Frequently Asked Pregnancy Questions
We understand that pregnancy can be a time of excitement as well as apprehension. Each pregnancy is different, and we hope to help you have the most positive experience that you can. There are many questions and concerns that are common to pregnancy and our Raleigh gynecology practice has provided information on some of these topics here, including ideas for relieving some of the most frequent discomforts. Of course, we are always available to answer your questions in the office.
Nausea and vomiting in early pregnancy is not always limited to “morning” sickness. Eat small, frequent meals starting first thing in the morning. Avoid greasy and spicy foods. Make sure you are taking in plenty of fluids. Try sucking on peppermint or sour hard candy. Consider sipping on a carbonated drink. “Sea Bands” motion-sickness wrist pressure bands are available at drug stores and may be helpful. You may also try Vitamin B6 supplements, 100mg/day. Prescription medications may be recommended in some cases. Please contact the office if you are unable to keep down food and liquids for more than 12 hours.
Listed below are medications that you can safely use for minor symptoms and discomforts of pregnancy. In general, it is recommended that any unnecessary medications be avoided, especially in the first 12 weeks of pregnancy. Medications for chronic medical problems such as diabetes, high blood pressure, thyroid disease, and seizure disorders should be continued until you can talk to your physician about them.
- Acetaminophen (Tylenol)
- Do not use: aspirin, ibuprofen, or naproxen
- Cold symptoms
- Robitussin regular or DM for cough
- Sudafed PE (after 12 weeks of pregnancy)
- Saline nasal spray, humidifier for congestion
- Salt water gargles, Cepacol lozenges for sore throat
- Allergy symptoms
- Benadryl, Claritin, Zyrtec or Plain Allegra
- Tums, Mylanta, Pepcid or Zantac
- Do not use: Pepto-Bismol
- Colace, fiber supplements (Metamucil, Benefiber, Citrucel, Fibercon, Miralax)
- Increase water intake and natural fiber in your diet
- Avoid constipation
- Anusol, Preparation H, Tucks pads
- Yeast infection
- Monistat 7
- Imodium, Imodium AD
If any symptoms that you are treating over the counter seem to be worsening instead of improving, contact the office for advice.
Exercise in pregnancy is healthy and may help you to feel better and stronger. Most moderate intensity exercise routines can be safely continued in pregnancy. Recommended activities include walking, swimming, stationary bicycle, low impact aerobics, yoga, and free weights. Avoid activities requiring extended time flat on your back or standing still in one position. You may find that your balance is not as good during pregnancy. Drink plenty of fluids during your workouts, and discontinue any activity which causes abdominal pain, cramping, or back strain. Your physician will counsel you if any obstetrical/health reason arises requiring you to modify your routine.
A healthy balanced diet is very important during your pregnancy. The key to good nutrition is including a wide variety of foods including proteins, carbohydrates, fats, and minerals.
Things to avoid include raw or undercooked meat, alcohol, predatory fish (shark, swordfish, king mackerel, and tilefish). Also, avoid canned or fresh Tuna and limit other seafood (shrimp, etc) to 12 oz per week. Avoid unpasteurized milk and soft cheeses. Reheat deli meats until they are steaming hot. Limit consumption of fish from local rivers, lakes or ponds to no more than one 6 oz serving per week. Limit other fresh or canned ocean fish (salmon, tuna, flounder) or seafood (shrimp, oysters, clams) to no more than 12 oz per week.
Make sure to wash all fruits and vegetables thoroughly. It is also recommended by our Raleigh gynecology practice that you take a daily prenatal vitamin containing at least 1mg of folic acid to reduce the risk of birth defects and to ensure you are getting the extra nutrients that you need.
Every baby has periods of sleep and of activity through the day. You may start to feel occasional fetal movements starting around 17-21 weeks. By 24-26 weeks, you should feel several active periods of movement every day. If you feel at some time (after 26 weeks) that your baby is not moving adequately, perform a kick count. To do this, lie on your left side away from any distractions. Count all of the movements that you feel. When you get to 5, you may stop. If you do not feel at least 5 movements in an hour, call the office right away.
This is an optional blood test offered to low-risk patients in the 16th-17th week of pregnancy to assess the risk of chromosome abnormalities (such as Down’s syndrome) and birth defects (such as spina bifida). This screen cannot diagnose these problems or completely rule them out. It can only indicate an increased or reduced risk. Additional testing would be offered should your test results return abnormal.
A cesarean delivery may be indicated for many different reasons including the position of the baby, inability of the baby to fit through the pelvis, abnormalities of the placenta, and fetal stress with labor. Women may also elect to have a repeat cesarean section if they have undergone a cesarean delivery in the past.
In most cases, when a woman has had a cesarean section in the past, she will be given the option to consider a repeat cesarean section versus an attempted vaginal delivery with her next pregnancy. Vaginal birth after cesarean carries special risks, the most serious of which is the risk of rupture of the uterus, seen in 1/100 VBAC attempts. When a uterine rupture occurs, the mother and her baby may suffer significant complications. The advantages of VBAC when successful include more rapid recovery and shorter hospitalization. Your physicians will discuss these issues in detail with you in order to help you come to the best decision for you.
Cigarette smoking in pregnancy has been associated with increased risk of miscarriage, preterm delivery, low birth weight, placental abruption, and perinatal mortality. Following delivery, an increase in cases of respiratory and ear infections and of sudden infant death syndrome is observed in the infants of parents who smoke. Your doctors strongly encourage you to stop smoking and to ask for help if you need it.
All patients will be screened for diabetes of pregnancy in the second trimester. If results are elevated, a second confirmatory test will be ordered. Gestational diabetes affects 2-5% of pregnancies. Management includes consultation with an endocrinologist or a high-risk obstetric specialist, home blood sugar monitoring, and dietary changes to control blood glucose levels. Good control is necessary to promote normal growth of the baby and healthy development. Occasionally insulin is required to maintain desired blood sugar levels. If this is the case, you would be counseled regarding additional monitoring of the baby and any special considerations for delivery.
Swollen feet can be very common, especially late in pregnancy and in the warm weather months. This can be a sign of toxemia/preeclampsia, so if your blood pressure has been high or your swelling is associated with headaches, blurry vision, or nausea, you should contact the office. Most swelling is not related to toxemia. Limiting salt intake and drinking 8-10 glasses per day of water may help. Elevate your feet when you are able and consider using support pantyhose.
You may paint while you are pregnant. Make sure you use water-based paint only and work in a well-ventilated area. Limit painting to only 2 hours at a time and avoid sleeping in a recently painted room until the fumes are gone.
If you are experiencing a normal pregnancy without complications, you may travel by car or air up until the 36th week. We recommend that you stretch your legs while traveling at least every 2 hours and increase your fluid intake to avoid dehydration.
Your baby may change position frequently. By approximately 36 weeks, the majority of babies have settled into the head-down position. About 3% of healthy babies at term will present with the feet or bottom in the lowest part of the uterus–considered breech. Because of potentially serious risks, a vaginal delivery is not recommended if the baby remains breech. If the situation is appropriate, you may elect to undergo an (ECV) version procedure to attempt to turn the baby and increase the chances that you will have a vaginal delivery. The physician uses pressure on the mother’s abdomen to roll the baby into a head-down position. If the procedure is not successful or if you decide against a version attempt, then a cesarean delivery would be scheduled.
You can also try to encourage the baby to turn by using the following described positions. Place a supportive board or ramp against a couch at a 45° angle and lie on the board – head down and feet at the top for 5-10 minutes twice a day. You can also use pillows instead of a board to raise the pelvis off of the floor. These exercises may allow gravity to dislodge the baby’s breech from the pelvis, allowing him/her to turn.
You may have intermittent contractions through much of the pregnancy. These are called Braxton-Hicks contractions and they may or may not be painful. Labor occurs when the uterus tightens with contractions regularly every few minutes with increasing intensity. Other signs that labor may be approaching include a bloody or thick mucous discharge, increasing pelvic pressure, or loose stools. Your water may break during your labor or before it even starts. Or the physician may break the water to help encourage labor in the hospital. Call the office/answering service of our Raleigh gynecology practice when your contractions are strong and regular, about every 5 minutes, for about one hour. You should also call if you believe your water is broken, if you have a large amount of vaginal bleeding, or if your baby is not moving.
A full-term delivery may occur as early as 37 weeks or as late as 42 weeks (2 weeks past the due date). Allowing a pregnancy to continue beyond 42 weeks may increase the risks of harm to the baby and is not recommended. If you remain pregnant significantly past your due date, you will be assessed to see if the cervix is “ready.” Special tests may be done to make sure the baby remains healthy. Induction of labor would then be scheduled for between 41-42 weeks in most cases.