You just received, possibly, the biggest news of your life: You’re pregnant – and probably bewildered with excitement.
However, if you’re starting to panic about the changes ahead, don’t! Marianna Vardaka MD, an obstetrician and gynecologist at TriHealth, explains what to expect during the next nine months and how to make your pregnancy as comfortable as possible.
Your First Doctor’s Appointment
The earlier you schedule your first doctor's appointment, the better, says Dr. Vardaka. She suggests scheduling your doctor’s appointment six to eight weeks from the first date of your last period, unless you’re experiencing severe problems, like extreme cases of nausea or vomiting, or vaginal bleeding. In that case, make an appointment as soon as possible, or call 911.
When it comes to finding the right obstetrician, she says to choose a doctor based on the following criteria:
- The hospital where you would prefer to deliver (Doctors deliver at certain hospitals. This is also typically based on proximity, quality of care and recommendations from family or friends.)
- Whether you prefer a male or female obstetrician
- Online research
She always stresses the importance of setting up an interview with any prospects to get a feel for the personality of the office and to meet the staff. “The doctor has to be patient with calls after-hours,” Dr. Vardaka explains. “They need to feel comfortable to call whenever they have questions … We always tell the patients: No question is silly!”
How Long Should I Wait Before Sharing the News?
When to share pregnancy news is always up to the mother and father; but, if you’re looking for a particular benchmark, Dr. Vardaka suggests waiting until after the first ultrasound. “Once we see cardiac activity on the ultrasound, we are not completely out of the woods, but the chances [to miscarry] decrease.”
She also encourages women to have an ultrasound in the first trimester to accurately date the pregnancy and detect any health problems – for both the mother and fetus – early on. “In a nutshell, the earlier the patient comes in, if there is a hormonal abnormality, we may be able to support the pregnancy.”
Getting the Right Nutrients
Once you're pregnant, it’s important to follow a healthy diet that focuses on limiting sugar and salt intake and increasing consumption of leafy vegetables, colorful fruits, protein and calcium.
Focusing on folic acid intake is also critical during pregnancy. In fact, Dr. Vardaka recommends taking vitamins containing folic acid a couple months before conception, if you’re planning to get pregnant. “You prevent neural tube defects, so to start the vitamins when you are not even trying is the best way.”
Evidence shows that taking folic acid before and during pregnancy can also reduce the risk of certain birth defects, including spina bifida, anencephaly and some heart defects.
How Much Weight Will I Gain?
“The ultimate weight goal should be between 25 and 30 pounds,” Dr. Vardaka explains.
On the other hand, for recommended calorie-intake, “there is no set number … It always depends on the pre-pregnancy weight.” If the woman is at a healthy pre-pregnancy weight, but doesn’t follow a nutritious diet, Dr. Vardaka encourages her to change the types of calories she is ingesting. If the patient is underweight, then she needs to increase her calorie intake, whereas an overweight patient may need to reduce her calories.
Dr. Vardaka and her team check the patients at 24 weeks for gestational diabetes, which is a type of glucose intolerance that starts during pregnancy. If a patient does develop gestational diabetes, then she may refer the individual to a dietitian from the TriHealth Maternal-Fetal Medicine Department so they can help develop a diet plan that is usually centered on an 1800-calorie-per-day diet.
Exercise: What's Safe?
“Pregnancy should not be regarded as an illness,” Dr. Vardaka points out. “Older generations used to think that you need to slow down – that you can’t lift your arms over your head … those are myths.”
Women who are avid exercisers – even long-distance runners – do not need to tone down their fitness routine as long as their body is used to it. She reminds patients to use common sense. For example, certain floor exercises, like yoga or abdominal work that require lying flat on your back or on your stomach, eventually need to be phased out as the pregnancy progresses. She also warns that if a patient was not very active before her pregnancy, to be careful implementing a new routine.
Across the board, she says a brisk, 30-minute walk, daily, is the best exercise regimen for pregnant women. Staying active throughout one's pregnancy can even help with pushing during delivery.
Pregnancy Symptoms to Expect
Nausea and Vomiting
The first trimester is notorious for nausea and vomiting, which is caused by a rapid increase in the pregnancy hormone, human chorionic gonadotropin (hCG). Dr. Vardaka says an empty stomach may trigger nausea, so she always recommends having a healthy snack on hand to stave off queasiness. Snacks that may help include:
- Nuts - almonds, in particular (as long as you're not allergic)
- Apples and peanut butter
Nausea and vomiting usually go away at the start of the second trimester as the body adjusts and the pregnancy hormone levels out. In the second trimester the patient typically gets a burst of energy and most negative symptoms go away during this time.
Acne flare-ups, caused by the hormonal fluctuations that accompany pregnancy, may occur during the first trimester, as well. While there are certain over-the-counter medicines that a pregnant woman should abstain from (a list of medicines to avoid is usually given at the first doctor’s appointment), Dr. Vardaka says most topical medicines are okay.
However, if a woman has any medicines she is questioning, “I always recommend that they call their OB’s office.”
Acid Reflex and Heartburn
During the third trimester, women often experience pelvic pressure, as well as shortness of breath, which is caused by pressure on the chest brought about as the uterus enlarges. Similarly, pressure against the stomach may cause acid reflux or heart burn. Dr. Vardaka typically recommends Tums or Prevacid to curtail these symptoms.
Sleeping on an incline, at a slight angle may help, too. “Put one more pillow under the head so that there’s no regurgitation of that acidity," she says.
Many women experience swelling in the lower extremities – caused by the uterus enlarging – as they get closer to their due date. Elevating your legs, lying in bed on your side, wearing support pantyhose or stockings, or limiting salty foods may help this.