Most common pregnancy questions..
Updated: Feb 3, 2021
Here's the most common questions patients ask me at almost every New OB visit..
1 - What can I do about acne?
I'm OK with anything topical, but you can't swallow any pills for acne.
To be on the safe side, don't use high doses of Retinol, but it's unlikely anything topical will be harmful if you're using it properly.
2 - Can I dye my hair?
Sure. You cannot drink the hair dye, but I don't care if you get your hair dyed. That is not going to affect the baby.
3 - What can't I eat? Can I eat lunch meat? What fish should I avoid?
The 2 main goals with eating during pregnancy (besides obviously putting healthy foods in your body to help it function properly) are to:
avoid food poisoning, especially Listeria, which can be harmful to the baby
avoid foods that contain substances that could build up and be harmful to the baby, such as nitrates, mercury, alcohol..
To avoid food poisoning, try to stick with fresh, and/or well-cooked foods. Listeria is rare thankfully, but it can be harmful to a pregnancy. Listeria has been found in deli meat, but it has also been found in fresh spinach and canned peaches. It may be impossible to completely avoid any risk.
Wash produce thoroughly.
Don't eat any foods that smell bad (that's why you have super-smell).
Cook foods throughly to kill any bacteria that may be present.
Basically everything in moderation. Processed meats contain nitrates which can potentially be harmful in high doses. You can have a hot dog, but you wouldn't eat one every day. You can have a tuna fish sandwich, but you wouldn't eat that everyday.
Some fish contain really high levels of mercury, so it's best to avoid these fish:
bigeye tuna (that's not the canned kind).
It's perfectly safe to eat salmon and most other types of fish which are so healthy and good for you.
It's best to just avoid alcohol altogether, especially in the first trimester when the baby is forming. Although one glass wine or one beer during the 3rd trimester isn't going to do any harm, Fetal Alcohol Syndrome is a serious consequence when drinking gets out of hand.
4 - What meds are safe to take?
Your provider will likely give you a list of meds that are safe to take in pregnancy.
Tylenol (acetaminophen) is OK in moderation for headaches, aches and pains
Avoid ibuprofen and high doses of aspirin. (We may recommend a baby aspirin for some of you.)
Your prenatal vitamin is fine as long as it doesn't make you sick. If it does, then try taking it at night, or get a chewable one that may be easier to digest, or look for one without iron in it. Iron can upset the stomach, and you don't need extra iron unless you're anemic (which we will check at your first prenatal visit and again around your 3rd trimester)
We'll review all the meds you're taking. Don't just assume something is safe because it's a prescription. (For example you absolutely cannot take Xanax - it can cause birth defects.)
Don't stop taking a medication just because you're pregnant either. You may need your antidepressant more than ever. Just review all your meds with us to be sure. You should check with the doctor who prescribed you the medication to see whether you still need it or not, or if there is an alternative.
We cannot say that any over-the-counter supplements are definitely safe
5 - Can I drink coffee?
Yes, in moderation.
You can have 2 cups of coffee a day (or 200mg caffeine).
Caffeine has been well-studied and only in very high doses is caffeine potentially harmful.
So have a cup of coffee, don't drink 10.
Same with herbal teas. I'm not worried about a cup every other day or so, but not 3 cups a day.
6 - Can I exercise?
Sure, just listen to your body. If you feel like you're going to pass out, then you are.
Some days you will have more energy than other days
Walking, running, swimming, yoga are all fine.
You won't start a new weight training regimen or sign up for a marathon, but you can continue to exercise while pregnant.
If you're not used to regular exercise, start taking a daily walk or check out some prenatal yoga classes on youtube.
7 - Why am I so tired?
It is normal for you to feel more tired than you ever have in your whole life during that first trimester.
You can't stay awake past 7pm, right? It's because the baby is sucking the life out of you.
It takes a lot of energy to grow a human.
Raising that human will also be exhausting, so rest up.
You usually will feel better in the second trimester, but the 3rd trimester will be tough again.
8 - Can I have sex?
Sure, if you're up for it. There may be times during pregnancy when those hormones cause an increased libido, but there will be times when you are too exhausted to move. It's fine to have sex when you're feeling up to it.
Your partner cannot hurt the baby or cause a miscarriage. (I know they all think they're that well-endowed, but no.) Sometimes, if your cervix gets bumped you can have some spotting after intercourse. Your cervix is softer and more sensitive when you're pregnant. Again no worries, because that cannot cause a miscarriage or preterm labor. Just spotting.
Sometimes we put women on "pelvic rest" (No sex) when conditions like placenta previa or preterm labor arise, but these don't come about until later on and are not concerns during the first half of the pregnancy.
9 - What can I do about frequent nausea and vomiting? What if I can't keep any food down?
Try to hydrate.
Try to focus on pushing liquids if you can't eat... try smoothies, protein shakes, gatorade, whatever appeals to you. You will do better with small frequent meals, trying to nibble throughout the day rather than sitting down for a huge meal.
Carbohydrates will usually appeal to you more since they are easier to digest, so it's normal you prefer things like crackers, bread, and french fries. You may have some food aversions, or foods you just cannot even look at or smell (often meat and eggs).
Ginger is a known natural anti-nausea remedy, so you can buy some pickled ginger to nibble on or some ginger ale to sip (you can stir the bubbles out of it). They also sell ginger lollipops and candies which may help settle your stomach for a little while.
You can try over-the-counter vitamin B6 supplements. The recommended dose is 10-25mg every 6 hours. (max dose 200mg/day.)
Diclegis and Bonjesta are prescription meds that basically contain Vitamin B6 and Unisom (an over-the-counter sleep aid). This combo has been recommend for years, but someone was smart enough to combine it into one pill and charge a lot of money for it. So if your insurance doesn't cover it, it can be very pricey. Just get some over-the-counter Vitamin B6 and Unisom (doxylamine) 10-20mg to take at night.
Anti-nausea Rx meds
After that, we can also prescribe some other anti-nausea medications you can use as needed.
I usually tell patients they can go about 24 hours without keeping any food down, then we may recommend IV fluid hydration. If your urine is clear to a light yellow, you're hydrated. If your pee is really dark or you are barely making any urine, you need some hydration. Call your obstetric care provider's office and see if they can arrange this for you. They may have an outpatient or specific place they prefer you go rather than just to the ER.
Patients often worry that the baby isn't getting what she needs if they can't keep food down or aren't gaining weight. Let me reassure you, the baby does not care if you eat or not. It will take everything it needs from you, and then you just try to replace that. The baby is a very effective little parasite. You suffer, not the baby.
10 - What should I avoid?
Some women worry that because they're pregnant now, that they can't do much. (Or often this comes more from their partners.) But you are not a fragile flower now.
You can't cause yourself to have a miscarriage or go into preterm labor - seriously - it's just not that easy. You can engage in normal daily activities. You can go to work. You can move normally.
We would only say you need stop working if there are blood pressure or preterm labor issues that may occur later in pregnancy.
Sure I want you to avoid potentially harmful situations, such as sky diving and scuba diving, so no extreme sports, but that's just common sense, right?
Otherwise everything in moderation. Except crack cocaine. You absolutely cannot do crack cocaine.
So after your first prenatal visit, here's what you really need to know...
Your official due date.
This is determined based on your last menstrual period, as well your normal menstrual cycle lengths, possible known date of ovulation/conception, and an ultrasound if available.
Know your prenatal care schedule
We usually want an office visit once a month, then more frequently during the last 2 months. At each office visit we check your blood pressure and listen to the baby's heartbeat. We will measure the growth of the baby in the 2nd and 3rd trimester and address any issues that come up.
We'll discuss your genetic screening options. These tests are optional but will need to be done at 10-13 weeks. The type of test will depend on your age, your insurance plan and what's available in your area.
An ultrasound is usually done around 20 weeks to look at the anatomy of the baby and the location of your placenta.
We recommend no traveling after 34 weeks (last 1 1/2 months) and stay within an hour of the hospital
Review medical issues
It's important we've reviewed any medical issues you have and any medications you're taking.
You may need more frequent prenatal visits or a referral to high-risk OB specialist if available.