Frequently Asked Questions
I think I have morning sickness. What can I do?
Nausea and vomiting are two of the most common symptoms in early pregnancy. For many, they will resolve on their own as you transition into the second trimester. Some, unfortunately, experience these symptoms for a longer period of time.
Here are a few tips to help you manage nausea and vomiting:
- Eat smaller meals throughout the day instead of 3 larger meals. Plain foods like crackers, rice and bagels will settle more easily.
- Avoid triggers like an empty stomach, acidic foods or pungent odors.
- Ginger may help settle your stomach and can be found in many forms – lollipops, teas, drinks, hard candies and capsules.
- Pyridoxine (Vitamin B6) is available over-the-counter – you can take 25mg three times per day.
- A tablet of Unisom SleepTabs (Doxylamine succinate 25mg) can be taken at night with Vitamin B6. This combination helps with nausea the following day.
- Many women find relief with acupuncture.
If you are vomiting regularly, losing weight or unable to keep fluids down, please call the office to discuss if further precautions are needed or other prescription treatments would be recommended.
Are there certain foods to avoid during pregnancy?
Yes – there are certain foods that you should avoid eating during your pregnancy:
- Raw shellfish or eggs
- Raw or under-cooked meats
- Fish that contain mercury (shark, swordfish, king mackerel, and tilefish)
- Unpasteurized milk/cheese, juices, or ciders
- Foods that may contain Listeria (hot dogs, uncooked deli meats, or meat/seafood salads)
How much weight gain should I expect during my pregnancy?
We recommend that pregnant women who are currently at their ideal body weight consume an additional 300 kcal/day in dietary intake. Notice that that’s not very much!
Current weight gain recommendations depend on your pre-pregnancy weight and have been well established by ACOG, the Institute of Medicine (IOM), and the CDC:
|Body Mass Index (BMI)||Weight Gain
|Ideal Weight||18.5 – 24.9||25-35||37-54|
|Overweight||25 – 29.9||15-25||31-50|
What medications are safe to take during pregnancy?
It is difficult to “prove” the safety of prescription and over-the-counter medications, supplements, or topical creams/ointments during pregnancy. Our knowledge about medication safety in pregnancy is based on:
- Compiled registries that list complications caused by certain medications taken during pregnancy
- Animal models looking at the effects of medications during fetal development
It is important to review your current medications (hopefully before you conceive) to ensure that your regimen is appropriate and safe to continue during your pregnancy.
The following is a list of over-the-counter medications that are considered compatible with pregnancy:
|Headache, Fever, Aches||Tylenol|
|Allergy and Sinus||Benadryl, Sudafed, Actifed, Triaminic, Zyrtec, Claritin|
|Sore Throat||Chloraseptic spray, throat lozenges|
|Constipation||Colace, Senokot, Fibercon, Metamucil, Citrucel, Milk of Magnesium|
|Hemorrhoids||Tucks pads, Anusol, Preparation H|
|Heartburn||Tums, Mylanta, Pepcid, Prilosec|
Why am I constipated and what can I do?
Progesterone levels increase during pregnancy and this hormone slows your digestive tract, and this slower transit time results in more compact stool. Constipation is one of those other common symptoms that many women experience in early pregnancy.
Thankfully, we have several tips to help you poop!
- Eat a high fiber diet, including fruits, vegetables, bran cereal, whole grain breads and prunes. Your goal is 25-35 grams of fiber daily.
- If you aren’t getting enough fiber through dietary sources, a supplement like Metamucil is available over-the-counter and can help bulk up your intake.
- Stool softeners like Colace are safe to take during early pregnancy and you should follow the instructions on the bottle.
- Drink a lot of water! A good way to estimate your daily goal is to take your weight in pounds, divide that in half and that’s your water intake in ounces for the day. Ex: if you weigh 150 pounds, you would need 75 ounces of water daily.
- Get exercise and be active! Exercise increases blood flow to all of your organs, including your intestines. This encourages food to move through your gut.
- Natural Calm is an over-the-counter powdered magnesium supplement that helps dilate smooth muscles in our body. Since your intestines have smooth muscle fibers, it may help relieve constipation. NaturalCalm also helps with sleep, anxiety and restless legs.
- Laxatives are generally not recommended in pregnancy.
- Iron can cause constipation. Check your prenatal vitamin and if it contains iron or “ferrous sulfate,” you may want to change brands. Talk with your provider if you’ve been instructed to take an iron supplement as there are brands that are more easily digested.
If you see blood or have severe pain when having a bowel movement, please reach out to the office.
Is sex safe during pregnancy?
Go for it! In the majority of patients, intercourse is absolutely permitted.
Keep in mind that a small amount of bleeding or spotting is common after intercourse, especially during pregnancy. Your cervix has extra blood flow and any impact against it can result in some light bleeding. This is true after intercourse, an exam in the office or a pap smear while pregnant. If you notice bleeding after intercourse, you might want to abstain until you have spoken with a healthcare provider or until we have evaluated you in the office.
There are times in pregnancy when we would recommend against intercourse. If you have a shortened cervix or placenta previa, you should abstain.
Can I get a massage? What about hair coloring, nails and acupuncture?
Massage therapy is a great option for many of the aches and pains that occur during pregnancy. We recommend checking with your massage therapist to see if they are certified in prenatal massage.
We generally recommend that you avoid coloring or dying your hair in the first trimester as there is limited data available on the safety of most hair coloring products. With that said, one common thought is that topical application results in minimal systemic absorption and is not likely to have effects on the baby in the second or third trimester.
Manicures are safe if done in a well-ventilated area. Gel manicures use UV light to seal the nail polish and UVA radiation has been associated with the development of skin cancer. You should avoid gel manicures.
Acupuncture has proven beneficial for many different symptoms in pregnancy, such as nausea, back pain and sciatica. We recommend checking with your acupuncturist to see if they are certified to care for women during pregnancy or ask one of our providers for a referral. The same advice goes for Chiropractors and Reiki treatments.
Can I have physical therapy?
Physical therapy can be very useful during pregnancy, especially for women who have a history of an injury prior to pregnancy or other chronic pain. Speak with one of our providers to find out more about physical therapy and obtain information about referrals.
Can I travel?
Yes, you can travel during pregnancy. However, there are some restrictions that you should consider when making travel plans:
- Unexpected complications can occur during pregnancy and we recommend that you be aware of resources and hospitals where you could seek care, if necessary, at your destination.
- We would recommend against travel in the first trimester if you have had bleeding.
- We recommend against international travel after 32 weeks of pregnancy.
- We recommend against long distance (ie. >1-2 hours away from Sibley Hospital) after 36 weeks of pregnancy.
- Consider travel insurance for expensive trips.
- Airlines have different requirements for pregnant women and some may want a letter stating you are in good health and safe to travel. Please check with your airline carrier and give our staff at least 1 week’s notice to write a letter, if necessary.
Can I exercise?
Yes! In the majority of patients, exercise is absolutely permitted and encouraged.
In general, you should be able to continue your regular pre-pregnancy exercise routine throughout the first, second and third trimesters. Here are some helpful tips:
- Make sure you are able to talk through your exercise. If you are exercising and out of breath such that you cannot finish a sentence, you may want to scale back.
- Your exercise should feel good.
- Always stop if you are experiencing pain or other new symptoms.
- You do not need to routinely track your heart rate.
- Do not scuba dive while pregnant.
There are certain pregnancy complications that may limit your ability to exercise. One of our providers will advise you if this develops during your pregnancy.
Can I sleep on my back?
Early in pregnancy, you’re welcome to sleep in any comfortable position.
In the third trimester, you should avoid sleeping flat on your back. The major blood supply from the lower half of your body, your inferior vena cava, travels up the right side of your body. This large vein carries blood to your heart which, in turn, pumps blood to your uterus, placenta and baby. Lying down flat can limit this blood flow. Try putting a large pillow under one hip or sleep on your side.
Am I allowed to continue drinking coffee or caffeinated beverages?
Studies suggest that consuming up to 300mg of caffeine per day is generally considered safe. There are some studies that show a slight increased risk for miscarriage if you consume more than that amount of caffeine per day in the first trimester.
Keep in mind that the actual caffeine content of a cup of coffee or tea can vary quite a bit. Factors such as processing and brewing time affect the caffeine level. Bottled beverages list caffeine content in milligrams or mg. You can use these numbers as a guide for some common caffeinated beverages:
- Brewed 8oz – 96mg
- Brewed, decaf 8oz – 2mg
- Espresso 1oz – 64mg
- Espresso, decaf 1oz – 0 mg
- Brewed black 8oz – 47mg
- Brewed black, decaf 8oz – 2mg
- Brewed green – 28mg
- Bottled ready-to-drink – 19mg
- Cola 8oz – 22mg
- Citrus 8oz – 0mg
- Root Beer 8oz – 0mg
What is cord blood banking?
Cord blood is blood that is left in the umbilical cord and placenta after delivery. This blood is rich in stem cells that can be used to treat some types of diseases.
At the time of delivery, this blood can be drawn and sent to a private or public cord blood bank. The umbilical cord can be saved as well. Private cord blood banks reserve these stem cells for your use should you ever need them, whereas public cord blood banks use these cells for research or for someone else in need.
How much time off can I expect to take after my delivery?
The usual amount of medically necessary time off after a delivery is:
- 6 weeks for a vaginal birth
- 8 weeks for a cesarean section
Our office can assist with disability forms – please allow 2 – 4 weeks to complete any necessary paperwork. Extensive paperwork and revisions may accrue additional fees.