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Pregnancy FAQs

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.

To put 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.

Month 1

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?

Is it safe to have sex while pregnant? Yes. Women can keep having sex during a normal pregnancy.

Is it 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 evaluation.

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 birth.

When will 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.

How 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.

Month 2

What 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 beans.

How 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.

Is it 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.

Is it 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.

Is it 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.

What 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.

Month 3

What 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.

Is it 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.

When 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 less.

When 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.

How 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.

What 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.

Month 4

How 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.

When 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 pregnancy.

How 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.

Is it 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.

When 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.

Month 5

Will I 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.

Is it 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.

What 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.

What 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.

Why am 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.

How 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 nutritious foods.

Month 6

Is it 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.

Can I 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.

How 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.)

How do 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.

Will I 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.

Month 7

Can I 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 maternity leave.

What 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 plan.

What 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.

How do 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.

Should 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.

Month 8

What 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.

How 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.

How 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.

What 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).

Should 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.

What 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.

What 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.

Month 9

How 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.

What 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.

When 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 pregnancy.

How 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.

What 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.

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