General Instructions
Bleeding
Bleeding (spotting) is common during early pregnancy. 50% of patients have bleeding at sometime during their pregnancy. It is more concerning if bleeding is as heavy as a period or if there is cramping or severe pain. Please call the office if you have any bleeding, spotting or severe cramping. Most likely you will be seen that day. Some spotting is common after a pap smear or a vaginal exam and it may last a couple of days.
Colds, Cough, Headaches
Tylenol (regular or Extra Strength) is safe to take at any time during a pregnancy. Follow the direction on the bottle and your dosing will be accurate. For congestion or allergies Benadryl, Claritin or Zyrtec over the counter is safe. Throat lozenges, Robitussin plain or Robitussin DM are good for a cough. If you are running a fever over 101 call the office as you may need an antibiotic. Normal saline nasal spray (Ocean nasal spray or Ayr) may be used but not Afrin, Neosynephrine. A cool mist humidifier may also give some relief. Drink plenty of fluids.
Diseases
Chickenpox: If you have had chickenpox as a child you should be immune. If you did not have chickenpox, try to avoid exposure and call the office as soon as possible if you are exposed.
Fifth Disease: If exposure occurs we recommend checking titers to see if you are immune. Contact our office as soon as possible. If the titers indicate you have had a prior exposure, then you may be in contact with the ill person. If you are not immune we would recommend to avoid contact if possible. Frequent hand washing and good hygiene are helpful. If you work with children you may want to have titers drawn with your initial blood work to see if you are immune.
Roto Virius: Will not cause any problems with pregnancy. It causes stomach flu like symptoms of vomiting and diarrhea.
Hand, Foot and Mouth: Will not cause any problem with pregnancy.
Constipation
Maximize fiber first. Increasing dietary fiber with high fiber cereals (Fiber One or All Bran) is usually helpful but you may use over the counter fiber supplements such as Metamucil, Fibercon, Fiber Sure. Colace is a stool softener and can be added if fiber is not enough. Increasing your water intake may also help. Milk of Magnesia (three to four times a day) can be added to both of the above if needed. Over the counter Miralax is also available for more difficult cases. Lastly Magnesium citrate (bottle) can be used for acute constipation. It acts like an oral enema.
Dentist
We would encourage you to have your cleaning and regular check-ups. If you have cavities or tooth pain consult your dentist. Local anesthetic is safe, but no gas. If you need an antibiotic please have your dentist call our office if there are any questions regarding pregnancy. X-rays should only be done if absolutely necessary and your abdomen and neck areas should be shielded. Cavities should be filled.
Diarrhea
You may use Imodium. Drink lots of fluids. When diarrhea is improving you may try light foods such as bananas, rice, applesauce and toast. If diarrhea is severe please contact the office.
Douching
Never douch in pregnancy.
Exercise
Exercise has been shown to decrease the pushing length of labor and is healthy for mom and baby as long as there are no problems with pre-term labor or preeclampsia (toxemia). Don’t exercise to exhaustion. Stay well hydrated. Keep your core body temperature below 100 degrees.
Headaches
You may use Tylenol extra strength at any time in a pregnancy. If this doesn’t help call your doctor. Do not take Aleve, Ibuprofen, Motrin, Advil or Aspirin.
Heartburn
You may use Gaviscon, Tums, Rolaids, Mylanta. Do not use Pepto-Bismol as it contains aspirin. Avoid eating late in the evening and avoid foods you know give you problems, in particular foods with tomato based sauces. You may need to eat smaller more frequent meals. Limit your fluids after your evening meal. Elevate your head while sleeping by using extra pillows or 4 inch blocks placed under the head end of your bed frame. If needed you can add Pepcid AC or Zantac over the counter which decreases stomach acid production. If these medications fail we can add a prescription medicine like Nexium/Protonix.
Hemorrhoids
Over the counter remedies such as Preparation H, Anusol or Tucks are okay to use. Sitz baths may be used and donut pillows may be helpful. If this does not help please call the office. Avoid constipation (refer to earlier paragraph)
Hot Tubs
Avoid hot tubs as this can especially cause problems early in pregnancy by excessively raising your body temperature. A body temperature hot tub is okay. We recommend you keep your body temperature less than 100 degrees during pregnancy.
Insomnia
You may use Benadryl, Tylenol PM or any of the over the counter sleep aids (except Ibuprofen PM)
Immunizations
- DT (tetanus shot): Safe in pregnancy
- MMR (Measles, Mumps Rubella: Do not take in pregnancy
- HBV (Hepatitis B): Safe in pregnancy
- Flu shot: Safe in pregnancy
- TB skin test: Safe in pregnancy, but can be deferred until after delivery.
Swelling
Swelling of legs and feet is common. Decrease your salt intake and increase fluids. Canned foods such as soups tend to have a great deal of sodium. Everything should be fresh or frozen. Also avoid pork products and lunch meats as these tend to have more sodium. If the swelling is severe or sudden in onset please call the office. You may need to visit the office for a blood pressure check. Swelling associated with increased blood pressure, severe headache, blurred vision and abdominal pain could be preeclampsia or toxemia. Swelling alone however is very common.
Swimming
Swimming is safe even in lakes.
Tanning and Tanning Beds
The effects of tanning beds are detrimental to your skin but not the baby. If you choose to use make sure your body temperature does not rise above 100 degrees. Sunless tanning agents have not been studied therefore we have no safety information on them. We would not recommend using.
Travel
Travel is an individualized decision you will need to talk with your doctor. Generally travel up to about 32 weeks is okay. If flying, make an effort to use the restroom every 1-2 hours on long trips to keep blood flow to the legs and decrease swelling.
Yeast Infections
Over the counter meds may be used. Call your doctor’s office if OTC medications did not help.