I'm pregnant! Now what?

Initial OB visit-

At your first visit we will orient you to our practice, review your medical history, and discuss any current concerns that you are having. We will provide routine pregnancy counseling and education and answer any questions that you may have. You will have a transvaginal ultrasound to confirm the dating of the pregnancy. Lastly, you will have your initial prenatal labs drawn, and will have a full physical exam, with a pap smear, if needed.

Follow up OB visits-

All follow up visits include the assessment of blood pressure, weight, urinalysis, baby’s growth, and fetal heart sounds. 

Below is a schedule for the routine OB appointments. If at any point you feel like you need to be seen by a provider, please do not hesitate to call and speak with our staff so we can address your needs and concerns.

Routine OB schedule

-Up to 28 weeks – appointments every 4 weeks

-28-36 weeks -appointments every 2 weeks

-36 weeks until delivery – appointments every week

Initial OB visit-

The routine prenatal lab panel consists of routine blood count, a test for rubella antibodies, the pap smear, genital cultures, a test for syphilis, hepatitis B, HIV, blood type and antibody screen. Other testing if necessary might include a sickle cell screen. The American College of Obstetrics and Gynecology and The American Academy of Pediatricians recommends routine HIV testing in pregnancy.

Follow up OB visits-

• Anatomy Ultrasound:  We offer an ultrasound to all patients between 18 and 22 weeks.  This gives an opportunity to take a detailed look at how the baby is developing, and to detect any abnormalities.  It is at this ultrasound that a patient can find out the gender of the baby, if the genitals can be clearly seen by the sonographer.
• Glucose Challenge Test:  The likelihood of developing diabetes increases during pregnancy therefore we will perform routine screening at the 24-28 week visit. 
• Group Beta Strep:  This is a test done between 35 and 36 weeks.  This culture is looking for bacteria called beta strep.  It is a normal bacteria that is sometimes found in our bodies.  If you are a carrier, we will treat you with IV antibiotics during labor.

Additional testing and follow-up may be indicated and a provider will discuss this with you as needed throughout the pregnancy.

Below is a list of common medication recommended in pregnancy (for medications/treatments not listed here, contact our office):

Acne

• Topical Benzoyl Peroxide Cream

Allergy

• Actifed, Alavert, Allegra, Benadryl, Claritin, Zyrtec, Flonase, Nasonex

Cold/Flu

• Robitussin DM, Mucinex (plain or DM), Triaminic, Afrin Nasal Spray (maximum of 3 days), Breathe Right Strips, Tylenol Cold/Flu, Vicks VaporRub

Heartburn/Reflux/Gas

• Pepcid, Maalox, Mylanta, Tums, Zantac, Gas-X, Mylicon, Gaviscon, Milk of Magnesia, Prilosec, Nexium, Tagamet

Diarrhea

• Imodium, Kaopectate

Constipation

• Colace, Metamucil, Citrucel, Benefiber, Fibercon, Milk of Magnesia

Hemorrhoids

• Preparation H, Tucks pads, Warm Sitz Bath, Hydrocortisone Cream, Anusol

Fever/Aches and Pain

• Tylenol (Avoid NSAIDs such as Ibuprofen, Advil, and Motrin)

Sleep Trouble

• Benadryl, Unisom, Chamomile Tea, Tylenol PM (Avoid caffeine after noon)

Nausea/Vomiting

• Vitamin B6/Unisom Combination, Ginger Root (250 mg up to 4 times daily), Sea Bands, Dramamine

Skin Rash/Itch

• 1% Hydrocortisone Cream, Aloe, Anti-itch Cream, Caladryl Lotion, Calamine Lotion, Cocoa Butter, Cortaid, Eucerin Lotion, Sunscreen (SPF 30 or more), Vitamin E Lotion

Cough/Sore Throat

• Cough Drops, Robitussin, Cepacol, Warm Salt Water Gargle

Yeast Infection

• Monistat (3 or 7-day treatment)

Tooth Pain

• Orjel, Tylenol (Contact your dentist if pain persists)

 Medications Not Recommended During Pregnancy

• Alka Seltzer, Pepto Bismol, Ibuprofen, Advil, Motrin, Naproxen, Aleve, Anaprox, Castor Oil, Retin-A

Call our office if:

• You can’t keep liquids down for 12-24 hours
• You have abdominal pain, dizziness, extreme weakness
• You have a fever of 101 degrees or higher
• You develop a rash
• You experience pain or burning with urination

Most women only require 300 extra calories per day during pregnancy. Extra nutrients needed during pregnancy include iron, folic acid, and protein. Some of these may be obtained with a prenatal vitamin supplement.

Some iron rich foods include poultry, pork, eggs, green leafy vegetables, sweet potatoes, enriched cereals/breads/rice, green beans, and black beans. Some protein rich foods include chicken, turkey, steak, eggs, pinto beans, nut butters, Greek yogurt, cottage cheese, milk/soy milk, and string cheese.

Due to the common occurrence of nausea and vomiting in pregnancy, especially during the first trimester, some pregnant women find it very helpful to eat smaller more frequent meals throughout the day versus 3 large meals.

Foods to avoid

-Unpasteurized milk or soft cheeses

-Unpasteurized/cold pressed juices and kombucha

-Prepared meats, like hotdogs, and deli meats, unless they are heated until steaming hot

-Raw or undercooked meat, poultry, shellfish

-Shark, swordfish, king mackerel, tilefish

Seafood that is low in mercury, including shrimp, canned light tuna, salmon, and catfish ARE SAFE to eat during pregnancy. You can safely eat 2 servings, or 12 oz. of these fish per week during pregnancy.

Not only is exercise safe in pregnancy, but it is recommended that all healthy women should begin or continue moderate aerobic activity during pregnancy! Guidelines recommend exercising at least 30 minutes per day. A good rule of thumb for intensity or exertion level is still being able to speak in short sentences while exercising.

Exercise has many benefits for your pregnancy and overall health! Walking, swimming, stationary cycling, and aerobics are just a few examples. Activities with a high risk of falling or abdominal injury should be avoided during pregnancy. Some examples of this are snow and water skiing, horseback riding, and other contact sports.

After the 1st trimester avoid exercises that require you to lie flat on your back for long periods of time.

Caffeine intake should be limited to 200mg or less each day. This is the equivalent of 1-2 small cups of coffee per day. Be mindful that all coffee is not created equally and some varieties may contain different amounts of caffeine. Caffeine is also present in many sodas, teas, chocolate, and some medications. Check labels with the nutritional information and caffeine amounts.

Although studies are limited, excessive caffeine intake can affect your baby’s ability to grow well, or be smaller than average. In addition, there is a very small increase in miscarriage with large consumptions of caffeine, thus the restrictive recommendations to 200mg/day.

Immunization is an essential part of care for adults, including pregnant women. The American College of Obstetrics and Gynecologists recommend the following vaccines during pregnancy:

-Influenza

-Tdap

-COVID-19

There are many vaccines that are not safe during pregnancy and therefore may not be given during pregnancy including MMR and Varicella vaccines.  Please consult your provider before receiving a vaccine during pregnancy.