Frequently Asked Questions – Obstetrics

I just found out I am pregnant. When should I make an appointment?
 

We recommend scheduling a New OB appointment with a provider between 7-10 weeks. If you have a history of prior miscarriage, ectopic pregnancy, are having bleeding or want to come in earlier please call our office. We can schedule you for serial hcg levels to see whether your pregnancy is progressing normally and/or a viability ultrasound at 6 weeks.

Can I exercise while I am pregnant?
 
  • Exercise in pregnancy is generally recommended for healthy women. In fact, pregnant women are encouraged to engage in 30 minutes of exercise a day. Pregnancy is not a time, however, to start a brand-new vigorous exercise program to “get into shape”. Let your body set its own limits. Start out slowly and increase your exercise at your own pace. If you are tired, become short of breath or dizzy, slow down. If it hurts, do not do it. During periods of increased activity, it is also important to increase your water intake.
  • Aerobic dancing, walking, swimming, regular yoga, and stationery cycling are all good forms of exercise during pregnancy. High impact or step aerobics, “hot” yoga, scuba diving, skiing or snowboarding, soccer, and other competitive team sports generally should be avoided.
Can I travel while I am pregnant?
 

Most women with a healthy pregnancy are safe to travel domestically before 36 weeks and internationally prior to 34 weeks. If you are at risk for preterm labor or have other high risk conditions it may be advisable to restrict travel, please talk with your doctor. During travel it is important to stay hydrated and get up and move around on the airplane to help prevent blood clots.

Is it ok to drink caffeine while I am pregnant?
 

Low to moderate caffeine intake (<200mg/day) is considered safe during pregnancy. This is equivalent to 1-2 cups of coffee/day. Higher intake of caffeine (more than 200-300mg/day) may increase the risk of miscarriage, although studies have been conflicting.

What foods should I avoid during pregnancy?
 
  • Avoid unpasteurized soft cheeses such as Brie, feta, goat, blue, or camembert (May contain Listeria).
  • Avoid hot dogs and deli meats unless heated to steaming hot (May contain Listeria).
  • Avoid seafood with high levels of mercury (Shark, Swordfish, King Mackerel, or Tilefish). See EPA recommendations regarding guidelines for eating fish during pregnancy.
  • Avoid raw or undercooked meats (May contain Toxoplasmosis).
What is toxoplasmosis?
 

Toxoplasmosis is a disease that presents serious implications if contracted during pregnancy. It is associated with eye malformations, mental retardation, and other brain malformations. In addition, some children develop hydrocephalus (water on the brain) and are subsequently mentally retarded or have other related complications. Fortunately, toxoplasmosis is uncommon in the Pacific Northwest. However, to minimize the risk of maternal infection, avoid eating raw meat, raw eggs, or undercooked poultry. We recommend that all meats, seafood, poultry and eggs be thoroughly cooked before eating or tasting. Heating food to an internal temperature of 150 degrees or more kills toxoplasma organisms as well as other bacteria and parasites. Be careful not to touch your mouth, nose, or eyes after handling raw meat or poultry. Hands, utensils, and kitchen surfaces coming into contact with these raw foods should be thoroughly washed. These precautions will also help prevent you from getting Salmonella food poisoning that is relatively common in undercooked eggs and poultry. Pregnant women should refrain from handling soiled cat litter. Toxoplasma infection in domestic cats can be prevented by feeding them only dry or canned food and restricting them from hunting birds and rodents; however, remember that other people’s cats may not have undergone these precautions. When outdoors, avoid contact with or wear gloves and a facemask when handling materials that are potentially contaminated with cat feces (for example, garden soil, lawns, and sandboxes) and thoroughly wash your hands when finished.

What can I do to protect myself and my baby from listeria?
 

Pregnant women are at high risk for getting sick from Listeria, harmful bacteria found in many foods. Listeria can lead to a disease called listeriosis. Listeriosis can cause miscarriage, premature delivery, serious sickness, or death of a newborn baby. If you are pregnant, you need to know what foods are safe to eat.

How will I know If I have listeriosis?

Because the illness could take weeks to show up, you may not know you have it. Early signs may include fever, chills, muscle aches, diarrhea, and upset stomach. At first you may have flu-like symptoms such as fever, chills, muscle aches, diarrhea, and upset stomach. Later you could develop a stiff neck, headache, convulsions, or lose your balance.

What should I do If I think I have listeriosis?

Call our office if you have any signs. If you have listeriosis, there are treatments that can be given.

Fight Bacteria – Fight BAC!®

  • Clean: Wash hands often with soap and warm water. Use clean dishes, spoons, knives, and forks. Wash countertops with hot soapy water and clean up spills right away.
  • Separate: Keep raw meat, fish, and poultry away from other food that will not be cooked.
  • Cook: Cook food to a safe minimum internal temperature. Check with a food thermometer. Ground beef 160 °F; Pork 160 °F; Poultry 165 °F.
  • Chill: Refrigerate or freeze within 2 hours–refrigerate or freeze within 1 hour in hot weather (above 90 °F). Don’t leave meat, fish, poultry, or cooked food sitting out.
I have a cold. What medications are considered safe during pregnancy?
 

COLD/ALLERGY MEDICATIONS DURING PREGNANCY

The following are common medications that have been approved by all the physicians for use during pregnancy:

1st Trimester (12 weeks or less):

  • Acetaminophen (such as Tylenol) – as directed on the label
  • Vicks Vapo-Rub
  • Cough drops
  • Honey mixed with lemon/lemon juice for cough
  • Saline nasal spray
  • Chloraseptic throat spray for scratchy throat.

2nd and 3rd Trimesters (over 12 weeks), in addition to the above:

  • Diphenhydramine (such as Benadryl, Claritin, Zyrtec)
  • Pseudoephedrine (such as Sudafed)
  • Cough syrup with Dextromethorphan (such as Robitussin DM)
  • Afrin nasal spray for no longer than 48 hours

If you have used these medications for more than 5 to 7 days or feel that these are not working, please give us a call before you try other medications not listed.

Avoid herbal remedies in pill or supplement form, such as Echinacea. These products have not been studied sufficiently in pregnancy to determine their safety during pregnancy.

If you have a fever, painful cough or worsening sore throat, see your primary care provider for evaluation.

What other medications are considered safe during pregnancy?
 

Over-the-counter gastrointestinal medications can be helpful at times and are considered safe to use intermittently. These include:

  • Antacids (such as Tums or a liquid antacid) for an upset stomach or heartburn; or Zantac if a trial of Tums or antacids has not helped
  • Stool softener docusate sodium (DSS) or fiber products (such as Metamucil, Fibercon or Citracel) to help relieve constipation
  • Simethicone (such as Gas X or Mylecon) for excessive bloating from gas
  • Miralax for constipation
Should I get a flu vaccine while I am pregnant?
 

Yes. The CDC and ACOG recommend the flu vaccine if you will be pregnant during the flu season. It is safe to get during any trimester and is recommended due to the increased risk for severe illness related to influenza.

Should I get the TDAP vaccine while I am pregnant?
 

Yes. The TDAP protects you and your baby against pertussis (whooping cough) which is highly contagious and can be life-threatening for small children. The vaccine is recommended for women during EACH pregnancy between 27-34 weeks.

Can I sleep on my back while I am pregnant?
 

During the first half of your pregnancy it is safe to continue sleeping on your back. After 20 weeks it is best to avoid lying on your back for prolonged periods of time. Sleeping tilted to one side or another can help to maximize blood flow to you and your baby. Try using a pillow between your legs or behind your back to get more comfortable. Don’t be alarmed if you wake up on your back after going to sleep on your side. Spending moderate amounts of time on your back does not have an adverse effect on your baby’s health.

What aesthetic services are safe during pregnancy?
 
  • There is limited data on the use of hair dye during pregnancy, but animal studies have shown no adverse effects. Only a minimal amount of hair dye is absorbed through the scalp and is unlikely to cause harm, but if you would like to be especially careful you can wait until after the first trimester. Highlights should be fine since hair dye is not applied directly to the scalp.
  • Nail care is considered, although a well ventilated salon is preferred.
  • Massage (avoid deep tissue massage on abdomen)
  • Waxing or electrolysis
  • Facials
  • Not recommended during pregnancy: tanning (both beds or spray on tanning) and teeth whitening.
What can I use to treat acne during pregnancy?
 

Over the counter Acne treatment products with salicylic acid should be avoided. It is OK to use products containing lactic acid or benzoyl peroxide. Please talk with your provider about any prescription medications that may be needed.

Is it safe to have dental work done during pregnancy?
 

D It is safe to have your teeth cleaned during pregnancy. Local anesthesia to numb the area is safe if repair work is needed. Avoid nitrous oxide “laughing gas,” x-rays, and teeth whitening.

Is it ok to paint or be around paint fumes while pregnant?
 

Household painting (with latex-based paint) should be safe after your first trimester, although it is helpful to have someone else do the painting. Be cautious of dust and paint fumes, and keep the room well-ventilated during the project. If you are remodeling an older home, we recommend you avoid lead-based paint, paint chips, and paint dust. Low volatile organic compound paints are a good alternative.

I’m pregnant and may have been exposed to Fifth Disease (Parvovirus B19). What should I do?
 

Please call our office. Your provider may order a blood test to see if you are already immune to Parvovirus. If you are not immune and found to be expected, your baby can be monitored by ultrasound for signs of infection.

Who will deliver my baby?
 

One of our seven Northwest Women’s Healthcare obstetricians is on call 24/7. The physician who is on call will take care of you at the hospital and deliver your baby. During your third trimester you can choose to rotate your ob appointments to meet some of the other physicians ahead of time. All of our physicians share a similar philosophy of supporting your individual needs while pursuing the end goal of healthy mom and healthy baby.

Where will I delivery my baby?
 

The physicians at Northwest Women’s Healthcare deliver babies at Swedish Medical Center First Hill, Seattle

Can I do a VBAC?
 

Yes, in most circumstances. Our practice is very supportive of TOLAC (trial of labor after cesarean section). Most women who have a prior cesarean section are candidates for a trial of labor. Approximately 60-80% of women are successful, and the overall risk for uterine rupture is low. You can discuss with your obstetrician the overall risks/benefits, and what factors may improve or decrease your chances of success.

Will I get an episiotomy?
 

We avoid episiotomies whenever possible, although in certain circumstances it may be necessary for a safe delivery.