Common Concerns During Pregnancy

Most miscarriages occur during the first 12 weeks of pregnancy, so you may want to wait until this critical period is over before telling others of your pregnancy. However, it may be difficult to keep such a secret to yourself. If you have an ultrasound at 8 weeks of pregnancy and see a heartbeat, your chance of miscarriage is less than 2 percent, and you may feel safe sharing your news.

You should have at least three well-balanced meals every day. In general, you should eat foods that are clean and well-cooked. Avoid:

• raw meat, such as sushi
• undercooked beef, pork, or chicken, including hot dogs
• unpasteurized milk or cheeses
• undercooked eggs
• improperly washed fruits and vegetables

Foods or beverages containing aspartame, or NutraSweet, are safe in moderation (one to two servings per day), if you don’t have a disease called phenylketonuria.

Some women develop a condition known as pica, giving them unusual urges to eat chalk, clay, talcum powder, or crayons. Discuss these cravings with your doctor and avoid these substances.

If you have diabetes or are diagnosed with gestational diabetes during pregnancy, you should follow the American Diabetes Association (ADA) diet, and avoid fruits, juices, and high-carbohydrate snacks, like candy bars, cakes, cookies, and sodas.

Some doctors suggest you don’t drink any caffeine during pregnancy and others advise limited consumption. Caffeine is a stimulant, so it increases your blood pressure and heart rate, which is not recommended during pregnancy. Caffeine use can also lead to dehydration, so be sure to drink plenty of water.

Caffeine also crosses through the placenta to your baby and can affect them. It can also affect your sleep patterns, and the baby’s. There has been no definitive research linking moderate caffeine use, defined as less than five cups of coffee a day, to miscarriage or birth defects. The current recommendation is 100 to 200 milligrams per day, or about one small cup of coffee.

You should not drink any alcohol during pregnancy, especially during the first trimester. Fetal alcohol syndrome is a serious condition. It’s unknown how much alcohol consumption causes it — it might be a glass of wine a day or a glass a week. However, with the onset of early labor pains at the end of pregnancy, your doctor may suggest you drink a little wine and take a warm shower, also known as hydrotherapy. This may help ease your discomfort.

Acetaminophen (Tylenol) is generally safe to use during pregnancy, although you should consult your doctor first. You can take as much as two extra-strength tablets, 500 milligrams each, every four hours, up to four times a day. Maximum consumption per day should be limited to 4,000 mg or less. You can take acetaminophen to treat headaches, body aches, and other pains during pregnancy, but if headaches persist despite maximum doses of acetaminophen, contact your doctor immediately. Your headaches may be a sign of something more serious.

Aspirin and ibuprofen should not be taken during pregnancy unless you are specifically instructed to by your doctor. There are medical or obstetrical conditions that require aspirin or other nonsteroidal anti-inflammatory agents during pregnancy, but only under the strict supervision of your doctor.

Progesterone production in the ovaries is critical until about the 9th or 10th week of pregnancy. Progesterone prepares the endometrium, the lining of the uterus, for implantation of the pre-embryo. Soon after, the placenta will produce enough progesterone to maintain the pregnancy.

Measuring progesterone levels can be difficult, but levels below 7 ng/ml are associated with miscarriage. These levels are rarely found in women who don’t have a history of at least three miscarriages. If you have a history of miscarriage and a low progesterone level, extra progesterone as a vaginal suppository, intramuscular injection, or pill may be an option.

You should avoid hot tubs and saunas during pregnancy, particularly during your first trimester. The excessive heat may predispose your baby to neural tube defects. Warm showers and tub baths are safe and are often quite soothing for body aches.

If you have a cat, particularly an outdoor cat, let your doctor know so you can be tested for toxoplasmosis. You should not change your cat’s litter box. Also be meticulous about washing your hands after close contact with your cat or with dirt from working in the garden.

Toxoplasmosis is transmitted to humans from infected cat feces or poorly cooked meat from an infected animal. The infection can be transmitted to your unborn baby and lead to devastating complications, including miscarriage. The treatment for toxoplasmosis is complicated and requires obtaining special permission from the Food and Drug Administration (FDA) for a medication that isn’t readily available in the United States. Fortunately, most women are already immune to toxoplasmosis from prior exposures in childhood and therefore can’t be reinfected.

Domestic violence affects almost 1 in 6 pregnant women in the United States. Domestic violence increases complications during pregnancy, and can double the risk of preterm labor and miscarriage.

Many women who have been abused don’t show up for their prenatal appointments, and this is especially true if you are bruised or injured at the time of the appointment. It’s also common for a woman who is at risk for or being abused to bring her partner to her prenatal visits. An abusive partner will rarely leave a woman unaccompanied and typically attempts to take control of the meeting.

Reporting abuse

If you are in a violent relationship, it’s important to report your situation. If you have been battered before, pregnancy increases the likelihood that you will be battered again. If you are experiencing abuse, tell someone you trust to get support. Your regular checkups with your doctor may be a good time to tell them about any physical abuse you may be experiencing. Your doctor can give you information about support services and where to go for help.

Despite ongoing abuse, many women are unable or unwilling to leave an abusive partner. The reasons are complex. If you have been abused and choose to stay with your partner for whatever reason, you need an exit plan for you and your children in case you find yourself in a dire situation.

Find out what resources are available in your community. Police stations, shelters, counseling avenues, and legal aid organizations provide help in emergency situations.

Support

If you need help or want to talk to someone about an abusive situation, you can call the 24-hour National Domestic Violence helpline at 800-799-7233 or 800-787-3224 (TTY). These numbers can be reached from anywhere in the United States.

Other web resources:

• Facebook’s domestic violence page
• Women Thrive
• S.A.F.E.

Pack some needed supplies and leave them at a friend or neighbor’s home. Remember to pack clothes for you and your children, toiletries, documents for school enrollment or to obtain public aid, including birth certificates and rent receipts, an extra set of car keys, cash or checkbook, and a special toy for each child.

Remember, every day you remain in your home you are at risk. Talk to your doctor and friends and plan ahead.

Pregnancy is an exciting time, but it can also be stressful. Above are answers and resources to some common questions people have about pregnancy, and there are plenty of other resources out there as well. Be sure to read books, do research on the internet, talk to friends who’ve had kids, and as always, ask your doctor any questions.