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What to Expect. . .

Now that you are pregnant, you may be feeling a little uncomfortable. This discomfort is caused by your hormones and your body adapting to pregnancy.  If at any time these symptoms become severe, you need to seek help from a physician or emergency room. 

TIREDNESS, FATIGUE

Your body is now working overtime as your pregnancy develops.  Fatigue is common in pregnancy, especially during the first and third trimesters.

  • Rest as much as possible
  • Exercise to restore energy
  • Stay away from caffeine and sugar

MORNING SICKNESS

Morning sickness refers to nausea and vomiting during pregnancy, most often during the first trimester.  It is most common in the morning, but some women may experience it at other times or even all day long.

Coping with Morning Sickness

  • Eat a few crackers before getting out of bed in the morning
  • Eat small, frequent meals during the day to avoid hunger
  • Drink plenty of fluids
  • Avoid fatty, spicy, fried, and strongly-flavored foods
  • Get plenty of rest
  • Avoid smoking and secondhand smoke
  • Talk to your healthcare professional about taking vitamin B-6, ginger, or anti-nausea medications to help ease your symptoms

FREQUENT URINATION

Pressure against the bladder by the growing uterus will make you need to use the bathroom more often.

BREAST TENDERNESS

Tender breasts and sensitive nipples are also a very normal part of pregnancy.

  • Wearing a bra with good support may help

DIZZINESS

Some women experience dizziness when they move or rise quickly.  To avoid dizziness:

  • Change positions slowly
  • Do NOT go long periods without eating
  • Drink plenty of fluids

HEARTBURN

Tips to minimize heartburn during pregnancy:

  • Eat small frequent meals
  • Avoid spicy and fried foods
  • Do NOT lie down directly after eating

CONSTIPATION

Constipation during early and late pregnancy is caused by changing hormones as well as the pressure against the intestine by the growing uterus.

  • Drink plenty of fluids
  • Do NOT take laxatives during your pregnancy without the recommendation of your doctor
  • See Approved Medication List under Guide to a Healthy Pregnancy

SPOTTING OR CRAMPING

It is not uncommon for some women to experience spotting or cramping the first few weeks of pregnancy. However, if you have bright red vaginal bleeding and/or cramps worse than menstrual cramps, contact your healthcare provider immediately or go to the nearest emergency room.

EMOTIONAL UPS AND DOWNS

Changing hormones and disruption to your life may cause you to feel like you are on an emotional roller coaster.  Talking about your feelings with a caring professional or supportive friend may help.  Avoid caffeine and sugar to help regulate hormones.  Getting enough sleep can also help!

Warning Signs

If any of the following symptoms occur, contact your healthcare professional immediately or go to the ER.

  • Vaginal bleeding
  • Sudden gush or leaking of fluid
  • Severe nausea or vomiting lasting more than 24 hours
  • Severe abdominal cramping
  • Increased, unusual thirst with reduced amounts of urine
  • Sudden weight gain with puffiness in hands and face
  • Chills and fever over 100 degrees
  • Burning or pain when urinating
  • Severe, constant headaches with dizziness, blurred vision or spots
  • Signs of labor

30% of pregnancies end in miscarriage.

What is a Miscarriage?

In medical terms, a miscarriage is called a spontaneous abortion.  A miscarriage is the loss of a pregnancy less than halfway (20 weeks) through the pregnancy.

You may not know that you had a miscarriage. However, one or more of the symptoms listed below may suggest, yet do not prove, that you are miscarrying or have already miscarried.

Symptoms

  1. Bleeding greater than your typical menstrual period
  2. Mild to severe back pain (often worse than normal menstrual cramps)
  3. True, painful contractions happening every 5-20 minutes
  4. Bright, red bleeding saturating more than a pad with blood in one hour, with or without cramps
  5. Tissue or clot-like material passing from the vagina
  6. Sudden decrease in signs of pregnancy

Having a miscarriage can be emotionally difficult. During this challenging time, there are two things you should know:

  1. There is probably nothing you did or did not do that caused the pregnancy to be lost.
  2. Most women who miscarry go on to experience full-term pregnancies later.

Treatment

As continued blood loss can harm you, you should:

  • Seek immediate medical attention
  • Immediately visit your doctor or go to a nearby hospital’s emergency room

If all of the pregnancy tissue has been passed, you may be given medication and have follow-up visits with your physician.

Miscarriage will either be confirmed or ruled out by a:

  • Pelvic examination
  • Ultrasound
  • Falling pregnancy hormone levels in your blood

If some tissue remains in your uterus, you may need to have a procedure done to remove it to control further blood flow or be given medication to induce removal of tissue.

If your blood type is Rh negative, you will be given a Rhogam injection, which prevents Rh problems in future pregnancies.

Reference: http://americanpregnancy.org/pregnancy-complications/miscarriage/

What is it?

An ectopic pregnancy is a pregnancy that is growing outside the main cavity of your uterus. An ectopic pregnancy can also be referred to as a “tubal pregnancy” when the pregnancy implants in one of the fallopian tubes.

While a pregnancy normally grows inside the uterus, an ectopic pregnancy can be in the fallopian tubes, in the ovary, cervix, or the abdominal cavity (belly).

This type of pregnancy cannot survive outside the uterus and cannot be placed inside the uterus.

Symptoms

With a tubal pregnancy, you may not experience any bleeding.  You may have:

  • Sharp or stabbing pain on one side that may come and go and vary in intensity.
    • The pain may be in the pelvis, abdomen, or even the shoulder and neck due to blood from a ruptured ectopic pregnancy gathering up under the diaphragm.
  • Vaginal bleeding, which is heavier or lighter than your normal period
  • Gastrointestinal symptoms
  • Weakness, dizziness, or fainting

Treatment

  1. It is important to contact your doctor immediately if you are experiencing sharp pain that lasts more than a few minutes or if you have bleeding. If you do not already have a doctor, go to a nearby hospital’s emergency department.
  2. Ectopic pregnancies are confirmed or ruled out by blood tests and a repeat pregnancy test, pelvic exam, and/or an ultrasound.
  3. Medication may be used to safely treat an ectopic pregnancy.
  4. Surgical intervention may be needed.
  5. Discuss the Rh factor with your healthcare provider.

References:  http://americanpregnancy.org/pregnancy-complications/ectopic-pregnancy/  https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088

Do you know your blood type?

This is a very important question if you are pregnant, are miscarrying, have an ectopic pregnancy. or plan to have an abortion.

Just as there are different major blood groups, such as type A and type B blood, there also is an “Rh factor.”  The Rh factor is the type of protein found on the red blood cells.  Most people have the Rh factor, which means they are Rh-positive.  However, others do not have the Rh factor, meaning that they are Rh-negative.  A simple blood test can tell whether you are Rh-positive or Rh-negative.

Why does it matter?

The Rh factor causes problems when an Rh-negative person’s blood comes in contact with Rh-positive blood.  During pregnancy, the woman and baby do not share blood systems.  However, a small amount of blood from the baby (whether Rh- or Rh+) can cross the placenta over to the woman’s system.  If the baby is Rh-positive, these Rh-negative women become sensitized during their first pregnancy.  The mother’s body makes antibodies that attach to the blood of the Rh-positive baby in subsequent pregnancies.  When this happens, the antibodies break down the baby’s red blood cells, which causes anemia and/or serious illness, brain damage or even the baby’s death.  The initial pregnancy and each subsequent pregnancy must be treated; in most cases, the condition becomes worse in later pregnancies.

What should I do?

A simple blood test can identify a woman’s blood type and Rh factor.  Another blood test, called an antibody screen, can show if an Rh-negative woman has developed antibodies to Rh-positive blood.

Whether you plan to have an elective abortion or carry your pregnancy to term, you need to have this simple blood test done. Without treatment of the antibodies in your system, if you are Rh-negative, any subsequent pregnancies will be adversely affected.

Contact your healthcare provider for more information on the Rh Factor.

Source: American College of Obstetrics & Gynecology

The First 12 Weeks of Pregnancy

Week 1:  You will have had your last menstrual period. At this time, the baby has not yet been conceived, but your uterus is preparing for fertilization.

Week 2:  Your body is continuing to prepare for ovulation and fertilization.

Week 3: Your baby has been conceived, though it is still too soon to get a positive pregnancy test.

Week 4: The cells forming your baby have now attached to the uterus. Your baby’s amniotic sac and placenta are now forming, and their cells begin to divide into future organs.

Week 5: Your baby’s circulatory system is developing! Two tubes have formed: one for the brain and spinal cord, and the other for their heart.

Week 6: The eyes, lungs, limb buds, and digestive system begin forming. Your baby’s brain and spinal cord have now developed! You may be feeling some nausea and heartburn at this time; this is perfectly normal and nothing to worry about.

Week 7: Your baby’s arms and legs are growing, and the tongue is forming. He or she is even starting to grow some hair! You may be experiencing pregnancy signs like tender breasts and morning sickness.

Week 8: Your baby’s face is taking shape with a pair of eyes, a nose, ears, and an upper lip. Bones are also forming. Right now, your baby’s fingers and toes are webbed. You may also be feeling some morning sickness.

Week 9: Your baby has officially begun to move! The legs are fully formed, and the internal reproductive organs are developing. You may feel very tired at this stage of pregnancy; this is very common.

Week 10: Your baby is officially a fetus, and his or her profile is well-defined. The eyes are open, and brain connections are forming.  The baby’s fingers and toes are no longer webbed, and unique fingerprint ridges start forming from friction. You may be starting to show.

Week 11: Fingernails and irises in the eyes are forming, and your baby’s fingers and toes have developed! Their external genitalia also start forming.

Week 12: Your baby’s kidneys start producing urine, and their teeth are forming. You will be able to hear their heart activity at this time!

Prenatal Care. . . A Healthy Start

Prenatal care is important to the health and future of your unborn baby.  The purpose of prenatal care is to:

  • Monitor the progress of your pregnancy
  • Oversee the health of your baby
  • Determine potential problems before they become serious
  • Prevent or treat any pregnancy complications

The sooner you get started with your prenatal care, the better!

  • Start early on prenatal care with a healthcare provider
  • Take a prenatal vitamin
  • Eat healthy
  • Do not smoke or drink alcohol

Early Pregnancy Symptoms

As your hormones change and your body adapts to the pregnancy, you may experience early pregnancy symptoms.  For more information on these symptoms, see Early Pregnancy Symptoms.

Self-Care Tips

Oral Health

You should take good care of your teeth and gums while pregnant.  Tooth and gum disease can affect the health of your developing baby.

To maintain good oral health:

  • Tell your dentist you are pregnant
  • Continue routine dental checkups
  • Avoid dental x-rays
  • Report bleeding or gum swelling
  • Follow good oral hygiene practices

Hair and Nail Care

Perms, body waves, hair dyes (coloring and highlights) expose you to strong chemicals.  If you have concerns, consult your healthcare provider or consider postponing the use of chemicals on your hair during pregnancy.

Manicures and pedicures are safe during pregnancy.  A few tips to follow before treating yourself include:

  • Be sure salon is well ventilated
  • Err on the side of caution and forgo acrylic nails
  • Avoid massage between your heel and ankle bone (this could cause contractions)

Exercise

Exercise is important during pregnancy to help maintain a balance in your body.  Avoid exercises that lead to exhaustion, might cause you to lose your balance and fall, or cause pain or discomfort.  Excellent forms of exercise include walking or swimming.

  • Aim for 30 minutes of exercise, four to five times a week
  • Consult your doctor before you begin a new exercise program

Nutrition

It’s important to eat healthy when pregnant.  A diet rich in iron, protein, calcium, vitamin A, vitamin B, vitamin C, and folic acid are essential to your health and the health of your baby.

  • Eat lots of fresh vegetables and fruits
  • Milk or milk products provide a good source of calcium
  • Whole grain breads and cereals are a good source of vitamin B and iron
  • Lean meat and eggs provide a good source of protein and iron

Rest

Listen to your body and give yourself time to rest.

Pregnancy Weight Gain

A gradual weight gain of 20-35 lbs above your normal weight is recommended.  Most women do not gain much weight during their first trimester; some will even lose a couple of pounds if they have significant nausea or vomiting.  After three months, a steady weight gain of 3-4 lbs per month is advised.

Pregnancy is NOT the time to try to lose weight.

Precautions During Pregnancy

Taking good care of yourself is important.  There are several things you should avoid to ensure a healthy pregnancy.  The following things should be avoided at all costs.  Even the smallest amounts can cause serious health issues and problems for your baby.

  • Alcohol
  • Smoking
  • Illicit Drugs

Problems caused by the use of alcohol, smoking, and drugs include:

  • Birth defects
  • Miscarriage
  • Premature birth
  • Fetal alcohol syndrome
  • Mental retardation
  • Abnormal development
  • Learning disabilities
  • Increased risk of SIDS (Sudden Infant Death Syndrome)

Other things to avoid include:

  • Paint fumes and insecticides
  • Caffeine, artificial sweeteners, and energy drinks
  • Hot tubs or saunas
  • Medications not approved by your doctor
  • Cat feces; do not empty a cat litter box

Smoking – Tips to Quit

When you smoke, there is less oxygen in your blood to carry to your developing baby.  Secondhand smoke is just as harmful.  Make a plan to quit and give your baby a smoke-free start.

  • Throw away cigarettes, lighters, and ashtrays
  • Stay away from things and places that make you want to smoke
  • Chew on raw vegetables or other healthy snacks
  • Talk to your healthcare provider before taking any medications to help you quit
  • Ask your partner or a friend to quit with you
  • Ask your family and others not to smoke around you
  • Ask your healthcare provider for information to help you quit

Pregnant women should limit taking any medications, whether prescription or over-the-counter.  If you currently take a prescription medication, consult with your doctor before discontinuing.  The following medications are generally safe during pregnancy and are approved by our medical director.

  • Pain (headache, backache)
    • Tylenol, Extra-Strength Tylenol
  • Upper Respiratory Symptoms (cold, cough, sinus)
    • Sudafed, Tylenol Sinus, Dimetapp, Chlor-Trimeton, Benadryl, Robitussin (DM)
  • Sore Throat
    • Chloraseptic spray, Cepastat lozenges, frequent warm salt water gargles
  • Nausea & Vomiting
    • Vitamin B6 (25mg 3X/day), Unisom (1/2 tablet 3X/day), Emetrol, or ask doctor for a presciption medication
  • Heartburn & Indigestion
    • Tums, Rolaids, Maalox, Mylanta
  • Diarrhea
    • Kaopectate if less than 15 weeks pregnant
    • Imodium if more than 15 weeks pregnant
  • Yeast Infection
    • Over-the-counter 7-day vaginal cream
  • Constipation
    • Metamucil wafers, Citrucel, Perdiem Fiber, Fibercon, Colace (stool softener) INCREASE WATER INTAKE; NO LAXATIVES
  • Gas
    • Mylanta II, Maalox Plus, Gas-X, Phazyme
  • Hemorrhoids
    • Annusol-HC cream, Preparation-H, Tucks

DO NOT take the following (unless ordered by your doctor)

  • Aspirin
  • Anti-inflammatory medications
  • Narcotics
  • Cortisone/Steroids
  • Stimulants