27790 W. Highway 22, #37, Barrington, Illinois 60010 Phone: 847-382-4406  Fax: 847-382-7098  E-mail: obgpez@aol.com

Frequently Asked Questions (FAQs)
About Pregnancy

Caffeine/ Constipation / Cold and allergy symptoms / Exercise and work / Exposure to chickenpox / Gum swelling or bleeding / Headaches / Heartburn / Hemorrhoids / Herbs and extra vitamins / Intercourse / Leg cramps / Nausea and/or vomiting / Permanents or hair color / Postpartum depression / Safe to paint / Saunas, hot tubs, and tanning booths / Swelling / Travel / Weight gain / Yeast infections

Can I drink caffeine?

What can I do to relieve constipation?

· As many as half of all pregnant women have problems with constipation. One of the reasons for this may be the change in hormones during pregnancy that cause slowing of food movement through the digestive tract.
· Other causes may be inadequate fluid intake or insufficient fiber in the diet. Sometimes iron supplements may cause constipation. During the last part of pregnancy, pressure on the rectum from your uterus may add to the problem.
· Constipation is usually curable with exercise, diet and adequate fluids.

General Treatment Measures

· Drink at least 8 glasses of water each day, including 1-2 glasses of fruit juice, such a prune juice.
· Include bulk foods, foods high in fiber, such as bran, bran cereals, and raw fruits and vegetables.
· Exercise daily-walking is a good form of exercise. Exercise and good physical fitness helps to maintain healthy bowel patterns.
· For occasional constipation, you may use a stool softener laxative, mild nonprescription laxative, or enema. Do not use laxatives or enemas regularly as this can cause dependency. Avoid harsh laxatives and cathartics, such as Epson salts or Ex-Lax. The best laxatives are bulk-formers, such as bran, psyllium, polycarbophil and methylcellulose (found in Metamucil and Citrucel).
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What can I take if I have cold or allergy symptoms?

· Increase fluids (especially water) to two quarts per day.
· Get extra rest.
· Use a cool mist vaporizer/humidifier at night to moisten the air you breathe to keep nasal/bronchial secretions thin and flowing.
· Saline gargles (one teaspoon of salt in ½ cup warm water) every four hours while awake will decrease the mucus in the back of throat and help relieve a sore throat.
· Saline nose drops (NOT Afrin or Neo-Synephrine) upon rising in the morning and at bedtime to moisten secretions.
· Plain Tylenol two tablets every four hours as needed for aches (a maximum of six tablets in 24 hours.) It is preferable to not use during the first trimester and not at all for one week prior to your triple test.
· Coughing can be relieved by mixing one teaspoon of honey and 2-3 drops of lemon juice. Hold this in your mouth until the honey thins and then swallow. If coughing interrupts sleep or cause vomiting, call your health care provider. You may try Robitussin, an over-the-counter cough medication, after the first trimester.
· Sudafed may also be used for symptoms of congestion. Take as directed on package. Preferable to not take this in your first trimester of pregnancy.
· Take your temperature, orally, twice daily, call us if your temperature is greater than 100.4 Fahrenheit.
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Is it safe to continue to exercise and work during pregnancy?

· Exercising during pregnancy can help minimize minor discomfort associated with pregnancy, improve your posture, enhance circulation, assist with control of relaxation and/or expulsion during delivery, and provide a feeling of general well-being. A well-conditioned body will perform better and more reliably during the stress of advanced pregnancy, labor, and delivery. Preconditioning will contribute to a quicker recovery of body contour following delivery.
· Exercise regularly, rather than occasionally. Your exercise program should be planned around your prepregnancy fitness level. This is NOT a good time to begin a new, difficult exercise or sport, such as running a marathon for the first time. If you were active before pregnancy, you can continue to be within reason. If, for example, you play tennis, you can still play unless you have special problems of feel very tired. A good "rule of thumb" is to limit exertion to about 2/3 of what you could do before pregnancy. Women who were not exercising prior to pregnancy are advised to begin an exercise program.
· Stop any exercise right away if you develop signs of dizziness, bleeding, faintness, abdominal or back pain, overly rapid heart rate or shortness of breath. If symptoms continue call our office.
· Most of the time, a healthy woman with no complications in her pregnancy can continue working until the end of her pregnancy. Some women may need to make some changes. If you are experiencing problems that you feel may be due to your job, please discuss them with your health care provider at your office appointments. Your family should be able to help you at home as fatigue increases towards the end of your pregnancy.
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What should I do if I am pregnant and a family member has or has been exposed to Chicken pox?

· Most adults are immune to chicken pox, either from having the disease of by forming immunity from a mild exposure. If you have had chicken pox in the past, you and your baby are protected (immune). If you are not sure, ask your health care provider to check your immunity with a blood test. If this shows positive immunity, you and your baby are protected. If it shows no immunity, an injection of a medicine called Varicella Immune Globulin (VZIG) may be given to prevent chicken pox. This injection must be given within 72 hours of exposure to chicken pox, in order to be effective.
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Is it normal for my gums to swell and/or bleed during pregnancy?

· The extra hormones in your body during pregnancy may cause your gums to swell and bleed. Floss and brush regularly, using a soft toothbrush. Having a dental checkup early in pregnancy is a good idea to be sure your mouth is healthy. Local anesthesia, if needed, does not pose a risk during pregnancy as long as epinephrine is not used with the local anesthetic. Dental x-rays should only be done if necessary and with your abdomen shielded with lead.
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What can I use for headaches during pregnancy?

· Headaches are fairly common during pregnancy. Usually headaches are NOT a sign of a serious problem. How often they occur and how bad they are may vary. It is important to discuss with your health care provider what medications you can use for your headache. You should contact your health care provider if your headache does not go away, returns frequently, is severe, causes blurry vision or spots in front of your eyes, or is accompanied by nausea.
· You may use Tylenol (acetaminophen) ONLY two regular tablets of one extra-strength tablet for headaches.
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What can I do to prevent or reduce heartburn?

· Indigestion is frequently called heartburn. This does NOT mean that something is wrong with your heart. Heartburn is a burning feeling in the center of the chest and upper abdomen and seems to rise into your throat. It is frequently accompanied by an unpleasant taste in the mouth and burping. It is caused by a backflow of acid from the stomach into the esophagus. The muscles that close off the upper stomach become lax, allowing stomach acids to enter the esophagus and irritate its lining. This may be worsened by pregnancy because pregnancy hormone levels increase stomach acid production and decreases the emptying time of the stomach contents. In addition, your growing uterus presses up on your stomach.
· Eat small frequent meals, 5 or 6 per day instead of 2 or 3 large meals. Avoid drinking large amounts of fluids with meals.
· Avoid foods that cause gas and spicy or greasy foods.
· Do not eat or drink before bedtime.
· Wait 2 hours after eating before exercising.
· No alcohol or smoking.
· Avoid very hot or very cold fluids.
· Antacids may be helpful, (in moderation due to salt content) such as Maalox, Tums, or Gaviscon. Liquid forms are often more effective than tablet forms. If heartburn is frequent and only briefly relieved by antacids, speak with your health care provider.
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What should I do if I have hemorrhoids?

· Pregnant women who are constipated frequently have hemorrhoids. Hemorrhoids are dilated (varicose) veins of the rectum or anus. They may be painful, itchy, swollen, and sometimes may bleed. Straining during bowel movements and having hard stools may make hemorrhoids worse and can sometimes cause them to protrude at the anal opening.
· Do not take over-the-counter medications while pregnant until you check with your health care provider. Hemorrhoids usually improve after the baby is born.
· Avoid constipation: drink 8 to 10 glasses of water a day and include plenty of fiber in your diet.
· Exercise regularly.
· Avoid straining and prolonged sitting on the toilet, don't try to hurry bowel movements.
· Use a stool softener if a laxative is needed or Anusol HC.
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Are herbs and extra vitamins safe during pregnancy?

· No, your prenatal vitamins should be the only supplement used during pregnancy unless your health care provider specifically instructs you to use an additional product.
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Is it safe to continue to have sexual intercourse during pregnancy?

· Some couples worry about having intercourse during pregnancy. They may be afraid that it will cause a miscarriage. For a healthy woman with a normal pregnancy, intercourse is safe into the last weeks of pregnancy. You and your partner may want to experiment with different positions that may be more comfortable for you. If you are having problems in your pregnancy, your health care provider may advise you to limit or avoid intercourse as necessary.
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Are leg cramps common in pregnancy?

· Yes, you may find that you have an increase in leg cramps in the second and third trimesters of pregnancy. Get plenty of calcium (three glasses of milk or supplement) and potassium (bananas and oranges). Stretching your legs before going to bed may help relieve cramps.
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What can I do to decrease nausea and vomiting during pregnancy?

· Eat smaller, more frequent meals. Try 6 small meals with snacks in between.
· These foods may NOT be well tolerated: greasy or fried foods (they take longer to leave the stomach and therefore may cause nausea and/or heartburn), very sweet foods, spicy hot foods, and foods with strong odors.
· Drink fluids between meals, not with meals.
· Drink chilled or cold beverages, for instance, decaffeinated soda. Don't drink diet soda, you need the calories at this point.
· Eat slowly and rest after meals. It is best to rest while sitting in an upright position for about one hour after eating.
· Dry toast, soda crackers, or dry pre-sweetened cereals (dry starches) may help relieve nausea.
· Keep track of when you feel nauseated, and what causes it.
· If continued vomiting occurs, do not eat of drink anything until the vomiting has stopped. As you feel better, try small amounts of clear liquids such as broth, Jello, apple, grape or cranberry juice, and/or popsicles.
· Tart or salty foods such as lemons or pickles may decrease nausea.
· Avoid mixing hot and cold foods at a meal, as it may stimulate nausea.
· Avoid eating in a room that is stuffy, too warm, or has cooking smells that may disagree with you.
· Avoid the sight/smell of foods that bother you. Eat meals out or have others bring prepared food to you.
· Wear loose fitting clothing.
· Ask your health care provider about medicine to help control the nausea.
These are signs that you need to call your health care provider:
    *Unable to keep anything down for more than two days.
    *Fainting
    *Vomiting blood
    *Your weight drops more than five pounds within a week
    *Rib pain
    *Jaundice (skin is yellow)
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Is it okay to color or perm my hair during pregnancy?

· Pregnant women often have concerns about the safety of hair dyes and permanents during pregnancy. There is no scientific data on this issue, but it seems unlikely that these types of exposures are harmful. Some women have found that permanents during pregnancy may not "take."
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Is it safe to paint while I am pregnant?

· Latex paints manufactured prior to 1991 used small amounts of mercury in them as a preservative. There was some concern that this mercury could present a health hazard, so mercury is no longer used in latex paints. The fumes from latex paints are not felt to be a specific risk to a developing baby, but it is always wise to paint in a well-ventilated area. The fumes from oil-based paints, turpentine, paint thinner, etc., are best to be avoided by pregnant women. Also, while pregnant, avoid the use of a ladder to reduce the risk of falling.
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What is postpartum depression?

· Postpartum depression is a mood disorder with postpartum onset.
· Occurrence: Postpartum depression develops in approximately 10% of all postpartum women. The greatest risk occurs at approximately 4 weeks after delivery.
· Contributing factors: Risks for postpartum depression include primiparity (first pregnancy), history of postpartum depression, lack of social support, and lack of stable relationships.
· Signs and symptoms: Symptoms of postpartum depression are the same as those of any major depression: sadness, frequent crying, insomnia, appetite change, difficulty concentrating, worthless feelings, inadequate feelings, lack of concern about personal appearance, persistent anxiety, and irritability toward others.
· Treatment may require counseling, anticipatory guidance, support from others and antidepressant therapy.

· Approximately 50% of new mothers may experience some degree of baby "blues" (postpartum blues) a few days after delivery. Most common time is 3 to 10 days after delivery (but can occur anytime in the first year) and usually last anywhere from 48 hours to 2 weeks. This is the result of many factors, some of which are emotional letdown following delivery, physical discomfort of the immediate postpartum period, fatigue, and anxiety.
· Postpartum blues are treated with anticipatory guidance and counseling.

· The most severe form of postpartum mental disorder is postpartum psychosis. It is a relatively uncommon disorder.
· Women with postpartum psychosis may lose touch with reality. They have stretches of lucidity alternating with psychosis. Also frequently noted are symptoms of confusion and disorientation. The woman who is psychotic usually will have difficulty in caring for her infant, and may have delusions leading t thoughts of self-harm or harm of the infant.
· The peak onset of psychotic symptoms is 10 to 14 days after childbirth, but the risk remains high for months after delivery.
· Treatment may include hospitalization, medication, counseling and support from others.

· It is important for a woman to report feelings of sadness following delivery to her health care provider.
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Can I use a sauna, hot tub or tanning booth while I am pregnant?

· The use of saunas, hot tubs, and tanning booths is not recommended during pregnancy. The extreme temperature could potentially harm the developing baby. Extremely hot baths are not recommended as well. Bath temperatures should be below 100 degrees Fahrenheit.
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Is it normal to swell during pregnancy?

· A certain amount of swelling (edema) is normal during pregnancy. If occurs most often in the legs and primarily in the third trimester and may be worse with pregnancy during the summer months. Elevating your legs during the day (feet above the level of your head), and resting during the day and sleeping on your left side may help reduce swelling.
· Decrease prolonged standing or sitting, with brief periods of walking from time to time.
· Do not wear constrictive clothing or stockings or socks that have a tight band of elastic around the legs.
· Let your health care provider know if you have swelling in your hands (your rings are too tight), or face.
· Do not take diuretics "water pills" for swelling unless they have been prescribed for you by your health care provider.
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May I travel during pregnancy?

· Most women can travel safely until close to their due date. Frequently, the most comfortable time to travel is in the middle of pregnancy. Problems are least likely to happen during this time. Many women have concerns regarding seat belts during pregnancy. You are much better off wearing your seat belt during pregnancy. The baby is well protected in the uterus from trauma, however, car accidents are the most common source of trauma during pregnancy. The most common cause of fetal death is maternal death, and maternal death is much less likely in pregnant women who wear seat belts. Both lap and shoulder belts should be worn at all times. The lap belt should be worn low on the hips, not over the uterus. When traveling long distance, by car, we recommend you get out to walk every one to two hours and not sit with your legs crossed. **Remember, after delivery, you must have an approved car seat in your car in order to take your baby home from the hospital.

· Women also have concerns about flying during pregnancy. In general, there is no increased risk for women who fly during pregnancy. Any woman who sits for long periods of time without getting up for a walk is at risk for developing a blood clot in her legs. For this reason, on flights over two hours, you should get up, stretch your legs, and take a walk up and down the aisle. Because of this, an aisle seat may be preferable.
· Our office recommends that patients do not travel at all after 8 months (32 weeks).
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What are the recommended weight gain guidelines for pregnancy?

· Recommended guidelines for the range of total weight gain and the pattern of weight gain should be based on prepregnancy weight for height. The pattern of weight gain is as important as total weight gain during pregnancy.

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Are yeast infections common during pregnancy?

· It is not uncommon to have yeast infections during pregnancy. If you develop a yeast infection, it is safe for you to use over-the-counter products, such as Monistat. However, if you are early in your pregnancy, before 12 weeks, use the cream externally only. After 12 weeks, it is safe to gently use the applicator internally.
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