Obstetrics FAQ

Q:What if I am taking Antidepressants?

A: Prior to your first OB provider visit, if you are taking an antidepressant you should continue until discussed with a provider.

Q: What if I have bleeding?

A: FIRST TRIMESTER:
You should monitor if:

You should call if:

If bleeding occurs during the second or third trimester call the office.

Q: What kind of activity can I do when I am pregnant?

A: You must use precautions during physical activity.  Avoid jerky, bouncy, high impact motions.  You should do low impact activities only. i.e. walking, swimming, riding in a car, etc.  Kickboxing is not recommended and only low impact aerobics.

Q: What can I take if I have allergies?

A: It is safe to take the following OTC medications for allergy symptoms:
-Zyrtec                       
-Claritin D           
-Benadryl 25mg 2x a day or 50mg @ bedtime
-Benadryl Cream 
-Calamine Lotion
-Any saline nasal spray  
-Eye Drops (Tears Naturale)

Q: Can I see a chiropractor when I am pregnant?

A: Yes, you may see a chiropractor while you are pregnant.  Our practice does not make referrals to the chiropractor, but you may decide to go on your own if you please. Make sure to try and avoid any x-rays.

Q: What can I take if I have a cold?

A: The following OTC medications are okay to use:
-Actifed or Actifed plus
-Robitussin or Robitussin DM (even in the first trimester)
-Sudafed or Sudafed Plus
-Saline Nasal Spray (AYR, Ocean Nasal Spray)
-Throat Lozenges (any kind)
-Tylenol, Tylenol Plus, Tylenol Sinus, Extra Strength Tylenol (Acetaminophen)
-Vicks Vapor Rub
-Warm saltwater gargles (1 tsp salt and 8oz warm water)
-Vitamin C 500-1000mg daily
You may also try the following relief measures:
-cool mist water
-homemade chicken noodle soup

Make sure to increase your fluid intake, rest and use Tylenol as needed.  You should use as little medication as possible, especially for the first trimester.  If your temperature reaches 101 or higher, or you experience chest pain of any kind you need to call the office.  If your symptoms last longer than 7-10 days call.

Q:  How do I know if I have a breast infection/Mastitis?

A: Signs of a breast infection include the following:
-Elevated temperature
-Red, sore area of the breast
-Flu like symptoms (i.e. chills, fatigue, aching joints)
-symptoms occurring on just one breast

*If you have these symptoms, please call our office to schedule an appointment.

* If fever is absent, it is most likely a blocked milk duct.  We recommend warm packs to the breast, an analgesic (Tylenol or Ibuprofen) and massage of the affected area.

Q:  What should I do if I have cracked or bleeding nipples?

A: If you have cracked or bleeding nipples, there are few different ways you can try to relieve your discomfort.
-Use a nipple shield
-Air dry and expose to light (may use low set hair dryer, 1 ½ to 2 feet away to assist drying)
-May use pure lanolin on nipples (don’t need to wash off before nursing)
-Check position of baby and check latch on
-Rub on breast milk and allow to air dry

Q:  What should I do if my baby has thrush or I have thrush on my nipples?

A: If your baby has thrush or you have thrush on your nipples, you can try the following:
-Apply Nystatin Cream externally to breast twice a day (30mg tube)
- You need to treat the baby at the same time
-Change breast pads every feeding (use disposable pads or maxi pads cut in half)
-Wash bra in hot water and air dry
-Wash babies’ pacifier, toys and bottles in hot, soapy water and allow to air dry.
-Watch for concurrent yeast infection

Q: What should I do if I am constipated?

A: You may take the following medications for constipation relief:

-Any over the counter fiber
-Citrucel
-Dialose
-Doxidan
-Dulcolax suppository
-Duphalac Liquid
-Fibercon
-Fleets enema
-Metamucil (powdered drink or flavored wafers)
-Mineral Oil (1/4 cup mineral oil; mix with applesauce; may need to start with every 12 hours and then reduce to daily.  Taper off as stools improve)
-Milk of Magnesia
-Pericolace

A few you could try to help other then medication would be to avoid bananas, increase your bulk containing foods such as apples with the skin, bran cereal, broccoli, cauliflower, celery, dried peaches, prunes and raw carrots.  Also, increase your water intake to 6 glasses per day.

Q: Can I have dental work while I am pregnant?

A: Yes, you may have dental work while pregnant.  Just use the following precautions:

Q:  What should I do if I feel dizzy?

A: Transient dizziness or “Feeling faint” are very common in pregnancy, especially in the first trimester.

-Avoid sitting, standing or lying flat on your back for long periods of time
-Avoid rising quickly
-Avoid large meals, eat frequent small meals
-Avoid hot baths, showers and hot tubs
-If feeling faint, always sit down on the floor or chair or lie down to avoid falling with syncope.
-If fainting or loss of consciousness has occurred call ASAP.
-If you are persistently dizzy, please call.

Q: Can I use an electric blanket?

A: Yes, but it should not be set higher than 98 degrees.

Q: I had an episiotomy, how should I take care of it?

A: You should do the following to take care of the affected area
-Use tub sitz baths (plain warm water) 10 to 15 minutes up to 3 times daily
-Cleanse with

Q: What if I develop pain on one side that progressively worsens, bleeding, shortness of breath, shoulder pain, or light headedness or feeling “faint”?

A: Please call the office ASAP.

Q: What can I use for facial care?

A:  For prescription meds you may use the following:

Avoid Metro Gel, Ret-in A, anything topical containing vitamin A, and Tetracycline.  Anything over the counter that does not contain any of the following substances, are safe to use.

Q: What can I take if I have a fever or pain?

A: You can take Tylenol or Acetaminophen.  Avoid aspirin as it decreases amniotic fluid, and avoid Ibuprofen.

Q:  What should I do if I have diarrhea?

A: If you have diarrhea occurring without a fever or blood in the stool you may use Kaopectate or Imodium AD or Plain.  These are both sold over the counter.

Q: What if I have vomiting?

A: If you are vomiting, it is important to watch for dehydration. The signs and symptoms for dehydration are decrease urine output and dry mucus membranes.  Some things you can try to help would be clear fluids (sips and advance slowly), avoid milk, BRAT diet (bananas, rice, applesauce, toast as tolerated) and rest.

Q: Is it safe to have my hair done while I am pregnant?

A: Yes, there are no restrictions on having your hair done.

Q: Is it safe to use a heating pad while pregnant?

A: You can use a heating pad set on low heat for no longer than 20 minutes at a time.

Q:  What can I take for a headache while I am pregnant?

A: You can take Tylenol (Acetaminophen) or Extra Strength Tylenol. NO ASPIRIN OR IBUPROPHEN.
* Things you can try to relieve a headache without medication are to sit in a dark quiet room, apply a cold pack to your head, and make sure you are staying hydrated.  You should drink at least one glass of water every 2 to 3 hours.  Avoid caffeine such as coffee, tea, soda, or chocolate.  If you experience vision changes, or you have a persistent headache unrelieved by Extra Strength Tylenol, call the office.
* If you have a sinus headache, you may take Actifed, Sudafed, Tylenol Cold, or Tylenol Sinus.  If you have no improvement or if symptoms worsen in 7 days call the office.
* If you experience blurred vision, sudden weight gain, and/or increased blood pressure accompanied with your headache, call the office ASAP.

Q: What is safe to take for heartburn while I am pregnant?

A:  You may take any of the following medications:

Q: What can I use for Hemorrhoids?

A:  You can use the following OTC medications:
              - Preparation H cream or suppository
              - Tucks
              - Dermoplast spray
Try the following to help relieve discomfort:
- Sitz baths
- MOM packs (2x2 gauze soaked in milk of magnesium / refrigerate, apply to rectal area)
- Sit on pillow or donut pillow
 - High fiber cereal - 2 bowls of All Bran per day
 - May need stool softener (Colace)
- Avoid sitting on stool for any length of time - on and off
- Painful, unrelieved with above measures should be seen same day, may need to be incised.

Q: What if I have a Herpes outbreak during my pregnancy?
            Generally Herpes Labialis (Cold Sore) is not treated in pregnancy, only genital HSV.  If you are on prophylaxis prior to pregnancy, you should be advised to discontinue prophylaxis and consult our office if episode of genital HSV occurs. 
           
         If your outbreak is genital call the office.
              - Wash hands thoroughly after urination
              - No creams or lotions until after evaluation
  - Cold compresses, tepid bath, or Domoboro compresses, locally, may be soothing                                 
              - Avoid sexual relations until no lesions                                                                                  - If lesions are present at time of delivery, would not want to deliver vaginally.
              - You will be treated during your last month of pregnancy with oral prophylaxis

Q: What Injections/Skin tests can I receive?

A:       
- Flu immunization may be given throughout entire pregnancy (especially to those in high risk areas) or if will be in second or third trimester during flu season.
- Hepatitis vaccine may be given if patient is high risk of if series has been already started prior to pregnancy.    
            - Tetanus may be given.
            - TB Mantoux (PPD) test may be given.
- Avoid pregnancy for one month after small pox vaccination or close contact with vaccinated person for 3 to 4 weeks.

Q: What Insect repellents can I use?

A:        - Use child formulations (Avoid “Deet” containing products)
            - Use as sparingly as possible
            - Do not inhale

Q: What if I am experiencing leg cramps?

A: If your pain is characterized by tenderness, redness and warmth to touch in specific site it may be associated with decreased calcium.
- You may try a Calcium supplement 1200 to 1500mg daily (Total: including dietary calcium) or
              - Dr. Scholls arch supports and support hose

Q: What should I do if I have Lice? (Head and Pubic)

A: You may use Rid or Nix as directed.
 - Make sure all nits are removed with the comb provided, may need to repeat in one week if still living lice, wash in hot soapy water all combs, brushes, bed linens, pillowcases, clothing and hats.
 - Vacuum couches, chairs, where head may rest
 - Check other family members and treat as needed

           
Q: What can I do for Motion Sickness?

A: You can use the following OTC medications:
              - Pressure Point Bracelet
              - Dramamine after first trimester
              - DO NOT use Transderm scope patches (Scopolamine class C)

Q: What can I do for Nausea?
A:            MEDICATION WHICH MAY BE USED:
              - Coke Syrup
              - Vitamin B6 25mg twice a day - may be taken alone or with Unisom ½ tab (Rx)
              - Emetrol (similar to Coke syrup without caffeine 1 to 2 tablespoons every 15 minutes until vomiting stops). If lose first dose, repeat in 5 minutes. If #5 doses without resolution: call office or on call doctor.
            NURSING MEASURES:
- Eat something before getting out of bed or sitting up - then stay in bed for 15 to 20 minutes
              - Eat small amounts every 1 to 2 hours
              - Cold foods are better
              - Easily digested foods: rice, mashed potatoes, chicken, turkey, soups, jello
              - Avoid spicy, greasy, fried foods
 If you are unable to keep fluids down or have decreased urination (need to be able to void at least every 3 to 4 hours) or dry mouth call the office.

Q: Is it safe to use self tanning lotion?

A:  Yes, there are no restrictions on tanning lotions.

Q: Are there any weight restrictions while I am pregnant?

A:  Prior to 20 weeks there are no restrictions, after 20 weeks limit to 25-30 pounds.  Call our office if you have any questions.

Q: Is it safe to use sunscreen?

A:  It is safe to use commercial sunscreen.

Q: Is it safe to travel while I am pregnant?

A: If you must travel, get up and move at least every hour. The best time to travel if your pregnancy is uncomplicated would be the second trimester. If you must travel during the third trimester, be cautious. Take copy of your prenatal record along.  Be aware you may deliver at an unknown hospital with unknown personnel. Some carriers (i.e.: some airlines, cruise lines) restrict travel after certain weeks of gestation without a doctor’s statement; you should consult the carrier to find if they have any restrictions and what those may be.

Q:   What if I am experiencing painful or frequent urination?

A: If you are experiencing these symptoms, you could have a urinary infection and should call the office for evaluation.

Q: What are symptoms of labor?

A: Here is a list of common labor symptoms:

If you have any of these signs, check for contractions

How to check for contractions:

Q:  What should I do if I have a rash on my body?

A:  If you have a rash you should call the office.

Q: What is round ligament pain?

A: Round ligament pain occurs around 20 weeks gestation and is characterized as sharp, stabbing, or knife-like pain (right and/or left abdomen) or (right and/or left lower                       quadrant) It is usually associated with sudden movement or change of position i.e.: arising from sitting, moving about or exertion (such as lifting).  It does not usually occur at rest. It is in absence of other symptoms / i.e.: bleeding, UTI symptoms, fever, or N&V.           

We advise the following to help with the pain:
              - Avoid sudden position change
              - Support abdomen when coughing / pelvic support
              - Rest
              - Low set heat pad to affected area
              - Tylenol, plain or Extra Strength