Obstetrics Location 378 South Branch Road Suite 403 Hillsborough, NJ 08844 (908) 369-0970 Travel During Pregnancy Once you become pregnant, pregnancy hormones increase your risk of developing blood clots in your legs. No matter what stage in the pregnancy, it is important that you not sit for extended periods of times. Our recommendation is that if you will be sitting for an extended period of time, either in an airplane or in the car, you should get up to walk every hour in an effort to decrease the risk of blood clot development. Call immediately if you develop leg pain, swelling, shortness of breath or chest pain. Although rare, blood clots can migrate to the lungs. If you choose to travel between 20-36 weeks gestation, there are special considerations. This is strongly discouraged for any patients with a history of preterm labor, preterm delivery, previous surgery on their cervix, or any other risk factors for preterm birth, such as infection, uterine anomaly, etc. If you find that travel is essential, we suggest that you make an appointment shortly before your departure so that we may check your cervix. Be sure that you travel to places within an hour of a neonatal unit (a special hospital that cares for premature babies.) After 36 weeks, the baby shouldn’t have problems with maturity, but we recommend that prior to traveling, you locate hospitals that have obstetrical services. During pregnancy, airlines may ask for a physicians note before allowing you to board.  To avoid problems at the airport, ask for a note at the visit prior to your travel date. Return to Menu Cold and Allergy Symptoms Use a cool mist vaporizer/humidifier at night. This moistens the air you breathe to keep secretions flowing. Saline gargles (one teaspoon of salt in ½ cup warm water) every four hours while awake will cut the mucus in the back of the throat and relieves mild soreness. Any brand of saline nose drops (NOT regular Afrin or Neo-Synephrine) at bedtime and on arising in the morning will help moisten secretions. Tylenol two extra-strength tablets every six hours if necessary for aches or fevers. Fevers are not harmful in pregnancy unless they reach 103 or above.  Treat fevers below this level with Tylenol.  Call the office or your primary care provider for fevers above 103. Coughing can be relieved with one teaspoon of honey and 2-3 drops of lemon juice. Hold this in your mouth until the honey thins and then swallow. If coughing interrupts sleep or causes vomiting, call your doctor. You may try Robitussin DM, an over-the-counter cough medication, after the first trimester. Actifed or Sudafed may also be use for symptom of congestion when taken as directed on the package. It is preferable that you not take this in your first trimester of pregnancy. The antihistamines chlorpheniramine, loratadine, doxylamine, brompheniramine, phenindamine, pheniramine, triprolidine, and diphenhydramine are considered low risk during pregnancy, but they can make you sleepy, especially doxylamine and diphenhydramine. Return to Menu Hair Coloring Often pregnant women have concerns about the safety of hair dyes and permanents during pregnancy. There is no scientific data on this question, but it seems unlikely that these types of exposures are harmful.  Return to Menu Saunas, Hot Tubs, and Tanning The use of saunas, hot tubs, and tanning booths is not recommended in pregnancy. The extreme temperature could potentially damage the developing baby. Extremely hot baths are not recommended during pregnancy. Bath temperatures should be below 100° Fahrenheit.  It is safe to be in the sun during pregnancy, but the skin may be more prone to sunburn.  Use of higher UV protection sunscreen is recommended. Return to Menu Nausea and Vomiting  The following suggestions may be useful in relieving nausea and vomiting: Remember, "any calorie is a good calorie" so eat what stays down for you. Eat smaller, more frequent meals- that is- six small meals and snacks. Drink fluids between meals, not with meals. Eat foods that are at room temperature or cooler. Hot foods may trigger nausea. Drink beverages chilled or cold. Decaffeinated soda is often well tolerated. Don't opt for diet soda, you need the calories right now. Eat slowly and rest after meals. It is best to rest sitting in an upright position for about one hour after eating. Dry toast, soda crackers, or dry pre-sweetened cereals may relieve periods of nausea.  If continued vomiting occurs, do not eat or drink anything until the vomiting has stopped. As you feel better, try some small amounts of clear liquids (broth, Jello, apple, grape, or cranberry juice, and/or popsicles.) Tart or salty foods such as lemons or pickles may help decrease nausea. Avoid mixing hot and cold foods at a meal, as it may stimulate nausea. Ask your doctor about medicine to control nausea. These are signs that you need to call your doctor: Unable to keep anything down for more than two days Fainting Vomiting blood Rib pain Jaundice (skin is greenish or yellow) Your weight drops more than five pounds within a week Return to Menu Exercise and Work  Exercise can help strengthen muscles used in labor and delivery and lessen some of the discomforts of pregnancy. It may give you more energy and make you feel better. The type of exercise you can do during pregnancy depends on your health and how active you were before you became pregnant. This is not a good time to take up a new, hard sport. If you were active before, you can continue to be within reason.  If you can speak in full sentences while exercising, you are not overexerting.  Lifting more than 20 pounds is not advised. Most of the time, a healthy woman with no complications in her pregnancy can keep working until the end of her pregnancy. Some may need to make some changes. If you are experiencing problems that you feel may be related to your job, please discuss this at one of your office appointments. Your family should be able to help you at home as fatigue increases at the end of your pregnancy. Return to Menu Swelling  A certain amount of swelling (called edema) is normal during pregnancy. It occurs most often in the legs. Elevating the legs usually makes the swelling less by the next morning. Swelling can begin during the last few months of pregnancy, and it may occur more often in the summer. Let your doctor or nurse know if you have swelling in your hands or face, because this may be a sign of another problem.  Never take medications (water pills) for swelling unless they have been prescribed for you. Elevate you legs when possible Rest in bed on your side Lie down with your legs raised on a small footstool or several pillows Do not wear stockings or socks that have a tight band of elastic around the legs. If you must sit a lot on the job, stand up and move around from time to time. Try not to stand still for long periods of time. Return to Menu Chickenpox and Shingles exposure Most adults are immune to chicken pox, either from having the disease or by forming immunity from a mild exposure. If you have had chicken pox in the past, you and your baby are protected.  We check for immunity to chicken pox with the first set of prenatal bloodwork.  If this shows positive immunity, you are both protected.  Shingles is the painful return of the chicken pox (Varicella) virus in people who have already had it.  If you already had chickenpox, you cannot catch shingles from someone with chickenpox or shingles.  If you have not had chicken pox, you should avoid contact with people with shingles.  If you get shingles in pregnancy it can be treated with safe medication. Return to Menu Headaches Headaches are common during pregnancy. Usually headaches do not signal a serious problem. How often they occur and how bad they are may vary.  You may use Tylenol (acetaminophen) two extra-strength tablets for headaches. You should contact our office if your headache does not go away, returns very often, is very severe, causes blurry vision or spots in front of your eyes, or is accompanied by nausea or you have high blood pressure. Return to Menu Constipation At least half of all pregnant women seem to have problems with constipation. One reason for this may be changes in hormones that slow the movement of food through the digestive tract. Sometimes iron supplements may also cause constipation. During the last part of pregnancy, pressure on your rectum from your uterus may add to the problem. Here are some suggestions that may help: Drink plenty of liquids – at least 6-8 glasses of water each day, including 1-2 glasses of fruit juice such as prune juice Eat food high in fiber, such as raw fruits and vegetables and bran cereals. Exercise daily – walking is a good form of exercise. Colace is a stool softener that may be taken twice daily during pregnancy.  This is available over the counter.  Metamucil or miralax may also be helpful. Return to Menu Bleeding Gums and Dental Visits During pregnancy, the extra hormones in your body may cause your gums to swell and bleed. Floss and brush regularly, using a soft toothbrush, to keep your teeth in good shape. Having a dental checkup early in pregnancy is a good idea to be sure your mouth is healthy. Local anesthesia, if needed, does not pose a risk during pregnancy. Dental x-rays can be done, if necessary, with your abdomen shielded. Return to Menu Leg Cramps In the last three months of pregnancy, you may find that you have more leg cramps. Get plenty of calcium (three glasses of milk or supplement) and potassium (oranges, bananas, and leafy green vegetables) Stretching your legs before going to bed can help relieve cramps. Avoid pointing your toes when stretching or exercising. Return to Menu Painting Latex paints manufactured before 1991 used small amounts of mercury as a preservative. There was some concern that this mercury could present a health hazard, so mercury is no longer used in latex paints. The fumes from latex paints are not felt to be a specific risk to a developing baby, but it is always wise to paint in a well-ventilated area. The fumes from oil-based paints, turpentine, paint thinner, etc., are best avoided by pregnant women. Also, remember when painting to avoid use of a ladder to reduce the risk of injuries due to a fall. Return to Menu Sexual Intercourse Some people worry about having intercourse during pregnancy. They may be afraid it will cause a miscarriage. For a healthy woman with a normal pregnancy, intercourse is safe into the last weeks of pregnancy. For your comfort, you and your partner may want to try different positions. We may advise you to limit or avoid sex if there are signs of problems in your pregnancy. Return to Menu Heartburn Indigestion is commonly called heartburn, but it does not mean that anything is wrong with your heart. It is a burning feeling that starts in the stomach and seems to rise into the throat. It occurs when digested food from your stomach, which contains acid, is pushed up into your esophagus (the tube leading from the throat to the stomach.) Liquids that you drink also take up space in your stomach, so they may also add to the problem. Changes that take place in your body during pregnancy may worsen indigestion. Changes in your hormone levels slow digestion and relax the muscle that normally prevents the digested food and acids in your stomach from entering the esophagus. In addition, your growing uterus presses up on your stomach. To help relieve heartburn, try the following: Eat five or six small meals a day instead of two or three large ones. (A glass of fluid may be equal in volume to a small meal, so avoid drinking large amounts of fluids with meals.) Avoid foods that cause gas, such as spicy or greasy foods. Do not eat or drink several hours before bedtime. Wait two hours after eating before exercising. Antacids may be helpful, such as Maalox, Tums, or Gaviscon. Liquid will be more effective than tablets. If the problem is frequent and only briefly relieved by antacids, please let us know. Return to Menu Hemorrhoids Very often pregnant women who are constipated also have hemorrhoids. Hemorrhoids are varicose (or swollen) veins of the rectum. They are often painful. Straining during bowel movements and having very hard stools may make hemorrhoids worse and can sometimes cause them to protrude from the rectum. Preparation H, Anusol, Tucks, and Witch Hazel are safe to use in pregnancy . Hemorrhoids usually improve after the baby is born. Several things can help give relief or avoid the problem in the first place: Avoiding getting constipated Eating a high-fiber diet Drinking plenty of liquids Return to Menu Yeast Infections It is not uncommon to develop a yeast infection during pregnancy. If such an infection does occur, it is safe for you to use over-the-counter products, such as Monistat. These are readily available at stores.  However, if you are early in your pregnancy, before 12 weeks, it is important that the cream be used externally only. After 12 weeks, it is safe to gently use the applicator internally. Return to Menu Herbs and Extra Vitamins Your prenatal vitamins should be the only herbal supplement used during pregnancy unless your provider specifically directs you to use an additional product.  If you do not get adequate calcium and vitamin D in your diet, supplementation is suggested. Return to Menu Frequently Asked Questions About Pregnancy Travel During Pregnancy Cold and Allergy Symptoms Hair Coloring Saunas, Hot Tubs, and Tanning Nausea and Vomiting Exercise and Work Swelling Chickenpox and Shingles Exposure Headaches Constipation Bleeding Gums and Dental Visits Leg Cramps Painting Sexual Intercourse Heartburn Hemorrhoids Yeast Infections Herbs and Extra Vitamins Obstetrics-Home What To Expect Your First Prenatal Visit Prenatal Testing Ultrasound Obstetrics FAQs Medications in Pregnancy