QUESTIONS ABOUT YOUR PREGNANCY

We will try to answer any questions you might have when you are in the office for your appointment; please feel free to ask any of the staff. If you do have questions that can’t wait until your next visit, call during office hours if possible so we can check your records. It is a good idea to make a list of your questions as they come up, and then bring the list with you to the office so that they can be discussed a the office.

WHAT TO EXPECT

A normal pregnancy lasts about 280 days or 10 lunar months of 28 days each, or 40 weeks. Your first few office visits are every 4 weeks until 28 week, followed by every 2 weeks until 36 weeks, and then every week until delivery. At your first visit, we will take your history and perform your physical examination. In addition, your first visit usually includes a vaginal ultrasound to confirm the age of the pregnancy. We also do your first blood tests at this visit and share the results with you at your following visit.

6-8 Weeks
8-10 Weeks
15-19 Weeks
18-21 Weeks
24-26 Weeks
28-32 Weeks
32-36 Weeks
36 Weeks to Delivery

QUESTIONS ABOUT YOUR PREGNANCY

Smoking
Alcohol
Medications
Weight
Morning Sickness
Exercise
Tanning
Coloring Your Hair
Pregnancy and Lamaze Classes
Cesarean Section Classes
Seatbelts
Ultrasounds
Diabetes Screening
Other Lab tests
When to go to the Hospital

6-8 Weeks
Congratulations! This is an exciting time, and we appreciate you allowing us to be a part of your joy and excitement! You're in store for many changes over these next few months, and we are always available day or night to answer any questions that may come up throughout your pregnancy. You may also notice the start of some nausea which is not much fun at all, but which is typically short lived. When you call the office to schedule an appointment, let us know when the first day of your last menstrual period, it will help us determine how far you are with your pregnancy. If you're not sure - don't worry! Your first visit includes an ultrasound that will determine how far along you are in the pregnancy.
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8-10 Weeks
A vaginal ultrasound may be performed at this visit, but may not be necessary if one has already been performed at the office. Blood tests will also be ordered at this visit to be certain everything is going well. Some of the tests included are Type and Rh, Antibody Screen, Hemoglobin and Hematocrit, RPR (syphilis), Rubella, Hepatitis B, Toxoplasmosis, and HIV. A Sickle Cell test may also be ordered depending on the practitioner's recommendation. Toe rays become present by ultrasound, and even spontaneous movement begins that you can see! We will be sure to give you some pictures you can take home so that you can show everyone the 'new addition' to the family!
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15-19 Weeks
The baby is now about 5 inches long. Your baby is now making urine which actually becomes part of the amniotic fluid! The baby will practice "breathing" this fluid in and out of its lungs, which helps with lung development. Your practitioner will also offer an optional test called a quad screen test to check for various potential abnormalities; this is best obtained at about 17 weeks. There is also a Cystic Fibrosis screening, but not all insurance companies cover this test. You may also start to feel the baby moving around at this time. Not all moms can feel the baby moving at this point; so don't be worried if you can't feel movements yet!
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18-21 Weeks
At 20 weeks you have made it the halfway point, but there are many more changes to come! Your uterus is really growing now, and you can probably feel it above your pubic bone. Problems such as nasal congestion, sweating, and increased vaginal discharge are normal and nothing to worry about. You may also notice some trouble with breathing; this is also normal (but not much fun!) Your practitioner may order a second ultrasound to check all of baby's anatomy; they may even be able to tell you if it is a boy or girl (If you want to know!) Baby is now about 10 to 11 inches long, and you will definitely be feeling movements by this time.
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24-26 Weeks
By now, you are getting used to coming the office for your regular evaluations, good thing because they will be happening more frequently soon. You will receive a bottle of "Glucola" which is a sugar drink to be taken at about 28 weeks to check for gestational diabetes. (Depending on your insurance you may get this sugar drink directly from the lab.) A tape measure is used to check how the uterus and is growing which gives your practitioner a good idea about your baby's growth. It is normal to have some variations in measurement, your practitioner will let you know if there is any concern, so don't be alarmed if the measurements aren't just right, and ask if you have any questions. Baby now weighs a little over one pound or more! Remember to stay hydrated by drinking plenty of water, especially during the summer.
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28-32 Weeks
You made it to the third trimester! You will definitely notice more weight gain at this time. This is not only healthy for the pregnancy, but proper weight gain is also healthier for the baby! Having a healthy diet is the most important thing you can do to this point. This is not the time to go on a diet, because this could actually harm the baby. This is also a great time to talk to your practitioner about a birthing plan if you would like, it can help to be certain that all your expectations about the delivery are understood, even though they may not all be met depending on your particular circumstances. Remember that several blood tests will be performed at this time, including hemoglobin and hematocrit, antibody screen, RPR (syphilis), and the one-hour glucose test. You may also need a shot of rhogam depending on your blood type, ask your practitioner if you're unsure.
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32-36 Weeks
This is a great time to talk about several important subjects, including episiotomy, pain relief in labor, and fetal monitoring. There are also several positions for you can consider for delivery, each with their own good and bad points - ask your practitioner if you have any questions. Remember to let us know if you notice any decrease in baby's movements! A rollover test will also be performed for first time mothers to check your blood pressure for abnormalities. There may be some leaking from the breasts for a few people; this is normal and nothing to worry about. By this point, baby weighs about two and a half pounds! Early signs of labor include pain, bleeding, contractions, intense pelvic pressure, or a sudden gush of water. If this occurs go to the hospital! Good posture, exercise, and an adequate amount of rest will help you with all the aches and pains you might be experiencing - don't worry, it won't be long now!
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36 Weeks to Delivery!
Around 36 weeks, we will begin weekly vaginal checks (to monitor dilatation of the cervix and check babies position). About this time we will also order some tests including a Beta Strep culture, Hemoglobin and Hematocrit, and an Antibody Screen. You may also notice Braxton Hicks contractions; this is just the uterus practicing for the upcoming birth. You may also notice more heartburn, this is common and can be relieved by small frequent meals, Tums or Mylanta, or sitting upright after a meal. If this doesn't work be sure to tell your practitioner. If you think you're in labor, it's always best to go to the hospital even though you might not truly be in labor and be sent home. Don't worry, it's always better to be safe then sorry! Even if you need to go home you'll know that your baby is fine, and you can always go back if the contractions start up again. Eventually labor does come and you'll be relaxing at the hospital with your new addition to the family! Congratulations, you made it!
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Smoking We suggest that you stop all smoking during pregnancy and breast feeding. There is no safe amount to smoke while you are pregnant, but if you must smoke, limit your cigarettes to 5 each day or less. Remember that if you do decide to smoke to limit all your smoking to outside your home and outside your car.
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Alcohol There is NO safe amount or kind of alcohol to drink during pregnancy, and there is no safe time in pregnancy to drink. Please stop all beer, wine, and liquor. » Back to top

Medications
It is important to take your pregnancy vitamins and iron the entire time you are pregnant. You may use Tylenol for headaches and minor discomfort, and you can use Sudafed, 30mg, for cold symptoms. You can use non-medicated throat lozenges for a sore throat. The B.R.A.T. diet (Bananas, Rice, Applesauce, and Toast) is good to treat diarrhea, as is Gatorade. Do not use any other medicine unless you have discussed it with your practitioner, which would include prescription medicine, over-the-counter medicine, creams, liquids, sprays, and especially someone else’s medicine.
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Weight
The ideal weight gain in pregnancy for a woman who starts pregnancy at a normal weight is about 25 to 35 pounds; an overweight woman should try not to gain more than 25 pounds. A woman who begins her pregnancy at less than 110 pounds should gain at least 30 to 40 pounds. The average weight gain works out to be about 2 pounds per month for the first 6 months and about a pound a week after that until delivery. Pregnancy is not the time to diet to lose weight--it is an excellent time to adjust your diet to get the best possible foods for your growing baby. “GOOD” foods include fresh fruit and vegetables, lean meats (broiled, not fried), poultry, fish, cheese, whole wheat bread, margarine, skimmed milk. Do not eat undercooked meats while pregnant.
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“Morning sickness” and vomiting
Your body begins to work much harder very early in pregnancy, and it is easy to get overheated. Your stomach also takes a longer time to empty in pregnancy. This combination makes it easier for you to feel warm, nauseated, or even vomit. Dress as cool as you can (you can always add layers of clothes) and eat and drink much more often but in small amounts so that your stomach doesn't’t get to full. Keep your home, car, and workplace cool; avoid heavy and hard to digest foods, and limit your use of carbonated beverages. It is OK to use the Sea-bands or acupressure for nausea or vomiting, and there are some medications that can be used, either in suppository form or by injection as prescribed by your practitioner.
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Exercise
You should avoid getting overheated while pregnant, especially during the first 3 months; do not use saunas, steam baths, or hot tubs, and do not wear clothing that “doesn't’t breathe.” The American College of Obstetricians and Gynecologists recommends no more than 30 minutes of exercise every other day for pregnant women. Do not participate in violent exercise like water or snow skiing, snowmobiling, skateboarding, horseback riding, or roller-skating. There are exercise classes run by the hospital especially for pregnant women; most women will benefit from these.
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Tanning
We urge you NOT to tan while pregnant or trying to get pregnant.
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Coloring your hair or “perming” your hair
We advise you not to color your hair, especially in the first 3 months of your pregnancy; the color does get absorbed through your skin and goes through your blood stream and to your baby. Patients and their hairdressers often say that the permanents do not “take” as well during pregnancy.
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Pregnancy and Lamaze and Other Classes
These are given by the hospital, and we strongly urge you to attend. Ask someone in our office for copies of the current schedule. There are also classes for brothers and sisters (siblings) of the new baby and classes for grandparents, too.
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Cesarean Section Classes
Unless your practitioner recommends otherwise, we plan on having you deliver your baby vaginally. Unfortunately, about one in five women will deliver their baby by cesarean section, so we strongly recommend that you attend the cesarean section classes at the hospital to at least get an idea about some of the differences in delivering from “above” compared to “below.”
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Seatbelts
WEAR THEM Lap and shoulder belts whenever you are in the car while you are pregnant (you should always wear them in the car).
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Ultrasounds
We can do an ultrasound examination of your pregnancy, typically at about 18 to 20 menstrual weeks (18 to 20 weeks since your last menstrual period); this examination is painless and safe for you and your baby, and it should give us and you more accurate information as to how far along your pregnancy is and what your approximate due date should be. We should be able to show you the heart beating and other structures of the baby and placenta (sometimes babies and placentas!). This examination is optional unless we need to establish a correct date to schedule a repeat cesarean section.
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Diabetes Screening
you will be tested for diabetes using a sweet drink followed by a blood test; this is usually done at about 28 weeks of pregnancy.
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Other Laboratory Tests

There are several “blood tests” that will be done to check on how well your pregnancy is progressing; some tests will be done early in the pregnancy, while others will be done later. Please tell the staff if you have a cat in your home.
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When to go to the Hospital

If contractions are regular (10 min. or less) or if you have a history of short labor, please go to the hospital. Come sooner if you are from out of town. If you are bleeding the same amount as you would during your period or more, go to the hospital. There may be spotting of blood after pelvic exams, this is normal and is no cause for worry. If you think your water has broken (or if there is a trickle, leak, gush, or even if you think that your membranes have ruptured), this is an EMERGENCY. Go to the hospital immediately. DO NOT eat or drink anything if you think you are in labor. When going to the hospital, go to the emergency room entrance. The hospital will call the physician on call for you if they not already there. DO NOT attempt to call the physician or the hospital yourself as this may waste time in getting to the hospital. If you are not in labor you will be able to go home with the reassurance that everything is normal.
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