Frequently Asked Questions of Pregnancy

Click on the links below to learn more about:
What Medications are Safe During Pregnancy?
What are Some Common Discomforts Experienced During Pregnancy?
What About Alcohol Intake and Recreational Drug Use During Pregnancy?
Is Smoking Harmful During Pregnancy?
Is It Safe to Travel?
Can I Have Intercourse?
Should I Exercise?
Why Do My Gums Bleed?
How Much Caffeine is Safe?
Can I Change My Cat's Litter Box During Pregnancy?
Can I Color My Hair While Pregnant?
Are Hot Tubs Safe?
Can I Use a Tanning Booth?
My Mother Told Me...
What Tests May be Performed During My Pregnancy?

What Medications are Safe During Pregnancy?

• Please check with the office before taking any over-the-counter or prescription medication.
• Regular strength acetaminophen (Tylenol) is the medication of choice for pain or fever. Please do not take aspirin, ibuprofen, or naproxen sodium unless directed by your physican or midwife. If you have a fever of 100.6 or higher, please call the office or your family doctor.
• For sinus congestion with colds, allergies, or flu, you may take pseudoephedrine (Sudafed). You may use a saline nasal spray, such as Ocean or Nasal. ¼ Neosynephrine nasal spray may be used for no longer than 3 days at a time. You may take Robitussin DM for coughs or chest congestion. A warm salt-water gargle is recommended for a sore throat. You may use throat drops, spray, or lozenges. A cool air vaporizer may help you sleep at night. It is essential to increase fluid intake and get sufficient rest. If your nasal or throat drainage changes from a clear color, please call your provider.

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What are Some Common Discomforts Experienced During Pregnancy?

• Diarrhea - If this occurs, increase your fluids to at least 6 to 8 glasses a day. Avoid milk or milk products until the diarrhea has resolved. Follow the BRATT diet: Bananas, Rice, Applesause, Tea, or Toast. If you obtain no relief in 24 hours of the BRATT diet, Kaopectate or Immodium may be purchased without a prescription. If the diarrhea continues for more than 48 hours, please call the office.
• Constipation - The best way to combat constipation is through prevention. Drink 8 to 10 glasses of liquids a day. Include fruit juices (prune and apple juices are especially helpful). Increase the fiber in your diet by eating bran or shredded wheat cereals, bran muffins, as well as raw fruits and vegetables. Exercise daily (walking is good). If constipation should occur, there are several non-prescription medications that may be used - Metamucil, Citrucel, Fibercon, Per Diem, Fibermed Biscuits, Haley's MO, and Milk of Magnesia.
• Heartburn or Indigestion - Eat small, frequent meals (5 or 6 a day). Drink liquids, especially milk, between meals rather than with meals. Avoid fatty or fried foods and carbonated beverages. Sit up during and for one hour following meals. You may use non-prescription antacids - do not use one with simethicone (an anti-gas formula).
• Nausea (Morning Sickness) - Although nausea and vomiting in pregnancy is commonly referred to as "morning sickness", it can occur at any time of the day or night, usually when the stomach is empty. Try keeping something in your stomach - eat small, frequent meals (5 or 6 a day). If nausea is a problem when you get up in the morning, try a high protein snack before bed and a few pretzels or dry crackers before getting out of bed in the morning. Avoid unpleasant odors. Avoid dehydration as this can increase your nausea. You can try drinking ginger or peppermint tea, or chewing a thin sliver of fresh ginger (careful, it's hot) - do not take ginger supplements. Over-the-counter seasickness bands help some people. There is a band available with a prescription that uses a small electrical impulse that has met with some success. Taking your vitamin at night may help, or switching to a chewable formula. Emetrol, a sugar-based syrup, can be purchased without a prescription and may be helpful. Anytime you are unable to keep even fluids down for 24 hours - please call the office.
• Urinary Tract Infections - Symptoms of a urinary tract infection can include pain or burning with urination and increased frequency of urination. The urine may be cloudy or have a strong odor. Unexplained lower abdominal cramping, often accompanied by a backache, can also mean a UTI. An untreated urinary tract infection can cause premature labor, so please do not delay seeking treatment. Please call the office with these symptoms and we will arrange a urinalysis for you. It is essentail to drink plenty of water and fruit juices (8 to 10 glasses a day). Please avoid caffeinated and carbonated beverages, as they can be irritating to the bladder.
• Edema - Some edema, or swelling, is normal during pregnancy. Generally it appears in the ankles and legs during the final months. Elevate your legs whenever possible. Rest on your left side. Reduce your intake of foods containing salt. Many foods are loaded with salt, such as fast foods and pizza, processed foods (deli meats), and food from a box (macaroni and cheese), jar (spaghetti sauce), or cans (soup). Drinking adequate water is the best way to get rid of excess swelling, so drink 8 to 10 glasses a day. Please call the office if the swelling is severe or if accompanied by a headache unrelieved by Tylenol, or if you have visual changes, or upper right abdominal pain.
• Bleeding - Spotting of blood may occur in 40% of all normal pregnancies during the first trimester. If you are spotting, begin best rest and call the office. Avoid heavy lifting, exercise, and sexual intercourse for 48 hours after the last episode of spotting.

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What About Alcohol Intake and Recreational Drug Use During Pregnancy?

• We recommend no alcohol intake during pregnancy. Alcohol can cause mental retardation and slow growth. Medical researchers do not know how much alcohol it takes to affect the developing baby during pregnancy. The fetus is especially vulnerable during the first trimester when all the major systems are forming.
• Recreational drug use, especially cocaine, can cause serious complications - miscarriage, fetal stroke, brain damage, and even fetal death. Your baby may become addicted to any drugs you take. If you have used such a substance during pregnancy, please alert your physician or midwife.

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Is Smoking Harmful During Pregnancy?
Smoking interferes with the oxygen and nutrient supply to the baby. Pregnancy is a tremendous incentive to quit smoking. Women who smoke during pregnancy have a greater risk of smaller babies, premature births, miscarriage, stillbirth, and increased respiratory problems in the baby after birth. When a woman smokes, blood vessels constrict, reducing the amount of oxygen and nutrients delivered to the baby. In addition, the fetus is exposed to carbon dioxide, tar, and nicotine. Some studies show an increased risk of Sudden Infant Death Syndrome (SIDS) in babies exposed to cigarette smoke during pregnancy. There is recent evidence linking smoking to learning disabilities and growth retardation. Our providers would like to assist all women in smoking cessation.

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Is It Safe to Travel?
Travel by any mode of transportation is considered safe up to the seventh month of pregnancy. If traveling by car, it is advisable to stop every 1 to 2 hours to stretch and move your legs. Eat healthy snacks and take along lots of water to drink in the car. Always use seat belts, with the lap belt low on the abdomen. After the seventh month, check with the office before traveling.

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Can I Have Intercourse?
Intercourse can be a normal activity during pregnancy. Unless there is a specific problem with the pregnancy, such as bleeding, or preterm contractions, sexual intercourse is safe during pregnancy. It may be necessary to experiment with position and depth of penetration to avoid discomfort. If intercourse is painful or causes bleeding or prolonged contractions (it is normal to have some contractions following intercourse), please talk with your physician or midwife.

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Should I Exercise?
Regular exercise is important during pregnancy to maintain a healthy lifestyle. Walking, swimming, bicycle riding, and prenantal exercise classes are all recommended. You may continue normal sports activity, although it is not the time to take up a new sport. The American College of Obstetricians and Gynecologists recommend keeping the heart rate under 140 (take your pulse for 6 seconds, multiply by 10). Do not exercise lying flat on your back after 16 weeks of pregnancy.

Some exercises are not recommended during pregnancy: snow skiing, water skiing, and horseback riding.

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It is recommended to continue routine dental care during pregnancy. If dental work is necessary, it is safe for the dentist to use a local anesthetic such as Novocain. Please inform your dentist that you are pregnant and if X-Rays are required, they can be safely performed with the abdomen shielded.

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How Much Caffeine is Safe?
Caffeine may be used in moderation. It is believed that two or fewer cups of a beverage with caffeine should be safe. If a mother drinks more caffeine, the baby can be born with a caffeine addition, interfering with sleeping and eating during the first weeks of life. Beverages with caffeine include coffee, tea, chocolate and caffeinated sodas.

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Can I Change My Cat's Litter Box During Pregnancy?
Cat bowel movements may contain a parasite that can cause a serious infection. This infection can lead to birth defects. The chance of becoming infected is small, but it is best to be cautious. You should not change the kitty litter if at all possible. If you have to change the litter, use rubber gloves, wear a mask and wash your hands afterward. You should also wear gardening gloves when digging in the dirt in an area the neighborhood cats may use as a kitty litter box.

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Can I Color My Hair While Pregnant?
According to hair dressing experts, chemicals used to treat hair are not dangerous to use during pregnancy. It is safe to get your hair colored, highlighted or permed in a well-ventilated room. Be aware, however, because of the changes of pregnancy, that the treatment to your hair may not "take" as it normally would when you are not pregnant.

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Are Hot Tubs Safe?
We do not recommend any water hot enough to raise the core body temperature of a pregnant woman, since a marked increase in maternal temperature may adversely affect the baby. Even with tub baths, the water should not be so hot as to cause your skin to become reddened or for you to become dizzy when standing.

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Can I Use a Tanning Booth?
Although not contraindicated in pregnancy, we do not recommend the use of tanning beds because of the risk of skin cancer. A sunscreen is recommended when outdoors.

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My Mother Told Me...
There are many myths and misconceptions involving pregnancy. Most of these have little basis in reality. If you have any questions about what you are told by a relative or friend, please do not hesitate to call the office and ask to speak with a nurse.

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What Tests May be Performed During My Pregnancy?
Routine Testing - It is standard of care to obtain the following tests on the first visit for your pregnancy:

• CBC - A complete blood count is done to determine the ability to carry oxygen and nutrients through the body and to the fetus. This is repeated when the glucose challenge test is performed, and sometimes at around 36 weeks if you were anemic on an earlier visit.
• Rubella Titer - This test is done to determine your immunity status to Rubella (the German Measles). If the test shows non-immunity, the imunization will be offered at the time of delivery.
• Hepatitis B - This test determines whether you have Hepatitis B, or are a carrier. If you are a carrier, your baby will need to be vaccinated at birth.
• Blood Type and Rh, Antibody Screen - If you are Rh negative and the father of the baby is Rh positive, there is the possibility the baby could inherit the father's blood type which could cause a problem during this or future pregnancies. Fortunately, we can prevent this in most cases by giving you an injection of Rhogam - this prevents your immune system from responding to the baby's Rh-positive blood cells. If you are Rh positive, there is nothing to worry about.
• HIV - an HIV (AIDS) test will be offered. It is your choice if you would like to have this test performed. If you are infected, you can transmit the virus to the baby. With medications and pregnancy management, we can decrease the likelihood of transmitting the virus to the baby. We can perform this test any time during the pregnancy if you decide not to have it at your first visit.
• Syphilis - Ohio state law mandates the testing for this sexually transmitted disease.
• Pap Smear - This test detects cancerous and pre-cancerous changes in the cervix (the opening to the womb, located at the top of the vagina).
• Gonorrhea and Chlamydia Cultures - These sexually transmitted diseases can cause complications in the newborn. Both infections are easily treated during pregnancy.

The following tests are offered later in the pregnancy:

• Triple Screen Test - This blood test combines the results of three laboratory values, alpha-fetoprotein (AFP), estriol, and Beta Human Choriogonadotropin (BHCG) to predict the risk of a fetus with a neural tube defect (such as Spina Bifida), the risk of Down Syndrome, and Trisomy 18 (a syndrome of several chromosomal birth defects). Results are reported as a ratio, such as 1:200 or 1:50,000. This test is done between 15 and 20 weeks and is offered to all pregnant women. It is your choice if you would like to have this test.
• Amniocentesis - Women who are 35 years or older during pregnancy have a greater risk than younger women of giving birth to a baby with a chromosomal defect (the most well-known is Down's Syndrome). Amniocentesis is offered at this age because the risk of miscarriage from the procedure equals or is less than the risk of chromosomal birth defects. (Approximately 1:270 at the age of 35). It is generally performed during the 14th to 16th weeks of pregnancy. Using ultrasound as a guide, a needle is placed through the abdomen into the uterus to collect amniotic fluid for testing. Cells obtained are cultured in a laboratory for evaluation of the chromosomes. Results of the studies are available in about two weeks. In addition, the fluid is tested for the level of alpha-fetoprotein, to detect a neural tube defect such as Spina Bifida.
• Chorionic Villi Sampling (CVS) - This test is offered to the same age group as amniocentesis, but is performed earlier in the pregnancy (10 to 12 weeks). A small sample of cells is taken from the placenta where it is attached to the wall of the uterus, rather than from amniotic fluid. Chromosomal birth defects, such as Down's Syndrome, can be detected. Results of the chromosomal studies are available in approximately two weeks. The risk of miscarriage is about the same as with an amniocentesis and there is an additional risk of limb deformities with this test. The CVS is performed too early to detect neural tube defects. A separate blood test (AFP) can be performed between 15 and 20 weeks.
• Glucose Challenge Test (GCT) - This creening test is performed on all pregnant patients (who are not already known to be diabetic) between the 24th and 30th week of pregnancy as a screening test for gestational diabetes (diabetes during pregnancy). If your score is elevated, a nurse will call you to arrange for a 3 hour glucose tolerance test, a definitive test for gestational diabetes.
• Ultrasound or Sonogram - A sonogram is an image of the developing fetus produced using specially directed sound waves. This painless procedure can give information concerning the age of the baby, the position, the possibility of multiple gestation, and some major birth defects. Minor birth defects are usually not seen on routine ultrasound screens. Ideally this test is done between 18 and 20 weeks to allow for confirmation of the due date and adequate evaluation of the fetus.
• Non-Stress Test - This test may be recommended after 32 weeks for a variety of reasons, including:
  1. Multiple gestation
  2. Maternal smoking
  3. High blood pressure
  4. A perceived decrease in fetal movement
  5. Age (older than 35 or a teenager)
  6. Diabetes or gestational diabetes

  An external fetal monitor is placed on your abdomen. The baby's heart rate is evaluated with relation to its movements. This test generally takes from 20 to 30 minutes and predicts the baby's well-being inside the uterus.

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