Pregnancy is one of the most profound experiences of a woman's life, and one of the most medically significant. In the Philippines, maternal and infant mortality remain higher than in comparable countries — largely because too many women access prenatal care late, rely on unverified traditional practices, or do not recognise warning signs that require urgent medical attention.
This guide is for every Filipina who is planning a pregnancy, already pregnant, or supporting someone who is. Our aim is simple: to give you the knowledge to make informed decisions, ask the right questions, and know when to seek care.
Pre-Pregnancy: Planning Ahead
The Preconception Check-up
The most important prenatal visit you can make is the one before you are pregnant. A preconception check-up with your OB-GYN identifies health issues that could affect pregnancy and allows you to optimise your health before conception. This visit should include: blood pressure measurement, blood glucose, complete blood count (to detect anaemia), thyroid function, blood type and Rh factor, cervical cancer screening (Pap smear), sexually transmitted infection screening, rubella immunity, and hepatitis B status.
Folic Acid: Start Now
Folic acid — vitamin B9 — is the single most evidence-supported preconception supplement. Adequate folic acid in the weeks before and after conception dramatically reduces the risk of neural tube defects (spina bifida and anencephaly) — conditions affecting the baby's brain and spinal cord that form in the first 28 days of pregnancy, often before a woman even knows she is pregnant. The recommended dose is 400–800 micrograms daily, starting at least one month before trying to conceive and continuing through the first trimester. Most prenatal vitamins contain this dose.
What to Stop Before Conceiving
- Smoking: Tobacco use is associated with miscarriage, ectopic pregnancy, preterm birth, low birth weight, and sudden infant death syndrome. Stop as early as possible — ideally before conception.
- Alcohol: There is no established safe level of alcohol consumption during pregnancy. Fetal alcohol syndrome causes permanent intellectual and developmental disabilities. Stop completely.
- Certain medications: Some commonly used medications are unsafe in pregnancy, including certain acne medications (isotretinoin), blood pressure drugs (ACE inhibitors), and some psychiatric medications. Review all your medications with your doctor before trying to conceive.
- High-dose vitamin A: Excess preformed vitamin A (retinol, not beta-carotene) is teratogenic. Avoid supplements containing high-dose vitamin A and liver consumption in excess.
Ideal Weight Before Conception
Body weight at conception significantly affects pregnancy outcomes. Women who are underweight face higher risks of preterm birth and low birth weight. Women with obesity face higher risks of gestational diabetes, hypertension (preeclampsia), caesarean delivery, and birth defects. If possible, working toward a healthy BMI before conceiving improves outcomes. Even a 5–10% reduction in weight in women with obesity can meaningfully reduce pregnancy risks.
Genetic Counseling
Filipino families with a history of genetic conditions — thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, Down syndrome in a first-degree relative, or recurrent miscarriage — should consider genetic counselling before pregnancy. Genetic testing can identify carrier status for conditions that may affect a child, allowing informed family planning decisions. CHH's OB-GYN team can facilitate appropriate referrals.
First Trimester (Weeks 1–13)
Your First OB Visit
Book your first OB appointment as soon as a home pregnancy test is positive — ideally before 8 weeks. This visit confirms the pregnancy with ultrasound, estimates your due date, establishes baseline health measurements, orders initial blood tests, and begins your prenatal care record. First trimester ultrasound is important for accurate dating, which affects the interpretation of all subsequent screening tests.
Prenatal Vitamins
Start a prenatal vitamin immediately. The key components are: folic acid (400–800 mcg), iron (27 mg), calcium (1,000 mg), vitamin D (600 IU), and iodine (150 mcg). Many Filipino women are iodine-deficient, and severe iodine deficiency causes intellectual disability in children. If you experience nausea from prenatal vitamins (common in the first trimester), try taking them at bedtime with food.
Morning Sickness
Despite the name, nausea and vomiting in pregnancy can occur at any time of day. It affects up to 80% of pregnant women in the first trimester and usually resolves by weeks 12–16. Strategies that help: eating small, frequent meals; avoiding strong smells; ginger in food or drinks; vitamin B6 supplementation (discuss with your OB). If vomiting is severe, frequent, and preventing adequate food and fluid intake — a condition called hyperemesis gravidarum — you need medical treatment, as dehydration and malnutrition can harm both mother and baby.
Miscarriage Risk and Signs
Around 10–20% of known pregnancies end in miscarriage, the vast majority in the first trimester and most due to chromosomal abnormalities in the embryo. This is important to understand: most miscarriages are not caused by anything the mother did or did not do. Signs of possible miscarriage include vaginal bleeding (especially heavier than spotting), cramping or pain in the lower abdomen, and passage of tissue. These symptoms require urgent evaluation. Not all early bleeding leads to miscarriage, and some pregnancies continue normally despite early spotting.
| First Trimester Milestone | When | What Happens |
|---|---|---|
| Positive home pregnancy test | Week 4–5 | hCG detectable in urine; book OB appointment |
| First ultrasound | Weeks 6–10 | Heartbeat visible; dating confirmed |
| Nuchal translucency scan | Weeks 11–14 | Down syndrome and other chromosomal screening |
| First trimester blood tests | Week 8–12 | Blood type, CBC, VDRL, hepatitis B, HIV, blood glucose |
| Morning sickness typically peaks | Weeks 8–10 | Usually resolves by week 14–16 |
Second Trimester (Weeks 14–27)
The second trimester is often called the "honeymoon" of pregnancy — nausea typically resolves, energy returns, and the pregnancy becomes visibly apparent. It is also the trimester with the most important diagnostic screening appointments.
Anomaly Scan (Level 2 Ultrasound)
The anatomy scan at 18–22 weeks is the most comprehensive ultrasound of pregnancy. It examines the baby's brain, heart, spine, kidneys, limbs, and face in detail, looking for structural abnormalities. It also assesses the placenta, amniotic fluid, and cervical length. This is typically when the baby's sex can be determined if desired. Attend this appointment — it is not optional screening, it is essential care.
Gestational Diabetes Screening
Gestational diabetes — high blood sugar that develops during pregnancy — affects approximately 1 in 7 Filipino pregnancies, a higher rate than global averages, reflecting the Filipino population's elevated diabetes risk. The glucose challenge test (GCT) is done at 24–28 weeks; if abnormal, a glucose tolerance test (GTT) follows. Untreated gestational diabetes increases risk of large babies, complicated delivery, and future type 2 diabetes in both mother and child. It is highly manageable with diet, monitoring, and if needed, medication.
Common Second-Trimester Discomforts
Backache, round ligament pain (sharp stabbing pains in the lower abdomen when changing position), leg cramps, heartburn, and nasal congestion are all common and normal. Varicose veins and haemorrhoids also frequently develop. Compression stockings, proper footwear, sleeping on the left side with a pillow between the knees, and avoiding prolonged standing help manage these discomforts.
Safe Exercise in Pregnancy
Exercise during pregnancy is beneficial — not dangerous. Regular moderate activity reduces gestational diabetes risk, controls weight gain, improves mood and sleep, may shorten labour, and helps postpartum recovery. Recommended activities include walking, swimming, prenatal yoga, and stationary cycling. Avoid contact sports, activities with fall risk, and exercises done lying flat on the back after week 16. Exercise can be continued throughout pregnancy unless your OB advises otherwise due to specific complications.
Third Trimester (Weeks 28–40)
Birth Planning
Discuss your birth preferences with your OB before 35 weeks. A birth plan is not about demanding a specific experience — it is about informed decision-making. Topics to discuss: your preferred delivery mode (vaginal vs. caesarean if medically indicated), pain management options (epidural, natural methods), who you want present during labour and delivery, cord clamping preferences, and newborn care preferences (early skin-to-skin, breastfeeding initiation).
Hospital Bag Checklist
Prepare your hospital bag by week 36. Include: your OB-GYN's contact information and prenatal records, PhilHealth ID and membership documents, a valid government ID, comfortable loose clothing and a change for discharge, toiletries, a phone charger, infant clothing and newborn diapers (hospitals usually provide some, but confirm with CHH), and your chosen breast pump if planning to breastfeed.
Signs of Labour
True labour contractions are regular, progressively stronger, longer, and closer together — they do not stop when you change position or rest. Braxton Hicks contractions ("false labour") are irregular, do not intensify, and typically ease with rest or hydration. Other signs of labour: rupture of membranes ("water breaking") — go to the hospital immediately regardless of contraction status; bloody show (pink or bloody mucus discharge); persistent lower back pain with pelvic pressure.
These symptoms at any stage of pregnancy require an immediate ER visit or call to (032) 255-8000:
- Severe headache that does not improve with paracetamol
- Visual disturbances — blurring, flashing lights, or seeing spots
- Sudden severe swelling of the face, hands, or feet
- Severe upper abdominal pain (especially right side or under the ribs)
- Heavy vaginal bleeding at any point in pregnancy
- Baby not moving as usual — reduced or absent fetal movement after 28 weeks
- Fever above 38°C
- Difficulty breathing or chest pain
- Signs of labour before 37 weeks (preterm labour)
- Rupture of membranes (water breaking) at any gestational age
Filipino Cultural Context
Hilot and Traditional Birth Attendants
Hilot — traditional Filipino healing massage — has cultural roots in communities across the Philippines. Some women continue to seek hilot during pregnancy, particularly for musculoskeletal discomfort. While gentle relaxation massage by a trained practitioner may be safe, abdominal massage during pregnancy carries real risks — including risk of placental abruption and premature labour. Traditional attempts to turn a breech baby through external manipulation by a non-medically trained hilot are dangerous and should not be done. Any massage or physical intervention during pregnancy should be discussed with your OB.
Herbal Remedies to Avoid During Pregnancy
Several herbal remedies commonly used in Filipino households are contraindicated in pregnancy due to uterotonic (contraction-stimulating) or other harmful effects:
- Lagundi (Vitex negundo): Some preparations may affect the uterus; avoid medicinal doses
- Sambong: Avoid in pregnancy; limited safety data
- Akapulko: Avoid during pregnancy
- High-dose herbal teas not specifically formulated for pregnancy
- Bitter melon (ampalaya) supplements in large amounts — has hypoglycemic and uterotonic effects
As a general rule: no herbal supplement, traditional remedy, or over-the-counter medication should be taken during pregnancy without first discussing with your OB. Even substances that seem natural and harmless may have powerful biological effects.
PhilHealth Maternity Coverage
Active PhilHealth members are entitled to maternity benefit coverage for up to 4 deliveries (normal spontaneous delivery, caesarean section, or miscarriage/ectopic pregnancy management). Coverage includes hospitalisation, physician fees for the attending OB and paediatrician, newborn care package, and certain antenatal services. To maximise your PhilHealth benefits at CHH:
- Ensure your PhilHealth contributions are up to date (at least 3 monthly contributions in the past 12 months)
- Enrol in the Maternity Notification process with PhilHealth before delivery
- Present your PhilHealth ID and MDR (Member Data Record) on admission
- Ask the CHH admissions team about Case Rate packages for delivery, which provide predictable coverage amounts
CHH Maternal Care Services
Chong Hua Hospital's OB-GYN department provides comprehensive maternal care from preconception through postpartum. Our obstetric team includes board-certified OB-GYN specialists with subspecialty training in maternal-fetal medicine (high-risk pregnancy), offering advanced monitoring and management for pregnancies complicated by gestational diabetes, hypertension, multiple gestation, or foetal anomalies.
CHH's Neonatal Intensive Care Unit (NICU) is one of the most advanced in Cebu, providing Level III neonatal care for premature infants or newborns requiring intensive support. For women with high-risk pregnancies or expectation of a premature delivery, CHH's integrated OB-GYN and Neonatology team provides seamless care from delivery through the NICU.
Postpartum care is also available through CHH, including breastfeeding support with certified lactation consultants, postpartum mental health screening and support, and coordination with CHH's Nutrition department for maternal and infant nutrition counselling.
Delivery options discussed with your OB at CHH include vaginal birth (including water birth where appropriate) and caesarean section. CHH's labour rooms are equipped for family-centred delivery, supporting the presence of a support person (partner or family member) during labour and birth when medically permitted.