Pregnancy confirmation visit
Welcome to pregnancy! During these first three months, your body is undergoing many changes. Fatigue, nausea, backaches and mood swings are all very common at this stage. These usually go away as your pregnancy progresses. Some slight vaginal spotting is usually normal at this stage. However, any heavy bleeding or cramping signals the need for further evaluation, so please contact your physician.
We would like to see you for your first visit between 6-8 weeks, so please call for an appointment. At this initial pregnancy visit, we will perform an ultrasound to make sure the pregnancy is normal and then you will see your doctor. You will then be seen every 2-4 weeks after that.
Nutrition in pregnancy
In general, eating a well-balanced diet rich in fruits, vegetables, whole grains and a variety of other foods is great during pregnancy. Make sure all produce is washed thoroughly before eating..
Unpasteurized milk and cheese
These carry a risk of listeria, which is an infection that can be very serious to pregnant women and their unborn children. Most cheeses are now made with pasteurized milk – check the label if you are unsure.
Refrigerated pâté or meat spreads
Canned spreads should be fine.
Refrigerated smoked seafood (lox, nova-style)
Canned or shelf-stable seafood is okay.
Deli meats and hot dogs
These also carry the risk of listeria. They are safe if you heat these to steaming (160 degrees). Be sure to wash your hands after handling.
If you wish to eat bean sprouts during your pregnancy, they should be cooked to prevent listeria.
Sushi made with vegetables or cooked seafood is okay. All fish should be cooked!
Fish are a great source of omega-3 fatty acids and protein and should be a healthy part of your diet even during pregnancy. We recommend 1-2 servings a week. There are, however, a few fish you should avoid: tilefish, shark, king mackerel, marlin. Tuna should also be limited or avoided during pregnancy. Shellfish are fine to eat.
In addition, fish caught in local NC waters are high in mercury and should be avoided. Visit http://www.epa.gov/ost/fish for more information.
Drinking alcohol when you're pregnant can be very harmful to your baby. It can cause your baby to have a range of lifelong health conditions. Drinking alcohol during pregnancy can cause miscarriage, preterm birth and stillbirth.
Moderate amounts of caffeine are acceptable (one cup of coffee/tea or two sodas a day) are okay. Avoid high doses of caffeine (greater than 3 cups of coffee a day), especially in the first trimester, as this has been linked to miscarriage.
Visit http://www.fda.gov/aboutfda/centersoffices/officeoffoods/cfsan/default.htm for more information on food safety in pregnancy.
How much weight should I gain?
The recommended weight gain during pregnancy is 20-35 pounds for the average weight woman. If you were overweight pre-pregnancy, we would recommend that you gain less during pregnancy. If you are underweight or have a multiple gestation, we would recommend you gain more during pregnancy.
Can I exercise?
Yes, as long as you follow a few guidelines. It is generally safe to continue exercising at the same intensity you were doing pre-pregnancy. Pregnancy is not the time to start a new routine. You can continue strength-training and aerobic exercise. If you find that an exercise is uncomfortable or you feel off-balance, you should stop that part of the routine.
Many women find that walking, swimming and some types of yoga are comfortable throughout pregnancy. You, of course, want to avoid any exercise where you may have trauma to your abdomen. Make sure that during exercise, you drink lots of water to stay hydrated and to cool off. Saunas and hot tubs are off limits during pregnancy.
Can I travel?
Yes. We typically believe that travel is safe in pregnancy until 36 weeks gestation, unless complications such as preterm labor are present. Most domestic airlines will allow you to fly until 36 weeks (usually 35 weeks international).
If you do travel, make sure that you walk and stretch your legs every couple of hours. Also, make sure that you stay hydrated while traveling. Consider taking a copy of your prenatal record with you. If you are having complications of pregnancy, consult with your physician prior to travel.
Is it okay to continue being sexually active?
In general, sexual activity is safe throughout pregnancy. Some complications of pregnancy including preterm labor, vaginal bleeding and placenta previa may lead your physician to recommend avoidance of sexual activity.
Can I go to the dentist while pregnant?
Yes, you can continue to have routine dental check-ups during pregnancy. If you need dental treatment during pregnancy, local anesthesia is safe, but your dentist may require a note from your doctor. If you need antibiotics or pain medications, there are several you can take safely during pregnancy. Your dentist can contact us with any questions.
What medications are safe to take during pregnancy?
If you are taking any prescription medications, we recommend that you continue on them unless otherwise instructed by your physician. There are some over-the-counter (OTC) medications that you may take if needed during pregnancy. If these over-the-counter remedies do not help, please contact your physician for further advice and treatment.
- Tylenol (acetaminophen) 650 mg to 1000 mg every 4-6 hours as needed
- Do NOT use Advil, ibuprofen, Motrin, or Aleve unless directed by your physician
- Extra rest, fluids, a cool mist vaporizer and saline nasal spray are all non-medical options that can help.
- Antihistamines such as Benadryl (diphendhydramine) and Claritin (loratadine) can be used safely.
- Decongestants such as pseudoephedrine can be used for short-term relief (found in Mucinex-D, Sudafed, Claritin-D)
- Cough drops, throat lozenges, chloraseptic spray, Robitussin DM
- Tums, Rolaids, Mylanta, Gas-X
- Zantac, Pepcid, and Prilosec can be used if antacids are ineffective
Some nausea is considered normal during the first trimester and this usually improves when you enter the 2nd trimester. There are some things that you can do to feel better:
- Get up slowly in the morning. Sit on the side of the bed for a few minutes.
- Eat small frequent meals with snacks in between. Avoid an empty stomach.
- Stay hydrated with fluids (water, ginger ale, sports drinks, etc). Try seltzer water mixed with juice if you cannot tolerate water.
- Switch from your prenatal vitamin to a children’s vitamin with at least 400 mcg of folic acid daily (also, try taking the vitamin at bedtime).
- Try ginger ale, ginger candies, ginger tablets, or even a small amount of ginger held in your mouth.
- Avoid strong smelling foods and greasy foods. Avoid over-eating.
There are some over-the-counter medications that are safe and effective:
- Vitamin B6 25-50 mg two to three times a day.
- Unisom (generic name doxylamine) can be added to this: ½ tablet at bedtime (up to 3 times a day if tolerated).
- Emetrol can also be tried following the package directions.
Hyperemesis gravidarum is a more serious condition characterized by severe nausea/vomiting and weight loss greater than 5-10% of body weight. Please call for an appointment if you are concerned you could be suffering from this.
- Increase fiber intake including use of fiber supplements
- Colace 100 mg twice a day as a stool softener
- Milk of magnesia, magnesium citrate and miralax (polyethylene glycol) can be used if needed for more severe constipation.
- If no relief is obtained with the above methods, a tap water enema can be performed.
- Immodium for short-term use
- Monistat (3 or 7 day treatment recommended)
- Benadryl (diphenhydramine), Unisom (doxylamine), Tylenol PM