Staying healthy during pregnancy comes down to a handful of priorities: eating well, staying active, keeping up with prenatal visits, and avoiding a short list of genuinely risky substances and foods. Most of it is straightforward, and knowing the specific numbers and timelines makes it easier to follow through.
What to Eat and Which Supplements Matter
A prenatal vitamin fills the gaps that even a solid diet can leave. The most important nutrients during pregnancy, and the daily amounts your body needs, are:
- Folate: 600 mcg per day, critical for preventing neural tube defects in the first weeks of development
- Iron: 27 mg per day, supporting the roughly 50% increase in blood volume your body produces
- Iodine: 220 mcg per day, essential for your baby’s brain and thyroid development
- Vitamin D: 15 mcg (600 IU) per day, for bone growth and immune function
Most prenatal vitamins cover these amounts, but check the label. Iron in particular is worth verifying because some gummy prenatals skip it. If you weren’t already taking folate before conceiving, start immediately. Neural tube development happens in the first four weeks, often before you know you’re pregnant.
Beyond supplements, focus on whole foods: lean protein, fruits, vegetables, whole grains, and dairy or calcium-rich alternatives. You don’t need to eat for two. Calorie needs increase only modestly, by about 340 extra calories per day in the second trimester and 450 in the third. That’s roughly an extra snack, not an extra meal.
Foods to Avoid
Pregnant women are 10 times more likely to get a Listeria infection than the general population, and certain foodborne illnesses carry serious risks for the baby. The foods worth genuinely avoiding fall into a few categories.
High-mercury fish: shark, swordfish, king mackerel, and tilefish. Other fish and seafood are not only safe but beneficial. Aim for two to three servings a week of lower-mercury options like salmon, shrimp, tilapia, or canned light tuna.
Listeria risks: unheated deli meats, cold cuts, and hot dogs (heating them until steaming makes them safe); refrigerated pâté or meat spreads; soft cheeses made from unpasteurized milk like queso fresco, brie, camembert, and blue cheese; unpasteurized juice, cider, or raw milk; premade deli salads like coleslaw, potato salad, and chicken salad; and raw sprouts such as alfalfa or bean sprouts.
Raw or undercooked items: runny eggs, raw cookie dough or batter (both for the eggs and the raw flour), undercooked meat or poultry, and sushi made with raw fish. Also wash all fresh fruits and vegetables thoroughly, including pre-bagged lettuce.
Caffeine and Substances to Limit
The recommended maximum for caffeine during pregnancy is 200 mg per day, roughly two standard cups of coffee. That includes caffeine from tea, soda, chocolate, and energy drinks, so tally your total intake rather than just counting coffee. In a large cohort study, only about 6% of pregnant women exceeded this limit in the first trimester, and even fewer did later in pregnancy, suggesting most people manage this adjustment without much difficulty.
Alcohol has no established safe amount during pregnancy. The same applies to recreational drugs and nicotine, including vaping. If you’re struggling to stop any of these, your prenatal care provider can connect you with support that’s specifically designed for pregnancy.
How Much Exercise You Need
The goal is at least 150 minutes of moderate-intensity aerobic activity per week. You can split that into 30-minute sessions five days a week, or break it into smaller 10-minute blocks throughout the day if that feels more manageable. Walking, swimming, stationary cycling, and prenatal yoga all count. If you were a runner or lifted weights before pregnancy, you can generally continue with modifications.
Avoid activities with a high risk of falls or abdominal impact, like contact sports, skiing, or horseback riding. Jerky, bouncy, or high-impact movements also increase injury risk as your joints loosen throughout pregnancy.
Stop exercising and contact your provider if you experience vaginal bleeding, dizziness or faintness, shortness of breath before you’ve even started, chest pain, muscle weakness, calf pain or swelling, painful contractions, or fluid leaking from your vagina. These are warning signs that need immediate attention, not something to push through.
Weight Gain by BMI Category
How much weight you should gain depends on where you started. The CDC’s recommendations for a single pregnancy are:
- Underweight (BMI under 18.5): 28 to 40 pounds
- Normal weight (BMI 18.5 to 24.9): 25 to 35 pounds
- Overweight (BMI 25 to 29.9): 15 to 25 pounds
- Obese (BMI 30 to 39.9): 11 to 20 pounds
Weight gain is rarely steady. Most people gain little in the first trimester and then pick up to about a pound per week in the second and third trimesters. Your provider will track your weight at every visit, so you’ll get feedback along the way if anything looks off.
Prenatal Visit Schedule
Your first prenatal appointment typically happens around weeks 8 to 10. Expect an examination, blood work, a urine test, and possibly your first ultrasound. From there, the standard schedule is monthly visits until week 28, twice a month from weeks 28 to 36, and then weekly until delivery.
At most visits your provider will check your blood pressure, weight, and urine, and listen to the baby’s heartbeat. Specific screenings happen at set points. Between weeks 11 and 13, a first-trimester screening combines a blood test with an ultrasound that measures fluid at the back of the baby’s neck to assess the risk of certain chromosomal conditions. An anatomy scan around week 20 checks the baby’s organs, limbs, and growth. Glucose screening for gestational diabetes usually happens between weeks 24 and 28.
If you have a high-risk pregnancy due to conditions like high blood pressure, diabetes, or a history of preterm birth, you’ll likely have more frequent visits and additional monitoring.
Vaccines During Pregnancy
Two vaccines are routinely recommended for every pregnancy. The flu shot is recommended seasonally regardless of trimester. The Tdap vaccine, which protects against whooping cough, is recommended during each pregnancy between weeks 27 and 36. Getting Tdap in this window allows your body to produce antibodies and pass them to your baby, providing protection during the newborn’s first few months before they can be vaccinated themselves.
A newer recommendation is the RSV vaccine, given as a single dose between weeks 32 and 36 during RSV season (September through January in most of the continental U.S.). This protects infants from respiratory syncytial virus, which can cause severe illness in newborns. Hepatitis B vaccination is also recommended if you haven’t been previously vaccinated.
Sleep and Hydration
After 28 weeks, try to fall asleep on your side rather than flat on your back. Back sleeping in the third trimester can compress a major vein that returns blood to your heart, and research has linked it to a higher risk of stillbirth and babies born smaller than expected. Left-side sleeping is often cited as ideal, but either side is fine. If you wake up on your back, just roll over. A pillow between your knees or behind your back can help you stay on your side comfortably.
For fluids, aim for 8 to 12 cups per day (64 to 96 ounces). Your blood volume increases significantly during pregnancy, and dehydration can contribute to headaches, constipation, and even preterm contractions. Water is the best choice, but milk, herbal tea, and other non-caffeinated beverages all count toward your daily total. If plain water feels unappealing, adding fruit slices or ice can help.
Mental Health During Pregnancy
Mood changes during pregnancy are common, but persistent sadness, anxiety, hopelessness, or loss of interest in things you normally enjoy can signal something beyond typical hormonal shifts. Depression and anxiety affect an estimated 1 in 5 women during pregnancy or in the year after delivery, and they’re just as real and treatable as any physical complication.
Pay attention if you’re feeling overwhelmed most of the day, having trouble sleeping even when you’re exhausted, withdrawing from people you’re close to, or experiencing intrusive worrying thoughts about the baby’s safety. These patterns are worth raising with your provider. Treatment options, including therapy and certain medications considered safe during pregnancy, can make a meaningful difference. The earlier you address it, the better the outcomes tend to be for both you and your baby.