Q. What medicines can I take?
A. Before taking any over-the-counter or prescription medication not mentioned below, you should check with the office. You should not take aspirin, ibuprofen, or naproxen sodium unless directed to do so by your physician or midwife. Regular strength acetaminophen (Tylenol) is the medication of choice for pain or fever. If you have a fever of 100.4 or higher, please call the office.
For sinus congestion with colds, allergies, or flu, pseudoephedrine (Sudafed) may be used. You also may use a saline nasal spray, such as Ocean or Nasal. Do not use Neosynephrine nasal spray for longer than 3 days. You may take Robitussin DM for coughs or chest congestion. A warm salt-water gargle is recommended for a sore throat. Throat drops, spray, or lozenges are acceptable. A cool air vaporizer may help you sleep at night. Increased fluid intake and getting sufficient rest are essential. If your nasal or throat drainage changes from a clear color, please call the office.
Q. What are the warning signs of pregnancy?
A. The important warning signs of pregnancy are and If any of these occur please contact the office immediately:
- Vaginal bleeding
- Leaking vaginal fluid
- Change or decrease in baby’s movement (once you start feeling movement at 18-24 weeks)
- Severe headaches accompanied by increased swelling in hands and feet and/or face and visual changes such as spots before your eyes
- Burning with urination
- Temperature above 100.4 degrees
Q. What are some common problems experienced during pregnancy?
A. Diarrhea – Should this happen increase your fluids intake to at least 6 to 8 glasses every day. Avoid milk or milk products until the diarrhea has stopped. Eat foods such as bananas, rice, apple sauce, tea, and toast for 24 hours. If you obtain no relief you may use Kaopectate or Imodium which can be purchased without a prescription. If the diarrhea continues for more than 24 hours, please call the office.
Constipation – You should be drinking 8 to 10 glasses of liquids a day while you’re pregnant. This will help to prevent you becoming constipated in the first place. Fruit juices such as prune and apple juice are very good at keeping you regular and should be included. You should also increase the fiber in your diet by eating bran or shredded wheat cereals, bran muffins, raw fruits and vegetables. Daily exercise, particularly walking, will also help to prevent constipation. If constipation should occur, there are several non-prescription medications that may be used – Metamucil, Citrucel, Fibercon, Per Diem, Fibermed Biscuits, Haley’s MO, and Milk of Magnesia.
Heartburn or Indigestion - Eat small, frequent meals (5 or 6 a day). Drink liquids, especially milk, between meals rather than with meals. Avoid fatty or fried foods, alcohol (which we recommend you avoid at all times during your pregnancy) and carbonated beverages. Sit up during and for one hour following meals. You may use non-prescription low sodium antacids such as Maalox, Tums or Rolaids – do not use one with simethicone (an anti-gas formula). Zantac or Pepcid may be helpful. You can also try eating crackers. If no relief with these measures, notify your provider.
Nausea (Morning Sickness) - Nausea and vomiting in pregnancy is commonly referred to as “morning sickness”, but it can occur at any time of the day or night, usually when the stomach is empty. Keeping something in your stomach by eating small, frequent meals (5 or 6 a day) will help to prevent it from happening. Avoid spicy and greasy foods. Try antacids to help settle your stomach and eat a clear liquid diet for 24 hours. If nausea is a problem when you get up in the morning, try a high protein snack before bed and eat something before getting out of bed in the morning such as pretzels or soda crackers. Dehydration can also increase your nausea so drink plenty of fluids. Avoid unpleasant odors. Over-the-counter seasickness medication helps some people. Taking your vitamin at night may help, or switching to a chewable formula. Emetrol, a sugar-based syrup, can be purchased without a prescription and may be helpful. Vitamin B6 over-the-counter is a good first choice in treating morning sickness. If these conservative measures are not successful in getting your nausea/vomiting to an acceptable level, please notify your provider. You should call the office anytime you are unable to keep fluids down for 24 hours.
Urinary Tract Infections - Symptoms of a urinary tract infection include pain or burning with urination and increased frequency of urination. The urine may be cloudy or have a strong odor. Unexplained lower abdominal cramping, often accompanied by a backache, can also mean a UTI. An untreated urinary tract infection can cause premature labor, so do not delay seeking treatment. If you suffer from these symptoms you should call the office and we will arrange a urinalysis for you. It is essential to drink plenty of water and fruit juices (8 to 10 glasses a day) if you think you have a urinary tract infection. You should also avoid caffeinated and carbonated beverages, as they can irritate the bladder and increase your pain and discomfort.
Edema - Some edema, or swelling, is normal during pregnancy. Generally edema appears in the ankles and legs during the final months of pregnancy. To reduce your discomfort you should elevate your legs whenever possible. Other things you can do are to rest on your left side and reduce your intake of foods containing salt (many foods such as fast food, pizza, deli meats, boxed food, ready made meals and food from a can or jar such as spaghetti sauce and canned tomatoes contain large amounts of salt). Drinking an adequate amount of water is the best way to get rid of excess swelling, so drink 8 to 10 glasses a day. Please call the office if the swelling is severe or if accompanied by a headache unrelieved by Tylenol, or if you have visual changes, or upper right abdominal pain.
Bleeding - Spotting of blood may occur in 40% of all normal pregnancies during the first trimester. If you are spotting, begin best rest and call the office. Avoid heavy lifting, exercise, and sexual intercourse for 48 hours after the last episode of spotting.
Q. How much weight gain can be expected?
A. The weight gain recommended during pregnancy is generally 20-30 pounds. However, this can be different for each individual. As everyone is different you should discuss your particular situation with your doctor.
Q. Can I eat meat, fish and poultry?
A. Meat, fish and poultry are all part of a healthy diet but you should make sure they are well cooked. However, fish and shellfish all contain traces of mercury which may be harmful to a baby’s developing nervous system. Pregnant or breastfeeding mothers should avoid shark, swordfish, mackerel and tilefish. Limit other seafood including canned tuna to 2 servings per week. >> Return to top
Q. Can I drink or use any drugs when I’m pregnant?
A. Alcohol - Alcohol can cause mental retardation and slow growth. Because medical researchers do not know how much alcohol it takes to affect the developing baby during pregnancy we recommend you do not drink. The fetus is especially vulnerable during the first trimester when all the major systems are forming.
Drugs - Recreational drug use, especially cocaine, can cause serious complications – miscarriage, fetal stroke, brain damage, and even fetal death. Your baby may become addicted to any drugs you take. If you have used such a substance during pregnancy, please alert your physician or midwife.
Q. Can I smoke?
A. Smoking harms your baby! Women who smoke during pregnancy have a greater risk of smaller babies, premature births, miscarriage, stillbirth, and increased respiratory problems in the baby after birth because smoking interferes with the oxygen and nutrient supply. In addition, the fetus is exposed to carbon dioxide, tar, and nicotine. Some studies show an increased risk of Sudden Infant Death Syndrome (SIDS) in babies exposed to cigarette smoke during pregnancy. There is recent evidence linking smoking to learning disabilities and growth retardation.
Q. Why do my gums bleed?
A. Your gums may bleed more easily when you are pregnant. This is because of the increased blood supply to the oral tissues during pregnancy. You should brush at least twice daily using a soft toothbrush and also floss once a day. You should continue routine dental care during your pregnancy but you must inform your dentist that you are pregnant. They will need to know this so that they can use the correct anesthetic and take the necessary precautions for X-rays.
Q. Should I exercise?
A. Regular exercise is important. Walking, swimming, cycling, and prenatal exercise classes are all recommended. Swimming is safe during pregnancy as long as your bag of water is not leaking. Low impact aerobics are an excellent way of exercising during pregnancy and classes are available in the community.
You may continue normal sports activity although you should keep your heart rate under 140 (take your pulse for 6 seconds, multiply by 10). Do not exercise lying flat on your back after 16 weeks of pregnancy. If any activity causes you pain you should discontinue it immediately. Be sure to discuss specific sports activities with your physician. Some exercises that are not recommended during pregnancy are snow or water skiing, ice skating, horseback riding, or other exercises that may expose your body to extreme physical jarring or impact.
Q. Can I have sexual intercourse?
A. Unless you’ve been told to refrain or there is a specific problem with the pregnancy, such as bleeding, leaking bag of water, or pre-term contractions, sexual intercourse is safe during pregnancy. It may be necessary to experiment to avoid discomfort. If intercourse is painful or causes bleeding or prolonged contractions (it is normal to have some contractions following intercourse), please talk with your physician or midwife.
Q. Is caffeine safe?
A. Caffeine, in moderation, is safe. Moderation is considered two or fewer caffeine containing beverages per day. If a mother drinks more caffeine, the baby can be born with a caffeine addiction. This addition will interfere with sleep patterns and eating during the first weeks. Beverages that contain caffeine include coffee, tea, chocolate and many carbonated soft drinks.
Q. Can I change my cat’s litter box during pregnancy?
A. You should avoid changing the kitty litter if at all possible since cat bowel movements may contain a parasite that can cause a serious infection. These infections can lead to birth defects. If you have to change the litter, use rubber gloves, wear a mask and wash your hands afterward. You should also wear gardening gloves when digging in the dirt in an area the neighborhood cats may use as a kitty litter box.
Q. Can I color my hair while pregnant?
A. As long as you have your hair colored, highlighted or permed in a well-ventilated room it is safe. However, due to hormonal changes caused by pregnancy you hair is unlikely to react in the same way as it did before you became pregnant.
Q. Can I use a tanning booth?
A. Pregnancy is not a reason to stop using a tanning booth. However, as skin cancer is now the most common form of cancer with more than a million new cases every year we recommend that you do not use them. All medical practitioners recommend you use a sun screen when outdoors whether pregnant or not .
Q. What types of tests are going to be performed during the pregnancy?
A. We will do the following routine tests during your first visit:
- Rubella Titer – We do this test to determine your immunity status to Rubella (German Measles). If the test shows non-immunity, the immunization will be offered to you when you deliver.
- CBC - A complete blood count is done to determine your body’s ability to carry oxygen and nutrients through it to your baby. This is repeated when we do the glucose challenge test (see below) and sometimes at around 36 weeks if we find you are anemic on an earlier visit.
- Blood Type and Rh, Antibody Screen - If you are Rh negative and the father of the baby is Rh positive, there is the possibility the baby could inherit the father’s blood type which could cause a problem during this or future pregnancies. Fortunately, we can prevent this in most cases by giving you an injection of Rhogam – this prevents your immune system from responding to the baby’s Rh-positive blood cells. If you are Rh positive, there is nothing to worry about.
- Hepatitis B - This test determines whether you have Hepatitis B, or if you are a carrier. If you are a carrier, your baby will need to be vaccinated at birth.
- HIV – we recommend HIV testing to all pregnant women. If you are infected, you can transmit the virus to the baby. We can decrease the chances of this happening with medications and pregnancy management, which is why we like to perform this test. The test can be performed at any time during your pregnancy if you decide not to have it at your first visit.
- Gonorhea/Chlamydia/Syphilis - Testing for sexually transmitted diseases.
- Pap Smear - This test detects cancerous and pre-cancerous changes in the cervix (the opening to the womb, located at the top of the vagina).
The following tests may be offered later in the pregnancy:
- Quadruple Screen Test - This blood test combines the results of four laboratory values, alpha-fetoprotein (AFP), estriol, Beta Human Choriogonadotropin (BHCG), and inhibin A to predict the chance that your baby has a chromosomal abnormality such as Down Syndrome or Trisomy 18 while also providing valuable information as to whether or not the spinal cord was inadequately developed leading to a neural tube defect (such as Spina Bifida). Results are reported as a ratio, such as 1:200 or 1:50,000. This test is done between 15 and 20 weeks and is offered to all pregnant women. It is your choice if you would like to have this test. This is a screening tool that if abnormal would lead to the recommendation for ultrasound and/or amniocentesis.
- Amniocentesis - Women who are 35 years or older during pregnancy have a greater risk than younger women of giving birth to a baby with a chromosomal defect (the most well-known is Down’s Syndrome). Amniocentesis is offered at this age because the risk of miscarriage from the procedure equals or is less than the risk of chromosomal birth defects. (Approximately 1:270 at the age of 35). We generally perform this test between the 14th an 16th week of pregnancy. Using ultrasound as a guide, a needle is placed through the abdomen into the uterus to collect amniotic fluid for testing. Cells obtained are cultured in a laboratory for evaluation of the chromosomes. Results of the studies are available in about two weeks. In addition, the fluid is tested for the level of alpha-fetoprotein, to detect a neural tube defect such as Spina Bifida.
- Chorionic Villi Sampling (CVS) - This test is offered to the same age group as amniocentesis, but is performed earlier in the pregnancy (10 to 12 weeks). A small sample of cells is taken from the placenta where it is attached to the wall of the uterus, rather than from amniotic fluid. Chromosomal birth defects, such as Down’s Syndrome, can be detected. Results of the chromosomal studies are available in approximately two weeks. The risk of miscarriage is about the same as with an amniocentesis but there is an additional risk of limb deformities with this test. The CVS is performed too early to detect neural tube defects. A separate blood test (AFP) can be performed between 15 and 20 weeks.
- Glucose Challenge Test (GCT) - This screening test is performed on all pregnant patients (who are not already known to be diabetic) between the 24th and 30th week of pregnancy as a screening test for gestational diabetes (diabetes during pregnancy). If your score is elevated, a nurse will call you to arrange for a 3 hour glucose tolerance test, a definitive test for gestational diabetes.
- Ultrasound or Sonogram - A sonogram is an image of the developing fetus produced using specially directed sound waves. This painless procedure can give information concerning the age of the baby, the position, the possibility of multiple gestation, and some major birth defects. Minor birth defects are usually not seen on routine ultrasound screens. Ideally this test is done between 18 and 20 weeks to allow for confirmation of the due date and adequate evaluation of the fetus.
For a Non-Stress Test, an external fetal monitor is placed on your abdomen. The baby’s heart rate is evaluated with relation to its movements. This test generally takes from 20 to 30 minutes and predicts the baby’s well-being inside the uterus. This test may be recommended for a variety of reasons, including:
- Multiple gestation
- Maternal smoking
- High blood pressure
- A perceived decrease in fetal movement
- Age (older than 35 or a teenager)
- Diabetes or gestational diabetes
Q. May I travel during pregnancy?
A. Most women can travel safely until close to their due date. For most women, the most comfortable time to travel is in the middle of pregnancy. Problems are least likely to happen during this time. During pregnancy, many women have concerns about seat belts. There is no question that you are much better off wearing your seat belt during pregnancy. The baby is very well protected in the uterus from trauma, but car accidents are the most common source of trauma during pregnancy. The most common reason for fetal death is maternal death, and maternal death is much less likely in mothers who wear seat belts. Both lap and shoulder belts should be worn at all times. The lap belt should be worn low on the hips, not over the uterus. Also remember that after delivery, an approved car seat must be in you car in order to take your baby home from the hospital. We recommend you not sit with your legs crossed and that you get out to walk every two hours.
People also have concerns about flying during pregnancy. In general, there does not seem to be an increased risk for women who fly during pregnancy. Any woman who sits for long periods of time without getting up for a walk is at risk for developing a blood clot in her legs. For this reason, on flights over two hours, you should get up, stretch your legs, and take a walk up and down the aisle. Because of this, an aisle seat is usually advisable.
Our office recommends that patients do not travel at all in their ninth month, and restrict travel to within two to three hours from home during their eighth month.
Q. What can I do for cold and allergy symptoms?
A. Colds are miserable things, even at the best of times, but there are increased concerns during pregnancy. Many things can relieve symptoms at home, sometimes eliminating the need for an office visit.
- Use a cool mist vaporizer/humidifier at night. This moistens the air you breathe to keep secretions flowing.
- Saline gargles (one teaspoon of salt in ½ cup warm water) every four hours while awake will cut the mucus in the back of the throat and relieves mild soreness.
- Any brand of saline nose drops (NOT regular Afrin or Neo-Synephrine) at bedtime and on arising in the morning will help moisten secretions.
- Tylenol (plain) two tablets every four hours if necessary for aches (maximum of six tablets in 24 hours.) Preferably not during the first trimester and not at all for one week before your triple test.
- Take your temperature, orally, twice daily – call us if your temperature is greater that 100.4 Fahrenheit.
- Coughing can be relieved with one teaspoon of honey and 2-3 drops of lemon juice. Hold this in your mouth until the honey thins and then swallow. If coughing interrupts sleep or causes vomiting, call your doctor. You may try Robitussin DM, an over-the-counter cough medication, after the first trimester.
- Increase fluids (especially water) to two quarts a day.
- Get extra rest, if possible.
- Actifed or Sudafed may also be use for symptom of congestion when taken as directed on the package. It is preferable that you not take this in your first trimester of pregnancy.
May I color or perm my hair during pregnancy?
Often pregnant women have concerns about the safety of hair dyes and permanents during pregnancy. There is no scientific data on this question, but it seems unlikely that these types of exposures are harmful.
Q. Are saunas, hot tubs, and tanning booths safe during pregnancy?
A. The use of saunas, hot tubs, and tanning booths is not recommended in pregnancy. The extreme temperature could potentially damage the developing baby. Extremely hot baths are not recommended during pregnancy. Bath temperatures should be below 100 ° Fahrenheit.
Q. What can I do for nausea and vomiting during pregnancy?
A. The following suggestions may be useful in relieving nausea and vomiting. First, try not to over eat. Additionally these foods may not be well tolerated:
- Greasy or fried foods, as they take longer to leave the stomach
- Very sweet foods
- Spicy hot foods
- Foods with strong odors
- Eat smaller, more frequent meals, that is six small meals and snacks.
- Drink fluids between meals, not with meals.
- Eat foods that are at room temperature or cooler. Hot foods may trigger nausea.
- Drink beverages chilled or cold. Decaffeinated soda is often well tolerated. Don’t opt for diet soda, you need the calories right now.
- Eat slowly and rest after meals. It is best to rest sitting in an upright position for about one hour after eating.
- Dry toast, soda crackers, or dry pre-sweetened cereals may relieve periods of nausea.
- Keep track of when you feel nausea and what causes it.
- If continued vomiting occurs, do not eat or drink anything until the vomiting has stopped. As you feel better, try some small amounts of clear liquids (broth, Jello, apple, grape, or cranberry juice, and/or popsicles.)
- Tart or salty foods such as lemons or pickles may help decrease nausea.
- Avoid mixing hot and cold foods at a meal, as it may stimulate nausea.
- Ask your doctor about medicine to control nausea.
- Avoid eating in a room that is stuffy, too warm, or has cooking smells/odors that may disagree with you.
- Wear loose fitting clothing.
- To avoid the sight/smell of foods, eat meals out or have others bring prepared food to you.
- These are signs that you need to call your doctor:
- Unable to keep anything down for more than two days
- Vomiting blood
- Rib pain
- Jaundice (skin is greenish or yellow)
- Your weight drops more than five pounds within a week
Q. Is it normal for swelling to occur?
A. A certain amount of swelling (called edema) is normal during pregnancy. It occurs most often in the legs. Elevating the legs usually makes the swelling less by the next morning. Swelling can begin during the last few months of pregnancy, and it may occur more often in the summer. Let your doctor or nurse know if you have swelling in your hands or face, because this may be a sign of another problem. A clue that your hands are swollen is that your rings are too tight. Never take medications (water pills) for swelling unless they have been prescribed for you.
- Elevate you legs when possible
- Rest in bed on your side
- Lie down with your legs raised on a small footstool or several pillows
- Do not wear stockings or socks that have a tight band of elastic around the legs
- If you must sit a lot on the job, stand up and move around from time to time
- Try not to stand still for long periods of time
Q. If I am pregnant and a family member has or has been exposed to chicken pox, what should I do?
A. Most adults are immune to chicken pox, either from having the disease or by forming immunity from a mild exposure. If you have had chicken pox in the past, you and your baby are protected. If you are not sure, ask your doctor to check your immunity with a blood test. If this shows positive immunity, you are both protected. If it shows no immunity, an injection of a medicine called Varicella Immune Globulin (VZIG) may be given to prevent chicken pox. In order to be effective, this injection must be given within 72 hours of exposure.
Q. What can I do for headaches during pregnancy?
A. Headaches are common during pregnancy. Usually headaches do not signal a serious problem. How often they occur and how bad they are may vary. It is important to discuss with your health care team which medications you can use for the headache. You should contact your doctor if your headache does not go away, returns very often, is very severe, causes blurry vision or spots in front of your eyes, or is accompanied by nausea. You may use Tylenol (acetaminophen) two regular tablets or one extra-strength tablet for headaches.
Q. What can I do to relieve constipation?
A. At least half of all pregnant women seem to have problems with constipation. One reason for this may be changes in hormones that slow the movement of food through the digestive tract. Sometimes iron supplements may also cause constipation. During the last part of pregnancy, pressure on your rectum from your uterus may add to the problem. Here are some suggestions that may help:
- Drink plenty of liquids – at least 6-8 glasses of water each day, including 1-2 glasses of fruit juice such as prune juice. Liquids (such as coffee, tea and cola) which make you go to the bathroom should not be drunk. They will tend to create a negative water balance in your body and thus make your stools harder and more difficult to pass.
- Eat food high in fiber, such as raw fruits and vegetables and bran cereals
- Exercise daily – walking is a good form of exercise
Q. Are leg cramps normal?
A. In the last three months of pregnancy, you may find that you have more leg cramps. Get plenty of calcium (three glasses of milk or supplement) and potassium (oranges or bananas.) Stretching you legs before going to bed can help relieve cramps. Avoid pointing your toes when stretching or exercising.
Q. Is it safe to paint during pregnancy?
A. Latex paints manufactured before 1991 used small amounts of mercury as a preservative. There was some concern that this mercury could present a health hazard, so mercury is no longer used in latex paints. The fumes from latex paints are not felt to be a specific risk to a developing baby, but it is always wise to paint in a well-ventilated area. The fumes from oil-based paints, turpentine, paint thinner, etc., are best avoided by pregnant women. Also, remember when painting to avoid use of a ladder to reduce the risk of injuries due to a fall.
Q. What can you do to reduce or prevent heartburn?
A. Indigestion is commonly called heartburn, but it does not mean that anything is wrong with your heart. It is a burning feeling that starts in the stomach and seems to rise into the throat. It occurs when digested food from your stomach, which contains acid, is pushed up into your esophagus (the tube leading from the throat to the stomach.) Liquids that you drink also take up space in your stomach, so they may also add to the problem.
Changes that take place in your body during pregnancy may worsen indigestion. Changes in your hormone levels slow digestion and relax the muscle that normally prevents the digested food and acids in your stomach from entering the esophagus. In addition, your growing uterus presses up on your stomach.
To help relieve heartburn, try the following:
- Eat five or six small meals a day instead of two or three large ones. (A glass of fluid may be equal in volume to a small meal, so avoid drinking large amounts of fluids with meals.)
- Avoid foods that cause gas, such as spicy or greasy foods
- Do not eat or drink several hours before bedtime
- Wait two hours after eating before exercising
- Antacids may be helpful, such as Maalox, Tums, or Gaviscon. Liquid will be more effective than tablets. If the problem is frequent and only briefly relieved by antacids, speak with your doctor or midwife.
Q. Are haemorrhoids common during pregnancy?
A. Very often pregnant women who are constipated also have haemorrhoids. Haemorrhoids are varicose (or swollen) veins of the rectum. They are often painful. Straining during bowel movements and having very hard stools may make haemorrhoids worse and can sometimes cause them to protrude from the rectum.
Do not take drug store cures while you are pregnant without first checking with your doctor or nurse. Haemorrhoids usually improve after the baby is born. Several things can help give relief or avoid the problem in the first place:
- Avoid getting constipated
- Eat a high fiber diet
- Drink plenty of liquids
Q. Are yeast infections common during pregnancy?
A. It is not uncommon to develop a yeast infection during pregnancy. If such an infection does occur, it is safe for you to use over-the-counter products, such as Monistat. These are readily available at stores.
However, if you are early in your pregnancy, before 12 weeks, it is important that the cream be used externally only. After 12 weeks, it is safe to gently use the applicator internally.
Q. Are herbs and extra vitamins safe during pregnancy?
A. No, your prenatal vitamins should be the only supplement used during pregnancy unless your provider specifically directs you to use an additional product.
This site is for informational purposes only and is not intended to provide medical advice. Please seek advice from a health care professional for any serious medical condition.
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