Travel During Pregnancy

• Exercise your legs periodically during prolonged sitting. If unable to get up, as in air travel, move your ankles around and bend and straighten your knees.
• Check with the airline with which you plan to travel to see if they require a letter from your provider.
• Be cautious about what you eat and drink; use bottled water, even to brush your teeth, in areas known to have water that can cause gastrointestinal upset.
• Check with your primary care provider or a health care provider specializing in Travel Medicine about the need for immunization if you are traveling overseas.
• It is your responsibility to check and see if your insurance carrier has any restrictions on travel. Some policies will not pay costs of care for pregnancy if you travel after a certain gestation (most often 36 weeks).

Back to Information Page

Sex During Pregnancy

• After the membranes (bag of water) have ruptured there is danger of infection. (Also tub baths, swimming and douches are dangerous at this time.)
• When bleeding or premature contractions occur.
• If you are known to have placenta previa (the placenta covers the cervix).
• Women who have had repeated miscarriages (more than 2) should avoid intercourse during the time when they have miscarried before.

The only sexual activity that has been documented as dangerous is blowing air into the vagina of a pregnant woman. This can detach the placenta from the uterine wall and cause an air embolism.

If you have questions about sex, please feel free to discuss them with your physician. We welcome your questions.


Back to Information Page

Exercise During Pregnancy

• Those in which there is a danger of getting hit in the abdomen
• Those in which there is risk of a severe fall
• Those in which you are required to lie flat on your back for more than a couple of minutes (this pertains to after 20 weeks gestation)

Common Questions and Concerns of Pregnancy

Abdominal Pain

POSSIBLE CAUSES:

• Round Ligament Pain: Sharp, pulling pains low on either side down toward the groin. They usually increase with movement such as when you move quickly or turn over.

• Braxton Hicks Contractions: Mild, irregular tightening of your uterus that does not increase in intensity or frequency, and disappears spontaneously. It may be more intense after intercourse or when you are dehydrated.

• Constipation: See bowel problems.

PREVENTION AND TREATMENT:

• Change positions slowly, especially from lying to sitting to standing.
• Prop a pillow under your belly when you lay on your side.
• Take a warm (not hot) bath.
• Keep yourself well hydrated (8-10 glasses of water a day).
• Wear a pregnancy abdominal support belt.
• If needed, you may take Tylenol

• Accept them as normal. Keep yourself hydrated, with 8-10 glasses of water a day.
• Take calcium supplements to decrease uterine irritability.
• Take rest breaks during the day.

NOTE: The following conditions may also cause abdominal pain in pregnancy, and do need to be reported to the Doctor.

• Urinary Tract Infection:
  See bladder problems.
  
• Preterm Labor:
  See preterm labor section.
  
• Appendicitis:
  Severe usually right sided abdominal pain which may be accompanied by nausea or vomiting and fever.
  
• Gallbladder or Liver Problems:
  Severe right upper abdominal pain. Gallbladder disease may also be accompanied by nausea or vomiting and/or fever.

Back to Information Page

Back Pain

POSSIBLE CAUSES:

• Stress on back muscles from the extra weight in the abdomen.
• Kidney infection or kidney stone: Pain above the waist and toward one side or the other. These may be accompanied by fever.
• Preterm labor i.e. before 37 weeks:  Pain that comes and goes and is accompanied by tightening of the uterus. There may also be an increase in the amount of vaginal discharge compared to that you have noticed in the earlier part of pregnancy. (see also Preterm Labor section)

PREVENTION AND TREATMENT:

• Massage Therapy (call our office for information).
• Yoga (call our office for information)
• Good posture.
• Proper body mechanics when changing position or lifting.
• Pelvic rock exercises.
• Firm mattress.
• Extra rest.
• Tylenol up to 1000 mg every 3-4 hours.
• Warm (not hot) bath or heating pad on low setting (be careful of burns).

Back to Information Page

Bladder Problems

Urinary Tract Infection (UTI)

CAUSE:

SIGNS AND SYMPTOMS:

• Frequency, having to urinate more than usual.
• Burning when you urinate.
• Not able to urinate when you try.
• Lower abdominal pressure and/or tenderness.
• Blood in your urine.
• Fever.
• Back pain, over your kidneys.

PREVENTION:

• Drink a lot of fluids, particularly water and/or cranberry juice. Do not restrict fluids hoping you won't have to urinate as much. You will actually spend a lot more time in the bathroom and have more pain.
• Urinate frequently, do not hold it.
• Wear loose, cotton clothes.
• Use white, non-perfumed toilet paper.
• Wash before and after sex - a good idea for your partner, too.
• Urinate immediately after intercourse.

WHAT IF I DEVELOP A UTI?

• Contact our office as soon as possible.
• We will arrange for you to do a urine culture for testing.
• Depending on your symptoms, we will either start you on an antibiotic as soon as you've done the laboratory test, or wait until we have results.
• Take all of your antibiotic, even if you no longer have signs and symptoms.
• After your medication is finished, you should have another urine culture done to be sure the infection is gone.

Top

Back to Information Page

Incontinence

CAUSE:

WHAT CAN I DO FOR INCONTINENCE (BLADDER LEAKING)?

• Kegel exercises. Click here for a description of Kegel exercises or you can get information from the office. Do at least 20 repetitions, and hold each to the count of ten. Do these several times a day.
• Wear a pad, and change it frequently.
• Try to have your bladder empty, or cross your legs before coughing or sneezing.

Remember that you are not alone; many pregnant women have this problem.

Top

Back to Information Page

Bleeding (Vaginal)

POSSIBLE CAUSES:

• Small amounts of spotting may be normal in pregnancy. This may occur after a Pap smear, vaginal exam, intercourse, or when the embryo implants into your uterine wall (about the time you miss your first period). Light spotting that is not associated with cramping or abdominal pain does not increase your chance of miscarriage and most often resolves spontaneously.
• Cervical polyps.
• More serious causes may be threatened miscarriage, ectopic pregnancy, placenta previa, or placental separation.

Any spotting in pregnancy should be reported to your physician.

Top

Back to Information Page

Bowel Problems

POSSIBLE CAUSES:

• Constipation: Iron or calcium supplements or dietary deficiencies (not enough fiber or water).
• Hemorrhoids: Constipation or impaired circulation due to weight of the uterus on major veins. These are really varicose veins of the rectum.

PREVENTION AND TREATMENT:

• Eat a diet high in fiber (fruits, vegetables, whole grains).
• Drink lots of water.
• Have regular bowel habits.
• Exercise daily.
• Avoid sitting for long periods of time.
• Use stool softeners - Docusate Sodium - such as Colace. Fiber supplements, such as Metamucil, are also helpful but fluid intake must be increased with them.
• Rectal medications (Preparation H, Anusol) are available to help and may be used during pregnancy.

Top

Back to Information Page

Colds, Upper Respiratory Infections

POSSIBLE CAUSES:

Treatment:

• In general, any cold medicine (see Medications section) should contain a single ingredient and no alcohol. Read the labels. Take the lowest dose possible and only when needed. Vitamin C, 500mgs, 2-3 times per day may help to shorten the duration of symptoms. Also remember to rest, eat well, and drink lots of fluids.
• Fever: A high fever (101°F or higher) does not maintain the healthiest environment for developing babies, especially in early pregnancy. Therefore, they should be treated. You can take up to 1000mg of acetominophen (2 extra strength Tylenol) every 6 hours, but call your physician to let us know you have a fever. Do not take Aspirin (acetylsalicylic acid or ASA) or ibuprofen.
• Cough/Sore Throat: Cough drops are safe, but do not eat them like candy. They have lots of empty calories. Robitussin is an expectorant cough syrup that can help to loosen congestion. Drinking more fluids can do the same thing.
• Nasal Congestion: The decongestant pseudoephedrine (brand name example Sudafed) may be the best choice for cold symptoms. Antihistamines, for example Chlortrimeton or Benadryl may be better for seasonal allergies. Nasal saline spray or drops, a cool mist humidifier, and lots of oral fluids will also help to loosen congestion. Try sleeping with your head elevated on several pillows. Mentholatum or Vicks VapoRub placed on the outside of your nose may also help you to feel the air moving through, and reduce your subjective sensation of stuffiness.

The best principle is to use medications only when you really need to. They may help you sleep, and rest is a very important thing in pregnancy. Remember, these medications do not make a virus go away. Only time, rest, and drinking plenty of fluids will do that. These medications just help you feel better while you are waiting.

Top

Back to Information Page

Dizziness/Faintness

POSSIBLE CAUSES:

• A drop in blood pressure when changing position from lying down to sitting or from sitting to standing can be the cause of dizziness. Pregnancy hormones cause blood vessels to relax which contributes to this phenomenon.
• Low blood sugar may be another cause.

Let your physician know if you actually lose consciousness or fall when light-headed.

PREVENTION AND TREATMENT:

• Move slowly, especially when rising.
• Drink plenty of fluids.
• Wear support hose to prevent pooling of blood in legs.
• Eat well-balanced meals and nourishing snacks.

Top

Back to Information Page

Fatigue

POSSIBLE CAUSES:

• Hormones of pregnancy, mostly in the 1st trimester.
• Later in the pregnancy, carrying extra weight and lack of sleep due to urinary frequency and/or general discomfort.

PREVENTION AND TREATMENT:

• Extra rest, nap when possible, go to bed earlier
• Adequate calories and most fluids by 7 pm
• Regular exercise, but do not overdo it, stay fit.
• Decrease or avoid caffeine.
• Experiment with extra pillows to sleep more comfortably. For example: Tuck one under your tummy and another between your knees.
• Traditional Chinese Medicine techniques (contact our office for more information)

Top

Back to Information Page

Headaches

POSSIBLE CAUSES:

• Sinus pressure from increased fluid volume.
• Eye strain from vision changes.
• Allergies, colds, or flu
• Headaches can be a symptom of high blood pressure.

PREVENTION AND TREATMENT:

• Extra rest.
• Acetaminophen (i.e. Tylenol) up to 1000mg every 4 hours.
• A decongestant for a cold or an antihistamine if you have allergies.
• Traditional Chinese Medicine techniques can be very effective.
• Consult your ophthalmologist or optometrist if your vision changes.

Top

Back to Information Page

Heartburn and Indigestion

POSSIBLE CAUSES:

• Increased stomach acid reflux into your esophagus
• Slowed digestion in pregnancy.

PREVENTION AND TREATMENT:

• Eat small, frequent meals.
• Do not drink fluids with meals, drink them in between meals.
• Minimize acidic or greasy foods.
• Antacids, preferably antacids that have both magnesium and aluminum and are low in sodium (i.e. Mylanta or Gelusil). Magnesium antacids by themselves can cause diarrhea. Aluminum antacids by themselves can cause constipation. Tums contain only calcium and are good for extra calcium, but don't relieve heartburn for very long. Rolaids contain both calcium and magnesium, but not aluminum and are a good choice if you need calcium and have heartburn.

Top

Back to Information Page

Nausea and Vomiting (Morning Sickness)

POSSIBLE CAUSES:

• It is not known what causes morning sickness. There are a number of different theories. It has a relationship to the amount of pregnancy hormone in the blood. Suffice it to say, it happens. It usually peaks around 9 to 10 weeks. Although some women have some queasiness until delivery, it usually has improved significantly or is gone by 14 to 16 weeks.
• The popular name is "morning sickness" but it can be all day or it can be worst at another time of the day.

PREVENTION AND TREATMENT:

• Strive mainly to keep fluids in. Do not force yourself to eat solid food if you are vomiting it.
• If you can tolerate some foods, choose foods high in protein.
• Eat small, frequent meals.
• Try to keep something in your stomach at all times. An empty stomach can make you more nauseated.
• Do not drink liquids with meals, drink them in between.
• Have dry crackers before rising in the morning.
• Eat a bedtime snack, preferably of protein.
• Eat foods that appeal to you and those that do not have strong odors.
• Structure your life so you can rest at the time you usually feel worst, and do more and eat more at times you usually feel better.
• Keep yourself well hydrated. You may only tolerate small sips of fluid or ice chips at a time.
• Take vitamin B6 up to 200mg per day. Take half in the morning and half in the evening or when you can keep it down.
• Drink mint and/or raspberry teas.
• Wear sea bands, acupressure bracelets that put pressure on the Neiguan point of the wrist (two thumbs up from the hand on the inside of the wrist, and about 1cm deep)
• Sip on flat cola, but do not overdo the caffeine and sugar, apple or grape juice can be substituted.
• Traditional Chinese Medicine techniques can be very effective in treatment (call our office for more information)

• Do not eat or drink anything for 4-5 hours. Then slowly start sipping flat cola. If tolerated, slowly increase the amount of liquid you take, and slowly introduce solids. Good bland solids to start with are bananas, rice, apple sauce and toast (the "b.r.a.t." diet). The pace at which you add solids back can vary from 24 hours to several days.

Top

Back to Information Page

Leg Cramps

POSSIBLE CAUSES:

• Impaired circulation in the legs
• Electrolyte (mineral) imbalance.

PREVENTION AND TREATMENT:

• See also sections on swelling and varicose veins.
• Do not point toes.
• Extra rest.
• Take calcium supplements (1000-1500 mg per day). Take your supplement or a glass of milk before bedtime.
• To relieve cramps, stretch leg out and bend ankle with toes toward your head, (Point your heels!). Hold this position until the muscle relaxes. It may feel bruised for a few hours afterwards.

Top

Back to Information Page

Shortness of Breath

POSSIBLE CAUSES:

• Normal changes in your balance of oxygen and carbon dioxide make you feel as though you are short of breath. This is often worst in the first two-thirds of your pregnancy.
• Increasing pressure against your diaphragm by your growing uterus may also make you feel short of breath. Actually you are able to pull in more air than when you were not pregnant, because your chest has expanded. This is a subjective feeling of shortness of breath.

PREVENTION AND TREATMENT:

• Relax and consciously slow and deepen your breathing.
• Stretch your arms up, to further expand your chest.
• Sleep with your head and chest elevated.
• Listen to your body; rest when needed and do not over exert yourself.
• Make sure to buy larger bras, not just cup size but also measurement.

Top

Back to Information Page

Skin Changes (Stretch Marks, Excessive Pigmentation)

POSSIBLE CAUSES:

• Pregnancy hormones cause changes in pigmentation such as darkening of the breast nipple area and the line down the middle of the abdomen (called linea nigra).
• Stretch marks are caused by the rapidly enlarging uterus, sometimes hips and breasts too. Genetics and skin elasticity also play a part in whether or not a person gets stretch marks.
• Other skin changes such as rashes or itching may occur. Call your physician if it is severe.

PREVENTION AND TREATMENT:

• Generally stretch marks and pigment changes are not preventable.
• Lotions, creams, or ointments may relieve dryness and discomfort.
• Stretch marks will fade, to some extent, and increased pigment will resolve after delivery, but it takes several months for these to happen.
• Avoid excess weight gain to keep stretch marks from becoming extreme.

Top

Back to Information Page

Swelling

POSSIBLE CAUSES:

• Swelling of the feet is common in late pregnancy due to increased blood volume and increased abdominal pressure that traps fluid in the legs.
• Other, more serious causes include preeclampsia or pregnancy induced hypertension. This usually involves rapid weight gain, rapidly developing swelling of feet, hands and/or face, along with elevated blood pressure and protein in the urine. These symptoms may also be accompanied by persistent headache, upper abdominal pain, and/or visual disturbances described as spots in front of the eyes or flashing lights. Any of these symptoms need to be reported immediately to your physician.

PREVENTION AND TREATMENT:

• Elevate feet for a period of time each day.
• Do not sit or stand for long periods of time. Get up and walk around.
• Avoid tight, restrictive clothing or knee socks.
• Wear support hose.
• Drink lots of fluid, at least 8-10 glasses per day.
• Swimming, or water immersion in shoulder deep water.

Top

Back to Information Page

Vaginal Discharge

POSSIBLE CAUSES:

• Pregnancy hormones cause increased vaginal secretions (leukorrhea).
• Infections 
• Leaking of amniotic fluid.

PREVENTION AND TREATMENT:

• Do not douche.
• Wear cotton underwear (not just cotton crotch).
• Avoid constrictive clothing.
• Go without underwear while sleeping and at home during the day whenever possible.
• Sanitary pads should be used only when absolutely necessary and changed frequently.

Top

Back to Information Page

Varicose Veins

POSSIBLE CAUSES:

• Increased blood volume.
• Increased abdominal pressure that traps fluid in your legs.
• Relaxation of blood vessel walls.

PREVENTION AND TREATMENT:

• Follow all of the suggestions for swelling in pregnancy.
• If commercial maternity support hose do not give adequate relief, prescription support hose are available.

• Abrupt onset of severe leg pain.
• Swelling of one leg, one side more than the other.
• Localized pain, warmth or redness of leg.

Top

Back to Information Page