As obstetricians and midwives, we understand how chronic conditions such as thyroid disease, high blood pressure, diabetes, anemia and other medical problems can affect your pregnancy. To best care for your unborn baby, we may involve other medical specialists, such as perinatologists, cardiologists, endocrinologists and kidney specialists into your care. If you develop a problem that is unrelated to your pregnancy, we ask that you make an appointment with your regular medical doctor’s office for an evaluation and treatment. Colds, ear infections, sore throats and other common illnesses are usually best taken care of by your primary care physician.
Dental hygiene is very important during pregnancy. We recommend regular dental checkups and routine cleaning during your pregnancy. If you need any other dental procedures, it is important that you know which procedures are okay and which are not. Be sure to tell your dentist that you are pregnant.
- X-rays are fine when your stomach is shielded with a lead apron, any time after 13 weeks.
- Local anesthesia, such as Novocain, is okay. We ask that your dentist use local anesthesia without epinephrine.
- Fillings, root canals and tooth repairs may be done during pregnancy
- If you need antibiotics for a dental procedure or problem, please have your dentist call our office so we can recommend an antibiotic that is safe in pregnancy. If you know you will need an antibiotic ahead of time, you can call and we will give you recommended antibiotics. Many antibiotics, such as penicillin, erythromycin and cephalosporin are safe to use during pregnancy.
Weight gain recommendations during pregnancy are based upon your Body Mass Index (BMI), a measurement that is calculated from your pre-pregnant weight and height. Women of average weight for height are recommended to gain 25-35 pounds. This may vary depending on your individual needs. Women who are overweight pre-pregnancy will be encouraged to gain less and those who are underweight should gain more. Most women will need an extra 300 calories per day plus additional iron, protein and folic acid. A balanced diet and a vitamin and mineral supplement will help you meet those needs.
The principles of a good diet in pregnancy are not much different from those of an everyday healthy diet. You will want to choose foods that are low in fat and sugar, and high in fiber and protein. Fruits, vegetables and whole grains are good staples.
Be sure to take your prenatal vitamin every day. Sometimes it is easier if you take it on a full stomach or at night. If one brand of vitamin is not agreeing with you, we can try another brand.
Products with NutraSweet, Splenda and caffeine are fine if you use them sparingly. One to two cups of coffee per day or 150-300mg. of caffeine per day is considered safe in pregnancy.
Here are a few suggestions of lower calorie food choices that provide good nutrition:
- Drink skim milk or 1% instead of whole or 2%milk
- Choose nonfat or skim milk dairy products such as cheese, cottage cheese and yogurt
- Eat fresh fruit instead of drinking fruit juice
- Drink 6-8 glasses of water per day instead of fruit juice, juice drinks, sweetened ice tea and soda.
- Choose low fat salad dressings and replace mayonnaise with low fat yogurt
- Purchase leaner cuts of meat and poultry and cut off all visible fat and skin before cooking
GENERAL FOOD SAFETY
- Thoroughly cook all meat such as beef, pork and poultry
- Wash raw fruits and vegetables before eating
- Keep uncooked meats separate from vegetables, cooked foods and ready-to-eat food.
- Avoid unpasteurized (raw) milk or foods made from unpasteurized milk.
- Wash hands, knives and cutting boards after handling uncooked meats.
- Consume perishable and ready-to-eat foods as soon as possible.
- Limit Solid White Tuna to 6 ounces (one average meal) per week maximum. For more information check http://www.fda.gov/food/foodsafety/product-specificinformation/seafood/foodbornepathogenscontaminants/methylmercury/ucm115662.htm
Things to Avoid
- Do NOT Smoke or spend time around people who are smoking
- Do NOT Drinking alcoholic beverages
- Do NOT Use recreational drugs while pregnant
- Please do not take any extra vitamins or herbal supplements without checking with us first.
- Avoid hot tubs and whirlpool baths. Indoor and outdoor swimming pools are fine as are warm tub baths and showers.
- It is okay to color and perm your hair while you are pregnant.
- It is okay to paint with latex paints while you are pregnant if you work in a well-ventilated room and leave the area if you don’t feel well while you are working.
Regular exercise of medium intensity is encouraged during your pregnancy. Physically active women with uncomplicated pregnancies should be able to remain active during pregnancy. Women with certain medical conditions such as poorly controlled hypertension, lung problems or heart disease may be advised not to exercise. Should you develop complications during your pregnancy, such as preterm labor, bleeding, high blood pressure or if your baby is not growing well, we may advise you to reduce your activity.
Some safe activities during pregnancy are yoga, brisk walking, hiking, backpacking, jogging, swimming, using fitness equipment such as elliptical machines, treadmill, stationary bike or Nordic Track are fine. Pregnancy is not a time to take up a new sport that demands significant coordination such as rollerblading or step aerobics. If you would like to start exercising, walking is a great beginning exercise that you and your baby can continue after delivery.
As your pregnancy progresses, you will need to adjust your exercise routine and your pace to meet the changing needs of your baby. Avoid prolonged period of exercise on you back after your fourth month. You will notice your center of gravity changes as your pregnancy progresses because the weight you gain is not evenly distributed. In addition, pregnancy hormones loosen and soften the ligaments that support your joints. As a result, your balance becomes less stable and you are more prone to falls. Low impact activities are generally safer in pregnancy.
Be sure to stop exercising if you become short of breath, overheated, dizzy, dehydrated or uncomfortable. Avoid exercise in extreme heat and humidity. Avoid sports that can result in trauma to you or your baby. Sports such as soccer, basketball or hockey should be avoided. Activities that increase your risk of falling or for abdominal trauma such as gymnastics, cycling, water or snow skiing, snowboarding, rock climbing, vigorous racquet sports and horseback riding should be avoided. DO NOT scuba dive because of the potential danger from air bubbles that can form in your blood stream as you surface.
Sex and Sexual Intercourse
Sexual intercourse during pregnancy is perfectly fine as long as you are comfortable. Most women can have sex until the baby is born. Your baby is well cushioned in the amniotic fluid within your uterus and will be safe. You should avoid intercourse if your pregnancy is complicated by preterm labor, bleeding or an abnormal location of your placenta. We will counsel you if you develop a clinical condition that requires abstinence. Also, if you think your “bag of water” is broken or leaking, you should avoid intercourse and go to the hospital for evaluation.
Generally, the best time to enjoy a trip is during the middle months of pregnancy. Air travel is fine but most airlines generally do not allow travel after 36 weeks. Some airlines may require a medical provider’s note for travel during pregnancy at any time. Metal detectors at security checkpoints are safe. Please tell us if you plan to travel out of the country so we can give any special recommendations that are needed. The quickest form of transportation to your destination is best.
While you are traveling be sure to stay well hydrated, allow for plenty of stops to use the bathroom and to walk around. If you are on an airplane, get up and walk up and down the aisle as much as you can. You should flex your feet, stretch your calf muscles, rotate your ankles and wiggle your toes while you are in your seat.
If you are traveling by car you should always wear your seatbelt and shoulder harness. Some women worry that the belt will hurt the baby if the car stops suddenly or there is a crash. Studies show that the baby almost always recovers from seatbelt pressure. Risks to the mother and her baby who are not protected by the seatbelt during an accident are usually far more serious than those caused by a seatbelt. Keep the lap belt low, under your abdomen and adjust the shoulder harness between your breasts and keep them as snug as possible. We discourage motorcycle travel during pregnancy.