Pregnancy FAQ

Thank you for choosing Westar  OB/GYN to care for you during your pregnancy. We are dedicated to providing the best care for you and your unborn baby. Our team of professionals provides a multidisciplinary approach to help you achieve the best possible outcome: a healthy mother and a healthy baby.

 

In order to have time to dedicate to their families and to limit sleep-deprivation while caring for patients, Drs. Alan Murnane, Angela Rouse, Seretha Ransom,  Justin Himler, Alicia Thompson, and Elizabeth Cummins share call.

 

Dr. Cummins has her own practice on Lazelle Road, and shares our commitment to excellence in patient care.  Westar OB/GYN doctors practice exclusively at Mount Carmel St. Ann’s Hospital. If you need to speak to a physician after office hours, simply call the main office number (614) 818-0300 and choose the option to speak to the on-call doctor. (If it is late at night and you are in labor, you can simply go to St. Ann’s and the doctor on-call will be informed by the hospital.)

 

Our Certified Nurse Practitioners, Katie Elliot and Carey Barber, and our Certified Nurse Midwife, Eileen Sirois, are an important part of our health care team. They focus on wellness care and patient education. If you have a noncomplicated pregnancy, you may choose to have most of your prenatal care with Katie, Carey, or Eileen, even though they do not deliver babies.

 

Our office will contact your insurance company to verify maternity benefits. We strongly encourage you to become familiar with your insurance company’s maternity benefit details as well. Our staff will establish a payment plan for the portion of your bill that your insurance is not expected to cover. We have found that ultrasounds, non-stress tests, lab work, and additional problem visits may not be covered. These services are billed separately, and will increase the cost of your care.

 

In this packet is an outline that describes what you can expect during the normal course of your pregnancy. We will discuss any differences your care may require as changes arise.

 

Sincerely,

 

The Staff of Westar OB/GYN

What to expect during routine pregnancy visits

4-8 Weeks Gestation

  • Pregnancy confirmation by urine pregnancy test
  • Pap smear/annual exam if due
  • New OB teaching/packet given
  • Offer genetic testing

7-9 Weeks Gestation

  • Pregnancy confirmation by urine pregnancy test
  • Pap smear/annual exam if due
  • New OB teaching/packet given
  • Ultrasound for viability and dates
  • Prenatal lab work drawn
  • Offer genetic testing

12 Weeks Gestation

  • Routine prenatal appointment with physician
  • Continue monthly appointments

16 Weeks Gestation

  • Routine prenatal appointment
  • AFP testing offered

20 Weeks Gestation

  • Ultrasound for fetal anatomic survey
  • Optional gender check
  • Routine prenatal appointment after ultrasound

24 Weeks Gestation

  • Routine prenatal appointment
  • 1 hour following taking glucose drink, lab work is drawn for gestational diabetes and anemia screening.

28 Weeks Gestation

  • Drink glucose drink upon check-in (if not done at 24 weeks)
  • Routine prenatal appointment
  • RhoGam administration if applicable
  • Begin every other week appointments
  • Schedule repeat C-section, if applicable

30 Weeks Gestation

  • Routine prenatal appointment
  • Birth plan (type of delivery expected)

32 Weeks Gestation

  • Routine prenatal appointment
  • Boostrix (Tdap) vaccine offered/given

34 Weeks Gestation

  • Routine prenatal appointment

36 Weeks Gestation

  • Routine prenatal appointment
  • Group B Beta Strep test
  • Cervical Check
  • Begin weekly appointments

37 Weeks Gestation to Delivery

  • Routine prenatal appointment with physician and cervical check

Low-Risk Over The Counter Medication During Pregnancy

Coughs, Cold, and Congestion

  • Contact 12-hour cold maximum strength, severe cold and flu, continuous action, cough formula (Robitussin, Delsym)
  • Benadryl allergy/cold,
  • Sudafed, Actifed (Only after 12 weeks gestation)
  • Tylenol Cold non-drowsy
  • Any cough drops or throat sprays
  • Chlor-Trimeton, Vicks, Mucinex
  • Claritin or Zyrtec for allergies
  • Saline nasal spray, Afrin, Dristan, RhinoCort, Flonase

Pain Relievers

  • Extra strength Tylenol, Acetaminophen
  • NO Motrin, Advil, or Aleve during pregnancy unless directed by physician

Antacids

  • Maalox, Maalox Plus, Mylanta II, Tums, Rolaids
  • Riopan
  • Pepcid, Zantac, or Prilosec

Stool Softeners

  • Colace, Surfak, Metamucil, Citrucel, Fibercon, Milk of Magnesia, Miralax

Diarrhea

  • Kaopectate or Imodium, Pedialyte, Gatorade. (not Pepto-Bismol)
  • BRAT diet (banana, white rice, apple juice, plain toast)
  • Please call office if diarrhea lasts more than 2 days

Hemorrhoids

  • Preparation H, Anusol, Tucks, Witch Hazel  (keep pads in refrigerator)

Nausea and vomiting

  • Vitamin B6 25mg 3-4 times per day (It comes in 100mg tabs – need to cut in fourths to take 25mg.)
  • Emetrol (if not diabetic)
  • Emetrex (NOT IMITREX, WHICH IS USED FOR MIGRAINES)
  • Sea Bands
  • Vitamin B6 25mg and Unisom at bedtime
  • Ginger root capsules one tablet before meals
  • Sip on homemade lemonade and eat pretzels throughout the day

Rashes

  • Benadryl cream or oral tablet
  • Caladryl lotion/cream
  • 1% Hydrocortisone ointment

Facts About Weight Gain

  • For women who were normal weight before pregnancy with a BMI of 18.5-24.9, the recommended weight gain guideline is 25-35 pounds.
  • Women who are underweight, with a BMI of less than 18.5, should gain between 28-40 pounds unless your healthcare provider says differently.
  • Women who begin pregnancy overweight, with a BMI of 30 or more, should strive for a weight gain of 11-20 pounds unless directed differently by your provider.
  • Eating healthy meals will allow you to gain adequate amount of weight during your pregnancy. Putting on weight that is unnecessary is easy to do when you’re eating junk food and foods that are higher in fat.
  • Eating a well-rounded diet is important. According to the American Congress of Obstetricians and Gynecologists, a pregnant woman of normal weight who gets less than 30 minutes of exercise a week should strive for a caloric intake of 1800/day for the first trimester, 2200/day for the second trimester, and 2400/day for the third trimester.

 

These calories should be attained by eating a diet of grains, dairy, protein, fruits/vegetables, and healthy fats and oils. Limiting processed foods, sugars, and extra fat can help you attain your goals.

Weight Distribution in the Average Woman

  • 7 ½ lbs is about how much the baby will weigh by the end of your pregnancy.
  • 1 ½ lbs is how much the placenta weighs.
  • 4 lbs is attributed to increased fluid volume.
  • 2 lbs is the weight of the uterus.
  • 2 lbs is the weight of the breast tissue.
  • 4 lbs is because of increased blood volume.
  • 7 lbs is attributed to maternal stores of fat, protein, and other nutrients.
  • 2 lbs for amniotic fluid.
  • Total: 30 lbs

 

On a Trimester Basis in a Woman with a Normal Pre-Pregnancy Weight:

  • First trimester: 1-4.5 pounds
  • Second trimester: 1-2 pounds per week
  • Third trimester: 1-2 pounds per week

Exercise During Pregnancy

In this discussion of exercise during pregnancy, you will learn which muscle groups you should concentrate on when you exercise. Tips for exercising during pregnancy are also offered. You will find out what kind of exercise you are allowed to do and when you should stop exercising. You should not exercise to lose weight while you are pregnant.

 

When should I start exercising?

Childbirth is among the most physically stressful challenges a woman ever faces. Regular exercise during pregnancy:

 

  • Strengthens muscles needed for labor and delivery
  • Helps reduce backaches, constipation, bloating, and swelling
  • Improves posture
  • Gives you energy and improves your mood
  • Lessons some of the discomforts of pregnancy
  • Helps you feel less tired and sleep better

 

Exercise in preparation for pregnancy and childbirth should begin when you’re planning to get pregnant. The sooner you begin exercising, the better you will feel. A big mistake many women make is not starting an exercise program until the last 3 months because your enlarged uterus and breasts cause a shift of the physical center of gravity, effecting your balance.

 

Before you begin an exercise program, discuss it with you healthcare provider. Make sure you follow his/her advice on an exercise program that is appropriate for you. If you are experiencing problems with your pregnancy, you should not exercise. Exercise can affect the amount of oxygen available to your baby.

 

Which muscle groups are most important to exercise?

In addition to your heart, the three muscle groups you should concentrate on during pregnancy are the muscles of your back, pelvis, and abdomen. Strengthening your abdominal muscles will make it easier to support the increasing weight of your baby. You will also be able to push with more strength and more effectively during the last phase of delivering your baby.

Strengthening your pelvic muscles will permit your vagina to widen more easily during childbirth. This will help prevent urinary problems (leaking urine when you cough or sneeze) after delivery. Strengthening back muscles and doing exercises to improve posture will minimize the strain of pregnancy on your lower back. It will prevent discomfort caused by poor posture.

 

What Kind of Exercise Can I Do?

Many old ideas about strenuous exercise during pregnancy have been disproved in recent years. The type and intensity of sports and exercise you participate in during pregnancy depends on your health and how active you were before you were pregnant. This is probably not a good time to take up a strenuous sport. If you were active before you become pregnant, however, there is no reason you cannot continue within reason.

 

Walking: If you did not do any exercise before becoming pregnant, walking is a good way to begin an exercise program.

 

Tennis: If you are an active tennis player, you can probably continue to play unless you have special problems or feel unusually tired. Just be aware of your change in balance and how it effects rapin movement.

 

Jogging: If you jog, you probably can continue as long as you feel comfortable. Avoid becoming overheated, and stop if you feel uncomfortable or unusually tired. Remember to drink plenty of water.

 

Swimming: If you are a swimmer, you can continue to swim. Swimming is an excellent form of exercise. The water supports your weight while you tone and strengthen many different muscles. Scuba diving is not advised.

 

Golf and bowling: Both of these sports are good forms of recreation. You will just have to adjust to your enlarged abdomen. Be careful not to lose your balance.

 

Snow skiing, water skiing, and surfing: These sports can be dangerous because you can hit the ground or water with great force. Falling while traveling at such fast speeds could harm your baby. Talk to your healthcare provider before participating in these activities.

 

Climbing, hiking, and skiing above 10,000 feet: Elevation above 10,000 feet can deprive you and your baby of oxygen and cause premature labor. Avoid strenuous exercise at this altitude, especially if you normally live close to sea level.

 

What are the Guidelines for Exercising during Pregnancy?

Warming up and cooling down are very important. Start slowly and build up to more demanding exercises. Toward the end of an exercise session, gradually slow down your activity. Try working back through the exercise in reverse order.

 

Regular exercise (at least 3 times a week) is better for you than spurts of exercise followed by long periods of no activity.

 

Check your pulse during peak activity. Slow down your activity if your heart starts beating faster than the target range recommended by your healthcare provider. Don’t exceed a heart rate of 140 beats per minute. Exercise that is too strenuous may speed up the baby’s heartbeat to a dangerous level. In general, if you are able to carry on a conversation comfortably while exercising, your heart rate is probably within the recommended limits. Check to make sure.

 

Don’t try to do too much. Remember that the extra weight you are carrying will make you work harder as you exercise. Stop immediately if you feel tired, short of breath, or  dizzy.

 

Drink water often before, during, and after exercise to prevent dehydration. Take a break in your workout to drink more water if needed. Don’t participate in sports and exercise in which you might fall or be bumped.

 

Be very careful with your back. Avoid positions and exercises that increase the bend in your back. They put extra stress on the stretched abdominal muscles and compress your spinal joints. Deep knee bends, double leg raises, and straight leg toe touches also may injure the tissue that connect your back joint and legs.

 

Do not get overheated. Avoid outdoor exercise in hot, humid weather. Also avoid hot-tubs, whirlpools, or saunas. Becoming overheated during pregnancy increases the baby’s temperature. If the baby’s temperature increases too much, it can affect the cells developing in the baby’s nervous system and brain.

 

Do not exercise if you have an illness with a temperature of 100 degrees F or higher. Avoid jerky, bouncy, or high motions that require jarring or rapid changes in direction. Examples of such movements are those that can occur with contact sports, jump roping, and trampoline jumping. These motions may cause back, abdominal, pelvic, and leg pain. They could also cause you to lose your balance.

 

Wear a good fitting support bra to protect your enlarged breasts.

 

Make exercise a part of your daily life. Daily tasks can double a exercise sessions if you do the following:

 

  • Tighten your abdominal muscles when you are standing or sitting
  • Squat when you lift anything, whether it is light or heavy
  • Rotate your feet anytime your feet are elevated
  • Check your posture each time you pass a mirror

 

When Should I Stop Exercising?

You should stop exercising and call your healthcare provider if you have any unusual symptoms such as:

 

  • Pain, including pelvic pain, uterine contractions, or chest pain
  • Trouble walking
  • Bleeding or leaking fluid from the vagina
  • Fainting or dizziness
  • An increase in shortness of breath
  • Irregular heartbeat (skipped beats or very rapid beats)

 

Remember that it is very important to discuss you plans for exercise with your healthcare provider. If you are experiencing problems with your pregnancy, exercise is not advised. Talk to your healthcare provider if you have any questions.

 

*The Sports Medicine Patient Advisor

Toxoplasmosis

The best way to protect your unborn child is by protecting yourself against Toxoplasmosis:

  • Wash your hands with hot soapy water after any exposure to soil, sand, raw meat, or unwashed vegetables.
  • Cook your meat completely (no pink should be seen and the juices should be clear). The internal temperature of the meat should reach at least 160°F.
  • Do not sample meat until it is cooked thoroughly.
  • Freeze meat for several days before cooking to greatly reduce the chance of infection.
  • Wash all cutting boards and knives thoroughly with hot soapy water after each use.
  • Wash and/or peel all fruits and vegetables before eating them.
  • Wear gloves when gardening or handling sand from a sandbox. Wash hands afterward.
  • Avoid drinking untreated water, particularly when traveling in less developed countries.

 

Cats:

 

No you don’t have to give up your cat if you are pregnant. Follow these helpful tips to help you reduce your risk of exposing yourself to Toxoplasma:

 

  • Have someone else change the litter box if possible. If you have to change it, wear disposable gloves and wash your hands thoroughly with soap and water afterward.
  • Change the litter box daily because the parasite does not become infectious until 1-5 days after it is shed in the feces.
  • Feed your cat commercial dry or canned food.
  • Never feed your cat raw meat because this can be a source of Toxoplasmosis infection.
  • Keep indoor cats indoors.
  • Avoid stray cats, especially kittens.
  • Cover your outdoor sandbox.
  • Do not get a new cat while you’re pregnant.

 

What exactly is Toxoplasmosis?

 

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. More than 60 million people in the United States probably carry the toxoplasma parasite, but very few have symptoms because the immune system usually keeps the parasite from causing illness. However, expectant mothers should be cautious because an infection can cause problems in pregnancy.

 

How can it affect my unborn child?

 

If you are pregnant and become infected with the parasite for the first time during or just before your pregnancy, you can pass the infection to your unborn child even if you don’t have any symptoms. Most infants who are infected while in the womb have no symptoms at birth but later in life may develop serious symptoms, such as blindness or mental retardation. A small percentage of infected newborns have serious eye or brain damage at birth.

 

How is Toxoplasmosis Spread?

 

Cats play an important role in the spread of Toxoplasmosis. They become infected by eating infected rodents, birds, or other small animals. The parasite is then passed in the cat’s feces. Kittens and young cats can shed millions of parasites in their feces for as long as 3 weeks after infection. Mature cats are less likely to shed Toxoplasma. Cats and kittens prefer litter boxes, garden soils, and sand boxes for elimination, and you may be exposed unintentionally by touching your mouth after changing the litter box or while gardening without gloves. Fruits and vegetables can be contaminated with soil or water and will infect you if you eat them before washing and peeling them. Animals such as pig, deer, and sheep become infected by eating feed that has been contaminated by cat feces. The parasite forms cysts in the muscle of the food animals. People can be infected by eating undercooked meat and even handling raw meat that contains the cysts and not washing their hands thoroughly afterwards.

 

How do I know if I’ve been infected?

Your healthcare provider may suggest a blood test to check for antibodies to Toxoplasma if you are pregnant or have a weakened immune system.

 

When should I be concerned?

Generally if a woman has been infected with Toxoplasma before becoming pregnant, the infant will be protected because the mother is immune. Some experts suggest waiting for 6 months after a recent infection to become pregnant. See your health care provider if you have any question about Toxoplasma and pregnancy.

 

For more information on Toxoplasma, ask your healthcare provider or visit:

www.cdc.gov/ncidod/dpd/parasites/toxoplasmosis

Protect your baby and yourself from Listeriosis

Pregnant women are at high risk for getting sick from Listeria, harmful bacteria found in many foods. Listeria can cause a disease called Listeriosis. Listeriosis can cause a miscarriage, premature delivery, serious sickness, or the death of a newborn baby. If you are pregnant, you need to know what foods are safe to eat.

 

How do I know if I have Listeriosis?

Because the illness could take weeks to show up, you may not know you have it:

 

  • Early signs may include fever, chills, muscle aches, diarrhea, and upset stomach.
  • At first you may feel like you have the flu. Later on, you could have a stiff neck, headache, convulsions, or lose your balance.
  • Every year 2,500 Americans become sick from Listeriosis; 1 out of 5 die from it.

 

**Call your healthcare provider if you have any of the signs; it can be treated**

 

What should I do if I think I have Listeriosis?

  • Clean: Wash hands often with soap and warm water. Use clean dishes, spoons, knives, and forks. Wash countertops with hot soapy water and clean up spills right away.
  • Separate: Keep raw meat, fish, and poultry away from other food that will not be cooked.
  • Cook: Cook food to a safe minimum internal temperature. Check with a food thermometer.
  • Chill: Refrigerate or freeze within 2 hours; in hot weather (above 90°F), refrigerate or freeze within one hour. Don’t leave meat, fish, or poultry, or cooked food sitting out.

 

What can I do to keep my food safe?

 

  • Listeria can grow in the refrigerator. The refrigerator should be at 40°F or lower, and the freezer 0°F or lower. Use the refrigerator thermometer to check your refrigerator’s temp.
  • Clean up all spills in your refrigerator right away, especially juices from hot dogs, raw meat, or chicken/turkey.
  • Clean inside walls and shelves of your refrigerator with hot soapy water, then rinse.
  • Use precooked or ready-to-eat foods as soon as you can. Don’t store it too long.
  • Wash your hands after you touch hot dogs, raw meat, poultry, seafood, or their juices.

 

What can I do to keep my baby and myself safe from Listeriosis?

  • Do not eat hot dogs, luncheon meat, bologna, or other deli meats unless they are reheated until steaming hot.
  • Do not eat refrigerated pate meat spreads from a meat counter or smoked seafood found in the refrigerated section of the store. Foods that don’t need refrigeration, like canned tuna and canned salmon, are okay to eat. Refrigerate after opening.
  • Do not drink raw (unpasteurized) milk, and do not eat foods that contain it.
  • Do not eat salads made in the store, such as ham salad, chicken salad, egg salad, tuna salad, or any seafood salad.
  • Do not eat soft cheese such as feta, queso blanco, queso fresco, brie, camembert cheeses, bleu cheese, and panela unless it has been made with pasteurized milk. Make sure the label says, “Made with pasteurized milk.”

 

*For more information about food safety and recommended meat and poultry temperatures: U.S. Department of Agriculture.

Pregnancy and Fish Information

On January 19, 2017, the U.S. Food and Drug Administration, (FDA) and the U.S. Environmental Protection agency (EPA) issued revised advise regarding fish consumption for pregnant women or women who may become pregnant, as well as breastfeeding mothers, and parents of young children. ACOG encourages pregnant women, women who may become pregnant, and breastfeeding mothers to follow the FDA and EPA’s revised advice to:

 

  • Eat 2-3 servings a week (8-12 ounces in total) of a variety of fish
  • Eat only 1 serving a week (no more than 6 ounces) of some fish, such as albacore (white) tuna and fish with similar mercury concentrations to albacore (white)
  • Avoid certain fish with the highest mercury concentrations
  • Check for advisories for fish caught by family and friends, and where no advisories exist, limit eating those fish to one serving a week, and do not eat other fish that week.
  • Women who follow this advice may experience the benefits of seafood consumption without experiencing an increase in related risk from mercury to themselves or their babies.

ACOG suggest that women discuss with their obstetrician-gynecologists or other obstetric providers the revised FDA and EPA advice and the potential benefits of seafood consumption, while keeping in mind the 3 serving/12 ounce per week limit in order to avoid the harmful effects of mercury.

 

Advice about eating fish, from the Environmental Protection Agency and Food and Drug Administration revised fish advice, availability. Available at:

https://www.federalregister.gov/documents/2017/01/19/2017-01073/advice-abou-eating-fish-from-the-environmental-protection-agency-and-food-and-drug-administration

 

To learn more about what led the FDA to update its recommendations, read Why We Want Pregnant Women and Children to Eat More Fish. To learn more about the FDA’s revised advice, visit Eating Fish: What Pregnant Women and Parents Should Know.

Frequently asked questions and answers

 

Can I still drink caffeine when pregnant?

Yes, less than 200mg of caffeine or 1 cup daily

Can I use flea/tick solution on my cat or dog?

Yes

When can I find out the sex of the baby?

At 20 week U/S

Can I color my hair?

Yes, but wait until after 12 weeks

Can I get a perm?

Yes, but it may not last

Can I get a massage?

Yes, but it must be a maternity massage

Can I get a manicure/pedicure?

Yes

What can I do about leg and feet swelling?

Wear compression hose, drink lots of water, avoid salty foods, and elevate legs when possible.

What about leg cramps (charley horse)?

We are not sure what causes leg cramps, but try to straighten your leg and gently flex your ankle and toes back toward your shins several times

When do I get the glucose test?

At 28 weeks

Can I fly in an airplane?

Yes, but not after 36 weeks

What about long car rides?

Drink  plenty of water and have stretch breaks every 2 hours

Can I get in a hot tub/sauna

No, during first trimester. OK after first trimester, but get out of the water if you feel too warm.

Can I paint my nursery?

Yes

When can I first feel the baby move?

Around 17-20 weeks

Tanning beds?

Tanning beds are safe for the developing fetus but can give you skin cancer. Spray tans and self-tanning lotions are fine.

How many ultrasounds do I get in a normal pregnancy?

One in the beginning to establish a due date, and another at 20 weeks to inspect fetal anatomy

Is heavy white discharge normal?

Yes, from the hormones

Can I produce/leak breast milk?

Yes, this is normal, it can start at 20 weeks gestation

Can I still have sex while pregnant?

Yes, unless your provider tells you not to

Can I get dental work or x-rays?

Yes, we can provide a dental note if needed

Contact Us

Locations

Westerville
444 N. Cleveland Ave. Suite 120
Westerville, OH 43082

Sunbury
65 E. Granville St.
Sunbury, OH 43074

Monday to Friday: 8:00 AM to 4:00 PM
Saturday/Sunday: Closed

Phone: (614) 818-0300
Fax:  (614) 818-0313