What Now If I..? During Pregnancy

Here is a list of common worries or queries many mothers-to-be face during the course of their pregnancy, labor and after giving birth. They wonder on how the choices they make and the actions they take will impact on the fetus, on their health and on the pregnancy in general. Perhaps you may have wondered about them yourself!

I got the flu / a cold!

Since colds and flu are viral attacks antibiotics won't remedy illness the way a bacterial illness can be cured. You have no choice but to let it run its course. Avoid decongestants, antihistamines and cough medicines which contain alcohol unless with your doctor's permission. Try non-medical tactics such as using a humidifier to help ease breathing problems, elevate your sleeping position with the aid of pillows; drink hot broths to open nasal passages, have cool baths or compressors. Use menthol rubs such as Vicks. In general acetaminophen (paracetemol or Tylenol) is considered safe as a fever-reducer. Most importantly take ample rest to ward off more dangerous infections. The flu vaccine is not advisable in the first trimester as it can cause fever which can be dangerous to the fetus.

I take allergy medications!

Most medications are safe including allergy shots but check with your doctor nevertheless. Allergies usually worsen during pregnancy because of your hormones; on the other hand, allergies can clear up too. Check with your doctor on cortisone sprays - they are not absorbed into your blood.

I get migraines!

Sometimes headaches disappear during pregnancy and sometimes they don't. If they don't it is best to take the no drug approach: consider lying down in a dark room with a cool compress over your eyes, take walks in the open air, avoid known food triggers and include meditation into your regime. Most standard migraine drugs are not safe but acetaminophen taken sometimes is safe.

I am lactose-intolerant!

Doctors usually prescribe calcium supplements. Check with your doctor on lactase pills that will supply the missing enzyme required to break down milk sugar. Other options are lactose-reduce milk and cheese, buttermilk and some yogurts. Sometimes the problem eases in late pregnancy.

I hate milk!

In addition to the above suggestions, make the effort to take dark green vegetables, small boned fish, custards, tofu, calcium fortified bread and orange juice with added calcium. Blend milk or nonfat milk powder into foods such as soups, eggs, cereals etc. Avoid caffeinated drinks or salty foods when you eat calcium rich foods as these affect calcium absorption

I can't keep anything down!

During the first trimester calorie intake is not that important; keeping yourself hydrated and healthy is. Whatever little you can eat make your choices as healthful as possible and drink lots of fluids. Salty fluids such as soups or beverages like Gatorade helps. If you cannot even down fluids, have dry skin and notice your urine getting darker, contact your doctor.

I have asthma!

Pregnancy has no effect on asthma about 50% of the time. Most of the new inhalers are safe to use during pregnancy - check with your doctor.

I still have morning sickness in my second trimester!

If you still feel sickish after the 4th month you should work doubly hard at ensuring that whatever you are eating is laden with nutrition. With the fetus growing inside of you, it will take certain nutrients from your reserves and very soon your body stores will reach depletion point i.e. your health will be at risk. If nausea persists into the 5th month inform your doctor so that you can get dietary advice and be monitored for possible problems such as anemia and dehydration.

I forgot to take a prenatal vitamin!

One day's lapse won't do harm if you are generally eating a balanced diet. Do not try to make up for the nutrient loss by taking two pills the next day - an overdose of vitamins is any day more harmful than a brief deficit. Try taking your vitamin every day at the same time so it becomes a habit. Pop your vitamin with a glass of orange juice to increase iron absorption.

I am gaining weight too fast!

A steady weight gain after week 24 is necessary, so do not try dieting or cutting back on calories. Brief sessions of exercise are better than none at all. Water retention can be mistaken for weight gain so check first. Even if your weight jumps from one checkup to another don't panic - your doctor is monitoring your vital signs to rule out health problems. If you gain more than a pound or two in a single day and notice puffiness in your ankles and face, alert your doctor.

I am gaining weight too slowly!

Your doctor checks your weight at each visit to see if you are gaining appropriately. If you are gaining inadequately your doc may review your diet and suggest a calorie dense diet as well as assess your physical activity level to see if you are not overdoing the exercise bit.

I don't feel like doing anything!

By the eight or ninth month your size alone will make getting out of bed a big deal, forget your routine activities. While this is expected you ought to be able to keep up with basic exercises such as stretches and kegels along with walking or swimming. Reduce the frequency or the length of time or distance but don't cut back totally. By continuing with some exercise regime you will improve your mood and prepare yourself for labor. However you are exempted from the above if you are very close to your due date - by then no one feels like doing much anyway.

I fell!

Falls rarely cause injury to baby or mother. Your child is very secure inside the sac and your own softened ligaments insure you against sprains. After a fall sit down and wait to feel your baby move, a sign that fetus is just fine. If still in doubt your doctor can monitor fetal heartbeat or do a sonogram. Should you have severe abdominal pain, vaginal bleeding or other fluid releases alert your doctor asap.

My water breaks and I am out in public!

This is a common fear. In just about 10% of pregnancies do membranes break before labor begins. Often it happens in the evening or night hours when you are at home. But if it happens when you are out, try to stay calm and get help. Call your doctor before going home.

I feel sick during labor!

It is not unusual to vomit while in labor especially during the transitional phase or after some medications. Just do as your body dictates and don't worry about reactions.

I wish to change my mind about pain relief!

Speak up. Not everything will go according to plan so you are entitled to changes. You can always change your mind about your preferences. The final decision though will rest on how the labor is progressing.

It's too late for epidural!

That means your labor is progressing so rapidly that you are near the finishing line (read you are near or at transition). Epidural at this point may not work to dull the pain as you dilate fully. It may also act as an impediment to your pushing.

I am too tired to nurse right away!

There is no rule saying that you must begin feeding minutes within delivery. Try as soon as you feel up to it, ideally within the first 4 hours of delivery. Newborns can breastfeed up to 12 times and should nurse at least 8 times without restrictions.

I have inverted nipples!

What is important is that the baby latches on to the areola successfully. Some women can draw out their nipples on their own by simply pinching them between the thumb and forefinger; you can also consult the lactation consultant for some exercises. Alternatively you can depend on devices such as breast shells, suction molds and breast pumps.

My baby doesn't seem interested!

It is common for newborns to nurse slowly with frequent pauses in between - that is because sucking is hard work. If your baby doesn't seem enthused about making up for the skipped feed when the next one is due, consult your pediatrician. Your doctor will want to see if baby is gaining adequately and is not sick.

I don't produce enough milk!

Only about 5 in 100 women are truly unable to breastfeed. Breast size and nipple shape have nothing to do with it; sometimes fatigue and anxiety can interfere with lactation, so be sure you are getting enough rest. Breastfeeding within the first hours of life and not offering any formula or water in between will help establish a healthy milk supply. Breastfeeding on demand also leads to more milk production.

I am sick!

Continuing to feed can help protect your baby from the illness because of the antibodies your body is manufacturing. Many types of medications are safe if you need to take any including acetaminophen, ibuprofen, antibiotics. Inform your doctor you are breastfeeding and double check on the drug's safety.

Breastfeeding is wearing me out!

Mothers often complain of lethargy since nursing mothers are literally giving something of themselves to their babies. Breastfeeding isn't exclusively to be blamed - fatigue in early months is due to recovery from the birth process and the irregular sleep-wake patterns. Rest and nutrition helps to restore your health; nursing mothers need 300-500 calories a day ideally from protein and calcium sources such as milk.

My breasts leak all the time!

Leaking is most common before a regular feeding pattern is established - thinking about your baby, milk in the unsuckled breast and the accidental rub of a shirt or towel or foreplay can trigger the let down reflex. To absorb leaks use breast pads and change them often to keep the area dry. Excessive leakage often stops within few months after a more predictable pattern is formed.

I have breast implants!

Depending on the incision site, there should be no problem. Inform your pediatrician about the implants so that baby's weight gain can be monitored. Also be in the know of the probability of silicone and other by-products from ruptured implants contaminating breast milk - many experts believe that silicone leakage is so slight that the benefits of mother's milk outweigh any risk.

I have had a breast reduction surgery!

This depends on the technique used. Your plastic surgeon can tell if the ducts were left intact and functioning.

I had a section and I want to start my exercise program!

A c-section is a major op. Wait for at least 2 weeks before making any attempt to start on simple work out like stretching. Get your doc to approve on any abdominal work (usually 4-8 weeks are required following the surgery). Begin slowly with isometric exercises. If the incision hurts or pulls at any time during exercise, you are probably doing too much too soon.