Obstetrics Care

Here you will find answers to the most common questions and instructions for pregnancy and postpartum patients. If you have a question regarding a subject which is not listed, please feel free to contact our office for more information.

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Before Pregnancy       What to Expect at Appointments       Common Concerns in Pregnancy       Post Partum Care       Obstetrics Resources

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Common Concerns in Pregnancy

Nausea
Sometimes called morning sickness, is very common. This usually occurs in the first 12 weeks, but can last longer. Your baby will be fine, even if you cannot eat very much during this time. The goal is to prevent dehydration.

Recommendations:

• Eat 5-6 small meals a day, increasing protein
• Avoid spicy or greasy foods and anything that is hard to digest
• Separate solids from liquids
• Eat crackers one half hour before getting out of bed
• Can try teas... raspberry, ginger, etc and ginger root capsules
• Emetrol, Dramamine, and Meclizine are safe to use
• Increase fluids
• Acupuncture, meditation, and massage therapy can be used
• Call if you cannot tolerate anything by mouth and keep appointments so that you and your doctor can discern if weight loss is dangerous or dehydration is occurring.

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Hemorrhoids
Caused by increasing uterine pressure, venous dilatation, constipation, and heavy lifting

Recommendations:

• Avoid constipation (See Constipation recommendations)
• Avoid heavy lifting
• You can use Tucks pads, ice packs (no heat), and Anusol/Preparation-H
• Call if they are blue in color and painful

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Constipation
Caused by sluggish bowels

Recommendations:

• Increase water. You need 64-96 ounces daily
• Increase fiber in your diet (try a cereal each morning with > 3gm fiber)
• Exercise regularly
• Fiber therapy- Metamucil, Fibercon, or Citrucel
• Colace and Milk of Magnesia can be used

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Headache
Caused by hormonal changes, dehydration, congestion, and allergies

Recommendations:

• Increase water and eat small frequent meals
• Rest adequately
• Can use Tylenol, Tylenol PM
• Can use treatments under Sinus/Allergies/Colds
• Acupuncture, meditation, and massage therapy can be used

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Diarrhea
Below are recommendations for diarrhea caused by stomach viruses:

• Increase fluids to avoid dehydration
• BRAT diet – bananas, rice, apple sauce, toast
• Can use Imodium AD
• Call if persists after 2 doses of Imodium

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Heartburn and Indigestion
Caused by hormonal and physical changes of pregnancy that slow down the digestive track

Recommendations:

• Avoid spicy, greasy foods and foods with fat or are hard to digest
• Chew food slowly and don't overeat
• Eat small, frequent meals
• Don't lie down after eating; elevate the head of your bed
• Can use Maalox, Mylanta, Mylicon, Tums, Pepcid AC, Zantac

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Sinus/Allergies/Colds
These problems can be worse in pregnancy and can result in increased mucous secretions, dry mucosal membranes and increased symptoms in which case, antibiotics don't help.

Recommendations:

• Increase fluids, use humidifiers, use saline nose spray
• Can use decongestants like Sudafed, Dimetapp, Tylenol Cold & Sinus
• Can use antihistamines like Claritin, Benadryl, Tavist
• Get your flu vaccine!

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Nosebleeds
Caused by dry nasal passages and worsened by vascular changes in pregnancy

Recommendations:

• Saline nose spray 3-4 times daily
• Use a humidifier
• Vaseline jelly to lower nasal septum

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Cough
Remember that water is the best expectorant.

Recommendations:

• May use Robitussin or Triaminic
• Drink water
• Call if you have a fever and a productive cough
• Get your flu vaccine!

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Sore throat
Usually cause by nasal drainage into the throat or viral infections in which case, antibiotics don't help.

Recommendations:

• Decongestants (like Sudafed) to help decrease drainage
• Warm saltwater gargles
• Can use throat lozenges and Chloraseptic

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Yeast
Very common in pregnancy. Symptoms include white clumpy vaginal discharge, itching, and burning.

Recommendations:

• Can use Monistat/Femstat 3 or 7 day treatments (although applicators may be contraindicated if you are at risk for preterm labor or if you have certain placental condition so please call our office if you have any concerns prior to use).
• Wear loose fitting clothes and cotton under garments
• Dry off completely after bathing; may use a hair dryer to decrease moisture
• Change out of moist clothes quickly after exercise, swimming, etc.
• Call if discharge is yellow, green, or has a foul odor, or continues despite treatment.

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Intercourse
Okay anytime during pregnancy unless your physician has recommended otherwise.

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Leg Cramps
May increase with dehydration.

Recommendations:

• Increase water
• Stretch (especially before going to bed)
• Exercise regularly
• Increase calcium to recommended daily dose with diet or Tums
• Increase Potassium in your diet with bananas or figs

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Insomnia
Common in late pregnancy

Recommendations:

• Exercise regularly, stay active in the day
• Try relaxation techniques... warm bath before bed, decrease stimulus in bedroom (for example, no TV), meditation, stretching before bedtime
• Can use Benadryl, Tylenol PM

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Frequency of Urination
Caused by a growing pregnancy pushing on the bladder. This may be worse in the 1st and 3rd trimester.

Recommendation: Call if it is accompanied by burning, pain, blood, or fever

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Backache
Caused by increased weight, postural changes, and pressure from a growing pregnancy.

Recommendations:

• Avoid lifting and high heels
• Maintain good posture
• Exercise and stretch regularly; use back exercises
• Use a maternity belt- available at Motherhood and BabiesRUs
• Can use heating pad, Tylenol, or ice packs to lower back

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Varicose Veins/Spider Veins
Caused by increased pressure from pregnancy and increased venous dilatation.

Recommendations:

• Avoid tight clothes
• Avoid squatting, sitting, or standing at length
• Wear support hose- available at Motherhood (full length hose are better than knee or thigh high)
• Wear Maternity belt – available at Motherhood or BabieRUs
• Elevate feet above the level of the heart when resting
• Call if warmth, palpable clot, chest pain, shortness of breath

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Swelling
Most common in late pregnancy and in hot weather and in women who are on their feet throughout the day.

Recommendations:

• Increase water
• Avoid salty foods
• Elevate feet above the level of the heart when resting
• Exercise
• Avoid squatting, sitting, or standing at length
• Wear support hose- available at Motherhood (full length hose are better than knee or thigh high)
• Wear Maternity belt – available at Motherhood or BabieRUs
• Call if warmth, palpable clot, chest pain, shortness of breath, concerns

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Exercise
You may continue the same exercise program you had before pregnancy unless we have recommended otherwise.

Recommendations:

• Decrease as needed for comfort in pregnancy
• Don't try to train for a new level of exercising
• Make sure you can still talk through your exercise (if you are too winded to talk, you should probably stop.)
• Try not to lift more than 25 ponds
• Don't exercise while lying on your back
• Try to avoid exercises that test your balance (skiing, tennis, horseback riding)

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Dental work
You can have your teeth cleaned, have fillings, have teeth pulled, and have x-rays if they shield your abdomen. They can use local numbing medicine and certain antibiotics. Make sure you tell your dentist you are pregnant and let us know if he or she would like a note from us. It is actually better for your pregnancy if you maintain good dentition during pregnancy.

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Diet
The American College of Ob/Gyn makes the following suggestions during pregnancy::

• Add 100-300 cal/day to your diet (300 calories is equivalent to a small snack-for example, ½ peanut butter and jelly sandwich and 1 glass low fat milk)
• Daily amount of Grains – 6 ounces
• Vegetables – 2 ½ cups
• Fruit – 1 ½ - 2 cups
• Meat/Beans – 5 – 5 ½ ounces
• Normal weight gain for underweight person – 28-40 pounds
• Normal weight person – 28-35 pounds
• Overweight person – 15-25 pounds
• Obese person – 15 pounds
• With twins – 35-45 pounds
• Avoid unpasteurized cheese/milk, raw/undercooked meat or fish, deli meat -unless it has been re-heated until steaming.
• Avoid the following fish: shark, king mackerel or tile fish and if eating tuna, eat canned albacore light tuna. Limit fish to 2 meals per week.

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Contractions
Contractions can be normal in pregnancy but some can be a sign of labor or preterm labor.

Recommendation: Call if contractions are painful, more than 6 in one hour, continue to increase in intensity and do not resolve with rest and hydration.

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Leaking breasts
Can be normal occurrence in pregnancy but please discuss with your doctor at your appointment to confirm that the discharge is normal.

Recommendation: Avoid stimulating the breast and do not try to express the milk as this will only make you produce more.

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Leaking Water/water breaking
Call anytime you think that you are leaking amniotic fluid, usually associated with a constant trickle or gush of fluid.

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Fetal movement
After 28 weeks of pregnancy, it is important to count fetal movement daily

Recommendations:

• Pick a time when you are not distracted
• Pick a time when the baby is usually active (often this is after a meal)
• Count fetal movements and make sure your reach ten counted movements before 1 hour has passed. (If you get to ten before an hour has passed, you can stop counting.) Call if you are unable to get this amount.

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Other Recommendations

• Avoid hot tubs, saunas, and tanning beds
• Self tanning creams are safe (if they do not contain retinol)
• Avoid Smoking/tobacco, alcohol, caffeine, dieting
• Register early for childbirth classes (by 20 weeks). Call (828) 213-8113.