pregnancy guidelinesEXERCISE GUIDELINES

  • Avoid contact sports.
  • Reduce weight bearing exercise (such as running) in favor of non weight bearing exercise (swimming, bicycling).  This is tolerated more easily especially as your weight increases.  Also joint relaxation is more common in pregnancy and dislocations are less likely with non weight bearing exercise.
  • Be sure to exercise for shorter periods and rest more frequently.  One sensible approach is to alternate 15 minutes of exercise 15 minutes of exercise with 5 minutes to rest.
  • Activities with a high risk of falling or abdominal trauma should be avoided (i.e. downhill skiing, gymnastics, etc.)
  • Scuba diving should be avoided throughout pregnancy because the fetus is at a higher risk of decompression sickness.
  • Avoid anaerobic exercise (making yourself short of breath rapidly).  Avoiding maximal exercise will prevent the buildup of lactate and acidosis that accompanies exhaustive exercise.  A rule of thumb for a reasonable level or aerobic exercise is that you should be able to carry on a conversation while exercising.
  • Avoid heart rates above 160; Exception: if you were already exercising at training levels before your pregnancy it may be safe for you to continue even if it means a heart rate over 160.  However we strongly encourage adequate rest period every 15 minutes.
  • Discontinue exercise immediately if you experience any of the following and please notify us immediately if you experience any of the following and please notify us immediately: vaginal bleeding, contradictions, numbness, dizziness, chest pain, shortness of breath, or abdominal pain.
  • Maintain a regular program of prenatal care.  Patients should keep their physicians informed of the type and amount of exercise performed.  Fetal well being, adequate weight gain and our well being are our goals.

DIET

  • Eat healthy meals with a balanced diet low in saturated fat.
  • Avoid skipping meals.
  • Avoid excessive amounts of vitamin A.
  • Avoid unpasteurized cheeses.
  • Please consume only fully cooked meat and eggs.
  • Rinse fruits and vegetables prior to consumption.
  • Avoid raw sprouts since the root is difficult to clean.
  • Clean utensils and preparation areas after working with raw meat.
  • Avoid predatory and older fish because they contain higher levels of mercury; they include shark, mackerel and tilefish.  Commonly consumed fish with lower levels of mercury include shrimp, canned light tuna, salmon, Pollack and catfish.  Albacore tuna has more mercury than canned light tuna and therefore consumption should be limited to once weekly.
  • Limit caffeine intake to less than 300 mg/day (an 8 oz serving of drip coffee contains 234 mg of caffeine)
  • Artificial sweeteners:  to date none are associated with an increased risk of birth defects above the baseline rate in the general population (sweeteners evaluated include aspartamine (Nutrasweet), sucralose (Splenda), saccharin (Sweet’N Low), acesulfame potassium (Sunett) and stevioside (Stevia).  Please use these in moderation when pregnant.

ACTIVITIES TO AVOID

  • Avoid hot tubs, whirlpools and tanning beds.
  • Avoid kitty litter boxes (increases risks of exposure to toxoplasmosis)
  • Avoid exposure to chicken pox, measles or fifth disease; if you are exposed please contact us immediately.
  • If you develop a fever of 101 or greater please inform us immediately.
  • Avoid nicotine and alcohol.
  • Avoid aspirin containing products, ibuprofen or dextromethorphan.
  • Avoid inhaling fumes (if you need to paint use only latex based paints in a well ventilated area (wear a mask, use fans).

DENTAL PROCEDURES

Essential dental procedures may be performed during pregnancy.  Elective procedures of any type are best performed upon completion of your pregnancy.  If it becomes necessary to have some dental work during your pregnancy, this can be done safely with minimal risk.  The following points address commonly asked questions about dental procedures:

  • X-rays with abdominal shielding, can be done.  Limit x-rays to the minimum numbers needed to complete procedure safely.
  • Local anesthetics can be used.
  • Penicillin or erythromycin antibiotics can be used if you are not allergic.

SEXUAL INTERCOURSE

Sexual intercourse can be continued as long as it does not cause you to have pain or bleeding.  For certain problems, you be told to avoid sex.  Some women find that sex is more comfortable during pregnancy if they are on top or lying side to side.  Feel free to ask questions about sexual relations during your visits.

WORKING DURING PREGNANCY

Generally, you can work right up to the end of your pregnancy.  The only types of jobs that might be a problem are those where you work around certain chemicals or x-rays.  Also, we recommend that you don’t lift more than 20-25 pounds during your pregnancy.

SLEEPING POSITIONS IN PREGNANCY

Finding a comfortable sleeping position can become a challenge after the first half of pregnancy. Some women with special health considerations, such as hypertension or diabetes, will be asked to sleep primarily on their left sides, as the left-side-lying positions provides for maximum blood flow to the placenta, and thus to the baby.  If you do not have any special considerations, almost any sleeping position, other than flat on your back is fine.  If you are a “tummy-sleeper” try this position:

Lie down first on your back.  Place a large body pillow next to you, along the length of your body.  Bend your knee and bring the leg farthest away from the body pillow up and over, rolling into the body pillow.  This will give you the feeling of lying on your tummy.  If you are a back sleeper, you may continue to lie on your back, but place a pillow under one hip or under your shoulders so you are not lying completely flat.  Lying completely flat on your back after the first half of your pregnancy can result in decreased blood flow to both you and your baby as the weight of the uterus compresses the large blood vessel that lies against your spine.  If you find yourself waking up on your back in the middle of the night, that is fine, simply readjust your positions so you are not lying flat.  If you are using the side-lying position to sleep, your hips may start to ache from lying on one side.  You may need to change your position frequently during the night to be comfortable. Large body pillows and the use of extra small pillows with help with comfortable positioning.  You may find that a pillow with help with comfortable positioning.  You may find that a pillow placed between your legs (if on your side) or under your knees or ankles (if on your back) increases your comfort).

CHOOSING A PEDIATRICIAN

During the course of your pregnancy, you will need to choose a pediatrician or a family doctor to take care of the baby at the hospital.  Many physicians request that you contact their office before the birth of the baby.  Check your insurance and make sure the pediatrician you choose is on their list.  Some expectant parents find it useful to have a meeting with the baby doctor during the course of the pregnancy.

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