What is Prenatal Care?

Prenatal care describes the care you receive during your pregnancy. As part of your prenatal care, your doctor will:

  • Determine when your baby is expected to be born.
  • Discuss nutrition, physical activity, work, and common pregnancy complaints, such as morning sickness, heartburn, and backache.
  • Monitor your health to watch for issues or problems.
  • Monitor your baby’s growth.
  • Talk to you about pregnancy, labor, and delivery, and make a plan for your labor and delivery, so you’re prepared.
  • Talk with you about what to expect after your delivery.
  • Do testing during your pregnancy.

What Happens at My First Prenatal Visit?

We will ask about your health and prior medical history to identify issues that may need to be monitored during your pregnancy. A physical exam to assess your health will be done. We will also do tests that can include:

  • A urine test.
  • Blood tests – Some blood tests check your health. Other blood tests check for specific conditions that may cause problems for you or your baby.
  • Lab tests on a sample of cells from the cervix – The doctor will use a swab to take some cells from the cervix.
  • An ultrasound – An ultrasound uses sound waves to create pictures of the inside of your body and of your baby. This test is done to check your due date and see if you are pregnant with more than one baby. This may be done at a timing that is appropriate for your pregnancy as a prematurely early ultrasound may not detect pregnancy and cause undue strife.

What Will Happen at Each Prenatal Visit?

In the United States, at all prenatal visits (including the first visit), the doctor will:

  • Ask about your symptoms and answer any questions you have.
  • Check your blood pressure – Having high blood pressure can lead to problems, including a serious condition called “preeclampsia.”
  • Check your weight – The amount of weight you should gain during pregnancy depends partly on what your weight was before you got pregnant.
  • Measure the size of your uterus – Your uterus will get bigger as your pregnancy progresses.
  • Listen to your baby’s heartbeat – The doctor will be able to hear your baby’s heartbeat starting at about 12 weeks of pregnancy.
  • Test your urine to check for sugar or protein – Having sugar or protein in your urine might be a sign of a more serious problem.
  • Ask about your baby’s movements – Women start feeling their baby move at different times. Most women feel their baby move by 20 to 25 weeks of pregnancy.
  • Check your baby’s position in your uterus – In the last 3 months of pregnancy, the doctor will check your baby’s position at each visit. He or she will check whether your baby’s head or buttocks are down and closest to your vagina.

What Other Tests Are Part of Prenatal Care?

Your doctor or midwife will order other tests during your pregnancy. These include routine tests that all pregnant women will have. They also include tests that some women choose to have.

Tests done during pregnancy can include:

  • A test to check for diabetes (high blood sugar) – This involves drinking a sugar drink and then having your blood drawn.
  • Blood tests to check for certain conditions or infections – These include tests to check your blood type and see if you have a condition called anemia. They also include tests to check for infections that you could pass to your baby or that could harm your baby. Some of these infections are rubella, hepatitis B, and syphilis.
  • An ultrasound – This test checks your placenta, the fluid around your baby, how your baby is growing, and how your baby’s organs are developing.
  • Tests to check for birth defects or problems babies can be born with – For example, women can choose to test their baby for Down syndrome. Down syndrome is a life-long condition that causes medical and learning problems. Another common test is to check for spina bifida, a birth defect that involves the spine (backbone). If a disease runs in your family, your doctor or midwife can tell you whether your baby might be at risk.
  • Tests on your vaginal discharge (the fluid that leaks from your vagina) to check for an infection.

How Often Will I See My Doctor During Pregnancy?

Your visits to your doctor or midwife will get more frequent as your pregnancy progresses. One common schedule of visits is the following:

  • Every 4 weeks until you are about 32 weeks pregnant
  • Then every 2 to 3 weeks until you are about 36 weeks pregnant
  • Then every week until delivery

Women with certain medical conditions (including conditions they had before they got pregnant) might need to see their doctor or midwife more often. They might also need other tests to follow their medical condition during pregnancy.

What Should I Change in My Pregnancy?

Please make every effort to stop smoking during pregnancy. Babies born to mothers who smoke tend to be smaller and have more problems after delivery. Smoking can also cause mothers to have lung problems, more colds, high blood pressure, and problems with the placenta. Alcohol should not be consumed during pregnancy. Drinking any type of alcohol raises the risk of certain birth defects.

What Can I Take For a Cold?

Most over the counter medications are safe in pregnancy. These include Tylenol, Sudafed, Robitussin, Claritin, Unisom, Benadryl, and Mucinex. Avoid medications that contain aspirin, ibuprofen,phenylephrine or alcohol. See “Safe Medications in Pregnancy” for a detailed list of common illnesses and suggested treatments. Please consult us if you have any questions

What Can I Take For a Constipation?

Unfortunately, constipation is a very common problem during pregnancy. Pregnancy hormones may slow your bowels and lead to constipation. It is best to start by eating a well-balanced diet that includes fruit and fiber and drink plenty of water (2 quarts per day or until your urine is a light yellow). If this does not help, you may try an over the counter stool softener such as Colace (Docusate) twice a day. If this fails to bring relief, you may also try Miralax, an over the counter laxative. This should not be used on a regular basis. If constipation persists, call you doctor.

I am pregnant and my belly is big, do I need to wear a seatbelt?

You should absolutely continue to wear your seatbelt when you are pregnant. This protects both you and your baby. It is important to wear both the lap and shoulder belt. Buckle the lap belt low on your hips, below your belly. Place the shoulder belt off to the side of your belly and between your breasts. Never place the shoulder belt below your arm. Your seat belt should fit snugly to avoid injury to you and your baby.

Are airbags safe in pregnancy?

Yes. They are designed to be used with your seatbelt and serve as another layer of protection if you are in an accident. If you are driving, the steering wheel should be at least 10 inches from your chest. As your belly grows, this may not be possible. In this case, try to angle the steering wheel towards your chest to help avoid injury to your abdomen in the event of an accident.

How much weight should I gain during pregnancy?

Women who are normal weight before pregnancy (BMI <25) should gain between 25 to 35 pounds. If you are starting the pregnancy slightly overweight (BMI >30), your goal weight gain is between 10 and 20 pounds. If you are more overweight (BMI >40) your goal is to gain around 5 pounds during the pregnancy.

Is it safe to exercise while I’m pregnant?

Yes, most exercises can be safe. We encourage to maintain an active lifestyle. However, we do not recommend setting new exercise records during pregnancy Exercise has many benefits during your pregnancy. Staying in shape increases your energy level, improves your mood, helps prevent back pain, and will make you ready for labor. Safe exercise types include walking, swimming, aerobics, and cycling. You should avoid gymnastics, skiing, and horseback riding and contact sports like soccer and basketball.

How vigorously can I exercise?

You should avoid activities that require quick changes of direction. Be careful that you do not overheat when exercising. Drink plenty of fluids and wear cool, loose fitting clothes. After the first trimester, avoid doing any exercises flat on your back. Stop exercising if you experience vaginal bleeding, contractions, chest pain, dizziness, or shortness of breath.

How can I prevent back pain in pregnancy?

Back pain is a common problem in pregnancy and is caused by changes in posture, hormones, and stretching of the abdominal muscles. To avoid problems, wear low-heeled (not flat) shoes with good arch support. Always lift by bending your knees and ask for help when moving large or heavy objects. Sleep on your side with 1 or 2 pillows between your knees. If you have to stand for long periods of time, place one foot on a stool or a box. Consider using compressive stockings to prevent leg edema. When sitting, use good posture and place a small pillow to support your lower back. A regular exercise routine that includes walking or swimming is very important for preventing back injury.

What can I use to treat back pain?

Start by applying heat or ice to your lower back and have your partner massage the area. Stretches and exercises for the back can be very beneficial and will help increase muscle tone to prevent further injury. Swimming and walking are both excellent activities for both treating and preventing back pain. If none of these steps help, ask us about other options.

What can I do to prevent stretch marks?

Most women develop stretch marks at some point during the pregnancy. These occur when the skin stretches quickly as the fetus grows. Many lotions and oils are advertised that claim to prevent stretch marks, but none have been proven to consistently be effective. Using a heavy, moisturizing lotion will help keep your skin soft, but may not prevent stretch marks. Many stretch marks fade with time. Using a sunless tanning lotion can help hide some of these marks.

Can I travel when I’m pregnant?

Yes. The best time to travel is typically between 14 and 28 weeks as most problems tend to happen in early or late pregnancy. During a car trip, make sure that you stop to stretch your legs and walk every 2 hours to help avoid blood clots. Airplane travel is safe, although some airlines restrict travel after 36 weeks. If you travel during the last month of pregnancy, you may deliver elsewhere. Check with us before departing on any long trips.

How do I know when I’m in labor?

When you are in labor, the uterus will contract causing your cervix to dilate. These contractions will cause your abdomen to become hard. Between contractions, your uterus will relax and your abdomen will become soft. Labor contractions are typically stronger than a painful menstrual cramp and will last for 30 to 70 seconds. They will become stronger as time goes on and get closer together. When they are coming at regular intervals (approximately every 3 to 5 minutes) and have lasted for 3 to 4 hours, contact us.

What is false labor?

Your uterus may contract off and on before your labor actually begins. These irregular contractions are called Braxton-Hicks contractions or false labor. They can be painful but typically do not come at regular intervals and are not as strong as true labor contractions. Braxton-Hicks contractions are a normal part of pregnancy.

I went to the bathroom and noticed some blood spotting. Is that normal?

Yes. This is a very common finding during pregnancy and is usually not anything to worry about. This happens as the uterus grows causing the cervix to leak small amounts of blood. This usually will stop with time. Call us if the bleeding increases or becomes heavy like a period.

What are signs that labor may be beginning?

Continuous Leakage of Water – This may indicate that your water has broken. This is typically a large amount of fluid that will soak through your clothes and continues to leak even after the initial gush. If this happens, call us. A small leakage of fluid that does not continue may just be urine leaking and is unlikely to indicate that labor is approaching.

Heavy Vaginal Bleeding – If you begin to have bleeding like a heavy period, call us. This may be a sign that labor is beginning. It is very common to have some spotting, especially after using the restroom. This is not usually associated with labor and will stop with time.

What is normal baby movement?

The sensation of your baby’s movement will change during your pregnancy. You can expect to begin feeling movement between 16 to 18 weeks. Early on, this will be sporadic and you may not feel the baby move every day. As the baby grows, you will feel more and more movement. Later in pregnancy, the movements you feel may be smaller. This is normal. During the third trimester (after 28 weeks), count fetal movements every 24 hours. Pick a time of the day when the baby is most active. Mark down on a piece of paper each time you feel a movement (any movement counts). Stop when you feel 10 movements. If you do not feel 10 movements in two hours, call us.