Pregnancy

Choosing an obstetrician is one of the first important decisions you will make as an expectant parent. You need a medical practice where you feel welcome, and where you are comfortable asking questions and expressing concerns. North Spokane Women’s Health offers the highest level and most up to date care for both routine and high-risk pregnancies. We also offer on-site ultrasonography and Non Stress Testing.

We invite you to allow North Spokane Women’s Health to provide you with a practice where you will feel at home. Should you have any other questions, or if you want to come in for a consultation, please call. Thank you for allowing us to be a part of your pregnancy!

Common Questions Contact Us

COMMON THINGS TO AVOID

Alcohol, any illegal drugs, cigarettes and birth control pills. Studies have determined that the above substances can result in premature birth, low birth weight and/or increased chance of miscarriage or birth defects.

Discuss all other drugs, over the counter medications and herbal remedies with your obstetrician.

Many food supplements have not been adequately studied to determine safety in pregnancy.

Doxycycline, Minocin or Tetracycline types of antibiotics.

Aspirin, Ibuprofen, Naproxen and 1-day yeast medications.

Nitrous Oxide during a dental visit.

Common Questions

Click a Quick Link to reference information about pregnancy warning signs, normal changes to expect, things to avoid, nutrition, and other helpful hints.

PREGNANCY WARNING SIGNS

Persistent nausea or vomiting interfering with adequate food or fluid intake
Any bleeding except spotting after vaginal exam
Leaking or gushing of fluid from the vagina
Severe, persistent headaches not relieved by Tylenol
Disturbance of vision, i.e., spots, flashes of light or blind spots
Pain or burning with urination
Severe shortness of breath
Irritating vaginal discharge or sores near the vaginal opening
Abdominal pain and/or cramping lasting longer than one hour
Severe dizziness or fainting
Temperature over 101 degrees F.
Cramping, contractions, tightening or pressure occurring in a regular pattern
No fetal movement or decrease in fetal movement after 28 weeks of pregnancy
Sudden swelling or weight gain
Sudden decrease in urinary output, fever or backache

NORMAL CHANGES

Early changes:

Mild increased vaginal discharge without itch or irritation
Increased thirst and/or salivation
Fatigue and/or inability to sleep
Changes in food preference and appetite
Darkening of pigmented areas of skin or striae (stretch marks)
Ligament pain and pressure in back, groin and pelvis
Cessation of menstruation
Weight gain
Mild nausea and/or vomiting
Breast changes (growth & tenderness)
Mood swings
Mild headache
Nose bleeds

Later changes:

Quickening around 4-5 months (fetal movement)
Abdominal enlargement due to uterine expansion
Uterine contractions (Braxton-Hicks)
Hemorrhoids
Breast enlargement
Inability to sleep
Generalized aches and pains, particularly in the hips and pelvis
Mild shortness of breath
Back pain

APPROVED MEDICATIONS DURING PREGNANCY

Iron supplements for anemia
Regular or extra strength Tylenol or acetominophen for pain, fever, flu or headaches
Bran, extra water, fruits and vegetables, Citrucel, Metamucil or Docusate Sodium, 100 mg. forconstipation
Tylenol Cold/Sinus, Chlor-Trimeton 4 mg., Benadryl 25 mg., Claritin 10 mg., Sudafed, Actifed, Vicks VapoRub, Robitussin, cough drops without zinc or Echinacea and Saline Nasal Spray for a common cold, sore throat or cough (after 1^st trimester)
Monistat and Gyne-Lotrimin 3 or 7-day treatment for a yeast infection (after 1^st trimester)
Imodium (if after the 1^sttrimester) for diarrhea
Simethicone (if after the 1^sttrimester) for gas pain
Erythromycin, Penicillin, Cephalosporin or Macrodantin antibiotics by prescription only
Calcium supplements (not dolomite calcium or oyster shell)
Prenatal vitamins

NUTRITION

Your diet should be balanced in food groups with not more than 30% fat and minimizing unnecessary carbohydrate intake. Anticipated weight gain should be 25-35 pounds if your weight is normal. If you are 20% or more overweight suggest 0-15 pounds. If you are less than 110 pounds suggest 35-45 pounds.

A reduction in salt intake is very important. Do not add table salt, reduce fried foods and eat plenty of fresh fruits and vegetables. Avoid sweets, starchy foods and sodas containing caffeine.

Protein intake should consist of lean meats, cheese, eggs, legumes, fish and cooked seafood. However, fish and shellfish should be limited to 12 ounces per week of store bought fish or six ounces of fresh-caught or freshwater fish. Do not eat shark, swordfish, king mackerel, tuna steaks or tilefish secondary to mercury content.

Cheeses should be limited to hard or processed cheese, such as cottage cheese or cream cheese. Avoid soft cheeses such as Brie, feta and blue-veined cheeses. Do not drink unpasteurized milk, or eat cold hot dogs, cold cuts, lunch meats, pates, meat spread or smoked seafood (unless cooked to steaming hot before eating) due to a potential bacterial infection called Listeria.

Skim milk and green leafy vegetables should be incorporated into your diet. Fresh fruits and vegetables should be washed and kept separate from raw meats.

Use separate cutting boards, knives and containers for uncooked meats, vegetables and ready-to-eat foods. Wash hands, knives and cutting boards after handling.

For more information on food safety of food borne illnesses you can contact the CDC or the US Food and Drug Administration.

STANDARD TESTS PERFORMED

Blood tests are done at the initial visit to determine Rh and blood type, rubella immunity, blood count and thyroid condition. We also test for Syphilis, Hepatitis, and HIV. The results take one to two weeks.

Urine screens are periodically performed to check for protein and sugar.

Ultrasounds are done to determine viability and fetal age at the first doctor visit. At 11-12 weeks, if desired, to check for increased risk of specific birth defects. At 18-20 weeks for placenta placement, position and anatomy. Ultrasounds performed at a different location will be discussed at the patient’s next visit unless there are problems and then the doctor will discuss the results with the patient right away.

Gestational Diabetes/Glucola screening is done between 24-28 weeks. Please allow four days for the results.

Group B Beta-Strep testing is done at 36 weeks. If this tests positive, it means antibiotics will be given during delivery to prevent pneumonia in the baby.

Quad/integrated Prenatal Risk Screens are offered as first and second trimester blood tests to check for increased risk of birth defects such as spina bifida, Down’s syndrome and Trisomy-I 8. The results are available approximately 7 days after the second blood test.

Amniocentesis may be recommended if you are over the age of 35 or you or your partner have a family history of genetic problems.

Rubella Immunization will be advised following delivery if you are not immune.

RhoGAM is given to women who are Rh-negative at 28 weeks and after delivery. It may also be given for bleeding during one’s pregnancy, early second trimester, miscarriage or ectopic pregnancy.

Non-stress Tests (Fetal Heart Rate Monitoring) may be recommended to determine the health of the baby and placenta.

Genetic Counseling may be recommended if there is a family history of genetic abnormalities, advanced maternal age or prior child with defects.

Cystic Fibrosis screening tests are available to see if one or both parents carry the gene.

NAUSEA AND VOMITING

Nausea and vomiting may exist until around the 14^th week of pregnancy. It may be worse in the morning, but unless it is excessive or interferes with adequate food retention, should not be cause for alarm.

Eating a few dry crackers before getting out of bed may decrease the nausea. A daily walk in the fresh air should help. Avoid strong odors and avoid rich, spicy, fatty and fried foods.

Eat multiple small snacks during the day rather than a few large meals and drink at least eight ounce glasses of water, milk or juice each day to stay hydrated.

PREGNANCY VISIT AND FEES

Please make regular appointments every four weeks for the first seven months, then at two-week intervals during the eighth month and weekly appointments during the ninth month of your pregnancy. Try to schedule at least three months in advance.

The global obstetrical fee refers to the professional component for services rendered by your primary obstetrician. This includes routine obstetrical visits; their services for labor and delivery and the routine postpartum care for six weeks following delivery. In the event of a “high risk” delivery the global charge will be higher. Tests, the laboratory fee, anesthesiologist, pathologist, hospital and other outside resources are additional charges.

If you have any questions, please call one of our bookkeepers, the hospital billing department, and check your benefits with your insurance company.

OTHER HELPFUL HINTS

Dental Procedures can be performed under local anesthesia with Novocain without epinephrine.

Prenatal Exercise: Stay hydrated and attempt to keep your pulse under 140 beats per minute. Low impact exercise is encouraged. Swimming and running are acceptable as long as you are used to doing it and feel comfortable. Stretch well to avoid back or ligament injury. Avoid shortness of breath. Horseback riding, water-skiing or wakeboarding, contact sports or other rough activities are not recommended. If there is a suspicion of premature labor, ruptured membranes or bleeding, please contact your physician for activity restrictions.

Tanning Booths should be avoided during pregnancy, as the risk is unknown.

Paint: Latex paint is fine with adequate ventilation.

Hot Tubs and Saunas: Avoid overheating the body. The water temperature should be less than 100 degrees. If you feel over-heated, exit the tub or sauna until you have cooled down.

Permanents & Hair Coloring: These are acceptable during pregnancy; however, be sure to inform your stylist of your pregnancy as some changes with your body may affect your hair.

Varicose Veins may appear at any time in pregnancy. Support stockings are available over the counter and by prescription, so ask your doctor to advise you on which you should obtain.

Inverted Nipples: If you are planning to breastfeed, check with your doctor on what you can do prior to delivery to help the breastfeeding process.

Intercourse throughout an uncomplicated pregnancy is acceptable. Avoid douching or other activity that may increase the air pressure in the vagina and discuss any concerns with your obstetrician.

Travel: There is no known harm from commercial air travel during a normal pregnancy. However, it is best to be close to the hospital when you are nearing full term. Some physicians restrict air travel after the 32nd week of pregnancy.

Avoid prolonged sitting. Try to walk around every 60 minutes. This is especially important in the third trimester.

Keep well hydrated and wear loose shoes as your feet may swell.

Pediatrician Services should be arranged prior to delivery.

Infant Car Seats are required by law. Please be prepared to transport your newborn home from the hospital in a safety device.

Hospital Classes & Tour are recommended. This helps to learn where to park, where the appropriate entrance for Labor & Delivery is located, and can help answer a variety of pregnancy and postpartum questions. We recommend Childbirth Education classes through our office with our registered nurse and childbirth educator, Linda Peterson @ 466-6508 for information.

Pre-registration to the hospital is also very important to reduce delays once you are in labor and arrive at the hospital.

Labor: Labor at full term is characterized by rhythmic (regularly spaced) contractions occurring every 3-8 minutes and lasting 30-60 seconds. Contractions are usually strong enough to interrupt your ability to walk or talk.

Premature labor (prior to full term) can be completely painless and might only feel like a rhythmic tightening of the uterus or mild pressure.

Sometimes the first event marking the onset of labor is leakage of the bag of water. This can occur without any contractions and should be reported as soon as you are aware of it. Usually the water is clear but it can also be green, yellow or brown. Be sure the fluid does not have a urine odor, as inadvertent urinary leakage is common as the baby puts more pressure on your bladder.

Be sure to call if you experience any bleeding, as that could be a sign of a problem. Do not confuse “a jelly-like, blood-colored discharge” with bleeding. This is the “mucous plug” or “bloody show” and its passage carries no significance near term.

Some women in labor do not have these classic signs, as there is a great variability to the labor process. Please always call if you have any concerns or questions.

When you contact our office, please let us know that you are in labor so we can give priority handling to your call. After hours, you will reach a recording that asks you to call 482-2229 to reach the physician on call.

“I was very pleased and grateful for the assistance and care I received when I was pregnant as well as through the delivery process. My doctor is an exceptional doctor. He truly cares about his patients. He makes you feel well cared for and he listens to your concerns.”