OBSTETRICS FAQ

When should I see the doctor for my first prenatal visit?

Call the office as soon as you know you are pregnant (positive home pregnancy test) and we will schedule an appointment for you to be seen when you are 2-3 weeks late for your period (6-7 weeks pregnant).

How much folic acid should I take when I am pregnant?

• Women who might get pregnant should take 0.4 milligrams of folic acid daily. Pregnant women should have at least 0.4 milligrams each day during the first 3 months of pregnancy. Folic acid reduces the risk of spina bifida and neural tube defects.
• Women who have had a child affected with such a disorder need higher doses of folic acid-4 milligrams daily, starting at least 1 month before pregnancy  and during the first 3 months of pregnancy.
• Folic acid is available as part of a multivitamin preparation and as a single vitamin supplement. Food sources include dark leafy vegetables and collard greens, citrus fruits and juices, whole grain breads and cereals, beans (such as pinto, black beans and chickpeas).

Can I eat fish during pregnancy?

Fish containing low mercury content such as salmon, shrimp, scallops, catfish, and tilapia are safe to eat.

Avoid consuming high mercury containing fish such as tilefish, shark, swordfish, king mackerel, fresh tuna.

Limit canned tuna intake to 5 ounces per week (the equivalent of a drained 6-ounce can). Limit eating all types of fish to a total of 12 ounces per week. See www.epa.gov/ost/fish

What foods should I avoid in pregnancy?

• For certain types of fish see above
• Avoid unpasteurized products such as raw milk, soft cheeses(feta goat cheese, brie) as these can cause Listeriosis. UDSA fact sheet on listeriosis http://www.fsis.usda.gov/Fact_Sheets/Protect_Your_Baby/index.asp
• Avoid raw foods such as raw eggs, fish, sushi, deli meats to reduce the risk of salmonella. Make sure all meat is cooked well. Hot dogs are safe to eat during pregnancy, just be sure to heat them until they are steaming.
• Avoid alcoholic beverages. No amount of alcohol in pregnancy is known to be safe.
• Avoid excess caffeine intake. There are no substantiated studies showing moderate caffeine use is associated with adverse pregnancy outcomes. There should be no problem with mild to moderate caffeine use.

Can I get my hair colored?

With regards to hair dyes, no data exists showing an increased risk of birth defects or association with cancer. http://www.otispregnancy.org/files/hairtreatments.pdf

Can I exercise when I am pregnant?
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Can I travel when I am pregnant?
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What medication can I take for a cold when I am pregnant?
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Should I bank my baby’s cord blood?

Cord blood banking is the process in which blood is drawn from the umbilical cord after the baby is delivered and the cord cut, while the placenta is still attached to the uterus. The procedure can be done after a vaginal delivery or Cesarean Section and is not harmful to the mother or baby. Cord blood is processed and cryopreserved by a cord banking company and contains stem cells which can be of potential future use to the baby or relative of the baby. Examples include treatment of blood related cancers and bone marrow diseases such as lymphoma and leukemia.

If you choose to bank your baby’s cord blood you should research different companies including cost into your selection criteria. There is a physician collection fee for cord blood collection during a delivery.

Can I get the flu shot when I am pregnant?

It is recommended that you get the influenza vaccine when you are pregnant during flu season. You can even be vaccinated during the first trimester. Click for answer

What do I do if I am exposed to a child diagnosed with Fifth’s Disease?

You need to make an appointment with your doctor for a blood test for antibodies to parvovirus. Click for answer

I was exposed to someone with shingles and I am pregnant. What should I do?

Shingles (herpes-zoster) is due to reactivation of the chicken pox virus, varicella. You were tested for your immunity to varicella when you had your prenatal blood work at your first visit. Check with your doctor to confirm if you are immune to varicella. (you are immune if you previously had chicken pox or the vaccine).

If you are immune, you cannot get chicken pox or shingles by being exposed to a person with either disease, and the fetus will not be affected.

If you are not immune and you have had exposure to chicken pox or shingles you may be a candidate for an immune globulin injection. Please discuss with your doctor.

Can I use saunas or Jacuzzi while I am pregnant?

No saunas, hot tubs, or Jacuzzi. Excess heat may be dangerous to the fetus. You can bathe without concern, but avoid very hot baths lasting a long time.

GYNECOLOGY FAQ

When should I have my first pap smear?

A pap smear can detect abnormal cervical changes before they become cancerous. It is a highly effective tool for cervical cancer screening and prevention.

In 2009 guidelines were changed by the American College of Obstetricians and Gynecologists (ACOG). Updated guidelines recommend women should have their first pap smear at age 21(it was previously recommended that women have their first pap smear 3 years after being sexually active or at age 21, whichever came first).

Can I have a pap smear if I have my period?

You can have a pap smear if you have your period if the flow is very light. In general, you should try to schedule your annual exam when you are not on your period if possible.

What do I do if I miss birth control pills?

• If you miss 1pill, take TWO pills the next day, and then continue as normal taking 1 pill every day. You are still protected from being pregnant.
• If you miss 2 pills, take TWO pills on the next 2 days, and then continue as normal taking 1 pill each day. Use condoms as backup for rest of the month.
• Note, if you miss pills you may experience irregular bleeding or spotting (breakthrough bleeding)
• If you are late for your period, check a pregnancy test.

Is the intra-uterine contraceptive device (IUD) an effective form of birth control?

Two intrauterine devices (IUDs) are available, Paragard and Mirena. Both are highly efficient at preventing pregnancy. IUDs are also the most cost effective in the long term compared to other methods. In addition to being long acting methods of birth control, they are reversible, allowing return to fertility when they are removed. Make an appointment with your doctor if you think an IUD is right for you.

Is the contraceptive patch safe?

Recent studies have shown that the level of estrogen you are exposed to by taking the Ortho Evra patch is higher than using combined oral contraceptive pills. Please make an appointment with your doctor to discuss if the patch is a good choice for you.

What should I do if I think I have a vaginal infection, such as yeast?

Call the doctor’s office and speak to someone about your symptoms.

What do I do if I think I have a bladder infection (urinary tract infection, UTI)?

Increase your intake of water. Avoid caffeine, alcohol and spicy food. Call the doctor’s office and speak to someone about your symptoms.

Should I get the HPV Vaccine?

Please discuss the HPV Vaccine and its availability with your doctor.

I recently became menopausal and suffer terrible hot flashes. Is hormone replacement therapy (HRT) safe to use?

HRT, although  the most effective for the treatment of vasomotor symptoms, should be used at the lowest possible dose for the shortest duration of time , to reduce the risk of breast cancer, blood clots , heart disease( WHI Studies 2002). Recent studies suggest that when used early during menopause, in the first 10 years, it is also safe. You should discuss HRT and its alternatives with your doctor.

How much calcium do I need?
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I am postmenopausal and experiencing vaginal bleeding or spotting?

Call your doctor. You need to be evaluated by an ultrasound and/or an endometrial biopsy.

My mother has a history of breast cancer, when should I have my first mammogram?
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My partner was just diagnosed with genital warts?

You should make an appointment to be evaluated by your doctor.