Pregnancy Information

We Welcome You To The World Of Pregnancy!

Pregnancy is generally 40 weeks or 10 lunar months. This is calculated from the first day of your last period. You may, however, deliver three weeks early or up to two weeks late. Plan on this range of time when thinking of your "due date."

Rocky Mountain OB-GYN Doctors & Nurse Practitioners

Prenatal Visit Schedule:

0-28 weeks of pregnancy — every 4 weeks
28-36 weeks — every 2-3 weeks
36 weeks until delivery — weekly

It is our suggestion that at some point during your pregnancy, you rotate seeing the doctors, so that you will be comfortable with whichever one is on call when you go into labor.

Important Dates to Remember:

• Initial Visit: Review medical history, perform physical examination and pap smear, obtain blood tests (including blood type, complete blood count, tests for infection.)
• Optional First Trimester Tests (not covered by all insurance plans)
• Cystic fibrosis screening- blood test to determine if you are carrier of cystic fibrosis (a heritable severe chronic disease)
• First trimester testing for Down's syndrome - ultrasound and blood test done at 11 - 13.2 weeks.
• 16 week visit: Optional Quad Screen blood test (screening for neural tube defects and Down's syndrome.)
  Sign up for prenatal classes.
• 20 week visit: Detailed ultrasound (bring a blank DVD-R disc if you wish.)
• 28 week visit: Blood test for Gestational Diabetes and for anemia. If you are Rh negative, you will receive a Rhogam injection.
• 28-32 weeks: Pre-register for hospital.
  Select pediatrician.
  Take prenatal classes.
• 36 weeks: Group B Strep vaginal culture.

Some visits will be shorter than others but please feel free to ask us questions at any time.

Here is some information that may be helpful for you.

Morning sickness. Nausea and vomiting of pregnancy is usually self-limited and mild. Get plenty of rest and avoid smells that bother you. Try eating crackers before you get out of bed in the morning. Eat several small meals instead of three large meals. Avoid spicy and fatty foods. You may also try ginger-containing foods or ginger capsules 200 mg three times a day. Vitamin B6 supplements may also help at 25 mg three times a day. If you cannot keep any foods or fluids down, please call the office.

Travel. You may travel until 34-36 weeks. Check with your airline to determine if you need a note from your doctor before your flight. You may go to the mountains during your pregnancy, but try to limit your activity to below 10,000 feet due to the decreased oxygen at higher elevations. As always, stay hydrated and use plenty of sunscreen.

Diet. Your goal weight gain during your pregnancy is 25-35 pounds. Watch what you are eating and avoid junk foods. Minimize your use of sweeteners, such as NutraSweet and Splenda.

• Caffeine. Minimize your use to 1-2 cups of caffeine products per day (coffee, tea, chocolate, Coke.)
• Fish. You may eat up to 12 ounces (2 average meals) per week of fish low in mercury (e.g. salmon, shrimp.) Canned light tuna has less mercury than albacore. Avoid shark, swordfish, king mackerel, and tilefish.
• Cheese/ Meats. Avoid foods that are high risk for listeria infection including hot dogs, deli meats (okay if reheated to steaming), soft cheeses, pates or meat spreads, unpasteurized milk or milk products, raw or undercooked meats.
• Water. Drink 2-3 quarts of water a day (8-12 glasses, or 64-96 ounces.)

Smoking. Do not smoke in pregnancy. It causes small babies, premature birth and/or bleeding.

Alcohol. Do not drink alcohol in pregnancy. No research is available indicating how much alcohol does not jeopardize the fetus. Many women have inadvertently had alcohol early in pregnancy without subsequent problems for the baby, but the best policy is none while attempting pregnancy and certainly once pregnancy is known.

Exercise. Regular exercise (at least 3 times a week) helps prevent gestational diabetes and decreases your risk of postpartum depression. Recommended activities include swimming, elliptical or stair machines and yoga. Avoid high impact and abdominal exercises. Do not do activities that can cause falling or heavy contact. No scuba diving but snorkeling is okay. Walking, jogging and cycling are fine although they may become increasingly uncomfortable later in pregnancy. Avoid exercises while lying on your back after 12 weeks. Do not exercise to exhaustion. Drink lots of water while exercising.

Constipation. Constipation is common throughout pregnancy. It can be a result of hormonal effects and/or mechanical pressure. Start by increasing the fiber in your diet (fresh fruit, vegetables, whole grain breads, high fiber cereals.) Increase your water intake to 2-3 quarts daily. Begin a stool softener (see enclosed list.) Avoid laxatives. Calcium carbonate (like Tums) can make constipation worse. Blood in your stool may be a sign of straining or hemorrhoids- notify us at your next visit or sooner if symptoms worsen.

Other

Hot tubs. Avoid saunas, steam baths, hot tubs (>100 degrees), and electric blankets as they may be harmful to the fetus' neurological development.

Cats. Avoid changing cat litter.

Hair Dye. There is no evidence suggests any fetal effects.

Lying on Back. Avoid lying flat on your back after the first trimester. The pressure of the uterus can decrease blood return from your legs. If you feel nauseated or light-headed after lying flat on your back, move slightly to your side to shift your uterus.

Painting. Latex painting is generally safe in pregnancy. Use in a well-ventilated room. Avoid using a sprayer. Avoid lead- and oil-based paints.

Aches, Pains, etc.

Headaches. Headaches are fairly common in pregnancy. You may take 2 plain or extra-strength Tylenol every 6 hours. If your headaches are one-sided or associated with blurred vision, please call the office.

Side pain. Many women experience side pain during pregnancy, especially when exercising, stretching or lifting. This is usually ligament pain caused by a growing uterus pulling on the ligaments. For relief, you may use heat, rest, Tylenol or massage.

Heartburn. Indigestion and heartburn are very common in pregnancy. Please see the list of OTC medications.

Vaginal Discharge. It is normal to have thicker vaginal discharge. Do not douche in pregnancy. If you leak clear watery fluid, call the office.

Fetal Movement. Expect fetal movement around 20-24 weeks. After 28 weeks, make a "mental note" of daily fetal movement. You should feel your baby move at least 12 movements a day. Easy times to monitor for movement are at bedtime (lying on your left side) or just after a meal. If you feel less than 12 movements in a day, please call the office.

Preterm Uterine Contractions (less than 37 weeks.) Stay well hydrated. Listen to your body and rest intermittently. If, in spite of rest and fluids, you experience any of the following, please call the office:

• Six or more contractions in one hour.
• Change or increase in pelvic pressure (pressure on your pubic bone, groin and legs is normal in late pregnancy.)
• Change in low backaches.
• Intermittent cramping low in the abdomen often accompanied by loose stool.
• Changes in vaginal discharge, such as watery, brown or pink tinged.

PLEASE FEEL FREE TO CALL the office with any questions.

Rocky Mountain OB-GYN, P.C.
Rose (303) 399-0055
Sky Ridge (303) 708-0055

CAUTION:
* Use all medications sparingly during the first 12 weeks.
* Do not use any aspirin or ibuprofen (Advil or Motrin) products.

Acceptable over-the-counter (OTC) medications during pregnancy:

Follow the directions on the package for all medications unless we instruct you otherwise.

PLEASE CALL RIGHT AWAY (EVEN AT NIGHT OR WEEKENDS) IF YOU HAVE ANY OF THE BELOW:

Early in pregnancy:

• Heavy vaginal bleeding.
• Vomiting that does not subside, especially if unable to keep fluids down.
• Burning or painful urination.
• Severe pelvic or abdominal pain.

Later in pregnancy:

• 5-1-1 Rule: Contractions which occur every 5 minutes, last 1 minute, having continued for 1 hour.
• Heavy vaginal bleeding (like a period.)
• Ruptured membranes/ break the "bag of water," even if you do not have any contractions.
• Decreased fetal movement.
• You do not need to call if you pass your "mucous plug."