What should I consider before trying to become pregnant?

A woman’s overall health is probably the most important thing. Her weight is important—a good healthy weight is always a good starting point. Examine your list of medications. Make sure you’re on a prenatal vitamin.

Options are available for genetic screening. There are some tests we can do before pregnancy to see if you carry any inheritable genetic conditions which could be useful for family planning.

Make sure your vaccines are up to date.

There are some travel considerations – some places are not very good to travel to if you're about to get pregnant. So, all those things are things that we consider.

What are early signs of pregnancy?

The most obvious sign that might indicate that you're pregnant is a missed period. Nausea and vomiting are very common, as well as breast tenderness and possibly some cramping.

When should I see an OB-GYN?

Make your appointment as soon as you know you’re pregnant. We do our best to time the first visit to come at a certain point during the first trimester if we can, but the earlier you can call, the better so that we can have some flexibility with scheduling.

What can I expect in my first visit?

The first visit is full of activities. There's a long interview process where we investigate your medical history and then do a physical exam. We talk a lot about what to expect with the pregnancy. You can also expect some lab work and an ultrasound on the first visit.

How often will I see the OB-GYN?

We generally consider an entire pregnancy to last 40 weeks, and so your due date will fall at 40 weeks exactly. If you're dividing that up into trimesters, we consider the first 14 weeks the first trimester and then the third trimester starts around 28 weeks.

We break up the prenatal care based on where you are in those weeks. During your pregnancy we can divide up the visits in various ways based on the risk of the pregnancy itself. If Mom is a low risk pregnancy, we would see her generally every four to six weeks in the first two trimesters, every two weeks generally in the third trimester, and then weekly or in the last month of pregnancy. We might see Mom more frequently if she’s higher risk.

Do I need a prenatal vitamin?

Ideally, you should start a prenatal vitamin a month before conception. I usually don't make a recommendation for one particular brand.

Prenatal vitamins are sufficient as long as they contain enough folic acid and iron. Some people like DHA in their prenatal vitamins, but the main thing is just something that you're able to tolerate and keep down.

What about prenatal nutrition?

A healthy assortment of fruits, vegetables and protein would be the most useful. I wouldn't specify a particular food, but whatever you like and can keep down. In general, I would avoid foods that are empty calories such as flour and sugar—those are generally your enemies when you're trying to maintain a healthy diet in pregnancy.

What about morning sickness?

Morning sickness is very common in pregnancy, and there are medications that can help. Doxylamine (Unisom) over the counter and vitamin B6 are very useful and safe in pregnancy. Sometimes ginger-based foods and drinks can be helpful for pregnancy-associated nausea.

Believe it or not, the earlier you start a prenatal vitamin before you're pregnant can help. We often recommend small, frequent bland foods in the first trimester and lots of hydration.

To ward off early nausea, keep a packet of crackers beside your bed and munch on those first thing in the morning before your feet hit the floor. If those things don't work, call our office. There are some prescription medications that we call in very frequently for women, and a lot of tips and tricks that we can try.

Is there anything I need to avoid during pregnancy?

I would recommend no alcohol in pregnancy. There's not been an established safe amount of alcohol in pregnancy. It’s best to stop smoking during pregnancy as it can cause some complications with your pregnancy.

What should I expect in my first trimester?

No two women are the same and no two pregnancies are the same. Even within the same person it's hard to predict how you will feel with your first trimester.

Some women sail through the first trimester with no problems or symptoms at all, and other women have a lot of trouble with nausea, vomiting, cramping, lightheadedness, dizziness and all kinds of undesirable feelings. I say it's impossible to grow a human without noticing, so all those are usually expected and manageable.

The first trimester is probably the most crucial for the baby, when all the baby’s organ systems are developing.
Your baby will take from you what it needs regardless of how you feel, so it’s important to maintain good health and wellness. Stay hydrated –it’s easy to get dehydrated, especially due to all the nausea and vomiting, but you want to keep that prenatal vitamin down.

Eat healthy food, fruits and vegetables, and keep a balanced diet.

What should I expect in my second trimester?

The second trimester is probably the easiest part of pregnancy. Some women feel better in the second trimester than they do outside of pregnancy.

Mainly you will notice that your baby is growing, and your belly is growing. You will start to look pregnant—you’ll have a baby bump overnight almost sometimes. You'll notice the first movement of the baby in the second trimester.

A lot of women report a lot of lightheadedness or dizziness in the second trimester because their blood pressure has at its lowest point in the pregnancy. We recommend lots of hydration to overcome that and increase your blood volume to compensate for that. Those feelings are temporary and usually get better. The nausea is usually gone in the second trimester.

You will probably have a lot more energy for exercise in the second trimester. Take advantage of feeling well in the second trimester and stay very active.

Should I exercise during pregnancy?

You need to get in about 150 minutes of aerobic exercise a week. Getting your heart rate to your target range for aerobic activity is important, but don't overexert because then you can't sustain it for 150 minutes and get the benefits. Anything you can do in the gym you can do in pregnancy. I would avoid contact sports obviously and use your common sense, but running, biking, elliptical, swimming—all those things are useful, so exercise right up to the very end if you can. You'll find that it takes less effort to reach your target heart rate range when you're very pregnant, so keeping track of your heart rate to know how much exertion is required is key.

What about OB visits?

At each visit you can expect something a little bit different, but most visits we're just checking in with you, making sure you’re feeling well, especially in the early parts of the pregnancy. In the second half of pregnancy we start measuring for fetal growth at each visit. We make sure the baby is doing well with an adequate heartbeat. In the second trimester we'll do the glucose test to screen for gestational diabetes.

In the last month of pregnancy, we'll start checking your cervix to see if you’re dilated any and progressing in that way.

Should I get a flu shot?

We recommend that all pregnant women get the flu shot as soon as they can. It’s very important to avoid people you know that are sick.

Do I need a birth plan?

A birth plan is very personal thing, and we try to be very flexible. I do not expect my patients necessarily to bring a birth plan for me. Our plan is to have a baby, and keep Mom and baby healthy and family happy. How we do that is completely up to you.

If there’s something that is important to you, it’s always good to write that down and make us aware because when you are in the midst of labor, it's very hard to communicate those desires. We want you to have a good experience—whatever is important to you is important to us.

Growing Your Family

There’s much to consider when you're trying to plan a family. It's always good to sit down with your physician when you're considering pregnancy and discuss the implications and your health and whether pregnancy is a good fit. If you have any questions, call us.