What should I do before I get pregnant to ensure a healthy pregnancy?
A human Gestation is 40 weeks long, however many people don't usually consider the 3 to 6 months prior to conception an important part of the whole process. When many women come in for their annual exams and say “we are going to start trying to have a baby this year” we immediately start them on a prenatal vitamin. This is a multivitamin specifically formulated for pregnancy. It's particularly important to get sufficient folic acid before getting pregnant. This nutrient helps prevent birth defects like spina bifida; so you will need healthy levels of folic acid right from the start. If you choose to use an over the counter Prenatal Vitamin, look for a one that contains 1000 milligrams of calcium and 1000 micrograms of folic acid. Many women do not get enough calcium in their diets on a day to day basis. Why not get ahead start on your calcium intake. It keeps your bones strong and helps baby's bones and teeth develop.
We also discuss your social history, like smoking. If you smoke, quit. Smoking poses many risks to a developing baby, including spontaneous miscarriages, placental abruption, and low birth weight. You may also find it more difficult to become pregnant in the first place if you smoke, as smoking is linked with decreased fertility in both women and men.
Your diet plays an important role in conceiving and while being pregnant. We counsel you on your diet. We encourage eating a healthy diet (lots of leafy greens, lean proteins, and fiber). Increase your amount of water consumption to at least 8-10 8 oz glasses of water.
We review any medications that you are taking, and talk about any chronic illnesses or conditions that you may have as well. If you have any health problems, it is important to let us know. Get any health problems -- like diabetes and high blood pressure -- under control. If you are seriously overweight, talk to your doctor about how to maintain a healthy weight.
What Prenatal Tests will I need?
Once you are pregnant, we order a Prenatal Panel. This is a series of standard blood tests, which test for: hepatitis B, syphilis, recreational drugs, alcohol, anemia, your blood type and Rh factor and HIV. These are just a handful of the tests that are run, but commonly, the most important. Should you have questions or concerns about the different tests ordered, please DO NOT hesitate to talk with your doctor, BEFORE they are ordered and drawn.
Each individual has a blood type that is either the same as someone else or different. We classify the blood with 4 different blood types A, B, AB, and O. Each of the different blood types have proteins specific to that blood type on the surfaces of their red blood cells. Each of the four blood types is additionally classified according to the presence of another protein on the surface of red blood cells that indicates the Rh factor. If you carry this protein, you are Rh positive. If you don't carry the protein, you are Rh negative.
Most people - about 85% - are Rh positive. But if a woman who is Rh negative and a man who is Rh positive conceive a baby, there is the potential for a baby to have a health problem. The baby growing inside the Rh-negative mother may have Rh-positive blood, inherited from the father. Approximately half of the children born to an Rh-negative mother and Rh-positive father will be Rh positive.
When a woman with the potential to develop Rh incompatibility is pregnant, doctors administer a series of two Rh immune-globulin shots during her first pregnancy. The first shot is given around the 28th week of pregnancy and the second within 72 hours after giving birth to an Rh positive infant. Rhogam acts like a vaccine to prevent the mother's blood from developing antibodies to the unborn fetus's blood.
What should and shouldn't I eat while I'm pregnant?
You're eating for two, but just what are you two supposed to be eating? Should you really, literally, be eating for TWO?
Get all essential vitamins and minerals daily. Remember to take your prenatal vitamin. That means sticking with the prenatal vitamins you started prior to becoming pregnant, as well as eating a healthy diet. Fill your plate with leafy greens, fruits, and whole grains (like wheat breads and cereals). Get plenty of calcium-rich foods like broccoli and low-fat milk and yogurt, to help build your baby's bones and teeth. Stick to lean meats like chicken and turkey. Don't over do it. When you are pregnant you should ONLY add an additional 300-400 EXTRA calories a day.
Fish with lots of mercury. High levels of mercury can damage a baby's developing brain. Cut out fish like swordfish, tilefish and shark. If you love your tuna and snapper, you can still eat it -- just cut back.
Raw fish
Soft cheeses like brie, feta, gorgonzola, and Roquefort. They may contain bacteria called listeria that can cross the placenta, potentially causing miscarriage or leading to a life-threatening infection.
Alcohol. There is no known safe level of exposure to alcohol for a fetus. Prenatal exposure (in the womb) to alcohol can interfere with baby's healthy development and lead to fetal alcohol syndrome, FAS, one of the most common causes of mental handicaps and the only one that is completely preventable.
Caffeine. Some studies show that moderate caffeine intake during pregnancy is OK; others have found a link to miscarriage, so it's particularly important to steer clear of caffeine during the first trimester at least. Large amounts of caffeine have been linked to premature birth and low birth weight, so do your best to switch to decaf' and if you can't cut it out entirely, limit intake to 2 eight ounce glasses per day or less.
Generally speaking, it is safer to eliminate all caffeine from your diet all together.
*** The CDC has great and up to date info on the recommendations for what not to eat during pregnancy. Go to www.cdc.gov
Do's and Don'ts of activity, traveling, sex, and household chores!!
DO:
Exercise. Light to moderate exercise during pregnancy is good for you, strengthening your back and abdominal muscles, improving your balance and helping to speed your recovery after delivery. Keep in mind, we generally tell our patients to not lift anything greater than 10 pounds. Low impact aerobics, general stretching and walking, swimming, stationary cycling, and yoga are all acceptable to do while pregnant. The American College of Obstetricians and Gynecologists recommends that you focus on non-weight-bearing activities and those that don't require an enormous amount of balance (so some of those extremely challenging yoga postures may be out until postpartum and weight lifting and contact sports…not a good idea either) Wear loose-fitting, lightweight clothing while exercising, get plenty of fluids, and don't work to the point of exhaustion. When you reach your second and third trimesters, don't do exercises that require lying on your back. And always be sure to check with your doctor about any exercise program before getting started. Some women -- such as those with preeclampsia, preterm labor, and hypertension or heart disease -- may be advised not to exercise or to pursue very limited physical activities. Contact sports are discouraged during all trimesters of pregnancy.
Have sex. Unless you have a high-risk pregnancy and your doctor has advised you against it, which he or she WILL tell you if you are high risk, sex during pregnancy is safe. You won't hurt the baby. (The baby is protected by your amniotic fluid and your cervix is closed.) You may need to try different positions that allow yourself to be more comfortable though, especially in later pregnancy, avoid lying flat on your back during sex; the uterus can compress the veins in the back of your abdomen and leave you lightheaded or nauseous.
Travel by airplane -- sometimes. The American College of Obstetricians and Gynecologists says that the second trimester is the safest time for air travel, when you're at the lowest risk of miscarriage or premature labor. Generally, if you have a healthy, uncomplicated pregnancy, there's no special risk posed by commercial air travel. We recommend that air travel not be in your plans after 30 weeks gestation. Always let your doctor know about your travel plans a few weeks to a month prior. If there are any circumstances that we would not allow you to travel, we would want you to know in plenty of time. Be sure to stay hydrated during the flight by drinking plenty of fluids, and keep your seat belt on! And no matter whether you're traveling by car, train, bus or plane, get up and move around every so often, and be sure to stretch your legs and back. Rule of thumb: NO traveling by car greater than a 4 hour radius after 36 weeks.
DON'T:
Change the cat's litter box. No, this isn't just an excuse to get out of doing it; cat feces can transmit an infection called toxoplasmosis, which is why we test for this in the beginning of pregnancy, if you have cats. A toxoplasmosis infection can lead to severe problems in newborns, including low birth weight, jaundice, mental handicaps, and convulsions.
Use saunas, hot tubs, and tanning booths. Excessive heat can be harmful to the baby, and has been linked to spinal malformations.
Paint. Let somebody else paint the baby's room; pregnant women shouldn't be exposed to toxic substances and chemicals, which include paint and cleaning solvents. Typically water soluble paint is ok, but if you are unsure, don't do it.
How much weight should I gain during pregnancy?
Just because you are pregnant, it doesn't mean endless day and night eating. The occasional midnight Dairy Queen runs are ok, but it is best to follow these guidelines for weight gain:
If you're at a normal weight before pregnancy, gain between 25 to 35 pounds during pregnancy.
If you are overweight before pregnancy, gain 15 to 25 pounds.
If you are underweight prior to pregnancy, gain 28 to 40 pounds.
For multiple births, consult your doctor (usually, you should gain about 35 to 45 pounds for twins).
The average woman should gain about 2 to 4 pounds during her first three months of pregnancy, and 1 pound a week for the remainder of her pregnancy.
When should I call my doctor between regular visits?
If you have questions that you forgot to ask while at your appointment, or ones that you thought of between appointments, it is best to write them down for your next visit. However, if something is wrong, or you notice that things are different today, here is a list to follow of only SOME of the reasons to call the office. Please remember, don't ever feel that your questions are stupid, it is better to be safe than sorry.
Unusual or severe cramping or abdominal pain.
Significant slowing in the baby's movements after 28 weeks (less than 10 movements in a 2-hour period).
Shortness of breath or difficulty breathing.
Any period like bleeding in the second or third trimester.
Signs of premature labor, such as regular pains or tightening in the lower back or abdomen or significant fluid discharge.
Pain or cramping in the arms, legs, or chest.
Fever over 101 degrees Fahrenheit.
Severe or persistent diarrhea or vomiting.
Fainting spells or dizziness.
Blurred vision or spots in front of your eyes.
Swelling in your hands, fingers, or face, despite increasing your fluids, lying on your side or keeping your feet elevated.
You have fallen down.
Severe headaches that are not going away despite Tylenol use.
You were in a car accident.
Trauma to your abdomen.