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1Navigang Your Pregnancy NavigatingYour Pregnancy Innovative Midwifery and Women’s HealthSupporng Women, Connecng Families, Strengthening Communies
Navigang Your Pregnancy 23Navigang Your Pregnancy Table of ContentsOverview ......................................................................................................... 4Who will care for me during pregnancy, labor, and delivery .......................... 4Our Providers .............................................................................................. 4Where will I deliver my baby? ...................................................................... 5Prenatal Care ............................................................................................... 5 Patient Portal ............................................................................................... 5Who to Call After Hours ............................................................................... 5BIRTHCare Group Sessions ........................................................................... 6 Office Hours ................................................................................................. 7Prenatal Visit Schedule ................................................................................. 7-9 Pregnancy Medication List ......................................................................... 10-16The Dangers of Smoking While Pregnant ........................................................ 17How Can Smoking Harm Your Baby ................................................................. 17Benefits - When You Stop Smoking ............................................................ 17-18Environmental Hazards During Pregnancy ................................................. 18-19Pesticides ......................................................................................................... 18Cleaning Products ............................................................................................ 18Lead Exposure .................................................................................................. 19Acrylic Nails ...................................................................................................... 19Hair Products ................................................................................................... 19Nausea/Vomiting in Pregnancy ...................................................................... 20Do All Women Experience Nausea or Vomiting During Pregnancy? .............. 20What Causes Nausea and Vomiting During Pregnancy? ................................. 20Is Nausea and Vomiting During Pregnancy Dangerous? ................................. 21How Are Nausea and Vomiting Treated? ........................................................ 21 Medication for Nausea and Vomiting ............................................................ 22Taking Good Care of Yourself in Pregnancy .................................................... 23What Should I Eat? ......................................................................................... 23Seafood ........................................................................................................... 24What is Safe to Eat? ................................................................................... 24-25Exercising While Pregnant ......................................................................... 27-28How Much Weight Should I Gain During My Pregnancy? .............................. 28How Much Should I Eat During Pregnancy? ................................................... 29Warning Signs in Pregnancy ............................................................................... 30Contact Your Provider If You Experience These Symptoms ............................ 30When to See Your Provider As Soon As Possible ............................................ 30Early Pregnancy Warning Signs (Before 20 Weeks) ........................................ 30Mid to Late Pregnancy Warning Signs (After 20 Weeks) ................................ 30Genetic TestingWhat Information Do These Tests Provide?.................................................... 31What Are the Types of Prenatal Genetic Tests Offered at TPMG? ................. 31NIPT/MaterniT21 Plus ..................................................................................... 32Quad Screen ............................................................................................... 32-33Other More Specific Tests ............................................................................... 33Interested in NIPT/MaterniT21 Plus? What Now? ............................................. 34Personalized Pregnancy Care .............................................................................. 35
Navigang Your Pregnancy 23Navigang Your Pregnancy Table of ContentsOverview ......................................................................................................... 4Who will care for me during pregnancy, labor, and delivery .......................... 4Our Providers .............................................................................................. 4Where will I deliver my baby? ...................................................................... 5Prenatal Care ............................................................................................... 5 Patient Portal ............................................................................................... 5Who to Call After Hours ............................................................................... 5BIRTHCare Group Sessions ........................................................................... 6 Office Hours ................................................................................................. 7Prenatal Visit Schedule ................................................................................. 7-9 Pregnancy Medication List ......................................................................... 10-16The Dangers of Smoking While Pregnant ........................................................ 17How Can Smoking Harm Your Baby ................................................................. 17Benefits - When You Stop Smoking ............................................................ 17-18Environmental Hazards During Pregnancy ................................................. 18-19Pesticides ......................................................................................................... 18Cleaning Products ............................................................................................ 18Lead Exposure .................................................................................................. 19Acrylic Nails ...................................................................................................... 19Hair Products ................................................................................................... 19Nausea/Vomiting in Pregnancy ...................................................................... 20Do All Women Experience Nausea or Vomiting During Pregnancy? .............. 20What Causes Nausea and Vomiting During Pregnancy? ................................. 20Is Nausea and Vomiting During Pregnancy Dangerous? ................................. 21How Are Nausea and Vomiting Treated? ........................................................ 21 Medication for Nausea and Vomiting ............................................................ 22Taking Good Care of Yourself in Pregnancy .................................................... 23What Should I Eat? ......................................................................................... 23Seafood ........................................................................................................... 24What is Safe to Eat? ................................................................................... 24-25Exercising While Pregnant ......................................................................... 27-28How Much Weight Should I Gain During My Pregnancy? .............................. 28How Much Should I Eat During Pregnancy? ................................................... 29Warning Signs in Pregnancy ............................................................................... 30Contact Your Provider If You Experience These Symptoms ............................ 30When to See Your Provider As Soon As Possible ............................................ 30Early Pregnancy Warning Signs (Before 20 Weeks) ........................................ 30Mid to Late Pregnancy Warning Signs (After 20 Weeks) ................................ 30Genetic TestingWhat Information Do These Tests Provide?.................................................... 31What Are the Types of Prenatal Genetic Tests Offered at TPMG? ................. 31NIPT/MaterniT21 Plus ..................................................................................... 32Quad Screen ............................................................................................... 32-33Other More Specific Tests ............................................................................... 33Interested in NIPT/MaterniT21 Plus? What Now? ............................................. 34Personalized Pregnancy Care .............................................................................. 35
Navigang Your Pregnancy 45Navigang Your Pregnancy OverviewThank you for choosing Innovave Midwifery and Women’s Health a division of TPMG Obstetrics & Gynecology to provide your care during this excing me. In this guide you will nd helpful resources, answers to frequently asked quesons, and what to expect at each upcoming prenatal visit. Please review this informaiton and bring your addional quesons or concerns to your next prenatal visit. We are excited to walk this journey with you! Who Will Care for Me During Pregnancy, Labor and Delivery?Our medical providers include physicians, nurse practitioners, and certified nurse-midwives at multiple locations throughout the Peninsula. Our midwives are present at the hospital 24 hours a day, 7 days a week. The midwives support most of the vaginal deliveries. Physicians will provide additional support if a medical need arises.Our Providers:Obstetricians❱ Jerey D. Morrison, MD, FACOG❱ Laura R. Cordes, MD❱ Teresa X. Tan, MDHospitalist❱ Deneishia S. Fisher, MDNurse Praconers❱ Barbara Garner, MSN, FNP-BC ❱ Lesley Kendrick, DNP, FNP-BC❱ Isabelle Smoot, MSN, FNP-CCered Nurse-Midwives❱ MaryAnn Cheuvront, DNP, CNM❱ Susan M. Coxson, MSN, ARNP, CNM❱ Jennifer H. Farris, MSN, CNM❱ Megan Lord, MSN, CNM❱ Stefanie Schwarz, DNP, CNM, RNC-MNN, C-EFM, CLC❱ Adrienne Jones, MSN, APRN, CNM❱ Betsy L. England, MSN, CNM, RNC-OB, C-EFMWhere Will I Deliver My Baby?Our providers serve families at Mary Immaculate Hospital in Newport News. If you need hospital care from this point forward, we ask that you use this facility, so we can participate in your care and stay informed on your medical condition. If you are out-of-town and you are not feeling well, please seek care wherever you are located.Prenatal CareYou can expect approximately 10 prenatal visits plus 1-2 ultrasounds during your prenatal care. In the pages to follow, you will find a more detailed outline of what to expect at each of these visits. If complications arise and you become high-risk, we may advise you to be seen more frequently or have additional testing. To best provide timely prenatal visits for everyone, we ask that you arrive on time for each appointment. If you must cancel or reschedule, please notify the office at least 24 hours in advance.Patient PortalStay connected with your provider by enrolling in our new Patient Portal, Intelichart. Our Patient Portal allows you to have greater access to your provider with digital updates on visits, prescription status, recent labs, and online messaging. Who to Call After Hours? Babies arrive at all hours of the day and night, as do complications, concerns or questions. For after office hours emergencies, please call our main number (757) 223-9794, and press option 1 to reach the on-call provider. To ensure the on-call providers can address your emergency promptly, please be available at the number you leave with the answering service and be sure that your phone allows for “private callers”. We ask that all non-emergent questions or concerns be directed to our staff during office hours. You may also send questions through the Patient Portal at any time. ENROLL TODAY - IT’S FREE, SIMPLE, AND SECUREVIEW TEST RESULTS MESSAGE YOUR PROVIDERREQUEST A PRESCRIPTION REFILLMANAGE APPOINTMENTSON-THE-GO MOBILE APP
Navigang Your Pregnancy 45Navigang Your Pregnancy OverviewThank you for choosing Innovave Midwifery and Women’s Health a division of TPMG Obstetrics & Gynecology to provide your care during this excing me. In this guide you will nd helpful resources, answers to frequently asked quesons, and what to expect at each upcoming prenatal visit. Please review this informaiton and bring your addional quesons or concerns to your next prenatal visit. We are excited to walk this journey with you! Who Will Care for Me During Pregnancy, Labor and Delivery?Our medical providers include physicians, nurse practitioners, and certified nurse-midwives at multiple locations throughout the Peninsula. Our midwives are present at the hospital 24 hours a day, 7 days a week. The midwives support most of the vaginal deliveries. Physicians will provide additional support if a medical need arises.Our Providers:Obstetricians❱ Jerey D. Morrison, MD, FACOG❱ Laura R. Cordes, MD❱ Teresa X. Tan, MDHospitalist❱ Deneishia S. Fisher, MDNurse Praconers❱ Barbara Garner, MSN, FNP-BC ❱ Lesley Kendrick, DNP, FNP-BC❱ Isabelle Smoot, MSN, FNP-CCered Nurse-Midwives❱ MaryAnn Cheuvront, DNP, CNM❱ Susan M. Coxson, MSN, ARNP, CNM❱ Jennifer H. Farris, MSN, CNM❱ Megan Lord, MSN, CNM❱ Stefanie Schwarz, DNP, CNM, RNC-MNN, C-EFM, CLC❱ Adrienne Jones, MSN, APRN, CNM❱ Betsy L. England, MSN, CNM, RNC-OB, C-EFMWhere Will I Deliver My Baby?Our providers serve families at Mary Immaculate Hospital in Newport News. If you need hospital care from this point forward, we ask that you use this facility, so we can participate in your care and stay informed on your medical condition. If you are out-of-town and you are not feeling well, please seek care wherever you are located.Prenatal CareYou can expect approximately 10 prenatal visits plus 1-2 ultrasounds during your prenatal care. In the pages to follow, you will find a more detailed outline of what to expect at each of these visits. If complications arise and you become high-risk, we may advise you to be seen more frequently or have additional testing. To best provide timely prenatal visits for everyone, we ask that you arrive on time for each appointment. If you must cancel or reschedule, please notify the office at least 24 hours in advance.Patient PortalStay connected with your provider by enrolling in our new Patient Portal, Intelichart. Our Patient Portal allows you to have greater access to your provider with digital updates on visits, prescription status, recent labs, and online messaging. Who to Call After Hours? Babies arrive at all hours of the day and night, as do complications, concerns or questions. For after office hours emergencies, please call our main number (757) 223-9794, and press option 1 to reach the on-call provider. To ensure the on-call providers can address your emergency promptly, please be available at the number you leave with the answering service and be sure that your phone allows for “private callers”. We ask that all non-emergent questions or concerns be directed to our staff during office hours. You may also send questions through the Patient Portal at any time. ENROLL TODAY - IT’S FREE, SIMPLE, AND SECUREVIEW TEST RESULTS MESSAGE YOUR PROVIDERREQUEST A PRESCRIPTION REFILLMANAGE APPOINTMENTSON-THE-GO MOBILE APP
Navigang Your Pregnancy 67Navigang Your Pregnancy Office HoursNewport News and Hampton: ❱ Monday - Thursday: 8:00 am to 5:00 pm❱ Friday: 8:00 am to 3:30 pmGloucester: ❱ Monday - Thursday: 8:00 am to 4:00 pm❱ Friday: 8:00 am to 12:30 pmWilliamsburg: ❱ Monday - Thursday: 8:00 am to 4:00 pm❱ Friday: 8:00 am to 3:30 pm We are excited to partner with you during your pregnancy and look forward to seeing you make many new and exciting memories.Prenatal Visit ScheduleGestationalAgePrenatal Care Visit Lab Tests Return In6 - 10 weeksConfirmation Visit• Ultrasound to confirm pregnancy and due date• Meet with a provider to review ultrasound and discuss due date• Address any concerns or answer any questions• Discuss BIRTHCare and sign up if interestedNone 4 - 6 weeks12 - 14 weeksNew OB Visit (first official pregnancy visit)• Listen to the baby’s heartbeat• Discuss prenatal care and practice overview• Overview of genetic testing: discuss available testing• Answer any questions or concernsBlood type/Rh factorAntibody testing, Complete blood count (CBC), Rubella immunity, Hemoglobin, electrophoresis, HIV, Hepatitis B, Syphilis, Gonorrhea/Chlamydia, Urine culture, and NIPT if desired, Pap smear if needed4 - 6 weeks16 - 18 weeks• Listen to the baby’s heartbeat• Review lab results• Discuss upcoming ultrasound• Answer any questions or concernsQuad/MSAFP if desired, Early gestational diabetes screening if needed. 4 weeks20 weeks• Morphology/Anatomy Ultrasound: This routine ultrasound checks your baby’s size and organs. It includes evaluating your baby’s heart, lungs, head/brain, spine, stomach, kidneys, bladder, genitalia, arms, legs, hands, feet, placenta, umbilical cord and amniotic fluid.• Baby’s gender is revealed, if you desire• Review lab results, if needed• Answer any questions or concernsNo additional testing 4 weeks24 weeks• Listen to the baby’s heartbeat• Start measuring your belly to make sure your baby is growing well• Review gestational diabetes screening drink (glucola) and instructions as well as acceptable alternatives, if desired• Answer any questions or concernsNo additional testing 4 weeksBelow is a general outline of the pregnancy visit schedule. Your visits may vary according to you and your baby’s needs.
Navigang Your Pregnancy 67Navigang Your Pregnancy Office HoursNewport News and Hampton: ❱ Monday - Thursday: 8:00 am to 5:00 pm❱ Friday: 8:00 am to 3:30 pmGloucester: ❱ Monday - Thursday: 8:00 am to 4:00 pm❱ Friday: 8:00 am to 12:30 pmWilliamsburg: ❱ Monday - Thursday: 8:00 am to 4:00 pm❱ Friday: 8:00 am to 3:30 pm We are excited to partner with you during your pregnancy and look forward to seeing you make many new and exciting memories.Prenatal Visit ScheduleGestationalAgePrenatal Care Visit Lab Tests Return In6 - 10 weeksConfirmation Visit• Ultrasound to confirm pregnancy and due date• Meet with a provider to review ultrasound and discuss due date• Address any concerns or answer any questions• Discuss BIRTHCare and sign up if interestedNone 4 - 6 weeks12 - 14 weeksNew OB Visit (first official pregnancy visit)• Listen to the baby’s heartbeat• Discuss prenatal care and practice overview• Overview of genetic testing: discuss available testing• Answer any questions or concernsBlood type/Rh factorAntibody testing, Complete blood count (CBC), Rubella immunity, Hemoglobin, electrophoresis, HIV, Hepatitis B, Syphilis, Gonorrhea/Chlamydia, Urine culture, and NIPT if desired, Pap smear if needed4 - 6 weeks16 - 18 weeks• Listen to the baby’s heartbeat• Review lab results• Discuss upcoming ultrasound• Answer any questions or concernsQuad/MSAFP if desired, Early gestational diabetes screening if needed. 4 weeks20 weeks• Morphology/Anatomy Ultrasound: This routine ultrasound checks your baby’s size and organs. It includes evaluating your baby’s heart, lungs, head/brain, spine, stomach, kidneys, bladder, genitalia, arms, legs, hands, feet, placenta, umbilical cord and amniotic fluid.• Baby’s gender is revealed, if you desire• Review lab results, if needed• Answer any questions or concernsNo additional testing 4 weeks24 weeks• Listen to the baby’s heartbeat• Start measuring your belly to make sure your baby is growing well• Review gestational diabetes screening drink (glucola) and instructions as well as acceptable alternatives, if desired• Answer any questions or concernsNo additional testing 4 weeksBelow is a general outline of the pregnancy visit schedule. Your visits may vary according to you and your baby’s needs.
Navigang Your Pregnancy 89Navigang Your Pregnancy GestationalAgePrenatal Care Visit Lab Tests Return In28 weeks• Gestational diabetes screening: your blood draw is performed one hour after finishing your glucola drink. This may be before or after your visit. • Listen to the baby’s heartbeat• Measure your belly • Review 3rd trimester education book • Rhogam shot (if Rh negative) • Tdap, if desired can be given from 27-36 weeks of gestation• Answer any questions or concernsGestational Diabetes screening, CBC, Antibody test (if RH negative blood type)2 weeks30 weeks32 weeks34 weeks• Listen to the baby’s heartbeat• Measure your belly• Review lab results if needed• Answer any questions or concernsNo additional testing 2 weeks36 weeks• Listen to the baby’s heartbeat• Measure your belly• Confirm that baby is head down• Collect Group Beta Strep (GBS) swab, this is a normal bacteria in our bodies that may be in your vagina near birth. It may increase your baby’s risk of getting sick after birth. It is treated with antibiotics. More information will be given at the visit.• Cervical exam if desired• Answer any questions or concerns. GBS 1 week37 weeks38 weeks• Listen to the baby’s heartbeat• Measure your belly• Discuss GBS test results• Cervical exam, if desired• Answer any questions or concernsNo Additional Testing1 week39 weeks• Listen to the baby’s heartbeat• Measure your belly• Discuss scheduling induction at 41 weeks pregnant• Cervical exam, if desired• Answer any questions or concernsNo Additional Testing 1 week40 weeks• Listen to the baby’s heartbeat• Measure your belly• Cervical exam, if desired• Answer any questions or concernsNo Additional Testing1 week, if needed**If any results need immediate follow-up, our office will call you. Please keep your contact information up-to-date. Routine results will be reviewed with you at your next OB visit. You can view your labs at any time in the Patient Portal.**Hampton Office2240 Coliseum DriveSuite B, Hampton, VA 23666P: (757) 223-9794Newport News Office860 Omni Boulevard, Suite 110Newport News, VA 23606P: (757) 223-9794 mytpmg.com❱ Are you a first-time mom looking for greater educational resources to prepare for motherhood?❱ Are you interested in meeting other expectant mothers who are on a similar pregnancy journey?❱ Are you new to the area or feeling alone in your pregnancy?Reasons to Join BIRTHCare: Bringing Increased Recognition To Health in pregnancyBIRTHCare Ask about next sessions availableScan this QR Codeto Learn MoreTPMG Obstetrics and GynecologyWe plan to equip, empower, and encourage women on their birth journey through guided group sessions. BIRTHCare focuses on trimester-specific topics and includes 10 (2-hour) sessions. During this time we discuss topics from what to expect at labor and delivery to postpartum self-care. Of course, we will also have time set aside to listen to your baby, measure your belly, and answer any private questions you may have.
Navigang Your Pregnancy 89Navigang Your Pregnancy GestationalAgePrenatal Care Visit Lab Tests Return In28 weeks• Gestational diabetes screening: your blood draw is performed one hour after finishing your glucola drink. This may be before or after your visit. • Listen to the baby’s heartbeat• Measure your belly • Review 3rd trimester education book • Rhogam shot (if Rh negative) • Tdap, if desired can be given from 27-36 weeks of gestation• Answer any questions or concernsGestational Diabetes screening, CBC, Antibody test (if RH negative blood type)2 weeks30 weeks32 weeks34 weeks• Listen to the baby’s heartbeat• Measure your belly• Review lab results if needed• Answer any questions or concernsNo additional testing 2 weeks36 weeks• Listen to the baby’s heartbeat• Measure your belly• Confirm that baby is head down• Collect Group Beta Strep (GBS) swab, this is a normal bacteria in our bodies that may be in your vagina near birth. It may increase your baby’s risk of getting sick after birth. It is treated with antibiotics. More information will be given at the visit.• Cervical exam if desired• Answer any questions or concerns. GBS 1 week37 weeks38 weeks• Listen to the baby’s heartbeat• Measure your belly• Discuss GBS test results• Cervical exam, if desired• Answer any questions or concernsNo Additional Testing1 week39 weeks• Listen to the baby’s heartbeat• Measure your belly• Discuss scheduling induction at 41 weeks pregnant• Cervical exam, if desired• Answer any questions or concernsNo Additional Testing 1 week40 weeks• Listen to the baby’s heartbeat• Measure your belly• Cervical exam, if desired• Answer any questions or concernsNo Additional Testing1 week, if needed**If any results need immediate follow-up, our office will call you. Please keep your contact information up-to-date. Routine results will be reviewed with you at your next OB visit. You can view your labs at any time in the Patient Portal.**Hampton Office2240 Coliseum DriveSuite B, Hampton, VA 23666P: (757) 223-9794Newport News Office860 Omni Boulevard, Suite 110Newport News, VA 23606P: (757) 223-9794 mytpmg.com❱ Are you a first-time mom looking for greater educational resources to prepare for motherhood?❱ Are you interested in meeting other expectant mothers who are on a similar pregnancy journey?❱ Are you new to the area or feeling alone in your pregnancy?Reasons to Join BIRTHCare: Bringing Increased Recognition To Health in pregnancyBIRTHCare Ask about next sessions availableScan this QR Codeto Learn MoreTPMG Obstetrics and GynecologyWe plan to equip, empower, and encourage women on their birth journey through guided group sessions. BIRTHCare focuses on trimester-specific topics and includes 10 (2-hour) sessions. During this time we discuss topics from what to expect at labor and delivery to postpartum self-care. Of course, we will also have time set aside to listen to your baby, measure your belly, and answer any private questions you may have.
Navigang Your Pregnancy 1011Navigang Your Pregnancy Talk with your provider about your current medications. We encourage you to exercise caution with medications and only use when medically appropriate.Pregnancy Medication ListMedication Name1st Trimester (1-13 weeks)2nd Trimester(14-27 weeks)3rd Trimester(28-40 weeks)Lactation0-6 mthsLactation6-12 mthsLactation>12 mthsANTACIDS/REFLUXSee indigestion/gasNatural Remedies:Avoid lying flat. Consume 6 small meals versus 3 large meals daily. Avoid greasy/spicy foods.Maalox, Mylantam, Tums, RolaidsYES YES YES YES YES YESPepto-Bismol (bismuth subsalicylate)YESNO NO YES YES YESPepcid (famotidine) 20 mg twice dailyYES YES YES YES YES YESNexium (esomeprazole) RxYES YES YES YES YES YESPrevacid (lansoprazole) RxYES YES YES YES YES YESPrilosec (omeprazole) YES YES YES YES YES YESProtonix (pantoprazole) RxYES YES YES YES YES YESANTI-DIARRHEAImodium (loperamide) YES YES YES YES YES YESKaopectate/Pepto-Bismol (bismuth subsalicylate)YESNO NO YES YES YESMetamucil YES YES YES YES YES YESANTI-NAUSEA/ANTI-VOMITTINGNatural Remedies:Vitamin B6 or B-Natal pop (3x daily) can take with ½ tablet Unisom (sleep aid) at bedtime. Ginger capsules (1500mg). Flavored teas: chamomile, peppermint, ginger, or raspberry leaf. Papaya enzymes. Carob. Sea bands. Essential oil therapy: lemon, mint, or ginger.Diclegis Rx YES YES YESDoxylamine (Unisom sleep tabs) YES YES YES YES YES YESPhenergan (promethazine) RxYES YES YES YES YES YESReglan (metoclopramide) RxYES YES YES YES YES YESZofran (ondansetron) Rx YES YES YES YES YES YESMedication Name1st Trimester (1-13 weeks)2nd Trimester(14-27 weeks)3rd Trimester(28-40 weeks)Lactation0-6 mthsLactation6-12 mthsLactation>12 mthsANTIFUNGALS (Yeast)Natural Remedies:Avoid high carbs or sugar diet. DO NOT DOUCHE. Consume yogurt with active (live) cultures. Use probiotics. Nystatin Rx YES YES YES YES YES YESDiflucan (fluconazole) RxYES YES YES YES YES YESGynazole 1 (butoconazole) RxYES YES YES YES YES YESGyne-lotrimin 3-7 days (clotrimazole)YES YES YES YES YES YESMonistat 1 day (miconazole, tioconazole) not preferredYES YES YES YES YES YESMonistat 3-7 day (miconazole)YES YES YES YES YES YESTerazol YES YES YES YES YES YESANTIHISTAMINES/DECONGESTANTS/COUGH/COLDNatural Remedies:Increase water intake (8-10 cups daily). Nasal saline sprays or drops. Neti Pot. Drinking warm liquids (tea, water with lemon, clear broth) every 1-2 hours. Use of humidifier or diffuser (consider adding Eucalyptus oil, Myrrh oil, or Frankincense oil). Warm salt water gargles for sore throats.Allegra (fexofenadine) YES YES YES YES YES YESAfrin Nasal Spray (oxymetazoline) NO NO NO NO NO NOBenadryl (diphenhydramine)YES YES YES YES YES YESChlor-trimeton (chlorpheniramine)YES YES YES YES YES YESClaritin (loratadine) YES YES YES YES YES YESCough Drops, Cepacol, Chloraseptic lozenges/sprayYES YES YES YES YES YESDay/NyQuilNO NO NO YES YES YESDimetapp / TriaminicYES YES YES YES YES YESFlonase YES YES YES YES YES YESMucinex (guaifenesin) YES YES YES YES YES YES
Navigang Your Pregnancy 1011Navigang Your Pregnancy Talk with your provider about your current medications. We encourage you to exercise caution with medications and only use when medically appropriate.Pregnancy Medication ListMedication Name1st Trimester (1-13 weeks)2nd Trimester(14-27 weeks)3rd Trimester(28-40 weeks)Lactation0-6 mthsLactation6-12 mthsLactation>12 mthsANTACIDS/REFLUXSee indigestion/gasNatural Remedies:Avoid lying flat. Consume 6 small meals versus 3 large meals daily. Avoid greasy/spicy foods.Maalox, Mylantam, Tums, RolaidsYES YES YES YES YES YESPepto-Bismol (bismuth subsalicylate)YESNO NO YES YES YESPepcid (famotidine) 20 mg twice dailyYES YES YES YES YES YESNexium (esomeprazole) RxYES YES YES YES YES YESPrevacid (lansoprazole) RxYES YES YES YES YES YESPrilosec (omeprazole) YES YES YES YES YES YESProtonix (pantoprazole) RxYES YES YES YES YES YESANTI-DIARRHEAImodium (loperamide) YES YES YES YES YES YESKaopectate/Pepto-Bismol (bismuth subsalicylate)YESNO NO YES YES YESMetamucil YES YES YES YES YES YESANTI-NAUSEA/ANTI-VOMITTINGNatural Remedies:Vitamin B6 or B-Natal pop (3x daily) can take with ½ tablet Unisom (sleep aid) at bedtime. Ginger capsules (1500mg). Flavored teas: chamomile, peppermint, ginger, or raspberry leaf. Papaya enzymes. Carob. Sea bands. Essential oil therapy: lemon, mint, or ginger.Diclegis Rx YES YES YESDoxylamine (Unisom sleep tabs) YES YES YES YES YES YESPhenergan (promethazine) RxYES YES YES YES YES YESReglan (metoclopramide) RxYES YES YES YES YES YESZofran (ondansetron) Rx YES YES YES YES YES YESMedication Name1st Trimester (1-13 weeks)2nd Trimester(14-27 weeks)3rd Trimester(28-40 weeks)Lactation0-6 mthsLactation6-12 mthsLactation>12 mthsANTIFUNGALS (Yeast)Natural Remedies:Avoid high carbs or sugar diet. DO NOT DOUCHE. Consume yogurt with active (live) cultures. Use probiotics. Nystatin Rx YES YES YES YES YES YESDiflucan (fluconazole) RxYES YES YES YES YES YESGynazole 1 (butoconazole) RxYES YES YES YES YES YESGyne-lotrimin 3-7 days (clotrimazole)YES YES YES YES YES YESMonistat 1 day (miconazole, tioconazole) not preferredYES YES YES YES YES YESMonistat 3-7 day (miconazole)YES YES YES YES YES YESTerazol YES YES YES YES YES YESANTIHISTAMINES/DECONGESTANTS/COUGH/COLDNatural Remedies:Increase water intake (8-10 cups daily). Nasal saline sprays or drops. Neti Pot. Drinking warm liquids (tea, water with lemon, clear broth) every 1-2 hours. Use of humidifier or diffuser (consider adding Eucalyptus oil, Myrrh oil, or Frankincense oil). Warm salt water gargles for sore throats.Allegra (fexofenadine) YES YES YES YES YES YESAfrin Nasal Spray (oxymetazoline) NO NO NO NO NO NOBenadryl (diphenhydramine)YES YES YES YES YES YESChlor-trimeton (chlorpheniramine)YES YES YES YES YES YESClaritin (loratadine) YES YES YES YES YES YESCough Drops, Cepacol, Chloraseptic lozenges/sprayYES YES YES YES YES YESDay/NyQuilNO NO NO YES YES YESDimetapp / TriaminicYES YES YES YES YES YESFlonase YES YES YES YES YES YESMucinex (guaifenesin) YES YES YES YES YES YES
Navigang Your Pregnancy 1213Navigang Your Pregnancy ANTIHISTAMINES/DECONGESTANTS/COUGH/COLDNatural Remedies:Increase water intake (8-10 cups daily). Nasal saline sprays or drops. Neti Pot. Drinking warm liquids (tea, water with lemon, clear broth) every 1-2 hours. Use of humidifier or diffuser (consider adding Eucalyptus oil, Myrrh oil, or Frankincense oil). Warm salt water gargles for sore throats.Mucinex-D YES YES YES YES YES NOPhenylephrine YES YES YES YES YES YESRobitussin Cough, Delsym (dextromethorphan)YES YES YES YES YES YESRobitussin Cough & ColdYES YES YES YES YES YESRobitussin DM YES YES YES YES YES YESSudafed(pseudoephedrine)NO YES YES YES YES NOTylenol Cold & Flu YES YES YES YES YES YESVicks VapoRub YES YES YES YES YES YESZicam YES YES YES YES YES YESZyrtec (cetirizine) YES YES YES YES YES YESANTIVIRALSTamiflu (oseltamivir) YES YES YES YES YES YESFamvir (famciclovir) Rx YES YES YES YES YES YESValtrex (valacyclovir) Rx YES YES YES YES YES YESZovirax (acyclovir) Rx YES YES YES YES YES YESINSOMNIANatural Remedies:Lavendar oil in bath or apply to temples and wrists. Sleepy Time teaBenadryl (diphenhydramine)YES YES YES YES YES YESCalcium/Magnesium YES YES YES YES YES YESUnisom (doxylamine) YES YES YES YES YES YESSominex (diphenhydramine)YES YES YES YES YES YESNatural Calm MagnesiumYES YES YES YES YES YESINSOMNIANatural Remedies:Lavendar oil in bath or apply to temples and wrists. Sleepy Time teaTylenol PM YES YES YES YES YES YESINDIGESTION/GASNatural Remedies:1-2 drops of peppermint oil, ginger oil, or orange oil in a capsule or directly under your tongue followed by water. Well chewed hazelnuts. Ginger capsules or tea.Papaya enzyme or leaf teaYES YES YES YES YES YESBromelain (pineapple enzyme)YES YES YES YES YES YESDigestive Enzymes YES YES YES YES YES YESGas X (Simethicone) YES YES YES YES YES YESPhazyme (Simethicone)YES YES YES YES YES YESMylicon (Simethicone) YES YES YES YES YES YESCONSTIPATION/LAXATIVES/STOOL SOFTENERSNatural Remedies:Increase water intake (8-10 cups daily). Exercise regularly. Decrease starchy and processed food. Increase fiber (dark green, leafy veggies). Consume prunes or prune juice. Drink warm water with juice of one lemon (can add 1Tbsp of flax seed/oil and/or 1Tbsp of ground psyllium husk). Slippery elm herb.Citrucel YES YES YES YES YES YESColace (docusate sodium) YES YES YES YES YES YESDulcolax Tablets (bisacodyl)YES YES YES YES YES YESMetamucil/Fibercon YES YES YES YES YES YESLactulose Rx YES YES YES YES YES YESMilk of Magnesia YES YES YES YES YES YESMiralax YES YES YES YES YES YESNatural Calm MagnesiumYES YES YES YES YES YESSenokot YES YES YES YES YES YESPAIN/FEVER/HEADACHENatural Remedies:Increase water intake (8-10 cups daily). Caffeine (tea, soda, coffee). Drinking ¼ cup of peppermint tea hourly. Using peppermint or lavender oil on areas of discomfort/pain. Epsom salt baths. Hot/Cold packs. Yoga. Exercise. Chiropractic care. Massage therapy. May need Physical Therapy or Pelvic Floor Therapy. ** Seek care if fever >100.4 and/or headache is unrelieved with medication after 20 weeks gestation**Aleve (naproxen sodium)NO NO NO YES YES YES
Navigang Your Pregnancy 1213Navigang Your Pregnancy ANTIHISTAMINES/DECONGESTANTS/COUGH/COLDNatural Remedies:Increase water intake (8-10 cups daily). Nasal saline sprays or drops. Neti Pot. Drinking warm liquids (tea, water with lemon, clear broth) every 1-2 hours. Use of humidifier or diffuser (consider adding Eucalyptus oil, Myrrh oil, or Frankincense oil). Warm salt water gargles for sore throats.Mucinex-D YES YES YES YES YES NOPhenylephrine YES YES YES YES YES YESRobitussin Cough, Delsym (dextromethorphan)YES YES YES YES YES YESRobitussin Cough & ColdYES YES YES YES YES YESRobitussin DM YES YES YES YES YES YESSudafed(pseudoephedrine)NO YES YES YES YES NOTylenol Cold & Flu YES YES YES YES YES YESVicks VapoRub YES YES YES YES YES YESZicam YES YES YES YES YES YESZyrtec (cetirizine) YES YES YES YES YES YESANTIVIRALSTamiflu (oseltamivir) YES YES YES YES YES YESFamvir (famciclovir) Rx YES YES YES YES YES YESValtrex (valacyclovir) Rx YES YES YES YES YES YESZovirax (acyclovir) Rx YES YES YES YES YES YESINSOMNIANatural Remedies:Lavendar oil in bath or apply to temples and wrists. Sleepy Time teaBenadryl (diphenhydramine)YES YES YES YES YES YESCalcium/Magnesium YES YES YES YES YES YESUnisom (doxylamine) YES YES YES YES YES YESSominex (diphenhydramine)YES YES YES YES YES YESNatural Calm MagnesiumYES YES YES YES YES YESINSOMNIANatural Remedies:Lavendar oil in bath or apply to temples and wrists. Sleepy Time teaTylenol PM YES YES YES YES YES YESINDIGESTION/GASNatural Remedies:1-2 drops of peppermint oil, ginger oil, or orange oil in a capsule or directly under your tongue followed by water. Well chewed hazelnuts. Ginger capsules or tea.Papaya enzyme or leaf teaYES YES YES YES YES YESBromelain (pineapple enzyme)YES YES YES YES YES YESDigestive Enzymes YES YES YES YES YES YESGas X (Simethicone) YES YES YES YES YES YESPhazyme (Simethicone)YES YES YES YES YES YESMylicon (Simethicone) YES YES YES YES YES YESCONSTIPATION/LAXATIVES/STOOL SOFTENERSNatural Remedies:Increase water intake (8-10 cups daily). Exercise regularly. Decrease starchy and processed food. Increase fiber (dark green, leafy veggies). Consume prunes or prune juice. Drink warm water with juice of one lemon (can add 1Tbsp of flax seed/oil and/or 1Tbsp of ground psyllium husk). Slippery elm herb.Citrucel YES YES YES YES YES YESColace (docusate sodium) YES YES YES YES YES YESDulcolax Tablets (bisacodyl)YES YES YES YES YES YESMetamucil/Fibercon YES YES YES YES YES YESLactulose Rx YES YES YES YES YES YESMilk of Magnesia YES YES YES YES YES YESMiralax YES YES YES YES YES YESNatural Calm MagnesiumYES YES YES YES YES YESSenokot YES YES YES YES YES YESPAIN/FEVER/HEADACHENatural Remedies:Increase water intake (8-10 cups daily). Caffeine (tea, soda, coffee). Drinking ¼ cup of peppermint tea hourly. Using peppermint or lavender oil on areas of discomfort/pain. Epsom salt baths. Hot/Cold packs. Yoga. Exercise. Chiropractic care. Massage therapy. May need Physical Therapy or Pelvic Floor Therapy. ** Seek care if fever >100.4 and/or headache is unrelieved with medication after 20 weeks gestation**Aleve (naproxen sodium)NO NO NO YES YES YES
Navigang Your Pregnancy 1415Navigang Your Pregnancy PAIN/FEVER/HEADACHENatural Remedies:Increase water intake (8-10 cups daily). Caffeine (tea, soda, coffee). Drinking ¼ cup of peppermint tea hourly. Using peppermint or lavender oil on areas of discomfort/pain. Epsom salt baths. Hot/Cold packs. Yoga. Exercise. Chiropractic care. Massage therapy.May need Physical Therapy or Pelvic Floor Therapy. ** Seek care if fever >100.4 and/or headache is unrelieved with medication after 20 weeks gestation**Aspirin (81 mg) If prescribed If prescribed If prescribed YES YES YESBengay Ointment YES YES YES YES YES YESMotrin, Advil (ibuprofen)NO NO NO YES YES YESTylenol (acetaminophen)YES YES YES YES YES YESTOPICAL CREAMS/OINTMENTSNatural Remedies:Lavendar or pepperment oil directly to site. Dilute oil 1:1 with carrier oil. Oatmeal baths.Benadryl, hydrocortisone, caladryl cream (itching)YES YES YES YES YES YESDigestive Enzymes YES YES YES YES YES YESGas X (Simethicone) YES YES YES YES YES YESRetin A YES YES YES YES YES YESSalicylic Acid NO NO NO YES YES YESBenzoyl Peroxide NO NO NO YES YES YESNeosporin/BacitracinYES YES YES YES YES YESHEMORRHOIDSNatural Remedies:Increase water intake (8-10 cups daily). Avoid straining for bowel movement. Warm sitz baths for 10 min throughout day. Witch hazel or white bark infused cloths: pour 1 pint of boiling water over 1 oz of herbs and steep for 10 hours. Apply several times daily; hot or cold. Refrigerate. Use hemorrhoid E.O. blend: 1oz fractionated coconut oil or KY jelly blended with 4 drops of cypress, 4 drops of helichrysum, and 2 drops of peppermint - apply directly and massage gently.Anusol (cream or suppository)YES YES YES YES YES YESPreparation H YES YES YES YES YES YESTucks Pads YES YES YES YES YES YESLEG CRAMPSNatural Remedies:Soak feet in warm bath with 5 drops of geranium, 10 dorps of lavendar, and 2 drops of cypress.Natural Calm YES YES YES YES YES YESTums (calcium carbonate)YES YES YES YES YES YESUTI SYMPTOMSNatural Remedies:Increase water intake (8-10 cups daily). Do not hold urine for prolonged periods. Cranberry juice and/or capsules often (avoid “cocktail” version).Azo YES YES YES YES YES YESMost people know that smoking causes cancer and other major health problems. Smoking while pregnant or even being around cigarette smoke during pregnancy can cause health concerns for you and your baby. How Can Smoke Harm Your Baby?• Smoking increases the chance that your baby is born prematurely. Premature babies often have health problems after being born.• Smoking raises your baby’s risk for birth defects, including cleft lip, cleft palate, or both. A cleft is an opening in your baby’s lip or in the roof of his or her mouth (palate). He or she can have trouble eating properly and is likely to need surgery. • Smoking slows your baby’s growth before birth. Your baby may be born too small, even when born full-term.• Smoking can damage your baby’s developing lungs and brain. The damage can last through childhood and into the teen years. • Smoking doubles your risk of abnormal bleeding during pregnancy and delivery. This can put both you and your baby in danger. • Babies of moms who smoke during pregnancy—and babies exposed to cigarette smoke after birth—have a higher risk for SIDS, Sudden Infant Death Syndrome.It is best to quit smoking before you get pregnant. But if you’re already pregnant, quitting can still help protect you and your baby from health problems. It’s never too late to quit smoking. If you need help, talk to your provider.Benefits - When You Stop Smoking • Your baby gets more oxygen, even after 1 day.• Your baby will grow better.• Your baby is less likely to be born too early. • You’ll have more energy and breathe more easily.The Dangers of Smoking While PregnantSources: Dutton, L. A., Densmore, J.E., Turner, M.B (2010). A pocket guide to clinical midwifery, the efficient midwife. Sudbury, MA: Jones & Bartlett Publishers Fritz, S. (2012). Essenal oils for pregnancy, birth, and babies. Sierra Vista, AZ: Gently Born Publicaons. Gladstar, R. (1993). Herbal healing for women. New York, NY: Rockefeller CenterWeed, S. (1986). Wise woman herbal for the childbearing year. Boulder, CO: Informed Homebirth. This informaon also comes from the app Infant Risk Center from Texas Tech University Health Sciences Center. You can nd expanded informaon on this app or by going to infantrisk.com.
Navigang Your Pregnancy 1415Navigang Your Pregnancy PAIN/FEVER/HEADACHENatural Remedies:Increase water intake (8-10 cups daily). Caffeine (tea, soda, coffee). Drinking ¼ cup of peppermint tea hourly. Using peppermint or lavender oil on areas of discomfort/pain. Epsom salt baths. Hot/Cold packs. Yoga. Exercise. Chiropractic care. Massage therapy.May need Physical Therapy or Pelvic Floor Therapy. ** Seek care if fever >100.4 and/or headache is unrelieved with medication after 20 weeks gestation**Aspirin (81 mg) If prescribed If prescribed If prescribed YES YES YESBengay Ointment YES YES YES YES YES YESMotrin, Advil (ibuprofen)NO NO NO YES YES YESTylenol (acetaminophen)YES YES YES YES YES YESTOPICAL CREAMS/OINTMENTSNatural Remedies:Lavendar or pepperment oil directly to site. Dilute oil 1:1 with carrier oil. Oatmeal baths.Benadryl, hydrocortisone, caladryl cream (itching)YES YES YES YES YES YESDigestive Enzymes YES YES YES YES YES YESGas X (Simethicone) YES YES YES YES YES YESRetin A YES YES YES YES YES YESSalicylic Acid NO NO NO YES YES YESBenzoyl Peroxide NO NO NO YES YES YESNeosporin/BacitracinYES YES YES YES YES YESHEMORRHOIDSNatural Remedies:Increase water intake (8-10 cups daily). Avoid straining for bowel movement. Warm sitz baths for 10 min throughout day. Witch hazel or white bark infused cloths: pour 1 pint of boiling water over 1 oz of herbs and steep for 10 hours. Apply several times daily; hot or cold. Refrigerate. Use hemorrhoid E.O. blend: 1oz fractionated coconut oil or KY jelly blended with 4 drops of cypress, 4 drops of helichrysum, and 2 drops of peppermint - apply directly and massage gently.Anusol (cream or suppository)YES YES YES YES YES YESPreparation H YES YES YES YES YES YESTucks Pads YES YES YES YES YES YESLEG CRAMPSNatural Remedies:Soak feet in warm bath with 5 drops of geranium, 10 dorps of lavendar, and 2 drops of cypress.Natural Calm YES YES YES YES YES YESTums (calcium carbonate)YES YES YES YES YES YESUTI SYMPTOMSNatural Remedies:Increase water intake (8-10 cups daily). Do not hold urine for prolonged periods. Cranberry juice and/or capsules often (avoid “cocktail” version).Azo YES YES YES YES YES YESMost people know that smoking causes cancer and other major health problems. Smoking while pregnant or even being around cigarette smoke during pregnancy can cause health concerns for you and your baby. How Can Smoke Harm Your Baby?• Smoking increases the chance that your baby is born prematurely. Premature babies often have health problems after being born.• Smoking raises your baby’s risk for birth defects, including cleft lip, cleft palate, or both. A cleft is an opening in your baby’s lip or in the roof of his or her mouth (palate). He or she can have trouble eating properly and is likely to need surgery. • Smoking slows your baby’s growth before birth. Your baby may be born too small, even when born full-term.• Smoking can damage your baby’s developing lungs and brain. The damage can last through childhood and into the teen years. • Smoking doubles your risk of abnormal bleeding during pregnancy and delivery. This can put both you and your baby in danger. • Babies of moms who smoke during pregnancy—and babies exposed to cigarette smoke after birth—have a higher risk for SIDS, Sudden Infant Death Syndrome.It is best to quit smoking before you get pregnant. But if you’re already pregnant, quitting can still help protect you and your baby from health problems. It’s never too late to quit smoking. If you need help, talk to your provider.Benefits - When You Stop Smoking • Your baby gets more oxygen, even after 1 day.• Your baby will grow better.• Your baby is less likely to be born too early. • You’ll have more energy and breathe more easily.The Dangers of Smoking While PregnantSources: Dutton, L. A., Densmore, J.E., Turner, M.B (2010). A pocket guide to clinical midwifery, the efficient midwife. Sudbury, MA: Jones & Bartlett Publishers Fritz, S. (2012). Essenal oils for pregnancy, birth, and babies. Sierra Vista, AZ: Gently Born Publicaons. Gladstar, R. (1993). Herbal healing for women. New York, NY: Rockefeller CenterWeed, S. (1986). Wise woman herbal for the childbearing year. Boulder, CO: Informed Homebirth. This informaon also comes from the app Infant Risk Center from Texas Tech University Health Sciences Center. You can nd expanded informaon on this app or by going to infantrisk.com.
Navigang Your Pregnancy 1617Navigang Your Pregnancy If you smoked previously and had a healthy pregnancy in the past, there’s no guarantee that your next pregnancy will be healthy. When you smoke during pregnancy, you put your health and your baby’s health at risk.PesticidesPesticides are chemicals used to kill bugs. They are found in water, on fruits and vegetables, in gardens and parks, and most places plants grow. Make sure to wash all fruits and vegetables before eating them. It is a good idea to peel them, too. Pregnant women should avoid pesticides, but if you must use them: have someone else apply the chemical if possible or wear gloves and clothing that you can wash. Avoid being in the area where pesticides have been used for 24 hours. Remove food, dishes, towels, and eating utensils from the area where pesticides are used. Cleaning Products There are lots of chemicals used in cleaning products. Make sure to read the labels for warnings for pregnant women. NEVER use anything labeled “toxic.” Do not mix ammonia and chlorine products. The mixture makes a gas that is harmful for anyone. There are many natural products, which can be safer to use during pregnancy. If you use any cleaning products, make sure to wear thick rubber gloves and open the windows to get rid of the fumes.Environmental Hazards During PregnancyLead Exposure Lead can be damaging to the nervous system. It has been illegal to use lead in household products since 1978, but lead might be found in the paint and pipes present in older homes. Other sources of lead include drinking water from old pipes, lead crystal glassware, some ceramic dishes, wicks of scented candles, and the plastic grips on some hand tools. Lead may also be found in some arts and crafts materials, such as oil paints, ceramic glazes, and stained-glass supplies. If you think you have lead paint in your home, you can paint over it with latex paint, or there are ways to have it removed safely. You should not be in or around the house for several hours when this happens. If you think your water may have lead in it, contact your state health department to nd out how to get your pipes tested. Many home-water lters do not remove lead, so you should read their labels carefully. Only use cold tap water and let the water run for 30 to 60 seconds before drinking it. Never use tap water to prepare infant formula. If you are worried about the pipes in your home, use a reverse osmosis water lter such as a Brita.Some pregnant women have a desire to eat clay soil or chips of clay pottery. This is called “pica” and can result in lead poisoning. Let your health care provider know if you are eating clay.Acrylic Nails Chemicals used in nail salons can be dangerous and may cause nausea, headaches, or dizziness. These symptoms can happen to anyone but may be more likely when you’re pregnant due to a heightened sense of smell. Consider avoiding nail salons while pregnant.Hair Products Hair products such as dyes, permanents, and straighteners are all safe to use during pregnancy. You will get a very small amount of the chemical into your body from your scalp, but there are no reports that this exposure is harmful to you or your baby.
Navigang Your Pregnancy 1617Navigang Your Pregnancy If you smoked previously and had a healthy pregnancy in the past, there’s no guarantee that your next pregnancy will be healthy. When you smoke during pregnancy, you put your health and your baby’s health at risk.PesticidesPesticides are chemicals used to kill bugs. They are found in water, on fruits and vegetables, in gardens and parks, and most places plants grow. Make sure to wash all fruits and vegetables before eating them. It is a good idea to peel them, too. Pregnant women should avoid pesticides, but if you must use them: have someone else apply the chemical if possible or wear gloves and clothing that you can wash. Avoid being in the area where pesticides have been used for 24 hours. Remove food, dishes, towels, and eating utensils from the area where pesticides are used. Cleaning Products There are lots of chemicals used in cleaning products. Make sure to read the labels for warnings for pregnant women. NEVER use anything labeled “toxic.” Do not mix ammonia and chlorine products. The mixture makes a gas that is harmful for anyone. There are many natural products, which can be safer to use during pregnancy. If you use any cleaning products, make sure to wear thick rubber gloves and open the windows to get rid of the fumes.Environmental Hazards During PregnancyLead Exposure Lead can be damaging to the nervous system. It has been illegal to use lead in household products since 1978, but lead might be found in the paint and pipes present in older homes. Other sources of lead include drinking water from old pipes, lead crystal glassware, some ceramic dishes, wicks of scented candles, and the plastic grips on some hand tools. Lead may also be found in some arts and crafts materials, such as oil paints, ceramic glazes, and stained-glass supplies. If you think you have lead paint in your home, you can paint over it with latex paint, or there are ways to have it removed safely. You should not be in or around the house for several hours when this happens. If you think your water may have lead in it, contact your state health department to nd out how to get your pipes tested. Many home-water lters do not remove lead, so you should read their labels carefully. Only use cold tap water and let the water run for 30 to 60 seconds before drinking it. Never use tap water to prepare infant formula. If you are worried about the pipes in your home, use a reverse osmosis water lter such as a Brita.Some pregnant women have a desire to eat clay soil or chips of clay pottery. This is called “pica” and can result in lead poisoning. Let your health care provider know if you are eating clay.Acrylic Nails Chemicals used in nail salons can be dangerous and may cause nausea, headaches, or dizziness. These symptoms can happen to anyone but may be more likely when you’re pregnant due to a heightened sense of smell. Consider avoiding nail salons while pregnant.Hair Products Hair products such as dyes, permanents, and straighteners are all safe to use during pregnancy. You will get a very small amount of the chemical into your body from your scalp, but there are no reports that this exposure is harmful to you or your baby.
Navigang Your Pregnancy 1819Navigang Your Pregnancy Do All Women Experience Nausea or Vomiting During Pregnancy? About 1 in 4 pregnant women have only mild nausea. Three of every 10 pregnant women have nausea that is bad enough to interfere with their daily lives. Half of all pregnant women have both nausea and vomiting during the first months of pregnancy. Nausea and vomiting during pregnancy tends to be the worst at 8 to 10 weeks after your last menstrual period. It usually goes away by 12 to 16 weeks of pregnancy. Nausea and vomiting during pregnancy is often called “morning sickness” but can occur at any time day or night.What Causes Nausea and Vomiting During Pregnancy? The cause of nausea and vomiting during pregnancy is still unknown. Changes in hormone levels may be involved. If your mother had morning sickness when she was pregnant, you may be more likely to have nausea and vomiting during pregnancy. A history of motion sickness or stomach problems before you got pregnant may be another risk factor. Nausea during pregnancy is worse if you are dehydrated (there is not enough fluid in your body) or if the level of sugar in your blood is low from not eating often enough.Is Nausea and Vomiting During Pregnancy Dangerous? Mild nausea and vomiting may make you feel awful, but it will not hurt you or your baby. You can talk to your provider about ways to make you feel better if nausea and/or vomiting is making it hard for you to do your normal activities. Lots of vomiting that makes it difficult to keep food down is rare and can cause health problems. You should call your health care provider if any of the following happen:• You are not able to keep any liquids or foods down for 24 hours• You are vomiting several times a day or after every meal• You have abdominal pain, difficulty urinating, or a fever• You do not urinate as often as usual and your urine is dark in colorNausea/Vomiting in Pregnancy• You are weak, dizzy, or faint when you stand up• You do not gain weight or you lose weight in a weekHow Are Nausea and Vomiting Treated? The following is a list of things you can try before starting prescription medication:• Diet changes are the initial treatment for nausea and vomiting in pregnancy.• Eat small meals and frequent snacks slowly before feeling hungry to avoid an empty stomach.• Avoid drinking fluids on an empty stomach.• Protein filled snacks may decrease nausea. Consider eating a few nuts before getting out of bed in the morning and before going to bed at night.• BRAT Diet: Bananas, Rice, Applesauce, and plain Toast when reintroducing food after period of nausea and vomiting.• Eliminate coffee and spicy, odorous, high fat, acidic, and very sweet foods.• Drinking peppermint tea or sucking peppermint or sour candies can reduce nausea after eating.• Ginger may help - recommended dose is 250 mg four times daily or try ginger chews, tea, or candy (pregnancy pops).• Broth (vegetable or chicken or beef broth) eaten slowly by the spoonful.• Lemonade or coke slushy: Pour lemonade or coke into a glass and place in the freezer until it has slush-like consistency (not frozen); eat slowly.• Acupuncture is an alternative treatment proven to help with nausea and vomiting ask for recommendations.
Navigang Your Pregnancy 1819Navigang Your Pregnancy Do All Women Experience Nausea or Vomiting During Pregnancy? About 1 in 4 pregnant women have only mild nausea. Three of every 10 pregnant women have nausea that is bad enough to interfere with their daily lives. Half of all pregnant women have both nausea and vomiting during the first months of pregnancy. Nausea and vomiting during pregnancy tends to be the worst at 8 to 10 weeks after your last menstrual period. It usually goes away by 12 to 16 weeks of pregnancy. Nausea and vomiting during pregnancy is often called “morning sickness” but can occur at any time day or night.What Causes Nausea and Vomiting During Pregnancy? The cause of nausea and vomiting during pregnancy is still unknown. Changes in hormone levels may be involved. If your mother had morning sickness when she was pregnant, you may be more likely to have nausea and vomiting during pregnancy. A history of motion sickness or stomach problems before you got pregnant may be another risk factor. Nausea during pregnancy is worse if you are dehydrated (there is not enough fluid in your body) or if the level of sugar in your blood is low from not eating often enough.Is Nausea and Vomiting During Pregnancy Dangerous? Mild nausea and vomiting may make you feel awful, but it will not hurt you or your baby. You can talk to your provider about ways to make you feel better if nausea and/or vomiting is making it hard for you to do your normal activities. Lots of vomiting that makes it difficult to keep food down is rare and can cause health problems. You should call your health care provider if any of the following happen:• You are not able to keep any liquids or foods down for 24 hours• You are vomiting several times a day or after every meal• You have abdominal pain, difficulty urinating, or a fever• You do not urinate as often as usual and your urine is dark in colorNausea/Vomiting in Pregnancy• You are weak, dizzy, or faint when you stand up• You do not gain weight or you lose weight in a weekHow Are Nausea and Vomiting Treated? The following is a list of things you can try before starting prescription medication:• Diet changes are the initial treatment for nausea and vomiting in pregnancy.• Eat small meals and frequent snacks slowly before feeling hungry to avoid an empty stomach.• Avoid drinking fluids on an empty stomach.• Protein filled snacks may decrease nausea. Consider eating a few nuts before getting out of bed in the morning and before going to bed at night.• BRAT Diet: Bananas, Rice, Applesauce, and plain Toast when reintroducing food after period of nausea and vomiting.• Eliminate coffee and spicy, odorous, high fat, acidic, and very sweet foods.• Drinking peppermint tea or sucking peppermint or sour candies can reduce nausea after eating.• Ginger may help - recommended dose is 250 mg four times daily or try ginger chews, tea, or candy (pregnancy pops).• Broth (vegetable or chicken or beef broth) eaten slowly by the spoonful.• Lemonade or coke slushy: Pour lemonade or coke into a glass and place in the freezer until it has slush-like consistency (not frozen); eat slowly.• Acupuncture is an alternative treatment proven to help with nausea and vomiting ask for recommendations.
Navigang Your Pregnancy 2021Navigang Your Pregnancy Medication for Nausea and VomitingIf diet changes and acupuncture do not work, then your doctor may recommend and/or prescribe medications for you. Many drugs have been shown to be safe during pregnancy, but others have limited safety information. Diclegis/Bonjesta or B6 (Pyridoxine) and Unisom (Doxylamine) are the only FDA approved drugs for nausea and vomiting in pregnancy. Phenergan may also be prescribed to you if these medications do not work. For nausea and vomiting, take Vitamin B6 and Unisom tablets as directed below:• Take Vitamin B6 (25 mg) up to 3 times a day alone. Some women find this is effective for nausea. If that does not work, then:• Day 1: Take (1) 25 mg tablet of Vitamin B6 and one half (12.5 mg) of a 25 mg tablet of Doxylamine (Unisom) at bedtime. If no improvement or not enough improvement by day 3 then:• Day 3: Take (1) Vitamin B6, 25 mg tablet and one half (12.5 mg) of a 25 mg tablet of Doxylamine (Unisom) in morning, and Vitamin B6, 25mg one tab and one half (12.5 mg) of a 25 mg tablet of Doxylamine (Unisom) at bedtime. If symptoms persist:• Day 4: Start Vitamin B6 25mg one tablet and Doxylamine 25mg half tablet (12.5 mg) in the morning, 25mg Vitamin B6 at lunch and Vitamin B6 25mg one tab and one half (12.5 mg) of a 25 mg tablet of Doxylamine (Unisom) at bedtime.What Should I Eat? You do not have to eat a lot of extra food during pregnancy. But it is important to eat the right food. You only need around 400 extra calories per day than you needed before you were pregnant. You will feel better if you eat something every few hours. Eating small meals 5 or 6 times a day rather than larger meals less often will help you feel better and make sure your baby has a steady supply of food. Every day, make sure you have: • 6 to 8 glasses of water. • 6 to 9 servings of whole grains, like bread or pasta. By reading the label, you will know that you are getting “whole” grains and not just brown-colored bread or pasta (1 slice of bread or one half cup of cooked pasta is a serving). • 3 to 4 servings of fruit. Fresh, raw fruit is best (1 small apple or one half cup of chopped fruit is a serving).• 4 to 5 servings of vegetables (1 medium carrot or one half cup of chopped vegetables is a serving).• 2 to 3 servings of lean meat, fish, eggs, or nuts. (A piece of meat the size of a pack of playing cards is 1 serving).• 1 serving of Vitamin C-rich food, like oranges, sweet peppers, or tomatoes (a half of a cup is a serving). • 2 to 3 servings of iron-rich foods (black-eye peas, sweet potatoes, greens, dried fruit, or meat).• 1 serving of a food rich in folic acid (dark greens, leafy vegetables) one half cup is a serving.Taking Good Care of Yourself in Pregnancy
Navigang Your Pregnancy 2021Navigang Your Pregnancy Medication for Nausea and VomitingIf diet changes and acupuncture do not work, then your doctor may recommend and/or prescribe medications for you. Many drugs have been shown to be safe during pregnancy, but others have limited safety information. Diclegis/Bonjesta or B6 (Pyridoxine) and Unisom (Doxylamine) are the only FDA approved drugs for nausea and vomiting in pregnancy. Phenergan may also be prescribed to you if these medications do not work. For nausea and vomiting, take Vitamin B6 and Unisom tablets as directed below:• Take Vitamin B6 (25 mg) up to 3 times a day alone. Some women find this is effective for nausea. If that does not work, then:• Day 1: Take (1) 25 mg tablet of Vitamin B6 and one half (12.5 mg) of a 25 mg tablet of Doxylamine (Unisom) at bedtime. If no improvement or not enough improvement by day 3 then:• Day 3: Take (1) Vitamin B6, 25 mg tablet and one half (12.5 mg) of a 25 mg tablet of Doxylamine (Unisom) in morning, and Vitamin B6, 25mg one tab and one half (12.5 mg) of a 25 mg tablet of Doxylamine (Unisom) at bedtime. If symptoms persist:• Day 4: Start Vitamin B6 25mg one tablet and Doxylamine 25mg half tablet (12.5 mg) in the morning, 25mg Vitamin B6 at lunch and Vitamin B6 25mg one tab and one half (12.5 mg) of a 25 mg tablet of Doxylamine (Unisom) at bedtime.What Should I Eat? You do not have to eat a lot of extra food during pregnancy. But it is important to eat the right food. You only need around 400 extra calories per day than you needed before you were pregnant. You will feel better if you eat something every few hours. Eating small meals 5 or 6 times a day rather than larger meals less often will help you feel better and make sure your baby has a steady supply of food. Every day, make sure you have: • 6 to 8 glasses of water. • 6 to 9 servings of whole grains, like bread or pasta. By reading the label, you will know that you are getting “whole” grains and not just brown-colored bread or pasta (1 slice of bread or one half cup of cooked pasta is a serving). • 3 to 4 servings of fruit. Fresh, raw fruit is best (1 small apple or one half cup of chopped fruit is a serving).• 4 to 5 servings of vegetables (1 medium carrot or one half cup of chopped vegetables is a serving).• 2 to 3 servings of lean meat, fish, eggs, or nuts. (A piece of meat the size of a pack of playing cards is 1 serving).• 1 serving of Vitamin C-rich food, like oranges, sweet peppers, or tomatoes (a half of a cup is a serving). • 2 to 3 servings of iron-rich foods (black-eye peas, sweet potatoes, greens, dried fruit, or meat).• 1 serving of a food rich in folic acid (dark greens, leafy vegetables) one half cup is a serving.Taking Good Care of Yourself in Pregnancy
Navigang Your Pregnancy 2223Navigang Your Pregnancy What is Safe to Eat?The Food and Drug Administration (FDA), the Environmental Protection Agency (EPA), and the 2015-2020 Dietary Guidelines for Americans recommend that pregnant women eat at least 8 ounces and up to 12 ounces (340 grams) of a variety of seafood low in mercury a week. That’s about two to three servings.Seafood that is low in mercury and high in omega-3 fatty acids, such as:• Salmon, anchovies, herring, sardines, tilapia, catfish, freshwater trout, pacific mackerel, shrimp, pollock, cod, and canned light tuna.General Precautions:• To reduce exposure to mercury do not eat shark, swordfish, king mackerel or tilefish. • Limit white (albacore) tuna and tuna steaks to 6 oz (170 grams) a week.• To avoid harmful bacteria or viruses, don’t eat uncooked fish and shellfish, including oysters, sushi, sashimi, and refrigerated uncooked seafood labeled nova style, lox, kippered, smoked or jerky.• If you eat fish from local waters, pay attention to local advisories. If advice isn’t available, limit fish from local water to 6 ounces (170 grams) a week.• Cook seafood properly. Most seafood should be cooked to an internal temperature of 145 F (63 C). Fish is done when it separates into flakes and appears opaque throughout. Cook shrimp and lobster until the flesh is pearly and opaque. Cook clams, mussels, and oysters until their shells open. Discard any that don’t open. • Dairy products are an important source of calcium, and calcium helps build strong bones and teeth. But some dairy products carry dangerous germs. To keep yourself and your baby safe, eat and drink only pasteurized dairy products.• Any food that is spoiled or not cooked well can make you sick. Do not eat any meat or fish that has not been cooked all the way through. Do not eat any cooked food that has not been kept hot or chilled.• Wash knives, cutting boards, and your hands between handling raw meat and any other food like fruits and vegetables that you plan to eat raw.• Wash all fruits and vegetables with 1 tablespoon of vinegar in a pan of water to kill germs before you eat them.• Alcohol - There is no known safe amount of alcohol in pregnancy. It is safest to avoid all alcohol.• Caffeine - 2 cups of a caffeinated beverage each day is safe during pregnancy. This means 2 small cups of coffee or tea or 1 can of caffeinated soda. This is equivalent to 200 mg of caffeine. Avoid coffee beverages with excessive added sugars often found at coffee shops and in grocery stores.The Importance of Prenatal Vitamins:• A healthy diet is the best way to get the vitamins and minerals you need, but during pregnancy you might fall short on key nutrients. Prenatal vitamins can help fill any gaps.• Folic acid helps prevent neural tube defects. These defects are serious abnormalities of the fetal brain and spinal cord. Ideally, you’ll begin taking extra folic acid at least 3 months before you become pregnant. • Iron supports the development of the placenta and fetus. Iron helps your body make blood to supply oxygen to the fetus. Iron also helps prevent anemia, a condition in which blood has a low number of healthy red blood cells.• If you find that your vitamins upset your stomach, try taking your prenatal vitamin at night before you go to bed.
Navigang Your Pregnancy 2223Navigang Your Pregnancy What is Safe to Eat?The Food and Drug Administration (FDA), the Environmental Protection Agency (EPA), and the 2015-2020 Dietary Guidelines for Americans recommend that pregnant women eat at least 8 ounces and up to 12 ounces (340 grams) of a variety of seafood low in mercury a week. That’s about two to three servings.Seafood that is low in mercury and high in omega-3 fatty acids, such as:• Salmon, anchovies, herring, sardines, tilapia, catfish, freshwater trout, pacific mackerel, shrimp, pollock, cod, and canned light tuna.General Precautions:• To reduce exposure to mercury do not eat shark, swordfish, king mackerel or tilefish. • Limit white (albacore) tuna and tuna steaks to 6 oz (170 grams) a week.• To avoid harmful bacteria or viruses, don’t eat uncooked fish and shellfish, including oysters, sushi, sashimi, and refrigerated uncooked seafood labeled nova style, lox, kippered, smoked or jerky.• If you eat fish from local waters, pay attention to local advisories. If advice isn’t available, limit fish from local water to 6 ounces (170 grams) a week.• Cook seafood properly. Most seafood should be cooked to an internal temperature of 145 F (63 C). Fish is done when it separates into flakes and appears opaque throughout. Cook shrimp and lobster until the flesh is pearly and opaque. Cook clams, mussels, and oysters until their shells open. Discard any that don’t open. • Dairy products are an important source of calcium, and calcium helps build strong bones and teeth. But some dairy products carry dangerous germs. To keep yourself and your baby safe, eat and drink only pasteurized dairy products.• Any food that is spoiled or not cooked well can make you sick. Do not eat any meat or fish that has not been cooked all the way through. Do not eat any cooked food that has not been kept hot or chilled.• Wash knives, cutting boards, and your hands between handling raw meat and any other food like fruits and vegetables that you plan to eat raw.• Wash all fruits and vegetables with 1 tablespoon of vinegar in a pan of water to kill germs before you eat them.• Alcohol - There is no known safe amount of alcohol in pregnancy. It is safest to avoid all alcohol.• Caffeine - 2 cups of a caffeinated beverage each day is safe during pregnancy. This means 2 small cups of coffee or tea or 1 can of caffeinated soda. This is equivalent to 200 mg of caffeine. Avoid coffee beverages with excessive added sugars often found at coffee shops and in grocery stores.The Importance of Prenatal Vitamins:• A healthy diet is the best way to get the vitamins and minerals you need, but during pregnancy you might fall short on key nutrients. Prenatal vitamins can help fill any gaps.• Folic acid helps prevent neural tube defects. These defects are serious abnormalities of the fetal brain and spinal cord. Ideally, you’ll begin taking extra folic acid at least 3 months before you become pregnant. • Iron supports the development of the placenta and fetus. Iron helps your body make blood to supply oxygen to the fetus. Iron also helps prevent anemia, a condition in which blood has a low number of healthy red blood cells.• If you find that your vitamins upset your stomach, try taking your prenatal vitamin at night before you go to bed.
Navigang Your Pregnancy 2425Navigang Your Pregnancy Source: Food and Drug Administration and Environmental Protection Agency (EPA)Exercising While PregnantIt is safe to exercise during pregnancy if you are healthy and there are no complications in your pregnancy. It is always best to discuss this topic with your provider during your first prenatal visit. Exercising regularly has several benefits for the mom and the baby:• Promotes healthy weight gain during pregnancy• Reduces back pain• Helps with constipation• Helps the mom lose the baby weight after the baby is born• Improves overall healthIf you were physically active before pregnancy, you can usually continue your workout routine during pregnancy. Listen to your body closely. If an activity becomes painful or very difficult, use a modification. If you are new to exercise, the following activities are safe in pregnancy:• Walking • Stationary bicycling• Pregnancy yoga• Modified Pilates Some sports can put you at an increased risk of injury and should be avoided. Those include:• Skydiving• Gymnastics• Horseback riding• Snow skiing/Water skiing• Surfing • Contact sports (boxing, soccer, football, basketball)• Ice Hockey• Scuba DivingPlease keep in mind, exercising is safe during pregnancy with some exceptions. Every person and pregnancy is different. Ask your provider early in pregnancy if exercise is safe for you.
Navigang Your Pregnancy 2425Navigang Your Pregnancy Source: Food and Drug Administration and Environmental Protection Agency (EPA)Exercising While PregnantIt is safe to exercise during pregnancy if you are healthy and there are no complications in your pregnancy. It is always best to discuss this topic with your provider during your first prenatal visit. Exercising regularly has several benefits for the mom and the baby:• Promotes healthy weight gain during pregnancy• Reduces back pain• Helps with constipation• Helps the mom lose the baby weight after the baby is born• Improves overall healthIf you were physically active before pregnancy, you can usually continue your workout routine during pregnancy. Listen to your body closely. If an activity becomes painful or very difficult, use a modification. If you are new to exercise, the following activities are safe in pregnancy:• Walking • Stationary bicycling• Pregnancy yoga• Modified Pilates Some sports can put you at an increased risk of injury and should be avoided. Those include:• Skydiving• Gymnastics• Horseback riding• Snow skiing/Water skiing• Surfing • Contact sports (boxing, soccer, football, basketball)• Ice Hockey• Scuba DivingPlease keep in mind, exercising is safe during pregnancy with some exceptions. Every person and pregnancy is different. Ask your provider early in pregnancy if exercise is safe for you.
Navigang Your Pregnancy 2627Navigang Your Pregnancy How Much Weight Should I Gain During My Pregnancy?The healthiest weight gain for you during pregnancy depends on your body mass index (BMI) before you were pregnant. Your BMI is based on your height and weight. Your BMI number will tell you if you are underweight, normal, overweight, or obese. You can use the chart at the top of the next page to find your BMI number. If you have a BMI of 25 or more before you start pregnancy, it is healthiest if you gain less weight during pregnancy.Pre-pregnancy Weight Healthy Weight Gain During PregnancyUnderweight (BMI less than 18.5) 28 - 40 lbsNormal (BMI between 18.5 and 24.9) 25 - 35 lbsOverweight (BMI between 25.0 and 29.9) 15 - 25 lbsObese (BMI of 30 or more) 11 - 20 lbsUse this chart to calculate your BMI. You can also use tools on the internet to calculate your BMI.
Navigang Your Pregnancy 2627Navigang Your Pregnancy How Much Weight Should I Gain During My Pregnancy?The healthiest weight gain for you during pregnancy depends on your body mass index (BMI) before you were pregnant. Your BMI is based on your height and weight. Your BMI number will tell you if you are underweight, normal, overweight, or obese. You can use the chart at the top of the next page to find your BMI number. If you have a BMI of 25 or more before you start pregnancy, it is healthiest if you gain less weight during pregnancy.Pre-pregnancy Weight Healthy Weight Gain During PregnancyUnderweight (BMI less than 18.5) 28 - 40 lbsNormal (BMI between 18.5 and 24.9) 25 - 35 lbsOverweight (BMI between 25.0 and 29.9) 15 - 25 lbsObese (BMI of 30 or more) 11 - 20 lbsUse this chart to calculate your BMI. You can also use tools on the internet to calculate your BMI.
Navigang Your Pregnancy 2829Navigang Your Pregnancy Contact Your Provider Immediately If You Experience These Symptoms: • Severe nausea or vomiting • Bleeding from your vagina that is heavier than spotting • Clear fluid leaking from your vagina • Fever or chills not relieved by Tylenol • Shortness of breath or a racing heart • Pain or swelling in one leg • Experienced a hit or blow to your stomach from a fall, car accident or violence incidentWhen to See Your Provider As Soon As Possible: • Problems with your emotional health that lasts longer than 2 weeks - such as feeling depressed or anxious, or being unable to do your usual everyday tasks • An unusual discharge from your vagina • Weight loss • A feeling of needing to urinate frequently, pain or burning feeling when you urinate Early Pregnancy Warning Signs (Before 20 weeks): Contact your provider if you have: • Severe pain or cramping in your lower abdomen - especially if you also have bleeding from your vagina • Dizziness or faintingMid to Late Pregnancy Warning Signs (After 20 weeks): Contact your provider if you have: • Changes in your vision, flashing lights or blurry vision • A headache that doesn’t get better with pain-relieving medicine • Pain under your ribs on the right side • Extreme itchiness of your skin, especially your hands and feetWarning Signs in PregnancyWhat Information Do These Tests Provide?Prenatal genetic testing gives parents-to-be information about whether their baby has certain genetic disorders. Genetic disorders are caused by changes in a person’s genes or chromosomes. Aneuploidy is a condition in which there are missing or extra chromosomes. In a trisomy, there is an extra chromosome. In a monosomy, a chromosome is missing. Inherited disorders are caused by changes in genes called mutations. Inherited disorders include sickle cell disease, cystic fibrosis, Tay-Sachs disease, and many others. In most cases, both parents must carry the same gene to have an affected child.Prenatal genetic testing is a screening test and will deliver a result indicating whether there is increased or decreased risk that your baby has the condition being screened.Most tests will screen negative and may not require any further testing. However, any patient with a positive result may be offered genetic counseling and/or diagnostic testing with the maternal fetal medicine doctors for confirmation of test results. And like many screening tests, there is a risk of false negative and false positive results. Only a diagnostic test will deliver a definitive positive or negative result, so remember to speak with your healthcare provider about your test results. What are the Types of Prenatal Genetic Tests Offered at TPMG? We routinely offer two non-invasive genetic tests performed through maternal blood draw:NIPT (MaterniT21 Plus) with or without gender• The NIPT/MaterniT21 can be done any time after 9 weeks and requires you to be preauthorized before it can be performed. You must do the preauthorization online with LabCorp. There is a form at the end of this booklet that will walk you through how to get preauthorization.Genetic Testing
Navigang Your Pregnancy 2829Navigang Your Pregnancy Contact Your Provider Immediately If You Experience These Symptoms: • Severe nausea or vomiting • Bleeding from your vagina that is heavier than spotting • Clear fluid leaking from your vagina • Fever or chills not relieved by Tylenol • Shortness of breath or a racing heart • Pain or swelling in one leg • Experienced a hit or blow to your stomach from a fall, car accident or violence incidentWhen to See Your Provider As Soon As Possible: • Problems with your emotional health that lasts longer than 2 weeks - such as feeling depressed or anxious, or being unable to do your usual everyday tasks • An unusual discharge from your vagina • Weight loss • A feeling of needing to urinate frequently, pain or burning feeling when you urinate Early Pregnancy Warning Signs (Before 20 weeks): Contact your provider if you have: • Severe pain or cramping in your lower abdomen - especially if you also have bleeding from your vagina • Dizziness or faintingMid to Late Pregnancy Warning Signs (After 20 weeks): Contact your provider if you have: • Changes in your vision, flashing lights or blurry vision • A headache that doesn’t get better with pain-relieving medicine • Pain under your ribs on the right side • Extreme itchiness of your skin, especially your hands and feetWarning Signs in PregnancyWhat Information Do These Tests Provide?Prenatal genetic testing gives parents-to-be information about whether their baby has certain genetic disorders. Genetic disorders are caused by changes in a person’s genes or chromosomes. Aneuploidy is a condition in which there are missing or extra chromosomes. In a trisomy, there is an extra chromosome. In a monosomy, a chromosome is missing. Inherited disorders are caused by changes in genes called mutations. Inherited disorders include sickle cell disease, cystic fibrosis, Tay-Sachs disease, and many others. In most cases, both parents must carry the same gene to have an affected child.Prenatal genetic testing is a screening test and will deliver a result indicating whether there is increased or decreased risk that your baby has the condition being screened.Most tests will screen negative and may not require any further testing. However, any patient with a positive result may be offered genetic counseling and/or diagnostic testing with the maternal fetal medicine doctors for confirmation of test results. And like many screening tests, there is a risk of false negative and false positive results. Only a diagnostic test will deliver a definitive positive or negative result, so remember to speak with your healthcare provider about your test results. What are the Types of Prenatal Genetic Tests Offered at TPMG? We routinely offer two non-invasive genetic tests performed through maternal blood draw:NIPT (MaterniT21 Plus) with or without gender• The NIPT/MaterniT21 can be done any time after 9 weeks and requires you to be preauthorized before it can be performed. You must do the preauthorization online with LabCorp. There is a form at the end of this booklet that will walk you through how to get preauthorization.Genetic Testing
Navigang Your Pregnancy 3031Navigang Your Pregnancy • MaterniT21 Plus screens for certain chromosomal abnormalities called trisomies. These include Trisomy 21 (Down syndrome), Trisomy 18 (Edwards syndrome), Trisomy 13 (Patau syndrome), Trisomy 16 and Trisomy 22. MaterniT21 Plus also identifies fetal sex. It digs deeper, screening for other less common but serious conditions as well. These include certain sex chromosome aneuploidies or SCAs (abnormal numbers of X or Y chromosome) and selected microdeletions (missing parts of chromosomes). These rare abnormalities can have profound consequences in the life and health of your child. These less common abnormalities include SCAS 45, X (Turner Syndrome), 47, XXY (Klinefelter syndrome) 47, XXX (Triple X Syndrome) 47, XYY (XYY Syndrome). Microdeletions include 22q (DiGeorge Syndrome), 11q (Jacobsen syndrome), 5p (Cri-du-chat syndrome), 8q (Langer-Giedion syndrome), 1p36 deletion syndrome, 4p (Wolf-Hirschhorn syndrome), and 15q (Prader-Willi syndrome; Angelman syndrome).Quad Screen• The Quad Screen is covered by all insurance companies and is performed anytime between 16-weeks and 20.6-weeks gestation. • The Quad Screen is a maternal blood test which looks for four specific substances-AFP, hCG, Estriol, and Inhibin-A. • The quad screen measures high and low levels of AFP, abnormal levels of hCG and estriol, and high levels of Inhibin-A. The results are combined with the mother’s age and ethnicity in order to assess the probabilities of potential genetic disorders. High levels of AFP may suggest that the developing baby has a neural tube defect such as spina bifida or anencephaly. However, the most common reason for elevated AFP levels is inaccurate dating of the pregnancy. Low levels of AFP and abnormal levels of hCG and estriol may indicate that the developing baby has Trisomy 21(Down syndrome), Trisomy 18 (Edwards Syndrome) or another type of chromosome abnormality. Other Specific Tests• If you believe you need testing for cystic fibrosis, spinal muscular atrophy, or fragile X carrier testing, please discuss with your provider. Pregnancy is an exciting time in your life that comes with many questions. Making the right decision about genetic testing for your baby is no exception. TPMG offers NIPT/MaterniT21 Plus. This test is not always fully covered by your health insurance. If this is a test you would like performed, follow these steps for insurance preauthorization. Please note preauthorization is mandatory for most insurance plans. If preauthorization is not obtained before the test is submitted to the lab, you may be responsible for the full cost of the test.Online you can either type in the link: https://womenshealth.labcorp.com/patients/pregnancy/noninvasive-prenatal-screeningOR you can Google: LabCorp Women’s Health: NIPS/NIPT Noninvasive Chromosome testing (should be first option that comes up) Then: NIPT/MaterniT21 Plus Preauthorization Instructions:If you don’t immediately receive an estimate a member of Every Mom Pledge Team will reach out to discuss your options. Scroll down and click on MaterniT21Scroll down and click on Understanding Costs: Use our Cost EstimatorClick on PregnancyClick on MaterniT21Fill out your personal informationOnce filled out the cost estimator will give you a cost
Navigang Your Pregnancy 3031Navigang Your Pregnancy • MaterniT21 Plus screens for certain chromosomal abnormalities called trisomies. These include Trisomy 21 (Down syndrome), Trisomy 18 (Edwards syndrome), Trisomy 13 (Patau syndrome), Trisomy 16 and Trisomy 22. MaterniT21 Plus also identifies fetal sex. It digs deeper, screening for other less common but serious conditions as well. These include certain sex chromosome aneuploidies or SCAs (abnormal numbers of X or Y chromosome) and selected microdeletions (missing parts of chromosomes). These rare abnormalities can have profound consequences in the life and health of your child. These less common abnormalities include SCAS 45, X (Turner Syndrome), 47, XXY (Klinefelter syndrome) 47, XXX (Triple X Syndrome) 47, XYY (XYY Syndrome). Microdeletions include 22q (DiGeorge Syndrome), 11q (Jacobsen syndrome), 5p (Cri-du-chat syndrome), 8q (Langer-Giedion syndrome), 1p36 deletion syndrome, 4p (Wolf-Hirschhorn syndrome), and 15q (Prader-Willi syndrome; Angelman syndrome).Quad Screen• The Quad Screen is covered by all insurance companies and is performed anytime between 16-weeks and 20.6-weeks gestation. • The Quad Screen is a maternal blood test which looks for four specific substances-AFP, hCG, Estriol, and Inhibin-A. • The quad screen measures high and low levels of AFP, abnormal levels of hCG and estriol, and high levels of Inhibin-A. The results are combined with the mother’s age and ethnicity in order to assess the probabilities of potential genetic disorders. High levels of AFP may suggest that the developing baby has a neural tube defect such as spina bifida or anencephaly. However, the most common reason for elevated AFP levels is inaccurate dating of the pregnancy. Low levels of AFP and abnormal levels of hCG and estriol may indicate that the developing baby has Trisomy 21(Down syndrome), Trisomy 18 (Edwards Syndrome) or another type of chromosome abnormality. Other Specific Tests• If you believe you need testing for cystic fibrosis, spinal muscular atrophy, or fragile X carrier testing, please discuss with your provider. Pregnancy is an exciting time in your life that comes with many questions. Making the right decision about genetic testing for your baby is no exception. TPMG offers NIPT/MaterniT21 Plus. This test is not always fully covered by your health insurance. If this is a test you would like performed, follow these steps for insurance preauthorization. Please note preauthorization is mandatory for most insurance plans. If preauthorization is not obtained before the test is submitted to the lab, you may be responsible for the full cost of the test.Online you can either type in the link: https://womenshealth.labcorp.com/patients/pregnancy/noninvasive-prenatal-screeningOR you can Google: LabCorp Women’s Health: NIPS/NIPT Noninvasive Chromosome testing (should be first option that comes up) Then: NIPT/MaterniT21 Plus Preauthorization Instructions:If you don’t immediately receive an estimate a member of Every Mom Pledge Team will reach out to discuss your options. Scroll down and click on MaterniT21Scroll down and click on Understanding Costs: Use our Cost EstimatorClick on PregnancyClick on MaterniT21Fill out your personal informationOnce filled out the cost estimator will give you a cost
Navigang Your Pregnancy 32Personalized Pregnancy CareInnovative Midwifery & Women’s HealthOur team of Certified Nurse-Midwifes prioritize respectful, compassionate care as patients embark on this exciting chapter in life. We hope you experience a personalized approach to prenatal care, labor and delivery, and post postpartum care that aligns with your personal choices.Thank you for entrusting us with your care and congratulations on your pregnancy!