When should I make my first appointment?

Call the office when you have a positive pregnancy test. Your first appointment will be scheduled for when you are around 7 weeks pregnant. At that visit, we will perform an ultrasound to look at the baby and confirm your due date.

How often will I see my doctor or midwife?

Each woman’s pregnancy is unique and your care will be individualized to meet your needs. In general, you can expect to be seen every four weeks until you reach 28 weeks. After that, you will be seen every two weeks until your 36th week. During the last month of your pregnancy (37 – 40 weeks), you will be seen every week.

When will I receive an ultrasound?

You will have an ultrasound done at your first visit to determine the number of babies and also to confirm your due date. If everything progresses normally, your next ultrasound will be done at 20 weeks. At that time, a detailed 4D ultrasound is done to scan for birth defects and other problems. This will also be the time when you can learn the sex of your baby, if you wish.

What types of tests are recommended during pregnancy?

All women will have blood work done at some point during the first or second trimester. These tests will check your blood count, blood type, and will look for other infections such as syphilis, hepatitis B, rubella, and HIV. It is important to screen for these infections for the health of your baby. You may also need a pap smear during the pregnancy and at that time you will be screened for other STDs that can cause serious problems for your baby. At around 26 to 38 weeks, you will be screened for diabetes with a simple finger-poke blood test.  In addition, you will be given the option early in the pregnancy to screen for other genetic abnormalities such as Down Syndrome, Cystic Fibrosis, and Spina Bifida. These tests are not required, but do give mothers and their doctors the chance to learn more about the baby. Ask your doctor for more information on these genetic tests.

Is it normal to have bleeding during early pregnancy?

Many women have some bleeding during the first 12 weeks of pregnancy. This is a common occurrence and typically does not mean there is a problem with the pregnancy. Bleeding can be caused by intercourse, a cervical infection, or from normal changes during pregnancy. Slight bleeding often stops on its own. If you are changing a pad more than once an hour, contact your doctor.

I am early pregnant and having cramping. Is that normal?

Yes. It is a common and normal to have cramping during early pregnancy. The uterus grows in pregnancy and this stretching can cause the uterus to contract or cramp. This is usually nothing to worry about and simply indicates that your baby is growing normally. To help with the pain, take 1 or 2 Tylenol, get off your feet, and drink plenty of fluids. If the cramping worsens, contact your doctor.

Is it normal to have pain down by my groin?

Yes. This is a very common problem called “round ligament pain.” This happens as the uterus grows in early pregnancy causing the ligaments that support the uterus to stretch. Most women experience this at some time. This can be treated with Tylenol, a heating pad, and a warm bath. It often helps to lie on the side that hurts the most (For example: if your left side hurts, lie on your left side). This takes the tension off the ligament and may bring relief. Typically, this pain will go away as you progress through the second trimester.

What can I take for morning sickness?

Morning sickness is a common problem in early pregnancy that is caused by rising levels of pregnancy hormones. If you are affected by morning sickness, try to eat at least six small meals a day and avoid spicy, greasy foods. It may be helpful to eat crackers before you get out of bed in the morning. If these tactics don’t work, you may try the over the counter remedies Vitamin B6 and Unisom (Doxylamine).

Which prenatal vitamins should I be taking?

Pregnant women should be taking a prenatal vitamin to provide additional nutrients that are needed during pregnancy. Choosing a prenatal vitamin should not be a complex decision as most all of the over the counter vitamins are acceptable options. Be sure that the vitamin you choose has at least 400 mcg of folic acid (aka folate or vitamin B9). Other important nutrients to look for include iron (40mg), calcium (1000mg), zinc, manganese, iodine, and vitamin B6.

Do I need to eat extra while I’m pregnant?

Most women only need to consume an extra 300 calories during pregnancy. A well-balanced diet is very important while you are pregnant and should include fruit, vegetables, and protein. The USDA has designed an interactive website with meal ideas for expectant moms and breastfeeding women. This plan is called, “Daily Food Plan for Moms,” is at http://www.choosemyplate.gov/pregnancy-breastfeeding.html.

Should I avoid eating fish while I’m pregnant?

“Predator Fish” such as shark, swordfish, king mackerel, and tilefish should be avoided because they are high in mercury that can harm a developing fetus. You should also avoid eating sushi that contains raw fish. You may eat up to 12 ounces per week (about two meals) of other common fish such as salmon, light tuna (not albacore), shrimp, and cod.

Can I drink caffeine during pregnancy?

Moderate caffeine consumption is safe during pregnancy. It is recommended not to drink more than 200mg of caffeine (Two 8-ounce cups of brewed coffee) per day. Higher caffeine intake may be associated with pregnancy complications.

What other substances should I avoid?

Please make every effort to stop smoking during pregnancy. Babies born to mothers who smoke tend to be smaller and have more problems after delivery. Smoking can also cause mothers to have lung problems, more colds, high blood pressure, and problems with the placenta. Alcohol should not be consumed during pregnancy. Drinking any type of alcohol raises the risk of certain birth defects.

What can I take for a cold?

Most over the counter medications are safe in pregnancy. These include Tylenol, Sudafed, Robitussin, Claritin, Unisom, Benadryl, and Mucinex. Avoid medications that contain aspirin, ibuprofen or alcohol. See “Safe Medications in Pregnancy” for a detailed list of common illnesses and suggested treatments. Please consult your doctor if you have any questions.

What can I take for constipation?

Unfortunately, constipation is a very common problem during pregnancy. It is best to start by eating a well-balanced diet that includes fruit and fiber and drink plenty of water (2 quarts per day or until your urine is a light yellow). If this does not help, you may try an over the counter stool softener such as Colace (Docusate) twice a day. If this fails to bring relief, you may also try Miralax, an over the counter laxative. This should not be used on a regular basis. If constipation persists, call your doctor.

How should I wear my seatbelt when I’m pregnant?

You should definitely continue to wear your seatbelt when you are pregnant. This protects both you and your baby. It is important to wear both the lap and shoulder belt. Buckle the lap belt low on your hips, below your belly.  Place the shoulder belt off to the side of your belly and between your breasts. Never place the shoulder belt below your arm. Your seat belt should fit snugly to avoid injury to you and your baby.

Are airbags safe in pregnancy?

Yes. They are designed to be used with your seatbelt and serve as another layer of protection if you are in an accident. If you are driving, the steering wheel should be at least 10 inches from your chest. As your belly grows, this may not be possible. In this case, try to angle the steering wheel towards your chest to help avoid injury to your abdomen in the event of an accident.

How much weight should I gain during pregnancy?

Women who are normal weight before pregnancy (BMI <25) should gain between 25 to 35 pounds. If you are starting the pregnancy slightly overweight (BMI >30), your goal weight gain is between 10 and 20 pounds. If you are more overweight (BMI >40) your goal is to gain around 5 pounds during the pregnancy. Ask your doctor for a personalized recommendation for your pregnancy.

Is it safe to exercise while I’m pregnant?

Yes. Exercise has many benefits during your pregnancy. Staying in shape increases your energy level, improves your mood, helps prevent back pain, and will make you more ready for labor. Safe exercise types include walking, swimming, aerobics, and cycling. You should avoid any sports where there is a high risk of falling such as gymnastics, skiing, and horseback riding and contact sports like soccer and basketball.

How vigorously can I exercise?

You should avoid activities that require quick changes of direction, jumping, and jarring movements as these can stress your joints and cause injury. Be careful that you do not overheat when exercising. Drink plenty of fluids and wear cool, loose fitting clothes. After the first trimester, avoid doing any exercises flat on your back. Stop exercising if you experience vaginal bleeding, contractions, chest pain, dizziness, or shortness of breath.

How can I prevent back pain in pregnancy?

Back pain is a common problem in pregnancy and is caused by changes in posture, hormones, and stretching of the abdominal muscles. To avoid problems, wear low-heeled (not flat) shoes with good arch support. Always lift by bending your knees and ask for help when moving large or heavy objects. Sleep on your side with 1 or 2 pillows between your knees. If you have to stand for long periods of time, place one foot on a stool or a box. When sitting, use good posture and place a small pillow to support your lower back. A regular exercise routine that includes walking or swimming is very important for preventing back injury.

What can I use to treat back pain?

Start by applying heat or ice to your lower back and have your partner massage the area. Stretches and exercises for the back can be very beneficial and will help increase muscle tone to prevent further injury. Swimming and walking are both excellent activities for both treating and preventing back pain. If none of these steps help, ask your doctor about other options such as support braces and physical therapy.

What can I do to prevent stretch marks?

Most women develop stretch marks at some point during the pregnancy. These occur when the skin stretches quickly as the fetus grows. Many lotions and oils are advertised that claim to prevent stretch marks, but none have been proven to consistently be effective. Using a heavy, moisturizing lotion will help keep your skin soft, but may not completely prevent stretch marks. Fortunately, many stretch marks fade with time. Using a sunless tanning lotion can help hide some of these marks.

Can I travel when I’m pregnant?

Yes. The best time to travel is typically between 14 and 28 weeks as most problems tend to happen in early or late pregnancy. During a car trip, make sure that you stop to stretch your legs and walk every 2 hours to help avoid blood clots. Airplane travel is safe, although some airlines restrict travel after 36 weeks. If you travel during the last month of pregnancy, you run the risk of delivering elsewhere. Check with your doctor before departing on any long trips.

 

Frequent Labor Questions

How do I know when I’m in labor?

When you are in labor, the uterus will contract causing your cervix to dilate. These contractions will cause your abdomen to become hard. Between contractions, your uterus will relax and your abdomen will become soft. Labor contractions are typically stronger than a painful menstrual cramp and will last for 30 to 70 seconds. They will become stronger as time goes on and get closer together. When they are coming at regular intervals (approximately every 3 to 5 minutes) and have lasted for 3 to 4 hours, contact your doctor.

I just went to the bathroom and noticed some blood spotting. Is that normal?

Yes. This is a very common finding during pregnancy and is usually not anything to worry about. This happens as the uterus grows causing the cervix to leak small amounts of blood. This usually will stop with time. Call your doctor if the bleeding increases or becomes heavy like a period.

What are other signs that labor may be beginning?

Continuous Leakage of Water – This may indicate that your water has broken. This is typically a large amount of fluid that will soak through your clothes and continues to leak even after the initial gush. If this happens, call your doctor. A small leakage of fluid that does not continue may just be urine leaking and is unlikely to indicate that labor is approaching.
Heavy Vaginal Bleeding – If you begin to have bleeding like a heavy period, call your doctor. This may be a sign that labor is beginning.  It is very common to have some spotting, especially after using the restroom. This is not usually associated with labor and will stop with time.

What is false labor?

Your uterus may contract off and on before your labor actually begins. These irregular contractions are called Braxton-Hicks contractions or false labor. They can be painful but typically do not come at regular intervals and are not as strong as true labor contractions. Braxton-Hicks contractions are a normal part of pregnancy.

How can I tell the difference between true and false labor?

 False LaborTrue Labor
Strength of contractionsUsually weak and don’t get stronger with time. Usually felt in the front.Get stronger as time goes by. More painful than a strong menstrual cramp.
Change with movementContractions may go away with walking, resting, or even with a change in position.Contractions continue despite changes in position or movement.
Timing of contractionsTypically irregular and don’t get closer together.Contractions are regular and get closer together (every 3 – 5 minutes) and continue this way for several hours.

What is normal baby movement?

The sensation of your baby’s movement will change during your pregnancy. You can expect to begin feeling movement between 16 to 18 weeks. Early on, this will be sporadic and you may not feel the baby move every day. As the baby grows, you will feel more and more movement. During the third trimester (after 28 weeks), your baby should move approximately 10 times every two hours. As the baby grows, the movement you feel will be smaller. This is normal. If you are ever concerned that your baby is not moving enough, find a quiet place to sit and have a snack or drink a glass of water. Mark down on a piece of paper each time you feel a movement (any movement counts). Stop when you feel 10 movements. This can be repeated each morning. If you do not feel 10 movements in two hours, call your doctor.