Info for Pregnancy


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Please refer to the OTC list available above, this list was created by the physicians in our office so that you could purchase over the counter medications for common symptoms during pregnancy without having to worry about the safety. You do not need to call us prior to purchasing or taking the medications on this list.

Useful Links

EvergreenHealth Family Maternity Center

EvergreenHealth Maternity Guide

Do you desire a Vaginal Birth after a Cesarean Section, otherwise known as a VBAC? Please go to the link below

VBAC handout - MUST BE READ prior to signing consents

Pregnancy Information




You are more susceptible to these when pregnant. Try to drink lots of fluids and get more rest as it can take longer to recover than usual. You may use OTC throat lozenges, Sudafed, Robitussin, or Tylenol to relieve symptoms. Make sure the cold medicine you take does not contain alcohol. Antibiotics may be recommended if symptoms persist over two weeks. Please contact your primary care physician for diagnosis and management. Nasal irrigation is very helpful for sinus congestion. You may buy this over-the-counter (Neti-Pot.) Flu vaccines are highly recommended. You may get them wherever they are available. We carry the preservative (thimeresol) free vaccines. Coverage is subject to your insurance. As referenced before please go to our OTC medication form for downloading to get the list of safe medications for a cold

Nausea and Vomiting

This is quite common during the first 14 weeks of pregnancy. Nausea can be lessened by eating small amounts every 2 hours, eating crackers or hard candy before getting out of bed in the morning, drinking spearmint or peppermint teas, limiting fatty foods and strong smelling foods. You can try ginger capsules (250 mg 4 times per day), Unisom, and Vitamin B6 (50 mg twice per day) that are medicines sold without a prescription. Please refer to our OTC (Over the Counter) medication list at the top of the page, this list was created by our physicians for a reference on what is safe. Prescription medicines such as Phenergan, Hydroxyzine, or Zofran may be needed. Seabands are elastic wristbands that apply pressure to a pressure point and relieve nausea sometimes. They can be bought without a prescription. All of these are safe and quite helpful for most women. If your vomiting is severe enough to cause dehydration, we need to see you and may need to coordinate administration of IV fluids. Nausea often returns at the end of pregnancy, possibly due to acid reflux. If this is your experience, please let your provider know. We may be able to help.

Constipation and Bloating

Constipation is difficulty having bowel movements. Frequency of bowel movements may vary from every other day to 2-3 times per day. Eat foods high in fiber like apples, pears, carrots, celery, whole wheat bread and cereal. Drink pear juice, prune juice, warm tea or coffee to aid in having a bowel movement. Getting lots of exercise and drinking lots of water will also help. You could try most kinds of stool softeners or fiber sources like Metamucil, Fibercon, Citrucel, Benefiber if you continue to have a severe problem. If these do not work, please let us know. We may advise using an OTC laxative or enema.

Intestinal gas is a bother during the first few months of pregnancy. Warm liquids may help. Some women have success with GasX, Digel, or Phazyme.


Ultrasound exams are a diagnostic imaging tool that is usually performed at approximately the 20th week of pregnancy to survey normal anatomy, rule out birth defects and placental problems. We do not require a full bladder for this scan. Most women require only this single scan during their pregnancy but more may be ordered when medically indicated. For example, ultrasound exams may be performed early in pregnancy to confirm your due date, check for the presence of twins and find your baby’s heartbeat. We may require that your bladder is full if you are having a first trimester scan. Later in your pregnancy, an ultrasound may be done to check on the growth of your baby and/or measure your amniotic fluid. Ultrasound is usually done by applying warm ultrasound gel on your skin then moving a small transducer over your abdomen. Specific indications require a vaginal probe which may be performed at any stage of pregnancy.  Diagnostic ultrasound utilizes sound waves to produce images and have never been found to cause problems for your baby. We will provide you with a complimentary DVD at your 20-week ultrasound with still and real-time images.

The majority of obstetrical ultrasound exams are performed in our office, but some are done at Maternal Fetal Medicine (MFM). Should you have a BMI over 35, we will recommend you have your ultrasounds at MFM in order to attain the best possible image. We will also refer you to MFM for any high risk situation such as advanced maternal age, twins, diabetes, small or large baby, etc.

You are welcome to have two guests in the ultrasound room during the entire exam. Near the end of the scan, other guests and supervised children may join during the digital recording portion. Please do not bring unaccompanied children unless they are secured in a seat or stroller.

Please turn off cell phones and pagers during your ultrasound appointment.


We recommend eating normal portions of healthy foods at least 3-4 times per day. Protein builds strong babies.

Good sources of protein come in several categories:

  • Dairy products like milk, yogurt, and cheese (Pasteurized cheese is safe, even if it is a soft cheese. Do not eat homemade cheese.)
  • Plant sources like tofu, soy nuts, regular nuts, whole grain bread, lentils and beans
  • Meat sources like chicken, turkey, beef and pork (Do not eat raw meat.)
  • Fish is healthy and recommended in pregnancy, following some basic guidelines. Salmon, cod, scallops, shrimp, tilapia, and canned light tuna are all fine to eat 2-3 times a week. Sushi is safe, as long as it is not raw. Be sure your sushi is being properly handled and is refrigerated. This is an excellent time to experiment with vegetarian sushi.

Vitamins are important. Good source of high vitamin foods include:

  • Vegetables like spinach, asparagus, squash, and broccoli
  • Fruits like berries, melons, apples, oranges, and pears
  • Dark, leafy greens such as kale and kohlrabi

Water prevents and treats lots of problems in pregnancy. Drink at least 8 glasses of water per day and avoid more than 1 caffeinated beverage per day. Clear urine is the best indicator of proper hydration.

Avoid large or frequent servings of rice, juice, pasta, bagels, muffins, ice cream, cake, cookies, fast food, and soda.

The concern over deli meat involves a very rare infection called listeria. While it is recommended to heat your deli meat, the risk is very low to contract listeria, even without heating the meat.
1-888-674-6854 USDA Meat and Poultry Hotline
1-888-723-3366 FDA Food information Line


It is important to get daily exercise while pregnant as your labor will be shorter and less painful and you will have a lower chance of a Cesarean birth. Twenty to thirty minutes of brisk walking, swimming, yoga, aerobics, or weight machines is very helpful. Avoid sports such as skiing, horseback riding, or contact sports that could cause serious injury or abdominal trauma. Listen to your body when you exercise. Your tolerance will be lower and it is important to slow down or stop if you are out of breath. Exercise to tone your muscles, but not to the point of exhaustion. Abdominal crunches are not recommended during pregnancy.


Headaches are common in the first 4 months of pregnancy. While not usually severe, they often last for several days. Extra sleep, regular small meals, cold compresses to forehead, drinking fluids, and extra-strength Tylenol every 4 hours might be helpful. Narcotics are safe but are discouraged as they can cause worsen headaches with prolonged use. Migraine symptoms often improve during pregnancy. Do not use your usual migraine medicine while pregnant until you check with your provider.

Dental Health

Oral health continues to be important during pregnancy. You should go for your routine exams/cleaning as recommended by your dentist. We recommend having your teeth cleaned in your second trimester. X-rays are safe with proper shielding. If you need any dental work performed, local lidocaine with epinephrine and most antibiotics are safe for you and your baby. Nitrous oxide may be used for limited amounts of time. Chewing xylitol-containing gum four to five times a day, or using xylitol rinses, after eating, has been shown to decrease the bacteria which can cause dental caries/decay. This will benefit you and your baby. In a mother prone to cavities, decreasing the oral bacteria when pregnant may decrease a young child’s potential for cavities. The bacteria that cause cavities are transmitted to the fetus through the placenta.


Air travel is safe. Flying does not harm the baby or cause labor but you should not fly after 36 weeks of pregnancy just in case you go into labor. When flying, drink lots of water and avoid the salty snacks which can make the inevitable swollen ankles much worse. Sit in the aisle seat so you can get up and move often. Moving your legs frequently (walking or doing calf pumps while you sit) will help prevent blood clots. Compression stockings may be helpful for long trips. It is a good idea to bring your prenatal records with you in case you develop a problem.

If your flight is over two hours, it is recommended you take a low dose baby aspirin (81mg) to help prevent blood clots. Take one the day before you travel, one the day that you travel, and one the day after. Repeat this on the trip home.

If traveling to developing countries, avoid fruits that you cannot peel, tap water, lettuce, and vegetables that may be washed in tap water. Avoid foods sold by street vendors and do not have ice in beverages. Get a hepatitis A vaccine before going to Mexico or any third world country.

Sexual Intercourse

Sex is generally safe in pregnancy unless there is concern for possible miscarriage or preterm labor. Avoid lying on your back during sex once your belly is big as it can be very uncomfortable. Orgasms will give you uterine cramps but are rarely dangerous. It is true that sex can trigger labor if you are near your due date.


Insomnia is very common in pregnancy due to worries, excitement, and discomforts. Try warm baths and warm, non-caffeinated beverages before bed. Use lots of pillows to get into comfortable positions. Once your belly becomes larger, it can be uncomfortable to lie on your back. While laying on your back may become uncomfortable after about 20 weeks of pregnancy, it is not dangerous for your baby. Prop yourself with pillows on your side and/or with the upper body slightly elevated if needed. Avoid stimulating activities before bed. You may use Unisom, Tylenol PM, or Benadryl safely.

Heartburn/Acid Reflux

This is quite common in pregnancy, especially in the later months and in overweight women. Eat small meals and avoid lying down for several hours after eating. You may use Tums, Zantac (150 mg twice per day which may be increased to 300mg twice per day if needed), Prevacid, Pepcid, Nexium or Prilosec OTC safely. If you need medication every day, ask for a prescription. Some insurances require you try over-the-counter medicine first.


These are swollen veins at the rectal opening. They may feel like bulging skin and they may bleed, itch, or throb. You need to avoid constipation to prevent them from getting worse. You may purchase Tucks or Anusol without a prescription. If these do not help, please ask your provider for a prescription for Analpram HC or Anusol HC. Occasionally surgery may be needed for very hard or enlarged hemorrhoids. These will shrink after your delivery, but women are often left with a little loose skin at the rectal opening.

Hair Dyes, Perms, Foiling, Tanning Beds, Manicures, Artificial Nails

These beauty treatments are all safe during pregnancy. Tanning beds, however, are bad for your skin and have been proven to contribute to skin cancer.

Back Pain

Most women have back pain at some time in their pregnancy due to hormonal changes causing loose joints. To lessen back pain, avoid sitting for long periods. If you are unable to do this, put a stool or box under your feet. Avoid bending, arching or twisting motions. When lifting heavy things, squat down keeping back straight and use leg muscles instead of your back.

Try moist heat or cold packs to area, getting massages, or sitting in a warm bath. Some women are helped by chiropractic care, physical therapy, or acupuncture. Wearing supportive, low-heeled shoes or an abdominal binder may help. Taking Tylenol is safe and may help. Gentle exercise will strengthen back muscles to prevent strain.

Sciatica is a type of sharp pain in the nerve that runs down your buttock and back of your leg. Try the things listed above, but this usually goes away in 1-2 weeks. We can give you a list of back strengthening exercises that may help. If the pain is very bad or is lasting a long time, a referral to a physical therapist may be advised.

Please call us if you have mid-back pain that is off to one side (kidney region) or if you have intermittent back pain that comes every few minutes BEFORE 37 weeks (this could be preterm labor.)

Fetal Movement Counting

Mothers usually feel movements by the baby around 20-22 weeks, though some mothers feel this much earlier. Healthy babies are very active, particularly in the evening. Some perfectly normal babies may sleep quietly for as long as 60 minutes without moving. Counting your baby’s movements beginning at about 28 weeks can be helpful in finding problems. Pick a time during the day or evening that your baby is normally active and count 10 separate movements. Record the time you started counting until you feel the 10th movement. If you feel 10 movements in less than 2 hours, stop counting until the next day. If you do not feel 10 movements within one two-hour period, contact your provider.


Outdoor cats can carry a disease called toxoplasmosis which can harm your baby if you are exposed for the first time. Avoid cleaning the litter box of these cats. Most women are already immune. If you are worried that you might get infected, ask us to test you for the antibodies. Indoor cats (who have always lived indoors) are safe. Report any serious bites or scratches from a kitten. You will need antibiotics.


There is no safe amount of any of these substances. We strongly advise that you quit completely. If you used a small amount before you knew you were pregnant (before the 6th week of pregnancy), any effects to the baby are highly unlikely. If you need help quitting, please tell us. We can help.


Brief exposure to hot tubs and saunas is not dangerous. It is important to listen to your body while in the heat. Your heat tolerance will most likely be lower during pregnancy. You may feel dizzy. The best way to avoid this is to always stay well hydrated!


If you are being hurt emotionally or physically, please report this to us. It generally worsens as your pregnancy progresses. WE CAN HELP! You may also call 1-800-562-6025. This is a city-supported help line.

Forms Completion

If you need to have any forms completed by your provider, please allow 7 business days for processing. All fees ($25) must be paid in full prior to completion. This includes, but is not limited to, forms for FMLA, Disability, and Leave of Absence.

Contacting Us

If you have any concerns about your pregnancy, please feel free to call our office. There is always a consulting nurse available to help. We are best prepared to serve you if you call, rather than drop by the office. Sometimes we can help you over the phone. If you need to be seen, we will set up an appointment for you.