MATERNITY CARE FREQUENTLY ASKED QUESTIONS
I’m thinking about getting pregnant — how can I preprare?
Try to change your lifestyle to be as healthy as possible when you start planning pregnancy. Healthy eating habits and light physical activity are great ways to invest in your future baby’s health. You should start taking folic acid or a multi-vitamin supplement with at least 400mg of folic acid in it before you get pregnant. Lifestyle changes such as quitting smoking, illicit drugs and alcohol are recommended. Speak to your doctor if you are taking any prescription medications before getting pregnant to determine if they are safe to continue while pregnant.
I think I got pregnant on a night when I was very drunk. How will this affect the baby?
First, you should stop worrying. It’s not possible to put the clock back and stress won’t help you or your pregnancy. Unless you continue to drink alcohol in your pregnancy it is very unlikely that you have done any harm.
You should now avoid alcohol — and if this is a problem for you — seek help. Since your baby’s development will be assessed using ultrasound scanning, you will soon be able to get further reassurance.
I take prescription medications and just found out I am pregnant, what should I do?
You should consult a physician. Never stop a prescription medication until you have spoken to a doctor first, many medications should be continued in pregnancy. The only prescription medication you can stop when pregnant without consulting a doctor is the birth control pill.
I’m pregnant and have a cold, what can I take for my symptoms?
Common colds frequently occur in pregnancy and can easily be treated, there is no need to worry as a cold will not harm your baby. Ways to treat your cold are: get lots of rest, drink lots of fluids, use salt water gargles for sore throats, and use neti pots, humidifiers and steamers for congestion.
Some over the counter medications can be used safely in pregnancy for the common cold: Tylenol or acetaminophen can be used for fever or aches, dextromethorphan can be used as a cough suppressant, saline nasal spays can be used for nasal congestion, throat lozenges can be used for sore throats and Gravol can be used for nausea and vomiting.
Avoid using ibuprofen (Advil/Motrin), NSAIDs such as Aleve, codeine or aspirin in pregnancy. Remember, the common cold does not present danger to your pregnancy but other viral illnesses or the flu can be problematic. Consult a doctor if you have a rash, a high fever that does not resolve with acetaminophen, dizziness, difficulty breathing, chest pain or pressure, severe vomiting or diarrhea, contractions or labour pains, or decrease movement of your baby.
I have allergies, is there anything I can use to relieve my symptoms?
The best way to deal with allergies in pregnancy is to avoid allergy triggers. You can also safely use saline nasal sprays, neti pots for congestion, and nasal strips at night to help with breathing. If you are not able to control your symptoms adequately with the above measures and need a medication you can use Claritin, Benedryl or Chlor tripolon. These medications are considered to be class B medications in pregnancy- meaning that animal studies have not shown any risk to unborn babies when their mothers are exposed to these medications while pregnant. If you do use these medications please discuss your use with your doctor.
I’m pregnant, should I get a flu vaccine?
Unfortunately pregnant women are more susceptible to the flu than non-pregnant women because the immune system is lowered in pregnancy. Pregnant women are also more likely to suffer from complications of the flu such as pneumonia, severe infections and preterm delivery. For these reasons it is highly recommended that all pregnant women get a flu vaccine.
There have been multiple studies in the scientific literature involving thousands of women that have shown the flu vaccine to be safe and to not cause any harm to pregnant women or their babies. In addition, both the FDA and CDC routine monitoring of adverse events have not shown any concerns with the flu vaccine being administered to pregnant women.
What can I do about nausea during pregnancy?
Nausea is very common in the first trimester of pregnancy and usually diminishes by the time you are 12-13 weeks pregnant. To help with nausea you can: eat small frequent meals; drink lots of fluids (cold, clear carbonated beverages often help); avoid hot, spicy, fatty and odorous foods; avoid heat; try to get lots of rest (being tired will contribute to your nausea); eat slowly; and avoid lying down after eating. Vitamin B6 can be used to help with nausea in pregnancy, also your doctor can prescribe medication if required. You should seek help if you are vomiting repetitively, getting dehydrated, unable to eat or drink for 12 hours, or are losing weight.
I’m getting back pain in my pregnancy, what can I do?
Back pain is very common in pregnancy. It is caused by your weight gain, hormones that relax ligaments in your back and pelvis, and by the changes in your center of gravity. Ways to alleviate your pain can include:
- Try not to gain excessive weight, this can make back pain worse.
- Practice good posture and sit in chairs with good back support.
- Wear comfortable low heeled (not flat) shoes with good support.
- Sleep on your side with a pillow between your legs.
- Squat when you lift using your legs rather than your back.
- Remain active. Regular physical activity can help your back stay strong. Recommended exercises include walking, yoga, swimming or water exercises.
- Consider a maternity support belt, this can be beneficial for some women.
- Consider massage therapy, physical therapy, acupuncture or chiropractic therapy. When making your appointment make sure your practitioner knows you are pregnant and is comfortable working on a pregnant woman.
If your back pain is severe or associate with other symptoms such as weakness in your legs you should consult a doctor.
Remember back pain can be a sign of preterm labour, if your pain is like period cramps or associated with contractions, bleeding, urinary symptoms or fever you should consult a doctor immediately.
What screening tests are offered in pregnancy?
Multiple screening tests will be offered during your prenatal care. You should have routine blood tests including screening for your blood type, antibodies in your blood, infectious diseases, hemoglobin levels, and urinary tract infections. You will be offered prenatal genetic screening, which for most women consists of a blood test, that can screen your baby for chromosonal abnormalities or neural tube defects. Your doctor will explain the test further during one of your early appointments.
A gestational diabetes screen is recommended at 24-28 weeks GA. This will also be discussed with you at one of your appointments. You will be offered an ultrasound of your baby when 18-20 weeks GA. Some women will require more than one ultrasound in their pregnancy, and your doctor will discuss this with you.
Should I do prenatal classes?
Prenatal classes are generally encouraged if this is your first pregnancy. Classes can provide you with valuable information and can alleviate fears or concerns that you may have. They can also help you prepare for events that may occur during your delivery such as requiring an epidural or a caesarean section. Prenatal classes often provide an opportunity to form relationships with other women and families who are pregnant at the same time as you. These relationships can be helpful after the baby is born in providing socializing and support.
How common is it to have a miscarriage and is there anything I can do to stop it from happening to me?
Sadly, miscarriages are quite common. It is thought that one in five pregnancies end in miscarriage. Most of these happen very early and some women may not even realise that they have been pregnant. Happily, the majority of women who do have a miscarriage go on to have successful following pregnancies.
There is very little you can do to prevent a miscarriage but it is important to stop smoking, drinking alcohol and using recreational drugs. You should also rest and eat sensibly. Talk to your doctor if you have already had more than one miscarriage.
Is sex safe in pregnancy?
Safe sexual intercourse during pregnancy is not associated with adverse outcomes except for women with placenta previa or other causes of bleeding. Speak to your doctor if you have any concerns about having sex when pregnant.
Is it safe to drink coffee during my pregnancy?
You can still enjoy your coffee when pregnant but you may have to limit the amount you drink. It is recommended that you do not drink more that 200mg of caffeine per day which is equivalent to two cups of instant coffee or one cup of brewed coffee per day. Decaffeinated coffee is safe in pregnancy.
How can I safely exercise while pregnant?
Exercise during pregnancy is generally considered safe for most healthy women and can even relieve some of the discomforts of pregnancy. However, it is normal to find that you may not be able to be as active as you were prior to pregnancy. Some forms of exercise that are particularly good for pregnant women are walking, swimming, stationary cycling, and yoga. It is recommended that you focus on non-weight-bearing activities and those that don’t require an enormous amount of balance to avoid falls. Wear loose-fitting, lightweight clothing while exercising, get plenty of fluids, and don’t work to the point of exhaustion. Excessive heat exposure should be avoided during exercise including the use of hot tubs or saunas.
When you reach your second and third trimesters, never do workouts that pose a risk of trauma to your abdomen while pregnant. Always be sure to check with your doctor about any exercise program before getting started.
Is it safe to use hair products during pregnancy?
Hair products are unlikely to cause any problems in your pregnancy. Studies have shown that receiving hair treatments 3-4 times during your pregnancy does not increase the risk of adverse effects on your baby.
Is it safe to paint or be around paint fumes during pregnancy?
There is no evidence that it is not safe to paint but the following precautions are advisable.
a) Limit the amount of time you spend working with oil-based paints. It’s hard to say exactly how much exposure is safe, so use your best judgment. If at any time you begin to feel ill from the fumes, stop working and get fresh air until you feel better.
b) Good ventilation is necessary. Keep the windows open to avoid inhaling paint fumes and wear a mask or ventilator to screen out harmful particles and fumes.
c) Wear gloves, long pants, and a long-sleeved shirt to protect your skin from getting covered in paint.
d) To avoid accidentally ingesting any chemicals, don’t eat or drink where you work.
Can I travel during my pregnancy?
Generally, if you have a healthy, uncomplicated pregnancy, there’s no special risk posed by commercial air travel. It is not sensible to fly past 36 weeks in case you go into labour. Some international flights will not let you travel after 32-34 weeks gestational age.
Be sure to stay well hydrated when traveling and keep your seat belt on. Lap belts should be worn snugly, low on the pelvic bone and under the baby. Shoulder belts should be tight against the chest. Whether you are traveling by car, train, bus or plane, get up and move around every so often, and be sure to stretch your legs and back. If you are traveling outside of Canada always make sure you have appropriate medical insurance.
I’m so tired of being pregnant. Can you induce labor for me?
We need a medical reason to induce labor, such as pre-eclampsia (high blood pressure and protein in the urine, a condition that can lead to seizures in the mom), intrauterine growth retardation (baby not growing adequately) and diabetes, to name a few. Induction of labor is a medical intervention that can have complications including increasing your risk of having a C-section. It is not an instant “fix” and it can sometimes take days to get you into labor. If your pregnancy is normal, “mother nature” is better at bringing you into labor than we doctors are. Once you’ve reached your estimated due date, we still want to give mother nature a chance to trigger your labor and so we will not intervene before you are 10 days past your due date. This timing is determined from studies showing an increased risk of stillbirth (baby dying in the uterus) after 14 days post due date.
Do you do routine episiotomies?
No! Episiotomies have a small but important role in delivery care, and are only done if absolutely necessary. For example, if the baby is distressed and near birth we may need to do an episiotomy to deliver the baby quickly. It may also be done in an assisted delivery with a vacuum or forceps.