Pregnant Women (notice)

The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have developed an algorithm to aid practitioners in assessing and managing pregnant women with suspected or confirmed COVID-19. View the algorithm. At this time, very little is known about COVID-19, particularly related to its effect on pregnant women and infants, and there currently are no recommendations specific to pregnant women regarding the evaluation or management of COVID-19. Currently available data on COVID-19 does not indicate that pregnant women are at increased risk. However, pregnant women are known to be at greater risk of severe morbidity and mortality from other respiratory infections such as influenza and SARS-CoV. As such, pregnant women should be considered an at-risk population for COVID-19. Adverse infant outcomes (eg, preterm birth) have been reported among infants born to mothers positive for COVID-19 during pregnancy. However, this information is based on limited data and it is not clear that these outcomes were related to maternal infection. Currently it is unclear if COVID-19 can cross through the transplacental route to the fetus. In limited recent case series of infants born to mothers infected with COVID-19 published in the peer-reviewed literature, none of the infants have tested positive for COVID-19 (1).

Pregnancy FAQs

We have assembled these Pregnancy FAQs (Frequently Asked Questions) to help with decisions about your health (and your baby’s health) during pregnancy. In most cases AVOIDANCE OF MEDICATIONS (both prescribed and over-the-counter), especially in the first trimester, is SAFEST during pregnancy. No medication is considered 100% safe in pregnancy.

What should you avoid during your pregnancy?

Smoking
Drugs and alcohol
Prescription and over the counter medications (unless advised to continue by your doctor)
Saccharin
Douching
Tampon use
Caffeine (Except in limited quantities: 1 caffeinated drink per day. Products containing caffeine include: coffee, tea, colas, cocoa)

What are the most common complications of pregnancy?

Heartburn. If needed you may use Maalox, Milk of Magnesia, Mylanta, Rolaids, or Tums.

Colds. Increase fluid intake, especially clear liquids, stay at home if possible and rest. Use a vaporizer at night if congested. You may use Tylenol as directed for fever, aches or pains (do not use more than the recommended daily dose). Do not use any nasal spray except Ayr or Ocean nasal saline unless prescribed by your physician.

Fever. Call the office immediately if your fever is above 100.4 degrees F.

Headaches. Tylenol, as needed, is the preferred treatment if necessary. Do not use Advil, Aleve, Aspirin, ibuprofen or Nuprin. Do not use prescription migraine medication without first discussing it with your doctor.

Constipation. Increase your water intake to six to eight glasses per day. Increase bulk by eating more fiber, including bran cereals, fruits, and raw vegetables. Stool softeners such as Colace, or fiber products like Citrucel, Fibercon, Konsyl, and Metamucil are permitted in pregnancy (no prescription is needed). Do not use laxatives or enemas.

Morning Sickness. Eat six to eight small meals per day. Do not skip meals. Keep two to three saltine crackers by your bedside at night and eat them before getting out of bed. A small snack before going to bed may also help. Antacids, Altoid mints, ginger tea, and lemon drops may help.

Vomiting. If excessive, please call the office.

Dental Problems. Routine dental care/cleaning, as well as dental complications including cavities, can and should be taken care of by your dental provider. Please notify your dentist of your pregnancy. Wear a shield for all X-rays. Local anesthetics are preferred. Cosmetic dental procedures should be delayed until after completion of the pregnancy.

When Seeing Other Physicians. Be sure to let them know that you are pregnant. Clear all prescriptions with us and avoid X-rays when possible.

Are there specific diet guidelines to follow during pregnancy?

Weight Gain. A weight gain of two or three pounds per month for a total of 25-35 pounds is desirable if you are a normal weight. For women who are overweight, 15-25 pounds is recommended. For women who are underweight, 35-45 pounds is recommended.

Protein. Lean beef, chicken, and turkey (baked or broiled, not fried) are your best sources of protein.

Fish. Eat no more than four ounces (about one small serving) of tuna per week. Limit your total intake of tuna and cooked fish to twice a week. Avoid swordfish, shark, king mackerel and tilefish (also called golden or white snapper) as these can contain potentially risky levels of mercury.

Listeria. Listeria is a very rare infection, affecting less than 1 in 100,000 people in the United States per year. Listeria bacteria is found in uncooked meats, uncooked vegetables, unpasteurized milk, and processed foods. To prevent listeria exposure, avoid soft cheeses, such as feta, Brie, Camembert, blue-veined cheese, and Mexican style cheeses such as queso fresco, queso blanco, and Panela. Avoid hot dogs/luncheon meats/deli meats unless they have been properly reheated to steaming (or about 160 degrees F). Avoid refrigerated meat spreads and refrigerated smoked seafood. Canned meat spreads or canned smoked seafood are fine. Practice safe food handling. Any pasteurized dairy products, such as cream cheese, are fine.

Milk. Two or three glasses of milk daily (low-fat, or skim is fine) are recommended. If you cannot drink milk, yogurt, cheese, and calcium supplements are also good (Citracal, Caltrate, Tums or Viactiv).

Iron. Liver, peaches, grapes, dried apricots, raisins, egg yolks, fresh spinach, and peanut butter are rich in iron. An iron supplement will be recommended to you during your sixth month.

Seasoning. Onion, lemon, garlic, and pepper are good choices. Avoid prepared salts like onion or garlic salt. Avoid soy sauce and salty foods like chips/salted nuts. Limit salt intake (hide your salt shaker!).

Recommended Snacks. Fresh fruits, fresh vegetables, hard-boiled eggs, raisins or other dried fruits, unsalted nuts, baked turkey or chicken.

Is it ok to have cosmetic treatments during pregnancy?

It is unknown if hair straightening, hair permanents, highlighting, manicures/pedicures and/or coloring of hair is harmful to the pregnancy. If you choose to undergo these treatments, they need to be done in a well-ventilated area by skilled/licensed professionals.

Is it ok to have a massage while pregnant?

Pregnancy massage is usually safe if the therapist is licensed and equipped with a special table.

Can you exercise during pregnancy?

We encourage healthy patients to exercise during pregnancy as tolerated. However, avoid water skiing, downhill skiing, any high impact sports, horseback riding, scuba diving, hot tubs, and tanning beds. Pregnancy exercise videos may also be used.

Is it safe to have sex while pregnant?

You may continue to have sexual intercourse throughout your pregnancy unless you feel uncomfortable or your doctor advises you otherwise.

Is it common to have swelling in your legs while pregnant?

Swelling in both legs is very common in pregnancy and will increase in hot weather, with prolonged standing and increased activity. Increase water intake to eight glasses per day and avoid adding salt to your food. Elevate your feet and legs above the level of your heart to improve circulation. Lie on your side when possible. Let your doctor know if you are experiencing swelling in the face or hands.

What are the symptoms of a miscarriage?

Active bleeding, passing of tissue or clots, or severe cramps are symptoms of miscarriage. If at any time you should have vaginal bleeding, severe cramps, or a sudden gush of water or leakage from the vagina, call the office immediately.

Is it safe to travel while pregnant?

We do not recommend traveling during the first three months or the last three months of pregnancy. If you must travel, stop frequently, empty your bladder and walk frequently. Blood clots in the legs (DVT) and lungs (PE) are a serious complication associated with travel and pregnancy and can be life-threatening. Travel to high altitudes may cause headaches, nausea, shortness of breath or severe altitude sickness. Please discuss any travel plans with your doctor.