It’s quite common for pregnant women to have a lot of questions for their family physician or obstetrician, especially if it's their first time expecting a child. Moms-to-be want to know what’s safe for them and their growing babies. There’s a lot of information available on the internet, but it’s important to remember that, while the internet is a powerful tool, you have to be cautious about which sources of information to trust. Many women are concerned with what foods are safe to eat, which procedures to undergo, and what the basic no-nos are. Below, Beau Links, DO, PPG – Family Medicine, who provides obstetric and newborn care at Parkview Huntington Hospital, discusses some of the most common questions he receives in the office.
Q: Can I eat fish during pregnancy?
A: Fish and shellfish can be an important part of a healthy diet. However, nearly all fish and shellfish contain traces of mercury. For most people, the risk from mercury in fish and shellfish is not a health concern, but some types of fish and shellfish contain higher levels of mercury that may harm the developing nervous system in babies and young children. Larger fish (swordfish, shark, king mackerel and tilefish) pose the greatest risk to a developing baby or small child because these fish have lived longer and have had more time to accumulate mercury. All uncooked fish and shellfish should be avoided during pregnancy. Raw seafood is more likely to contain bacteria and parasites than cooked seafood.
Q: Can I start or continue to exercise while pregnant?
A: It’s vital for pregnant women to stay active and fit. Exercise during pregnancy may help relieve some common discomforts and help you get energized. Of course, your experience and current fitness levels should guide your physical activity. If you’re new to exercise, then yoga, Pilates, tai chi, water aerobics (yes, it’s okay to swim), and dancing would be fun choices. If you’ve been lifting weights before your pregnancy, it would be OK to continue, but know your body (now’s not the time to be working on new PRs) and be aware of increased flexibility as your pregnancy progresses (thanks to the hormone, relaxin). Use your best judgment when considering exercise choices (sorry, Jiu-jitsu, you’re out).
Q: Can I sleep on my back?
A: Women have been giving birth for thousands of years, and I’m sure at least one of them has slept on their back at one time or another. What’s the big concern here? After 20 weeks, your uterus’s increasing weight can apply pressure to a major blood vessel (the vena cava) behind the uterus that can get compressed when a mom-to-be lies on her back. This big vessel brings blood back to your heart. Less blood flow back to your heart means less blood flow to your baby. If you don’t spend the entire night on your back (and what pregnant woman doesn’t toss and turn to find a comfortable position at night?), you should be fine. A pillow placed between your back and the mattress can keep you at a 20- to 30-degree angle, which allows most back sleepers to maintain their position of choice.
Q: Can I drink coffee while pregnant?
A: Twelve ounces of coffee contains 200 mg of caffeine. Drinking that amount or less per day should
Q: Why am I so tired all the time?
A: You’re growing a human being in your body -- that takes a lot of energy. Sleep whenever you can. Literally, anytime.
Q: Can I change my cat’s litter box?
A: Cats are not dogs, let’s just get that straight. My cat and I have an understanding: I don’t bother her when she sleeps, and she agrees to poop in the litter box. And there lies the problem. Cat feces can transmit an infection called toxoplasmosis. It's unlikely that indoor cats have toxoplasmosis, but pregnant women who are exposed to toxoplasmosis can run a risk of serious birth defects in their developing baby. Just to be safe, have someone else change the litter box, if possible.
Q: How much weight should I gain during pregnancy?
A: It depends on your pre-pregnancy weight. If you have a normal BMI (18.5 - 24.9), then 25 - 35 pounds would be reasonable. If your BMI is higher than that, say, above 30, less than 20 pounds of weight gain is recommended. During the first trimester, you may not need any additional calories above your normal intake. During the second trimester, you need about an additional 340 calories a day, and in the third trimester, you need roughly 450 additional calories a day. You definitely don’t need to “eat for two.”
Q: Why am I so gassy? Why can’t I poop?
A: You can blame your hormones for this one, especially progesterone. Progesterone relaxes tissues all over your body, including your GI tract. This GI tract relaxation slows down the movement of your bowels, potentially causing gas, heartburn and constipation.
Q: Is it safe to get vaccines while pregnant?
A: We continue to recommend vaccines during pregnancy, especially the influenza and Tdap vaccines. Women who contract influenza while pregnant are at a higher risk of dying and being hospitalized due to the flu. When a mother gets the shot while she's still pregnant, flu-fighting antibodies are transferred to her developing baby. The Tdap (tetanus, diphtheria and pertussis) vaccine is recommended between the 27th and 36th week of gestation. The Tdap vaccine is a safe and effective way to protect you and your baby from serious illness and complications of pertussis (whooping cough).
Q: Is sex safe during pregnancy?
A: There are instances when I would caution against having sex while pregnant, such as unexplained vaginal bleeding, or you’re leaking amniotic fluid, or your cervix has begun to open prematurely, or your placenta completely covers your cervical opening. Sex can be safe while pregnant. It’s important to find comfortable positions (these may change as the pregnancy progresses) and keep an open line of communication between you and your partner. And if you don’t want to have sex, that’s OK and common as well. There's more to intimacy than sex. Share your needs and concerns with your partner in an open and loving way. Condoms should be used unless you’re in a mutually monogamous relationship, and with any new partners.