Obstetrics Frequently Asked Questions
- What should I expect during my regularly scheduled visits?
- Should I take vitamins?
- What nutritional considerations will I have while pregnant?
- What can I do if I experience morning sickness?
- What about hair color, tanning and waxing while pregnant?
- May I have dental work done while I am pregnant?
- Can I take medications while I am pregnant?
- What over the counter medications are approved for use during pregnancy?
- What should I do if I think I have been exposed to Chicken pox or Fifth Disease?
- What special tests and procedures should I be aware of?
- What are some of the signs and symptoms that I should call immediately for?
- How will I know if I am in labor?
Welcome to the Frequently Asked Questions Section. Here you will find answers to the several of the most commonly asked questions. If you do not see the answer to your questions here, please refer to the GVOG OB Education Handbook where you will find much more information.
As always, if you have any questions left unanswered, please call our office.
What should I expect during my regularly scheduled visits?
The First Visit – Generally between 6-8 Weeks: At your first appointment we will obtain a medical and family history, perform a complete physical exam, answer any questions you may have and provide you with general pregnancy related information. Routine laboratory testing including a pap smear, cultures and urinalysis will be performed. We will check your weight, blood pressure, and do a physical exam. You will also be given a lab requisition for blood work to be drawn and analyzed. These tests may include:
- Blood count to check for anemia and infection
- Blood type and RH factor
- Abnormal antibodies
- Serology (syphilis)
- Rubella to check for immunity to German measles
- Sickle Cell
- Varicella if no history of Chicken pox
In certain situations, an ultrasound exam may be ordered. This is not done routinely and will be ordered only if the provider determines it is medically necessary and will provide important clinical information.
If any of these tests results are not normal you will be notified. Otherwise, they will be reviewed with you at your next office visit. Generally, the next appointment will be with your own doctor and will be scheduled approximately 4 weeks after the first one.
8 -12 Weeks: At each appointment we will check your weight, fetal growth, blood pressure, and urine for protein and sugar. We will review your laboratory tests, listen for your baby’s heart beat, and answer any questions you may have. Your partner is welcome to come with you. A pelvic exam is not usually required again until about 36 weeks.
12-16 Weeks: Routine prenatal visit to check your weight, blood pressure, urine for protein and sugar, fetal growth and fetal heart rate.
16-20 Weeks: Routine prenatal visit to check your weight, blood pressure, urine for protein and sugar, fetal growth and fetal heart rate. We will check the growth of your uterus, and give you a lab slip for your AFP test if you desire. This optional blood test screens for neural tube defects and assesses your risk for having a baby with Downs Syndrome.
18-20 Weeks: An ultrasound to check your baby’s anatomy and growth will be scheduled between 18-22 weeks. You can bring a blank VCR tape to the ultrasound appointment and a few minutes of video will be captured for you of the baby during the ultrasound exam. You may also consider if you would like to learn the sex of the baby. This visit is often combined with a prenatal visit.
20-24 Weeks: Routine prenatal visit. You will be given a requisition and instructions on how and when to get your glucose screening and blood count done. If any of these test results are not normal you will be notified.
24-28 Weeks: Routine prenatal visit. If you are Rh negative, you will be tested for the development of antibodies and given an injection of RhoGam. By now you should be registered for childbirth classes and have chosen a pediatrician. After this appointment you may start coming every 2 weeks.
28-30 Weeks: Routine prenatal visit to check your weight, blood pressure, urine for protein and sugar, fetal growth and fetal heart rate.
30-32 Weeks: Routine prenatal visit to check your weight, blood pressure, urine for protein and sugar, fetal growth, position of the baby and fetal heart rate.
32-34 Weeks: Routine prenatal visit to check your weight, blood pressure, urine for protein and sugar, fetal growth, position of the baby and fetal heart rate.
34-36 Weeks: Routine prenatal. At this visit we will also do a vaginal/rectal culture to check for a bacteria called Group B Strep, which may be harmful to your baby if present at the time of delivery and is untreated. You will now start weekly visits.
36-37 Weeks: Routine prenatal visit. We will also review the signs of labor and you will be given instructions about when and how to contact us when your labor starts.
38 Weeks until Delivery: Routine prenatal visit. We will do a vaginal exam each week to check the status of your cervix and the baby’s position. After a vaginal exam you may experience some slight spotting or staining.
Should I take vitamins?
The need for supplemental vitamins during pregnancy is generally recommended. You may purchase prenatal vitamins at your local pharmacy. Make sure your vitamins contain 30-60 mg of iron and at least 800 mcg of folic acid. Vitamins may cause some stomach distress in early pregnancy. If stomach distress occurs, or if you are unable to swallow pills, you may try 2 children’s chewable vitamins a day. It is also suggested to take vitamins before bed to decrease stomach distress.
What nutritional considerations will I have while pregnant?
Weight gain and Nutrition
For women whose weight is average prior to pregnancy, a gain of 25 to 35 pounds appears to be associated with the most favorable outcome. Generally, this can be accomplished by an increase of 300 calories a day. (A yogurt and a piece of fruit equals 300 calories.) In most women, increasing 300 calories a day can be attained by eating according to your appetite. Meals adequate in milk, dairy products, fruits, vegetables, meats or other protein foods, breads, and cereals are best.
Eliminate raw fish (sushi) and non-pasteurized soft cheeses (brie, feta and blue cheese).
According to the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA), it is recommended you do not eat shark, swordfish, king mackeral or tilefish during pregnancy, and if nursing, due to the high levels of mercury they contain. You may eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury. A few of the most commonly eaten fish, which are low in mercury are shrimp, canned light tuna, salmon and pollock. Another commonly eaten fish, albacore (“white”) tuna contains more mercury than canned light tuna. It is recommended that you limit your intake of albacore tuna to no more than 6 ounces per week of your total 12 ounces.
Eliminate caffeine in your diet.
Avoid snacks such as candy, pastries, and those that are very salty.
It is important to increase your intake of fluids, especially water.
For most pregnant women, Aspartame (NutraSweet / Equal) seems to be safe. However, women with a hereditary error of body chemistry called PKU (phenylketonuria) should not consume foods or drinks with this ingredient. If you have special dietary concerns please consult with your provider.
What can I do if I experience morning sickness?
Morning Sickness occurs most commonly in the first 12 weeks of pregnancy. In some women, morning sickness may persist beyond this point. Morning sickness is generally caused by the many changes going on in your body, especially hormonal changes. Eating small frequent meals may help to relieve morning sickness. Dry crackers, pretzels, anything with ginger, (gingerale, gingersnaps, dry ginger in capsules or ginger tea), and sometimes sour things like sourballs or lemon peel may help. Many women find it helpful to avoid foods that are spicy, fried, gas producing or acidic. Vitamin B6 (100mg 2x per day) and Unisom 12.5 mg. 3x per day may be helpful if other measures do not seem to work. It is important to keep well hydrated. If these measures don’t help, or if unable to keep fluids down or persistent vomiting occurs, call the office.
What about hair color, tanning and waxing while pregnant?
Hair Coloring and Permanents
We suggest that you wait until the second trimester before treating your hair with chemicals, and then only rarely.
Though there is no data to support any ill effect on the pregnancy, tanning has been proven harmful to your skin. We do not recommend it.
Waxing and Electrolysis
Fine during pregnancy.
May I have dental work done while I am pregnant?
You should continue to have your regularly scheduled cleanings and any necessary dental work performed. You must notify the dentist that you are pregnant.
For dental care:
- We approve x-rays with abdominal shielding.
- We approve cleanings, fillings and extractions if needed.
- We approve the use of Novocaine with / without Epinephrine.
- Nitrous Oxide, or “gas”, should not be used during pregnancy.
- If antibiotics are required, we prefer Penicillin, Ampicillian, a Cephalosporin and Clindamycin. Tetracycline and Floxins should be avoided.
Can I take medications while I am pregnant?
NO medication can be guaranteed as “absolutely safe” during pregnancy. However, if your symptoms are severe, certain medications may be indicated. It is especially important to control fevers and prevent dehydration while you are pregnant. If indicated, your primary care physician or dentist may order prescription medications. Please remind them that you are pregnant. If they have any questions regarding medications during pregnancy, they can consult with our staff.
What over the counter medications are approved for use during pregnancy?
The following are medications we have approved for use during pregnancy. All may be taken as directed on the product label unless otherwise indicated.
Shots and Vaccines
- Allergy Shots – It is OK to continue receiving your allergy shots.
- Flu Shots – Influenza vaccines may be used at any time during pregnancy.
- Vaccines – Do not have an MMR vaccine or the varicella (chicken pox) vaccine during pregnancy. Tine test and PPD for tuberculosis may be performed during pregnancy
What should I do if I think I have been exposed to Chicken pox or Fifth Disease?
Chicken pox (Varicella)
If you’ve previously had the chicken pox you have immunity and do not need to be concerned. If you have never had the chicken pox, you should notify us and avoid exposure to anyone with the chicken pox.
Also known as ParvoVirus. About half of all adults have antibodies to it. Infection during pregnancy can be a concern. You should notify us if you think you may have been exposed.
What special tests and procedures should I be aware of?
Special Tests and Procedures
Amniocentesis: Generally performed at the perinatology office at Highland Hospital or Strong Memorial Hospital between 14-16 weeks of pregnancy, a small amount of amniotic fluid is withdrawn from the bag of fluid that surrounds the baby with the guidance of ultrasound. This fluid, which contains fetal cells, is then sent to a lab and analyzed. Cultures can be performed which can be studied for chromosomal abnormalities, such as in Downs Syndrome. Amniocentesis will also reveal the sex of the baby.
Chorionic Villi Sampling (CVS): Usually performed between 10-12 weeks. A sample of tissue is removed from the cervical canal with the guidance of ultrasound. The data obtained is the same as amniocentesis.
Electronic Fetal Monitoring – Non Stress Test: A non-stress test evaluates the baby’s heart rate and movement. This test is completely external and painless and is performed by placing two belts around your abdomen. One belt has a TOCO that measures uterine contractions, another belt has a CARDIO that allows us to hear the baby’s heart rate. You will also be given a hand held device to push a button when the baby moves. This device will mark the movement on the printout. When a baby moves in utero, usually the heart rate will accelerate above the pre-determined baseline of the baby’s heart rate. When there are two accelerations, which meet criteria, in a 20- minute period, we consider it a reassuring sign of fetal well-being.
Kick Counts: One of the tools we sometimes use to determine fetal well-being is to monitor the number of times your baby moves each day. We suggest you begin this routinely once you are at 32 weeks gestation. It is simple to do, non-invasive and painless. Select a time each day, when the baby is generally the most active, to evaluate the number of times the baby moves or kicks. After a meal is generally a good time to perform kick counts. Count each time the baby kicks or moves until the baby has moved or kicked 10 times. Any movement, no matter how slight, counts towards the total number of kick counts. Write down the time you start to count the movements and the time you feel movement number 10. Your baby should move 10 times within two hours during an active period. If the baby does not move 10 times within two hours, that does not necessarily mean anything is wrong, however, if you have not felt the baby move at least 10 times in 8 hours, call our office or the doctor on call.
Ultrasound: Also referred to as a Sonogram. An ultrasound is a picture of the baby created using sound waves. Valuable information can be obtained from an ultrasound such as dating (determining the age of the baby), the size of the baby, and the number of babies! The location of the placenta can be determined and fetal growth can be evaluated. Rarely, birth defects may be detected. Ultrasound can also be used to assess fetal well being by evaluating fetal position, fetal movement, fetal breathing and fetal heart rate and amniotic fluid status.
What are some of the signs and symptoms that I should call immediately for?
The following signs and symptoms may indicate a serious problem and you should call us immediately!
- Severe headaches and visual changes
- Rapid weight gain and swelling of hands, ankles, feet and face
- If less than 34 weeks, uterine contractions ten minutes apart for an hour or six or more in an hour
- If between 34 and 37 weeks, uterine contractions five minutes apart for an hour.
- Menstrual like cramps in the lower abdomen that are continuous in nature and may be accompanied by bleeding or spotting
- Any leaking of fluid from the vagina, especially if large in amount or if bloody or greenish or brown tinged
- A decrease in fetal movement
- Any vaginal bleeding
How will I know if I am in labor?
Common Signs of Labor
- Contractions that are three to five minutes apart for more than one hour if this is your first baby, or five minutes apart if not your first pregnancy.
- Leaking of fluid, either a large gush or trickle, from the vagina
- Bloody Show, or mucous with streaks of blood, is normal and generally occurs up to 2 weeks before labor and delivery