**If at any time, you have urgent or emergent questions or concerns please call our office at (949) 829-5533. If you have general, non-urgent questions or concerns, we encourage you to look through this page and utilize your patient portal to contact our office.**
Common Concerns
Bleeding
- First Trimester Bleeding: if any bleeding occurs, call the office for instructions
- Second to Third Trimester Bleeding: If bleeding occurs after being examined in late pregnancy, do not be alarmed. Occasionally, patients will have a “bloody show” prior to labor that is usually dark brown and of mucous consistency. If this occurs, this can be from being recently examined or it could be possibly a sign of early labor. If bleeding becomes heavy, bright, red, or persistent notify the office immediately.
Cold Symptoms
We recommend the following medications in moderation if you develop a persistent cold:
- Congestion
- Sudafed: can be used twice per day after completion of your first trimester
- Vaporizers or some method of steam, such as a hot shower or steam tent
- Saline nasal drops or spray, Vicks VapoRub or Mentholatum
- Cough
- Robitussin (plain)
- Sore Throat
- Gargle with warm salt water
- Chloraspetic throat spray or lozenges
- Fever
- If your fever is higher than 101°F or 38.3°C, call the office
- Tylenol, two regular strength (325mg) tablets every four hours. Do not exceed more than 4000mg in 24 hours.
- Headaches and Aches
- Tylenol, two regular strength (325mg) tablets every four hours. Do not exceed more than 4000mg in 24 hours.
- If symptoms persist, or if your condition worsens, contact the office.
Contractions
Contractions are experienced differently from person to person. Most people describe contractions as feeling like severe abdominal pain, usually involving the entire abdomen or uterus and some people describe pain in just the lower abdomen or lower back.
Braxton Hicks
These contractions, which occur as the uterus grows, are normal occurrences in pregnancy. They are usually not painful and are not dangerous to the baby. To the mother it should only be considered a minor aggravation and to the baby is is merely like a hug. If they are particularly bothersome, a warm bath or heating pad will usually relieve them to a degree.
Dental Exams
Routine dental care is recommended. Please inform your dentist you are pregnant or a letter from your provider can be prepared for your dentist with the following recommendations:
- Double shield, if x-rays are necessary
- Use of plain local anesthetic, if necessary
- Use of pain medications from Category B and C, if necessary
- Use of antibiotics from Category B and C, if necessary
Dietary Concerns in Pregnancy
We recommend a well-balanced diet in pregnancy. Some foods should be avoided in pregnancy because they can transmit infections, such as Listeria, to the baby without mom experiencing any symptoms. Avoid eating hot dogs, luncheon meat, or deli meats unless they are reheated until steaming hot. Do not eat soft cheeses such as feta, brie, camembert, blue-veined cheeses, or Mexican-style cheeses such as queso blanco, queso fresco, and panela, unless they have labels that clearly state that they are made from pasteurized milk. Consume pasteurized milk and milk products only. Also, we recommend you avoid refrigerated pate or meat spreads. Do not eat refrigerated smoked salmon unless it is an ingredient added to a cooked dish.
Here is a FDA/EPA handout on Food Safety for Baby and Me
Consumption of Fish During Pregnancy
Fish can be an important part of a healthy diet. Some fish, however, may contain high levels of mercury that can harm a baby’s developing brain and nervous system.
By following these 3 recommendations for selecting and eating fish, you will receive the benefits of eating fish and shellfish and be confident that you have reduced your exposure to the harmful effects of mercury.
- Check your local advisories of the safety of fish caught by family and friends in your local lakes, rivers, and costal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish if caught from local waters, but do not consume any other fish that week.
- Do not eat shark, swordfish, king mackerel, or tilefish as they contain high levels of mercury
- Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are low in mercury such as: shrimp, canned light tuna, salmon, pollock, and catfish
- A commonly eaten fish, albacore or “white tuna” has more mercury than canned light tuna. So when choosing your two meals of fish and shellfish, do not eat more than 6 ounces (one average meal) of albacore tuna per week
Here is the FDA/EPA’s Advice About Eating Fish, if you might or become pregnant, are breastfeeding, and for children ages 1-11
Digestive Disorders
Constipation
We recommended taking control of this problem with your diet. Your diet should include bran or whole wheat, fresh fruits, vegetables, and an increase in fluids. If additional help is needed, Metamucil or Colace, may be used as directed. If the problem persists, contact the office.
Diarrhea
Do not consume any food or liquids for 12 hours. For the following 12 hours, only consume clear liquids. If additional help is needed take:
- One tablespoon of Kaopectate after each loose stool
- Imodium A-D as directed
If this problem persists, contact the office.
Heartburn/Indigestion
Overeating, eating too quickly, or spicy foods may contribute to heartburn. Avoid eating immediately before laying down. If additional help is needed, Riopan, Mylanta, or Tums may be taken as directed before meals and at bedtime.
Nausea and Vomiting
This can be normal during the first three months of pregnancy but can last longer. Avoid eating greasy or spicy foods. In addition, eat small frequent meals in order to keep your stomach full. If nausea and vomiting become severe, or if you lose more than three pounds, contact the office.
Hemorrhoids
Hemorrhoids are swollen and inflamed veins in the rectum and anus. They can be felt as hard, tender lumps, that can cause itching or bleeding. Straining during bowel movements contributes to this problem. Try to avoid constipation and prolonged sitting. Sitz baths, warm shallow baths, are recommended three to four times a day for 10-15 minutes at a time. Over the counter Anusol suppositories may be used. Hemorrhoids can regress after delivery but usually do not disappear completely. If pain persists, contact the office.
Discharge
It is not unusual to have increased vaginal discharge during pregnancy. Do not douche or use tampons. If irritation, discomfort, noticeable odor, or yellowish or brownish color occurs, contact the office. If you have a history of pre-term labor and discharge increases significantly, call the office.
Dizziness
This can be normal in early pregnancy. We advise rest and increasing your fluid intake. If it is persistent in early pregnancy or occurs in late pregnancy and is accompanied by visual disturbances, contact the office.
Edema (Swelling)
Increase rest and keep your feet elevated. Drink at least eight glasses (64 ounces) of water a day. Restrict salt intake and foods and drinks with a high preservative content. Avoid caffeine such as coffee, tea, and sodas.
Exercise and Recreation
You are permitted to continue most activities or sports in which you participated in before pregnancy. Some health clubs offer special exercise classes for pregnant individuals. We suggest you do not try to learn a new sport during pregnancy. Sports our providers recommended avoiding when you are pregnant include snowboarding, snow skiing, water skiing, kick boxing, horseback riding, soccer, and any sport in which may take a hard fall.
Jacuzzi/Hot Tub/Whirlpool Baths
Jacuzzi, hot tub, and/or whirlpool baths are not recommended during your first trimester of pregnancy. If you choose to use whirlpool baths later in your pregnancy, do not stay in the water for longer than 15 minutes each time and the temperature should not exceed 100°F or 37.77°C. Avoid direct pressure of the jets to the abdomen.
Labor
If your contractions are regular and if you feel that you are in labor, contact your provider. You may be asked to come to the office or go to the hospital to be checked. If your water breaks, notify the office immediately, no matter what time, day or night. If there is a doubt as to whether you are in actual or false labor, walk around and/or use local heat. If you are having false labor, movement or heat often causes most of these contractions to stop. Movement will usually make true contractions stronger.
Here is a copy of the office’s Labor Instructions
Medications/Alcohol
Only certain medications are permitted during pregnancy. Inform all of your healthcare providers if you are planning to become or are pregnant as this may affect the medications they prescribe for you. Alcohol is not recommended during pregnancy.
CBD/Marijuana
Individuals who are pregnant or breast feeding should discontinue the use of marijuana and CBD oil. There are possible harmful effects on both the mother and baby.
Here is a handout from the American College of Obstetricians and Gynecologists and the California Department of Public Health on Marijuana (Cannabis) in Pregnancy
Movement/Fetal Kick Counts
Babies have periods of sleep and activity throughout the day. By 28 weeks, you should feel several active periods of movement everyday. If you feel at some time (after 28 weeks) that the baby is not moving adequately, perform a kick-count.
*Babies can sleep for 20 to 40 minutes at a time and you may need to wait for them to wake up. The best time to count fetal movement is after a meal*
Kick-Count: Lie on your left side without any distractions and count all of the movements you feel. Babies should move on average, about 10 times in 2 hours referred to as the “Count to 10” method. If you regularly “Count to 10” with your baby’s movements you will be able to know your baby’s normal routine.
If you do not reach your kick-count, if you feel your baby is not moving as they normally do, or if you notice a significant decrease in your baby’s movement. call the office.
Pain
As the uterus increases in size, there will be some discomfort and pain due to ligaments stretching and increased blood supply. We advise modifications of activity with gradual rising and sitting, avoidance of sudden movement, heat and Tylenol. If the pain increases or persists, contact the office.
Backache
As the uterus increases in size, backaches are common. We recommend good posture, rest (with your feet elevated or resting on either side), Tylenol, and heat. If your backaches are severe, a maternity support band/belt may help. Usually a backache is the body’s way of recommending more rest.
Headache
You may use one or two regular strength Tylenol (325mg) every four hours. Do not exceed 4000mg in 24 hours. If your headache persists or is accompanied by visual disturbances, contact the office.
Poison and Chemical Exposure
Fumigation
If fumigation of your residence is necessary, leaving the premises for approximately eight hours after completion of fumigation is recommended. Have another person enter the residence to open doors and windows to ventilate before you enter.
Painting
Plan to pain on clear days as we recommend having doors and windows open for good ventilation
Salon Treatments
Permanents, hair coloring, and nail care should always be done in large, well-ventilated areas
Prenatal Vitamins
We recommend starting prenatal vitamins before you become pregnant, throughout your pregnancy, and during the postpartum period.
A prenatal vitamin should meet all of your needs and those of your developing baby. Essential elements such as folic acid, vitamin D, DHA, and iron are readily available in the correct dosage of most prescription prenatal vitamins. Over the counter vitamins may not have the recommended amounts of DHA and folic acid needed for the developing baby. Since these products are unregulated, sugars, fillers, and animal products may also be present.
Sexual Activity
Sexual activity may continue during pregnancy, as long as it remains comfortable. If a complication develops, further advice will be given by your provider. Frequently, increased uterine activity is noted after sexual activity.
Travel
If traveling by automobile, we recommend that you stop and walk around every two hours, for approximately 15 minutes. If traveling by airline, there are no restrictions under most circumstances. Be sure to wear a seatbelt during car travel, positioning the seat belt under the abdomen as your pregnancy advances. If you are planning to travel during your last month of pregnancy, we recommend that you do not travel more than one hour away from the hospital. If you must, please discuss this with your provider.
Refer to the CDC’s website for travel information and recommendations: https://wwwnc.cdc.gov/travel
Altitude
Travel to local mountain resorts is not usually a problem. Avoid strenuous activity or long strenuous hikes.