Many pregnant women fret too much about the wrong things, and pay too little attention to issues that can genuinely harm their pregnancy and baby. See how your concerns compare to other women’s, then learn whether or not your fears are well-founded and—the bottom line—what you can do to have a healthy and happy pregnancy.

First comes the excitement, followed immediately by the worry. Once you’ve adjusted to the fact that you’re pregnant, you may find yourself stressing about whether your baby will be born healthy . . . or you might have a miscarriage . . . or you won’t be able to stand the pain of labor . . . or be able to breastfeed. The list goes on and on.

If you tend toward worrying in the first place, there’s plenty of fodder in the news to keep you on high alert (killer cat litter, toxic sushi, collapsing cribs), and even the more laid-back among you may have moments of anxiety when the nurse is searching for the baby’s heartbeat on the ultrasound, it’s time for prenatal tests or seemingly strange symptoms arise. Add the surge in pregnancy hormones, and you’ve got a surefire recipe for angst.

But pregnancy risks are generally low, especially for healthy women, and don’t warrant a high level of concern on the part of most moms-to-be. To counter excess anxiety, experts advise trying to change the negative chatter in your head and tone down any extreme thoughts. “To do that you need to focus on the evidence that contradicts your worrisome thoughts,” says Sari Shepphird, Ph.D., a psychologist in Los Angeles.

That’s why we asked experts to provide a reality check on 10 of the things pregnant women worry about most, based on a recent March of Dimes survey (the number beside each worry is the percentage of respondents who reported having that concern). “If you keep reminding yourself of the facts, it will reduce speculation, which in turn reduces worry and stress,” says Shepphird. Also, she says, instead of worrying about things you can’t control (that martini you had before you knew you were pregnant), focus on what you do have control over (how much weight you gain during pregnancy).

Here’s the bottom line on some of the fears you’re likely to face during pregnancy, along with issues you might want to pay more attention to (see “5 Things You Should Worry About,”). Plus, we tell you what really counts—the simple things you can do to move past worry and improve your chances of having a healthy pregnancy and baby.

1. Birth defects (78%)

REALITY CHECK About 97 of every 100 babies born in the U.S. arrive without a major birth defect, such as spina bifida or Down syndrome. That’s the optimist’s way of viewing the 3 percent risk of delivering a baby who does have one. Plus, many birth defects, such as club foot, webbed toes and even some heart defects, are minor or very treatable. “Surgical treatments are available nowadays, and many of them are very successful,” says Richard Olney, M.D., a clinical geneticist at the National Center on Birth Defects and Developmental Disabilities in Atlanta.

If you’re not in a higher-risk group, the chances that you’ll have a baby with a birth defect may be even lower: Risk factors include diabetes, epilepsy, smoking, drinking alcohol and obesity, although for 70 percent of all birth defects, the cause is unknown.

WHAT YOU CAN DO Act as if you’re pregnant as soon as you decide you want a child (or even before—half of all pregnancies in the U.S. are unplanned). “Most structural birth defects occur as early as a week or two after you miss your period,” explains Michael Lu, M.D., associate professor of obstetrics and gynecology at the David Geffen School of Medicine at the University of California, Los Angeles. Waiting until you know you’re pregnant may be too late to prevent these defects.

Take at least 400 micrograms of folic acid daily to reduce the risk for neural-tube defects, such as spina bifida; eat a healthy, balanced diet; avoid fish that contain mercury; stop drinking alcohol, smoking cigarettes or using recreational or over-the-counter drugs; don’t eat undercooked meat or change the cat’s litter box (both are possible sources of toxo- plasmosis, an infection that can cause birth defects); lose weight, if needed; and make sure your blood sugar levels are normal.

2. Miscarriage (75%)

REALITY CHECK The risk of miscarriage is probably lower than you think. For women younger than 35, it’s 10 to 12 percent; for 35- to 39-year-olds, it’s 18 percent. (It does rise to 34 percent for women 40 to 44 years old.) But a great many pregnancies are lost so early that a woman never even realizes that she conceived. What’s even more reassuring is that by the time you see a heartbeat on an ultrasound (usually by week six or seven), the chance of having a miscarriage drops to less than 5 percent, says Lu.   

WHAT YOU CAN DO Remind yourself that most miscarriages occur because of chromosomal abnormalities that cannot be prevented; research does not show that exercise, sex or even heavy lifting can cause a miscarriage. One lifestyle caveat: Recent studies have shown that drinking two or more cups of coffee a day may increase your risk, as may contracting certain infections, including sexually transmitted diseases and gum disease.

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