Frequently Asked Questions about Pregnancy

 

Choices Women’s Medical Center offers all services for our patients who think they are pregnant. Have questions? Scroll through the most frequently asked questions about pregnancy compiled by our staff. Feel free to contact us on chat (at bottom right corner of this page), make an online appointment, or call us to make an appointment.

When do I make my first OB appointment?

As soon as think you may be pregnant, you should schedule a Confirmation of Pregnancy Appointment at Choices. Depending on the results, you will be given an Initial Prenatal appointment about 2-4 weeks after. This allows enough time for the fetus to grow large enough to be seen on an ultrasound and a heartbeat is usually detectable as well through a sonogram.

When should I start taking prenatal vitamins and which vitamins are recommended?

Ideally, prenatal vitamins should be started approximately 3 months prior to conception. Starting these vitamins, as soon as you know you are pregnant will go a long way towards a healthy foundation for your baby. A good prenatal vitamin will have folate, B vitamins such as B12 and B6 and zinc. You should also take about 400mg of the essential fatty acid DHA for neurologic development and Vitamin D3 daily, which is especially important in the second and third trimester.

Which medications are safe during pregnancy?

It is best to limit medications while you are pregnant. If you have a diagnosed, medical condition for which medication is necessary, please call your Choices provider immediately so we can discuss how to best manage your medications.

There also may be times when medications are necessary for the relief of certain common conditions. Below is a list of over the counter medications that are considered safe during pregnancy. Take all medications as directed and do not exceed maximum daily doses. If the condition for which you are taking medications does not improve with 1 or 2 doses, call your Choices physician to discuss.

Condition

Approved Medication

DO NOT TAKE

Pain/Headache/Fever

Acetaminophen (Tylenol)

Aspirin, Ibuprofen, or Naproxen UNLESS PRESCRIBED BY YOUR DOCTOR. Do not take anything listed as an NSAID.

Cold Symptoms

Robitussin (regular or DM), cough drops, DayQuil/NyQuil, Benadryl, Vick’s Vapor Rub, saline nasal spray, humidifier, salt water gargle, Cepacol lozenges, chloroseptic throat spray

Sudafed is OK, but avoid frequent use, especially during third trimester.

Heartburn/Indigestion

Tums, Maalox, Mylanta, Pepcid, Rolaids, Zantac

Allergy Symptoms

Benadryl, Claritin, Zyrtec, Allegra, Flonase

Constipation

Increase water intake, prune juice and natural fiber in diet. Can also try Magnesium Citrate powder, Colace, Milk of Magnesia, and fiber supplements such as Metamucil, Benefiber, and Citrucel.

Rectal suppositories MAY be used, but avoid after 36 weeks. Avoid enemas or colon cleansers at any time.

Hemorrhoids

Avoid constipation. Also try Preparation H, Tucks pads, Anusol cream or suppositories, diaper wipes.

Gas

Gas-X (simethicone), Mylicon, Mylanta Gas

Skin Irritation

Calamine lotion, hydrocortisone cream, Neosporin ointment

Nausea

Vitamin B6, ginger, Emetrol

Diarrhea

Imodium, Kaopectate

Insomnia

Unisom, Benadryl

Yeast Infection

Monistat-7, Femstat, Vagistat. It is better to use the ovules rather than the cream.

Pain Medications

Darvocet, Tylenol #3, Vicodin, Demoral

Local Anesthetics

Lidocaine without Epinephrine

Antibiotics (unless you are allergic)

Amoxicillin, Penicillin, Ampicillin, Clindamycin, Erythromycin, Keflex

What should I expect at my first OB visit?

After your Confirmation of Pregnancy Visit, you will have your Initial OB Visit where you will have a thorough review of your menstrual history, medical history and all current and previous medications will be discussed. Either at the Confirmation of Pregnancy visit or Initial Visit, you will have an ultrasound.

What about my mental health during my pregnancy?

Your mental health is very important to us. You will meet with a social worker various times throughout your pregnancy within our program. From joyful anticipation to fearful concern, pregnancy is an emotionally complex process. Based on a psychosocial assessment completed at your initial visit, a social worker will work with you in identifying stressors and creating an individualized plan to address all of your concerns and prepare for the arrival of the baby. Six weeks after the birth of your baby, we will schedule your post-partum visit to ensure that you are having a healthy recovery from your pregnancy where you will also meet with a social worker again.

How often do I need to see the doctor during my pregnancy?

A doctor’s appointment will be scheduled every 4 weeks until 28 weeks, then every 2 weeks until 36 weeks, and every week until delivery after 36 weeks. The entire pregnancy is approximately 40 weeks. You will also be seen postpartum. Each pregnancy is different and may require more or less visits.

How often will I have an ultrasound?

Typically, within the first two visits (Confirmation of Pregnancy or Initial Visit) you will have an ultrasound.

Around 18-22 weeks, an anatomy ultrasound is performed at an outside OB office. This is a high-resolution ultrasound where detail of the baby’s anatomy (skeleton, organs, spinal column, facial & head development, fingers/toes, organs, growth, fluid, placenta, etc.) is measured. The gender of the baby may be revealed at this appointment if requested.

A growth ultrasound may also be performed around 36 weeks for estimated fetal weight and fetal position. Ultrasounds will be performed for medical indications any time throughout your pregnancy if needed.

What is genetic screening and is it mandatory?

These are tests that screen for chromosomal problems. Down’s Syndrome (Trisomy 21), Trisomy 13 and Trisomy 18 are the most common chromosomal abnormalities. These tests are non-invasive and will not bring harm to mother or baby. This screening is optional.

Two options are available for genetic screening:

  1. Nuchal Translucency Scan- Scheduled usually between 11-13 weeks, this ultrasound involves measuring the Nuchal Fold (skin thickness of the back of the baby’s neck). This non-invasive test can then be paired with a blood test done on the mother. These screening tests can then indicate if further diagnostic testing for abnormalities are needed.
  2. Penta screen – A blood draw done on the pregnant mother done between 15- 20 weeks. This blood draw has a higher false negative rate than the NT scan but also screens for the above syndromes.

I am over 35, what are the increased risks to my baby or me?

Women can have a healthy pregnancy and delivery in their 30’s and beyond. A nutrient dense diet, moderate exercise, healthy sleep hygiene and stress management are each crucial.

Additional testing is offered to expectant mothers over the age of 35. Our office will aid you in scheduling an appointment with a genetic counselor. The genetic counselor will discuss any increased genetic risks and offer a more detailed test for genetic screening.

If any tests are abnormal your genetic counselor will inform you of further diagnostic options.

When can I find out my baby’s gender?

Most women will find out the baby’s gender at the anatomy ultrasound that is scheduled usually between 18- 20 weeks. However, if you are over 35 and decide to do some of the advanced genetic testing, the gender can be revealed as early as 10 weeks. If you are under 35 you can ask your doctor about this blood test done to reveal the gender early too! However, there may be additional fees associated with this testing.

What kind of testing is done during the pregnancy besides genetic screening?

First Trimester (7-10 weeks) – Blood work that includes: blood count to screen for anemia, immunity to some childhood diseases, blood type & Rh factor, and some genetics. Urine culture will be collected, as well as bloodwork for STD’s, HIV, hepatitis B, syphilis, blood type, immunity to Rubella (an infection that may harm the fetus). Cystic Fibrosis, Sickle Cell disease/trait or hereditary anemia diseases can be screened for.

Third Trimester (30-34 weeks) – HIV and blood count screening is repeated in blood. (34-36 weeks) – Vaginal swab to check for Group B Streptococcus (GBS), bacteria that normally live in a woman’s vagina. Some women have more growth than others, which is nothing to worry about in non-pregnant women. However, if a baby is exposed to GBS during delivery he/she could get very sick. If you are positive for GBS, you will be administered antibiotics during labor.

How much weight should I gain during my pregnancy?

A healthy woman, neither over nor underweight, should gain between 25-30 pounds during the entire pregnancy. However, some women may not actually gain this much and that is acceptable as long as they are eating a nutrient dense diet. The first trimester can be difficult because of increased nausea and stomach upset. Do not panic if you do not gain; you may even lose weight in the first trimester. If you are experiencing frequent vomiting, an anti-nausea medication may help. On the contrary some women may retain more water during pregnancy contributing to more weight gain. A nutrient dense diet is the best way to avoid excessive weight gain during pregnancy.

What foods do I need to avoid during pregnancy?

There are three main food-borne pathogens of concern for pregnant.

women: Toxoplasma, Listeria monocytogenes and Salmonella enterica. These organisms can be passed to the fetus and increase the risk for spontaneous abortion, stillbirth or perinatal complications. Pregnant women are more vulnerable to these pathogens because the immune system is compromised/less effective during pregnancy. Therefore, it is best to avoid raw fish, raw meat and unpasteurized dairy. Heating deli meats for 10 seconds is recommended. Sushi is commonly eaten by pregnant women in Japan and there is much controversy surrounding the recommendation that it should be avoided by American women. It is always best to act on the side of caution. Avoid high mercury fish such as shark, tilefish, king mackerel, and swordfish. Avoid CANNED albacore tuna.

  • Avoid consuming alcohol during pregnancy as there is no scientific research that establishes a safe level of alcohol intake during pregnancy. Alcohol consumption is known to increase the risk of miscarriage, premature birth, and fetal alcohol syndrome. Fetal alcohol syndrome is associated with mental impairment, learning disabilities and other deformities.
  • There is no medical evidence that sugar substitutes such as aspartame (Equal) or sucralose (Splenda) are harmful in pregnancy. However, it is best to consume a real food diet while pregnant and most products with artificial sweeteners are not the most nutrient dense choices. Save these foods for special occasions.
  • Caffeine in moderate amounts during pregnancy appears to be non-harmful; no studies have shown caffeine to be linked with miscarriage. Again, act on the side of caution and try to limit coffee to one cup per day. We do not recommend soda consumption (diet or non-diet) during pregnancy due to the high sugar and low nutrient profile.

Is it safe to exercise while pregnant?

The benefits of exercise during pregnancy have been well documented. Not only does a regular exercise program strengthen and tone the muscles, it helps relieve tension, as well as the aches and pains many women experience during pregnancy. Exercising while pregnant has also been shown to promote an easier delivery, a more rapid recovery, and maximizes metabolism. The aim of an exercise program during pregnancy is to establish and maintain a level of general good health and fitness. It should not be used as a means of weight loss. Pregnancy is never a good time to diet. There are, however, some activities that should be completely avoided during pregnancy. They include risky activities such as surfing, scuba diving, rough terrain mountain biking, skydiving, snow skiing, platform diving, and high-altitude mountain climbing. Activities that carry a high risk of falls or injury should be avoided. They include horseback riding, contact sports such as basketball, baseball, football, and volleyball, inline or ice-skating and racquet sports such as racquetball, tennis or squash.

If no exercise was practiced before becoming pregnant, the program will need to be less strenuous. Almost any type of exercise is safe if done in moderation. Keep in mind, however, that pregnant women are more susceptible to injury due to hormonal influences that cause joints and ligaments to become more lax than usual. There are several, recreational activities that are excellent for beginner exercisers. They include yoga, brisk walking, golf, swimming, and stationary bicycling.

The following exercises should be avoided:

  • Exercises that require jumping, jarring motions or rapid changes in direction
  • Exercises done lying flat on the back should be avoided after the first trimester. This position could allow the uterus to compress the large blood vessel returning blood to the heart. This situation can interfere with blood flow to the uterus and baby.
  • Strenuous exercise should be avoided in hot, humid weather, or during illness.
  • A pregnant woman’s temperature should not exceed 100.4 while exercising. To ensure this, she should drink plenty of water and avoid running outside in the heat of the day.

There are certain conditions in pregnancy, which would make it unwise to engage in an exercise program. Therefore, it is best to consult your Choices Provider for guidelines.

  • Hypertension (high blood pressure)
  • History of fetal growth retardation

If any of the following conditions are present, exercise should be avoided completely:

  • Ruptured membranes
  • Preterm labor
  • Vaginal bleeding
  • History of 3 or more spontaneous miscarriages
  • Heart or lung disease

What can I expect in the first trimester?

Hormone levels are rapidly rising in early pregnancy, which may cause some unpleasant side effects. Most women have extreme breast tenderness or fullness and it is common to feel extremely tired. Nausea is very common and can be associated with unpleasant smells/tastes. Women will find that a food or smell they liked before suddenly becomes very displeasing or revolting. If excessive vomiting occurs, there are several safe medications that can be prescribed to help minimize this occurrence. Many women will experience unpleasant gastrointestinal problems such as bloating, feelings of fullness, gas and constipation. Small, frequent meals may help. Drink LOTS of water! This will help for many reasons. If you are constipated, try a stool softener such as Colace twice a day or magnesium citrate powder. Increased fiber in the diet may also help.

Do not put too much pressure on yourself in the first trimester. Eat healthful food as tolerated, but there may be days when nothing sounds appealing. Protein shakes are another good option if tolerable.

What do I do if I start bleeding during pregnancy?

Bleeding when you are pregnant is never a good thing, but it does not always mean something terrible is happening. Always call us at 718-786-5000 ASAP if you experience bleeding during any stage of pregnancy.

First trimester bleeding/spotting in pregnancy can be common and does NOT always mean a miscarriage is imminent. Bleeding during implantation can be common and may resolve on its own. Also, the cells on a woman’s cervix change during pregnancy and bleed easily when touched, especially during intercourse.

When calling your Choices provider, be prepared to answer the following questions: Are you having severe cramps/pain with bleeding? Is the bleeding bright red or brown? Have you soaked any pads or is it just spotting? Have you recently had intercourse? More than likely we will have you make an appointment, so we can monitor the pregnancy and make sure you and the baby are still ok. If the bleeding starts after office hours, you may be instructed to go to the Emergency Room.

Second/Third Trimester bleeding may indicate a few things: the placenta could possibly be near your cervical opening, the placenta could be detaching, or possibly even early labor. Always call your doctor immediately if you experience any bleeding at this point.

Can I continue to have sex during pregnancy?

Yes! You can continue having sexual intercourse if you have an uncomplicated pregnancy. Check with your doctor if your pregnancy is considered high risk or if you have any concerns. In most cases, sex can be enjoyed throughout your pregnancy.

Some couples fear that intercourse will harm the baby or cause a miscarriage; however, the baby is very well protected by the uterus and the amniotic sac (bag of water). Intercourse will not cause the bag to break or hurt the baby. It is always best to consult your doctor for specific information, but, in general, comfort should be the determining factor with regard to sexual activity. It is best to observe the following precautions:

  • Avoid full body weight on the woman’s abdomen. Intercourse with both partners lying on their side is frequently more comfortable.
  • Do not have sexual relations if you are bleeding, leaking fluid from the vagina, or having pre-term labor.
  • Do not have sexual relations if you know your membranes are ruptured.
  • Nipple stimulation can cause the uterus to contract and may initiate preterm labor.
  • AFTER THE BABY: Intercourse is best postponed until after your postpartum visit with the physician. This will give the vaginal wall time to heal. In most cases, it is safe to resume intercourse after 4-6 weeks.

Is it common to experience pain during pregnancy?

Occasional pain during pregnancy is a normal thing; the whole body is growing and stretching as the pregnancy progresses. Many women experience round ligament pain as early as the second trimester. These ligaments keep the uterus attached to your pelvic area; as your uterus and baby grow bigger these ligaments will stretch and pull. They attach near your pelvic bone so this pain can be felt from the vaginal area to mid abdomen. Your rectus muscles (abdominal muscles) will also be stretched apart to make room for a growing uterus. This pain can be felt in the pelvic area and sometimes around the top of the abdominal area. It is completely normal for the above pains to come and go throughout pregnancy. If you are ever concerned about the intensity of your pain call your Choices provider.

Back pain in pregnancy is another normal occurrence because the spine naturally curves more during pregnancy and puts more strain on your back. You can try to wear a belly band or use Aspercreme to help alleviate this.

Hemorrhoids are common during pregnancy, especially in the third trimester. Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They can become painful, itchy, and irritated. You’re more likely to get hemorrhoids if you’re constipated, because straining to have a bowel movement swells your veins. Your growing baby also puts pressure on the large veins behind your uterus. You should call your doctor if yours bleed or hurt a lot. Hemorrhoids usually go away soon after your baby is born. Also see approved relief medication in the answer to the question, Which medications are safe during pregnancy?

Leg pain/nerve pain is also normal. As the uterus grows it compresses many nerves in

your pelvic area that travel to your legs. Most women will have pain in one leg more than the other depending on how your baby is sitting.

Carpal tunnel syndrome is common during pregnancy due to the swelling of the tissues around your wrists. You may experience hand or finger pain and tingling, sometimes even numbness. Wearing a wrist splint at night may be helpful.

Varicose veins can occur during pregnancy, usually in the lower half of the body. This is because the uterus is compressing the veins that allow the blood from the lower half of your body to drain back up into your heart causing the blood to back up in the veins. This tends to get worse with each pregnancy. Some women may even get varicose veins in the vaginal region. These veins are usually harmless, although their appearance may be upsetting. Try wearing compression socks or tights to relieve the pressure. These will typically go away after the pregnancy is over.

Swelling in the legs and arms is very common during pregnancy. Your blood volume and tissues are all expanding as your baby grows and this may cause swelling. Some women swell earlier than others. Try to get off your feet as much as you can and wear compression socks or tights. Tell your doctor about this at your next visit to make sure it’s a normal occurrence.

How often can I expect to feel the baby move?

Typically, women will start to feel regular fetal movements around 25 weeks. It may be earlier depending on number of pregnancies and size of mom and baby. After 25 weeks you should typically feel fetal movement at least one to two times per hour.

How do I know if I am in labor?

Most women will not need to worry about labor until after 37 weeks. Braxton-Hicks contractions may happen long before; these cause the uterus to tighten and are often painless. Your stomach may feel like a hard bowling ball for a few seconds and then go away. A labor contraction will feel unlike anything experienced before, most women describe it as a really bad menstrual cramp. It can start near your back and travel to your pelvic area. Labor contractions will be timed at regular intervals and progressively get stronger and closer together. Each woman will interpret labor pains a little differently; some women even say it feels like indigestion.

When do I call Choices?

A physician or nurse can be reached at all times by calling 718-786-5000. After hours and on Sunday’s, an answering service will connect you with a Choices provider for emergencies. Please limit after hour calls to emergencies only. Prescription refills, test results, and general questions should be directed to 718-349-9100 EXT. 105 during office hours: 8:00 am-5:00 pm Tuesday- Saturday.

The following concerns warrant a call to your doctor regardless of the time or day:

  • Contractions that are still present for more than 2 hours, are getting closer together, or are painful enough where you cannot speak through them. You may also proceed straight to the hospital. However, if you go to the hospital before true labor has begun there is a high chance you will be sent back home.
  • Your water breaks – call us or go to hospital as soon as you can!
  • Any vaginal bleeding
  • Absence of fetal movement as described above (section on fetal movement)

What should I take with me to the hospital?

You may want to pack two small bags for the hospital or birth center: one for the items you’ll need during labor, and another for items that you won’t need until after you give birth.

For Labor:

  • Picture ID and insurance card
  • Eyeglasses, if you wear them. Contact lenses may be difficult while you’re in the hospital but are fine to wear.
  • Whatever will help you relax. Some possibilities are: your own pillow (use a patterned or colorful pillowcase so it doesn’t get mixed up with the hospital pillows), music and something to play it on, a picture of someone or something you love, anything else you find reassuring. If you’re going to be induced, think about bringing something to read or watch because it may be a while before labor is underway.

After Delivery:

  • A fresh nightgown if you prefer to wear your own after delivery
  • Snacks! After many hours of labor, you’re likely to be pretty hungry, and you may not want to rely solely on hospital food. So bring your own –fresh or dried fruit, nuts, healthy protein bars such as Primal Kitchen, Epic beef jerky or whatever you think you’ll enjoy.
  • Toiletries: Pack a few personal items, such as a toothbrush and toothpaste, lip balm, deodorant, a brush and comb, makeup, and a hair band or barrettes. Hospitals usually provide soap, shampoo, and lotion, but you might prefer your own.
  • Comfortable nursing bras or regular bras. Whether or not you choose to breastfeed, your breasts are likely to be tender and swollen when your milk comes in, which can happen anytime during the first several days after delivery. A good bra can provide some comfort, and breast pads can be added to help absorb leaks.
  • If you are planning to breastfeed, a nursing pillow may be helpful to have in the hospital.
  • Several pairs of maternity underpants. Some women love the mesh underwear usually provided by the hospital, but others don’t. You can’t go wrong with your own roomy cotton underpants. The hospital will provide sanitary pads because you’ll bleed after delivery. Make sure you have a supply of heavy-duty pads waiting at home!
  • Baby book of your choice
  • A going-home outfit for you. Bring something roomy and easy to get into (believe it or not, you’ll probably still look 5 or 6 months pregnant) and a pair of flat, comfortable shoes.
  • A going-home outfit for baby. Pack something special, but easy to slip on a newborn, for those precious first pictures. A cute hat and blanket is also helpful.

*Your infant safety seat must be in place before you will be allowed to take your baby home.

*Do not bring jewelry, excessive cash, or credit cards or other valuables with you.

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