Ask an OB-GYN: I'm pregnant, what do I need to know? | The Indian SCENE

Ask an OB-GYN: I’m pregnant, what do I need to know?

If the opinions of family, friends and the Internet are feeling overwhelming, here's a digestible guide to your pregnancy journey.

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Amid the difficulties of the COVID-19 outbreak, there’s an inside joke among labor and delivery units across the country about how we will be seeing a COVID baby boom in the next 9-10 months — the “coronial” generation.

There are many questions I come across while speaking to new mothers about things they can and can not do while they are pregnant. Though there are many reliable sources available to answer these questions, sometimes the opinions of family and friends and the Internet can also be overwhelming. The following is a rundown of topics I like to talk to my patients about to help answer questions and ease their minds as they start their journey through pregnancy. 

Prenatal vitamins: You should start taking a prenatal vitamin when you start trying for pregnancy. A lot of growth and development happens in the early weeks of pregnancy, before you may even know you are pregnant, so it’s better to start one early. You do not need a prescription for these, you can buy them over the counter at your local pharmacy. In addition to other vitamins and minerals, prenatal vitamins contain folic acid. Folic acid deficiency is associated with neural tube defects (defects in the formation of the brain or spinal cord) and taking 400-800 mcg daily is recommended. It is also important to make sure your vitamin contains at least 30 mg of iron, 600 IU of Vitamin D and 100 0mg of calcium, as these are common deficiencies, too. 

Medications: Ideally you should review your list of medications with your OB-GYN doctor prior to getting pregnant. There are some medications you can continue in pregnancy and some that you will need to stop. Your OB-GYN will also provide a list of over the counter medications that are safe to take in pregnancy for common complaints such as colds, cough, allergies and constipation. 

Food and nutrition:

Everything you eat should be pasteurized. Most foods will have this noted on the packaging. This is to avoid food poisoning while pregnant, especially with the Listeria bacteria. 

Meat: Make sure all of your meat is hot and cooked; this includes fish/shellfish and deli meats. Try to avoid more than 2-3 servings of fish per week to avoid excessive heavy metal intake (lead or mercury). If you are a vegetarian, you can use eggs, nuts, lentils and protein shakes to add protein to your diet. 

Fruits & vegetables: Make sure these are washed well and you are following food warnings from health agencies. There is no evidence that you should avoid any particular fruits or vegetables, such as mangoes, papaya, or leafy greens during pregnancy.

Beverages: Make sure to stay hydrated and drink plenty of water while pregnant. Dehydration can lead to cramping. You can have your daily cup of coffee or tea, but stay below 200mg of caffeine a day. 

Nutrition: Don’t feel like you need to overeat or eat for two. Pregnant women only need about 350 extra calories a day, so eat when you are hungry and maintain a well-balanced diet. For someone starting pregnancy at a normal BMI, normal weight gain is 25 to 35 pounds throughout the pregnancy. For someone at an overweight or obese BMI, normal weight gain in pregnancy is 10 to 20 pounds. You can calculate your BMI (body mass index) online or have a discussion with your doctor about your BMI and what your target weight gain should be. 

Smoking, alcohol and drugs: Women should avoid all smoking, vaping, alcohol and other drug use while pregnant. 

Morning sickness: The symptoms of morning sickness can vary between women. In general, women will be nauseous when they are hungry, so it is advised to have small frequent snacks rather than large meals, especially in the first trimester. Try to stick with bland foods that are easy to digest. Having a snack in the middle of the night can help with morning symptoms so that you are not as hungry when you wake up. Ginger, mint and citrus-flavored things can help improve nausea as well. 

Exercise and activity: If you are having an uncomplicated pregnancy, there are no recommendations for bed rest and you can exercise regularly. If you already have an exercise program, you can continue what your body is used to doing. Otherwise, walking, swimming and yoga are all great exercises in pregnancy. There are no restrictions on bending or stairs, however, you should avoid lifting more than 50 lbs. You should also avoid anything “extreme,” such as sky diving, hot tubs and saunas. You may get dehydrated or short of breath more easily while pregnant, so make sure to listen to your body to know your limitations. Sexual activity is also fine in uncomplicated pregnancy; you may have some cramping and spotting after.

Travel: There are no restrictions against travel in pregnancy, however women should be familiar with any restrictions to areas they want to travel to, as well as any advisories due to infectious diseases (COVID-19, Zika) or political unrest. Make sure your vaccinations are up to date and you know how to get medical care in the area you are traveling to in case of an emergency. There are no restrictions against airline travel, just be sure to stay hydrated and walk every hour or so to prevent swelling and blood clots in your legs. Most OB-GYNs and airlines do not recommend airline travel after 32 to 34 weeks of pregnancy since the potential for labor starts to go up after this time. 

Remember that these are general guidelines and your medical history and pregnancy may lead you to have more specific recommendations. Always remember to review any questions with your doctor.

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