Pregnancy 6-12 Weeks
The following over-the-counter (OTC) drugs may be safely taken in pregnancy. Follow all the directions on the medication for adult dosage use, unless otherwise specified by your physician. DO NOT TAKE Motrin, Aspirin, Aleve, Advil or Anaprox during pregnancy without checking in advance with your physician.
| PROBLEM | Over-The-Counter | Call M.D. If: |
|---|---|---|
| Aches, Pains and Headache | Acetaminophen (Tylenol) 325mg, 1-2 every 6 hours, as needed | If your symptoms are not relieved by medication or your symptoms increase |
| Congestion (Nasal); Allergies | Sudafed; (any others that DO NOT contain Aspirin/Ibuprofen); Claritin Allergy; Chlor-Trimeton, Zyrtec; Benadryl, Humidified Air; Neti Pot | If fever is 100 degrees or above; congestion lasts more than 1 week |
| Constipation | Metamucil, Colace, Citrucel, Konsyl, Colace, Dulcolax, Dandolion or Mallow Tea | Rectal bleeding; no bowel movement for 1 week |
| Cough/Cold | Robitussin DM, Mucinex, Sudafed, Tylenol, Vicks VapoRub or other Guaifenesin cough syrups | Persists more than 1 week with medication; green/yellow sputum |
| Diarrhea (mild to moderate) | Imodium, BRAT Diet (bananas, rice, applesauce, toast or tea); Donna gel chewable tablets | Diarrhea more than 2 full days; fever present |
| Gas | Gas-X, Maalox Anti-Gas, Mylanta-Gas, Mylicon; Probiotics | Severe abdominal pain |
| Heartburn or Indigestion | Maalox, Mylanta, Tums, Rolaids, Prilosec, Prevacid, Zantac 150, Pepcid AC, Kaopectate, Papaya tablets with meals; Probiotics | No relief with medication |
| Hemorrhoids | Anusol-HC cream/suppositories, Tucks, Preparation H, chilled witch hazel packs or sitz bath | Bleeding or severe pain with medication |
| Hives | Benadryl (oral/cream), Caladryl lotion, Hydrocortisone cream; anti-fungal skin cream | Persists with medication; pain; or bleeding |
| Insomnia | Tylenol P.M., Benadryl, Unisom, Nytol, warm lavender bath, warm milk, turkey sandwich before bed or meditation | |
| Miscellaneous – Safe to take in pregnancy | Vitamin C, Iron Tablets, Calcium Tablets, Solarcaine or Teeth Whitener | |
| Mosquitoes | Avon Skintastic, any repellant that is safe for children under 12, NO DEET repellant | Minimal use of DEET repellent |
| Nausea | Vitamin B6: 25-50 mg-2 to 3 times per day, Dramamine, Ginger tablets/drops; Kaopectate | Persistent vomiting for more than 24 hours |
| Scratches or Cuts | Neosporin | Increased heat, pain, redness, swelling or discharge from the area |
| Sore Throat | Chloraseptic, Cepacol, Lozenges (Zinc, Vicks, etc.); warm salt water gargle; or mix ½ teaspoon of Kaopectate and ½ teaspoon Benadryl and gargle every 4 hours | Severe or persistent for more than 3 days; fever present; pus; or cannot eat or swallow |
| Vaginal Discharge (other than normal) | NO SELF-TREATMENT | Call for culture appointment. Please call office. |
| Vaginal Irritation/Itching | Vagisel, Monistat or Anti-Fungal Cream | Persistent discharge, itching, irritation; yellow or change in color |
Nausea and vomiting, also know as “morning sickness,” is common in early pregnancy. Though common, it is not experienced by everyone. While the cause of morning sickness remains unknown, it is believed that the sudden increase in hormones during pregnancy plays a key role in creating these symptoms. Nausea and vomiting in early pregnancy can range from mild to severe. Nausea usually subsides by the third month (end of the first trimester). In some cases, nausea and vomiting can still occur periodically throughout the pregnancy.
Severe Symptoms:
Hyperemesis Gravidarum (excessive vomiting in pregnancy):
This occurs in 0.5% to 2% of pregnancies. Excessive vomiting is one of the most common indications for hospitalization during the first trimester of pregnancy.
Risk Factors For Hyperemesis:
• Multiple fetuses
• Previous history of hyperemesis
• Carrying a female fetus
• Daughter and/or sister of women with the condition
• History of motion sickness
• History of migraine headaches
Treatment Options:
• Increase fluid intake
• Starting a multivitamin before or at the time of conception (may decrease severity of symptoms)
• Take vitamins with food instead of on an empty stomach
• Request a chewable vitamin to decrease nausea
• Vitamin B6 alone or Vitamin B6 with Doxylamine 12.5 milligrams (antihistamine) 25 milligrams 3 times per day or 50 milligrams 2 times per day
• Antihistamine – Benadryl or Dramamine (as directed)
• Prescription medications
Alternative Therapy Options:
• Ginger 250 milligrams, 3 times per day; powdered ginger is also available
• Fresh ginger root (located in the Produce Department): grate 1 teaspoon into a cup of boiling water and let steep 5 minutes – sip slowly
• Raspberry Leaf Tea (or ice cubes made from this; you can suck on the ice cubes)
• Peppermint Tea
• Dried Organic Orange Peels: Place peels in hot water (tea) and steep for 20 minutes
• Cinnamon Stick: 1 stick steeped in water for 6 to 10 minutes
• Fresh Lemon Oil: sniff 1 to 2 drops diffused
• Acupressure Bands (Sea Band)
• Hypnosis
At Home Treatment Options:
• Avoid smells that bother you
• Eat about 5 to 6 small meals each day
• Eat low-fat protein foods (lean meat, broiled fish, poultry (without skin), eggs, boiled beans)
• Eat more carbohydrates (plain baked potato, white rice, pasta, cereal, dry toast, pretzels, fruit, fruit juices). Please Note: A carbohydrate, mixed with a serving of protein right before bed, has shown to minimize nausea
• Avoid spicy and fatty foods
• Eat cracker or dry toast before getting up (you can have them ready at your bedside)
• Gelatin desserts (Jell-O); frozen Popsicles
• Drink broth, apple juice, regular ginger ale or 7-Up, sugared, decaffeinated or herbal teas
Call Your Physician If:
• Urine is dark in color
• No liquids can be held down
• Feeling dizzy or faint like when standing up
• Heart is pounding very hard or racing rapidly
• Begin vomiting blood
The body changes that take place in pregnancy may contribute to constipation. With less activity, not enough fiber and decreased fluid intake, constipation may become a problem.
Helpful Hints:
- Drink enough fluids: A minimum of 8 to 10 glasses of decaffeinated fluid per day
- Eat fresh fruits, vegetables, whole grain breads and cereal every day
- Keep fiber in your diet
- Try to exercise or move around regularly
Over-The-Counter Remedies:
- Metamucil (as directed)
- Citracel (as directed)
- Konsyl (as directed)
- Colace (Docusate Sodium) – (as directed)
- Dulcolax (as directed)
- Fleets enema (last resort) – Please discuss with your provider prior to using this product
Alternative Therapy Options:
- Cal-Mag Powder (please use as directed)
- Magna Calm Powder (mix Magna Calm Powder with hot water and enjoy the benefits of this tea-like beverage)
- Dandelion Tea
- Mallow Tea
Sexual activity can remain the same throughout pregnancy, unless indicated by your physician. Many pregnant women and their partners have questions about this topic; however, they are reluctant to ask. We hope you find this information useful.
Desire To have Sex In Pregnancy:
It is common that the sexual feelings will change in pregnancy. The hormone changes that occur in pregnancy can either increase or decrease your sex drive. Some women do not experience any change in their sexual desire. Your body and emotions are going through rapid change in pregnancy. Losing interest in sex in the first trimester is quite common, due to the nausea, vomiting and fatigue.
How to Stay Comfortable:
- Change position
- Water-based lubricant (Astroglide® – Over-the-Counter at pharmacies)
- Talk with your partner
Does It Affect The Baby:
The uterus and the bag of water protect the baby. Although the baby may become more active, due to movement and/or sound, the baby is fine.
When Sex Is Not Safe:
- Cerclage
- Premature or early labor
- Vaginal or abdominal pain
- Bleeding
- Broken bag of water
- Untreated STD
- If you have been placed on bed rest
If you feel you have any of the above, please contact your physician.
Communication and Intimacy:
You may experience mixed feelings about sex during pregnancy; however, remember your partner will too. Communicate with each other on what other activities you can do to promote intimacy. Spend quality time together. Once the baby arrives, it may be more difficult to do this.
Resuming Sexual Activity:
Usually 6 weeks postpartum, unless otherwise indicated by your physician.
It is acceptable to travel during your pregnancy, unless otherwise specified by your physician. Always inform us of your travel plans. The best time for travel is in your second trimester (14 to 24 weeks of pregnancy).
Guidelines For Travel
Car:
- If you are wearing a seat belt, never put the lap belt across your abdomen; the lap belt should be placed low on the hipbone.
- In the event of a fender bender or crash, please call your physician immediately.
- In order to stimulate blood flow, you must get up and walk around every one-half to one hour
Plane:
- Metal detectors are safe
- If possible, choose an aisle seat
- In order to stimulate blood flow, you must get up and walk around every one-half to one hour
Boat:
- Motion sickness may occur
- May wear Sea Bands
- Ginger tablet; ginger ale to decrease nausea
Foreign Travel:
- It is best to discuss this with your physician. Together, we can determine if this form of travel would be safe for you.
- Prior to travel, all shots/immunizations should be up-to-date.
- Become aware of unsafe food and water.
Tips:
- Always have a copy of your medical record with you, along with our office telephone number
- Keep all travel plans flexible
- In case your plans change, make sure to have travel insurance
- Keep moving – With long travel times, every ½ to 1 hour, you should be walking around
- Wear comfortable clothing (nothing constricting) and shoes
- Always carry light snacks and water
- Get plenty of fiber
- Drink plenty of fluids
- Locate the nearest Medical Care site
During pregnancy, a balanced diet is important for both you and your growing baby. If you have not eaten a healthy diet before pregnancy, now is the best time to start. Your physician and nutritionist will be able to help you get started and continue the process throughout your pregnancy.
Intake of Folic Acid and Iron during pregnancy is extremely important. Your prenatal vitamins have the recommended amounts of Folic Acid and Iron in them.
Folic Acid Recommendation: 1,000 mcg each day for one month before pregnancy and throughout your pregnancy.
DAILY FOOD SERVINGS (Based on a typical 2,000 calories per day ~ reference diet; your needs may be higher or lower; consult with a Registered Dietitian):
Food Group Amount Needed Serving Examples
GRAINS 6 ounces 1 slice of bread; 1 cup of cereal;
½ cup cooked rice, pasta or cereal
VEGETABLES 2-1/2 cups 1 cup of vegetables or veggie juice;
2 cups of leafy green vegetables
FRUIT 2 cups 1 cup of fruit or 100% fruit juice;
½ cup of dried fruit
MEAT AND BEANS 5-1/2 ounces 1 ounce of meat, poultry or fish;
¼ cup of cooked dry beans; 1 egg;
1 tablespoon of peanut butter;
½ ounce nuts/seeds
MILK 3 cups 1 cup of milk or yogurt; 1-1/2 ounces
of natural cheese; 2 ounces of processed cheese
It is better to eat many small meals throughout the day and snack in between. This will also help lessen nausea.
WHAT TO AVOID:
Alcohol (beer, wine and/or mixed drinks)
Illegal drugs
Smoking
Raw meat
Unpasteurized cheeses/milk
High mercury seafood (shark, swordfish, king mackerel, tilefish and albacore tuna)
Retin A prescriptions
AVERAGE WEIGHT GAIN IN PREGNANCY:
Underweight 25 – 40 pounds
Normal weight 25 – 35 pounds
Overweight 15 – 25 pounds
Obese 15 – 20 pounds
Twin Pregnancy 35 – 45 pounds
SPECIAL CONCERNS:
Vegetarian Diet:
Be sure you are getting enough protein. Supplementation is necessary, especially Iron, B12 and Vitamin D.
Lactose Intolerance:
Symptoms usually improve with pregnancy. However, if symptoms persist, calcium supplements will be recommended, as well as other calcium rich foods, such as sardines, salmon, spinach and orange juice.
Mercury:
AVOID eating shark, swordfish, king mackerel, tile fish and albacore tuna. However, you MAY eat canned chunk light tuna. Other types of fish are fine in limited amounts. You can eat up to 12 ounces (2 to 3 meals) of these types of fish or shellfish per week.
Listeriosis:
Caused by bacteria from unpasteurized milk, soft cheese and prepared/uncooked meats, poultry and shellfish, hot dogs and some deli meats. Symptoms include fever, chills, muscle aches and back pain. If these symptoms occur, please contact your physician. A culture and/or blood test can be performed to test for the illness. Listeriosis is treated with antibiotics. Be sure to wash all of your vegetables and fruits prior to ingestion.
PICA:
PICA is a strong urge to eat non-food items, such as clay, ice, laundry starch or cornstarch. If these urges occur, please contact your physician.
PREGNANCY NUTRITION COUNSELING
Peggy Tsevis, MPH, RD, LD
Registered Dietitian
We provide nutrition counseling for:
Pregnancy Nutrition
Gestational Diabetes
Post Partum Weight Loss
Nutrition While Nursing
Palatine (Monday): 10:00 a.m. to 5:30 p.m.
Woodfield (Tuesday): 10:00 a.m. to 5:30 p.m.
30 and 60 Minute Appointments
To schedule, please speak to a Receptionist.
All first trimester OB patients should schedule an appointment with our Registered Dietitian.
Topics that are covered include:
- Tips to reduce nausea/vomiting
- Increased nutrient needs for pregnancy
- Increased calorie needs and recommended weight gain
- Control weight gain and optimize baby’s growth
- Discussion of prenatal vitamins
- Guidelines for exercise and nutritional requirements
- Common digestive complaints in pregnancy
- Recommendations for caffeine intake, sweeteners, seafood, etc.
- Foods to avoid
- Promotion of breastfeeding and increased calorie/fluid needs
Often women, who have recently delivered a baby, will report feelings of sadness, anxiety and uncertainty, along with general feelings of being overwhelmed. Such feelings are typically mild in intensity and transient in duration and are often referred to as the “baby blues.” The baby blues generally emerge within the first couple of days after delivery and tend to go away as quickly as they came on. Feeling down or overwhelmed may be attributable to any one of the many changes that a woman goes through as a result of the pregnancy and delivery, whether they are physical, emotional, social or psychological changes.
What Happens If My Sadness Persists Or Gets Worse?
Sometimes, a woman may feel that instead of getting better, her symptoms of depression and anxiety become worse over time. In such instances, the depression can become extremely severe that it may interfere with a woman’s ability to adequately care for her baby or herself. Epidemiologists estimate that 1 out of 7 women, who deliver a baby, go on to develop this more moderate to severe form of depression called Postpartum Depression (PPD). PPD can develop anytime within one month following the delivery and, unlike the baby blues, can take several months to go away if left untreated. The signs and symptoms of PPD look very similar to a non-pregnancy related major depressive order and may include the following symptoms:
- Depressed mood
- Irritability
- Anxiety
- Diminished interest in pleasurable activities
- Social withdrawal
- Changes in appetite
- Changes in sleep
- Hyper or decreased motor activity
- Decreased motivation
- Feelings of hopelessness
- Loss of energy
- Feelings of worthlessness or guilt
- Decreased concentration
- Indecision
- Crying spells
- Thoughts of harm to self
POSTPARTUM DEPRESSION
In some rare instances, a woman with Postpartum Depression may go on to experience psychotic symptoms, such as hallucinations and delusions. Such instances present an increased risk to the safety of the woman and her baby because, often times, the delusions are centered on the newborn or the mother.
How Do I Know If I Am At Risk For PPD?
Any woman, who has a prior episode of Postpartum Depression, is at significantly greater risk of a recurring episode with subsequent births. In addition, any woman with a history of non-pregnancy related mood disturbance is at an increased risk of PPD. Finally, any woman who has an immediate family member with a history of a major mood disorder (e.g. Major Depression or Bipolar Disorder) is considered at greater risk.
What Should I Do If I Feel That I May Be Depressed After Delivering My Baby?
Feeling sad or overwhelmed at a time that should be an occasion of joy and celebration may lead some women to try to hide their feelings out of shame or guilty feelings. Instead, if you feel that you are sad and overwhelmed to the point that it interferes with your daily responsibilities to yourself or your baby, seek outside help by contacting your physician. It is especially important to seek immediate assistance if you find that you are having thoughts of harming yourself or your baby. Depression is treatable. Not acting on your concerns may place you or your baby in harms way and may prolong emotional suffering.
What Are My Treatment Options?
Many women respond favorably to supportive therapy or psychological therapy. WomanCare offers several therapists experienced in evaluating and treating depression and postpartum depression. Psychologic medications may also be an option and need to be discussed with your physician.
POSTPARTUM DEPRESSION RESOURCES
List of WomanCare Therapists:All WomanCare therapists are Licensed Clinical Psychologists with specialized training in working with perinatal women, who present with emotional concerns.
Rocco Domanico, Ph.D. WomanCare: (847) 221-4700; (847) 221-4800 and (847) 221-4900
Karla Anderson, Psy.D. WomanCare: (847) 221-4700
Kerry Mullen, Psy.D. WomanCare: (847) 221-4700 and (847) 221-4800
Ritu Trivedi-Purohit, Psy.D. WomanCare: (847) 221-4800 and (847) 221-4700
Ruth Field LCSW WomanCare: (847) 221–2200
Who Should I Contact?
- Your WomanCare physician
- Postpartum Support International: (800) 944-4773; www.postpartum.net/index.html
- American Psychological Association:
- Online PPD Support Group:
- Sources: American Psychological Association:
- Diagnostic and Statistical Manual of Mental Disorder – IIV.1994.American Psychiatric Association
List of Support Groups:
Leslie Stoutenburg: PPD group and Elk Grove – (847) 981-3594; (847) 755-3220
Susan Adler: Spanish PPD speaking group – (847) 956-5142
In-Patient Support/Education Referral: Jill Trapini, RNC, MS: Northwest Community Hospital, Arlington Heights, IL – (847) 618-7432
Web-Based Resources:
Postpartum Support International: 927 North Kellogg Avenue, Santa Barbara, CA 93111
Telephone: (805) 967-7636
Website: www.postpartum.net
IL – Sarah Allen: (847) 791-7722
Depression After Delivery: P. O. Box 1282 Morrisville, PA 19067
Telephone: (800) 944-4773
Website: www.depressionafterdelivey.com
IL – Susan Feingold: (847) 831-7731; Pager: (708) 817-3501
Miscellaneous:
National Suicide Crisis Hotline: 1 (800) Suicide – 1 (800) 784-2433
ENH Crisis Line: 1 (866) ENHMOMS – 1 (800) 364-6667 – (Referral to emergency Psychiatrist on North Shore)
Taking care and pampering yourself is needed as Your body is going through so many changes so taking care of yourself is a must not just to pamper your self but for your well being and general health.
Massage for the pregnant woman specifically addresses your changing needs to provide pain relief and relaxation during your pregnancy . Prenatal Massage therapists are specially trained to protect you with proper positioning for your comfort and safety.
- Massage – State Licensed Massage Therapists and certified in prenatal massage.
- Manicure/Pedicure
- When you make an appointment for a pedicure, please make sure that you specifically request a pregnancy pedicure; this is mandatory. Please note that you have “pressure points in your feet and, if not massaged properly, these “pressure points” can cause a pregnant woman to experience symptoms of pre-term labor. Therefore, if the technician is not properly licensed to provide you with a pregnancy pedicure, then refrain from any massaging during the pedicure.
- Hair highlighting/dyeing and perms are safe in pregnancy.
Exercise is usually safe – Try the following:
- Yoga
- Light Weights
- Stairmaster/Treadmill
- Swimming
- Taking a hot shower or sitting in a hot bath is appropriate. Additionally, it is safe to sit in a whirlpool tub with jets.
