Pregnant and want to stay well. What can I safely do?

Start with everyday habits. Wash your hands with soap for at least 20 seconds, as the US CDC advises, keep your distance from people who are coughing or have a fever and let fresh air into rooms, rest and protect your sleep, and keep food hygienic. Before taking any medicine or herbal remedy, including ones you buy yourself, check with a pharmacist, doctor or your antenatal clinic, and contact them straight away if you have a high temperature of 38°C or above.

Why does feeling unwell seem more worrying during pregnancy?

Many pregnant people say that an ordinary runny nose or sore throat feels more stressful than before. That is understandable, for the reasons below.

Many usual remedies need checking first

Before pregnancy, you might buy something from the pharmacy without thinking twice. England's NHS advises checking with a pharmacist, midwife or doctor before taking any medicine when you are pregnant, including painkillers and medicines you have bought. So it helps to know in advance who you will ask.

Tell your clinic about a high temperature

The NHS lists a high temperature among the pregnancy symptoms to get help for straight away, describing the signs as feeling hotter than usual, shivering, or a thermometer reading of 38°C or above. Keeping a thermometer at home makes it easier to know when to call.

Tiredness is common

The NHS explains that hormonal changes can make you feel tired, sick and emotional in the first 12 weeks, and that later on the extra weight you carry, an uncomfortable lying position and needing the toilet often can make it hard to sleep. Feeling run down this way is common in pregnancy, which is one more reason to look after rest.

What everyday habits help me stay well?

Wash your hands well and often

The CDC describes five steps: wet your hands with clean running water, apply soap and lather, scrub for at least 20 seconds, rinse under running water and dry with a clean towel or air dryer. Key times include before, during and after preparing food, after using the toilet, and after blowing your nose, coughing or sneezing. When soap and water are not available, the CDC says a hand sanitiser with at least 60% alcohol can be used.

Keep some distance and let in fresh air

The CDC lists good hygiene, such as washing hands regularly and cleaning commonly touched surfaces, and taking steps for cleaner air as everyday ways to stop germs spreading, and advises people who are ill to stay home and away from others. In practice, when someone at home or at work is coughing or has a fever, ask them to keep their distance and cover their coughs, open windows when the outside air allows, and wipe shared surfaces such as door handles and phones. If an older child is bringing things home from nursery, see My child often gets ill at nursery. How can we help at home?

Protect your sleep and rest

A 2018 analysis by Sedov and colleagues at the University of Calgary combined 24 studies with 11,002 pregnant women. On a standard sleep questionnaire (the PSQI), 45.7% had poor sleep quality, and the average score got worse from the second trimester (5.31) to the third (7.03). The studies used self-reported questionnaires and came from different countries, so the figures are a broad picture rather than a Thai figure.

For more on how short sleep adds up, see Why do I get ill easily after several nights of short sleep?

How can I keep food safe while pregnant?

The four steps

The CDC describes four steps to food safety. The temperatures below are converted from the CDC's Fahrenheit values.

On days hotter than 32°C, which are common in Thailand, use the 1-hour rule.

Foods to take extra care with

The NHS advises pregnant people to:

• cook chicken, pork, duck and other meat thoroughly, until there is no trace of pink or blood
• avoid raw fish and raw shellfish
• avoid unpasteurised milk and foods made from it
• cook cold cured meats, such as salami, pepperoni and prosciutto, until steaming hot
• wash fruit and vegetables thoroughly, because soil can contain bacteria that may make you unwell

Can I take medicine or herbal remedies when I feel unwell?

Check before you take anything

The NHS advises checking with your pharmacist, midwife or doctor before taking any prescribed medicine or medicine you have bought, and making sure any doctor or dentist knows you are pregnant before they prescribe anything. It also says never to stop a medicine that has been prescribed to keep you healthy without checking with your doctor first, because stopping could be harmful to both you and your baby. The CDC advises talking to your healthcare providers before starting or stopping any medicine, and including all prescriptions, over-the-counter medicines, herbal products and vitamins in that conversation.

How common medicine use is during pregnancy

These studies were done outside Thailand and rely on what women reported, but they show that taking something during pregnancy is common, which is why checking first matters.

"Natural" does not always mean suitable

The NHS says not all "natural" remedies are safe in pregnancy and advises telling your midwife, doctor or pharmacist if you are using herbal, homeopathic or aromatherapy remedies. In Thailand, that includes herbal drinks, traditional remedies and balms. Tell the pharmacist you are pregnant every time you buy something.

When should I contact my doctor or antenatal clinic?

Signs to act on straight away

The NHS advises getting help straight away for:

• a high temperature: feeling hotter than usual, shivering, or 38°C or above on a thermometer
• a change in your baby's movements
• vaginal bleeding or fluid leaking from the vagina
• sudden swelling of the face, hands, legs or feet
• a severe headache, or vision problems such as blurring or flashing lights
• breathlessness that comes on suddenly, or with chest pain or dizziness
• very severe vomiting
• pain in your tummy, pelvis or back, or any other pain you are worried about

Who to contact

Keep the phone number of your antenatal clinic or the hospital where you are booked somewhere easy to find. If you think it is an emergency, call 1669, Thailand's emergency medical number. At your next antenatal visit, ask which pharmacy products and home remedies are suitable for you, so you know before you need them.