December 29, 2023
Pregnancy brings so many changes. Your body physically grows bigger each week, your appetite changes and even your mood and emotions can be in flux. For first-time parents especially, this can be uncharted territory, and it may be hard to know what is normal or which advice is right. Annabel Mancillas, MD, and Carrie Wieneke, MD, are OB-GYNs at the health system who help patients navigate these issues every day. They answered some of the most common questions pregnant people ask.
Which prenatal vitamin is best?
The best prenatal vitamin is the one you’ll take, says Dr. Mancillas.
“A prenatal vitamin isn't going to work by osmosis or sitting on your counter or in your purse,” she says.
If you have a problem swallowing pills, it’s OK to choose a chewable. If you’re concerned about dyes in gummy vitamins, take a pill. The most important thing is that it has folic acid, which is required for the vitamin to be labeled as prenatal. Dr. Mancillas also said DHA is also good to look for when choosing the vitamin.
Maybe more surprising is the recommendation that you should start taking a prenatal vitamin before you get pregnant.
“We want you on that prenatal vitamin at least 1 month before you conceive,” says Dr. Mancillas.
What other supplements should I take?
No other supplements are recommended for all pregnant people. However, if lab testing shows you are anemic, you might be told to take iron. If you don’t drink milk or eat yogurt and cheese regularly, your doctor might recommend taking additional calcium. But ultimately, discuss any supplements with your OB-GYN.
How can I treat morning sickness?
Unfortunately, morning sickness is very normal and caused by changes in your hormones. Dr. Mancillas says that 90% of all pregnant patients are going to have nausea and 75% are going to vomit in the first trimester. The good news is that most people will wake up one morning and those symptoms will be gone. Until then, you can do a few things to get relief.
- Stay hydrated. Dr. Mancillas recommends cold, sour liquids like lemonade, ginger ale or water with flavoring, like lemon.
- Eat small meals frequently. “I recommend snack, breakfast, snack, snack, lunch, snack, snack, dinner, snack, snack,” says Dr. Mancillas. “Realizing that dinner is now probably a half a sandwich and maybe a half a serving of a vegetable.”
Is a strong sense of smell common?
“It is! The hard part is we don't really know why,” says Dr. Wieneke. “It's reported by the majority of pregnant patients, especially early, and then it kind of goes away near the end.”
She explained that it is tied to significant hormonal changes because menopausal people also experience it. However, there’s nothing you can do about it, and there’s no fix for it.
Is it normal to have food aversions?
Food aversions are common and often tied to having a stronger sense of smell and experiencing morning sickness. You may have that food aversion for the whole pregnancy, but it typically goes away once you deliver.
Should I be eating for 2?
In the first trimester, you don't really need to increase your caloric intake. In the second trimester, the recommendation from the American College of Obstetrics and Gynecology says to increase your caloric intake by about 300 calories a day, based on a 2,000-calorie diet. In the third trimester, increase that to 400 calories a day.
Dr. Mancillas says those should be good calories that are nutritionally dense. She recommends looking at MyPlate.gov for guidance on a healthy diet.
How much weight should I gain?
“When we think about weight gain and pregnancy, it really is dependent on what your body mass index is,” says Dr. Mancillas.
For a body mass index of 18.5 to 25, the recommended weight gain is 25 to 35 pounds. For people in the BMI category of 30 or higher, it’s recommended to gain 11 to 20 pounds. Remember this is over the course of the entire pregnancy; a lot of people don’t gain weight at all in the first trimester.
Is it OK to drink caffeine?
“For a low-risk pregnancy, the answer is yes, you can have caffeine,” says Dr. Mancillas.
However, the American College of Obstetrics and Gynecology recommends limiting that intake to 200 milligrams of caffeine a day. That's about a cup of regular coffee.
If you have a medical condition like heart disease or anxiety, your doctor may recommend against having any caffeine, but you should discuss it with them directly.
What are safe ways to treat constipation?
Constipation in pregnancy is very common. Dr. Wieneke recommends increasing your water intake and making sure you’re getting enough fiber. Good sources of fiber include apples, bananas and peas. If that isn’t working, Colace – a stool softener – and medications like MiraLAX are safe to take while pregnant.
Can I take any over-the-counter medication?
“In general, we try to recommend staying away from what we call NSAIDs, or nonsteroidal anti-inflammatory medications, without consulting with your obstetric provider,” says Dr. Mancillas.
While most over-the-counter medications are safe, it’s never a bad idea to talk to your doctor first.
Can I take my prescription medications?
Yes. In fact, you shouldn’t stop taking most prescribed medications.
“Stopping a medication is much more detrimental to your safety and your health as the birthing person than it is to the fetus,” says Dr. Wieneke.
Specifically, she mentioned continuing most medications for things like high blood pressure, depression and seizures. Share your list of medications with your OB-GYN and they will review them, go through the risks and talk about any potential changes ahead of time.
Can I keep exercising?
Whatever you were doing prior to pregnancy is okay to continue, except for contact sports. Dr. Mancillas also said activities that can increase trauma to your abdomen or increase your risk of falling are off limits. That includes basketball, soccer, hockey, bike riding, horseback riding, skydiving and any type of skiing. Recommended activities are things like swimming, stationary bike, brisk walking and light aerobics.
Is it normal to be short of breath?
Your heart beats more at rest in pregnancy, so the number of breaths you take per minute is higher. You may notice you get winded more easily with activity, like walking up a flight of stairs. That’s normal!
“Concerning signs, though, are persistent cough, chest pain, if you feel like you have palpitations, it feels like your heart skips a beat or feeling faint,” says Dr. Mancillas.
If you experience any of those symptoms, you need to talk to your OB-GYN.
Can we continue having sex?
In general, sex is safe during pregnancy. There are some exceptions if you are higher risk or develop certain conditions. Please talk to your care provider.
Is it OK to travel?
“The thing about pregnancies is that they can change on a dime,” says Dr. Wieneke.
That means you want to be prepared. Take your records with you when traveling, or, for health system patients, make sure you can access MyChart on your phone.
Dr. Wieneke says that travel within the US is safe up to 36 weeks. Traveling by air for long trips is ideal so you can get up and move around or use the bathroom. Traveling by car can be challenging because you don’t want to sit for long hours.
Can I go to the salon or spa?
Whether it’s getting your hair done, getting a manicure and pedicure or having a massage, a trip to the salon can be an essential part of self-care. You don’t have to give it up while pregnant.
“Pregnancy is not 9 months in jail,” says Dr. Wieneke. “We have to get through these 9 months in some way, and I think these are things that are perfect examples.”
She does have some guidelines though.
- Go to a reputable salon that uses clean practices and good techniques.
- Hair color, dyes and perms are generally safe.
- Massage is highly recommended for low-risk pregnant people, but it’s ideal to look for a prenatal massage that makes accommodations like positioning you differently and avoiding certain areas (like your abdomen and legs).
What can I do to prevent stretch marks?
Unfortunately stretch marks seem to be influenced by genetics. Some people get them more than others. Dr. Mancillas recommends keeping your skin hydrated with whatever lotion you already use. But there’s no magic cream or ointment to prevent the stretch marks.
Should I be feeling the baby move?
Dr. Wieneke says most patients don't feel their baby moving routinely until about the fifth month of pregnancy. After that, you should feel the baby move daily. It’s good to pay attention to the amount and time of movement.
“Once you get closer to delivery, sometimes those movements change,” says Dr. Wieneke. “As the baby gets bigger, the uterus doesn't grow exponentially that much, so the movements get to be a little bit more subtle and that can be normal.”
However, if you notice a significant change in movement that seems abnormal, you should contact your care provider immediately.
Will I be induced?
“When we think about the recommendations of inducing labor, we think that the risk to the mom and pregnancy surpass the risk of either an early term or preterm baby,” says Dr. Mancillas.
So, it is not a decision that is made lightly. Induction can be more common in situations with high blood pressure, preeclampsia or poorly controlled diabetes.
However, beginning at 13 weeks, you can discuss elective induction with your doctor. Dr. Mancillas said some studies show that induction at 39 weeks does help decrease the risk of needing a cesarean section.
Pregnancy is a really important time to be open and honest with your healthcare team.
“Ask those questions. Even if you might feel embarrassed,” says Dr. Mancillas. “Trust me, there's not a lot that we haven't heard.”
No question is too weird or inappropriate. Asking questions is essential to making sure you get the best care for yourself and your baby.