How can I manage pain control during labor? This is a personal choice, but in our practice the great majority of patients do opt for an epidural. Epidurals are a very safe and effective means of controlling the pain associated with childbirth. Complications from an epidural are extremely rare and often easily corrected. Anesthesiologists are available 24 hours a day during labor to help you whenever you request their services.
What do I need to know about nutrition during pregnancy? We need an average of only 300 extra calories daily during pregnancy (one bagel or ½ a deli sandwich). “Eating for two” will result in excessive weight gain. Most women will lose only 15-20 pounds in the first few weeks postpartum, with the rest stored as fat, so weight gain of 20-30 pounds is ideal (0-5 pounds in the first 12 weeks, and ½ pound-1 pound a week after that). Eat small frequent meals to avoid heartburn and hypoglycemia. Eat what you enjoy, but make healthy choices and go easy on sugars and starches to prevent excessive weight gain and gestational diabetes.
Certain fish accumulate high levels of mercury from swimming in polluted waters. The FDA recommends avoiding those fish that are highest in mercury, including Shark, Tilefish, Swordfish and King Mackerel. Shellfish, shrimp and smaller fish such as Snapper, Catfish and Salmon are lower in mercury, and up to 12 ounces a week is recommended. Canned tuna is low in mercury and can be included in the total of 12 ounces a week. Tuna steak is higher in mercury than canned tuna, and should be limited to 6 ounces a week. Learn more about fish and pregnancy.
Unpasteurized cheeses and deli meats can carry Listeria, a bacterium that can cause miscarriage and fetal infection. While this is extremely uncommon in the USA, it is wise to avoid regular intake of unpasteurized dairy products or deli meats for this reason. High temperatures kill listeria so deli meats heated in the microwave until steaming is certainly safe. We recommend avoiding highly processed foods such as canned foods and highly processed foods such as hot dogs. They contain chemicals that are not healthy for human consumption. Pregnancy is a good time to change bad eating habits to healthy ones.
Raw fish and meat can carry parasites and other microbes that could cause potential harm to the mother and fetus. While these infections are extremely rare, it is wise to avoid raw meat and fish for this reason.
There is no safe limit of alcohol in pregnancy. Complete avoidance is the best policy. Caffeine is safe in small quantities (1-2 caffeinated beverages daily).
There is no scientific evidence that nutrasweet (aspartame) or other sugar substitutes are harmful in pregnancy.
What are the best vitamins and supplements during pregnancy? Folic acid is a B vitamin that has been shown to reduce the risk of spina bifida. 1 mg (1000 micrograms) is recommended during the month prior to pregnancy and for the first 2 months after conception to reduce this risk. More folic acid may be recommended if you have a personal or family history of spina bifida including a prior affected child.
A prenatal vitamin is a general multivitamin with 800-1000 micrograms of folic acid, as well as calcium and iron. Most women continue their vitamins after the second month to help reduce anemia and make up for any imperfections in diet. If you are not anemic and eat a well balanced diet, stopping prenatal vitamins at 2 months of pregnancy is acceptable.
After 12 weeks the baby begins to make bone and will draw the necessary calcium from your bones. To prevent bone loss 1000-1500 mg of calcium is recommended. This equates to 4-5 servings of milk, yogurt or dairy. Since this is difficult to consume, take a calcium supplement (usually 500-600 mg) to make up the difference. Don’t take calcium and iron (in the multivitamin) at the same time as they can offset each other’s absorption. While calcium citrate (“Citracal”) is the best absorbed, other types of calcium such as fruit flavored “Tums” and “Viactiv” (chocolate flavored) may be more appealing.
If you eat fish 3 times weekly you are getting plenty of Omega-3 fatty acids, or Essential Fatty Acids (EFAs). If not, take a supplement containing 200mg of DHA (from fish oil or flax seed oil). EFAs have been shown to help fetal eye and brain development, may improve mom’s skin, hair and nails and are also passed into the breast milk.
Can I exercise during pregnancy? It is important to stay active during your pregnancy. If you have an uncomplicated pregnancy you can continue your current exercise regimen with a few modifications. When doing cardiovascular exercise (walking, running, biking, elliptical trainer) a good guideline is to keep your heart rate at a maximum of about 140 beats per minute. This will allow blood flow to go to the uterus as well as your large muscles. If you are working out with weights, modify exercises that require you to be flat on your back or flat on your stomach after 12 weeks. Abdominal exercises are ineffective during pregnancy.
If you do not exercise regularly, walk for 20-30 minutes 3-5 times a week. A total of 150 minutes of moderate exercise is recommended weekly. Prenatal yoga or pilates class are also of benefit during pregnancy.
Avoid exercises on your back after the second trimester.
Regular exercise is a great way to prevent excessive weight gain, reduce stress, and keep the physical strength necessary to deliver and take care of a new baby.
Occasionally complications such as bleeding, preterm labor or high blood pressure may prevent you from being able to exercise.
“What should I know about intercourse during pregnancy?” Sex is safe in pregnancy unless you have complications such as bleeding, preterm contractions or a low-lying placenta. Sex may make you have mild contractions; however, it will not make an otherwise healthy pregnant woman go into premature labor. Unless we tell you otherwise, continue your normal sexual practices if you want to.
“Can I travel during pregnancy?” If you have an uncomplicated pregnancy it is safe to travel until 36 weeks. It is unlikely that you will go into labor. After 36 weeks, we recommend staying close to home. We also discourage not leaving the country in the third trimester (after 26-28 weeks) unless absolutely necessary. Air travel is safe in pregnancy but may increase your risk for blood clots, so wear support hose on long flights and move about the cabin once an hour. With long road trips make frequent rest stops to stretch your legs and maintain circulation.
“What do I need to know about pets during pregnancy?” Outdoor cats can be exposed to Toxoplasmosis and can pass this parasite to humans through the feces. You could acquire it by changing the litter box of an infected cat. If your cat goes outside, have someone else change the litter box when you are pregnant, or wear gloves and wash your hands well. If your cat lives inside and only eats processed cat food she cannot get the disease. Cuddling your cat is safe and will not expose you to the disease. Dogs are not affected. Toxoplasmosis can be harmful to a developing fetus but is very rarely seen in the USA.
Can I have dental work during pregnancy? Routine dental work is safe during pregnancy and we encourage you to keep up with your normal dental health routine. Most dentists will require a note from us saying that the visit is safe, and we can give you a letter to take to your visit. We are also available to discuss the best options for medications and pain management with your dentist.
What are my options for pain control during labor? This is a personal choice, but in our practice the great majority of patients do opt for an epidural. Epidurals are a very safe and effective means of controlling the pain associated with childbirth. Complications from an epidural are extremely rare and often easily corrected. Anesthesiologists are available 24 hours a day during labor to help you whenever you request their services.