Saw a plus sign on
the pregnancy test and freaked out? You're not the only one. Here are nine
months' worth of burning pregnancy questions that almost every mom-to-be out
there has wondered about.
those worrying minds at ease, we asked Dr. Tomekia Lynn Strickland, a board-certified
OB-GYN, founder of Concierge Women's Wellness and an attending physician at
Cedars-Sinai's Department of OB-GYN, to give us some much-needed answers.
What foods should I avoid while
pregnant? Meats, fish and poultry should be fully cooked. Avoid unpasteurized
dairy products and juices. The concern for soft cheeses is that they are often
made with unpasteurized milk, which could contain the harmful bacteria listeria.
Soft pasteurized cheeses made in the U.S. are generally considered safe. We
also recommend avoiding cold cuts and cold deli meats for same concern of
possible exposure to bacteria. Avoid raw sprouts (including alfalfa, clover,
radish and mung bean). Bacteria can get into sprout seeds through cracks in the
shell; these bacteria are difficult to wash out.
Also avoid shark, swordfish, king
mackerel or tilefish. They may contain high levels of mercury. Women often ask
about the safety of sushi in pregnancy. For the sake of being safe, I'd prefer
women to wait until after the pregnancy to eat raw fish. The concern has to do
with exposure to bacteria and mercury levels. We do know that sushi-grade raw
fish is probably safe, as long as it was frozen properly as that eliminates
most bacteria. But why take the chance if you can't be sure of the source and
how it was processed?
safe to have sex while pregnant? Yes. Women
can keep having sex during a normal pregnancy.
normal to bleed during pregnancy? Understandably,
any degree of bleeding can be alarming for women. While it is common in all
stages of pregnancy, it doesn't mean it is normal. However, it also doesn't
mean doom. The important thing is to inform your provider for appropriate
When will I stop feeling so tired? Feeling tired is normal, especially during the early months.
It usually improves mid-pregnancy and often recurs in the weeks just before
I have symptoms and feel pregnant? Common
symptoms such as nausea, breast tenderness, having to urinate more frequently,
bloating and fatigue may be experienced as early as when you miss your period. These
symptoms, however, can vary from woman to woman and in the degree of severity. Some
women may have breast tenderness and nausea (morning sickness) very early, whereas
others may experience very mild nausea or none at all.
important is it to take prenatal vitamins? Taking prenatal vitamins is important. It's difficult for most of us (even
those with the best nutritional habits) to get everything we need from our
diets, especially the proper amounts of iron, calcium and folate/folic acid. Folic
acid is important for prevention of neural tube defects. Pregnant women also
need adequate amounts of vitamins A, B complex, E, C, D and zinc.
foods should I eat while pregnant? Include
lots of fresh fruits, vegetables and whole grains, some low-fat dairy products,
and a few sources of protein, such as lean meat, fish, eggs, or dried peas or
can I ease my morning sickness? If
your symptoms are mild, try small, frequent meals. Eat when hungry. Avoid spicy
and high-fat foods. Ginger ale and other clear carbonated beverages can be
soothing. Crackers first thing in the morning and ginger products have also been
found to be helpful. Avoid triggers such as strong smells. If none of that works,
your doctor can offer several prescription medications safe in pregnancy, along
with vitamin B6.
safe to exercise during pregnancy? Yes,
in a normal pregnancy, exercise is recommended and offers many benefits such as
improved mood, energy and sleep. Great options include swimming, walking and
pregnancy yoga. Avoid exercises that place you at higher risk of falling or causing
injury to the belly (like heavy dumbbells). Avoid exercising in heat or high
humidity. Avoid lying flat on your back after the third month of pregnancy.
What should I expect from my first
prenatal checkup? Your provider will obtain a detailed medical history and complete
a thorough physical exam. They will establish your due date based on your last
menstrual period and often with an ultrasound. They will listen to the baby's heartbeat,
obtain prenatal labs and prescribe prenatal vitamins. The visit also includes education about pregnancy and an opportunity to ask questions.
normal to feel cramping during pregnancy? It can be, usually at the very beginning of the pregnancy and again later in pregnancy
as you approach your due date. Many women also experience a pelvic discomfort
known as round ligament pain. It is considered normal in pregnancy. It occurs
in the second trimester when the round ligaments, which supports the uterus in
the pelvis, begin to stretch as the uterus grows. Moving slowly helps. It
eventually subsides as the pregnancy progress.
safe to drink alcohol while pregnant? The
problem with drinking alcohol during your pregnancy is that there is no amount
that has been proven to be safe. Some doctors recommend that you completely
avoid alcohol when you're expecting; others say that occasional light drinking
is unlikely to harm your baby. We know that alcohol is a teratogen and can cause
fetal alcohol syndrome, and increase risk of stillbirth.
are signs of a miscarriage? Bleeding,
cramping and pelvic pain are common signs but it's not absolute. Always call
your provider if such signs develop.
remedies are safe for pregnancy heartburn? Eat small, frequent meals. Avoid greasy and spicy foods. Take small sips of fluid
during meals. Try to eat sitting up and avoid laying down for at least 3 hours
after eating. Avoid eating close to bedtime. Heartburn medications that are
considered safe during pregnancy include antacids like Tums and Maalox, surface
agents like Carafate, histamine blockers such as Zantac and Pepcid, and proton
pump inhibitors like Prilosec and Nexium, but check with your doctor.
normal to have more vaginal discharge now that I'm pregnant? Yes. Estrogen and other factors increase blood flow to the vulva,
vagina and cervix, causing the mucous membranes to become more active and
leading to more vaginal discharge.
can I tell everyone I'm pregnant? While this
a personal decision for the patient, experience has taught many of us to
recommend women wait until after 12 weeks, when the risk of miscarriage is much
will I start to show? Every woman is different.
If you're a first-time mom, you could begin developing a baby bump any time
between 12 and 16 weeks. But if this isn't your first baby, you may start showing sooner.
What happens during an ultrasound appointment? When ultrasounds are performed early in pregnancy, it is
usually to confirm a heartbeat and assess your gestational age, which is
important for establishing your due date. These ultrasounds may best be
performed vaginally. You will be asked to remove your undergarments from the
waist down and will be positioned on the exam table in stirrups, like getting a
routine pelvic exam. It's usually not painful but there may be some discomfort.
Also check if beforehand if they prefer your bladder full or empty. Ultrasounds
performed in the second and third trimester are performed abdominally. Those
visits usually don't require any special preparation—just lay back and relax on
the exam table.
much coffee can I drink while pregnant? It's
best to limit caffeine to about 200 to 300 mg per day, which equates to 1 cup
of coffee. Green tea typically has a little less caffeine than coffee.
genetic tests do I need? All women should
be offered genetic testing in pregnancy before 20 weeks. Advances in testing
now supports screening tests for Down syndrome as early as 9 weeks. Some tests
are blood tests only and others include a blood test and special ultrasound
(nuchal translucency). Genetic testing options include: first trimester screen,
second trimester screen, several integrated screening test options and
cell-free DNA (such as MaterniT21 or Verify). Invasive testing such as an
amniocentesis or CVS is typically only recommended if one of the aforementioned
screening tests is abnormal.
can I ease pregnancy constipation? Drink
plenty of water and other fluids to stay hydrated. Eat a high fiber diet. Use stool
softeners, such as Colace and bulk-forming laxatives, if needed.
will I feel the baby move? We can see baby
movement with ultrasound as early as 7 to 8 weeks. Quickening is the term for a
mother's first sensation of baby movement, which is often described as a
fluttering sensation. This is usually felt around 16 weeks. For some women, actual
fetal kicking isn't felt until to closer to 25 weeks, especially with the first
much weight should I gain during pregnancy? The
recommended weight gain is about 25 to 35 lbs. These numbers shift depending on
your pre-pregnancy weight and BMI (i.e., underweight, normal weight,
overweight) and also if you are carrying one baby versus twins.
safe to have my hair colored or get my nails done while I'm pregnant? There are no good studies on occasional use of hair products
during pregnancy. The research available suggests dyes are not highly toxic. I
advise my patient to use natural dyes if possible and wait until after the first
trimester. The same advice goes for nail salons. Try locating salons that use
natural polishes or make sure it is a space with good ventilation.
can I find out my baby's gender? Most
women are able to learn the gender of their baby during the "anatomy
ultrasound" at 16 to 18 weeks. The cell-free DNA test available in the first
trimester for Down syndrome screening also provides information about the
baby's gender. It is important to note, however, the test is not offered for
the sole purpose of gender determination.
get stretch marks? Stretch marks are a natural result
of the skin stretching during pregnancy. It's common for most women. I find stretch
mark creams rarely meet the claims advertised and often genetics play a major
role. Most pregnancy resources recommend keeping the skin well-moisturized.
safe to take a hot bath or soak in a hot tub while I'm pregnant? Hot tubs and saunas probably should be avoided in pregnancy.
Heat exposure in the first trimester has been associated with neural tube
defects. It's OK to take baths, as long as the water isn't too hot.
medications are safe during pregnancy? There
are very clear guidelines on what over the counter medications and prescription
medications are safe and unsafe to take in pregnancy. Your prenatal provider
should have a list available for you and there are many reputable resources
online that also provide detailed lists. Always ask your doctor or midwife
first before taking any medication.
activities should I avoid while pregnant? Avoid
any activity that puts you at risk for falling or increases the chance of
trauma to your abdomen. Some examples include amusement park rides, downhill
skiing and contact sports.
I so gassy? The increase in progesterone hormone
in pregnancy slows digestion, providing more time for gas to be produced. As
your uterus enlarges, your intestines are shifted and crowded in your abdomen.
This slows digestion even more.
much food should I be eating during pregnancy? You need about 300 extra calories a day, especially later in
your pregnancy, when your baby grows quickly. These calories should come from
safe to travel during my pregnancy? Commercial
airline travel is generally safe for women with uncomplicated pregnancies, and
most airlines allow women to fly up to 37 weeks of gestation. There are other factors
to consider, such as location and access to medical care, high altitude, risk
of DVT (blood clots), etc. You can wear compression stockings to help minimize
risk of blood clots, as well as getting up and walking in the aisles for a few
minutes each hour. Always discuss travel plans with your provider.
sleep on my back during pregnancy? The
best way to sleep during the second half of your pregnancy is on your side. When
sleeping on your back, the weight of the uterus may compress the vena cava, the
main vein that carries blood back to the heart from your lower body region.
can I treat a cold when I'm pregnant? With
the common cold, symptoms generally resolve within 10 days. Supportive therapy includes
a heated humidifier for congestion, drinking warm tea, gargling with warm salt
water and using natural-based throat lozenges. Tylenol and many Tylenol-based
cold products may also be helpful. (Please check with your doctor first.)
I cope with frequent urination? Your
kidneys are filtering up to 50 percent more blood in pregnancy, leading to
frequent urination. A growing uterus also places more pressure on the bladder,
causing more trips to bathroom. While it's important to drink plenty of fluids during
pregnancy to stay hydrated, avoid drinking right before bedtime.
get hemorrhoids during pregnancy? Hemorrhoids
are very common as you approach your due date and after you deliver.
Constipation makes it worse, so remember to stay well hydrated and eat high-fiber
foods. Soaking in warm water can be soothing. Also try witch hazel pads and
topical anti-inflammatory creams.
look for a job while I'm pregnant? There
is no reason why you can't look for a job while you are pregnant. It is
important to consider that you will need a lot of flexibility for doctors'
appointments and there may be time requirements regarding qualifying for FMLA
classes should I take to prepare for childbirth? I definitely recommend attending some kind of childbirth
prep class, especially for new parents. Most hospital and birthing centers
offer programs that give parents-to-be an idea of what to expect during
childbirth, different pain management options and how to develop the best birth
can I do about leg pain during pregnancy? Leg
pain is common, especially in the last trimester. Some helpful options include
elevating your legs as often as possible, sleeping on your side with a pillow
propped between your legs, staying well hydrated, wearing compression socks and
wearing supportive, comfortable shoes.
I know if my contractions are Braxton Hicks or premature labor? Braxton Hicks contractions have irregular start and stop
times, and they usually don't get more intense over time. Braxton Hicks
contractions typically resolve with rest and hydration.
I hire a doula to help me deliver my baby? A
birth doula is a trained labor coach who assists you during labor and delivery.
They can help before labor and delivery by answering questions about what to
expect, easing fears, helping with developing a birth plan and generally
getting you ready for the arrival of your baby. Their services can range from
several hundred to over a thousand dollars and are not covered by insurance. It's
a personal decision and also depends on the support system you feel you already
have. Many women find their doula's emotional support in labor helpful.
kinds of things should I put in my birth plan? There are many templates available on the Internet to help
in developing your birth plan. Some moms-to-be include plans for the use of
pain medication and who will be present in the delivery room to support them. Make
sure you've have an opportunity to thoroughly review your birth plan with your
provider ahead of time. Also bring a copy with you to the hospital or birth
center. Your labor nurse usually reviews it with you as well. Labor nurses are
a vital and intimate part of your hospital birth journey.
often should I feel my baby kick? You
should feel your baby kick anywhere between 16 to 25 weeks. If this is your
first pregnancy, you may not experience kicking until close to 25 weeks. Women
can feel kicking as early as 13 weeks in their second pregnancy.
can I sleep better during the third trimester? Comfortable sleeping can be challenging. Propping a pillow
between your legs may help, as well as full-body pregnancy pillows. Avoid
sleeping on your back at this stage. Sleeping on the left side improves blood
circulation to the baby.
happens if I fail the gestational diabetes test? If your testing confirms gestational diabetes, our first
approach is conservative. Nutritional adjustments and adding a comfortable exercise
regimen like daily walking may be all that some women require. Home monitoring
of your blood sugar with a glucose monitor is also often provided. If necessary,
medication is recommended. We now have several treatments options in the form
of a pill (that is not insulin).
I consider cord blood banking? I
think so. It's always a discussion I have with my patients. The blood from baby's
umbilical cord is rich in stem cells that can be used to treat many diseases
and cancers. The research and its practical applications for your baby's health
continues to grow. I think it is wonderful parents now have the option of
banking their baby's blood for potential beneficial use later (even when that
child becomes a teenager and an adult). It is, however, an expensive investment
with initial costs around $1500 or more.
should I pack in my bag for the hospital? Some common suggestions: several changes of clothes, nursing bras, comfortable
underwear and large pads, baby outfits for photos and going home, toiletries,
camera and music.
happens if my baby comes early? Call
your doctor or midwife if you develop signs of labor before 37 weeks for
evaluation. There are women who do go into preterm labor and even deliver
early. It's not usually predictable (especially if it's your first baby) nor is
always clear why it happens. The gestational age at which your baby is born
greatly impacts how well your baby will do.
can I tell if the baby's head has dropped? Your baby feels and looks much lower. People can often see the difference, as
well. Your midwife or doctor can usually tell by feeling your stomach or when
they check your cervix to see how much your cervix is softening and dilating.
happens if my baby is breech? Breech
is when the baby's feet or butt is oriented towards the birth canal instead of
your baby's head. As you get further along in pregnancy, the position of your
baby is checked at each prenatal visit. This is usually done by feeling your
stomach with our hands. We can also tell by the location of the baby's heartbeat.
If we suspect breech, the next step is to look with an ultrasound. If breech is
confirmed we offer several options to see if we can get your baby to turn
including special exercises and a procedure called external cephalic version
(ECV). ECV is a procedure used to turn a fetus from a breech position or
side-lying (transverse) position into a head-down (vertex) position before
labor begins. It's done with our hands on the mother's abdomen. Cesarean
delivery may be necessary if the baby doesn't turn.
should I go on maternity leave? The
timing varies depending on the pregnancy and the type of work you do. In
uncomplicated pregnancies, I find many women wait until their due date or when
they have the baby to start maternity leave. Some women may start maternity
leave sooner if in significant discomfort or if there is a problem with the
can I prepare for breastfeeding? Many
women purchase or rent breast pumps before delivery. There is also patient
information about breastfeeding available through your midwife or doctor. Most
hospitals and birth centers have breastfeeding specialists available to help
you with breastfeeding after you give birth.
are the signs that I'm going into labor? Common
signs of labor include: passage of blood or mucous-like discharge (mucous
plug), leakage of fluid (amniotic fluid), contractions (the belly tightens then
relaxes), cramping or lower back pain.
When should I go to the hospital to
have the baby? This
is always a tricky question for patients, especially for new moms. We typically
suggest calling your midwife or doctor, or going into the hospital to see if
you are in labor, specifically if you are having at least 6 contractions for
more than 1 or 2 hours. I usually try to assess how intense or painful the
contractions are, as well. In my experience, the combination of more frequent
and painful contractions is a good sign it's time. I often feel it's time to go
to the hospital when patients contractions are so intense they have to pause
talking or walking, or when their disposition shifts from calm and comfortable
to significant discomfort, even pain.
Will I poop on the delivery table? This is a question I often get from
my own patients. My answer is yes. As odd as it may sound, I'm accustomed to
seeing it when women are pushing. We become stealth at clearing it fast and
keeping the area clean and air fresh. It really isn't as bad as you think!
You'll be focused on the amazing fact that your baby is very close to being in
your arms. Plus, I always tell my patients that when I see poop, I know they
are effectively pushing and focused on using the right muscles.