Pregnancy

Exercise Guidelines | Medications | Food Guidelines | VBAC | When To Call Your Doctor

Exercise Guidelines

General Information

  • Regular exercise of at least 3 times per week is preferable to intermittent activity.
  • Maximum maternal heart rate should not exceed 140 beats per minute (bpm).
  • Each exercise period should begin with a 5 minute warm-up, and end with a 10 to 15 minute cool down.
  • Deep flexion or extension of joints should be avoided due to connective tissue laxity.
  • Strenuous activity should not exceed 15 minutes in duration.
  • No Exercise should be performed in the supine position after 16-18 weeks gestation.
  • Maternal core body temp should not exceed 38 degrees C.

Jogging

  • Do not begin a jogging program while pregnant due to increased risk for musculoskeletal injuries.
  • If already involved in a jogging program, reduce mileage to less than 2 miles per day.
  • During times of high temperature and/or humidity, do not exercise.
  • Give special attention to terrain and running surfaces due to connective tissue changes associated with pregnancy and the potential for injury.
  • Wear running shoes with proper support.
  • If unable to jog, brisk walking may be suitable replacement exercise.

Aerobics

  • Aerobic programs should be tailored to the unique needs of the pregnant women to avoid injury to connective tissue.
  • Avoid hard surfaces, with no exercises performed in the supine position.
  • Limit repetitive movements to 10.

Swimming

  • The respiratory changes of pregnancy may make swimming difficult in late pregnancy.
  • Callisthenic movements in water are valid for maintenance of strength and flexibility.
  • Avoid swimming in water that is either too hot or too cold.
  • Jacuzzi temperatures above 38.5 degrees C should be avoided.
  • Lap swimming is a good means of maintaining aerobic capacity.

Bicycling

  • Use of a stationary bike for exercise can be started during pregnancy.
  • The stationary bike is preferable due to weight and balance changes during pregnancy.
  • Bicycling may cause low back stress, which may be reduced by using a more upright position.
  • Bicycling should be avoided out of doors during times of high temperature and high pollution.

Warning Signs - Women should be instructed to stop exercising and contact their healthcare provider if any of the following should appear:

  • Pain
  • Bleeding
  • Shortness of Breath
  • Pubic Pain
  • Dizziness
  • Faintness
  • Back pain
  • Difficulty Walking
  • Palpitations
  • Tachycardia (rapid heart rate)

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Medications

Over the Counter Medications Approved For Use During Pregnancy

**Do NOT use anything that contains PHENYLEPHRINE & PSEUDOEPHEDRINE**

** If you are a DIABETIC Patient, please check with your Provider First **

Pain relief, Headaches, Fever:

Acetaminophen, Tylenol, Anacin Aspirin-FREE

Upset Stomach, Heartburn, Gas, Reflux:

  • Antacids for Heartburn:
    Maalox, Mylanta, Rolaids, Tums, Riopan, Gelusil
  • Simethicone for Gas Pains:
    Gas-X, Maalox Anti-Gas, Mylanta Gas, Mylicon
  • Nausea or Upset Stomach:
    Emetrol, Unisom (sleep aide) generic-Doxylaine Succinate
  • Gastric Reflux:
    Pepcid AC, Zantac 75, Tagamet HB, Prilosec OTC

Sinus Problems:

Chlortrimeton,Tylenol Sinus, Claritan, plain Benadryl, Guaifenesin, Mucinex

Minor Sore Throat:

Chloraseptic Throat Spray, Throat Lozenges

Cough- Productive or Non-Productive:

  • Expectorant: Guaifenesin (Hytuss, Mucinex, Robitussin, Naldecon Senior Ex)
  • Cough Suppressant: Dextromethorphan (Benylin Adult, Robitussin Maximum Strength, Scot-Tussin DM, Vicks 44 Cough Relief)
  • Guaifenesin Plus Dextromethorphan: Benylin Expectorant, Robitussin DM, Vicks 44 E
  • Cough Drops, Vicks Vapor Rub

** AVOID Cold remedies that contain Alcohol. Also AVOID the Decongestants, Pseudoephedrine and Phenylephrine, which can affect blood flow to the Placenta and are NOT recommended for patients with High Blood Pressure!**

Allergy Relief:

  • Antihistamine: Chlorpheniramine (Chlor-Trimeton Allergy Tablets)
  • Antihistamine: Loratadine (Alavert, Claritan, Tavist ND, Triaminic Aller-Chews)
  • Antihistamine: Diphenhyhydramine (Banophen, Benadryl, Diphenhist, Genanist)

Diarrhea:

Loperamide Anti-Diarrhea medication ( Imodium AD, Kaopectate II, Maalox Anti-Diarrheal, Pepto Diarrhea Control )

** BRAT Diet to help bulk stools: Bananas, Rice, Applesauce, Toast **

Constipation:

  • Psyllium: Konsyl-D, Metamucil, Modane Bulk, Perdiem
  • Methylcellulose: Citrucel, Unifiber
  • Polycarbophil: Equalactin, Fiber-Lax, Fiber Norm, Konsyl-Fiber, Mitrolan
  • Laxatives/Stool Softners: Colace, Ducolax, Malt Supex, Milk of Magnesia

** Foods to Increase FIBER- dried beans, oats, oat bran, rice bran, barley, citrus fruits, apples, strawberries, peas, pears, potatoes, carrots, dried prunes, Uncle Sam’s Cereal**

Hemorrhoids:

Anusol, Preparation H, Preparation H Medicated Wipes, Tucks Medicated Pads, and warm soaks in the bath tub

Yeast Infections and other Fungal Infections such as Athlete’s Feet:

Yeast Infection:

  • Clotrimazole: Cruex, Gyne-Lotrimin 3, Lotrimin AF, Mycelex 7
  • Miconazole: Desenex, Femizol-M, Micatin, Monistat 3
  • Tioconazole: Monistat 1, Vagistat 1
  • Butoconazole: Femstat 3, Mycelex 3
  • Butenafine: Lotrimin Ultra

Athlete’s Feet:

  • Terbinatine: Lamisil AT
  • Tolnaftate: Absorbine Athlete's  Foot cream, Absorbine Footcare, Genaspor, Tinactin 
  • Undecylenic Acid: Cruex, Desenex, Fungi Cure, Tinacide

**Certain Cruex, Desenex, and Fungi Cure products may contain other antifungal agents NOT listed here and should NOT be used during pregnancy. Check labels CAREFULLY! **

Insomnia:

  • Diaphenhydramine: Benadryl, Maximum Strength Unisom Sleep Gels, Nytol, Sominex
  • Doxylamine Succinate: Unisom Night-Time Sleep Aide

First-Aid Preparations:

Cortaid, Lanacort, Polysporin

Lice Treatment:

Nix Lice Treatment

Poison Ivy:

Cortisone Cream, Benadryl Cream, Calamine Lotion

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Food Guidelines

From the FDA: “Fish and shellfish are an important part of a healthy diet. Fish and shellfish contain high-quality protein and other essential nutrients, are low in saturated fat, and contain omega-3 fatty acids. A well-balanced diet that includes a variety of fish and shellfish can contribute to heart health and children's proper growth and development. So, women and young children in particular should include fish or shellfish in their diets due to the many nutritional benefits.

However, nearly all fish and shellfish contain traces of mercury. For most people, the risk from mercury by eating fish and shellfish is not a health concern. Yet, some fish and shellfish contain higher levels of mercury that may harm an unborn baby or young child's developing nervous system. The risks from mercury in fish and shellfish depend on the amount eaten and the levels of mercury in the fish and shellfish. Therefore, the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) are advising women who may become pregnant, pregnant women, nursing mothers, and young children to avoid some types of fish and eat fish and shellfish that are lower in mercury.”

Do not eat fish containing high levels of mercury:

  • Shark
  • Swordfish
  • King Mackerel
  • Tilefish

Eat 2 meals a week of a variety of fish and shellfish that are lower in mercury, such as:

  • Shrimp
  • Canned light tuna
  • Salmon
  • Pollock
  • Catfish

Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don't consume any other fish during that week.

FAQ

What is mercury?

Mercury occurs naturally in the environment and can also be released into the air through industrial pollution. Mercury falls from the air and can accumulate in streams and oceans and is turned into methylmercury in the water. It is this type of mercury that can be harmful to your unborn baby and young child. Fish absorb the methylmercury as they feed in these waters and so it may build up in them. It builds up more in some types of fish and shellfish than others, depending on what the fish eat, which is why the levels in the fish vary.

I'm a woman who could have children but I'm not pregnant - so why should I be concerned about methylmercury?

If you regularly eat types of fish that are high in methylmercury, it can accumulate in your blood stream over time. Methylmercury is removed from the body naturally, but it may take over a year for the levels to drop significantly. Thus, it may be present in a woman even before she becomes pregnant. This is the reason why women who are trying to become pregnant should also avoid eating certain types of fish.

Is there methylmercury in all fish and shellfish?

Nearly all fish and shellfish contain traces of methylmercury. However, larger fish that have lived longer have the highest levels of methylmercury because they've had more time to accumulate it. These large fish (swordfish, shark, king mackerel and tilefish) pose the greatest risk. Other types of fish and shellfish may be eaten in the amounts recommended by FDA and EPA.

What about fish sticks and fast food sandwiches?

Fish sticks and "fast-food" sandwiches are commonly made from fish that are low in mercury.

The advice about canned tuna is in the advisory, but what's the advice about tuna steaks?

Because tuna steak generally contains higher levels of mercury than canned light tuna, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of tuna steak per week.

What if I eat more than the recommended amount of fish and shellfish in a week?

One week's consumption of fish does not change the level of methylmercury in the body much at all. If you eat a lot of fish one week, you can cut back for the next week or two. Just make sure you average the recommended amount per week.

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VBAC

Our providers support vaginal birth after cesarean section if desired and when appropriate. If you are interested please discuss with your provider. We will review the circumstances around your delivery by cesarean section and look at other risk factors to provide you our best prediction for your likelihood for success. In most incidences, this option is available to women who have had only 1 cesarean section.

We will need to review your dictated operative note from your prior delivery, so please bring a copy or the name and address of the hospital where your cesarean section was performed. As our office is adjacent to Overland Park Regional, we prefer to do these deliveries at OPR, so we can be more available.

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When To Call Your Doctor

If you experience any of the following before 37 weeks:

  • Persistent vomiting
  • Six or more contractions in one hour
  • Leaking of fluid or sudden gush from vagina
  • Any vaginal spotting or bleeding
  • Unusual or severe discomfort
  • Fever greater than 100.6 degrees C, especially if associated with abdominal pain
  • Rhythmic back pain or pelvic pressure, low dull backache, menstrual-like cramps, abdominal or pelvic cramping
  • A noticeable decrease in fetal movement. (28 weeks or beyond) (Less than 4 movements per hour or less than 10 movements in 2 hours)
  • Swelling of hands, face, legs, and feet
  • Painful urination

If you experience any of the following 37 weeks or beyond:

  • Regular, painful contractions, every 3 to 5 minutes apart (1st time mothers). If this is not your first child, call when your contractions are 5 minutes apart, lasting 60 seconds. If you have a history of very rapid labors, discuss this with your healthcare provider
  • Leaking of fluid, regardless of the presence or absence of contractions
  • Any significant amount of vaginal bleeding. A small amount of mucous, bloody show is normal. (If bleeding is like a menstrual cycle or heavier or wearing a maxi paid is required then please contact our office)
  • Fever greater than 100.6 degrees, especially if associated with abdominal pain
  • A noticeable decrease in fetal movement. It is a wives tale that decreased fetal movement is normal right before the onset of labor. Call for any noticeable decrease in fetal movement. (Remember, the baby can be more difficult to feel as you get closer to your due date. Make sure you are in a quiet place, free of distractions when trying to assess the amount of movement)
  • Visual disturbances: Dizziness, double vision, spots before eyes
  • Severe headache
  • Swelling of hands, face, legs, and feet
  • Painful urination

Post Partum:

  • Fever greater than 100.6 degrees, especially if associated with abdominal pain or increased bleeding or breast pain
  • Bleeding that consistently gets heavier instead of lighter
  • Worsening abdominal or episiotomy site pain
  • Foul smelling vaginal discharge
  • Unusual pain or redness of the breast(s)
  • Pain or difficulty with breast-feeding

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Overland Park Office
10550 Quivira, Ste.410
Overland Park, KS 66215
913.541.0990
Lawrence Office
3510 Clinton Place Ste. 310
Lawrence, KS 66047
785.841.0326
Shawnee Mission Office
8800 W. 75th Street, Suite 320
Shawnee Mission, KS 66204
913.362.2229
785.841.0326