Frequently Asked Questions

1.  What do I do if I think I have a temperature? 

If you think you have a fever, you need to take your temperature with a thermometer and call our office if it is above 100.4 degrees.  

2.  Can I go to the dentist while I am pregnant?  

It is very important to take good care of yourself when you are pregnant.  Dental health is very important.  You need to make sure that you visit the dentist to maintain your oral health.  There are certain things that we want the dentist to know.  Local anesthesia is okay and so are pain medicines that are on our list.  You may get x-rays but they need to shield your abdomen while taking them.  If you have anything besides a routine visit which is teeth cleaning, please call our office.  If your dentist requires a letter before your visit, please call our office BEFORE your schedule visit so we can get the letter ready for you.  

3.  Can I get X-Rays while I am pregnant? 

If you need x-rays during your pregnancy, you need to tell the x-ray technician that you are pregnant BEFORE they do the x-ray.  A shield for the abdomen will be provided during the x-ray procedure.  

4.  How much weight should I expect to gain during my pregnancy? 

Underweight women (those with a BMI of less than 18.5) should have a weight gain of 28-40 pounds.  Overweight women (those with a BMI of 25-29.9) should have a weight gain of 15-25 pounds.         Obese women (those with a BMI of 30 or greater) should have a weight gain of 11-20 pounds.      Average weight women (those with a BMI of 18.5-24.9) should have a weight gain of 25-35 pounds.  

5.  I am always tired, what can I do about that? 

Fatigue during pregnancy is normal.  Make sure you are getting plenty of rest.  If you feel tired, take a break and rest.  Make sure you are eating a well-balanced diet.  Eating the right foods will help you feel better.  A diet with lots of sweets and carbohydrates can make you feel more tired.  

6.  What can I do about breast tenderness? 

Breast tenderness is normal during pregnancy.  To help minimize the tenderness you need to wear a good supporting bra, such as a maternity or nursing bra.  Full figured bras also offer more support.  

7.  How can I prevent my legs and ankles from swelling? 

You cannot keep your legs and ankles from swelling but you can do things to make it better.  Make sure that when you are sitting you elevate your legs.  Your feet should ideally be higher than your heart.  An easy way to do this is to sit in a recliner or on a couch with your feet propped up on the armrest.  Avoid standing for long periods of time.  Wear loose clothing, especially at the wrist and ankles.  Limit your intake of salt.  Reduce or avoid foods that are high in salt, such as bacon, lunch meat and potato chips.  If you are having swelling in your face and hands, please let your doctor know. 

8.  I am constipated, what can I do to prevent that? 

Many pregnant women seem to have problems with constipation.  One reason for this may be the changes in the hormones that show the movement of food through the digestive tract.  Sometimes iron supplements also cause constipation.  During the last part of your pregnancy, pressure on your rectum from your uterus may add to the problem.                                                                                                                                               Some suggestions that may help: 

• Drink plenty of liquids, at least 6-8 glasses of water each day.  You should also include 1-2 glasses of fruit juice such as prune juice.  Liquids that contain caffeine such as coffee, tea and colas should be avoided.  These caffeinated drinks pull water from your intestines and make your stool harder and more difficult to pass. 
• Eat foods that are high in fiber such as raw fruits and vegetables and bran cereals.  Exercise is another way to help.  Walking daily can help with constipation.  

9.  What can I do if I have hemorrhoids? Hemorrhoids during pregnancy are often caused by constipation.  They occur because you have been straining during bowel movements.  Having hard stools can also make the hemorrhoids worse and can cause them to protrude from the rectum.  To help with relief of hemorrhoids or to avoid the problem you can eat a high fiber diet and drink plenty of liquids.  Avoid standing or sitting for long periods of time.  Do not strain with bowel movements.  Take a warm sits bath to help relieve any pain.  You can use Tucks pads or Anusol suppositories.  If these things do not relieve your symptoms, please call our office.  

10.  What can I do for a backache? 

Backaches are expected during pregnancy.  As you get bigger, you will experience more back pain at times.  You can help minimize your back pain by avoiding doing too much and getting too tired.  You need to practice good posture.  Wear low heeled shoes.  You can also wear a maternity belt.  When resting, elevate your legs on pillows.  You may take Tylenol for pain.  You may also use a heating pad only on your back.  Do not place the heating pad on your stomach.  

11.  Are leg cramps normal? 

In the last three months of pregnancy, you may find that you have more leg cramps.  Get plenty of calcium, at least 3 glasses of milk a day.  Get plenty of potassium which you can get from oranges or bananas.  You can stretch your legs before you go to bed to help relieve cramps.  When exercising or stretching, avoid pointing your toes.  Do not sit for long periods of time or cross your legs when you are sitting.  

12.  Sometimes I get dizzy, what should I do? 

Make sure you are eating a well-balanced diet.  Do not skip meals.  Make sure that when you stand up, you do it slowly.  If your dizziness continues, contact our office.  

13.  Is it normal for my gums to bleed during pregnancy? 

During pregnancy the extra hormones in your body may cause your gums to swell and bleed.  Floss and brush regularly, using a soft bristle toothbrush, to keep your teeth in good shape.  Have regular dental check ups.       

14.  Is it safe to paint during pregnancy? 

Latex paints manufactured before 1991 used small amounts of mercury 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 a good idea to paint in a well ventilated area.  The fumes from oil-based paints, turpentine, paint thinner, and other paint products are best avoided by pregnant women.  Also remember when painting to avoid use of a ladder to reduce the risk of injury due to a fall.  

15.  Can I perm or color my hair while pregnant?  

There is no evidence to suggest that hair color or permanents are harmful during pregnancy.  We recommend that you wait until after the first trimester to color or perm your hair.  Know that your hair may not perm well during the pregnancy. 

16.  Are saunas, hot tubs and tanning booths safe during pregnancy? 

The use of saunas, hot tubs and tanning booths is not recommended during pregnancy.  The extreme temperature could potentially damage the developing baby.  Extremely hot baths are not recommended during pregnancy.  Bath temperatures should be below 100 degrees Fahrenheit.   

17.  What is Pica? 

Pica is a rare craving to eat things other than food, such as ice, dirt, clay, baking soda, cornstarch and sheet rock.  Eating these things that do not contain nutrients can cause low iron anemia.  If you are craving these things please let your doctor know.  If you are craving ice, try freezing fruit juices or fruits to eat instead of ice.  These things do have nutritional value.  

18.  What is this brown mask on my face? 

Due to changes in hormone levels, including the hormones that stimulate pigmentation of the skin, brown, blotchy patches may occur on the face, forehead or cheeks.  This is often called the mask of pregnancy or chloasma, and often disappears soon after delivery.  Using sunscreen when you are outside can reduce the amount of darkening that occurs.  Other places that the skin pigment can change are the areas surrounding nipples, called the areolas.  A dark line frequently appears down the middle of the abdomen, called linea negra.  

19.  Is it normal for my nose to bleed or be congested during pregnancy? 

During pregnancy the lining of the respiratory tract receives more blood, often making it more congested.  This congestion can cause stuffiness in the nose or nosebleeds.  Also small blood vessels in the nose are easily damaged due to the increased blood pressure, causing nosebleeds.  You can use saline nose spray to help alleviate congestion.  You can also use a cool mist humidifier to help with congestion or nose bleeds.    

We know that you are very excited about your pregnancy and we want to tell you about what to expect during your prenatal visits.  

This is the usual schedule of visits and expected procedures but this can change if your doctor feels that is needed.   

First Prenatal Visit               

Routine Lab Work to Include: 

• Complete blood count Blood type and RH factor Antibody screen 
• Syphilis screen 
• Rubella screen 
• Hepatitis B surface antigen 
• Chlamydia culture 
• Gonorrhea culture
• Group B Strep culture 
• Cystic fibrosis screen (if desired)      

Complete History and Physical to include:       

• Pap smear (if indicated)       
• Urine culture        
• Plan your prenatal care and answer any questions   

1 to 2 weeks after first prenatal visit 

Ultrasound to confirm your due date   

16-18 weeks gestation   

Quad screen (if desired)  

20 weeks gestation  

Ultrasound to view your baby’s anatomy  

26-28 weeks gestation  

Screening for gestational diabetes  

28 weeks gestation  

 Rhogam injection if your blood type is negative  

34-35 weeks gestation  

Syphilis screen - Group B strep culture if your initial culture is negative   

Your prenatal visits will be every 4 weeks until you reach 28 weeks.  After that your visits will be every 2 weeks.    In your last month of pregnancy you will come every week and the doctor will check your cervix for any dilatation.    This is just a guideline and changes in your health and pregnancy will determine changes in the schedule of events.  

Pregnancy is a time when women are very careful about what medications and food they take.  It is wise to be careful about what you take but there are some over the counter medications that are relatively safe to take during your pregnancy.  Following is a list of medications that are safe to take during your pregnancy.  If you ever have a question about a medication that is not on this list, please call the office and we will let you know if it is safe for you to take.  

ACNE   

Any mild cleanser that does NOT contain salicylic acid or benzoyl peroxide 

COLD/ALLERGY/CONGESTION 

Ornex, Sudafed, Actifed, Claritin/Loratadine, Benadryl, Vick’s Vapor Rub, Plain Mucinex, Flonase, Ocean Spray Nasal Spray, Humist Nasal Spray.  A cool mist Humidifier is also effective. 

CONSTIPATION 

Colace, Docusate Sodium, Perdiem, Metamucil, Senokot, milk of magnesia, Fleets enema.  Before taking any medication try the following:  Powder bran, bran cereals, prunes, prune juice.  Increase roughage (fruits and all leafy vegetables).  Increase physical activity such as walking.  If no change, then try medicines.  It may take up to one week before you have results from the stool softeners. If constipation is not relieved with stool softeners or any of these medications, contact the office. 

COUGH 

Plain Robitussin, cough lozenges 

DIARRHEA 

Clear liquids until diarrhea stops.  This is things like Sprite, ginger ale, propel, Gatorade, Kool-Aid, tea, broth, Jello, popsicles, or any other liquid that you can see through.  Medications you may take are parapectolin or Imodium.  Call our office if you have no improvement in 24 hours. 

FEVER 

Tylenol or acetaminophen, regular or extra strength.  Please take your temperature with a thermometer and call our office with a fever above 100.4 degrees. 

GAS 

Plain GasX, simethicone      

HEADACHE 

Tylenol or acetaminophen, regular or extra strength.  Take as directed on bottle, not to exceed 8 tablets in 24 hours.               

 Do NOT use ibuprofen, Aleve, Advil, Motrin or Goody’s powders. 

HEARTBURN 

Digel, Maalox, Mylanta, Gelusel, Riopan, Tums or Pepcid AC.      

Do NOT use Rolaids or Alka Seltzer.  Other tips for relief of heartburn symptoms are to elevate the head on your bed with pillows.  Do not lie flat.  Do not eat 2 hours before you are going to bed.  Do not eat foods with acid (oranges, grapefruit, tomatoes), peppermint or foods and drinks with caffeine (sodas, tea, coffee, chocolate). 

HEMORRHOIDS 

Warm sits bath (soaking in a tub of warm water).  

Tucks pads can be used instead of toilet paper, and Anusol suppositories.  If the hemorrhoids persist please call the office. 

LAXATIVE 

Senokot, Metamucil, milk of magnesia, Fleets enema.   

MOTION SICKNESS 

Dramamine 

MOUTH SORES/ULCERS 

Oragel 

MUSCLE ACHES 

Bengay, Icy Hot that does not contain Methyl Salicylate.  Use products with Menthol ONLY.  

Do NOT use on your stomach.  

NAUSEA 

Emetrol, B6 products such as B-Natal and Preggie Pops. 

PAIN 

Tylenol or acetaminophen, regular or extra strength.  Take as directed on bottle, not to exceed 8 tablets in 24 hours.               

Do NOT use ibuprofen, Aleve, Advil, Motrin or Goody’s powders. 

RASHES/BUG BITES 

Cortaid, Lanacort or any ½% hydrocortisone cream, Benadryl cream or tablets, Calamine lotion 

SLEEP 

Benadryl, Unisom 

SORE THROAT 

Sucrets, Cepacol spray or lozenges, Chloraseptic spray or lozenges, warm salt water gargle 

STOOL SOFTENERS 

Colace, Docusate Sodium

YEAST INFECTION 

Monistat, Gyne-Lotrimin, miconazole  

The nausea you experience during pregnancy is temporary.  It usually diminishes after the end of the first trimester.  However you may experience some nausea occasionally throughout your pregnancy.  

Here are some general guidelines that may help. 

• Eat several small, frequent meals.  Even a few bites can help.  It is usually better to eat 5 or 6 small meals instead of 3 large ones. 
• Keep a source of dry carbohydrates such as saltine crackers near your bed.  Eat a few before you get out of bed in the morning if you experience nausea in the morning. 
• Carry some crackers with you, so you may eat a few when you experience nausea during the day.
• Take liquids between meals.  Do not wash your food down. 
• Avoid spicy, fries or fatty foods. 
• Take your prenatal vitamins after a meal.  

List of foods that should not make your nausea worse 

Beverages:  skim milk or fat free buttermilk, coffee, tea, unsweetened carbonated beverages 

Cheese and other milk products:  cheddar cheese, cottage cheese, plain yogurt 

Eggs:  Prepared any way except fried  

Meat, Fish or Poultry:  Lean cuts prepared any way except fried or gravy 

Fruits:  Fresh, unsweetened canned, cooked or frozen.  Some easily tolerated are applesauce,                                                           aaaaa apples, grapes, pears, bananas, berries, rhubarb, cantaloupe, watermelon.  Try to include citrus fruit as tolerated. 

Vegetables:  Fresh, frozen or canned.  Try to include both yellow and greens vegetables. 

Potato or Substitute:  May replace bread at meals.  Mashed, baked or boiled potato, rice, noodles or plain pasta. 

Cereal:  Hot or unsweetened cold Bread:  Whole grain or enriched plain bread, crackers Sweets:   White, brown or maple sugar, honey, molasses, jelly and jam, cream mints, gum drops or hard       candies 

Others: Clear broth, fat free bouillon, Jello         

List of foods that may increase your nausea 

Beverages:  Any other than those listed in foods that should not make your nausea worse 

Cheese:  Any other than those listed in foods that should not make your nausea worse 

Eggs: Fried Meat, Fish or Poultry:  Fatty or fried meat, fish or poultry 

Fruit:  Avocado, dried fruit, sugar sweetened canned, cooked or frozen  

Vegetables:  Any other than those listed in foods that should not make your nausea worse 

Potato or substitute:  Fried potato, potato chips, creamed or scalloped potatoes 

Cereal:  Sugar coated cereals 

Bread:  Quick breads, coffee cake, pancakes, waffles and sweet rolls 

Sweets: Any other than those listed in foods that should not make your nausea worse 

Others: Gravies, pastries, rich desserts, whipped cream, highly seasoned foods, fats, fatty foods, nuts, olives, doughnuts, buttered popcorn, rich stews and soups  

If diet does not control persistent vomiting, medicine may be needed.  There are several medications and products that can be purchased over the counter to help control nausea.  

Vitamin B6 has been shown to help with nausea during pregnancy.  Products that contain vitamin B6 are B-Natal and Preggy Pops.  They are available at most drug stores and Babies R Us. 

Emetrol is another over the counter product that is safe to use during pregnancy. 

There are also products such as Sea Bands, which are for nausea and can be purchased at most drug stores.  They are made for sea-sickness but some patients have found they help with nausea.   

If dietary changes and over the counter medication do not help your nausea, call the office so your doctor can order a prescription medication.  If none of this works you need to notify your doctor. 

What is Preterm labor? 

Preterm labor is a delivery before 37 weeks of gestation.  Preterm babies are at risk for problems with breathing, eating or keeping their normal body temperature.  The birth of a premature baby can affect your child health for many years.  

What are some of the symptoms of preterm labor? 

1. Uterine contractions:  Uterine contractions occur normally as pregnancy progresses.  These normal contractions (Braxton-Hicks) happen a few times a day, and/or when you change positions.  Uterine contractions that may cause preterm labor occur in a regular pattern and are more frequent.  They may be painful.  Any time you have more than 6 contractions in an hour, you need to call the office. 
2. Low, dull backache: It may come and go or be constant and is felt below the waist.
3. Menstrual like cramps. 
4. Pressure in the lower abdomen, back or thighs.  The pressure may feel like heaviness in the pelvis or like the baby is pushing down.
5. Intestinal cramping with or without diarrhea.  You may or may not have gas pains. 
6. Increase or change in vaginal discharge. 
7. A general feeling that something is not right or you are feeling bad.  

What should I do if the above symptoms continue? 

1. Bedrest on your left side.  Place a pillow under your lower back for support. 
2. Drink 6-8 large glasses of water or fruit juice.  No caffeine or carbonated drinks. 
3. If symptoms continue call your doctor. 

Vaccines are an important part of a healthy pregnancy. Vaccines help protect both you your baby from diseases like influenza and pertussis.     

Wilfredo A. Negron, MD, FACOG strongly recommends the following vaccines during pregnancy:   

Influenza “flu” vaccine: Pregnant women are at higher risk for serious complications from influenza, including hospitalization and death. The inactivated influenza vaccine (aka “the flu shot”) can be given at any point during the pregnancy, whenever it becomes available.   

Tetanus, Diphtheria and Pertussis Vaccine (Tdap): This vaccine protects you from tetanus, diphtheria and pertussis or “whooping cough.” A woman should get a Tdap shot during every pregnancy, and the best time to receive the shot is during the last trimester, between weeks 27 and 36 weeks gestation.  Getting vaccinated during this time provides your fetus with the most protective antibodies right before birth. This is important because newborns under 3 months old are at the highest risk for serious complications and death from whooping cough.  Since babies do not get their first pertussis vaccine (called DTaP) until two months of age, being vaccinated with Tdap during pregnancy can help protect your infant during this vulnerable time.   

Our staff can advise you on when and where to get these two vaccines. 

We encourage you to learn more! 

For more information, below are links to reputable online resources that  we trust to provide evidence-based information on vaccines during pregnancy: 

American College of Obstetricians and Gynecologists (ACOG): http://immunizationforwomen.org/patients/pregnancy/pregnancy.php 

Emory University:  

http://momvax.org 

U.S. Centers for Disease Control and Prevention (CDC): 

https://www.cdc.gov/vaccines/adults/rec-vac/pregnant.html 

http://www.cdc.gov/pertussis/pregnant/index.html 

1.  When should I get my first pap-smear? 

The first pap-smear should be done at age 21.  It does not matter if you are sexually active or not. 

2.  What are fibroids? 

Fibroids are very common benign solid tumors of the uterus.  They are so common that most studies show a prevalence of 20% - 50% of the population.  They are most common in the African American and Hispanic population. 

3.  What should I do if I have fibroids? 

If the fibroids are asymptomatic (no symptoms like bleeding, pain or pressure) there is no need for treatment.  Your gynecologist will go thru all your treatment options available if the fibroids are symptomatic. 

4.  What is vaginitis?  

Vaginitis is an infection of the vagina in which the most common symptom is vaginal discharge with or without itching.  The most common causes of vulvovaginitis (vaginitis) are bacterial, fungal (yeast), parasitic (trichomonas), and viral (herpes).  The treatment depends on the cause which can be easily diagnosed at your doctor’s office. 

5. What is considered abnormal uterine bleeding? 

The menstrual cycle normal range is between 24-35 days.  The way you date your cycle is the first day of bleeding until the next period.  The bleeding range is 2-6 days.  If you have bleeding more than 6 days and very heavy your gynecologist will discuss the cause and options for treatment. 

6.  When should I get my first mammogram? 

If you are not at high risk for breast cancer, the first mammogram should be at age 40. 

7.  What are the different kinds of birth control available? 

There are different kinds of methods; hormonal and non-hormonal. 

• Birth control pill or oral contraception – the most common of the hormonal 
• Depo-provera – it is a hormone injection 
• Nexplanon – a rod inserted in the arm (hormonal) 
• Vaginal ring – (hormonal) 
• IUD Mirena, IUD Skyla (contain hormones) 
• IUD Paragard (non-hormonal) 
• Diaphragm (non-hormonal) 
• Condoms (non-hormonal) 

8.  I started taking birth control pill, and I am spotting, is that normal? 

When you start oral contraception is not unusual to have some spotting the first 2 months.  If the bleeding continues for more than 2 -3 months you need to talk to your gynecologist.