6 Common Pregnancy Questions, Answered

By Gifford Ob/Gyn and Midwifery

1- When Should I Call My Ob/Gyn?

It is important that you call us before you take any medications or herbs. Acetaminophen is the only over-the-counter pain medication recommended for pregnancy. You should not take ibuprofen, naproxen or aspirin.

The following are potential warning signs during pregnancy. These symptoms do not always indicate that something is wrong, but they should be checked out. At any time during pregnancy you should call us if you experience:

• burning or discomfort with urination
• vaginal itching or unusual discharge
• persistent vomiting or diarrhea
• a temperature greater than 100.4 F
• signs of dehydration: urinating fewer than two times a day, lightheadedness, cannot keep any fluids down for more than 24 hours
• vaginal bleeding that is more than spotting (any bleeding after 20 weeks if you have not had an ultrasound)
• more than five or six uncomfortable contractions in an hour
• abdominal pain
• leaking of fluid from your vagina (please call day or night)
• severe or persistent headache that does not go away after taking Tylenol
• flashing lights in your vision, blurred vision, new pain in your upper abdomen
• severe swelling that is not just in your feet
• persistent dizziness or any fainting, rapid heartbeat or palpitations
• after 28 weeks, decreased fetal movement; fewer than 10 movements in two hours
• a bad fall or are in a motor vehicle accident
• fear, or are worried that “something isn’t right”

2- What Medications Can I Take During Pregnancy?

Although very few medications have been proven completely safe to use during pregnancy, there are several for common conditions that do not appear to cause significant harm. The following medications generally may be used safely during pregnancy. If you have questions, or need to take any medication for more than three days in a row, please contact your midwife. If you are interested in non-drug alternatives, please contact your midwife.

This information is not to be taken as medical advice. If you have questions or want information tailored to your personal needs, you must contact your provider.

*Never take more than 4000mg of acetaminophen in a 24-hour period. Remember to include all sources.

Constipation/Stool Softeners

• Colace (ducosate sodium)
• Magnesium Citrate
• Milk of Magnesia
• Miralax (polyethylene glycol)

Nausea

• 1/2 Unisom (doxylamine succinate) + 50 mg B6 (Start with one dose in the evening; add additional doses in the morning and early afternoon as needed.)
• Vaginal yeast infections
• Monistat 3 or 7 (miconazole)
• Gyne-Lotrimin 3 or 7 (clotrimazole)

3- What Can I Do to Prevent Nausea and Vomiting?

So, up front, we are going to stop using the term “morning sickness.” Many women experience Nausea and Vomiting of Pregnancy (NVP) continuously throughout the day and night, and others much more at night than in the morning. It ranges from mild nausea and food aversions to extreme amounts of vomiting that can be life-threatening.

There are many factors that contribute to NVP, which is why there is no one solution. What worked for you in the past may not work again, and what worked for your friend may not work for you. The remedy itself may be useful—just not for you right now.

The following information is very general and largely directed at milder forms of NVP. If you are unable to hold even liquids down for more than 24 hours, are urinating fewer than two times a day, have lost more than 5 pounds, or find that the condition is seriously impacting your ability to function, please contact your provider for help.

• Eat regularly—every two waking hours. It doesn’t have to be a lot, but something with a carbohydrate, a protein, and a small amount of fat.
• Rather than crackers in the morning, try a food higher in protein, such as Greek yogurt, nuts, peanut butter on toast or apples, or cheese.
• Avoid exhaustion. Fresh air can be very helpful. Getting out and taking a walk is good, but overexertion will usually aggravate your NVP.
• If you vomit a foul green bile in the morning, first thing before eating, quickly drink a pint of warm water and empty your stomach. After that you are often able to eat a decent meal.
• Peppermint gum/candy/mints/oil may suppress the urge to vomit.
• Sucking on ice can also suppress the urge to vomit.
• 1/4 cup liquid chlorophyll in a small amount of juice twice daily (reduces reabsorbed toxins in your intestine)
• Ginger has long been used to reduce NVP. You can try ginger tea, ginger ale, candied ginger or encapsulated ginger. It is considered safe even in fairly large doses, such as 3-4 cups of tea or up to 25 capsules per day
• 1/2 Unisom (doxylamine succinate) + 50 mg vitamin B6 taken first in the morning with additional doses in the morning and afternoon if needed. Since Unisom is a sleep aid, you can expect it to make you drowsy. When taken regularly, this effect will usually wear off in a couple of weeks. If this dosing schedule is not adequate, call your provider.

4- What Foods Are Safe During Pregnancy?

Pregnant women experience immune system changes that make it somewhat harder to fight off certain types of diseases. If a pregnant woman gets sick, there is always the additional concern about her unborn baby, both from the mother being sick and the possibility of the bacteria or virus being transmitted to the baby. Traditionally women have been strongly cautioned against eating any sort of raw or undercooked animal products due to the risks of listeria, toxoplasmosis, salmonella and e. coli contamination.

A Motherisk Update indicates that improved food safety regulations make these risks very small and that it is no longer necessary to recommend that pregnant women avoid deli meats, soft cheeses, or prepared salads. They still caution against raw eggs but indicate that the risk is very low.

General guidelines for safe food handling and preparation are always wise:

Keep hot foods hot.

• Heat or reheat foods to steaming.
• Cook meats thoroughly until there is no pink left. Look for clear juices in freshly cooked chicken or pork.

Keep cold foods cold.

• Refrigerate at 40 degrees Fahrenheit or less.
• Do not leave refrigerated foods out for more than two hours. Remember, in warm environments bacteria can multiply very rapidly.
• Defrost and marinate foods in the fridge.

Check the label.

• Avoid eating foods past their “use by” dates.
• Be aware of the “best by” dates.
• Follow cooking and storage information.

5- Can I Use Essential Oils While Pregnant?

Many people like to use essential oils and have found them to be very helpful. So, of course, they would like to continue benefiting from them during their pregnancy. We know that the oils are very potent and have powerful effects. While we are not experts in the use of essential oils and suggest that you consult a qualified practitioner who has experience working with pregnant women, we have included some general guidelines that you may find helpful:

• Only use one or two drops of essential oil at a time.
• Dilute the essential oil by mixing the drops with at least a teaspoon (5 ml) of a base oil before you add it to a bath or massage into your skin. Grapeseed oil or sweet almond oil work well as base oils.
• Use in a vaporizer. Long uses may contribute to nausea, so you may want to limit use to 10-15 minutes at a time.
• Many providers believe it is best to avoid any oil use during the first trimester while the baby’s organ systems are developing. The second and third trimesters are considered less likely to have adverse reactions. Overall there is little to no research on the uses of oils in human pregnancy.  Internal use is considered the most potent and potentially harmful while vaporizer use is generally considered safe.
• Over time, as oils are used more widely, acceptance and recognition of safety is likely to increase.

As long as your pregnancy is going well, the following oils generally are considered safe for you to use:

• Citrus oils, such as tangerine and neroli
• German chamomile
• Common lavender
• Frankincense
• Black pepper
• Peppermint
• Ylang ylang
• Eucalyptus
• Bergamot
• Cypress
• Rose
• Tea tree oil

The following essential oils are generally not considered safe for you to use while pregnant:

• Nutmeg, which may have hallucinogenic effects
• Rosemary, which may increase blood pressure, and may cause contractions
• Basil, which may contribute to abnormal cell development
• Jasmine and clary sage, which may trigger contractions
• Sage, which may cause bleeding in your uterus (womb)
• Juniper berry, which may affect your kidneys

In some circumstances, below, you should consider using oils only with the direction of a qualified naturopath. Some of these conditions are not compatible with out-of-hospital birth but we include the caution if you are simply looking for information.

• if you have a history of miscarriage (This is up to you, but there are concerns about stimulating contractions or altering pregnancy hormones during the first trimester.)
• if you have had any vaginal bleeding in this pregnancy
• if you have epilepsy
• if you have heart problems
• if you have diabetes, blood clotting problems, or have thyroid, liver or kidney disease

6- Can I Use Herbs While Pregnant?

Many women use herbs regularly for common complaints and illness, and herbs can be a wonderful tool to relieve and treat pregnancy difficulties. Very few herbs have been studied extensively enough to say they are safe for pregnancy use. Many, however, have been used traditionally for a long time and are viewed as presenting minimal risk by herbalists and midwives.

Dr. Aviva Jill-Romm, a midwife and physician, wrote a great article on the use of herbs during pregnancy. It provides a foundation for determining when risks outweigh benefits in the absence of quality research, and may help you determine your level of comfort with herbal use.

There are 5 herbs that are studied well enough to say they are safe during pregnancy:

• Ginger root—generally used for nausea and vomiting of pregnancy and the treatment of cold and flu symptoms
• Red raspberry leaf—age-old nutritive tonic for women, particularly during the childbearing year
• Cranberry—for urinary tract infection prevention
• Echinacea—used for treatment of colds
• Chamomile—used for sleep and relaxation

Some herbs should generally be avoided and tend to fall into certain types of categories. The following are commonly used herbs in these categories and do not represent any sort of complete list.