Pregnancy

Congratulations! Take a deep breath and get ready for an exciting time.

If you think you might be pregnant -- or if you are trying to get pregnant -- you should stop doing anything that can hurt the baby, like smoking, drinking alcohol, or using any of the substances listed below. Discuss any prescription medication that you are taking with our staff as soon as possible. Do not ever use previously prescribed medication without checking with us first.

If you are more than a week late for your period, please contact the office to schedule a urine or blood test. We can help you find out quickly whether or not you are pregnant.

During your pregnancy, it’s very important to avoid medications that might harm your baby. The most obvious solution is not to take any drugs. However, from a practical standpoint, that would be impossible. Risk factors have been assigned to many drugs, based on the level of risk the drug poses for your baby. Do not ever use previously prescribed medication without checking with us first. We have assembled a list of non-prescription drugs that you can use sparingly for minor problems.

Please consult with us before using any drug not listed below:

• Pain relief: Acetaminophen (Tylenol, Extra-Strength Tylenol)
• Cough suppressant: Robitussin, Robitussin DM
• Runny/stuffy nose: Sudafed, Benadryl, Actifed, Tylenol Cold
• Diarrhea: Kaopectate, Immodium
• Constipation: Stool softeners (Colace, Dialose, Metamucil) or laxatives (Peri-Colace, Dialose Plus, Milk of Magnesia, Metamucil)
• Antacids: Riopan, Riopan Plus, Mylanta, Maalox, Tums
• Sore throat: Chloraseptic, Cepacol gargle, Cepastat lozenges
• Nausea: Emetrol -- other anti-nausea medications are used only in extreme cases and must be discussed with your doctor individually
• Hemorrhoids: Ice packs are the most helpful, but you can also use hydrocortisone ointment, Tuck’s Pads, or Preparation H (all available without prescription)

DO NOT USE these drugs during your pregnancy:

• Aspirin
• Alcohol
• Tobacco
• Pepto-Bismal
• Ex-Lax
• Certain antibiotics (do not use old prescription medication)
• Illegal substances (i.e. marijuana, methamphetamines, crack, etc.)

You will get quicker and more thorough answers to your questions if you call during office hours. If we need to see you in the office or call in a prescription for you, there won’t be any delay or unnecessary trips to the emergency room. Many prescriptions cannot be filled without checking your chart first.

Don’t postpone your call until after work or until your condition gets worse!

• In case of bleeding
  Many pregnancies are accompanied by some spotting, usually following sex. However, if you start to bleed heavily (more than a maxi-pad every hour) or if your bleeding is accompanied by strong cramping, you should contact us immediately.
• If the baby hasn’t moved at least ten times a day
  After about 24 weeks you should feel the baby move at least 10 times a day. If your baby has not moved, it is important for you to do the following: get something to drink that contains sugar, but not caffeine (Sprite, 7Up); go to a quiet place without distractions (TV or people); and lay down for 30 minutes. If the baby has not moved 3 times during that time, contact us immediately.
• If you are having contractions
  Before 36 weeks:
  Lie down with your feet slightly higher than your head, making yourself as comfortable as possible. If you can, lie on your left side. Drink two glasses of water (dehydration is a common factor in experiencing premature contractions). Time the contractions. If they get closer than 7 minutes apart and are getting stronger despite lying down and drinking water, please contact us or go to Labor and Delivery at Salina Regional Health Center.
  After 36 weeks:
  Follow the instructions above. You may wait to go to Labor and Delivery until the contractions are coming regularly every five minutes and lasting 45 seconds or if the pain from the contractions worsens.

Please go to Labor and Delivery at SRHC immediately if:

• Your contractions are coming regularly as listed above.
• Your pain becomes severe.
• You start bleeding or have leakage of amniotic fluid.
• Your membranes break (will usually soak through your underwear and your clothing).

Glucose tolerance test
A glucose tolerance test (GTT) is done at 28 weeks to check for diabetes of pregnancy. It’s very important that you follow the instructions so that the test result is accurate!

• Nothing to eat or drink after 8:30 PM the night before your appointment. You may have sips of water.
• Arrive promptly at your appointment time to drink the glucose. One hour after you drink the glucose, your blood will be drawn. Do not eat or drink anything during this hour, including gum.
• Bring a snack with you to eat after your blood is drawn, like peanut butter and cheese crackers. Due to the fasting required for this test, sometimes the glucose drink will make you nauseous or light-headed. Make sure that you allow yourself time to recover!

Alpha fetal protein
An AFP blood test is done at 18 weeks to check for spina bifida, and Down syndrome.

Sonograms
Salina Women's Clinic doctors recommend that you have two sonograms at 18 and 28 weeks. We offer BabyView 4-D sonograms, utilizing the latest in fetal imaging. Please make sure that you visit with Karen or Jennifer to confirm that your insurance will pay for the sonograms (if they are for routine screening purposes, some insurance companies will not).

Yes. You will receive 3-D prints and a live 4-D recording. Best results can be seen between 24 and 28 weeks.

Call us for scheduling and pricing information.

We encourage all expecting patients to visit with Karen, who handles all insurance claims and billing. She can help alert you to potential financial concerns, as well as help you set up payment options.

You will be in the hospital a very short time -- usually 48 hours following a vaginal delivery and three days following a cesarean section. Here are some things you might want to remember:

• Personal care items (lip balm for dry lips, toothbrush and toothpaste, lotion, shampoo and hair care products, make-up)
• Focal point
• Lollipops or hard candy
• Nutritious snacks for your coach
• Tennis ball or other back massage equipment
• Lotion or powder for massage
• Robe, gown, warm socks or slippers
• Bras/nursing bras and breast pads
• Camera and batteries
• Video recorder, media, batteries
• Loose-fitting clothes for mom
• Going home outfit for baby
• Blanket
• List of phone numbers, pencil, and paper

Expect your energy level to be low the first few weeks after the baby’s birth. Listen to your body and pace yourself. Gradually increase your activity and exercise over time. During the first week, you may ride in a car and take walks, but rest as much as possible and avoid heavy lifting. In the second week following your delivery, you may begin exercises with activities like leg lifts, mild hip rolls, and very gentle sit ups. After three weeks, you may resume normal activities at home -- but continue to allow yourself rest periods.

Bathing: You may take a shallow tub bath or shower daily, but do not use douches or tampons until your follow up visit with your doctor at five to six weeks. If you had c-section, shower for the first ten days to two weeks. If a shower is not available, a very shallow tub bath may be taken.

Diet: You may resume eating a regular diet unless you had diet restrictions before your delivery. Continue taking your prenatal vitamins until they are gone. If you are breastfeeding, continue taking prenatal vitamins while you are nursing. Drink at least two quarts of fluid daily and if you are breastfeeding, drink one extra quart.

Pain: Pain medicine may be prescribed for you or you may take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain.

Mood: It is not unusual for you to have mood changes after delivery. While your family can help support you through these changes, if your emotions become overwhelming, please call our office, Dr. Boo, Dr. Graber or Dr. Carroll.

Breasts: If your breasts become full and painful and you are not breastfeeding, you can apply a tight binder or sports bra and ice packs. Do not express milk from breasts!

Bowels: You may notice a change in your bowel habits. If you become constipated, increase the amount of water you drink and the amount of fiber in your diet (bran flakes, prune juice, Metamucil, or Senakot). If you continue to have constipation, you may use over-the-counter medications like Colace or Milk of Magnesia, following the directions on the label. Limit consumption of milk and cheese, as they can cause you to become more constipated. If hemorrhoids are swollen and painful, soak in a tub bath and use Corticaine ointment or witch hazel pads (available over the counter) or Anusol suppositories (by prescription). If your episiotomy stitches become uncomfortable, taking a sitz bath three times a day can be very soothing.

Bleeding: The amount of bleeding that each patient has following a vaginal delivery varies greatly. The important thing is that it should not ever become extremely heavy -- heavier than the heaviest day of your period or soaking more than a pad every hour. You may bleed off and on or have some discharge for six to eight weeks after your delivery. External cleansing of the vaginal area is all that is necessary. Do not douche, use tampons, or have intercourse until after your follow-up visit with your doctor.

Contraception: Even if you are breastfeeding, it is possible that you can get pregnant. Talk with your doctor at your follow up appointment about contraception options.

Call our office immediately if any of the following occur:

• A temperature above 100.4 degrees
• Unusual pain that does not respond to pain medication
• Excessive vaginal bleeding (any amount that is heavier than the heaviest day of your period or soaking more than one pad per hour)
• Signs of a urinary tract infection like pain, burning, blood in your urine, or needing to go frequently
• Foul-smelling vaginal discharge
• Symptoms of mastitis (a very painful area of the breast that can also be red and hot to the touch and which may be accompanied by a temperature of 100.4 degrees or above)
• Feelings of depression

Expect your energy level to be low the first few weeks after the baby’s birth. Listen to your body and pace yourself. Don’t hesitate to nap when necessary. Gradually increase your activity and exercise over time. During the first week, you may ride in a car and take walks, but rest as much as possible and avoid heavy lifting. You may climb stairs. In the second week after your delivery, gradually increase your activity. If you are not on pain medication and it doesn’t hurt when you push the car brakes, you may drive. Do not lift more than 30 pounds (yes, that includes children). After three weeks, you may continue to increase your activities as you feel like it, but no exercises until your first post-operative check up. Make sure to continue to allow yourself rest periods in the morning and afternoon.

Showers are preferred for the first ten days to two weeks. If a shower is not available, a very shallow tub bath may be taken. Please resume eating a regular, well-balanced diet unless you had diet restrictions before your delivery. Continue taking your prenatal vitamins until they are gone. If you are breastfeeding, continue taking prenatal vitamins while you are nursing. Drink at least two quarts of fluid daily and if you are breastfeeding, drink one extra quart.

Pain medicine may be prescribed for you. Please follow the directions on the label. Or you may take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as the label indicates for pain.

It is not unusual for you to have mood changes after delivery. While your family can help support you through these changes, if your emotions become overwhelming, please call our office.

If your breasts become full and painful and you are not breastfeeding, you can apply a tight binder or sports bra and ice packs. Do not express milk from breasts!

You may notice a change in your bowel habits. If you become constipated, try some dietary changes like increasing the amount of fluid you drink and the amount of fiber in your diet (bran flakes, prune juice, Metamucil, or Senakot). If you continue to have constipation, you may try some over-the-counter medications such as Colace or Milk of Magnesia -- but please follow the directions on the label. Avoid consuming a lot of milk and cheese, as they can cause you to become more constipated. If hemorrhoids are swollen and painful, use a tub bath, Corticaine ointment (available over the counter), Anusol suppositories (by prescription) and/or witch hazel pads (over the counter).

The amount of bleeding that each patient has following delivery is quite variable. The important thing is that it should not ever become extremely heavy -- heavier than the heaviest day of your period or soaking more than a pad every hour. You may bleed off and on or have some discharge for six to eight weeks after your delivery. External cleansing of the vaginal area is all that is necessary. Do not douche, use tampons, or have intercourse until after your follow-up visit with your doctor.

Even if you are breastfeeding, it is possible that you can get pregnant. Talk with us at your follow up appointment about contraception options.

Call our office immediately if any of the following occur:

• A temperature above 100.4 degrees
• Unusual pain that does not respond to pain medication
• Excessive vaginal bleeding (any amount that is heavier than the heaviest day of your period or soaking more than one pad per hour)
• Signs of a urinary tract infection like pain, burning, blood in your urine, or needing to go frequently
• Foul-smelling vaginal discharge
• Redness or drainage around the wound
• Severe vomiting, diarrhea, or constipation
• Severe chest discomfort or cough
• Symptoms of mastitis (a very painful area of the breast that can also be red and hot to the touch and which may be accompanied by a temperature of 100.4 degrees or above)
• Feelings of depression

If you ever have any questions or concerns, do not hesitate to call the office. We are here to help you!