ANIMALS

1. Avoid changing kitty litter. Cat feces can carry toxoplasmosis bacteria, which can be harmful to your baby.

BLEEDING

1. Light, painless bleeding or spotting can occur after intercourse due to the cervix being bumped. If the bleeding persists, contact your provider.
2. If bleeding is steady, or if you have pain with bleeding, and you are greater than 20 weeks, GO TO LABOR AND DELIVERY TRIAGE AT ST LUKE’S IMMEDIATELY.
3. If you are under 20 weeks pregnant, and are bleeding, cramping, or have brown discharge, call your provider. If you pass any tissue, please save it.

BOWELS

1. CONSTIPATION
   1. Drink 6-8 glasses of water per day.
   2. Add bulk fiber (bran) to diet, fruit, dried fruit, prune juice, and vegetables.
   3. Walk for 5-30 minutes after meals.
   4. Metamucil or Citrucel
   5. Fiber-con tablets
   6. Colace
2. DIARRHEA
   1. If severe, stay on clear liquids for 24 hours.
   2. Kaopectate
   3. If no relief in 48 hours, consult your provider.
3. HEMORRHOIDS
   1. Anusol suppository (best), Tucks
   2. Warm tub soak for 20 minutes at least twice daily.
   3. Keep bowel movements soft (see “CONSTIPATION” above)
4. GAS
   1. Avoid gas forming foods like cabbage, onions and legumes.
   2. Avoid constipation

COLDS

1. FEVER
   1. Keep fever under 101
   2. DO NOT take aspirin or ibuprofen; it can have adverse effects on the baby.
   3. Increase fluids
   4. Rest
2. NASAL CONGESTION/ALLERGIES
   1. Vaporizer
   2. Saline nasal spray
   3. Chlor-Trimeton, plain Claritan, Zyrtec or Sudafed (sparingly and only if necessary)
3. SORE THROAT AND COUGH
   1. Gargle with warm, salt water.
   2. Sucrets, Cepacol throat lozenges, or Chloraseptic Spray if necessary
   3. Robitussin DM, only if necessary.
4. HEADACHE
   1. Ice pack, dark room, hydration, and rest.
   2. Call provider if headache persists; this can be a symptom of preeclampsia

CRAMPS

1. UTERINE
   1. Early in pregnancy, occasional cramps and sharp pains are common due to uterine growth, ligaments stretching, and fetal movement.
   2. If regular, frequent, painful cramps or contractions occur, go to Labor and Delivery Triage (if over 20 weeks), or call your provider (if before 20 weeks).
2. LEG
   1. Full-panty support hose with 25-35 mmHg.
   2. Increase calcium (Tums or Rolaids).
   3. Stretching exercises or massage

DENTAL CARE

1. Routine dental work is okay in pregnancy
2. If root canal or other extensive work is indicated by your dentist, check with your provider first for antibiotic recommendations.
3. Local anesthesia is ok. NO GAS!
4. X-rays are okay if your abdomen is protected by a lead apron.

EDEMA (SWELLING IN HANDS AND FEET)

1. Drink 6-8 glasses of water per day
2. Elevate feet as much possible during the day and elevate feet above heart in the evenings.
3. Decrease salt intake. Many foods and drinks have high sodium content.

EXERCISE

1. Daily exercise is encouraged to help you stay fit, control your weight, and be prepared for labor. Every day, try to get at least 30 minutes of moderate exercise.
2. Vigorous exercise such as jogging, aerobics, and weight lifting are okay only if your body is already used to these activities.
3. Swimming, walking and low impact aerobics are some of the best forms of exercise in pregnancy.
4. Avoid activities which might result in significant stresses on your joints or trauma to your abdomen, like snow and water skiing, soccer, softball, football, contact sports, and horseback riding. Scuba diving is not safe in pregnancy.
5. Keep your heart rate under 140 beats per minute while exercising so the baby gets enough oxygen through the placenta.
6. Do what feels okay, and stop if pain develops.

FETAL MOVEMENT

1. First movement is usually noticed between 14 and 20 weeks.
2. From 24 weeks on you should feel the baby move at least four times per hour, when you are actually paying attention to movement. During a busy and active day, you may not feel much movement until you are less active.
3. If you do not feel the baby move at least four times in an hour, drink something with sugar in it and recheck the fetal movement count. If the baby is still not moving at least four times in an hour go to Labor and Delivery Triage.

HAIR COLORING

1. Highlights are okay, but avoid full head hair color.
2. Make sure hair coloring is done in a well ventilated space.

INDIGESTION AND HEARTBURN

1. Eat small frequent meals, avoiding large meals and drinking liquids with meals.
2. Avoid tight fitting clothing.
3. Avoid irritating foods, caffeine, chocolate, fried foods, carbonated drinks, citrus juices, peppermint, spicy foods. Alcohol and tobacco also exacerbate heartburn and should not be used in pregnancy.
4. Eat at least two hours before lying down.
5. If needed, you may try TUMS and Rolaids often, or Maalox and Mylanta sparingly.
6. Call the office if you are in severe discomfort.

NAUSEA AND "MORNING SICKNESS"

1. Nausea and vomiting during pregnancy tends to peak around 8 to 10 weeks after your last period, usually going away by 12 to 16 weeks after your last period.
2. Keeping well hydrated is most important, nutrition is second.
3. Some women find that lemon hard candies, or lemon-flavored chewy candy, like Starbursts, help nausea levels.
4. Eat small frequent meals throughout the day.
5. Small sips of fluid throughout the day to stay hydrated, broth-based soups, fruit smoothies, popsicles, tea and sports drinks.
6. Eat dry crackers, toast, pretzels, dry cereal or other simple carbohydrates.
7. Do not allow your stomach to get empty.
8. Eat protein containing snacks like peanut butter, cheese slices, sliced turkey, eggs, nuts, dried fruit and trail mix.
9. Eat/drink ginger containing foods such as ginger ale, ginger tea, and ginger snaps.
10. Wrist acupressure bands (Sea-Bands)
11. Take Vitamin B-6 50mg in the morning and at night.
12. Take ½ Unisom (doxylamine succinate) (OTC) at night or every 12 hours as needed.
13. Call office or provider if unable to keep anything down for 24 hours.

PAINTING

1. Only if necessary, and only in well ventilated rooms.
2. Latex paint only; not oil based.

PRENATAL VITAMINS

1. Choose a quality prenatal vitamin.
2. Verify that there is at least 800 micrograms of folate or folic acid and DHA/EPA.

SEX

1. Sex during pregnancy is okay, as long as there hasn’t been any problem with spotting or bleeding.
2. Sex may continue throughout pregnancy, as long as both partners are comfortable.
3. If you have any questions, consult your provider.

TRAVEL

1. After 7 months, most airlines require consent from your OB provider to fly.
2. If driving, stop every one to two hours to get out and walk around. This will help to prevent blood clots in your legs.

WEIGHT GAIN

1. Your baby needs protein, minerals, vitamins, and calories to grow healthy, but significantly increasing the amount of food eaten daily is not necessary. You only need to eat an extra portion of protein each day.
2. Target weight gain for pregnancy is 11 to 40 pounds. Women who weigh more need to gain less and women who weigh less to gain more. Talk with your provider about the right weight gain for you. You will gain more weight towards the end of pregnancy, usually 1 pound per week the last ten weeks.
3. If activity decreases and appetite increases, avoid extra calories from high-fat foods such as butter, margarine, oil, cream, fried foods, salad dressings, pies, cakes, and cookies.
4. If you find that your weight is increasing too rapidly, think about what you are eating; a few desserts can add up fast.

FOOD SAFETY

1. Avoid cold deli meats and deli salads. Heat deli meats to steaming before consuming.
2.  Do not eat or drink unpasteurized raw milk, feta cheese, brie cheese, blue-veined cheeses, or Mexican-style queso blanco or queso fresco.
3. Do not eat raw meat, raw shellfish, foods with raw eggs, raw vegetable sprouts, or unpasteurized juices.
4. Wash all fruits and vegetables before eating.
5. Cook all meats all the way through.
6. Throw away food that is left at room temperature for 2 hours or more.
7. Okay to eat up to two 6-ounce servings of omega-3 fish per week.
8. Eat salmon no more than once per week.
9. Eat only “light” tuna. Do not eat albacore tuna.
10. Do NOT eat the following fish while you are pregnant: swordfish, tilefish, king mackerel, shark, tuna steaks, marlin, Spanish mackerel, orange roughy, or raw fish.

YEAST INFECTIONS

1. Use the over the counter Clortrimazole-7 day as directed; or prescription Terazol-7 is another option.
2. Contact your provider if symptoms persist after treatment.

LABOR

1. Go to Labor and Delivery Triage if contractions are every 5 to 10 minutes, lasting longer than 40-60 seconds, and feel much stronger than menstrual cramps.
2. If you are before 37 weeks, and have more than four painful contractions per hour, lie down, rest, and drink several glasses of fluids. If contractions do not stop, go to Labor and Delivery Triage.
3. Go to Labor and Delivery Triage if any leaking of fluid or bleeding more than a tablespoon of blood.

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FOUR RULES TO REMEMBER BEYOND 24 WEEKS OF PREGNANCY

GO TO LABOR AND DELIVERY TRIAGE IF ANY OF THE FOLLOWING:

1. REGULAR, FREQUENT, PAINFUL CONTRACTIONS OR SIGNIFICANT UTERINE PAIN
2. LEAKING FLUID
3. DECREASED FETAL MOVEMENT (LESS THAN 4 MOVEMENTS PER HOUR)
4. BLEEDING MORE THAN A TABLESPOON OF BLOOD