This is a brief list of the questions that may arise during your pregnancy. If you have further questions please don’t hesitate to call the office. Also visit our website at www.kmobgyn.com.
At which hospital will I deliver my baby?
Our physicians are proud to deliver at the Wake Med “Raleigh Campus”. The address is 3000 New Bern Avenue Raleigh, NC 27610.
How do I contact a physician if I have an emergent question/concern or may be in labor?
Always call our office at (919) 781-6200 with any questions or concerns. If you have an emergent question/concern or may be in labor outside of normal office hours (ie: between 5pm-8am, weekends and holidays), please still call our main office number first. The on-call physician will be paged and return your phone call as quickly as possible. If you are not experiencing a life-threatening emergency, always call our office number before proceeding to the hospital.
What should I be eating (and NOT eating) during pregnancy?
Most women only require ~ 300 extra calories per day during pregnancy—which is equal to half a sandwich and a glass of skim milk. Extra nutrients needed during pregnancy include iron, folic acid and protein; a portion of these may be obtained with a daily prenatal vitamin supplement. The U.S Department of Agriculture has designed an online interactive diet-planning program specifically for women who are pregnant or breastfeeding called the “Daily Food Plan for Moms”. You may access this program at www.choosemyplate.gov/mypyramidmoms/index.html.
Moderate caffeine intake of 200 milligrams per day or less (the amount in approximately two 8-oz cups of brewed coffee) does not appear to increase risk of miscarriage or preterm birth and is considered safe during pregnancy.
Foods to Avoid
- Unpasteurized milk or soft cheeses
- Raw or undercooked meat, poultry, shellfish
- Shark, swordfish, king mackerel, tilefish *Seafood that is low in mercury, including shrimp, canned light tuna, salmon, and catfish ARE SAFE TO EAT during pregnancy. You can safely eat up to 12 oz (about 2 meals) of these fish per week while you are pregnant
- Prepared meats, like hot dogs and deli meats, unless they are heated until steaming hot
How much weight should I gain?
Recommended weight gain during pregnancy depends on your pre-pregnancy weight. Women who have a normal body mass index (BMI), a measure of body fat based on height and weight, should gain between 25-35 pounds. If your BMI is > 30, the recommended weight gain is only 11-20 pounds. Anticipate gaining up to 5 pounds during the 1st trimester, and then ½ to 1 pound per week after that.
Is exercise safe during pregnancy?
Yes! Not only is exercise safe in pregnancy, but it is recommended that all healthy women should begin or continue moderate-intensity aerobic activity during pregnancy. Current guidelines recommend exercising at least 30 minutes per day on most days of the week. The American College of Obstetrics and Gynecology no longer recommends limiting maternal heart rate to 140 beats per minute. A good rule of thumb for a safe, moderate exertion level is being able to speak in short sentences while exercising.
Exercise has many benefits for your pregnancy health and can be accomplished easily with walking, swimming, stationary cycling and aerobics. Activities with a high risk of falling or personal injury like water skiing, snow skiing, horseback riding and contact sports should be avoided. After the 1st trimester of pregnancy, avoid exercises that require you to lie flat on your back for long periods at a time.
Can I travel while pregnant?
Yes. The best times to travel during pregnancy are typically between 14 and 28 weeks gestation because the most common pregnancy emergencies occur during the 1st and 3rd trimesters. However, for uncomplicated pregnancies, car and air travel can be done up to 36 weeks. Remember to drink plenty of water during travel to stay hydrated.
If traveling by car, it is recommended to stop every 2 hours or so to get out of the car and move around to increase circulation. If flying, it must be with a commercial airline or pressurized aircraft. Domestic airlines may require a medical certificate, especially if you are approaching the last month of pregnancy. If you are planning an international flight, the cut-off point for traveling with international airlines is often earlier. Many cruise companies require that you be less than 24 weeks to cruise. If there have been any complications in your pregnancy, please call the office before you make travel plans.
We are going on vacation. What activities are allowed?
Safety should always be kept in mind and common sense should prevail. Activities with a high risk of falling or personal injury like water skiing, snow skiing, horseback riding and contact sports should be avoided. Scuba diving is also not safe during pregnancy due to surrounding pressure changes and risk of decompression sickness. Avoid rides at amusement parks labeled “Not for Pregnant Women” or those that create sudden jerking movements.
Is it safe to use a hot tub or sauna while pregnant?
Hot tubs and saunas should be avoided during the first trimester as the heat may affect development of the neural tube, and could increase risk of neural tube defects like spina bifida. After the first trimester, it is prudent to limit hot tub use to 10-15 minutes and to stay well hydrated. Hot baths are safe as long as the water temperature is below 100ºF.
Can I “tan” while I’m pregnant?
Yes, pregnant women can tan outdoors, but need to use extra precautions because of increased sun sensitivity. Pregnant women are more prone to sunburn, sun spots, and sun exposure can worsen the “pregnancy mask” characterized by darkening of the skin around the eyes, nose and mouth. Be sure to use sunscreen and drink plenty of water because high temperatures can also cause dehydration.
Self-tanners (ie Mystic Tan) typically do not penetrate the skin and may be used safely in a well-ventilated area.
Am I allowed to paint?
Painting with latex paint is considered safe during pregnancy with proper ventilation. However, please do not climb on ladders while pregnant due to changes in balance and fall risk.
Is it safe to color my hair?
According to the American College of Obstetrics and Gynecology hair dyes are probably safe for use during pregnancy because so little dye is absorbed through the skin. We recommend avoiding hair coloring during 1st trimester and using partial head color or highlighting if possible to reduce dye exposure.
Do I need the Flu vaccine?
The flu vaccine is recommended by the American College of Obstetrics and Gynecology (ACOG) and the Centers for Disease Control (CDC) for all women who will be pregnant during the flu season. In order to receive the Flu vaccine, please schedule a separate nurse visit for your injection or you may receive the vaccine when you are here for an appointment. This can be given during any point in your pregnancy.
Are dental visits safe?
Yes, dental work, including routine cleanings and cavity fillings, is safe during pregnancy. Be sure to notify your dentist before your visit that you are pregnant. X-rays are safe during pregnancy if necessary, but require double lead shielding of the abdomen. If you require a dental filling or more extensive surgery, local anesthesia WITHOUT epinephrine is recommended. Most antibiotics used for dental purposes are in the penicillin family and are safe for use during pregnancy.
What if I am in an accident?
If you have any slips or falls and strike your abdomen, call our office immediately. When driving please wear your seat belt. If you have an automobile accident, please call our office as soon as possible.
I have severe nausea and vomiting. What can I do?
Nausea and vomiting of pregnancy is very common and affects 70-85% of women, with 50% of women experiencing both nausea and vomiting. Hormonal changes, emotional factors and delayed emptying of the stomach can all cause these symptoms. Unlike the common term “morning sickness”, nausea and vomiting of pregnancy may occur any time of day or night.
We recommend eating frequent small meals that combine protein and carbohydrate every few hours. You may also try eating a small bland snack, like crackers, before getting out of bed in the morning. Limit fatty and spicy foods intake. Eat foods high in B complex: Nuts, dried fruits, green leafy vegetables, brown rice & brewers yeast.
The American College of Obstetrics and Gynecology recommends Vitamin B6 25 mg by mouth 3-4 times per day as first line treatment for nausea and vomiting of pregnancy. You may also add doxylamine (over the counter Unisom) 12.5 mg (1/2 Unisom tab) by mouth 3-4 times per day to this regimen.
Call our office for weight loss, fever, diarrhea and if unable to keep liquids down for 12 hours.
What can I expect at my OB visits?
At each regularly scheduled visit the nurse will obtain any complaints or concerns, blood pressure, weight and a urine sample. The physician will measure fundal height of the uterus and measure fetal heart rate. Routine lab work, testing and ultrasound schedules are listed below.
- First trimester screening (optional) at Wake Med Raleigh or Duke Perinatology
- Receive glucola for Early 1 Hour Glucose Tolerance Test (GTT or O’Sullivan) if indicated
Early screening for gestational diabetes depends on personal risk factors including family history of diabetes, age > 35, pre-pregnancy weight, history of gestational diabetes with a previous pregnancy, or prior large baby
- Early 1 Hour Glucose Tolerance Test (GTT or “O’Sullivan”) blood work drawn if indicated
- Quadruple (“Quad” screen) or AFP only (optional) blood work drawn
- Ultrasound (Office). Anatomy ultrasound between 18 and 20 weeks at our office, Wake Med, or Duke Perinatology
- All patients receive glucola for 1 Hour Glucose Tolerance Test (GTT or “O’Sullivan”) Even if you have completed the Early 1 Hour GTT, this test is repeated at 26-28 weeks
- CBC, glucose (GTT or O’sullivan test), RPR, and HIV blood work drawn. If maternal blood type is Rh (-), an antibody screen is also performed
- If maternal blood type is Rh (-), receive Rhogam injection
- Receive Fetal Kick Count instructions
- Hemoglobin check
- Receive Group Beta Strep information sheet
- Group Beta Strep (GBS) Test performed
- Gonorrhea/Chlamydia cultures performed if indicated
- Begin pelvic exams at each visit.
Office visits are:
- every 4 weeks until 28 weeks
- every 2 weeks from 28 to 36 weeks
- every week from 36 weeks until delivery or as dictated by your history or physicians discretion
***IMPORTANT WARNING SIGNS***
Any of the following may be a warning that you need medical attention.
Call our office immediately if you experience any of these symptoms.
- Severe or persistent headache
- Blurred vision or spots before your eyes
- Severe abdominal pain or cramps, perhaps with nausea or diarrhea
- Severe or persistent vomiting
- Severe, unexplained pain the shoulder
- High fever (above 101’F)
- A sudden weight gain in just a few days
- Marked swelling in one leg greater than the other
- Vaginal bleeding
- Gush or flow of watery fluid from your vagina
- Marked decrease in urine output
- Regular contractions, getting stronger as time progresses
- Marked decrease or absence of fetal movement after 24 weeks gestation
***MORE WARNING SIGNS***
Any of the following may be warning signs that you are at risk for preterm labor and delivery.
Call our office immediately and be prepared to go straight to the hospital if required.
- Persistent or rhythmic low back pain that feels different from what you are used to in this pregnancy
- Menstrual-like cramps
- Intestinal cramps with or without diarrhea
- Pelvic pressure or rhythmic tightening that feels different from what you are used to in this pregnancy
- Watery discharge or a gush of fluid from your vagina
- Vaginal bleeding