Answers to Common Pregnancy Questions
Being pregnant is often an exciting time, but it can also raise many questions. You now have to think for two and take precautions to help ensure the healthy development of your baby. But you aren't the first woman to ask many of these questions. Below are some of the most common questions we are asked about pregnancy - from what foods are ok to eat, to symptoms to expect, and more.
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 your legs before going to bed can help relieve cramps. Avoid pointing your toes when stretching or exercising.
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.
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.
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, your hair is unlikely to react in the same way as it did before you became pregnant.
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.
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.
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.
Dental work is okay when you are pregnant, but you should make sure the dentist knows you are pregnant. If they take x-rays, you should be covered with a lead drape.
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.
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.
Inevitably, some pregnancies become high-risk after we begin taking care of them. However, depending on the high-risk reason(s), we may not accept some patients for care. When questions arise, these cases are evaluated individually by the physician.
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.
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.
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 addiction will interfere with sleep patterns and eating during the first weeks. Beverages that contain caffeine include coffee, tea, chocolate and many carbonated soft drinks.
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 your 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.
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 your car in order to take your baby home from the hospital. We recommend you not sit with your legs crossed and that you get up 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.
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.
The important warning signs during pregnancy are:
- 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
If any of these occur, please contact our office immediately.
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.
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.
The following suggestions may be useful in relieving nausea and vomiting. First, try not to over eat. 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
Additionally, the tips below may help relieve or reduce your nausea and vomiting:
- 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
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.
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.
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.