum-to-be you must also not neglect your own well-being at this precious time. If you want to feel good about yourself by the time the baby arrives, here are a few tips to help you enjoy the experience throughout the whole pregnancy.

Prenatal article - April 2023 (1)

Optimum nutrition for your baby’s development


The types of fats eaten during pregnancy have an effect on the development of your baby’s brain, as the brain structure is mostly made up of omega-3 and omega-6 fats. Although your baby will take what it needs, if you already have a fatty acid deficiency, your baby’s brain may miss out on these essential nutrients. Generally, we get plenty of omega-6 in our diets (if we are eating meat, eggs, nuts and grains), but omega-3 is commonly deficient. Omega-3s EPA and DHA found in oily fish are crucial for healthy brain development, especially as DHA is required to build the developing brain structure and to support visual and cognitive function. (1)

As recommendations are to eat more omega-3 fats but also to limit oily fish when pregnant, it can be confusing to know just what the ideal amount is. The seemingly contradictory advice is due to toxins (such as methylmercury) found in fish, which may cause harm to your baby if eaten in excess. As larger fish eat smaller fish, these larger fish (such as swordfish and tuna) contain higher levels of toxins. Smaller oily fish such as anchovies, mackerel and herring are ideal to eat during pregnancy. Please don’t be put off by very small amounts of contaminants, as the health benefits of including fish in your diet during pregnancy far outweigh any risks of very low levels of contaminants which your liver should be able to filter. Taking pure omega-3 EPA & DHA rich fish oils or algae oils is an alternative to eating fish, or they can be taken in addition to eating fish to ensure your intake is sufficient.


During pregnancy, folic acid (otherwise known as folate or vitamin B9) is possibly the most well-known vitamin required. With overwhelming evidence of folate deficiencies significantly increasing risk to neural tube defects (a serious condition involving deformed growth of the spine or brain), consuming folate-rich foods is essential. (2).Beans, lentils and most green foods such as spinach, asparagus and avocado are rich in folate.

As it is difficult to get enough from diet alone, it is widely advised to take a folate supplement during pregnancy. Supplementing with folic acid has shown to prevent 90% of neural tube defects. (3) You could otherwise take a prenatal multivitamin supplement including a wider range of nutrients, including 400 µg of folate. During pregnancy, folic acid or folate is crucial, but it is important to note that the quality of supplements varies hugely. Ensure you choose a supplement in the bioactive folate form L-methylfolate, ready for the body to metabolise. (4) Also, choosing a ‘clean label’ supplement (free from fillers such as silicon dioxide) is ideal during pregnancy.


Long gone are the days when we thought drinking cow’s milk alone would be enough for bone development. In children, calcium on its own has not shown to improve bone density. (5) Bone development is much more complex than simply providing calcium, as to optimise bone health, magnesium is required to transport the calcium into the bone structure and vitamin D is also needed for calcium absorption. Vitamin D levels during pregnancy also appear to affect bone density in offspring. (6)

Rich food sources of calcium include dark green leafy vegetables, dairy, almonds and fish. Magnesium-rich foods include dark green leafy vegetables, nuts, seeds, beans and lentils. To ensure that you are getting enough vitamin D, try to get 20 minutes of sun exposure each day to your skin, from the months April – October (in the UK). You may need longer exposure if you have dark skin.

If your intake of dairy is low or if you have a diet low in magnesium-rich foods, consider taking a calcium and magnesium supplement.

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Prenatal article - April 2023 (2)

Foods and drinks to avoid or limit during pregnancy

Although it is healthy to focus on nutritious foods to include in your diet during pregnancy, you also need to consider which foods are best avoided completely, or at least limited in your diet while pregnant.


Alcohol (avoid, especially during the first 3 months)

Cold meats, raw meat, pate (avoid due to high risk of toxoplasmosis parasite)

Unpasteurised soft cheeses such as feta, brie and soft blue cheeses (high risk of listeria bacterial infection)


Caffeine (in moderation is ok, i.e. 1-2 teas / coffees per day)

Large fish such as swordfish (due to methyl-mercury content and other toxic contaminants). Can be eaten occasionally e.g. once per month

Liver (due to vitamin A toxicity). Can be eaten occasionally e.g. once per month

During the early stages of pregnancy, especially the first 3 months, you should consider your alcohol intake. Official recommendations are to avoid alcohol during pregnancy, due to the high risk of alcohol inducing foetal abnormalities and miscarriage. Some individuals will choose to have the occasional drink; however, research has shown that just 4 alcoholic drinks per week is associated with a significant increased risk of miscarriage. (7) If you’ve had a few drinks before you found out you were pregnant, don’t worry, this is very common! As the biggest risk is miscarriage, if you are still pregnant, your baby is most likely doing absolutely fine.

A ‘wine and cheese night’ may be out of the question, but you can certainly still indulge in other delicious foods and drinks. If you are craving soft cheeses, you can opt for pasteurised soft cheeses; some have added herbs and garlic, making them a rich alternative, so you won’t feel like you are missing out. While caffeine is difficult to replace, try decaf alternatives to your usual drinks, or something different such as rooibos, a naturally caffeine-free option.

You can also now have poached eggs when pregnant! The majority of eggs have the British lion stamp, indicating that the eggs have been laid by hens vaccinated against salmonella. These types of eggs are considered safe to eat during pregnancy, even if the yolk is runny.

The risk of food poisoning and its consequences are much greater during pregnancy due to reduced immune function, so be cautious when handling certain foods. Reduce your risk of catching an infection by washing hands and surfaces thoroughly after preparing raw meat. Even vegetables can carry parasites such as toxoplasma in soil residues, so scrub your vegetables clean, especially if eating them raw. This parasite can be very harmful to an unborn baby, and can also be found in cat stools; consider wearing gloves if you are cleaning out a litter tray, especially if your cat has not had parasite preventative medication.

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Overcoming pregnancy symptoms

What your body does during pregnancy is incredible, but it certainly takes a toll on your body if your nutrition is not optimal. The array of unusual pregnancy early symptoms rarely come up in conversation (amongst non-pregnant women), from pregnancy leg cramps to acid reflux, so they can often come as a surprise if you are expecting your first baby. It’s difficult to predict what the symptoms of pregnancy will be for you as an individual, but the most common include morning sickness, fatigue and pregnancy lower back pain.

Prenatal article - April 2023 (3)

Coping with morning sickness

One of the first pregnancy symptoms is often nausea or vomiting in the first few months of pregnancy (often starting around pregnancy 6 weeks). While commonly known as ‘morning sickness’, it can actually occur at any time of day. This reaction could be considered as your body’s natural defence system to warn you off foods which may be harmful to your unborn baby, but the cause is not well understood.

Not only is morning sickness an absolute nuisance, it can also cause problems with how much food is properly consumed, and therefore could lead to nutritional deficiencies. Deficiency of protein and healthy fats are the main issues, which could lead to muscle loss, and your skin, hair and nails may suffer too.

If you are trying to suppress those nauseous feelings, within the first hour or so in the morning, try sipping on a glass of warm water with fresh lemon juice and/or fresh sliced ginger. Ginger has been shown to significantly reduce symptoms for pregnancy nausea when compared to a placebo. (8)

At least 30 minutes after finishing your drink, eat something simple and plain, such as a rice cake, rye cracker or oat cake. Plain carbohydrate foods are usually easier to stomach at this time, as they are less overpowering for pregnancy nausea. If you feel well enough, try having nut butter, avocado or cottage cheese on your cracker, to help slow the release of carbohydrates from the cracker, to stabilise your blood sugar levels.

Dealing with fatigue & optimising iron levels

During pregnancy, early symptoms also include fatigue and weakness, and it can be quite debilitating for some, especially if combined with low iron levels. With hormonal changes and an increased nutritional demand during these early stages of development, it is no surprise that you will often feel you need to rest.

Listen to your body and take it easy if you are feeling fatigued. You can still carry on with most normal daily life activities, but don’t overdo it, and don’t start any new forms of exercise that your body is not used to. To protect your baby against any stressors and to reduce risk of miscarriage, it is important to take things slowly. Relaxing forms of exercise such as yoga and swimming are particularly suitable at this time and maybe it’s even time for a pregnancy massage!

Another possible cause of low energy levels during pregnancy is low iron, resulting in anaemia. There is a valid reason for why this may be: iron is vital for the blood to support the transport of oxygen around the body, so imagine how crucial this is at a time when your baby needs oxygen and the amount of blood in your body is higher than ever. Avoid iron deficiency anaemia and associated low birth weight (9) by eating plenty of iron-rich foods. Iron is most highly concentrated in red meat, seafood, seeds, nuts, beans and pulses. Iron is even high in cacao, giving us a great explanation for our chocolate cravings! If your diet is low in these foods, you may wish to take an iron supplement. Although iron is required at higher levels during pregnancy, iron in high doses is actually toxic, so more is not always better.

Prenatal article - April 2023 (4)

Skin breakouts, dry skin & stretch marks

While we optimistically welcome a pregnancy glow for our skin, not everyone is so lucky. It’s actually quite common for the complete opposite to occur, and you may end up with skin issues.

If you usually have oily skin, you may experience breakouts while your hormones are running wild during the first trimester of pregnancy, but this often calms down later on in pregnancy. On the other hand, if you have dry skin, brittle nails and dry hair, this may be a sign that you are low on healthy fats. If your diet is low in fat, your baby will take the healthy fats from your skin, which could lead to dry skin and eczema during pregnancy, especially during the last 2 trimesters.

Whether your skin is oily or dry, you will almost always benefit from a good dose of healthy omega-3 to calm inflammation and provide moisture to your skin. Omega-3 fats are required for your skin, hair and nails, so if you aren’t having oily fish 2-3 times per week, then consider a high-dose omega-3 fish oil to provide EPA and DHA.

Although completely normal and usually harmless, if the possibility of developing stretch marks during pregnancy bothers you, there are a few new habits you could try to develop. Stretch marks are small tears of the skin which appear when an area of your skin grows quicker than your skin cells can replicate. Stretch marks are very common during pregnancy, but if you want to give your skin a boost of nutrition and blood flow, you may be able to help your skin cells keep up with your growing belly.

Key nutrients to support skin cell growth include zinc, iron, vitamin A, C and E and protein, specifically collagen. Omega-3 fats may also help to keep skin supple, keeping skin well moisturised from the inside.

Limit products which may dry out your skin (such as shower gels containing sodium lauryl sulphate), use a vitamin C serum, good moisturiser, and a natural oil such as rose hip or jojoba oil.

Any activities that increase blood flow are also great for improving the skin’s ability to replicate cells, so gentle exercise, skin brushing and pregnancy massage are all great to fit into your normal routine.

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Summary of the key supplements to take during pregnancy

As obtaining optimum levels of nutrients from the diet may be difficult during pregnancy, taking supplements may help you to reach your nutrient goals. Here are the key supplements to consider:


Taking a good all-round pregnancy-specific multivitamin will ensure that you are reaching your daily requirements of a wide range of vitamins and minerals, including folate and vitamin D.


To support brain development for your baby and to support your skin during pregnancy, take a high dose omega-3 EPA and DHA supplement.


If your protein intake is low (collagen is created from amino acids derived from protein in the diet), you may benefit from taking a collagen powder to support your skin health.

Suitable if your diet is low in dairy or other calcium- and magnesium-rich foods. Calcium and magnesium are often present in multivitamins, but only at low levels. For an adequate dose, this is best taken as an additional supplement.


1. Brenna JT, Carlson SE. Docosahexaenoic acid and human brain development: evidence that a dietary supply is needed for optimal development. J Hum Evol 2014 Dec;77:99-106

2.Fekete K, Berti C, Cetin I, Hermoso M, Koletzko BV, Decsi T. Perinatal folate supply: relevance in health outcome parameters. Matern Child Nutr 2010 Oct;6 Suppl 2:23-38.

3.Czeizel AE, Dudas I, Vereczkey A, Banhidy F. Folate deficiency and folic acid supplementation: the prevention of neural-tube defects and congenital heart defects. Nutrients 2013 Nov;5(11):4760-75.

4.Obeid R, Holzgreve W, Pietrzik K. Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects? J Perinat Med 2013 Sep 1;41(5):469-83.

5.Winzenberg T, Shaw K, Fryer J, Jones G. Effects of calcium supplementation on bone density in healthy children: meta-analysis of randomised controlled trials. BMJ 2006 Oct 14;333(7572):775.

6.Goodfellow LR, Cooper C, Harvey NC. Regulation of placental calcium transport and offspring bone health. Front Endocrinol (Lausanne) 2011;2:3.

7.Avalos LA, Roberts SC, Kaskutas LA, Block G, Li DK. Volume and type of alcohol during early pregnancy and the risk of miscarriage. Subst Use Misuse 2014 Sep;49(11):1437-45.

8.Viljoen E1, Visser J, Koen N, Musekiwa A. A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutr J 2014; 13:20.

9.Domellof M. Iron and other micronutrient deficiencies in low-birthweight infants. Nestle Nutr Inst Workshop Ser 2013;74:197-206

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This article focuses on optimising nutrition for you and your developing baby and relieving common pregnancy symtoms. If you require more support, feel free to contact our approachable team of nutrition professionals who will be more than happy to support you further or point you in the right direction.


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The use of targeted diet,supplement and lifestyle interventions


What is the dawn rule of 10 in pregnancy? ›

5 time checkups for normal pregnancy,10 times or more checkups for high risk pregnancy,started checkups since 10th week,18th week,24th wk,28th wk, 32th.

Can you get in trouble for no prenatal care? ›

In the United States, a woman's decision not to seek prenatal care can lead to legal consequences. If a baby is born with a health issue that could have been prevented or managed with prenatal care, the mother could face criminal charges, including neglect or endangerment.

Which trimester is the hardest? ›

What pregnancy trimester is the hardest? For many women, the first trimester of pregnancy is often the hardest. During this period, your body is going through a major transformation and needs time to adjust to the changes.

Can you have 2 placentas with 1 baby? ›

Two placentas are rare in pregnancies, including succenturiate pla- cental [1]. Two placentas with fused umbilical cord forming 3 ves- sels cord at the fetal end which has its own insertion site to each placental disc is an extremely rare case in a singleton pregnancy.

What is 411 pregnancy rule? ›

According to the "411 Rule" (commonly recommended by doulas and midwives), you should go to the hospital when your contractions are coming regularly 4 minutes apart, each one lasts at least 1 minute, and they have been following this pattern for at least 1 hour.

What is rule of 3 in pregnancy? ›

A detailed examination of the fetus is done in a systematic and reproducible manner. The "Rule of Three" approach entails visualizing 3 anatomical land marks in each part or plane of section of the fetus and its environment.

What happens to your baby if you don't take Prenatals? ›

If you're not taking prenatal vitamins, neural tube defects can appear: Anencephaly: This occurs when the baby's skull and brain doesn't form correctly. Babies that are born with anencephaly don't survive. Spina bifida: This occurs when the spine does not form correctly and the baby may have physical disabilities.

What happens if a mother does not get prenatal care? ›

Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care. Doctors can spot health problems early when they see mothers regularly.

What happens if I never go to the doctor while pregnant? ›

Protect your baby's health

If you go through pregnancy without appropriate prenatal care, your baby has a risk of low birth weight that's three times higher than babies born to mothers who received prenatal care.

What is the most fragile week of pregnancy? ›

The fetus is most vulnerable during the first 12 weeks. During this period of time, all of the major organs and body systems are forming and can be damaged if the fetus is exposed to drugs, infectious agents, radiation, certain medications, tobacco and toxic substances.

What's the worst week of pregnancy? ›

Even though it's called morning sickness, it can last all day and happen any time of day. At least 7 in 10 pregnant women have morning sickness in the first trimester (first 3 months) of pregnancy. It usually starts at about 6 weeks of pregnancy and is at its worst at about 9 weeks.

Which is the most delicate month of pregnancy? ›

First Trimester (0 to 13 Weeks)

Most miscarriages and birth defects occur during this period. Your body also undergoes major changes during the first trimester.

What is a Momo twin? ›

Understanding Monoaminotic 'Momo' Twins

Monochorionic twins are identical twins who share a single placenta. They represent around 70% of identical twin pregnancies. Monochorionic-diamniotic twins are identical twins who share a placenta, but each has their own amniotic sac.

What gender are twins with single placenta? ›

By definition, twins of a monochorionic pregnancy are of the same gender and share a single placenta (see Figs. 160.1 and 160.2). The intertwin membrane of monochorionic diamniotic pregnancies is composed of only two layers and appears thinner than the dividing membrane of dichorionic pregnancies.

Can two fathers father twins? ›

Can twins have different fathers? In rare cases, fraternal twins can be born from two different fathers in a phenomenon called heteropaternal superfecundation. Although uncommon, rare cases have been documented where a woman is pregnant by two different men at the same time.

What is rule of 5 in pregnancy? ›

The 5-1-1 Rule: The contractions come every 5 minutes, lasting 1 minute each, for at least 1 hour. Fluids and other signs: You might notice amniotic fluid from the sac that holds the baby.

What is the 5 5 5 rule pregnancy? ›

Prepare for the 5-5-5 rule: 5 days in the bed, 5 days on the bed, 5 days near the bed. This gives you a solid two weeks of focused intentional rest. It also helps to get your priorities in order when it comes to those eager visitors. They will get to see the baby, but they don't get to make the rules.

What is the 5 5 1 rule for pregnancy? ›

You may be in active labor if your contractions happen at least every 5 minutes, last for 1 minute each, and have been happening consistently for at least 1 hour.

What is the O code for pregnancy? ›

Pregnancy, childbirth and the puerperium ICD-10-CM Code range O00-O9A. The ICD-10 code range for Pregnancy, childbirth and the puerperium O00-O9A is medical classification list by the World Health Organization (WHO).

What does 3 5 mean in pregnancy? ›

4/5 = sitting on the pelvic brim. 3/5 = lower but most still above the brim. 2/5 = engaged, as most is below the brim. 1/5 or 0/5 = deeply engaged. If it's your first baby, engagement tends to happen in the last weeks.

What is the danger zone for pregnancy? ›

From a medical point of view, at 12 weeks a pregnancy is generally considered to be "safe". While a miscarriage (or later, stillbirth) can happen at any point during gestation, the odds are highest in the first trimester.

Is it OK to skip prenatal vitamins sometimes? ›

During that time, it's incredibly important that you get the right amount of folic acid. However, missing a day or two of taking your prenatal probably isn't going to make a difference for you or your baby as long as you remember to take your prenatal the rest of the time.

What vitamins shouldn't I take when pregnant? ›

If you're pregnant, you should avoid supplements and multivitamins containing vitamin A (retinol) - as too much of it can harm your baby's development. You should also avoid liver and liver products (including fish liver oil), as they are high in vitamin A.

How long can I go without Prenatals? ›

If you're not pregnant or planning a pregnancy, you can hold off on prenatals until you really need them (e.g., a few months before pregnancy, during pregnancy, and — often — for the duration of breastfeeding). Whether you're trying to get pregnant, or it's your third trimester, choose to nourish your body with Ritual.

What is considered late entry to prenatal care? ›

Notes: Late/No prenatal care is pregnancy-related care beginning in the 3rd trimester (7-9 months) or when no pregnancy-related care was received at all. Sources: National Center for Health Statistics, final natality data.

What is prenatal neglect? ›

Prenatal neglect means the unlawful use by a mother during pregnancy of a controlled dangerous substance that results in symptoms of withdrawal in the infant or the presence of a controlled substance in the infant's body.

Is prenatal necessary? ›

Taking prenatal vitamins before and during pregnancy lowers your baby's risk of complications like preterm birth and low birth weight, as well as congenital disorders, like spina bifida. Combined with regular prenatal care, taking prenatal vitamins is one of the best things you can do to give your baby a healthy start.

What can you refuse during labor? ›

For example, you have a right to refuse induction, decide whether or not to get an epidural, eat and drink during labor, and give birth in the position of your choice. You have the right to choose where to labor and give birth and leave the hospital or birth center against medical advice.

How long will doctor let you stay pregnant? ›

Most doctors and midwives are happy for you to go a few days over your due date as long as everything seems to be okay. Many will let pregnant women go up to two weeks over. After 42 weeks, however, the baby's health might be at risk.

What tests can I refuse during pregnancy? ›

What Can Mothers Refuse During Pregnancy?
  • Ultrasounds with No Medical Reason. For many women, just a single ultrasound is needed during pregnancy. ...
  • Cervical Exams. Cervical exams offer great screenings for certain problems like preterm labor arise, but routine cervical can be unnecessary. ...
  • Doctor Care. ...
  • Urine Testing. ...
  • Glucola.
Apr 24, 2018

Can you explain the 10 and 28 day rule for pregnancy? ›

A conservative approach used by some radiology facilities is to apply a 10-day rule only for examinations with the potential to deliver a high dose to the lower abdomen and pelvis, such as barium enemas and CT of the abdomen or pelvis. These facilities use a 28-day rule for all other examinations.

Why do they say 9 months pregnant when it 10? ›

Pregnancy is counted from the first day of your last menstrual period. This means an extra 2 weeks are counted at the beginning of your pregnancy when you aren't actually pregnant. So pregnancy lasts 10 months (40 weeks)—not 9 months—because of these extra weeks.

What chores should be avoided in early pregnancy? ›

Mopping, washing clothes, cleaning the floor and other chores which requires you to bend is not recommended during pregnancy. Pregnancy weight gain can cause a marginal shift in the body's centre of gravity and bending during this time can be risky for the sciatic nerve (runs from the lower back to the leg).

What is counted as first day of pregnancy? ›

Your weeks of pregnancy are dated from the first day of your last period. This means that in the first 2 weeks or so, you are not actually pregnant – your body is preparing for ovulation (releasing an egg from one of your ovaries) as usual. Your "getting pregnant" timeline is: day 1: the first day of your period.

What is the 521 rule in pregnancy? ›

Your doctor may have told you to follow the 5-1-1 rule. This means that you should call your doctor and head to the hospital when: Your contractions are coming every five minutes, or more frequently. Each contraction lasts one minute or longer.

Is 10 weeks too early to tell family about pregnancy? ›

At 10 weeks, you'll likely have had your first prenatal visit, where your healthcare provider has confirmed your pregnancy and assessed any risks. So, it might be a good time to share the news! But you may want to wait a couple more weeks when the risk of miscarriage is lower.

How many weeks are you when you first test positive? ›

If you get a positive test result on the first day of your missed period, it's probably about two weeks since you conceived. Some pregnancy tests can also give an estimation of when you might have conceived based on the level of HCG too .

What is the longest pregnancy on record? ›

The longest recorded human pregnancy was 375 days, or just over 12 and a half months, according to Guinness World Records. During this pregnancy, a woman named Beulah Hunter gave birth to a healthy baby girl in 1945.

How am I 4 weeks pregnant if I conceived 2 weeks ago? ›

Week 4 of pregnancy

For example, a fertilised egg may have implanted in your womb just 2 weeks ago, but if the first day of your last period was 4 weeks ago, this means you're officially four weeks pregnant! Pregnancy normally lasts from 37 weeks to 42 weeks from the first day of your last period.

Why is pregnancy counted from last period? ›

If you were having regular periods before pregnancy, your doctor will calculate your due date based off of your last menstrual period. This goes back to the fact that in order to get pregnant, your body ovulated—or released an egg—roughly in the middle of your cycle and it was fertilized by sperm.

Why shouldn't you bend when pregnant? ›

Pregnancy weight gain can cause a marginal shift in the body's centre of gravity and bending during this time can be risky for the sciatic nerve (runs from the lower back to the leg). So, if you feel uncomfortable while performing any task stop immediately.


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