Obstetrics

Q. What over-the-counter medications are safe to take during pregnancy?

                                      PROBLEM                            MEDICATION
                                      Allergies                               Benedryl, Claritin, Zyrtec
                                      Cold/flu/sinus                      Tylenol, saline nasal spray, Neti Pot *see below
                                      Cough                                   Robitussin, Robitussin DM, cough drops
                                      Constipation                        Colace, any fiber containing supplement (Fibercon, Metamucil, etc.) or cereal                                                                                                                               (FiberOne, All Bran)
                                      Diarrhea                               Imodium, Kaopectate (**Call doctor if diarrhea lasts more than 24 hours)
                                      Headache                             Tylenol (extra strength OK) 
                                                                                     DO NOT TAKE Advil, Ibuprofen, Motrin, Aleve, aspirin (unless instructed by your doctor)
                                      Heartburn                            Tums, Maalox, Pepcid, Pepcid AC, Zantac
                                      Hemorrhoids                       Preparation H, Tucks pads, Anusol
                                      Rashes                                  Hydrocortisone cream, Benadryl cream 
                                                                                    **if not resolving/improving over 24 hours, call   your doctor
                                      Yeast infection                    Monistat
*Most cold medications are generally regarded as safe in pregnancy if used for a short period (24-48 hours) of time. Here is some information about some of the components of common cold medications:
*Pseudoephedrine (Sudafed): This decongestant is OK to use on a short term basis after the first trimester. There have been some rare reports of birth defects with this medication if used in the first trimester.
*Phenylephrine (found in Tylenol Cold): This decongestant should not be used in patients experiencing any high blood pressure issues during their pregnancy.
*If using Nyquil or other nighttime cold medications, you may want to purchase the formulation that is alcohol-free.

Q. When should I make my first prenatal appointment?
Call us after you have a positive home pregnancy test.  We will make an appointment for you at approximately 6 ½ weeks of pregnancy.  We perform an ultrasound at your first visit to confirm your due date.

Q. What if I’ve had a miscarriage in the past?
Call us with your positive home pregnancy test.  We will schedule you to come in for lab work to check your HCG level (pregnancy hormone) and your progesterone (hormone that supports early pregnancy).  We follow the HCG level to make sure it rises correctly and then schedule an ultrasound for you at the appropriate time.


Q. What hospital will I deliver at?
Our doctors deliver at Northwest Community Hospital.  This hospital has an obstetrician and pediatrician present 24 hours a day, seven days a week.

Maternity services info: www.NCHbaby.org


Q. Are there any foods I should avoid?
It is recommended that pregnant women do not eat lunch meats or hot dogs unless reheated till steaming hot.  They also should not eat soft cheeses (goat, feta, blue, gorgonzola, brie, queso fresco) unless the package label indicates that the cheese is pasteurized.

Pregnant women can (and should!) eat fish—in moderation (no more than 12 ounces per week).  Avoid tilefish, shark, and mackerel as these have higher mercury content.  Albacore tuna has a higher mercury content than canned light tuna.  Therefore, it is recommended that pregnant women only eat 6 ounces of albacore tuna per week.
Pregnant women should avoid raw or undercooked foods (sorry, no raw sushi!).



Q. I have a cat---should I be worried?
Toxoplasmosis is a parasite that can be found in cat feces.  If a woman is exposed to this in pregnancy, her baby could be affected by hearing loss, mental retardation, and blindness.  Therefore, we recommend that you have someone else change your kitty litter during pregnancy.  If this is not possible, you should wear gloves when handling kitty litter and wash your hands thoroughly immediately following contact.  You may still pet and love your cat!!



Q. What about caffeine?
The current recommendation is that women consume no more than 200 mg of caffeine per day during pregnancy.  This may be most important during your first trimester as there have been some studies that link high caffeine intake with an increased risk of miscarriage.

The caffeine content of certain beverages and foods is listed here:
Coffee (8 oz) brewed (drip)  137 mg
Caffeinated soft drink (12 oz) 25-45 mg
Tea (brewed)   48 mg
Hot chocolate (12 oz) 8-12 mg
Dark chocolate bar   30 mg
Milk chocolate bar   11 mg
Dunkin Donuts 16 oz coffee  143 mg
Starbucks tall coffee (12 oz) 260 mg
Starbucks Grande Caffe Latte  150 mg



Q. Can I dye my hair/get highlights?
Yes.

Q. Can I have an occasional glass of wine during pregnancy? 
Alcohol consumption during pregnancy has been linked to birth defects and mental retardation.  No one knows exactly how much alcohol it takes to cause these problems.  Therefore, it is currently recommended that pregnant women avoid any alcohol intake during pregnancy.

Q. Can I travel during pregnancy?
The American College of Obstetrics and Gynecology state that in an uncomplicated pregnancy, a woman may travel by plane up to the 36th week of pregnancy within the United States.  The best time to travel is during your second trimester (14-28 weeks).  Generally, women feel better during this phase of pregnancy (less nausea, not too uncomfortable yet).  If you are taking a long trip, we recommend that you move around (flex and extend your legs, walk) in order to avoid blood clots.  If travelling by car, you should always wear your seat belt!

Q. Can I exercise during pregnancy?
If you currently exercise, you may continue to do so.  You may need to modify your work out somewhat to include more low impact activities.  In general, walking, elliptical machines, exercise bikes, prenatal exercise classes and light weight lifting are considered safe.  Activities that are high risk for falling or abdominal trauma (skiing, gymnastics, horseback riding) are not recommended.  If you have not previously exercised, please ask us for recommendations in the office.  If you experience any of these symptoms during exercise, you should stop immediately: vaginal bleeding, contractions, shortness of breath, dizziness, or chest pain.  You should always stay well hydrated during your work out.  After 20 weeks, we do not recommend exercises that require you to lay flat on your back like sit-ups.

Q. I’ve been exposed to Fifth’s disease—what should I do?
Please call the office and schedule a time to come in for bloodwork.  We will test to see if you’ve been infected by/exposed to Parvovirus, the virus that causes Fifth’s disease.  Most often, even if your bloodwork demonstrates a new infection, there will be no problems for your baby.  However, occasionally a fetus can develop anemia from parvovirus exposure, so we follow our exposed patients along with a high risk obstetrics physician to ensure the health of your baby.  
For more information:  www.cdc.gov/ncidod/dvrd/revb/respiratory/B19&preg.htm 


Q. I’ve been exposed to Shingles—what should I do?
If you had chicken pox in childhood, you are immune for life and shingles exposure will not affect you or your baby.  If you are not sure if you are immune to varicella (chicken pox), we can test for this and make further recommendations based on your results.

Q. I want to help paint the baby’s new nursery—is this OK?
Yes.  Paint fumes are not known to cause birth defects or harm to your baby.


Q. What do I do if I think I’m in labor? 
We recommend you call us if:

You are not full term and are experiencing tightening/cramping/contractions more than 4-6 times in one hour.  If this does occur, please drink lots of fluids, lay down on your side and rest.  If the contractions do not resolve, please call.  You should also call if you feel you are leaking fluid.
In any trimester of pregnancy, if you have bleeding like a menstrual period or heavier, call us.  It can be normal to have some light spotting after intercourse or a vaginal exam in the office.

If you are full term and begin to have contractions, time them.  When they have been five minutes or less apart over one to two hours and seem to be getting stronger, call us.  If you feel your water has broken, call us.
If you are in your third trimester, and are not feeling your baby move as much as usual, we recommend you eat and drink something, lie down on your side and pay close attention for movements. The American College of Obstetricians and Gynecologists (ACOG) recommends that you note the time it takes to feel 10 kicks, twists, turns, swishes, or rolls. A healthy baby should have 10 movements in less than 2 hours.  If you do not get enough movements, please call us.

 

Q. Who will deliver my baby?
We currently have 6 physicians that care for our obstetric patients.  The doctor that is on call when you go into labor is usually the doctor that will deliver your baby.  We do our best to ensure that you meet all of our OB doctors prior to your due date so that you will feel comfortable with the doctor that ends up delivering your baby.

 Q. Should I make a “birth plan”?
A birth plan is a statement of expectations and desires for the birth experience of parents-to-be.  It is completely optional.  As a group, it is our goal to help you achieve an exceptional delivery experience while doing what’s best to keep both you and your baby healthy.  We try to work with you and your family to meet your expectations and desires during the birthing process whether you’ve actually put those in writing or not.  Below is a short list of things that have mentioned in past birth plans and our philosophy regarding such:

I would like to move around during my labor.This is perfectly acceptable.  We have “telemetry” available at our hospital which allows for fetal monitoring while the patient is out of bed (walking, in rocking chair, etc.).
I would like a natural birth experience without pain medications. Whatever your wishes regarding pain control—they are OK with us.  If you do want an epidural, generally that is given during the beginning of the active phase of your labor and can be redosed if necessary.  If you do not want an epidural, our staff and nurses are happy to work with you to find comfortable positions and also can work with a doula if you so choose.
I would prefer not to receive Pitocin.  Pitocin is a medication used to bring on stronger and more frequent contractions.  It is the brand name for the hormone “oxytocin”, which is what your body produces naturally to cause contractions and labor.  It is most often used if we need to induce someone’s labor.  Many patients are able to go through labor without Pitocin.  However, sometimes labor “arrests”, meaning a patient’s cervix stops dilating.  Often it is due to the fact that contractions have slowed or are not strong enough.  In these cases, Pitocin can be used to augment your labor.  Before starting any such medications, we would always review that with you and decide together if that is the best thing for your labor.
I do not want a vacuum or forceps used for my delivery. These instruments are only used if medically necessary.  We will have a discussion with you if that time comes so that we can make the decision together.
I would like my husband with me during my entire labor and delivery.We are happy to have your husband with you during your delivery.  Our patients also sometimes request that their mother and/or mother-in-law also be present and this is usually possible as well.  If you require a c-section, only one family member is allowed with you in the operating room, however.

I do not want an IV. Although you do not need to be continuously hooked up to intravenous (IV) fluids, we recommend at least “saline lock”.  This means the IV is in your vein but not hooked up to any machines, bags, or pumps, thereby allowing you mobility.  We like to have the IV in place in case an emergency arises which requires IV access.
I do not want an episiotomy. An episiotomy is a surgical incision made in the perineum to enlarge the vaginal opening before the birth of the baby's head.  We do not perform “routine” episiotomies.  Most often, they are performed if there is concern about the baby’s well being and cutting an episiotomy might help expedite your baby’s delivery. 
I want to hold my baby as soon as possible.  As long as your baby is crying and vigorous at delivery time, we are happy to place the baby on your belly so you can begin bonding as soon as possible.  We are also happy to have the father cut the baby’s cord as long as the delivery has proceeded normally.  Occasionally, a baby may have a harder time in this transition period and need some extra stimulation and care.  In a case like that, we would bring the baby to the warmer first for evaluation, and then bring the baby back to you as soon as possible.  We’d also like you to breast feed when/if you feel ready.  There are a few things the nurses will need to do with the baby right after delivery (weight, length, warming, swaddling, etc.) and then she can help you with starting to breast feed.

Frequently Asked Questions:

​​Call Us:  847-394-3553

 Northwest Women's Consultants