It is very common for our patients to ask whether they can travel during their pregnancies. It is safest for you to stay within an hour of your delivery hospital during your pregnancy. There is potential risk of complications anytime during your pregnancy. If it is essential that you travel, below are some guidelines we hope will be of benefit.
- While travel during the first trimester, up to 13 weeks gestation, is likely to be safe, once you have had a normal ultrasound. If you choose to travel in the first trimester, be sure you have easy access to a hospital that provides obstetrical and gynecologic services.
- Once you become pregnant, pregnancy hormones increase your risk of developing blood clots in your legs. No matter what stage in the pregnancy, it is important that you not sit for extended periods of times. Our recommendation is that if you will be sitting for an extended period of time, either in an airplane or in the car, you should get up to walk every hour in an effort to decrease the risk of blood clot development. Call immediately if you develop leg pain, swelling, shortness of breath or chest pain.
- If you choose to travel between 20-36 weeks gestation, there are special considerations. This is strongly discouraged for any patients with a history of preterm labor, preterm delivery, previous surgery on their cervix, or any other risk factors for preterm birth, such as infection, uterine anomaly, etc. If you find that travel is essential, we suggest that you make an appointment shortly before your departure so that we may check your cervix. Be sure that you travel to places within an hour of a neonatal unit (a special hospital that cares for premature babies.)
- After 36 weeks, the baby shouldn’t have problems with maturity, but we recommend that prior to traveling, you locate hospitals that have in-house anesthesia coverage with epidurals available and in-house pediatric care.
Colds are miserable things, even at the best of times, but there are increased concerns during pregnancy. Many things can relieve symptoms at home, sometimes eliminating the need for an office visit.
- Use a cool mist vaporizer/humidifier at night. This moistens the air you breathe to keep secretions flowing.
- Saline gargles (one teaspoon of salt in ½ cup warm water) every four hours while awake will cut the mucus in the back of the throat and relieves mild soreness.
- Any brand of saline nose drops (NOT regular Afrin or Neo-Synephrine) at bedtime and on arising in the morning will help moisten secretions.
- Tylenol (plain) two tablets every four hours if necessary for aches (maximum of six tablets in 24 hours.)
- Take your temperature, orally, twice daily – call us if your temperature is greater that 100.4 Fahrenheit.
- Coughing can be relieved with Robitussin DM, an over-the-counter cough medication, after the first trimester.
- Increase fluids (especially water) to two quarts a day.
- Get extra rest, if possible.
- Actifed or Sudafed may also be use for symptom of congestion when taken as directed on the package. It is preferable that you not take this in your first trimester of pregnancy.
Often pregnant women have concerns about the safety of hair dyes and permanents during pregnancy. There is no scientific data on this question, but it seems unlikely that these types of exposures are harmful. Make sure to consult your physician prior to using any products.
The following suggestions may be useful in relieving nausea and vomiting:
- Remember, “any calorie is a good calorie” so eat what stays down for you.
- These foods may not be well tolerated:
- Greasy or fried foods, as they take longer to leave the stomach
- Very sweet foods
- Spicy hot foods
- Foods with strong odors
- Eat smaller, more frequent meals, that is six small meals and snacks.
- Drink fluids between meals, not with meals.
- Eat foods that are at room temperature or cooler. Hot foods may trigger nausea.
- Drink beverages chilled or cold. Decaffeinated soda is often well tolerated. Don’t opt for diet soda, you need the calories right now.
- Eat slowly and rest after meals. It is best to rest sitting in an upright position for about one hour after eating.
- Dry toast, soda crackers, or dry pre-sweetened cereals may relieve periods of nausea.
- Keep track of when you feel nausea and what causes it.
- If continued vomiting occurs, do not eat or drink anything until the vomiting has stopped. As you feel better, try some small amounts of clear liquids (broth, Jell, apple, grape, or cranberry juice, and/or popsicles.)
- Tart or salty foods such as lemons or pickles may help decrease nausea.
- Avoid mixing hot and cold foods at a meal, as it may stimulate nausea.
- Ask your doctor about medicine to control nausea.
- Avoid eating in a room that is stuffy, too warm, or has cooking smells/odors that may disagree with you.
- Wear loose fitting clothing.
- To avoid the sight/smell of foods, eat meals out or have others bring prepared food to you.
- These are signs that you need to call your doctor:
- Unable to keep anything down for more than two days
- Vomiting blood
- Rib pain
- Jaundice (skin is greenish or yellow)
- Your weight drops more than five pounds within a week
Exercise can help strengthen muscles used in labor and delivery and lessen some of the discomforts of pregnancy. It may give you more energy and make you feel better. The type of exercise you can do during pregnancy depends on your health and how active you were before you became pregnant. If you were active before, you can continue to be within reason. If, for example, you play tennis, you can still play unless you have special problems or feel very tired. A good “rule of thumb” is to limit exertion to about 2/3 of what you could do before pregnancy.
Most of the time, a healthy woman with no complications in her pregnancy can keep working until the end of her pregnancy. Some may need to make some changes. If you are experiencing problems that you feel may be related to your job, please discuss this at one of your office appointments. Your family should be able to help you at home as fatigue increases at the end of your pregnancy.
A certain amount of swelling (called edema) is normal during pregnancy. It occurs most often in the legs. Elevating the legs usually makes the swelling less by the next morning. Swelling can begin during the last few months of pregnancy, and it may occur more often in the summer. Let your doctor or nurse know if you have swelling in your hands or face, because this may be a sign of another problem. A clue that your hands are swollen is that your rings are too tight. Never take medications (water pills) for swelling unless they have been prescribed for you.
- Elevate you legs when possible
- Rest in bed on your side
- Lie down with your legs raised on a small footstool or several pillows
- Do not wear stockings or socks that have a tight band of elastic around the legs.
- If you must sit a lot on the job, stand up and move around from time to time.
- Try not to stand still for long periods of time.
Most adults are immune to chicken pox, either from having the disease or by forming immunity from a mild exposure. If you have had chicken pox in the past, you and your baby are protected. If you are not sure, ask your doctor to check your immunity with a blood test. If this shows positive immunity, you are both protected. If it shows no immunity, an injection of a medicine called Varicella Immune Globulin (VZIG) may be given to prevent chicken pox. In order to be effective, this injection must be given within 72 hours of exposure.
Headaches are common during pregnancy. Usually headaches do not signal a serious problem. How often they occur and how bad they are may vary. It is important to discuss with your health care team which medications you can use for the headache. You should contact your doctor if your headache does not go away, returns very often, is very severe, causes blurry vision or spots in front of your eyes, or is accompanied by nausea. You may use Tylenol (acetaminophen) two regular tablets or one extra-strength tablet for headaches.
At least half of all pregnant women seem to have problems with constipation. One reason for this may be changes in hormones that slow the movement of food through the digestive tract. Sometimes iron supplements may also cause constipation. During the last part of pregnancy, pressure on your rectum from your uterus may add to the problem. Here are some suggestions that may help:
- Drink plenty of liquids – at least 6-8 glasses of water each day, including 1-2 glasses of fruit juice such as prune juice. Liquids (such as coffee, tea and cola) which make you go to the bathroom should not be drunk. They will tend to create a negative water balance in your body and thus make your stools harder and more difficult to pass.
- Eat food high in fiber, such as raw fruits and vegetables and bran cereals.
- Exercise daily – walking is a good form of exercise.
In the last three months of pregnancy, you may find that you have more leg cramps. Get plenty of calcium (three glasses of milk or supplement) and potassium (oranges or bananas.) Stretching you legs before going to bed can help relieve cramps. Avoid pointing your toes when stretching or exercising.
Latex paints manufactured before 1991 used small amounts of mercury as a preservative. There was some concern that this mercury could present a health hazard, so mercury is no longer used in latex paints. The fumes from latex paints are not felt to be a specific risk to a developing baby, but it is always wise to paint in a well-ventilated area. The fumes from oil-based paints, turpentine, paint thinner, etc., are best avoided by pregnant women. Also, remember when painting to avoid use of a ladder to reduce the risk of injuries due to a fall.
Some people worry about having intercourse during pregnancy. They may be afraid it will cause a miscarriage. For a healthy woman with a normal pregnancy, intercourse is safe until the last weeks of pregnancy. Your doctor may advise you to limit or avoid sex if there are signs of problems in your pregnancy.
Indigestion is commonly called heartburn. It is a burning feeling that starts in the stomach and seems to rise into the throat. It occurs when digested food from your stomach, which contains acid, is pushed up into your esophagus (the tube leading from the throat to the stomach.) Liquids that you drink also take up space in your stomach, so they may also add to the problem.
Changes that take place in your body during pregnancy may worsen indigestion. Changes in your hormone levels slow digestion and relax the muscle that normally prevents the digested food and acids in your stomach from entering the esophagus. In addition, your growing uterus presses up on your stomach.
To help relieve heartburn, try the following:
- Eat five or six small meals a day instead of two or three large ones. (A glass of fluid may be equal in volume to a small meal, so avoid drinking large amounts of fluids with meals.)
- Avoid foods that cause gas, such as spicy or greasy foods.
- Do not eat or drink several hours before bedtime.
- Wait two hours after eating before exercising.
- Antacids may be helpful, such as Maalox or Tums. Liquid will be more effective than tablets. If the problem is frequent and only briefly relieved by antacids, speak with your doctor or midwife.
Very often pregnant women who are constipated also have hemorrhoids. Hemorrhoids are varicose (or swollen) veins of the rectum. They are often painful. Straining during bowel movements and having very hard stools may make hemorrhoids worse and can sometimes cause them to protrude from the rectum.
Do not take drugstore cures while you are pregnant without first checking with your doctor or nurse. Hemorrhoids usually improve after the baby is born. Several things can help give relief or avoid the problem in the first place:
- Avoid getting constipated.
- Eat a high-fiber diet.
- Drink plenty of liquids.
It is not uncommon to develop a yeast infection during pregnancy. If such an infection does occur, it is safe for you to use over-the-counter products, such as Monistat. These are readily available at stores. If you have an infection or discharge which is not relieved with the use of over-the-counter medications, make sure to make an appointment with your physician.
No, your prenatal vitamins should be the only supplement used during pregnancy unless your provider specifically directs you to use an additional product.