Prenatal Health

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Prenatal Health Care

Now that taking care of yourself has never been more important, you'll probably get advice from everyone-your doctor, family members, friends , co-workers and even complete strangers . But staying healthy during pregnancy depend s on you. It is crucial to arm yourself with information about the many ways to keep you and your baby as healthy as possible.

Key to protecting the health of your child is to get regular prenatal care. If you think you are pregnant, call your health care provider to schedule an appointment. You should have your first examination during the first 6 to 8 weeks of your pregnancy, which is when your menstrual period is 2 to 4 weeks late.

At this first visit, your health care provider will figure out how many weeks pregnant you are based on a physical examination and the date of your last period. He or she will also use this information to predict your delivery date. An ultrasound performed during your pregnancy will help to verify that date.
If you're healthy and there are no complicating risk factors, you can expect 10 see your health care provider:

• every 4 weeks until the 28th week of pregnancy

• then every 2 weeks until 36 weeks

• then once a week until delivery

Throughout your pregnancy, your health care provider will check your weigh t and blood pressure while also checking the growth and development of your baby. Such as feeling your abdomen, listening for the fetal heartbeat during the 2nd and 3rd trimester and measuring your belly. During the rest of your pregnancy, you'll also have prenatal tests, including blood, urine , cervical tests and at least one ultrasound .

It’s important to drink plenty of fluids, especially water during pregnancy. Drinking enough water each day can help prevent common problems such as dehydration and constipation.

Exercise

The 2005 dietary guidelines recommend that healthy pregnant women get 30 minutes or more of moderate intensity physical activity every day. Exercising during pregnancy has been shown to be extremely beneficial.

Regular exercise can help:
• prevent excess weight gain

• reduce pregnancy related problems, like back pain, swelling and constipation

• improve sleep

• increase energy

• improve outlook

• prepare for labor

• lessen recovery time
If you’ve been involved in an exercise program before becoming pregnant, talk to your health care provider about whether it’s safe to continue. If you haven’t been active and /or you have a high risk pregnancy, ask your health care provider how you can safely start.

Low-impact, moderate intensity exercise activities (such as walking or swimming) are great choices. You can also opt for yoga or Pilates class, DVD's, or videos that are tailored for pregnancy. These arc both low impact and work on strength, flexibility and relaxation.
But you should limit high impact aerobics and avoid certain sports and activities that pose a risk of falling or abdominal injury. Typical limitations include contact sports, downhill skiing, and horseback riding.

It is also important to be aware of how your body changes. During pregnancy, your body produces a hormone known as relaxin, which is believed to help prepare the pubic area and the cervix for the birth. The relaxin loosens the ligaments in your body, making you less stable and more prone to injury.
So it’s easy to overstretch or strain yourself f, especially the joint s in your pelvis, lower back and knees. In addition, your center of gravity shifts as your pregnancy progresses and may make you feel off balance. Keep these in mind when n you choose an activity, and don’t overdo it.

Whatever type of exercise you choose, make sure to take frequent breaks and remember to drink plenty of fluids. Use common sense and slow down or stop if you gel short of breath, or feel uncomfortable. If you have any questions about doing a certain sport or activity during your pregnancy, talk to your health care provider for specific guidelines.

Sleep

It’s important to get enough sleep during your pregnancy. Your body is working hard to accommodate a new life, so you’ll probably feel more tired than usual. As you r baby gets bigger, it will be harder to find a comfortable position when you’re trying to sleep.

Lying on your side with your knees bent is likely to be the most comfortable position as your pregnancy progresses. It also makes your heart's job easier because it keeps the baby's weight from applying pressure to the large blood vessels that carry blood to and from your heart and your feet and legs . Lying on your side can also help prevent or reduce varicose veins, constipation, hemorrhoids and swelling in your legs. Some doctors specifically recommend that pregnant women sleep on the left side.

Because your liver is on the right side of your abdomen, lying on your le ft side helps keep the uterus off that large organ. Lying on your left side also optimizes blood flow to the placenta and there fore, your baby. Ask what your health care provider recommends. In most cases, lying on either side should do the trick and help take some pressure off your back. To create a more comfortable resting position, either way, prop pillows between your legs, behind your back, and underneath your belly.

Some things to Avoid

When you’re pregnant, what you don’t put into your body (or ex pose your body to) is almost as important as what you do. Here are some things to avoid:

Alcohol
Although it may seem harmless to have a glass of wine at dinner or a mug of beer out with friend s, no one has determined what is a "safe amount" of alcohol to consume during pregnancy.

One of the most common known causes of mental and physical birth defects, alcohol produces more severe abnormalities in a developing fetus than heroin, cocaine, or marijuana.

Alcohol is easily passed along to the baby, who is less equipped to eliminate alcohol than the mother. That means an unborn baby tends to develop a high concentration of alcohol, which stays in the baby's system for longer periods than it would in the mother’s. And moderate alcohol intake, as well as periodic binge drinking, can damage a baby developing nervous system. If you had a drink or two before you even knew you were pregnant, don’t worry too much about it. But your best bet is not to drink alcohol at all for the rest of your pregnancy.

Recreational Drugs
Pregnant women who use drug s may be placing their unborn babies at risk for premature birth, poor growth, birth defects and behavior and learning problem s. Their babies could also be born addicted to those drugs themselves. If you’re pregnant and using drugs, your doctor can aid you in getting the appropriate help to quit your habit and have a healthier pregnancy. If you’ve used any drugs at any time during your pregnancy, it' s important to inform your health care provider, even if you ha quit.

Caffeine
High caffeine consumption has been linked to an increased miscarriage rate, so it's probably wise to limit or avoid caffeine altogether if you can.
If you're having a hard time cutting out coffee cold turkey, here’s how you can start:
• cut your consumption down to one or two c ups a day

• gradually reduce the amount by combining decaffeinated coffee with regular coffee

• eventually cut out the regular coffee altogether

Remember that caffeine is not limited to coffee. Green and black tea, cola and other soft drinks contain caffeine. Try switching to decaffeinated products (which may have some caffeine, but in smaller amounts) or caffeine free alternatives. If you’re wondering whether chocolate, which also contains caffeine, is a concern, the good news is that you can have it in moderation. The average chocolate bar has anywhere from 5 to 20 milligram s of caffeine. There is 95 to 135 milligrams of caffeine in a cup of brewed coffee. So, small amount s of chocolate are fine.

Changing the Liter Box
Pregnancy is the prime lime to get out of the cleaning kitty’s liter box. Why? Because an infection called toxoplasmosis can be spread through soiled cat liter boxes and can create serious problems, including prematurity, poor growth, and severe eye and brain damage. A pregnant woman who becomes infected often has no symptoms, but can still pass the infection to her unborn developing baby.

Over-the-Counter and Prescription Medications
Even common over-the-counter medications that are generally safe may be considered off-limits during pregnancy because of their potential effects on the baby. Certain prescript ion medications may also cause harm to the developing fetus. To make sure you don't take anything that could be harmful to your baby:

• ask your health care provider which medicines-both over-the-counter and prescription-are safe to take during pregnancy

• talk to yo ur health care provider about any prescription drugs you're taking.

• let all of your health care providers know that you are pregnant so that they'll keep that in mind when recommending or pre scribing any medications.

• discuss any questions about natural remedies, supplements, and vitamins

If you were prescribed a medication be fore you became pregnant for an illness, disease or condition you still should consult with your health care provider. If you become sick (i.e. with a cold) or have symptoms that arc causing you discomfort or pain (i.e. headache or backache), talk to your health care provider about medications you can take and tentative ways to help you feel better without medication.

Approved Over the Counter Medications During Pregnancy

Avoidance of all medications that are not essential for health is a good principle to achieve during pregnancy. However, certain illnesses during pregnancy occasionally justify the use of over the counter medications which we feel are least likely to be harmful. Use them only when needed and as little as possible. Please do not use any medication not listed without checking with us first.

Nausea
Those suffering from morning sickness often realize it is not necessarily restricted to the morning hours. Try eating frequent, small meals throughout the day and avoid greasy, fried, spicy or heavily seasoned food. Eating bread or crackers before getting out of bed in the morning is helpful. If these dietary measures are not effective, try Emetrol (2 tablespoons every 3 hours as needed) or vitamin 8 6 (25mg twice daily.) If nausea persists, try Dramamine (50mg every 4hours as needed.) If you’re vomiting and have bee n unable to ho ld down liquids for 24 hours or longer you will need to call the office.

Constipation
A common problem throughout pregnancy, constipation should be treated with dietary measures firs t. Try adding lots of fresh fruits and vegetables, fluid s and high fiber foods 10 your diet. If this doesn’t work, try a bulk producing product such as Metamucil, Citrucel or Fiber Can. Colace or Surfak can be used as stool softeners, but again the key factor is lots of fluid s. Milk of Magnesia can be used occasionally. Mineral oils, harsh laxatives and enemas should be avoided.

Indigestion, Heartburn and Gas
Milk of Magnesia is an effective non-constipating ant acid. You may also try Gaviscon, Mylanta II or Maalox Plus. Turns and Rolaids may al so be used but are more likely to cause constipation so be careful. Avoid baking soda or sodium bicarbonate due to high salt content. Simethicone is especially good for gas pains and heartburn.

Hemorrhoids
Above all avoid constipation. Warm soaks in the tub followed by witch hazel applications (or Tucks Pad s) can be soothing. Resting on your left side displaces the weight of the baby off the dilated hemorrhoids and is helpful. Preparation H may be used (apply 3-4 times a day as needed.)

Diarrhea
Episodes of diarrhea are usually brie f in duration and do not require medical therapy. Kaopectate (3-6 tablespoons after each liquid stool as needed.) may be used. It is important 10 maintain adequate fluid intake in order to prevent dehydration. Cutting back on dairy products during acute episode s of diarrhea and focusing on drinking clear liquids will help speed recovery. lmodium AD is another option which is approved for short term use.

Fever, Headache and Body Aches
Tylenol can help (1-2 tablets every 4-6 hours. not to exceed 6 tablets per day.) Aspirin, Ibuprofen or Aleve are not recommended unless prescribed by your physician.

Colds and Congestion
Sudafed Tylenol Sinus or Benadryl are safe to take as needed. If you prefer a nasal spray, Use Ocean Mist or a saline nasal spray (1·2 squeezes in each nostril as needed) A humidifier may also help relieve congestion.

Cough
Use plain Robitussin (2 teaspoons every 4 hours. not to exceed 12tsp. per day.)

Sore Throat
A saltwater gargle using 2 teaspoons of salt dissolved in a glass of warm water is usually effective. Over the counter throat lozenges may also be used along with Tylenol if needed.