We will plan to see you in the office roughly every 4 weeks until you get to 28 weeks, then every 2-3 weeks until 37 weeks, then every week. You will have your blood drawn at the 8-10 week visit, at 15-20 weeks for second trimester markers, and around 28 weeks to check for gestational diabetes and anemia. You will have an ultrasound at 18-20 weeks to make sure the baby is developing normally at a radiology center. Usually they will be able to tell you the sex of the baby if you are interested. We do not do that in our office. If everything looks fine, that may be the only formal ultrasound during the pregnancy or gynecologic conditions when necessary.
You may take regular or extra strength Tylenol (NOT cold or flu), use a saline nasal rinse and cool mist humidifier, and stay properly hydrated. However, if your fever rises over 101˚F, please call us. A high fever can be dangerous to your baby.
Nausea is common early in pregnancy. You can try to minimize it by eating frequent small meals or snacks, because an empty stomach makes nausea worse. It may help to keep some crackers next to your bed to eat before you get up in the morning. Sucking on a lollipop or hard candy can help as well. Concentrate on drinking enough liquids, especially water and juice. The nausea usually improves by 12 weeks, so hang in there!
Let us know if you can’t keep any food down or if you are losing weight. Avoid foods that trigger your nausea, such as fatty foods, red meat, fast food, etc. Don’t worry about not getting enough calcium or fruit during this time; you’ll make up for it later. Many women find that their prenatal vitamin makes the nausea worse. Try taking it at bedtime. If you still can’t take it, wait until you are past 12 weeks. We may recommend taking a children’s chewable vitamin (2 tablets a day) if you can’t take the prenatal vitamins.
It is important to eat a healthy diet during pregnancy, including lots of fresh fruit and vegetables. The FDA has advised that you avoid eating shark, swordfish, king mackerel and tilefish during pregnancy. The mercury levels in these fish are high enough to affect your baby’s brain development. They recommend no more than one can of albacore tuna per week, but canned light tuna is fine. There is no evidence that moderate amounts of caffeine will harm your baby. You should limit yourself to no more than two and a half cups of coffee or soda a day. Toxoplasmosis can be transmitted in raw meat, so avoid eating any raw meat during your pregnancy.
Exercise is important in a healthy pregnancy. If your pregnancy is uncomplicated, you are encouraged to exercise 30-45 minutes a day on most days of the week. Avoid very strenuous exercise or increasing your level of exercise quickly. You should stop exercising if you feel dizzy, develop a headache, chest pain or vaginal bleeding, or notice contractions. We recommend that you avoid activities that could involve falling and trauma to your abdomen, such as downhill skiing, horseback riding and gymnastics. Scuba diving is dangerous to your baby and should be avoided throughout pregnancy. Yoga is wonderful exercise, but certain positions are not recommended for pregnant women after 20 weeks. There are many pregnancy yoga classes available that are safe.
Please wear your seat belt at all times when you are in the car. As your belly gets bigger, put the lap belt over your hips instead of across you abdomen. The risk of injury from being thrown from the car in an accident is much greater than the risk of injury from the seatbelt. If you are in a car accident, please let us know.
Travel is generally safe during pregnancy. We are now recommending a baby aspirin (81mg) a few days before, during and a few days after your trip if it involves a car ride longer than 3 hours or any plan ride. If you take a long car trip, you should stop every 2-3 hours to walk around to prevent blood clots. If your pregnancy is uncomplicated and you have no chronic medical conditions, you can travel on airplanes up to 36 weeks. Most airlines will not allow international travel after 35 weeks. Many airlines will require documentation of gestational age. We will be happy to give this to you. Because air turbulence can be unexpected and there is a risk of trauma, you should wear your seat belt at all times. If the trip is long, you should walk around every few hours to prevent blood clots, and you may want to wear support hose to minimize swelling of your feet and ankles. Take into consideration the timing of your travel. We don’t want to risk you delivering far from home!
Please continue your regular dental care. Dental care during pregnancy is important, because gingivitis has been linked to preterm delivery. It is safe to have dental X-rays taken as long as they put a shield over your belly. Many dentists are hesitant to treat pregnant women. If you need to have dental work done, we will be happy to give you a note saying that it’s OK.
We recommend that you avoid tanning during pregnancy. In addition, there is a questionable link between hot tub use and miscarriage, so we recommend you avoid the hot tub during your first trimester. After that, do not stay in more than 10 minutes, and if possible, turn the temperature below 100˚ F.
If you have a cat, you should not change the litter box until your initial labs come back. Contact with cat feces could expose you to toxoplasmosis, a virus that could affect your baby. We will check to see if you are immune to this virus at your first visit. If you are immune, you may continue to change the litter box. If you are not immune, you will need to have someone else change the litter. If no one else is available to change the litter box, you should wear disposable gloves and a face mask and change it every day.
Hair coloring, dyes and perms are all OK during pregnancy.
Hoffman and Associates is an all-female OB-GYN doctor group with offices in Baltimore, Catonsville and Dundalk, Maryland. Led by Dr. Terry Hoffman, and in affiliation with Mercy Medical Center, our obstetricians and gynecologists offer an individualized approach to obstetrics, gynecology and menopause which allows us to provide women with top quality and compassionate medical care.
Tracie Cox, CNM, is a certified nurse midwife with the all-female Obstetrics and Gynecology group practice, Hoffman and Associates.