I’m, We’re, You’re What?!?

So, those two lines on the pregnancy test appeared.  Whether you feel excited, shocked, or scared, there a few things you need to know after you take a deep breath, or several.

As an OB/Gyn, I find many obstetrical patients, whether they are pregnant for the first time or the fifth, are unclear about what to expect throughout their pregnancy.  It can be confusing. Can you take ibuprofen? (During a specific time.) Is the doctor going to prescribe something that might hurt my baby without my knowing? (Never.) What do I do about that Diet Coke I crave? (You can have one. One.) I hope this article clears some of the confusion.

First, it is important to know what to expect during office visits. Every doctor does things a bit differently, but we all follow a general guideline for visits, depending on the gestational age, or month your are. This article will focus on your first visit.

Ideally, your first pregnancy visit will happen before you are 12 weeks (3 months) pregnant.

The first visit is usually the longest. You will receive an exam much like your annual well-woman exam with pap. Some physicians, like me, will perform an ultrasound or order one to confirm your due date. If you are certain of your last menstrual period (the first day of your last period) or LMP, some physicians will set your due date based on that and use the ultrasound at 20 weeks to confirm it. You will also have labs performed at this visit to make certain you are immune to certain diseases, like rubella.  These labs also check your blood type and check for sexually transmitted diseases like Hepatitis B and syphilis. Now you have a due date and are ready to go. Maybe.

Other considerations include:

  1. Are you taking a prenatal vitamin?  If you are not yet, you should start. The vitamins the doctor prescribes are really no different from the ones available over the counter to you. Make sure you have a vitamin with at least 800 mcg of folic acid. Folic acid is the most important part of any prenatal vitamin. If taken from early pregnancy, it can lower the risk of spina bifida and defects of the spinal canal. DHA or omega-3-fatty acids are important for brain and eye development, but are not essential.
  2. If you are on medications, are they safe in pregnancy? Your physician needs to know everything you take in order to answer this question. Some medications are fine during pregnancy, but can cause the baby to have side effects once born. Just because a medication doesn’t cause a baby to have physical abnormalities does not mean it does not have an effect on the baby.
  3. Do you smoke? Smoking increases the risk of sudden infant death syndrome and asthma, even if you quit when the baby is born. In heavy smokers, the baby’s size can be smaller. Don’t start thinking this is a great habit to take up, though. The reason the baby is smaller is because smoking reduces blood flow and oxygen to your baby. In effect, every time you light up, you might as well place a pillow over your baby’s face because you truly are suffocating it.
  4. Do you use marijuana or other drugs? Although many people think marijuana is safer than cigarette smoking, it is not. Babies born to women who use marijuana, meth, or other drugs, including narcotics, can have significant brain delays. Your baby may have ten fingers and ten toes, but it is at high risk for having a learning disability and behavior problems later on.

Other things to know:

Tylenol is best for pain relief. It is very safe. If you have migraines or other pain issues that Tylenol, or acetaminophen, does not help, talk with your doctor.

Seasonal allergies can be very bothersome when you are pregnant. Everything is swollen, including your nasal passages. Claritin, Zyrtec, and Benadryl work well and are safe. If you need a decongestant, you can take Sudafed. Nasal steroids, like Flonase, are also safe to use in limited quantities. Discuss this with your physician.

Nausea and vomiting are common, especially in the first trimester (1-3 months). The best initial treatment is a combination of Vitamin B6 and doxylamine (Unisom). There is currently a prescription medication available, Diclegis, that is a combination of these, but it doesn’t seem to be covered by many insurances. If you buy these two products over the counter and take 1 tablet of each at night, you will get the same effect. Ginger ale, ginger tea, and other sources of ginger have also been proven to help nausea and vomiting in pregnancy. If you find it difficult to not only eat, but keep fluids down, you need to see your doctor immediately.

Remember, you are not alone in this.  Never be afraid to call, ask questions, or voice things you worry about. Your OB and her staff is rooting for you to have a great pregnancy and the best outcome possible for you and your baby.