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Obgyn Newport

First time moms & pregnant moms

Being a first-time mom is an amazing experience and can seem overwhelming. Many women feel overwhelmed by the task and need to know how to handle it before it’s too late. Here are some tips to help you prepare mentally and physically for your new role. During your pregnancy, your body will undergo a lot of changes. Here’s how to deal with it.

We’ve split this document in different sections, so you might want to jump right to the topic of interest.

Safe medications for use during pregnancy

While some medications are generally safe to take during pregnancy, the effects of others on your unborn child are unknown. 

Certain medications can be especially damaging to a developing baby if taken during the first three months of pregnancy, often before a woman even realizes she’s expecting.

Here’s a short overview over safe medications during pregnancy.

gynecologist giving some medicine

Ginger, Vitamin B-6, Zofran, Reglan, Acupressure wrist bands

Tums, Pepcid (famotidine), Zantac, Ranitidine, Mylanta

Colace, Metamucil, FiberCon, Magnesium

Water, Tylenol (acetaminophen), Excedrin migraine (rare use ok)

Benadryl, Robitussin DM, Cepachol lozenges, Tylenol (acetaminophen), Claritin, Zyrtec, Humidifier, Saline nasal spray

Preparation-H with cortisone, Anusol-HC, Tuck’s pads, witch hazel

Cortisone cream, Benadryl Cream, Aloe vera and coconut oil

Benadryl, Tylenol PM, Unisom (doxylamine), Magnesium

Monistat, Vagistat, Femstat, Fluconazole

*Medications that Dr. Broad prescribes are safe during pregnancy. Advil/motrin/ibuprofen and Aleve/naproxen should be avoided.  If possible, try to avoid all medications during pregnancy especially within the first trimester.

1st Trimester

Morning sickness

Most women feel nauseated during pregnancy, especially during the first trimester. Symptoms usually start to improve around 11-13 weeks and most symptoms resolve by 16 weeks. 

Pregnant women should eat several small meals or snacks of bland food throughout the day. Ginger, Vitamin B-6 and acupressure bands have been shown to improve morning sickness. 

If these interventions are ineffective and you are losing weight or vomiting daily, Dr. Broad may prescribe Diclegis or Bonjesta (Vitamin B6 and Doxylamine combo) or Reglan to help.

doctor demonstrating first trimester
pregnant woman suffering with nausea in morning

How to prevent nausea

Get plenty of fresh air. Open windows and use fans. Walk outdoors. In the morning, get up slowly. Avoid sudden movements when getting out of bed. Try eating dry cereal, bread, crackers first thing to settle your stomach. 

Drink lots of fluids. Carry a water bottle with you and take small sips when you can. Try to drink at least 8 glasses of liquids every day. Add water to juices, make broth or noodle soups.

 Try snack foods like unsalted nuts, string cheese, crackers, dried fruits, trail mix or fruit juices. Eat small amounts every 2 or 3 hours, day or night. Try to eat even if you are not hungry. Decide which foods sound good to you. You may try: Ice cream, Yogurt, Cottage Cheese, Popsicles, Breads, Crackers, Dry Cereal, Berries, Peanut Butter, Lemonade, Melon, Popcorn, Sour candies.

 

Feeling tired

woman rubbing tired eyes

Fatigue during pregnancy is very common. Try to avoid napping for more than one hour during the day, as this may disrupt your normal sleep patterns. 30-45 minutes of daily exercise may be beneficial. 

If you are taking progesterone supplementation, only take it at night as the medication sometimes causes drowsiness.

Leg Swelling/Varicose Veins

pregnant woman massaging her swollen foot

If swelling develops much more in one leg versus the other, contact your physician. Generalized swelling of hands and feet is common and may simply be a sign that you were on your feet all day! Drinking more water should help. Elevate your feet above your heart when you are resting. Support or compression stockings may be necessary. Notify your physician if swelling develops suddenly or you are experiencing changes in your vision, have bad headaches or right upper abdominal pain.

Back pain

closeup of black woman with back pain

 As pregnancy hormones loosen the ligaments of your joints and your body adjusts to the growth of your uterus, you may experience back pain. You can improve these symptoms by stretching and doing back or core body exercises. 

Prenatal yoga is a great way to stretch and strengthen your core. Massage, heating pads on medium setting, chiropractic care and maternity support belts are safe.

Leg Cramps

leg cramps

Leg cramps may worsen during the third trimester. Magnesium supplementation daily or before bedtime may help. 

You should also increase water intake and foods rich in potassium and calcium.

During pregnancy avoid: high sugar foods, raw fish or meat, cold deli meat, the cat litterbox, X-rays, jacuzzi, spa or sauna, heavy lifting or prolonged standing. 

2nd Trimester

young woman in her second trimester of pregnancy

Many women will feel energized and healthy during their second trimester of pregnancy. 

You will become clearly pregnant, but not to the point where it will be impossible for you to move around. 

This is also your baby’s time of tremendous growth and development, so you may find yourself preoccupied with health checkups and delivery preparations.

What is the second trimester of pregnancy?
Because the changes that occur to you and your baby fall into three major categories of early, middle, and late pregnancy, as reflected in the first, second, and third trimesters, trimesters are a useful way to think about pregnancy.

The second trimester, which lasts from weeks 13 to 26, is the midst of your pregnancy.  One of the best things about this trimester for many women is that nausea may start to subside.

Preregister with Hoag Hospital Around 28-30 weeks is a good time to register at the hospital. You can do this online at

https://www.hoag.org/specialties-services/womens-health/conditions/pregnancy/

 Sign up for health education classes if desired. 

Hoag Hospital offers classes on breast feeding, infant CPR, childcare basics and birth preparation.

Start looking for who you would like to choose as a pediatrician for your baby.

Warning Signs to Contact your physician or go directly to the hospital if you have:

  • Menstrual-like cramps that come and go
  • Low, dull backache (that comes and goes)
  • Abdominal cramping (with or without nausea or diarrhea)
  •  Pressure (feels heavy) – Increase or change in vaginal discharge (mucous-like, watery, pink or bloody)
  • Fluid leaking from the vagina
  • 5 or more uterine contractions (tightening) in one hour (may be painless)

Diabetes Screen Test (24-28 weeks)

doctor checking glucose level in diabetic patient

This is a blood test to screen for gestational diabetes (pregnancy induced diabetes). The timing of this test is important. 

We will give you an order for the test to be done. For the screening test you will need to go fasting (at least 8 hours).

 Be prepared to wait- You will take an initial blood draw then drink a sugary drink and have your blood drawn one and two hours later.

Think about Birth Control Options

If you are considering a tubal ligation (permanent birth control after your deliver) you will need to sign a state mandated consent form. Please discuss this with your physician. If desired, Dr. Broad may perform tubal ligation at the time of cesarean delivery.

Another reliable long-term non-permanent and non-surgical option for birth control is the IUD. There is a non hormonal option (Copper IUD that is good for 10 years) and a hormonal option that reduces menstrual bleeding (progesterone only type that is good for 6 years) that can be placed in the office postpartum 6-8 weeks.

Other options for pregnancy prevention and family planning include a vaginal spermicide called Phexxi, condoms, and various hormonal options (progesterone only pills and implant and shot, and combined estrogen and progesterone containing pills, patch and vaginal ring) . 

Kick Counts

  1. Get in a comfortable lying or sitting position. Rest on your side.
  2. Count how long it takes for you baby to move 10 times. All movements count. Your baby should move 10 times in 2 hours.
  3. Jot down the time of the baby’s first movement and the time of the 10th kick.
  4. Since healthy babies have sleep cycles, your baby may kick less than usual or have less than 10 kicks in 2 hours.

If so, wake up the baby by drinking fluid (cold or sweet) or by walking for 5 minutes and then repeat the Kick Count.

  1. After repeating the Kick Count, if your baby still has had less than 10 kicks in 2 hours or there is a decrease in the fetal movement, contact your physician or go to labor and delivery.

If Your Blood Type is Rh negative

Problems caused by the Rh factor can be prevented in most cases with the use of a special medication called Rhogam. 

Treatment is recommended whenever there is bleeding during your pregnancy or at 28 weeks of pregnancy. We give the Rhogam shot in the office at your 28-week visit. And it is given after delivery in the hospital.

chemistry doctor analysing blood sample and typing

3rd Trimester

Pelvic Exams and Vaginal Culture

A vaginal and rectal bacterial culture is done between 35-36 weeks.

If this culture is positive for Group B streptococcus, we will recommend you are treated with IV antibiotics during labor. This is to protect your baby from serious infections caused by this bacteria during delivery.

Pelvic exams are performed around 37-38 weeks of pregnancy to check your cervix and fetal position.

Signs of Labor

Contact our office or go directly to the hospital if you have:

 
  • Strong regular contractions, every 5 minutes, that do not go away for at least one hour
  • Water bag breaks – a gush of fluid or a constant trickle
  • Vaginal bleeding
  • The baby is not moving 10 times in two hours

What do contractions feel like? 

Contractions often feel like cramping or abdominal tightening. Often times they are accompanied by lower back pain. The most important feature of true contractions is that the feeling comes and goes in a rhythmic fashion and are usually painful and “take your breath away.”

 When is the right time to go to the hospital for contractions? 

When contractions are painful to the point of interrupting your activities and/or regular (every 5 minutes for 2 hours) you should go to the hospital.

How do I know if I broke my water? The best sign, or indication, that a woman has broken the amniotic sac (waters), is continued or persistent leakage of a runny, watery substance. This fluid may be clear, bloody, greenish or yellowish but it should be the consistency of water.

pregnant belly on the third trimester

Birth plan

Your birthing experience is YOURS and will hopefully be a positive and personal one. Our shared goal is for a healthy mom and baby. 

I encourage pregnant patients to become educated about their upcoming birth.  When you have taken the time to learn about the process of giving birth, hospital procedures and what to expect the experience can be one that will put you at ease. 

What you chose for pain control if anything is YOURS and myself and your nurse and staff will help to support you. There are things that can arise during the labor process that can be unplanned so my goal is for you to trust that we have a shared goal and I will communicate with you and support you through the process.

 In general, Dr Broad does not perform episiotomies (unless emergency) and there are specific medical indications for a cesarean section if needed.

 Your nurses and physician will explain any changes in your plan of care if they arise.

When during labor is the right time to get an epidural? There is no absolutely right time for a woman to get her epidural in labor. Often times the best policy is to see how the labor progresses and to get your epidural when the pain becomes unbearable. Keep in mind that from the time you ask for your epidural until the time you have relief will often be at least 45 minutes.

Frequently asked questions

No. When a woman gets an epidural a small catheter is placed into the spinal column and medicine is continuously infused into this space. The amount of numbing medicine can be turned up or down so that a woman gets pain relief but is not entirely numb below the waist.

There other options for pain relief during labor. These are pain medications that can be given through your IV and nitrous oxide AKA Laughing gas. These medications work for about an hour and can be given up to 3 times. The downside of these medications is that they go to both the mother and the fetus and make both sleepy. Thus, these medications are typically not given close to delivery.

If a woman chooses not to get an epidural, if she requires stitches Dr. Broad will give a numbing injection to the area. After giving a few minutes for the medicine to work, he will be able to perform the stitches without the patient feeling pain.

Pediatrician We can give you a list of physicians in the area and remember to check with your insurance to make sure they are under your plan

Circumcision If you want your son circumcised, this can be done by your selected pediatrician during your hospitalization.

Breast milk has ingredients that cannot be found in infant formula. You can provide it for as short or as long as you want. Learning to breastfeed may be challenging and there are lactation specialists and nurses that can help you in the hospital and after.

 Even small amounts of breast milk will give you and your baby the following health advantages:

  • Breast milk is more easily digested. This is important for premature babies.
  • Breast milk helps protect babies from necrotizing enterocolitis a serious bowel infection.
  • Breast milk provides protection against infections, such as colds, ear infections and meningitis.
  • Moms of preemies have more infection fighting cells in their breast milk.
  • Breast milk helps PREVENT allergies.
  • Breast-milk-fed babies have higher IQ’s.
  • Breast milk babies have less SIDS (crib death).
  • Breastfeeding for 6 months or more gives extra protection to babies against diabetes, childhood cancers and obesity.
  • Moms who breastfeed have less risk of breast and ovarian cancer.

? If you have a vaginal delivery expect to stay in the hospital 24-48 hours. If you have a cesarean delivery expect to stay 48-72 hours. After delivery, criteria for discharge to home are that you are able to walk, urinate, pass gas, tolerate food and have pain control.

Continued menstrual like bleeding can continue 6-8 weeks after delivery. If you have heavy bleeding with blood clots, severe abdominal pain or fevers call immediately.

? It is normal for it to take several months for your body to get back to your “usual” cycles after childbirth. Sometimes a woman’s cycles change as she ages or after childbirth and this is normal.