Written by: Erica Stockwell DO MBA FACOG
After another hot summer here in Vegas, school is finally back in session, and with it, a reprieve for many parents. Let’s take this time to review the ABC’s of pregnancy. And yes, there will be a pop quiz at the end… just kidding! Here is an A-to-Z guide that offers handy tips throughout your pregnancy.
A is for anemia.
Anemia is an abnormal decrease in the amount of red blood cells in circulation. Red blood cells are responsible for carrying oxygen in the body and to baby. Anemia is common in pregnancy, and often due to iron deficiency. To avoid this, eat foods high in iron, such as leafy greens, seeds, and red meat to prevent anemia in pregnancy.
B is for bleeding.
Spotting in early pregnancy may be normal and attributed to implantation. However, heavy bleeding or bleeding in later trimesters is never considered normal and should be discussed with your physician.
C is for constipation.
Constipation is a common symptom of pregnancy and due to a slowed GI transit system as progesterone levels increase. Combat this with increasing your fluid intake and eating high fiber foods.
D is for diet.
There are certain foods to avoid when pregnant, such as raw meats and sushi, unpasteurized cheeses, alcohol, and excessive caffeine. Up to 200 mg of caffeine per day, which is the equivalent to a normal home-brewed mug of coffee, is considered safe. Fish contain mercury and the bigger the fish, the more mercury content. However, small to moderate amount of fish consumption is still considered safe in pregnancy.
E is for exercise.
Exercise is encouraged and recommended in pregnancy, however, very strenuous exercise that increases heart rate >140 bpm or puts a lot of strain on the body should be avoided.
F is for fatigue.
Energy levels wax and wane throughout pregnancy. Typically, fatigue onsets at the start of pregnancy, improves in the second trimester – often dubbed “the golden trimester” — and then returns the end of the third trimester.
G is for gender.
It’s becoming more and more rare to keep gender a surprise throughout pregnancy as technology allows for more accurate and earlier gender reveal in pregnancy. Typically, you’ll find out girl or boy at the time of your anatomy scan between 18-20 weeks gestation, assuming baby is cooperative. There is a blood test called cell free fetal DNA which can accurately determine XX (girl) vs XY (boy) as early as 10 weeks. However, the purpose of this test is not to find out gender, but to determine if there are any chromosomal abnormalities, such as Down Syndrome.
H is for heartburn.
Heartburn is a common symptom of pregnancy. Avoid heartburn by eating smaller meals more frequently. Also avoid spicy food and citrus. It’s important to drink plenty of water and to eat at least 1-2 hours hours prior to going to bed at night. An antacid like Tums is safe to take during pregnancy in limited amounts. But too many Tums may increase your risk of developing kidney stones. Most over the counter medications for reflux are considered safe in pregnancy, but be sure to discuss with your provider prior to taking.
I is for intercourse.
Unless you have any placental abnormalities or cervical shortening, intercourse is considered safe throughout pregnancy. If you experience any bleeding or discomfort, make sure to avoid intercourse until you discuss your symptoms with an OB/GYN. Near term, intercourse can help to prepare the cervix for labor due to the prostaglandins found in semen.
J is for joint pain.
As your belly expands, your body adjusts to changes in your center of gravity. These changes include a greater curvature in your lower back and relaxing of the pelvic bones. Relaxin, a hormone produced in pregnancy, is responsible for many of the aches and joint pains of pregnancy. It is also responsible for the increased width of feet that commonly occurs in pregnancy. Wearing a maternity support belt may help by bringing your center of gravity back towards your midline and alleviating some of the pressure on your back and hips.
K is for Kegels.
Urinary incontinence is a common occurrence of pregnancy due to the increase in intraabdominal pressure with a growing uterus and baby. The pelvic floor can become weak over time with the constant pressure. Strengthen your pelvic floor by practicing daily Kegel exercises. Strengthening these muscles may also help you to control your muscles during labor and delivery and prevent hemorrhoids. Continue your Kegels after pregnancy to rebuild and strengthen the pelvic floor muscles to prevent urinary incontinence in the long term. Information on how to perform Kegels can be found at americanpregnancy.org.
L is for love at first sight.
Meeting your child at birth is one of the few times in your life that you can truly say you felt love at first sight, but if this does not occur for you, do not be alarmed. For many, it takes time to form that bond with their baby. You are not a bad mother if you do not instantly feel a connection with your baby at birth. Give it some time. If over time you still do not feel a bond, this may be a sign of postpartum depression and should be discussed with your OB provider.
M is for Midwife.
A midwife is a trained health professional who helps healthy women during labor, delivery, and after the birth of their babies. Midwives may deliver babies at birthing centers, hospitals or at home and they often work in conjunction with OB/GYNs.
N is for nausea.
Nausea, or “morning sickness,” is a common symptom of pregnancy that is usually worst in the first trimester. Combat morning sickness by eating small frequent bland meals throughout the day, drinking plenty of water, getting enough sleep, adding Vitamin B6 to your vitamin regimen, adding ginger and/or lemon to your water, using peppermint oil aromatherapy, and evoking acupressure at your wrists.
O is for OB/GYN.
You’ll become a frequent visitor to your OB/GYN throughout your pregnancy. The typical schedule includes monthly visits throughout the first and second trimesters, every 2 weeks from 28 weeks to 36 weeks, and weekly from 36 weeks until delivery. If you are considered “high risk,” these visits may be increased in frequency. Most visits consist simply of checking your vitals (i.e. heart rate, blood pressure, weight), baby’s heart rate, and fundal height (size of your uterus). There are other key milestones throughout the pregnancy as well such as diabetes testing (performed between 24 and 28 weeks gestation), ultrasounds (mentioned under “U”), and testing for group beta strep with a vaginal swab (done approximately at 36 weeks gestation).
P is for preeclampsia.
Preeclampsia is a dangerous disease of pregnancy that is only curable by delivery. Patients with this disease experience increases in blood pressure and spill protein in their urine. Signs of preeclampsia include persistent headaches, changes in your vision (mostly described as bright flashes of light), body swelling, rapid increases in weight, and right upper abdominal pain. If you have any of these symptoms, be sure to see a doctor immediately to be checked out.
Q is for quickening.
Quickening is the term for when mothers can feel their babies move. This is often described as flutters or gas bubbles and can be felt as early as approximately 17 weeks of pregnancy.
R is for restless leg syndrome.
Restless legs and Charlie horses are common symptoms of pregnancy with unknown etiology. Prevent these unruly symptoms by maintaining adequate hydration as well as calcium, magnesium, and potassium intake. Leg massages are also helpful!
S is for sleep.
Insomnia is a common complaint of pregnancy due to hormonal changes and general discomfort as your body changes. It’s very important to get adequate rest in pregnancy. Aim for at least 8 hours of sleep per night. Take naps as needed during the day. Use a body pillow to help prop yourself in a comfortable position at night. Make sure to sleep on your side and not flat on your back as the weight of your uterus can push against your major vessels when on your back and decrease blood flow to the placenta and baby.
T is for toxoplasmosis.
Toxoplasmosis is an infection caused by a parasite and can pose serious risks to an unborn baby. Stay away from raw or undercooked meat, wash hands frequently, and if you have a kitty, avoid handling the cat litter.
U is for ultrasound.
In a typical pregnancy, you may receive 1 or 2 ultrasounds. These are typically performed early in pregnancy to confirm dating and halfway through the pregnancy to review anatomy. Additional ultrasounds may be warranted for evaluation of chromosomal abnormalities (called the first trimester screen and usually performed around 12 weeks of gestation), fetal growth, placenta, blood flow, fetal position or amniotic fluid level.
V is for varicosities.
Varicose veins are common in pregnancy and due to changing hormones, an increase in blood flow, and an increase in pressure as your belly grows. Prevent these by wearing compression hose and elevating your legs at rest.
W is for water.
Drink drink drink! It is very important throughout your pregnancy that you increase your water intake to at least a gallon per day. Dehydration can lead to contractions and low fluid levels around the baby.
X is for X-rays.
Generally speaking, radiation is avoided in pregnancy, but the rare X-ray if needed while pregnant, is considered safe with very limited potential for effect on the pregnancy. Try to avoid in the first trimester if possible.
Y is for yoga.
There are plenty of prenatal yoga classes available (such as through Fit4Mom), which are great to keep your body in prime condition for birthing. Yoga is also helpful for getting back in shape after delivery.
Z is for Zen.
It’s important to try to keep anxiety levels low in pregnancy as stress and anxiety can affect your overall health. If you experience a lot of anxiety with pregnancy, discuss this with your OB/GYN. Try things such as yoga and meditation to maintain your Zen.