Prenatal Care for You and Your Baby

What to avoid during pregnancy, common problems, diet guidelines, travel, exercise, and more.

We have assembled these basic guidelines to help with decisions about your health (and your baby’s) during pregnancy. If you have any questions about these guidelines, please call the office. In case of life threatening emergency, please dial 911. All calls to our offices after 5:00 pm will be forwarded to the answering service.

Prenatal Visits Schedule

A complete medical examination will be done at the time of your first prenatal visit. At this time, a prenatal profile, blood test, urinalysis, and cervical culture will be obtained. It is very important that you make every effort to keep your scheduled appointments for your obstetrical care. *Your due date is determined based on your last menstrual period or first sonogram.

Our physicians will want to see you on the following routine pre-natal visit schedule:

  • 4 – 28 Weeks: Every 4 Weeks
  • 28 – 36 Weeks: Every 2 Weeks
  • 36th Week – Delivery: Every Week

Estimated schedule of labs/sonograms that will be completed during your pregnancy:

At each of your pre-natal visits you will be asked for a urine sample and your weight and blood pressure will be recorded.
  • 11th – 13th weeks – UltraScreen
  • 15th – 19th Week: Quad Screen Blood Test
  • 20th Week: Sonogram
  • 27 Weeks, 1 Day: 1 Hour Glucose Test-CBC/Blood Test
  • 35 – 36 Weeks: CBC/STS/GBS Culture

General Prenatal and Obstetrical Information

RH Negative Blood Type

If you have the RH negative factor in your blood type, our office will monitor you closely with additional blood work throughout your pregnancy. If a Rhogam injection is needed your doctor/nurse will give more information.

Childbirth Education Classes

Women’s Health and Surgery Center  offers FREE prenatal birth classes. Please contact Kelly Sands at ksands@obgynvirginia.com or call 540-368-9472 for more information. For information on childbirth education classes via Mary Washington and Stafford Hospital,  please contact Mary Washington Healthcare Health Link at 540.741.1404 ext. 1 to request a current class schedule.

Obstetric Safe Medicine Information

At some time during your pregnancy you may become sick with a common illness such as a cold, headache, nausea, vomiting or sore throat. When this happens, you may want to take an over the counter (non prescription) medication to make you more comfortable. It is best to use little or no medications during pregnancy, especially during the first three months. However, if you do choose to take medication, please review our list of safe medications to take during pregnancy so that you can make the best decision for you and your baby. If you ever have a question or are uncertain about taking a medication, even one prescribed by another doctor, please call 540-720-7340 and speak with a nurse before taking the medication.

Common Pregnancy Discomforts

SYMPTOM/CAUSE
REMEDIES
THINGS TO AVOID
Backache – Caused by strain of increased uterine weight on back muscle, aggravated by poor posture. Good Posture, rest with weight off back, wear flat-heeled shoes, sleep on a firm mattress, try pelvic rock exercise Avoid high-heeled shoes, fatigue
Bladder Infection – May be caused by a preexisting asymptomatic infection or by catheterization at delivery. Drink plenty of water and acidic fruit juices. Cranberry juice is best. Increase vitamin C. Strict attention to feminine hygiene, wear cotton underwear, and consult doctor if symptoms persist to avoid development into kidney infection. Avoid tight underwear or underwear that is made of synthetic “non-breathing” materials. Avoid drinking coffee or black tea. Avoid catheterization, if possible.
Constipation – Progesterone relaxes smooth muscles of gut making it less effective, intestines compressed. Increase roughage in diet, daily walk, increase water, eat prunes, raise feet on foot stool and relax pelvic floor when on the toilet. 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). Avoid laxatives, mineral oil, and enemas.
Heartburn – Enlarging uterus presses on stomach, forcing stomach fluids back up into esophagus. Eat several small meals instead of three large ones, sit up straight, elevate ribcage, sleep with upper body propped up, and sip milk or tea. Avoid antacids; check with health care provider before use. Avoid greasy, spicy food, coffee and alcohol.
Hemorrhoids – Pregnancy hormones relax smooth muscles of veins, causing vasocongestion, may be aggravated by straining over bowel movements. Elevate feet, relax pelvic floor, drink plenty of fluids, eat roughage assume knee chest position, apply cold compresses with witch hazel. Hot bath Avoid straining and pushing too hard when having a bowel movement. Avoid developing constipation or diarrhea.
Insomnia – Often hard to sleep in the last months of pregnancy due to difficulty getting comfortable, frequency of urination, worries and fetal movements. Hot bath, drink hot milk or soothing herb teas at bedtime, use relaxation techniques, exercise daily, increase vitamin B intake, use massage, avoid caffeine. Avoid sleeping pills and tranquilizers. Avoid chamomile tea if you are allergic to ragweed.
Nausea – Possibly caused by hormonal changes and/or emotional factors. Increase intake of vitamin B6, eat 4-6 small meals per day, drink peppermint teas, and snack on toast or crackers before getting up in the morning, non-caffeinated ginger ale helps as well. Avoid cigarette smoking, greasy spicy food, and either an empty stomach or an over full stomach.
Shortness of Breath – Caused by pressure of enlarging uterus on diaphragm and lungs Maintain good posture; sit up straight, sleep with upper body propped up. Avoid Anemia Stop Smoking Avoid Over-Exertion
Varicose Veins – Decreased efficiency of venous return from the leg aggravated by enlarging uterus. Elevate legs frequently, use support stockings, and walk daily. Avoid prolonged standing, avoid sitting with crossed legs, constrictive clothing or garters.

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. The following recommendations are some things you can do in order to alleviate the discomfort of morning sickness.
  • Eat several small meals daily as opposed to 3 large meals
  • Eat dry crackers with juice before rising from bed in the morning.

If You Do Not Drink Milk

  • OsCal 500 – Calcium Supplement, non-prescription: take one tablet three times daily
  • Tums – 2 per day

Showers and Baths

Showers and baths may be taken. However, you may not be in a hot tub that is over 100°.

Breast Secretions

Breast secretions are normal during pregnancy. This commonly begins during the fourth month.

Dental Care

Regular dental visits are encouraged. Be sure that the dental staff is aware of the pregnancy. There are certain precautions that must be taken during pregnancy

Rest and Sleep

Enough rest is imperative. Increased tiredness during the early part of your pregnancy should subside your 12th week.

When To Call The Office

If you have any of these symptoms, don’t wait. Call your doctor’s office or go to the hospital. Call your doctor or nurse right away if you notice any of these symptoms:
  • CONTRACTIONS that are timed ten minutes apart for at least an hour.
  • A gush or slow leaking watery fluid from the vagina. This usually indicates that there is a rupture in the membranes of the bag of water surrounding the baby. It is very important to call our office even if this is not accompanied by contractions.
  • Any vaginal bleeding is considered abnormal. Call our office immediately.
  • Decreased fetal movement.
  • Any questions or concerns please call the office. (if after hours please have the physician on-call paged)

DIET GUIDELINES

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, un pasteurized 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. 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. Limit salt intake (hide your salt shaker!). Recommended Snacks Fresh fruits, fresh vegetables, hard-boiled eggs, raisins, baked turkey or chicken.

SWELLING

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.

TRAVEL

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. Travel to high altitudes may cause headaches, nausea, or shortness of breath until you become acclimated to the area.

SEXUAL ACTIVITY

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

EXERCISE

We encourage you to maintain the same level of activity you had prior to pregnancy. However, avoid water skiing, any high impact sports, horseback riding, scuba diving, hot tubs and tanning beds. Pregnancy exercise videos may also be used.

COSMETIC TREATMENTS, HAIR COLORING, AND MASSAGE

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

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 a sudden gush of water or leakage from the vagina, call the office immediately, even if there are no contractions.