Will eating fish and seafood during pregnancy harm my unborn baby?

Some varieties of fish may be contaminated with mercury (or “PCBs”), because of environmental pollutants. Larger, long-lived fish contain the highest levels of mercury. Mercury (which accumulates in the skin and fat in fish) has been found to cause cancer and it also crosses the placenta and can be harmful to unborn babies.

Pregnant women are advised to avoid eating shark, swordfish, king mackerel and tilefish (also called golden or white snapper). Limit tuna steak and albacore “white” tuna to one serving a month and canned light tuna to one 6-ounce can a week. Never eat raw or undercooked fish or shellfish such as oysters, clams, mussels or sushi, which may contain bacteria including salmonella and hepatitis A.

Always cook or freeze fish to kill possible parasites. It is recommended that fish be cooked to 140 degrees Fahrenheit or frozen for at least a week at -10 degrees Fahrenheit, which will kill most parasite larvae.

What in the world is “Kegel” exercises?

Kegel exercises (or “pelvic floor muscle exercises”) are a series of simple internal exercises done to strengthen and tone the muscles in your vaginal, rectal and perineal area. Your pelvic floor muscles may be stretched and weakened as a result of pregnancy and birth, which may result in uncontrollable incontinence.

By doing Kegel exercises daily during pregnancy, you can prepare your muscles for delivery and have a faster recovery postpartum. To perform Kegel exercises, identify your vaginal muscles by starting and stopping urination. When you stop your urine, you have located the correct muscles. Tighten the muscle for a count of four and relax for a count of four, over and over again. Repeat these exercises 2-3 times a day for five minutes.

Is it alright to sleep on my stomach while I’m pregnant?

During the first trimester, any sleep position is alright. But after 12 weeks or so, lying on your stomach may put pressure on your unborn baby and should be avoided when possible. Besides that, it can put added strain on your neck and back, causing pain.

Early in pregnancy, you’ll need to get used to sleeping on your side, which is the best position for pregnant women, especially the left side, which allows maximum blood flow to your baby and also keeps your baby’s weight from applying pressure to the inferior vena cava (the large vein that carries blood back to your heart). In addition, lying on your side will help take pressure off your back. Place pillows between your knees and one behind your back for extra support and to keep you from rolling during the night. Special “pregnancy pillows” may help even more.

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Can taking castor oil to induce labor harm my baby?

There is a debate over whether or not taking castor oil to bring on labor increases the risk of the baby having it’s first bowel movement before or during birth. A baby’s first stool is called meconium and if the baby inhales some, it can be very dangerous and can cause the baby to develop pneumonia. There is no clear evidence to support this theory as of now. A more common side effect is severe diarrhea, painful intestinal cramping (similar to food poisoning) and possibly nausea and vomiting in the mother, which can lead to dehydration. Castor oil has long been used as a strong laxative, which stimulates the bowels and bowel contractions are believed by some to help stimulate uterine contractions as well. In addition, castor oil is thought to stimulate production of prostaglandins, which induce labor. The safeness, as well as the effectiveness of castor oil to encourage the onset of labor is questionable. If you are overdue, your doctor or midwife can advise you on safer, gentler alternatives, if necessary. Effective induction methods include cervical prostaglandin suppositories or gel and rupturing the membranes.

My shoes don’t fit now that I’m in my third trimester. Should I be concerned?

It’s very common for women’s feet to get larger during pregnancy and for their shoe size to change. Besides not being able to fit into any of your pre-pregnancy clothes, your shoes are likely to feel snug now due partly to edema (swelling), caused by fluid retention, which tends to increase during the third trimester. Another reason for your foot expansion is after the second trimester, your body starts producing a hormone called relaxin, to prepare your body for delivery by loosening and softening up the ligaments in your pelvis to help accommodate passage of your baby through the birth canal. Relaxin loosens up other joints throughout your body as well, including your feet, which are particularly affected, causing them to slightly lose their arch and spread. In most cases, your feet will return to normal after the birth of your baby, although some women notice a half size difference. Even though this is a natural part of pregnancy, you need to take care of your feet by elevating them whenever possible and drinking plenty of fluids throughout the day to reduce edema. Orthopedic shoe inserts may be necessary to help support your falling arch. To be more comfortable, wear slip-on shoes that aren’t too tight and if you go shoe shopping, go later in the day, because feet tend to swell more as the day goes on, so the same shoes that feel comfortable in the morning, may be too tight in the evening.

Can you tell me what “nesting instincts” are?

Nesting instincts refer to the burst of energy that typically happens sometime during the ninth month of pregnancy and sometimes during the onset of labor. You may feel the uncontrollable need to rush around and take care of any unfinished business in preparation for your baby’s arrival. A day of preparing for your baby’s birth gives you the sense of accomplishment as well as a healthy diversion from the boredom that commonly is associated with the endless final weeks of pregnancy. Good projects include washing and folding baby clothes, sewing something for baby, setting up the nursery and shopping for baby items, although don’t overdo it to the point where you become exhausted.

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Cats, Ultrasounds and First Movements
Fish, Exercising and Sleep
Sex, Cesarean and Back Labor
Tanning Beds, Weight Gain and Areola Changes
Castor Oil, Smaller Shoes and Nesting Instincts
First Prenatal Visit

What happens at a first prenatal visit?
Your first prenatal visit will be longer and more involved than subsequent visits. Your doctor or midwife will likely ask you questions about your personal and family medical history, your partner’s medical history, as well as any concerns you may have.

Questions may cover issues such as any medications you are taking, known allergies or health problems, your menstruation history (including the date of your last menstrual period, so your due date can be determined), previous pregnancies (or miscarriages), ethnic background of you and your partner, your diet, recent birth control methods and any current or past habits (such as alcohol and drug use, as well as smoking).

Many times you can expect a complete physical exam at your first visit, including a pelvic exam and pap smear, if you haven’t had one recently. Your blood pressure will be taken, your weight and height will be noted and you’ll be asked to give a urine sample to test for sugar, protein and bacteria. Usually, a variety of routine blood tests will be done to identify your blood type, Rh factor (positive or negative) and whether you’re deficient in iron, which can lead to anemia. Blood tests may include checks for STDs such as syphilis, herpes and hepatitis B, even if you are low-risk for these diseases.

You may be given tests for rubella (German measles) immunity and human immunodeficiency virus (HIV) as well. All women should be offered HIV testing in pregnancy.

Occasionally, an ultrasound may be done routinely at the first visit, depending on the clinic you go to. Your first prenatal visit should be scheduled as soon as you suspect you are pregnant. Doctors and midwives usually want to see you before your 10th week, ideally between the 7th and 8th week of pregnancy. After your initial visit, you’ll go in once a month until your third trimester.

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First Prenatal Visit

Is it safe to have sex during the last trimester?

In most cases, it’s safe to continue to make love throughout pregnancy, up until your water breaks, but it’s a good idea for all couples to check with their doctor or midwife. Intercourse won’t rupture membranes and there’s no significant evidence that it causes premature labor in the last three months, as long as your pregnancy is uncomplicated and you have no history of preterm labor. You may have heard that the hormone prostaglandin (sometimes used to soften the cervix in early labor) is present in semen and could cause you to have your baby prematurely, but semen only contains very small amounts, which will not bring on labor. This may be disappointing news to some women who are close to their due dates or are overdue, who wish to trigger labor.

How can I avoid a cesarean birth?

Many women who have cesareans have had one previously, so the best way reduce your chances is by trying to avoid the first. The doctor or midwife you choose will be a key to avoiding an unnecessary cesarean. Find one that has a low cesarean rate and ask them about their philosophy on cesareans, when interviewing potential doctors or midwives. By avoiding an epidural or waiting until you are past 5 centimeters dilated, you can reduce some of the risk of a cesarean, because epidurals can slow labor down. During labor, avoid lying on your back for extended periods of time and try changing positions every 15- 30 minutes if possible. Lying on your back can make contractions less effective, causing labor to be prolonged, which could lead to a cesarean. Walking, squatting and any other position which allows gravity to help is best. Find a labor support person (or doula), who can provide continuous support during labor. This can also significantly reduce the risk of a cesarean.

What is back labor?

Back labor is when you feel the most pain and pressure in your lower back, just above your tailbone, during labor. Many times this is caused from the baby being in a posterior position (facing the mother’s abdomen, rather than facing down) in the birth canal. The first thing to do to relieve pain (as well as possibly encourage your baby to rotate) is to get off your back. Change positions frequently. Different positions can sometimes give the baby more room to turn. Counter-pressure may be helpful to lessen the pain of back labor. Have your partner or support person apply firm pressure to your lower back, using a tennis ball or their hands. Warm baths, showers and hot water bottles can be a relief also.

Menstrual Periods, Drinking and Hair Dye
Cats, Ultrasounds and First Movements
Fish, Exercising and Sleep
Sex, Cesarean and Back Labor
Tanning Beds, Weight Gain and Areola Changes
Castor Oil, Smaller Shoes and Nesting Instincts
First Prenatal Visit

I’ve heard it’s not safe to change my cat’s litter box. Why is that?

Cat feces may sometimes contain a parasite that causes toxoplasmosis. Toxoplasmosis can be very dangerous during pregnancy, posing serious risks to your unborn baby including miscarriage, stillbirth, premature delivery, mental retardation, blindness and other disabilities. Have someone else clean the litter box during your pregnancy, but if that’s not possible, always wear rubber gloves and wash your hands thoroughly when finished. Keep your cats indoors, so they won’t pick up the parasite if they don’t already carry it. An automatic litter box, which pretty much cleans itself, may be a great solution.

When will I get an ultrasound?

The majority of women will have their first ultrasound (or “sonogram”) early in the second trimester, usually between weeks 18 and 20 of pregnancy. This is the most common time for accurate detection of most major abnormalities and malformations and has generally become a matter of routine practice. Many centers are now performing ultrasounds at about 13-14 weeks to aid in diagnosis of Down Syndrome. Some doctors and midwives routinely do ultrasounds at about 7 weeks to confirm pregnancy, exclude ectopic pregnancy and measure crown-to-rump length for dating, while others only do first trimester ultrasounds if bleeding is present, an ectopic pregnancy is suspected or to get more accurate dating of the pregnancy. Additional ultrasounds will be ordered separately if an abnormality or problem related to your pregnancy is suspected.

When can I expect to feel my baby’s first movements?

Most women begin to notice gentle fluttering sensations (first movements are called “quickening”) around their 18th week of pregnancy. For first pregnancies, sometimes movements aren’t felt until a little later, possibly as late as the 22nd week of pregnancy. For subsequent pregnancies, occasionally movements can be felt as early as the 15th week. Second or third-time moms tend to feel movements and kicks earlier, because their uterine muscles are not as tight as they were the first time around and because movements are more easily recognized in subsequent pregnancies. Also, thinner women tend to feel movement earlier than overweight women on an average.
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