Guidelines for a Healthy Pregnancy and Delivery
Congratulations on your journey to parenthood. Anticipating the birth of your child can be both thrilling and overwhelming. Whether this is your first pregnancy or you have traveled down this path before, we encourage you to ask questions about labor and delivery throughout your care with us. Childbirth education classes are available at both Saint Mary’s and Renown. We feel that the key to a successful delivery and subsequently a healthy child is an open, enthusiastic and informed mother.
We have outlined the following information to assist you throughout the different stages of pregnancy. Contact us for additional information.
A prenatal vitamin containing 400 micrograms (0.4 milligrams) of folic acid is recommended on a daily basis while attempting and during pregnancy. If you have a history of a previous pregnancy with a neural tube defect, then you should take 4 milligrams of folic acid on a daily basis while attempting and during pregnancy.
Many women need to take prescription medication during their pregnancy for their own health. Many medications are safe during pregnancy and the benefit of some medications may outweigh the risk to your baby. All prescription medications and herbal supplements should be discussed with your physician at the start of your pregnancy or as they are prescribed to you.
Certain over the counter medications are safe in pregnancy:
- For fever or pain: Tylenol regular strength (325 mg) two every four hours
- For cough: Robitussin as directed on the label
- For congestion: Chlortrimetron as directed on the label
- For allergy: Benadryl or Claritin as directed on the label
- For sore throat: Sucrets or other throat lozenges
- For stuffy nose: saline nasal spray
- For constipation: Colace as directed on the label
- For hemorrhoids: Preparation-H ointment, Tucks pads or Anusol
- For diarrhea: Imodium AD as directed on the label
- the use of Aspirin or aspirin containing products
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
- laxatives and douches
Good dietary health is the gateway to a successful pregnancy. Pregnancy is a great time to examine your eating habits in order to provide a healthy framework for the rest of your life. A balanced diet full of raw fruits and vegetables, lean meat or protein with a limited amount of carbohydrates is optimal for pregnancy. In the final 6 months of your pregnancy, you should eat or drink approximately 100 more calories per day than you did prior to pregnancy.
Along with folic acid, 1200 milligrams of calcium, 5 micrograms of vitamin D and 27 milligrams of iron should be a lifelong addition to the healthy diet.
Omega-3 fatty acids, notably docosahexaenoic acid (DHA), are the best addition you can make to your diet when eating for two. DHA is essential for brain growth and eye development. A diet high in DHA may also lower your risk of postpartum depression. DHA is found in many common foods: wild salmon, walnuts, arugula, flax-seed and even chicken. Ask your physician about pregnancy-safe DHA supplements.
Recommended weight gain during pregnancy is 25 to 35 pounds for a female of ideal body weight, 15 to 25 pounds for an overweight female and 11 to 20 pounds for an obese female.
- Alcoholic beverages of any amount or variety
- Tuna, swordfish, tilapia (tile fish), shark and mackerel
- Raw (unpasteurized) honey
- Unpasteurized milk or soft cheeses
- Poorly cooked hot dogs or deli meats of uncertain origin
- More than one caffeinated beverage per day (one cup of coffee)
Pregnancy is a period of rapid emotional and physical change. Exercise plays a vital role in any woman’s journey towards good health. Exercise is especially helpful when trying to take control of the emotional and physical strain that your body undergoes during pregnancy.
A regular exercise program will help decrease your risk of hypertension and diabetes, decrease your length of labor and optimize the rate at which you recover your ideal body weight after delivery.
In the absence of medical or obstetrical complications, 30 minutes or more of moderate exercise on a daily basis is recommended for pregnant women.
A wide range of exercise appears to be safe in pregnancy. Moderate cardiovascular exercise is best such as swimming, walking, running and cycling.
Here are a few guidelines to follow:
- Please use common sense and avoid exercises in which you can fall or be hit
- Please avoid exercise on your back after your first trimester
- Please do not scuba-dive while pregnant
You should stop exercising and notify your physician if you experience any of the following:
- Chest pain
- Vaginal bleeding
- Severe uncontrollable headache
- Decreased fetal movement
- Amniotic fluid leakage
- Persistent muscle weakness
- Deep unrelenting calf pain
- Regular painful uterine contractions
If you have chronic health problems like diabetes, heart disease, lung disease, or are at risk for fetal growth restriction, preterm labor or bleeding please talk to your physician prior to initiation of a new exercise program.
Many couples worry about the safety of sex during pregnancy. Unless your physician tells you to avoid intercourse, you can have sex throughout the entire 9 months. Your baby is protected by your uterus and not at risk for injury. Intercourse can be a healthy part of your life during pregnancy, a great stress reliever and a conduit for bonding with your spouse.
There may be periods during your pregnancy when you want to have intercourse, but are physically uncomfortable with it. You can experiment with different positions that are easiest for you, or find other ways to be intimate with your partner.
Please call your doctor if you experience any of these symptoms during intercourse:
- Vaginal pain
- Leaking of fluid
It is truly important to get plenty of rest during your pregnancy. At least 7 hours of sleep each night is recommended. Having good sleep hygiene is the gateway to a restful evening. Here are a few tips:
- Go to the bathroom before going to bed
- Avoid watching television in your room
- Don’t tie up all the loose ends in your life just prior to bed time
- Don’t have a large meal directly prior to bed time
- Set aside at least 30 minutes of time prior to sleep for quiet meditation
- Position yourself on your left side if possible
- Use pillows to support your back, stomach and legs
- Take a warm shower before bed to ease muscle aches
- Take a regular strength Tylenol prior to bedtime
- If all else fails, Benadryl 25 to 50 milligrams taken 30 minutes prior to bedtime may make you drowsy
Women with poor dental hygiene are at risk for preterm labor and delivery. You should brush your teeth twice daily and floss regularly during pregnancy. Please follow-up with your dentist during pregnancy for routine cleaning and care.
Always alert your dentist of your pregnancy. Dental x-rays are safe during pregnancy as long as your stomach is shielded with a lead apron. It may be necessary to take an antibiotic before or after major dental work. Please have your dentist contact us with any questions or concerns.
If you have a cat or a bird, avoid cleaning the litter box or cage during pregnancy.
Worn correctly, seatbelts will protect both you and your unborn child from injury. Your lap strap should be worn under your belly and across your hips. Your shoulder strap should be worn between your breasts and to the side of your belly.
The Center for Disease Control (CDC), recommends a flu shot for all expectant mothers during flu season.
The American College of OB/GYN recommends the T-Dap vaccine to pregnant patients in any trimester and their partners.
New CDC Data: COVID-19 Vaccination Safe for Pregnant People.
It is safe to be tested for tuberculosis during pregnancy.
Any other vaccinations should be cleared by your physician.
Hot tubs, Baths and Saunas
Anything that raises your core body temperature over 102°F and keeps it there for a while is potentially dangerous during pregnancy. The likelihood of increasing your core body temperature significantly depends on the temperature of the hot tub or sauna, length of exposure, and extent of submersion. Many older studies indicate that hyperthermia of animals during early pregnancy can cause birth defects. Exposure to such extreme temperatures also puts you at risk for dehydration and low blood pressure.
We subsequently recommend caution. Pregnant women should spend no more than 10 minutes in a warm bath. Please avoid saunas, steam rooms, hot tubs, extremely hot baths as well as strenuous exercise in hot weather.
Tobacco, Alcohol and Drugs
Almost every woman must make lifestyle changes during her pregnancy. As an expectant mother it is important to realize that substances that you expose yourself to are also being exposed to your fetus.
Stopping smoking any time during pregnancy is better than not stopping at all. Nicotine and carbon monoxide from smoking reduces the amount of oxygen that your baby receives. Women who smoke regularly during pregnancy are at risk for placental problems, low-birth-weight infants and even stillbirth. Ask your doctor about strategies to aide you in stopping smoking.
Alcohol travels quickly through your bloodstream and subsequently to the fetus. It is unknown how much alcohol it takes to harm the fetus. All alcoholic beverages are a risk for you and your baby. Alcohol use during pregnancy can increase your risk of miscarriage and preterm labor. Alcohol abuse during pregnancy can cause mental retardation and fetal alcohol syndrome. It is important to talk to your doctor about your drinking habits, especially if you have been unable to stop drinking with the onset of your pregnancy. Alcoholics Anonymous
Multiple studies have shown it can lead to developmental delay and growth restriction; Additionally, we do not have any data on CBD oil and recommend against it.
Using illegal drugs or abusing prescription narcotics can cause problems for you and your baby throughout pregnancy. Illegal and prescription narcotic use can lead to miscarriage, birth defects, growth restriction, preterm labor and stillbirth. Babies exposed to these drugs during pregnancy are often addicted to them at birth and are at risk for behavioral problems later in life. It is important to talk to your physician honestly if you use or abuse prescription narcotics or street drugs like cocaine, heroin or methamphetamines. Narcotics Anonymous
Cleaning, Painting and Hair Products
Household cleaners used appropriately in a well-ventilated room are generally safe in pregnancy. Never mix ammonia with chlorine based products; the combination can produce deadly fumes. Use hand protection and common sense when cleaning.
Avoid exposure to lead based paint flakes. Avoid exposure to paint removers and the process of stripping paint (whether chemicals or sanders are used). Latex and oil based paint is safe to work with in pregnancy. Again, please make sure you are working in a well-ventilated space and use good judgment with respect to what you are trying to accomplish
Avoid long term exposure to insecticides or herbicides (as in a factory or heavily sprayed field). If spraying for insects inside, be sure all closets and kitchen cabinets are closed and all food preparation surfaces are covered. Ventilate your house well afterwards and wipe down any food preparation areas near the sprayed areas.
There is no good evidence that dying your hair, straightening your hair or getting a permanent is unsafe during pregnancy. Keep in mind that hair responds to such treatments unpredictably when under the influence of pregnancy hormones.
Signs of Labor
Determining when labor has begun can be an exciting yet frustrating experience. Most women give birth between 38 and 42 weeks of pregnancy. No one knows exactly what causes labor to start. The hallmarks of labor are regular uterine contractions associated with cervical dilation (opening). Certain changes may indicate the onset of labor:
- Increasing vaginal discharge of a clear pink or blood tinged mucus
- Feeling as if the baby has moved lower or “dropped,” as the baby’s head settles down into your pelvis
- Rupture of membranes, a discharge of watery fluid from your vagina in a trickle or gush that is not related to urination
- Contractions: your uterus tightens and relaxes (a rhythmic pattern that may feel like a strong backache or menstrual cramp) at regular intervals with increasing frequency and duration
When to call Your Doctor or go to the Hospital
If your pregnancy is between 36 and 42 weeks and you are experiencing regular persistent contractions at least every 5 minutes that are increasing in strength, duration and frequency, please report to labor and delivery.
If your pregnancy is between 36 and 42 weeks and you suspect you have ruptured your membranes, please report to labor and delivery.
Please Call Your Physician or Report to the Hospital at Any Point During Your Pregnancy if:
- You are experiencing uncontrollable vomiting
- You have a persistent, uncontrollable fever greater than or equal to 100.4 °F
- You are experiencing persistent pain or burning with urination
- You have uncontrollable headaches with associated visual changes
- You are experiencing swelling of the face or neck
- You are bleeding from the vagina – other than bloody mucus (It is common to have light spotting after a cervical check in the office or after intercourse)
- You are less than 36 weeks gestation and have had more than 5 painful contractions in a one hour period
- You suspect your water has broken
- You have constant severe abdominal pain with no relief between contractions
- Your baby is moving less than normal (10 distinct movements in a two hour period after 28 weeks gestation on a daily basis is considered reassuring)
- Your mood is such that you feel as though you may hurt yourself or your child