Bridgeview Women's Health: All-women OB/GYN Practice in Portland, OR

Common Concerns During Pregnancy

Can I eat this? Is it safe to take that? Dr. Leslie Hulton was kind enough to put together this FAQ answering some of your most common questions about what to watch out for during your pregnancy.

1. Diet, nutritional supplements, and weight gain: Caloric recommendations vary depending on your pre pregnancy weight and your level of physical activity. Please refer to ACOG’s patient pamphlet Nutrition During Pregnancy to determine your individual needs. It will answer your questions about basic nutrients and supplements, including vitamins, special nutrients, folic acid, and iron. If you are a vegetarian, you can continue your diet during pregnancy. You should refer to the ACOG brochure to ensure that you are getting the nutrients and protein that you and your baby need.

2. Caffeine: Studies about caffeine consumption are conflicting. It is safest to eliminate caffeine altogether, however moderate intake of 200 milligrams per day (the amount in two 8 ounce cups of brewed coffee per day) does not appear to lead to miscarriage or preterm birth. It is not clear if it increases the risk of having a low birth weight baby.

3. Artificial sweeteners: The Food and Drug Administration (FDA) advises that sucralose (Splenda) and aspartame (Equal and Nutrasweet) are safe for pregnancy and lactation at moderate levels of consumption. Aspartame is not safe for people with PKU. The FDA advises that saccharin safety is questionable and recommends that it be avoided in pregnancy.

4. Mercury: Pregnant women should not eat certain kinds of fish because they contain high levels of a form of mercury that can be harmful to the fetus. Please refer to the ACOG patient pamphlet Nutrition During Pregnancy for current recommendations.

5. Listeria: Listeriosis is an infection caused by eating foods contaminated by the listeria bacteria. Foods at risk are unpasteurized milk, unpasteurized soft cheese such as brie, feta and blue cheese, and prepared and uncooked meats, poultry, and shellfish. To prevent listeriosis, wash all fruits and vegetables before using them. Do not eat unpasteurized milk, soft cheese, raw or undercooked meat, poultry, or shellfish. Heat all prepared meats such as hot dogs and deli meats to steaming.

6. Exercise: Regular exercise is encouraged and may decrease your risk of gestational diabetes, reduce backache and stress, and improve sleep. Swimming, running, and other low impact exercise at a moderate level (you should be comfortable and able to talk normally) are best. We do not recommend horseback riding, snow skiing, water skiing or wake boarding. If any activity causes shortness of breath, pain, or bleeding, discontinue the activity. If the symptoms continue or there is suspicion of premature labor, ruptured membranes, or bleeding, you should contact your physician.

7. Herbal remedies: There is very little known about they safety of herbal medicines and non traditional medications during pregnancy. Be aware that the FDA does not regulate them and they may be contaminated by substances that are not safe for pregnancy.

8. Nausea and Vomiting: Nausea and vomiting are very common in early pregnancy as your pregnancy hormone (HCG) rises. It is best to eat small, frequent meals, and avoid fatty, greasy, fried, highly acidic, and spicy foods. Try to increase your fluid intake to avoid dehydration. Take your vitamin at a time of day when nausea is less of a problem. Vitamin B6 25 mg. in the morning and evening, ginger capsules, and Seabands (acupressure wristbands) may be helpful. If you are unable to keep any food or liquid down or are showing signs of dehydration (decreased urination, dark urine, light headedness and dizziness), call your doctor.

9. Heartburn: Heartburn is very common in pregnancy and may be treated with Tums at any time in the pregnancy. It often helps to eat smaller portions more frequently than to consume a large meal. If you are experiencing heartburn, avoid eating before bedtime and when sleeping, elevate your head with pillows. If these measures are not adequate, you may take maalox, pepcid, zantac, or prevacid which you can find over the counter. You may take the standard adult dose listed on the label.

10. Constipation: If you are experiencing constipation, increase your fluids, dietary fiber, and exercise. You may use psyllium supplements (metamucil) or flax seed. Use these consistently for several days. If you are still experiencing problems you may take docusate (colace) or milk of magnesia.

11. Headaches: Headaches may occur more often during your pregnancy, especially if you get them frequently when you are not pregnant. Preventive measures include eating small, frequent meals, drinking plenty of fluids, and getting adequate rest. If you need medication, it is safe to take tylenol at the standard dose recommended for an adult. Do not take NSAIDS (ibuprofen, naproxin) or aspirin. If a headache is severe or if it is associated with blurred vision, spots in front of your eyes, fever, or excessive nausea or vomiting, call the office.

12. Backache: Backache is very common in pregnancy. The best way to avoid back ache is to wear low heeled, comfortable shoes, use proper technique with lifting, refrain from lifting heavy objects, and to do a routine of back exercises that will strengthen your muscles. Please refer to ACOG patient pamphlet Easing Back Pain in Pregnancy.

13. Colds, cough, sore throat: For fever and aches, we recommend you take tylenol at the standard adult doses. For congestion, you may try inhaling steam, or use a Nettie Pot or saline nasal spray. If you are over 12 weeks gestation, you may take sudafed, actifed, or benadyl. For a sore throat, you may use cough drops or lozenges, and tylenol.

14. Allergies: You may safely take benadryl, sudafed, claritan, claritan-D or zyrtec after the first 12 weeks of pregnancy. If possible, it is probably best to avoid these in the first trimester unless your allergies are severe and require treatment.

15. Fever: You may take tylenol as directed on the package. Call the office if your temperature is over 101 especially if you have other symptoms such as severe headache, burning with urination, abdominal pain, or contractions.

16. Fainting: Fainting occurs when there is insufficient blood flow to the brain. Situations that precipitate fainting include sudden changes in standing, being overheated or dehydrated, or having low blood sugar. Signs that you might faint are light headedness, a sensation that the room is spinning, your vision starting to gray, a fast pulse and getting sweaty. Fainting is dangerous because you might hit your head or abdomen when you fall. If you feel like you might faint, immediately sit down with your head between your knees or lie down. To prevent the likelihood of fainting, eat a mid morning or afternoon snack, stay well hydrated, avoid hot showers or baths before eating or drinking in the morning, and avoid being overdressed in warm places.

17. Diarrhea: To avoid becoming dehydrated, increase clear liquids such as non caffeinated soft drinks, sports drinks such as gatorade, weak tea, or popsicles. Avoid milk products and greasy foods. Try the BRAT diet: bananas, rice, applesauce, and toast. Call the office if you have recently taken an antibiotic. You may take imodium as directed on the package. Call the office if your symptoms persist, if there is blood in your stool, or if your urine output has dramatically reduced and is dark.

18. Hemorrhoids: To prevent hemorrhoids, avoid getting constipated and try to refrain from straining with a bowel movement. Make sure your diet includes adequate dietary fiber, fruits and vegetables, and plenty of fluids. You may treat the burning and itching associated with hemorrhoids with Anusol HC, Preparation H, and Tucks. A sitz bath twice daily can be very helpful in reducing pain and swelling.

19. Itching: You may take benadryl as directed on the package.

20. Leg cramps: Leg cramping is common in pregnancy, especially in the second and third trimesters. Try stretching your calf muscles in the morning and evenings. It may help to take a calcium supplement.

21. Yeast infections: Yeast infections are common in pregnancy and are associated with a thick white vaginal discharge, itching, burning and reddening of the vulvar tissues. It is safe to use monistat at any time in pregnancy. This is available over the counter at all pharmacies. We recommend you use the 7 day cream or suppositories. Only insert the applicator halfway. If you are not sure you have a yeast infection or your symptoms persist, call the office.

22. Dental Work: Let your dentist know that you are pregnant. Routine dental cleaning is safe. Routine X-rays and elective dental work should be delayed until after birth. If X-rays are needed for emergency dental work, ensure your abdomen is shielded. Local anesthetics and most antibiotics including penicillins, cephalosporins, and clindamycin are safe. You should not use nitrous oxide. Postpone non emergency dental work until after the first trimester or delivery if possible.

23. Tanning beds, hot tubs, and saunas: Tanning beds will not hurt your pregnancy but are not good for you. If you choose to tan, be sure that you do not get overheated or burned. Avoid hot tubs when you are pregnant. Over heating your baby for prolonged periods of time is harmful. Do not use a sauna.

24. Hair coloring: Hair coloring is probably safe during pregnancy. You may choose to hold off coloring your hair with permanent dyes until after the first trimester if you have concerns.

25. House Painting: You may use water based latex paints during your pregnancy. Be sure to use adequate ventilation. Avoid removing old paint used before the 1970s because to the risk of lead exposure. We do not recommend that you use oil based paints.

26. Cats: It is perfectly safe to handle your cat during pregnancy. However, you should not change the cat litter because of an organism that may be present in the cat feces called toxoplasmosis. It is best to have someone else clean the litter box and you should not be in the room when it is cleaned because the cysts can aerosolize. By cleaning the litter box daily you can dramatically reduce the risk of exposure.

27. Travel: If you have an uncomplicated pregnancy, it is usually safe to travel until 34 weeks of pregnancy. If flying, the airlines might request a note from you obstetrician that you are safe to fly. It is important that you understand that there are risks involved with travel in pregnancy and therefore this is a personal decision you will need to make. We can only educate and advise. If traveling by car or plane, you should move around for several minutes every hour or two to increase circulation and to prevent blood clots. Stay adequately hydrated. If you show signs of a blood clot such as swelling or pain in one leg and not the other or shortness of breath, this could be a sign of a blood clot and you should seek medical attention.

28. Flu vaccines: Pregnant women are at increased risk of serious complications if they get the flu. ACOG and the CDC recommend that the flu vaccine be offered to all women. Women with egg allergies or a previous reaction to a vaccine should not get the vaccine.

29. Chickenpox: If you are exposed to someone with chicken pox and you have had chicken pox as a child or have had the chicken pox vaccine, you should be protected from infection. If you do not know, you can be tested to see if you have immunity. Most adults do have immunity. Pregnant women who do not have immunity need to get immune globulin within 4 days of exposure to try to prevent chickenpox or decrease the seriousness of the infection.