Comprehensive Guidance through Every Trimester
Surprise! You are pregnant! The hormones of early pregnancy may have you thinking you are on a physical and emotional rollercoaster. Elated? Shocked? Ambivalent? All at the same time? Most women have some of these feeling in their first trimester as they get adjusted to the idea of being pregnant. Perhaps you are experiencing cramping or feeling exhausted, nauseated, or bloated. While these signs and symptoms of a healthy pregnancy are a bit uncomfortable, they are usually gone by the time you reach 12 weeks gestation. Try to keep your sense of humor and your sense of wonder as your body becomes the home for a totally unique creation – your baby. Some things to do – take a prenatal vitamin every day. Drink 6-8 glasses of fluids a day and avoid caffeine. Eat a balanced diet if you can. For women with morning/all day sickness, the first trimester diet may consist mostly of carbohydrates as they tend to stay down better and provide comfort and quick energy.
Some Helpful Hints
- Nausea and Vomiting – eating smaller, more frequent meals (about every 3 hours) may help. You can also try ginger 250 mgs capsules three times daily as well as Vitamin B6 75 mgs three times daily. If your symptoms are persisting, contact your physician.
- Frequent Urination – Completely normal as your growing uterus puts pressure on your bladder. If you experience bleeding, pain, or urgency with urination, please contact your physician.
- Bloating and Cramping – your colon slows down a bit while you are pregnant to absorb more nutrients. Be sure to drink a 6-8 glasses of fluids every day and increase your fiber intake including things like whole grains, fresh fruits and vegetables to keep your colon functioning normally. The changes in your uterus are also a source of cramping in early pregnancy – almost like menstrual cramping. This is normal and should lessen as time goes by.
- Fatigue – Your body is very busy creating an entire human body – including a brain, a heart, lungs, and bones! It takes an incredible amount of energy to accomplish this work of art, so rest as much as you can in the first trimester. You will get your energy back around 16-18 weeks when your baby is almost fully formed.
By the second trimester of pregnancy you are starting to feel better – your appetite is back and you have more energy, you are more mentally and emotionally adjusted to the idea of having a baby, and you are ready for the fun part of the journey. You might like to begin a pregnancy journal to keep a record of your experiences as well as your thoughts, hopes, and dreams for this precious little one who has been entrusted to your care. Getting back to some regular exercise will help your sense of well-being as well as increasing your circulation and strengthening your core muscles. Keep your heart rate sustained to where you can keep a conversation during your workout. You can enjoy a brisk walk, a refreshing swim, or even plug in your favorite pregnancy exercise video. Plan to exercise for about 30 minutes 4-5 days a week. A good rule of thumb is that if you are out of breath, you need to slow down. Be sure to drink plenty or water before and after you exercise. Now is a good time to focus on eating a balanced diet. We really are what we eat, so making healthy choices during pregnancy is actually an investment in your body’s future. The baby growing inside of you takes vitamins, minerals and protein away from you so your diet is vital to staying healthy during pregnancy. Nutritionally speaking, fresh, organic foods are best.
Daily diet should include the following:
– 4-6 servings fruits and vegetables (V8-Fusion drink has a serving of fruit and vegetable in each 8oz glass)
– 3 servings protein (lean meats, fish, nuts, beans, eggs, protein bars/drinks)
– 6-8 servings cereals/grains (whole wheat bread, brown rice, wheat or vegetable pasta)
– 3 servings calcium-rich pasteurized foods (milk, yogurt, cheese)
– 6-8 glasses of fluids (avoid caffeine, enjoy water, milk, fruit juice, decaf tea or coffee, decaf soda)
Choose wisely to help you and your baby grow strong and healthy. Try your best to avoid fatty foods and empty calories. But now and then, treat yourself to your favorite dessert or fast food meal! Savor every bite.
One of the most thrilling moments in your second trimester occurs when you begin to feel your baby moving inside you. This usually happens between 18-20 weeks. At first, you may notice just a faint fluttering. Enjoy the feeling of wonder during these early days because before too long this child will be kicking and wiggling with such force that you cannot miss it!! Ligaments stretching as your uterus grows can feel like sharp twinges of pain low in the pelvis on the right and/or left side of the uterus. If these become severe or are accompanied by painful urination or bleeding, contact your nurse or physician.
Choose wisely to help you and your baby grow strong and healthy. Try your best to avoid fatty foods and empty calories. But now and then, treat yourself to your favorite dessert or fast food meal! Savor every bite. One of the most thrilling moments in your second trimester occurs when you begin to feel your baby moving inside you. This usually happens between 18-20 weeks. At first you may notice just a faint fluttering. Enjoy the feeling of wonder during these early days because before too long this child will be kicking and wiggling with such force that you cannot miss it! Ligaments stretching as your uterus grows can feel like sharp twinges of pain low in the pelvis on the right and/or left side of the uterus. If these become severe or are accompanied by painful urination or bleeding, contact your nurse or physician.
Here you are on the last leg of your journey through pregnancy. Baby is taking up most of the room in your abdomen now, reminding you with every wiggle and hiccup that it is time to get the nursery in order and sign up for those childbirth and breastfeeding classes you want to take. Your body begins to slow down and you may notice the following:
- Leg Cramps – increasing your calcium intake will help. 1200 mg calcium daily is recommended.
- Milk Leaking from the Breast – normal as your body gets ready to breastfeed.
- Swelling Feet – increase your fluid intake, avoid salt, and elevate your legs when possible.
- Heartburn – eat smaller meals. Avoid eating 3 hours before bedtime. Elevate the head of your bed 4 inches. Try antacids. Avoid acidic foods like tomato-based foods or citrus products.
- Increased Clear Vaginal Discharge – normal
- Hemorrhoids – caused by relaxed blood vessels coupled with constipation from inadequate fluid and fiber intake. Increase your fluids and fiber and try an over the counter medication. If this is a persistent problem, call your physician.
- Contractions – Braxton Hicks contractions feel like the baby is balling up low in the pelvis and are just practice contractions. If you notice real contractions (where the whole abdomen is getting hard and tight for 30-45 seconds) or Braxton Hicks contractions more than 4 in an hour, or if you notice a gush of fluid from the vagina or constant fluid leakage, bleeding, or decreased fetal movement, please call your physician immediately.
- Trouble Sleeping or Staying Asleep – going to the bathroom, inability to get in a comfortable position, anxious thoughts as you prepare for delivery, and changing hormones can all contribute to lack of sleep and make you feel tired and grumpy. Talk it over with your physician.
Commonly Asked Questions in Pregnancy
For women with monthly menstrual cycles, the age of the pregnancy is counted from the first day of your last cycle; there are 40 weeks in the average egg cycle from preparation in the ovary to the end of pregnancy. Assuming that you ovulated 2 weeks after your last cycle started, conception occurred at week 2 of the egg cycle; your baby should be born about 38 weeks later. If you have an irregular cycle, your due date will be based on measurement from your first ultrasound.
1000 mcg Folic acid and 75 mg Vitamin B-6 should be started the month prior to pregnancy to help reduce the risk of spina bifida; more folic acid may be recommended if you have a family history of spina bifida. Prenatal vitamins are multivitamins with folic acid added and are important to take on a daily basis during pregnancy to ensure nutritional balance. Calcium may be drawn from your bones or teeth as Baby’s skeletal system begins to form around 12 weeks. To protect your health, we recommend 1200 mgs. calcium daily. This equals 4-5 servings of milk, cheese or yogurt. If you do not enjoy dairy products or you are lactose intolerant, a calcium supplement can be taken; 600 mg twice a day is recommended to optimize absorption. DHA supplements are important to add to your daily nutritional plan if your diet does not include fish 3 times a week. DHA supplements contain Omega-3 and essential fatty acids that help support good brain and eye development.
Certain fish live in contaminated environments and consequently have higher levels of mercury in their tissues. The FDA recommends avoiding consumption of fish with higher levels of mercury, especially during pregnancy. For a list of what you can safely consume, see what has been provided below. Deli meats and unpasteurized dairy products can contain listeria, a bacterium that has been associated with miscarriage and fetal infection. Please be certain that your dairy products have been pasteurized and heat all processed meats until they are steaming hot to guard against infection. It is best to limit your intake of processed foods (fast food, frozen entrées, and canned goods) as they contain added salt and preservative chemicals that are not in the best interest of anyone’s health.
Please see the medication list attached for safe choices during pregnancy. If you need something that is not on the list, contact your nurse for further assistance.
During pregnancy, it is vital to stay hydrated. Dehydration can lead to early labor and even to miscarriage in extreme cases. Plan to consume 6-8 glasses of fluids daily including: water, milk, decaf tea or soda, fruit juices or soymilk. It is preferable to limit caffeine intake while pregnancy. Common products containing caffeine are coffee, tea, some sodas, and chocolate.
Highlights added to your hair with foils are considered safe in pregnancy as they do not sit on your scalp and so are not absorbed into the bloodstream. There are no studies that prove the safety of color products use during pregnancy, and therefore our best advice is to choose processing that does not sit on the scalp.
Normal temperature baths (98-100 degrees) are safe during pregnancy. Avoid exposure to higher temperature hot tubs or saunas, especially in the first trimester to the reduce risk of spina bifida. If you have frequent yeast infections or bacterial infections, you may want to switch to showers.
As long as you have an uncomplicated pregnancy, feel free to take trips by car/plane up to 30 weeks gestation; we do not recommend leaving the country unless it is absolutely necessary. Be sure to have a contingency plan in place at your destination and take time to stop and stretch along the way. You have an extra half-gallon of blood in your body when you are pregnant and relaxed blood vessels to accommodate it; consequently, you at greater risk for blood clot formation when you sit for long periods of time. Plan to stand up and walk around for five minutes or so every 2 hours to avoid clot formation and to encourage a rich oxygen supply to the placenta.
Please do! Routine dental care is especially important during pregnancy. If your dentist needs a note from us, we will be glad to provide one; just ask at your next office visit.
St. Elizabeth Hospital is where our doctors deliver. The Center for New Life is located on the third floor of the hospital; that is where you want to go when you are in labor. All the rooms on that floor are private rooms. Unless you deliver by C-section, you can plan to labor and stay in the same room; having Baby room in with you is optional. We encourage you to preregister for your delivery by the end of your fifth month by going to www.christushospital.org. If you need to make financial arrangements with the hospital, start early! There are discounts for cash deliveries if paid up front. Prenatal educational classes are offered at no charge to those who deliver at St. Elizabeth; the topics range from prepared childbirth to breastfeeding to infant/child CPR classes. Check out the events calendar at their website for more info!
Cats that go outside can be exposed to toxoplasmosis via wild food sources. You can be exposed to this parasite if you change the litter box of an infected cat. Cats that never go outside are at a very low risk of contracting toxoplasmosis. Loving your cat is perfectly safe while you are pregnant, but to be on the safe side, have someone else change the litter box!
Water-based paints are safe to use when you are pregnant. Make sure your room is well ventilated, and take frequent breaks to rest and stretch your muscles. As your baby grows, your center of gravity shifts making you a bit less stable on your feet; we recommend letting someone else paint those hard to reach places!
By your third trimester, the weight of the pregnancy could possibly decrease the blood flow in the large blood vessels that are close to your spine. While no evidence exists that lying on your back is harmful to your baby, lying with your abdomen tilted to the left or right would certainly optimize blood flow. Obviously, you are not in control of positions once you fall asleep! Before your third trimester, fall asleep in any position you like! If you have a pre-existing heart condition, please contact your nurse for further clarification.
Elevated hormone levels in early pregnancy can cause your breast to enlarge rather quickly and become very sensitive – even to the point of painful! While this condition is uncomfortable, it won’t last forever. As the pregnancy progresses, the tenderness usually fades and breast size returns to normal about 6 weeks after delivery or 6-8 weeks after you wean baby from breast-feeding.
Some Closing Thoughts on Pregnancy
For most women, pregnancy is a healthy state of being. Remember to take your prenatal vitamin daily, get plenty of fresh air and sunshine (wear sunscreen), drink 6-8 glasses of fluids daily, eat a balanced diet, get regular exercise, and rest when you feel the need. From time to time you may have some symptoms that are troublesome. You should contact your physician immediately if you have the following:
- Temp over 100.2 F
- Vomiting and/or diarrhea that lasts more than 12 hours
- Headache unresponsive to Tylenol /acetaminophen
- Visual disturbances
- Swelling that has not resolved after a night’s sleep
- Vaginal discharge with foul odor or itching
- Painful, urgent urination, or scant urination
- Fluid leakage from the vagina
- Increasing pelvic pain
- Decreased fetal movement
- Contracting more than 4 times in an hour before 37 weeks
- The feeling that something is not right
Maintaining a healthy sexual relationship is safe in pregnancy. Some women find with higher hormone levels that they enjoy intercourse more in pregnancy. At times, you may have less interest as you battle nausea, fatigue, and breast tenderness. Positions can be challenging as your abdomen grows. Keeping an open line of communication with your mate is crucial. There are many of ways to express affection, so have fun and be creative. If sex is uncomfortable, discuss it with your physician. We are honored to be sharing this life-changing journey with you and it is our goal to provide you with the very best health care during your pregnancy. Please feel free to call if you have any problems or questions.