Although an occasional drink in pregnancy carries no known risk to your baby, no level of drinking is proven to be safe. It is very clear, however, that heavy drinking throughout the pregnancy is harmful to a developing baby. Excess alcohol can result in growth problems and learning difficulties. If the drinking is chronic or severe enough, the baby is also at risk for fetal alcohol syndrome, a disorder that causes lifelong disabilities including facial abnormalities, poor growth, mental retardation and behavioral issues. With these risks in mind, our advice is to not drink at all during pregnancy.

Although smoking is not known to cause birth defects or mental retardation, it definitely has many long-term consequences for mother and child. So far, studies show that smoking during pregnancy can lead to problems for your baby such as low birth weight, placental abnormalities, childhood obesity and even SIDS (Sudden Infant Death Syndrome). After birth, your baby also could develop colic or asthma as a result of smoking during pregnancy. The best thing you can do to protect the health of your unborn child and yourself is to stop smoking. If you are ready to give it a try, we have several options that can improve your chances of success.

Morning sickness is a common complaint in early pregnancy and is thought to be related to temporary surges of pregnancy-related hormones. “Morning” sickness is somewhat of a misnomer because the symptoms can occur at any time of day or night. For most patients, symptoms resolve by about 14 weeks, around the beginning of your second trimester. However, a few patients may continue to experience nausea and vomiting throughout the entire pregnancy. To help alleviate symptoms, you first should try eating multiple small meals of bland foods throughout the day. Spicy or greasy foods as well as offensive odors should be avoided. Doctors often recommend the BRAT diet which stands for “bananas, rice, applesauce and toast.” Also, foods that contain ginger such as ginger ale or ginger snap cookies may be calming for the tummy. If these dietary changes do not help, please consult your doctor. There are several prescription strength medications that are very effective in relieving symptoms in most patients. In rare cases, patients who experience prolonged nausea and vomiting may need to be hospitalized for IV hydration or evaluation for other possible problems. Your doctor may also monitor your weight or check your urine to ensure that you are not suffering from dehydration or nutritional deficiencies.

Under most circumstances, your first ultrasound will be performed between 18 and 20 weeks of gestation. At this time, it is possible for the ultrasound technician to determine the sex of your baby with a high degree of accuracy.

If you have a medical or obstetric complication for which emergencies cannot be predicted, travel during pregnancy is not recommended. Otherwise, travel by car, plane, train or boat is perfectly fine. We recommend that you take a copy of your medical record just in case you encounter a problem. On route to your destination, you should take frequent breaks to stretch your legs. You also may want to try wearing support hose. These measures can help to reduce leg swelling and prevent formation of blood clots in the legs. If you are planning to travel by air, most U.S. airlines allow pregnant women to fly up to 36 weeks of gestation; the cutoff is 35 weeks of gestation for international flights. If your trip will take you to another country, please ask us if you will need any shots before you leave. And, be sure to send a postcard.

Yes. Dental cleaning and most routine dental procedures are safe in pregnancy. However, if you plan to have a major dental procedure, please consult your doctor first. We also recommend that you delay all cosmetic procedures until your baby is born.

Sometimes, the feces of household cats can contain a parasite called Toxoplasma. If you accidentally ingest this parasite, it could cause a rare but serious infection in your developing baby. In order to limit your exposure, please ask other family members to clean the cat?s litter box during your pregnancy. However, if you must continue to clean the litter box, be sure to wear gloves and to wash your hands afterwards. Although this may present a minor inconvenience, the good news is that it is fine to pet or cuddle your cat. Other types of common family pets are not known to be carriers of this parasite.

Fish and shellfish are great sources of protein, omega-3 fatty acids, and other nutrients. However, certain types of fish also contain high levels of mercury and can interfere with development of your baby?s nervous system. If you are pregnant or planning to become pregnant within the following year, you should avoid shark, swordfish, king mackerel, tilefish or any raw fish. Albacore tuna is also high in mercury so you may want to choose canned chunk light tuna instead. Other types of fish are fine in reasonable amounts. It is safe to eat up to 12 ounces (about 2 servings) of low-mercury fish and shellfish per week. Fish sticks and fast-food fish sandwiches are made from fish with low mercury levels and are safe in pregnancy. But, if you want to eat fish caught from recreational fishing, we advise that you contact your local health department first.

At your initial prenatal visit, your doctor will perform a simple blood test to check for the presence of the Rh antigen on your red blood cells. If you do not possess this antigen, you are said to be “Rh negative.” Although this is not an abnormal finding, your baby could be at risk for developing anemia. For this reason, you will need an injection of Rhogam, an antibody which helps to prevent fetal anemia in Rh negative women. This injection is usually given around 28 weeks of gestation, but you may require additional doses if your experience vaginal bleeding or trauma during your pregnancy.

Most pregnant women will experience swelling of the feet and ankles. This is partly because your pregnant belly compresses the vessels that normally drain fluid from your legs, resulting in an accumulation of fluid in the soft tissues of your ankles and feet. It is almost impossible to prevent swelling, but you can minimize this problem by avoiding salty foods and elevating your legs when possible.

Constipation is a common problem during pregnancy. It is caused by increased levels of a hormone called progesterone which serves to support your pregnancy. This hormone slows down motility of your GI tract resulting in constipation. If you take iron supplements, this may also aggravate the problem. If constipation is a problem for you, the first thing to try is dietary modifications. For example, you should increase the bulk in your diet with fresh fruit and veggies and drink plenty of water. You may also try over-the-counter fiber supplements or stool softeners. Laxatives are rarely necessary but may be prescribed by your doctor if other measures fail.

Hemorrhoids are a common problem in pregnancy and are caused by development of varicose veins of the rectum. Hemorrhoids readily develop during pregnancy because the growing uterus compresses the vessels that drain fluid from the rectal veins. Hemorrhoids may be worsened by straining during bowel movements and by the tendency for pregnant women to be constipated. Pain and swelling can usually be relieved with warm soaks, topical anesthetics and stool softeners. In rare cases, a small clot can form inside the engorged vein, causing severe pain. If this happens, your doctor may need to remove the clot under topical anesthesia. The good news is that hemorrhoids usually resolve quickly after pregnancy. The bad news is that you may be predisposed to develop hemorrhoids again because your veins have already been weakened.

The “bag of waters” refers to the fluid-filled amniotic sac that surrounds your developing baby. If the sac ruptures, you will experience leakage of watery fluid from the vagina. Generally, amniotic fluid is clear or straw-colored and may contain a few flecks of blood. Although many women report a large gush of fluid, you are just as likely to experience a slow leakage of fluid. If you think your bag of waters may be broken, please consult your physician promptly. You may need to be examined. Although it is normal for some women to experience a considerable amount of watery vaginal discharge during pregnancy, please do not assume this to be the case. It is important for your doctor to verify whether or not your membranes are ruptured.

Most women who are physically fit with uncomplicated pregnancies can continue to exercise during pregnancy. However, previously inactive women and those with medical or obstetric complications should not start an exercise program before discussing it with their doctor. Each sport or activity should be reviewed individually for potential risks. For example, activities with a high risk of falling or those with a high risk of abdominal trauma should be avoided during pregnancy. You should also limit the number of exercises done flat on your back because this could decrease the amount of oxygen your baby receives. Scuba diving should also be avoided because the baby is at risk for decompression sickness. In the absence of either medical or obstetric complications, 30 minutes of moderate exercise a day is recommended for most pregnant women. But, as you exercise, be sure to pay attention to your body. Do not exercise to the point of exhaustion. Your heart rate should stay below 140 beats per minute to ensure that your baby receives ample oxygen.

The vast majority of women can continue normal sexual relations during pregnancy. However, if you have had bleeding problems, certain placental problems, ruptured membranes or episodes of preterm labor, your doctor may ask you to abstain. It is true that intercourse can result in minor short-term contractions, but these will not cause preterm labor in an otherwise healthy pregnancy. So, unless your doctor tells you otherwise, sexual activity is considered to be safe in pregnancy.

Even if you are pregnant, your seatbelt should be worn at all times you are driving or riding as a passenger. The lap belt should rest snugly beneath the pregnant belly and above the pubic bones. The shoulder strap should go between your breasts as usual.

The first time you feel your baby move is called “quickening.” For first pregnancies, fetal movement usually is felt somewhere around 20 weeks. Women who have had a baby previously may detect movement a little earlier. Many women describe early fetal movement as butterflies in the tummy or like mild rumbles of gas. After quickening occurs, you should continue to feel regular movement of your baby although you may not feel a lot of movement at first. In later stages of pregnancy, some doctors recommend “kick counts” as a way to evaluate fetal movement. To do this test, you should go to a quiet room, lie down, and count the number of times your baby moves. Perception of 10 distinct moves in 2 hours is considered reassuring. If you perform this test and still believe your baby is not moving normally, you should call your doctor immediately.

As a patient of Ob/Gyn Associates of Denton, your baby likely will be delivered at Denton Regional Hospital. With this in mind, we recommend that you select a pediatrician who also sees patients at this hospital. This way, your baby?s doctor will be able to see your newborn in the hospital right after birth. It will be important for you to contact your pediatrician several weeks before your due date in order to establish an initial relationship. At your request, many pediatricians will meet with you before the birth of your baby in order to discuss the healthcare needs of your newborn. If you need help in finding a doctor for your baby, we have a list of excellent pediatricians from which you may choose.

Dr. Harvey is a member of the medical staff at Denton Regional Hospital, and she performs all deliveries at this facility. In the event that a higher level of care is required during your hospital stay, it may be necessary to transfer you or your newborn to the specialists at Medical City of Dallas or other appropriate hospital.

At Ob/Gyn and Associates of Denton, we believe the delivery of your child should be a positive and memorable experience. Attending the delivery of your new baby is very important to us, and we will make every effort to welcome your new baby into the world. However, there may be unavoidable circumstances at which time your doctor cannot be present. If this is the case, a well-trained colleague from the same group will attend your delivery.

There are many reasons why patients sometimes request an induction of labor. Indeed, a planned delivery is certainly more convenient for traveling family members, and an earlier delivery can put a welcomed end to the aches and pains of late pregnancy. However, you need to know that induction of labor involves risks and should be reserved only for cases of medical necessity. Induction can be difficult, prolonged, and physically stressful for both mother and baby. In some cases, induction can even result in a cesarean delivery that could have been avoided by waiting for nature to take its course. At Denton Ob/Gyn and Associates, our goal is to achieve the best outcome for you and your baby. We will not hesitate to induce your labor if the benefits outweigh the risks.

Yes. It is very important to have an IV placed once we determine that you are in labor. Many of the medications that you may need to support your labor and to provide pain control are administered through your IV line. Even though most vaginal deliveries proceed without complication, there is always a chance that your delivery could require an urgent surgical delivery. In the event that you experience such an event, it is vitally important to have an IV line in place.

An episiotomy is an incision that starts around the vaginal opening and extends a short distance towards the anus. After delivery, the incision is repaired with absorbable suture. In the postpartum period, warm soaks and spray anesthetics may be used to help with the discomfort. However, it is rare for a woman to experience prolonged or severe pain, wound problems, or infection, despite the relative dirtiness of this part of our body. In the past, it was believed that this procedure could help prevent tears into the rectum and urinary incontinence. However, studies in recent years have not been able to verify these benefits. In fact, it is now known that an episiotomy incision is more likely to extend into the rectum than if no incision had been made. For these reasons, the episiotomy has fallen somewhat out of favor. Although this procedure is not used routinely by most doctors any longer, it is still useful in some cases such as breech deliveries, a trapped shoulder, or when a serious spontaneous tear seems certain.

No woman should have to endure severe pain during childbirth. There are many safe and effective options for managing your pain. Epidural anesthesia offers the most effective form of pain relief and is used by most women in the U.S. With this method, a small catheter is placed in the epidural space of your lower back, allowing for continuous infusion of medication. You will feel a small sting when the local anesthetic is first administered, but placement of the epidural itself is not painful. The advantage of this method is that it allows for additional doses of pain medicine and can be used during a cesarean delivery. However, with this method, you will likely experience decreased control of your legs and an inability to empty your bladder. So, you will need to stay in bed until your epidural wears off, and you probably will need to have your bladder emptied with a small catheter. But, don?t worry. Your catheter will be placed after your epidural is working, so you won?t feel any discomfort.

For patients who do not want to use an epidural or cannot do so for medical reasons, it is also possible to use IV medications for pain control. However, the analgesic effects of these medications are generally limited and brief, and heavy sedation is common. These medications also are known to cross the placenta which means that your baby will be sleepy, too. This can cause your baby to have difficulties breathing after birth and to experience a slower transition into life outside of the womb. The decision to use IV agents to manage labor pain should be made after a careful consideration of the risks and benefits to your unique case.

In the event that you need a cesarean delivery, an epidural is almost always an effective way to provide complete anesthesia. However, occasionally, it is necessary to administer general anesthesia in which inhalation and IV agents are used. With this type of anesthesia, you will be “asleep” for your entire delivery, and your airway will be managed by trained anesthesia personnel.

Before your delivery, you should talk to your doctor about pain management so that you understand the risks and benefits of each option. Your comfort is worth it.

There is no reliable evidence that epidural analgesia causes chronic back pain. Although a few retrospective studies have found a link, these particular types of studies do not provide the most reliable evidence because they are based on the patient?s memory and personal perceptions of past events. More reliable types of studies have shown no significant association between epidural analgesia and chronic back pain.

Blood from your baby?s umbilical cord contains a source of important stem cells that could be used to treat blood diseases or advanced malignancies. In the past, these cells have been obtained from the bone marrow of a compatible sibling or other outside source. There is a national registry of bone marrow donors, but the problem is that finding a suitable match is not always easy. However, technology is being developed to use stem cells harvested from the umbilical cord to treat various blood disorders, particularly childhood malignancies. Preliminary reports of successful transplants of stem cells from cord blood have generated a lot of enthusiasm. Today, there are several privately owned for-profit companies that will bank your baby?s cord blood for potential future use. But, this can be a costly investment; there is a significant processing fee as well as an annual storage fee. Given the low probability of needing a stem cell transplant (between 1 in 1000 and 1 in 200,000 by age 18) and the uncertainty of success after long periods of storage, cord blood banking may or may not be such a good investment. Parents should not commit to this service without a realistic assessment of their return on investment.

Circumcision refers to the surgical removal of the foreskin and is usually done right after birth. This procedure has been performed for centuries in many cultures. Some studies have shown potential medical benefits to newborn male circumcision such as reduced incidences of penile cancer and urinary infections and less spreading of sexually transmitted diseases. However, these benefits are thought to be modest at best. According to the American Academy of Pediatrics there is not enough evidence at this time to recommend routine circumcision. This means the procedure is purely elective. In making your decision, it is certainly reasonable to take cultural, religious and ethnic traditions into consideration. If you choose to not circumcise your son, you will need to teach him proper hygiene, including how to retract the foreskin and wash underneath it. Otherwise, a cheese-like discharge called smegma can build up, causing odor and infection. For babies who receive circumcision, the incidence of complications is low and most usually includes minor bleeding, infection and scarring. Swaddling, oral sugar and Tylenol will reduce your baby?s stress response, but additional pain medication is required during the procedure. Most pediatricians will use anesthetic creams or a nerve block to ensure that your baby remains as pain-free as possible. Please be prepared for your baby to cry during the procedure and for a brief period afterwards. Your pediatrician will be able to discuss the risks and benefits of circumcision in greater detail so that you can decide what is right for your baby boy.