Frequently Asked Questions!

When should I tell people that I am pregnant?

Unfortunately, about 15% of diagnosed pregnancies end in miscarriage. The good news is that 85% do not. In most cases of miscarriage, the embryo stops growing before the cardiac system is developed, and we never see a heartbeat on the ultrasound. Once we see a heartbeat, the risk of miscarriage is much lower. If the baby has a heartbeat after 8 weeks from the last period, the risk of miscarriage is less than 5%. After the 12 weeks, the risk is less than 1%. Many patients choose to wait to tell others about the pregnancy based on these statistics.

 

What should I eat during pregnancy?

We need an average of only 300 extra calories daily during pregnancy (one bagel or ½ deli sandwich). Eating for two will result in excessive weight gain. Eat small frequent meals to avoid heartburn and hypoglycemia. Eat what you enjoy, but make healthy choices and go easy on sugars and starched to prevent excessive weight gain and gestational diabetes.

Certain fish accumulate high levels of mercury from swimming in polluted waters. The FDA recommends avoiding those fish that are highest in mercury, including sharks, tilefish, swordfish and king mackerel. Canned tuna is low in mercury and can be include in the total of 12 ounces a week. (If you would like more information on fish in pregnancy, go to www.seafood.org)

Unpasteurized cheeses and deli meats can carry listeria, a bacterium that can cause miscarriage and fetal infection. While this is extremely uncommon in the USA, you should avoid unpasteurized dairy products or deli meats for this reason. Listeria is killed by high temperatures so deli meats heated in the microwave until steaming are safe.

Raw fish and meat can carry parasites and other microbes that cause potential harm to the mother and fetus. While these infections are extremely rare, it is wise to avoid raw meat and fish for this reason.

There is no safe limit if alcohol in pregnancy. Complete avoidance is the best policy. Caffeine is safe in small quantities (1 caffeinated beverage daily).

There is no scientific evidence that NutraSweet (aspartame) or other sugar substitutes are harmful or safe in pregnancy. We recommend limiting your intake of sugar substitutes to one a day.

 

Can I exercise?

Staying active is great for you and the baby. If you have and uncomplicated pregnancy you can continue your current exercise regimen with a few modifications. When doing cardiovascular exercise (walking, running, biking, elliptical trainer) a good guideline is to keep your heart rate at a maximum of about 140 beats per minutes. This will allow blood flow to go to the uterus as well as you large muscles.

If you were not exercising regularly prior to pregnancy, walk for 20-30 minuets 3-5 times a week and consider a prenatal yoga class or DVD. Occasionally complications such as bleeding, preterm labor or high blood pressure will prevent you from being able to exercise, but for most women regular exercise is great way to prevent excessive weight gain, reduce stress, and keeps the physical strength necessary to deliver and take care of a new baby.

 

What about sex?

Sex is safe in pregnancy unless you have complications, such as bleeding, preterm contractions or a low lying placenta. While sex may make you have mild contractions, it will not make an otherwise healthy pregnant woman go into premature labor. Unless we tell you otherwise, continue your normal sexual practice if you want to.

 

Can I get my hair colored?

 Hair color is absolutely safe during pregnancy. The portion of your hair that is outside of the scalp is dead tissue and does not absorb anything into the bloodstream.

 

Can I travel?

If you have an uncomplicated pregnancy it is safe to travel until you are likely to go into labor. We generally recommend avoiding flying after 32 weeks and staying close to home after 36 weeks. We also recommend not leaving the country in the third trimester (after 26-28 weeks) unless absolutely necessary. Flying is safe in pregnancy but may increase your risk for blood clots, so wear support hose on long flights and move about the cabin once an hour. With long road trips make frequent rest stops (every 1-2 hours) to stretch your legs and maintain circulation.

 

Should I be worried if I have a cat?

Outdoor cats can be exposed to Toxoplasmosis and can pass this parasite to humans through the feces. A person can be exposed to it by changing the litter box of an infected cat. If your cat goes outside, have someone else change the litter box when you are pregnant. If your cat lives inside and only eats processed cat food she cannot get the disease. Cuddling your cat is safe and will not expose you to the disease. Dogs are not affected. Toxoplasmosis can be harmful to a developing fetus but it very rarely seen in the USA.

 

Which vitamins/ supplements should I take?

 Folic acid is a B vitamin that has been shown to reduce the risk of spina bifida. 1mg (1000 micrograms) is recommended prior to and during pregnancy. More folic acid may be recommended if you have a personal or family history of spina bifida including prior affected child.

After 12 weeks the baby begins to make bone and will draw the necessary calcium from your bones. To prevent bone loss 1000- 1500 mg of calcium is recommended daily during pregnancy. This equates to 4-5 servings of milk, yogurt or dairy. Since this is difficult to consume, take a calcium supplement (usually 500-600 mg) to make up difference. Don’t take calcium and iron (in multivitamin) at the same time as they can offset each other’s absorption.

If you eat fish 3 times weekly, you are getting plenty of omega -3 fatty acids, or Essential Fatty Acids (EFAs). If not, take a supplement containing 200mg of DHA (from fish oil or flax seed oil). There is a growing body of evidence that EFA deficiency may contribute to a number of pregnancy complications including preterm labor and preeclampsia. EFAs may help fetal eye and brain development, may improve mom’s skin hair and nails and also passed into the breast milk.

 

What medications can I take?

Please refer to our medication list to see safe choices for medications in pregnancy if you need a medication that is not on the list please call us during business hours for advice.

 

Should I have the baby tested for Down’s syndrome and other diseases?

Testing your baby disease prior to birth is a personal choice. Depending on your age, family history and race you may be at a higher risk of having a baby with a certain disease. Caucasians are more likely than people of other races to carry the gene for cystic fibrosis, for example. African Americans are more likely to carry the gene for sickle cell disease, and people of European Jewish ancestry are more likely to carry the gene for Tay Sach’s disease. Blood tests can be done to see if you carry the genes for any of these diseases, to help establish whether the baby may be affected.

Down’s syndrome (an extra chromosome 21) is a form of mental retardation. While it can happen to anyone’s baby, the chance increases as the mother gets older. At 35 years of age, the risk of having a baby with Down’s syndrome or other chromosomal disorders is about 1/200 and at 40 years is about 1/50. Women who are 35 or older may choose to have an amniocentesis to have a definite diagnosis. Other non- invasive tests are also available but are not 100% accurate.

These prenatal tests include 1St trimester ultrasound along with a blood test which can detect more than 85% of Down’s syndrome (“Ultrascreen”), and blood test alone at 16-20 weeks that detects about 75% of Down’s syndrome (“Quadscreen”). Women of any age may choose to do these non-invasive tests. Some patients opt not to test at all, because results would not change their feelings about the pregnancy. While there is no right or wrong answer your doctor will help you to make these decisions at the appropriate time.

 

Is ultrasound safe?

Obstetric ultrasound has been extensively studied and found to be safe for the baby. While no fetal harm has been found, current recommendations are to limit the use of ultrasound to that which is medically useful or necessary.

 

Can I go to the  dentist?

Routine dental work is safe during pregnancy and we encourage you to keep up with your normal dental health routine. Most dentists will require a note from us saying that the visit is safe, and we can give you a standardized letter to take to your visit.

 

Where will I deliver my baby?

We deliver at Memorial Hermann Katy Hospital. The hospital has a Level II nursery, which means they can usually care for babies born after 32 weeks. A lactation consultant is available, and anesthesia care is available at all times.

 

How do I register at the hospital?

You can register online at Memorial Hermann or in person at the hospital. Make sure you are registered 2-3 months before your due date. Registration takes a few minutes, and a nurse will usually have time to give you a quick tour.

 

When will I deliver?

Most people deliver close to their due date (40 weeks from the last period) and about 10% of women deliver before 37 weeks. It is more likely that you will go over your due date in the first pregnancy than in subsequent pregnancies. We generally recommend induction prior to 41 weeks if you have not delivered by then. If you have had a preterm (less than 37 weeks) delivery before, you are more likely to have another preterm delivery.

If you are planning a repeat C-section, we generally will schedule it at 39 weeks (1 week prior to your due date).

 

Who will deliver me?

Our doctors are on call for their own patients during the week (Mon.-Thurs.). If you deliver during the week, your own doctor will be there. If you deliver during a weekend, the doctor on call will be there. Our call group consists of female doctors only. If you would like to be sure that your own doctor delivers you, please discuss induction near your due date.

 

How long will I stay in the hospital?

After an uncomplicated vaginal delivery you can stay 24-48 hours. After an uncomplicated C-section you may be ready to leave as soon as 48 hours, or as long as 96 hours.

 

Who will my baby’s doctor be?

You will need a pediatrician to see your baby soon after delivery. We recommend choosing a pediatrician prior to delivery. If you do not already have one, we can recommend some excellent doctors for you to consider. After discharge, the first visits with the pediatrician are usually at 2 weeks of life, and you can make this appointment as soon as the baby is born.

 

Should I take childbirth class?

If this is your first baby you may want to take a childbirth class. While this not required it may help you to be more comfortable about what to expect. Most people take a class in the last 2-3 months or pregnancy. You can contact the hospital for more information regarding these classes and breast feeding classes.

 

Should I get an epidural?

This is a personal choice, but in our practice the majority of patents do opt for an epidural. Epidurals are a very safe and effective means of controlling the pain associated with childbirth. Complications from an epidural are extremely rare and often easily corrected (such as a severe headache). Anesthesiologists are available 24 hours a day to help you whenever you request their services.

 

Can I deliver vaginally after a C-section?

Vaginal birth after C-section (VBAC) is not offered in our practice. There is 2-4% risk that when a mother is in labor with a C-section scar on the uterus, the scar could open up and expel the baby and the placenta into the mother’s abdomen. This is called a uterine rupture and is a catastrophic emergency which can result in the death or permanent disability of the baby, as well as serious complications for the mother including severe blood loss and hysterectomy.

 

Will I get induced?

Some patients may choose and “elective” induction which is not medically necessary but is timed to provide convenience for family members, work schedules, or to coincide with your doctor’s schedule. Elective inductions are scheduled at 39 weeks or later.

 

Will I have episiotomy?

There is no evidence that routine episiotomies are beneficial, and we try to avoid them. At times your doctor may decide that it is safer to make a small episiotomy than to risk a large tear, but this decision is not made until the baby’s head is crowning. There are variable factors that we cannot control including the size of the baby and your body’s ability to stretch, which ultimately affect your ability to deliver without an episiotomy. It is less likely that you will have and episiotomy with each successive pregnancy.

 

Should I have my baby boy circumcised?

The American Academy of Pediatrics does not recommend circumcision for any medical reason. Still, many couples opt to have their baby boy circumcised for religious, cultural or cosmetic reasons. If you decide to have your baby boy circumcised our doctors perform the procedure with local anesthesia, usually on the day after birth.

 

Should I collect my baby’s cord blood?

Blood from your baby’s umbilical cord contains stem cells, which may be collected and stored after the baby’s birth. Stem cells have numerous current and possible future medical uses that warrant consideration. If you are interested in cord blood collection, visit the website of Cord Blood Registry to learn more. We can give you the necessary collection kits in our office if you decide to proceed.

 

What if I have other questions?

Since you are seen frequently, write your questions down and bring them to your next appointment. If you have more urgent questions, leave a message with your doctor’s nurse and you will get a reply by the end of the business day.

 

Use of Medications During Pregnancy

There is no medication considered to be 100% safe for long-term use in pregnancy. Each medication carries risks and benefits. We recommend avoiding any medications during the first 12 weeks of pregnancy, since this is a critical time for the development of the brain and heart.

Allergies

Claritin, Zyrtec, Rhinocort Aqua

Cold/Fever

Tylenol or Extra Strength Tylenol, Robitussin, Tylenol Sinus. Increase your fluids and rest. Report a fever over 101.0.

Cough

Robitussin DM, Delsym and or cough drops

Constipation

Metamucil, Surfak, Colace, Fibercon. Increase fiber and fluids in your diet.

Diarrhea

Kaopectate, Imodium AD.

Headache

Tylenol, Extra Strength Tylenol, Acetaminophen

Heart burn / Indigestion

Maalox, Mylanta, Tums, Pepcid

Hemorhoids

Anusol cream or suppositories, Preparation H, Tucks, Witch Hazel

Herpes

Zovirax cream, Valtrex

Gas

Mylicon, Mylanta

Nausea

Vitamin B6 (25 mg) 3 times a day, ginger in any form, Unisom (will make you sleepy)

Sore Throat

Cepacol lozenges, warm salt water for gargling, chloroseptic throat spray, Tylenol for pain.

Skin Irritation / Acne

Calamine lotion, and topical steroid including hydrocortisone, Neosporin Ointment, Aveeno lotion and benzoyl peroxide products.