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Obstetrics
Frequently Asked Pregnancy Questions

What should I know about travel?
Generally, travel is ok up to approximately 35 weeks gestation in an uncomplicated pregnancy. Please check with your provider before planning any trips near the middle or end of pregnancy or if you have high risk issues with your pregnancy. Any travel during pregnancy is at your own risk and it is recommended you know a hospital at your destination and bring a copy of your prenatal chart with you should you need care on your trip. You are more prone to blood clots in your deep veins when you are pregnant and these can be life threatening. To decrease this risk, anytime you are traveling, please get up and walk around every 1.5 to 2 hrs. Also remember to stay hydrated.

What do I need to know about nutrition?
In general, to meet the metabolic demands of your pregnancy, you need an increased caloric intake of 300 calories/day. This is not “eating for two” but instead a modest increase in calories. Please see the weight gain recommendations for further guidelines.

Please limit caffeine and artificial sweeteners to 2 servings/day or less.

We recommend 1200-1500 mg of calcium daily during pregnancy either in your diet or with supplements. If you use supplementary calcium, please avoid bone meal, dolomite, or oyster shell products as these may contain lead.

Do not take additional vitamin supplements unless directed by your physician to do so.

During the first trimester (3 months), do not worry a lot about the nutritional aspects of your diet. Sometimes you just need to eat whatever sounds good to control your nausea. Prenatal vitamins can be difficult to tolerate because of nausea in the first trimester. If this is the case for you, please substitute just folic acid – this will not contribute to nausea.

Pregnant women should limit consumption of undercooked meat, deli meat, sushi, and soft unpasturized cheeses because of a rare disease called Listeria that can have detrimental effects on a pregnancy.

Please avoid all alcohol when pregnant.

Is consuming Omega-3 / Fish Oil ok?
There are 3 fatty acids which are part of the Omega-3 group: DHA (docosahexaenoic acid), ALA (alphalinolenic acid), EPA (eicosapentaenoic acid). There is no official “recommended daily value” but the FDA recommends one should consume no more than 2 grams/day from supplements or no more than 3 grams/day total. These fats are felt to be lacking in the typical American diet. Omega-3s are felt to have a role in fetal brain and retina (eye) development.

Diet access to omega-3s in fish is restricted in pregnancy due to the contamination of some fish with mercury and other heavy metals. There are guidelines to allow for some omega-3 consumption but limit intake of heavy metals.

AVOID shark, swordfish, mackerel, tilefish, and tuna. Canned light tuna is ok; white albacore tuna is NOT ok as it may have higher mercury levels. Please see the Minnesota Department of Health Fish Consumption handout or website for more details of these guidelines and information about other fish.

We recommend supplements to get adequate, safe Omega-3s. Fish Oil / Omega-3 supplements: 100 - 500 mg DHA per day (depending on brand, 124-250 mg twice a day). Remember, these are supplements, not medications, so they are are NOT regulated by the FDA. Expecta is a Omega-3 supplement made by a baby formula company – many of our patients take this brand. Side effects: fish breath, bloating, flatulence, diarrhea, heartburn. Consider stopping supplements a few weeks before your due date because of possible increase in bleeding on these supplements.

What about my pets?
If you have a cat at home, don’t empty the litter box while pregnant. If you must, wear gloves, cover your mouth and nose with a hankerchief and empty the box at least every 24 hrs. Cats can carry an organism in their feces that causes toxoplasmosis.

Is sexual activity good or bad?
There is no need to limit intercourse during pregnancy unless there are special circumstances such as bleeding, a placenta previa, early contractions, or ruptured membranes. Please ask your provider if you have specific questions.

Can I wear my seat belt?
Please always wear your seatbelt during pregnancy. Wear the lap belt low across your hips (under your belly) and keep the shoulder harness on.

What if I experience violence?
Physical, emotional, and sexual violence and abuse against women are more common during pregnancy. If you do not feel safe or someone is hurting you in any manner, please let us know so we may help to ensure your safety and that of your baby.

What are fetal movement counts (aka “kick counts”)?
In the third trimester (after 28 weeks), you should pay attention to your fetus’ movements. Fetus’ go through sleep and wake cycles so they are not always moving. During active times for your fetus and when you are paying specific attention to the activity, you should feel 10 movements in 2 hours. If you do not feel this amount of movement, please call our office as it can be a sign of fetal stress.

Should I worry about chicken pox?
If you have had chicken pox previously, there is NO RISK to you during pregnancy. If you are exposed to someone with chicken pox and do not know if you have had it before, a blood test can be done to find out if you have had it previously.

What should I do if I have nausea?
It is recommended to eat small frequent meals. Be careful to maintain hydration by sipping liquids. Avoid any smells or foods that trigger your nausea. If that alone is not helping enough, there are a number of over the counter vitamins/medications that have been shown to be helpful. One of these is ginger and you may try this. Other suggestions are Vitamin B6 (pyridoxine) 25 to 50 mg and Unisom (doxylamine) 25-50 mg at bedtime. Benadryl 25 mg at bedtime instead of Unisom can also be tried. All these medications are safe in pregnancy. Please notify the clinic if you are unable to keep food and/or fluids down for 24 hours or more.

What should I do if I have a cold, allergies, pain, constipation, hemorrhoids, or heartburn?

  • Cold: colds tend to last longer in pregnancy – often up to 2 weeks. Colds are caused by a virus and there is no medication to cure a cold, like an antibiotic; they just need to run their course. To feel better, try to get lots of rest and drink fluids. You may use Tylenol, Robitussin DM, Sudafed, antihistamines, saline nasal sprays, or throat lozenges for cold symptoms. Please do not use Sudafed if you have high blood pressure.
  • Allergies: over the counter antihistamines are safe (Claritin, Zyrtec, Benadryl)
  • Pain: you may use Tylenol. Please do NOT take any aspirin or ibuprofen type products (this includes Motrin, Aleve, naproxyn or any product containing any of these pain medications).
  • Constipation: this is very common during pregnancy. You should get plenty of fluids, exercise, and eat a high fiber diet including lots of raw fruits and vegetables. You may try bran and prune juice. You may use Citrucel, Metamucil, Fibercon, Colace. If these aren’t working there are other over the counter medications that your provider can recommend.
  • Hemorrhoids: Anusol, Anusol HC, and Preparation H are safe to use in pregnancy.
  • Heartburn: This is a common problem. Limit spicy food, large meals, and eating right before lying down. Tums, Rolaids, Zantac, and Prilosec are all safe in pregnancy. If you have severe heartburn associated with a significant headache, please call our office or doctor on call.
**Whenever a medication is prescribed to you during your pregnancy, please be certain the doctor prescribing it knows that you are pregnant.

What about immunizations?
You may have your diptheria/tetanus booster during pregnancy. All pregnant women are recommended to have a flu shot during flu season. Flu shots are not given to newborns so by you getting the vaccine, you are helping to protect both yourself and your baby.

What about self tanners, coloring my hair, sunscreen and bug spray?
There is no good scientific information regarding the safety of self tanners and hair coloring. They are likely to be safe but some people avoid using them during pregnancy. Sunscreen is recommended all the time including during pregnancy. Insect repellent is recommended due to the risk of mosquito-transmitted viruses. You may use insect repellents with a low concentrations of DEET (up to 27% is considered a low concentration) and wear long sleeves and pants.

What about exposure to other environmental hazards?
Please avoid fumes from the following products: oil-based paints, paint thinners, paint/wood strippers, varnishes, pesticides, herbicides. Cigarette smoking has been associated with many complications in pregnancy including premature delivery, a low birth weight baby, and stillbirth. Infants around smokers have higher rates of upper respiratory infections, ear infections, and SIDS (Sudden Infant Death Syndrome).

Can I use hot tubs, saunas, or tanning beds during pregnancy?
Because your body temperature gets elevated, these can be harmful to the growing baby or to you. We recommend you do NOT use these during pregnancy. Warm baths with a water temperature less than 100 are ok.

Who will delivery my baby? What about physician “on call” coverage?
We currently have 10 physicians who take care of obstetric patients. The physicians in our group usually cover and deliver their own patients Monday through Friday from 7am to 5pm. Most doctors have ½ to 1 day per week when they are off and are covered by another physician. The doctors rotate call on weeknights, weekends, and holidays. Patients interested in care only by a female physician need to be aware that a female physician may not always be available for their delivery.

When should I call with questions? What about after business hours?
If you have non-emergent questions and or concerns, please write them down to discuss with your provider at your next scheduled appointment. If you have a concern or question that cannot wait until your next appointment, please call during weekday business hours (9-5) and a physician, nurse practitioner, or nurse will return your call.

If you have an emergency or urgent matter that cannot wait until business hours, there is a physician on call to address your concern. Please call the clinic number and leave a message with the answering service. The doctor on call will be notified and will return your call. Emergent or urgent concerns include heavy cramping, severe pain, labor, vaginal bleeding, thinking your water has broke, a severe headache, decrease or lack of fetal movement, or a fever of 101 or more.