Pregnancy FAQ's
- 1. What can I expect at my first visit?
- 2. Who will I see at my appointments?
- 3. What should I expect if I am pregnant with twins?
- 4. What about using alcohol, smoking, drugs, and caffeine?
- 5. Should I take a prenatal class?
- 6. Are any other classes offered if this is not my first child?
- 7. How do I find a Lactation Consultant?
- 8. What discomforts may I expect?
- 9. Is it safe to dye my hair when I'm pregnant?
What can I expect at my first visit?
Your very first visit in early pregnancy will be with the nurse or Nurse Practitioner. This visit will provide you with an overview of prenatal education that you will need throughout your pregnancy. In addition, comprehensive personal and family health histories will be reviewed with you to better assess any risk factors that could affect your pregnancy. A lab slip will be given to you during this visit so that initial blood work can be collected to establish baseline values. Occasionally, additional tests will be ordered but the initial labs will always include blood type and screen, CBC, RPR, Rubella titer, HIV, Hepatitis B, as well as a urine culture. An explanation of common labs in pregnancy will follow in the next section.
At your first or second OB visit, a representative of the Business Office will meet with you to discuss the billing and fees for your maternity care. Normally, a “global fee” is billed to your insurance at the time of delivery rather than paying at individual visits. Services covered under our “maternity package” will be reviewed with you, as well as any services or “out-of-pocket” expenses that may fall outside of that package. Our office will talk with your insurance carrier to verify maternity benefits, then will estimate your portion of the charges. Since co-insurance and deductibles can often amount to several hundred dollars, we will work with you to set up a plan to “pre-pay” as much of this as possible before your delivery so you won’t have to worry about our bill as well as the hospital and anesthesiologist charges after the delivery.
It is important that we have current insurance information, so if your coverage changes during your pregnancy, please notify our office immediately. Of course, we urge you to contact us at any time if you have questions about your account, insurance, or claims.
Your initial prenatal visit will be a medical exam. This visit is similar to an annual exam visit in which a complete exam, including a pelvic exam, will be done. A pelvic exam is done to make sure that the pregnancy is progressing at the expected rate in regards to the date of conception. In most cases, a pap smear will be done during the exam and occasionally, cultures may be taken as well if infection is suspected. At each visit, your blood pressure and weight will be taken by the nursing staff and you will be asked to give a urine sample. With that in mind, if you need to use the restroom as soon as you arrive, just let the receptionist know and she will give you the supplies needed to obtain a urine sample.
GARDASIL also helps protect girls and young women ages 9 to 26 against 70% of vaginal cancer cases and up to 50% of vulvar cancer cases.
GARDASIL may not fully protect everyone, nor will it protect against diseases caused by other HPV types or against diseases not caused by HPV. GARDASIL does not prevent all types of cervical cancer, so it's important for women to continue routine cervical cancer screenings. GARDASIL does not treat cancer or genital warts. GARDASIL is given as 3 injections over 6 months.
Who will I see at my appointments?
The main provider of your care during pregnancy is your doctor, but there may be times when another physician will attend to your needs. Doctors have many roles. Occasionally they take weekends (Saturday and Sunday) off so the doctor will not be on call. In addition, there may be other times he/she will be gone due to speaking engagements or educational seminars. In the event the doctor needs to be gone, another qualified physician of doctor’s choosing will cover any emergencies or deliveries in his/her absence. Rest assured because, as always nurses, and other office staff members are always there to help in any way possible.
What should I expect if I am pregnant with twins?
If you are pregnant with twins, keep in mind that the amount of weight gain appropriate is about 50 % more than those moms pregnant with one fetus. In addition, your weight gain will be a bit quicker as two fetuses will gain more quickly than one alone.
The woman carrying twins has at least twice as much to think about nutritionally as the woman carrying a single fetus. This doesn’t mean that she needs twice as many calories or nutrients, but it does mean she needs some additional daily nutritional requirements. The mother-to-be with twins needs an additional serving of protein, whole-grains, and calcium. Additionally, the need for daily iron intake increases.
What about using alcohol, smoking, drugs, and caffeine?
Most things are okay in moderation during pregnancy. Alcohol, smoking, and street drugs and many other-the-counter drugs are not. The placenta has several functions and one is to act as a “filter” for the baby. This “filter” works to eliminate many toxins from the baby, but alcohol passes right through the placenta to the fetus. Each time you take a drink of alcohol, so does your baby. Alcohol is broken down much slower by the fetus than in an adult, so levels of alcohol are higher for longer periods of time and can cause problems for mother and baby including miscarriage, stillbirth, low birth weight, mental retardation, and heart and brain defects of the fetus, physical deformities, and learning disabilities. No amount of alcohol use during pregnancy has been proven safe!
Smoking is harmful for you and your baby and increases the risk of complications during pregnancy. Chemicals in tobacco products interfere with the fetus receiving nutrients and oxygen. Blood vessels are constricted which causes damage to the placenta. This reduces the blood flow and thus oxygen to the fetus. Smoking is thought to cause preterm labor, placental previa, low birth weight, SIDS, childhood respiratory problems like asthma, physical growth deficit of baby and learning disabilities.
Marijuana causes problems similar to smoking by decreasing the oxygen and nutrients to baby. Using marijuana in pregnancy can result in miscarriage, stillbirth, irritability in the newborn, premature labor, and low birth weight.
Street drug use also causes many problems in the fetus. Cocaine is highly addictive for mom and fetus and causes constriction of blood vessels which decreases the blood flow to the fetus, decreasing the amount of oxygen and nutrients baby gets. Cocaine can cause preterm labor, miscarriage, placental abruption, low birth weight, increased irritability in the newborn, and brain damage.
There are no studies reporting absolute contraindications to caffeine use in pregnancy nor are there studies that report the safety of caffeine use in pregnancy. With this in mind, we recommend that caffeine be avoided in the first trimester, but may be consumed in moderation through the remaining pregnancy.
Should I take a prenatal class?
An important part of preparing for labor and delivery is prenatal class, particularly if this is your first pregnancy. Classes help prepare you for the labor and delivery process. The better educated you and your partner are about the process, the more relaxed you can be during labor.
Are there any other classes offered if this is not my first child?
Bringing a new baby home is an adjustment for the whole family. If you have other children at home, you and your little ones may want to look into attending the Sibling Class offered at your local Hospital. Your hospital stay and becoming a big sister or big brother will be discussed. A tour of the OB Unit is often given so children understand where you will be while you are away and the children often get to see a newborn.
How do I find a Lactation Consultant?
If you are having problems breastfeeding it is important to talk with your doctor, nurse or a breastfeeding support person such as a peer counselor or lactation consultant. To find a lactation consultant near you, contact the International Lactation.
Consultant Association:
ILCA Office
1500 Sunday Drive, Suite 102
Raleigh, North Carolina, 27607, USA
Telephone (919) 861-5577
Fax (919) 787-4916
E-mail: info@ilca.org
What discomforts may I expect?
You may experience some discomforts during pregnancy and have concerns about how to treat them as well as medications that are acceptable to take. Although we would suggest you use non-medicinal treatments first, if no relief is provided, talk to your doctor about which over-the-counter medications can be used in pregnancy after the first trimester (12 weeks gestation). Please call if you have specific questions regarding treatment or if symptoms do not improve or are getting worse.
Nausea and Vomiting
Nausea and vomiting may occur during the early months of pregnancy. It can occur any time of the day or night. It usually disappears after the third month. “Morning sickness” is actually the result of increased amounts of hormones produced by the ovaries early in pregnancy. These hormones cause an increase in the production of gastric juices. They also slow down your stomach and bowel functions. This results in a feeling of nausea and sometimes vomiting.
Prevention of morning sickness: try the following suggestions until you find what works for you:
- • Eat a piece of bread or a few crackers before you get out of bed in the morning (place them by your bed the night before) or when you feel nauseated.
- • Get out of bed slowly. Avoid sudden movements.
- • Have some yogurt, cottage cheese, juice, or milk before you go to bed, or before you get up. You can also try one of these if you have to get up during the night.
- • Eat several meals during the day so your stomach does not remain empty for very long.
- • Eat high-protein foods – eggs, cheese, nuts, meats, etc. – as well as fruits and fruit juices. • These foods help prevent low levels of sugar in your blood, which can also cause nausea.
- • Drink soups and other liquids between meals instead of with meals.
- • Avoid greasy or fried foods. They are hard to digest.
- • Avoid spicy, heavily seasoned foods, but salt to taste.
- • Avoid brushing teeth immediately after eating.
-
Remedies or morning sickness:
- • Rest as needed with feet up and head slightly elevated.
- • Slowly sip a carbonated beverage or carbonated water when you begin to feel nauseated.
- • Get fresh air. Take a walk, sleep with a window open. Use an exhaust fan when cooking.
- • Eat saltines & bananas.
- • Take deep, slow breaths.
- • Drink spearmint, raspberry leaf or peppermint tea.
- • If vomiting persists, or it becomes difficult to retain food/liquids, contact our office.
- • Avoid anti-nausea medication available over the counter unless recommended by our office.
Fatique
Increase rest, plan extra help around the house, especially the last month. Go to bed early.
Breast Tenderness
Breasts may become tender in early pregnancy due to hormonal changes in your body. Wear a supportive bra, even at night if necessary.
Dizziness
The dizziness may be due to anemia or low blood sugar, but most likely the pressure of the uterus on large blood vessels. Do not stand for long periods of time and don’t lie flat on your back. Get up slowly when sitting and avoid sudden changes in position. Eat several small meals throughout the day to keep blood sugar up.
Frequent Urination
The pressure of the growing uterus on the bladder can cause frequency of urination. If you experience pain, burning, or urgency with urination, you may have an infection so please call the office. Otherwise, use the restroom frequently, drink plenty of fluids, and do kegal exercises to build pelvic floor support.
Backache and Groin/Round Ligament Pain
Pregnancy hormones soften joints and ligaments which can cause pain in your back and in the lower abdomen. A common pain is round ligament pain in which the ligament that holds your uterus in place begins to stretch with your growing belly. Keep good posture and practice good body mechanics when lifting. Change positions frequently and perform exercises such as pelvic tilt and knee-chest positions. Soaks in a warm bath may also be helpful. For sacral-iliac joint pain (lower back near tail bone), alternative therapies like chiropractics or massage may relieve some discomfort. Please talk with the Doctor before doing alternative therapies.
Is it safe to dye my hair when I'm pregnant?
We don't know much about the safety of hair dyes during pregnancy. It's likely that when you apply hair dye, only a small amount is absorbed into your system. So very little chemicals, if any, would be able to get to your baby. In the few animal and human studies that have been done, no changes were seen in the developing baby.
Talk with your doctor if you have questions or concerns.
For more information on cosmetics or hair dye, contact the National Women's Health Information Center at 800-994-9662 or the following organizations:
Food and Drug Administration (FDA), OPHS, HHS
Phone: (888) 463-6332 (Consumer Information)
Office of Cosmetics and Colors Automated Information Line, FDA, OPHS, HHS
Phone: (888) 723-3366
American Academy of Dermatology (AAD)
Phone: (888) 462-3376
Mayo Foundation for Medical Education and Research Skin Center
Phone: (480) 301-8000