Pregnancy is a 40 wk period of gestation that is timed from the first day of your last menstrual period. Not everyone delivers at 40 weeks. In fact, only 5% of babies are delivered on their due date. There are many factors that come into play to decide when you will deliver. Remember, every pregnancy is unique and you will be bombarded by loving family members and friends telling you what to expect. Just remember they are NOT you. Accept their loving gestures and suggestions but if you have questions about their loving advice, write them down and discuss these with your doctor at your office visit.
TRAVEL- During uncomplicated pregnancy we advise not to sit for prolonged periods of time longer than an hour to avoid complications of blood clot formation (deep vein thrombosis). It is also important to keep yourself well hydrated. Air travel is NOT recommended after eight months (35 weeks) and after 28 weeks for transcontinental air travel, due to possibility of preterm labor or premature rupture of amniotic membranes.
EXERCISE- this is helpful to keep you in shape and avoid excess weight gain during your pregnancy. Your goal is for weight gain is a pound per week after 20 weeks. If your pregnancy is uncomplicated, you may continue to exercise with the following restrictions: Don’t get overheated or dehydrated. Keep your pulse below 140 and no high impact activities. We advise not to continue with swimming after 37 weeks.
SWELLING- It is common to have swelling in your feet and ankles during the last trimester of your pregnancy. Call our office if the swelling does not improve with rest or IF you develop new headaches or spots before your eyes or dizziness. Call our office if the swelling is worst in one leg with accompanying redness and/or pain of your calf.
PRE-TERM Labor: Between 20 to 36 weeks if you feel four or more uterine contractions per hour, whether they are painful or NOT, menstrual like abdominal cramps or pelvic pressure, or if you have pink or brown tinged mucous or watery discharge, or ANY BLEEDING, GO TO LABOR & DELIVERY of the hospital.
BREAKING OF YOUR WATER BAG- If your water breaks (it may be a gush of water or a steady trickle) GO TO THE HOSPITAL within one hour. Your water should be clear but if your baby had a bowel movement, it may be greenish in color.
SIGNS OF LABOR AFTER 36 WEEKS- Contractions start in the lower back and spread to the front. They may initially feel like menstrual cramps but they get harder and closer and do not go away with rest or change in position. If they go away after resting or walking, you may continue to labor at home. However, GO TO THE HOSPITAL when the contractions are less than five minutes apart and last a minute or longer for greater than two hours. AGAIN, IF YOUR WATER BREAKS, go to the hospital within an hour. Do not stay home to time the contractions.
FETAL KICK COUNTS: After your 28thweek, we want you to rest quietly and comfortably once daily. During this time, place your hands on your abdomen and count the number of times you feel the baby move. You should feel (10) movements in less than an hour. IF not, eat a snack, drink some cold water or juice, then try again. If you still feel fewer than 10 movements during the second hour, go to Labor and Delivery at your chosen hospital. DO NOT use home fetal Doppler to assess your baby’s wellbeing. It is UNSAFE and can lead to catastrophic complications. Call the doctor if you are unsure what to do.
VACCINATIONS- The optimal timing to administer Tdap is between 27 weeks and 37 weeks gestation. This is to maximize the maternal antibody response and passive antibody transfer to the newborn to protect against whooping cough. It is recommended to be vaccinated during each pregnancy. Since pregnant women can become quite ill with severe complications if contracted with Influenza, we recommend receiving the Influenza vaccine during the flu season.