Prenatal health

How well you take care of yourself during pregnancy has a direct effect on the health of your baby.

General Information

  • Although each pregnancy is unique, certain changes are common to all normal pregnancies. A basic understanding of physical and emotional changes during pregnancy helps a woman to understand pregnancy and have a positive experience. Preparing for pregnancy and birth is essential for this and can be accomplished by reading books, magazines and attending specialist prenatal classes (see ‘useful links’ under ‘useful information’)
  • Travel During Pregnancy. Travelling during pregnancy can be very enjoyable – it is much easier to take your baby with you in your womb rather than after birth with the pushchair, extra suitcases, etc…. Through the first two trimesters and into the third, it is perfectly safe to travel as long as you are not experiencing any complications and there are no reasons in particular for prohibiting travel. You can pass safely through the detectors at the airport but should aim to arrive on time and not have to run to the gate. On a flight you should stay hydrated and take an aisle seat so that you can walk around to help your circulation. For trips to foreign countries you should take advice from a travel clinic. It is not advised to visit countries affected by malaria when you are pregnant.
  • The average recommended weight gain during pregnancy is 12-14kg.

Preconceptual counselling

  • It is a good idea to arrange a consultation if you are considering trying for a baby. This provides the opportunity to check that there are no specific problems before you get pregnant and to discuss issues such as predicting the fertile period of your cycle.
  • A smear (PAP) test should be performed if you have not had one during the last three years and your immunity against Rubella (German measles) should be checked.
  • You should start taking 0.4 mg. of folic acid each day in case you become pregnant. Folic acid helps the formation of the baby in the first trimester and specifically decreases the risk of spina bifida. The spine forms around the time of your positive pregnancy test and so you should take folic acid whilst trying to conceive and not  wait for a positive test before starting.

Prenatal Screening

  • Urinary pregnancy kits provide accurate and fast results, and can detect pregnancy as early as 6 days after conception, or 1 day after a missed menstrual period. They are available in some general stores and in all pharmacies.
  • A variety of prenatal tests are available. While not all patients need or will have all the various tests, it is good to know what they are and to know that they are available.
  • Non-invasive prenatal testing (NIPTest, correctly termed the ‘cell-free DNA test’) – this is a relatively new test that analyses your baby’s chromosomes that are present in your blood. Possible abnormalities found by this test include Down’s syndrome and other abnormal copy numbers of chromosomes, deletions and duplications (‘bits’ of chromosomes missing or added on), and the test will also tell you the sex of the baby. There is no risk to the baby (unlike amniocentesis). It is highly accurate and takes 10 days for the result to be available. Unfortunately the test does not work for all patients for reasons that are still being evaluated. If this is the case then usually women are offered the Triple test (see below). Since July 2017,  Belgian health insurance companies reimburse this test. For those women with different insurance plans (from other countries), the test is usually reimbursed because it is ‘standard( here in Belgium. If not, the cost is 260 euros
  • Combined nuchal translucency test (commonly but erroneously referred to in Belgium as the ‘Triple test’) – this test is a screening test for Down’s syndrome and certain other chromosomal problems. It is performed between 11 and 14 weeks and was the routine test for chromosomal abnormalities until the NIPTest became freely available. It combines your age-related risk with the measurement of the skin thickness at the neck of your baby and a blood test for the levels of two hormones produced by the placenta. The result is available after 7-10 days and gives the probability of your baby having Down’s syndrome (eg: “there is a 1 in 1257 chance of your baby having Down’s syndrome”). 
  • Triple Test. The Triple Test is a prenatal blood test that measures alpha-fetoprotein (AFP), chorionic gonadotropin (hCG), and unconjugated estriol (uE3). The test is performed between the 14th and 19th week of pregnancy – it is usually performed if the NIPTest has failed to give a result.
  • Ultrasound. Ultrasound has been used for many years as a method of imaging a baby. There are no known risks associated with its general use. Modern scan machines provide excellent images but these depend on the conditions and the position of the baby. Please bring a USB key if you would like to have a picture of your baby. It is important to understand that no test is perfect and even with modern machines, problems with the baby are quite commonly missed.
  • Chorionic Villus Sampling. Chorionic villus sampling (CVS) is a procedure used to diagnose certain genetic problems in your baby in the first trimester of pregnancy. A needle is passed through your abdominal wall to obtain cells from your baby’s placenta. The test has been performed regularly since 1982, and many thousands have been performed around the world.
  • Amniocentesis. During amniocentesis a needle is passed through your abdominal wall into the amniotic sac of your baby. The cells in the fluid are examined principally to check that the number of chromosomes are correct. It is performed after 15 weeks gestational age.

Nutrition

  • Even before pregnancy begins, nutrition is a primary factor in the health of mother and baby. A well-balanced diet before conception contributes to a healthy pregnancy and will probably need few changes.
  • One of the most important things a woman can do to ensure a healthy pregnancy for herself and her baby is to eat a well-balanced diet Good nutrition during pregnancy is essential to creating an environment that allows the baby to grow and flourish.
  • When you are pregnant, your baby grows inside you. Everything you eat and drink while you are pregnant affects your baby.
  • Food can be contaminated with bacteria called toxoplasmosis. If you have never had this (or are unsure), you should take suitable precautions before and during your pregnancy – wash fruit and vegetables so that they are clean and do not contain any soil, and you should cook all meat thoroughly. A blood test is performed at the beginning of pregnancy to check your immunity and will be repeated every month if you have never had the infection. It is not dangerous for your baby if you get toxoplasmosis when you are breastfeeding.
  • You should eat pasteurised milk products (no soft cheese from the market), avoid raw eggs (in fresh mayonaise and Mousse au Chocolat) and avoid raw seafood. If you eat contaminated food, this can be dangerous for the pregnancy.