Questions to Ask Your Doctor, by Trimester

As you prepare for the arrival of your little one, it's normal to have a lot of questions, even before your first prenatal appointment. Write them down! It can be helpful to have a list of questions ready to take with you to your first prenatal visit (especially if you're a first-time mom). Here are some pregnancy questions you can add to your list for your doctor. 

FIRST TRIMESTER:

What can I do to help relieve morning sickness?

It’s important to rest and keep hydrated. Small, frequent volumes of fluid are better than trying to drink large amounts at once. Having an empty stomach can worsen nausea. You can avoid this by eating small, frequent meals as tolerated, such as crackers or biscuits. Natural remedies for morning sickness include water, ginger, inhaling lemon or peppermint essential oils, vitamin B6, and acupressure.

Unisom (doxylamine) is an over-the-counter antihistamine that can also be used. The recommended dose is 12.5 mg, which is a half tablet. The main side effect of Unisom is sleepiness, so it might be best to take it at night. Diclegis is a prescription drug that can be prescribed by obstetricians for severe symptoms of morning sickness, when lifestyle changes do not work.

How much weight should I gain during pregnancy?

It all depends on your pre-pregnancy weight. Recommendations for pregnancy weight gain are as follows:

Average weight: 25-35 lbs.

Underweight: 28-40 lbs.

Overweight: 15-25 lbs.

Obese: 11-20 lbs.

Keep in mind that it’s normal for mothers who are pregnant with multiples (twins or triplets) to gain additional weight.

What vitamins or supplements do I need to take?

Pregnant moms should take a vitamin that contains both Vitamin D (600 IU) and folic acid, which is also called folate (400 mcg). Vitamin D and folate are found in almost all prenatal vitamins. It’s also important that one’s diet contains sources of iron, calcium, and other vitamins. Pregnant women who adhere to special diets may need additional supplements during pregnancy. For example, moms who are vegans may need extra Vitamin B12 and those who are lactose intolerant may need calcium supplementation.

What medications and supplements should I avoid while pregnant?

Common prescribed and over-the-counter medications to avoid while pregnant include:

  • Aspirin, ibuprofen (Motrin, Aleve), and naproxen
  • Phenylephrine, pseudoephedrine (Sudafed), and other similar decongestants
  • Bismuth subsalicylate (Pepto-Bismol)
  • Isotretinoin (formerly sold as Accutane, now Absorica, Amnesteem, Claravis, Myorisan, Zenatane) taken for acne

Herbs to avoid include saw palmetto and passionflower. For a full list of potentially harmful herbs please refer to the American Pregnancy Association’s website.

The bottom line is that you should always talk to your healthcare provider, ob-gyn or midwife about the safety of any medications or supplements that you are taking during pregnancy! This is an important question to ask to help you have a healthy pregnancy. 

Do I need to avoid anything else?

Yes, pregnant women should avoid all of the following:

  • Alcohol and marijuana
  • Smoking and vaping
  • Fish that contain high levels of mercury. These include shark, swordfish, king mackerel, orange roughy, and tilefish. Limit white (albacore) tuna to 6 ounces a week.
  • Unpasteurized milk and foods
  • Hot dogs, luncheon meats, and cold cuts (unless they are heated until steaming hot just before serving)
  • Refrigerated pate, meat spreads, and smoked seafood
  • Raw and undercooked seafood, eggs, and meat
  • Changing cat litter boxes (due to risk of a parasite called toxoplasmosis)

SECOND TRIMESTER:

Can I still drink coffee?

Drinking up one cup of coffee (12 oz.) per day is safe throughout pregnancy. It’s important to remember, though, that caffeine can be found in other foods and beverages including soda, chocolate, tea, energy drinks, and coffee-flavored ice cream. Overall caffeine intake should be limited to less than 200 mg/day.

Can I keep getting my hair dyed or highlighted?

Hair coloring is considered safe as there is very little coloring product absorbed into one’s bloodstream through the scalp. However, women with open wounds on the scalp (i.e. cuts and abrasions) should avoid having their hair colored due to an increased risk of hair color absorption. Some women choose to be on the safe side and wait until the second trimester to resume hair coloring or highlighting. Chemical hair straightening should be avoided due to exposure to a chemical called formaldehyde that can harm a developing fetus.

What should I do for exercise?

Experts recommend that women should be physically active at least 30 minutes 3x per week throughout pregnancy. But what kind of exercise is safe? Walking, yoga, pilates, and/or swimming or all good options.

Activities that contain sudden jumps or stops and high-impact exercises should be avoided.

The American Congress of Obstetricians and Gynecologists (ACOG) recommends avoiding all contact and extreme sports during pregnancy, as well as scuba diving. Also, it’s recommended that you avoid lying flat on your back during exercise for prolonged periods of time as this position may interfere with blood flow to the uterus.

How much water should I be drinking?

You should aim to drink at least 10 eight-ounce glasses (2.5L) of water per day throughout your entire pregnancy. Some women find that setting a timer (i.e. on their phone) can remind them to drink at regular intervals.

Is it safe to take baths while I am pregnant?  How about going into hot tubs?

It’s totally fine to swim and take baths as long as your water has not broken -- in which case you should have already been in touch with your doctor or midwife! Hot tubs should be avoided, especially during the first half of pregnancy, due to the risk of miscarriage and birth defects from exposure to high temperatures.

Third Trimester:

Why do I need the glucose tolerance test (GTT)? Is it okay to “cheat” to pass it?

The GTT is a test for gestational diabetes, which occurs in 3-6% of pregnancies. If your screen is positive you will need to take a more complicated test that involves a longer fast. You should never “cheat” on the GTT as untreated gestational diabetes (which can happen if a test is falsely negative) is associated with serious problems in newborns including abnormal growth, low blood sugar, and birth defects.

What should I do now to prepare for breastfeeding?

The 3rd trimester is a great time to learn about breastfeeding through prenatal classes, books, websites, lactation support groups, videos, and podcasts. It’s also a good time to talk to your doctor or midwife to see if you have any risk factors for low milk production. These risk factors include a medical history of breast surgery, polycystic ovarian syndrome (PCOS), hypothyroidism, diabetes, and other autoimmune diseases. Also, be sure you've applied for a free breast pump through insurance. 

There has been increased awareness in recent years of the importance of preparing for your postpartum recovery. This period of time is sometimes referred to as the “4th trimester.” The University of North Carolina’s New Moms Health is an excellent resource for helping to prepare for your postpartum recovery and 4th trimester.

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How often should I feel my baby moving?

If you’re worried that you have not felt your baby move for a while you can do a “kick count.” This involves lying down on your left side and counting how long it takes to feel your baby move 10 times. Most babies will move 10 times by the 2-hour mark, but it’s often much quicker than this. Babies are usually the most active after moms eat a meal, eat something sweet, drink cold water, or participate in physical activity.

When do I need to stop flying? When should I stop all traveling?

Airplane travel is allowed up to about 36 weeks’ gestation for domestic travel but may be earlier for international flights. Since pregnant women are at risk of forming blood clots in their legs it’s recommended to wear compression socks and perform leg and ankle exercises while on long flights to prevent the development of clots. To be on the safe side, all travel plans in your 3rd trimester, whether by air or ground, should be discussed with your obstetrician or midwife.

Do I need to get any vaccines during my pregnancy?

Per Centers for Disease Control guidelines the measles, mumps, and rubella vaccine (MMR) should be given at least one month before pregnancy. The Tdap vaccine (to help protect against whooping cough) can be given at any time during pregnancy and the flu vaccine can be given at any time if pregnant during flu season (typically late fall through spring). Additionally, it is safe to receive all vaccines right after giving birth, even if you are breastfeeding.


About the Author

Jessica Madden, MD, is the Medical Director at Aeroflow BreastpumpsDr. Madden has been a board-certified pediatrician and neonatologist for over 15 years. She's currently on staff in the neonatal intensive care unit (NICU) at Rainbow Babies and Children’s Hospital in Cleveland, OH. She previously worked in the Boston and Cleveland Clinic Children’s Hospitals. In 2018 she started Primrose Newborn Care to provide in-home newborn medicine and lactation support. She also enjoys traveling, yoga, reading, and spending time with her children.

Information provided in blogs should not be used as a substitute for medical care or consultation.

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