Frequently Asked Questions

The best way to protect your unborn child’s health is by protecting yourself against Toxoplasmosis: 

• Wash your hands with hot soapy water after any exposure to soil, sand, raw meat, or unwashed vegetables
• Cook your meat completely (no pink should be seen and the juices should be clear). The internal temperature of the meat should reach at least 160°F.
• Do not sample meat until it is cooked thoroughly.
• Freeze meat for several days before cooking to greatly reduce the chance of infection.
• Wash all cutting boards and knives thoroughly with hot, soapy water after each use.
• Wash and/or peel all fruits and vegetables before eating them.
• Wear gloves when gardening or handling sand from a sandbox. Wash hands afterward.
• Avoid drinking untreated water, particularly when traveling in less developed countries.

Pregnant women are at high risk of getting sick from Listeria, a harmful bacteria found in many foods. Listeria can cause a disease called listeriosis. Listeriosis can cause a miscarriage, premature delivery, serious sickness, or the death of a newborn baby. If you are pregnant, you need to know what foods are safe to eat.

Because the illness could take weeks to show up, you may not know you have it.

• Early signs may include fever, chills, muscle aches, diarrhea, and an upset stomach.
• At first, you may feel like you have the flu. Later on, you could have a stiff neck, headache, convulsions, or lose your balance.
• Every year, 2,500 Americans become sick from listeriosis; 1 out of 5 die from it.

• Clean: Wash hands often with soap and warm water. Use clean dishes, spoons, knives, and forks. Wash countertops with hot, soapy water and clean up spills right away.
• Separate: Keep raw meat, fish, and poultry away from other food that will not be cooked.
• Cook: Cook food to a safe minimum internal temperature. Check with a food thermometer.
• Chill: Refrigerate or freeze within 2 hours; in hot weather (above 90°F), refrigerate or freeze within one hour. Don’t leave meat, fish, poultry, or cooked food sitting out.

• Listeria can grow in the refrigerator. The refrigerator should be at 40°F or lower, and the freezer at 0°F or lower. Use the refrigerator thermometer to check your refrigerator’s temperature.
• Clean up all spills in your refrigerator right away, especially juices from hot dogs, raw meat, or chicken/turkey.
• Clean the inside walls and shelves of your refrigerator with hot, soapy water, then rinse.
• Use precooked or ready-to-eat foods as soon as you can. Don’t store it for too long.
• Wash your hands after you touch hot dogs, raw meat, poultry, seafood, or their juices.

• Do not eat hot dogs, luncheon meat, bologna, or other deli meats unless they are reheated until steaming hot.
• Do not eat refrigerated pale meat spreads from a meat counter or smoked seafood found in the refrigerated section of the store.
• Foods that don’t need refrigeration, like canned tuna and canned salmon, are okay to eat. Refrigerate after opening.
• Do not drink raw (unpasteurized) milk, and do not eat foods that contain it.
• Do not eat salads made in the store, such as ham salad, chicken salad, egg salad, tuna salad, or any seafood salad.

Pregnancy and Fish Information

On January 19, 2017, the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) issued revised advice regarding fish consumption for pregnant women or women who may become pregnant, as well as breastfeeding mothers and parents of young children. ACOG encourages pregnant women, women who may become pregnant, and breastfeeding mothers to follow the FDA and EPA’s revised advice to:

• Eat 2-3 servings a week (8–12 ounces in total) of a variety of fish
• Eat only 1 serving a week (no more than 6 ounces) of some fish, such as albacore (white) tuna and fish with similar mercury concentrations to albacore (white)
• Avoid certain fish with the highest mercury concentrations
• Check for advisories for fish caught by family and friends, and where no advisories exist, limit eating those fish to one serving a week, and do not eat other fish that week.
• Women who follow this advice may experience the benefits of seafood consumption without experiencing an increase in related risks from mercury to themselves or their babies.

ACOG suggests that women discuss with their obstetrician-gynecologists or other obstetric providers the revised FDA and EPA advice and the potential benefits of seafood consumption while keeping in mind the 3 servings per 12 ounces per week limit to avoid the harmful effects of mercury.

Advice about eating fish from the Environmental Protection Agency and the Food and Drug Administration revised fish advice and availability. Available at:

https://www.federalregister.gov/documents/2017/01/19/2017-01073/advice-abou-eating-fish-from-the-environmental-protection-agency-and-food-and-drug-administration

• For women who were of normal weight before pregnancy with a BMI of 18.5-24.9, the recommended weight gain guideline is 25–35 pounds. 
• Women who are underweight, with a BMI of less than 18.5, should gain between 28 and 40 pounds unless their healthcare provider says otherwise. 
• Women who begin pregnancy overweight, with a BMI of 30 or more, should strive for a weight gain of 11–20 pounds unless directed differently by their provider. 
• Eating healthy meals will allow you to gain an adequate amount of weight during your pregnancy. Putting on unnecessary weight is easy to do when you’re eating junk food and foods that are higher in fat. 
• Eating a well-rounded diet is important. According to the American College of Obstetricians and Gynecologists, a pregnant woman of normal weight who gets less than 30 minutes of exercise a week should strive for a caloric intake of 1800/day for the first trimester, 2200/day for the second trimester, and 2400/day for the third trimester.

These calories should be attained by eating a diet of grains, dairy, protein, fruits/vegetables, and healthy fats and oils. Limiting processed foods, sugars, and extra fat can help you attain your goals. 

Weight Distribution for the Average Woman 

• 7 ½ lbs is about how much the baby will weigh by the end of your pregnancy. 1 1⁄2 lbs is how much the placenta weighs 
• 4 lbs is attributed to increased fluid volume. 
• 2 lbs is the weight of the uterus. 
• 2 lbs is the weight of the breast tissue. 4 lbs is because of increased blood volume. 
• 7lbs is attributed to maternal stores of fat, protein, and other nutrients. 
• 2 lbs for amniotic fluid.

Normal weight gain by trimester 

• First trimester: 1–4.5 pounds 
• Second trimester: 1-2 pounds per week 
• Third trimester: 1-2 pounds per week 

Yes, childbirth is among the most physically stressful challenges a woman ever faces. Regular exercise during pregnancy: 

• Strengthens muscles needed for labor and delivery 
• Helps reduce backaches, constipation, bloating, and swelling and improves pasture 
• Gives you energy and improves your mood
• Lessons some of the discomforts of pregnancy
• Helps you feel less tired and sleep better

Exercise in preparation for pregnancy and childbirth should begin when you’re planning to get pregnant. The sooner you begin exercising, the better you will feel. A big mistake many women make is not starting an exercise program until the last 3 months because their enlarged uterus and breasts cause a shift of the physical center of gravity, affecting their balance.

 Before you begin an exercise program, discuss it with your healthcare provider. Make sure you follow his/her advice on an exercise program that is appropriate for you. If you are experiencing problems with your pregnancy, you should not exercise. Exercise can affect the amount of oxygen available to your baby. 

In addition to your heart, the three muscle groups you should focus on during pregnancy are the muscles of your back, pelvis, and abdomen. Strengthening your abdominal muscles will make it easier to support the increasing weight of your baby. You will also be able to push with more strength and more effectively during the last phase of delivering your baby. Strengthening your pelvic muscles will permit your vagina to widen more easily during childbirth. This will help prevent urinary problems (leaking urine when you cough or sneeze) after delivery. Strengthening your back muscles and doing exercises to improve posture will minimize the strain of pregnancy on your lower back. It will prevent discomfort caused by poor posture

Many old ideas about strenuous exercise during pregnancy have been disproved in recent years. The type and intensity of sports and exercise you participate in during pregnancy depends on your health and how active you were before you were pregnant. This is probably not a good time to take up a strenuous sport. If you were active before you became pregnant, however, there is no reason you cannot continue within reason. 

Walking: if you did not do any exercise before becoming pregnant, walking is a good way to begin an exercise program. 

Tennis: if you are an active tennis player, you can probably continue to play unless you have special problems or feel unusually tired. Just be aware of your change in balance and how it affects your rapid movement. 

Jogging: If you jog, you can probably continue as long as you feel comfortable. Avoid becoming overheated, and stop if you feel uncomfortable or unusually tired. Remember to drink plenty of water. 

Swimming: If you are a swimmer, you can continue to swim. Swimming is an excellent form of exercise. The water supports your weight while you tone and strengthen many different muscles. Scuba diving is not advised. 

Golf and bowling: Both of these sports are good forms of recreation. You will just have to adjust to your enlarged abdomen. Be careful not to lose your balance. Snow skiing, water skiing, and surfing: These sports can be dangerous because you can hit the ground or water with great force. Falling while traveling at such fast speeds could harm your baby. Talk to your healthcare provider before participating in these activities
Climbing, hiking, and skiing above 19000 feet: Elevation above 10,000 feet can deprive you and your baby of oxygen and cause premature labor. Avoid strenuous exercise at this altitude, especially if you normally live close to sea level.

 Warming up and cooling down are very important. Start slowly and build up to more demanding exercises. Toward the end of an exercise session, gradually slow down your activity. Try working back through the exercise in reverse order. 

Regular exercise (at least 3 times a week) is better for you than spurts of exercise followed by long periods of no activity. 

Check your pulse during peak activity. Slow down your activity if your heart starts beating faster than the target range recommended by your healthcare provider. Don’t exceed a heart rate of 140 beats per minute. Exercise that is too strenuous may speed up the baby’s heartbeat to a dangerous level. In general, if you are able to carry on a conversation comfortably while exercising, your heart rate is probably within the recommended limits. Check to make sure. 

Don’t try to do too much. Remember that the extra weight you are carrying will make you work harder as you exercise. Stop immediately if you feel tired, short of breath, or dizzy. Drink water often before, during, and after exercise to prevent dehydration. Take a break from your workout to drink more water if needed. Don’t participate in sports or exercise in which you might fall or be bumped.

Be very careful with your back. Avoid positions and exercises that increase the bend in your back. They put extra stress on the stretched abdominal muscles and compress your spinal joints. Deep knee bends, double leg raises, and straight leg toe touches may injure the tissue that connects the back joint and legs.

Do not get overheated. Avoid outdoor exercise in hot, humid weather. Also avoid hot tubs, whirlpools, or saunas. Becoming overheated during pregnancy increases the baby’s temperature. If the baby’s temperature increases too much, it can affect the cells developing in the baby’s nervous system and brain.

 Do not exercise if you have an illness with a temperature of 100 degrees or higher. Avoid jerky, bouncy, or high motions that require jarring or rapid changes in direction. Examples of such movements are those that can occur with contact sports, jump roping, and trampoline jumping. These motions may cause back, abdominal, pelvic, and leg pain. They could also cause you to lose your balance. 

Wear a good-fitting support bra to protect your enlarged breasts 

Make exercise a part of your daily life. Daily tasks can double exercise sessions if you do the following: 

• Tighten your abdominal muscles when you are standing or sitting
•  Squat when you lift anything, whether it is light or heavy
• Rotate your feet anytime your feet are elevated
• Check your posture each time you pass a mirror 

You should stop exercising and call your healthcare provider if you have any unusual symptoms, such as:

• Pain, including pelvic pain, uterine contractions, or chest pain
• Trouble walking
• Bleeding or leaking fluid from the vagina
• Fainting or dizziness
•  An increase in shortness of breath
• irregular heartbeat (skipped beats or very rapid beats) 

Remember that it is very important to discuss your plans for exercise with your healthcare provider. If you are experiencing problems with your pregnancy, exercise is not advised. Talk to your healthcare provider if you have any questions. 

• Weight Gain: Recommendations on weight gain during pregnancy based on BMI.
• Exercise: Guidelines for exercising during pregnancy, including types of exercises and precautions.
• Dietary Precautions: Advice on avoiding certain foods to prevent toxoplasmosis and listeriosis.
• Fish Consumption: Information on safe fish consumption to avoid mercury exposure.
• Caffeine Consumption: Guidelines on caffeine intake.

Wear a compression hose, drink lots of water, avoid salty foods, and elevate your legs when possible.

We are not sure what causes leg cramps, but try to straighten your leg and gently flex your ankle and toes back toward your shins several times.

Yes, from the hormones

Yes, this is normal; it can start at 20 weeks gestation

Around 17–20 weeks

Yes, unless your provider tells you not to

Yes, we can provide a dental note if needed

Yes, less than 200mg of caffeine or 1 cup daily

We have found that there are problems, concerns, and/or issues that tend to present regularly during the course of a pregnancy. We have identified some of those issues and made recommendations as to how to best remedy them.

Nausea: Eat smaller amounts, more frequently; keep meals bland until your nausea passes. Excessive vomiting associated with or without diarrhea should be reported promptly. If this occurs, please call our office at 661-829-0026. You may need to be evaluated for dehydration.

Dizziness, Fainting, & Lightheadedness: Avoid sudden changes in posture. After lying down, get up slowly, rolling to your side, and then push up to the sitting position. Sometimes getting up too quickly causes your blood pressure to drop, resulting in these symptoms.

Groin Pain: Round Ligament pain is a sharp, sudden pain in the groin area caused by the uterus growing to accommodate the baby. Move carefully and avoid sudden movements; turn over carefully when in bed or getting up. Getting off your feet periodically is helpful. This commonly increases as pregnancy advances – a “Prenatal Cradle” or “Prenatal Sling” is helpful.

Hemorrhoids: Avoid constipation by increasing the amount of fluid and fiber in your diet. Sitting in a tub of warm (NOT hot) water is a soothing measure you can try.

Metamucil or Fibercon are helpful. Also, it is helpful to increase your intake of fruits, juices, bran, and water. Do not take any other medication(s) not previously approved by your doctor or one of the other physicians in our office. If the above medications do not relieve your symptoms, please call our office.