It is very common for our patients to ask whether they can travel during their pregnancies. It is safest for you to stay within an hour of HealthCare during your pregnancy. There is potential risk of complications anytime during your pregnancy. If it is essential that you travel, below are some guidelines we hope will be of benefit.

While travel during the first trimester, up to 13 weeks gestation, is likely to be safe, once you have had a normal ultrasound. There is still a 2% risk of miscarriage, which means there is a risk of hemorrhage requiring D&C. Once you become pregnant, pregnancy hormones increase your risk of developing blood clots in your legs. No matter what stage in the pregnancy, it is important that you not sit for extended periods of times. Our recommendation is that if you will be sitting for an extended period of time, either in an airplane or in the car, you should get up to walk every hour in an effort to decrease the risk of blood clot development. Call immediately if you develop leg pain, swelling, shortness of breath or chest pain. Although rare, blood clots can migrate to the lungs. If you choose to travel between 20-36 weeks gestation, there are special considerations. This is strongly discouraged for any patients with a history of preterm labor, preterm delivery, previous surgery on their cervix, or any other risk factors for preterm birth, such as infection, uterine anomaly, etc. If you find that travel is essential, we suggest that you make an appointment shortly before your departure.

Colds are miserable things, even at the best of times, but there are increased concerns during pregnancy. Many things can relieve symptoms at home, sometimes eliminating the need for an office visit.

Use a cool mist vaporizer/humidifier at night. This moistens the air you breathe to keep secretions flowing. Saline gargles (one teaspoon of salt in ½ cup warm water) every four hours while awake will cut the mucus in the back of the throat and relieves mild soreness Any brand of SALINE nose drops at bedtime and on arising in the morning will help moisten secretions. Panadol (plain) two tablets every four hours if necessary for aches (maximum of six tablets in 24 hours.) Preferably not during the first trimester and not at all for one week before your Nucal Translucency Scan. Take your temperature, orally, twice daily – call us if your temperature is greater that 38deg C. Coughing can be relieved with one teaspoon of honey and 2-3 drops of lemon juice. Hold this in your mouth until the honey thins and then swallow. If coughing interrupts sleep or causes vomiting, call your doctor. Increase fluids (especially water) to two litres a day. Get extra rest, if possible. Actifed or Sudafed may also be used for symptoms of congestion when taken as directed on the package. It is preferable that you not take this in your first trimester of pregnancy.

Pregnancy problems may occur in the middle of the night or on weekends as I work independently and therefore during the week are on call for my own patients but after hours please phone Pindara Hospital on 07 55889888 and talk to Maternity.

Often pregnant women have concerns about the safety of hair dyes and permanents during pregnancy. There is no scientific data on this question, but it seems unlikely that these types of exposures are harmful.

The use of saunas, hot tubs, and tanning booths is not recommended in pregnancy. The extreme temperature could Potentially damage the developing baby. Extremely hot baths are not recommended during pregnancy.

The following suggestions may be useful in relieving nausea and vomiting:

Remember, “any calorie is a good calorie” so eat what stays down for you.

These foods may not be well tolerated:

• Greasy or fried foods, as they take longer to leave the stomach
• Very sweet foods
• Spicy hot foods
• Foods with strong odours
• Eat smaller, more frequent meals, that is six small meals and snacks.
• Drink fluids between meals, not with meals.
• Eat foods that are at room temperature or cooler. Hot foods may trigger nausea.
• Drink beverages chilled or cold.
• Decaffeinated drinks are often well tolerated. Don’t opt for diet drinks , you need the calories right now.

• Eat slowly and rest after meals. It is best to rest sitting in an upright position for about one hour after eating.
• Dry toast, soda crackers, or dry pre-sweetened cereals may relieve periods of nausea.
• Keep track of when you feel nausea and what causes it.

If continued vomiting occurs, do not eat or drink anything until the vomiting has stopped. As you feel better, try some small amounts of clear liquids (broth, Jell, apple, grape, or cranberry juice, and/or iceblocks.)
Tart or salty foods such as lemons or pickles may help decrease nausea.
Avoid mixing hot and cold foods at a meal, as it may stimulate nausea.
Ask your doctor about medicine to control nausea.
Avoid eating in a room that is stuffy, too warm, or has cooking
smells/odors that may disagree with you.
Wear loose fitting clothing.
To avoid the sight/smell of foods, eat meals out or have others bring prepared food to you.These are signs that you need to call your doctor:

Unable to keep anything down for more than two days
Fainting
Vomiting blood
Rib pain
Jaundice (skin is greenish or yellow)
Your weight drops more than 2.2kg in a week
++ FOODS TO AVOID

http://www.americanpregnancy.org/pregnancyhealth/foodstoavoid.html

Is it safe to exercise and continue work during pregnancy?
Exercise can help strengthen muscles used in labor and delivery and lessen some of the discomforts of Pregnancy. It may give you more energy and make you feel better. The type of exercise you can do during depends on your health and how active you were before you became pregnant. This is not a good time to take up a new, hard sport. If you were active before, you can continue to be within reason. If, for example, you play tennis, you can still play, unless you have special problems or feel very tired. A good “rule of thumb” is to limit exertion to about 2/3 of what you could do before pregnancy. Most of the time, a healthy woman with no complications in her pregnancy can keep working until the end of her pregnancy. Some may need to make some changes. If you are experiencing problems that you feel may be related to your job, please discuss this at one of your office appointments. Your family should be able to help you at home as fatigue increases at the end of your pregnancy.

Is it normal for swelling to occur?
A certain amount of swelling (called edema) is normal during pregnancy. It occurs most often in the legs. Elevating the legs usually makes the swelling less by the next morning. Swelling can begin during the last few months of pregnancy, and it may occur more often in the summer. Let your doctor or nurse know if you have swelling in your hands or face, because this may be a sign of another problem. A clue that your hands are swollen is that your rings are too tight. Never take medications (water pills) for swelling unless they have been prescribed for you.

Elevate you legs when possible Rest in bed on your side Lie down with your legs raised on a small footstool or several pillows Do not wear stockings or socks that have a tight band of elastic around the legs. If you must sit a lot on the job, stand up and move around from time to time. Try not to stand still for long periods of time.

Exercise can help strengthen muscles used in labor and delivery and lessen some of the discomforts of Pregnancy. It may give you more energy and make you feel better. The type of exercise you can do during depends on your health and how active you were before you became pregnant. This is not a good time to take up a new, hard sport. If you were active before, you can continue to be within reason. If, for example, you play tennis, you can still play, unless you have special problems or feel very tired. A good “rule of thumb” is to limit exertion to about 2/3 of what you could do before pregnancy. Most of the time, a healthy woman with no complications in her pregnancy can keep working until the end of her pregnancy. Some may need to make some changes. If you are experiencing problems that you feel may be related to your job, please discuss this at one of your office appointments. Your family should be able to help you at home as fatigue increases at the end of your pregnancy.

A certain amount of swelling (called edema) is normal during pregnancy. It occurs most often in the legs. Elevating the legs usually makes the swelling less by the next morning. Swelling can begin during the last few months of pregnancy, and it may occur more often in the summer. Let your doctor or nurse know if you have swelling in your hands or face, because this may be a sign of another problem. A clue that your hands are swollen is that your rings are too tight. Never take medications (water pills) for swelling unless they have been prescribed for you.

Elevate you legs when possible Rest in bed on your side Lie down with your legs raised on a small footstool or several pillows Do not wear stockings or socks that have a tight band of elastic around the legs. If you must sit a lot on the job, stand up and move around from time to time. Try not to stand still for long periods of time.

Most adults are immune to chicken pox, either from having the disease or by forming immunity from a mild exposure. If you have had chicken pox in the past, you and your baby are protected. If you are not sure, ask your doctor to check your immunity with a blood test. If this shows positive immunity, you are both protected. If it shows no immunity, an injection of a medicine called Varicella Immune Globulin (VZIG) may be given to prevent chicken pox. In order to be effective, this injection must be given within 72 hours of exposure.

Headaches are common during pregnancy. Usually headaches do not signal a serious problem. How often they occur and how bad they are may vary. It is important to discuss with your doctor which medications you can use for the headache. You should contact your doctor if your headache does not go away, returns very often, is very severe, causes blurry vision or spots in front of your eyes, or is accompanied by nausea. You may use two Panadol.

At least half of all pregnant women seem to have problems with constipation. One reason for this may be changes in hormones that slow the movement of food through the digestive tract. Sometimes iron supplements may also cause constipation. During the last part of pregnancy, pressure on your rectum from your uterus may add to the problem.

Here are some suggestions that may help:

Drink plenty of liquids – at least 6-8 glasses of water each day, including 1-2 glasses of fruit juice such as prune juice. Liquids (such as coffee, tea and cola) which make you go to the bathroom should not be drunk. They will tend to create a negative water balance in your body and thus make your stools harder and more difficult to pass. Eat food high in fiber, such as raw fruits and vegetables, bran cereals, Raspberry leaf tea and Psyllium. Exercise daily – walking is a good form of exercise.

During pregnancy, the extra hormones in your body may cause your gums to swell and bleed. Floss and brush regularly, using a soft toothbrush, to keep your teeth in good shape. Having a dental checkup early in pregnancy is a good idea to be sure your mouth is healthy. Local anesthesia, if needed, does not pose a risk during pregnancy. Dental x-rays should only be done if necessary and with your abdomen shielded.

In the last three months of pregnancy, you may find that you have more leg cramps. Get plenty of calcium (three glasses of milk or supplement) and potassium (oranges or bananas.) Stretching you legs before going to bed can help relieve cramps. Avoid pointing your toes when stretching or exercising.

Latex paints manufactured before 1991 used small amounts of mercury as a preservative. There was some concern that this mercury could present a health hazard, so mercury is no longer used in latex paints. The fumes from latex paints are not felt to be a specific risk to a developing baby, but it is always wise to paint in a well-ventilated area. The fumes from oil-based paints, turpentine, paint thinner, etc., are best avoided by pregnant women. Also, remember when painting to avoid use of a ladder to reduce the risk of injuries due to a fall.

Some people worry about having intercourse during pregnancy. They may be afraid it will cause a miscarriage. For a healthy woman with a normal pregnancy, intercourse is safe into the last weeks of pregnancy. For your comfort, you and your partner may want to try different positions. Your doctor may advise you to limit or avoid sex if there are signs of problems in your pregnancy.

Indigestion is commonly called heartburn. It is a burning feeling that starts in the stomach and seems to rise into the throat. It occurs when digested food from your stomach, which contains acid, is pushed up into your oesophagus (the tube leading from the throat to the stomach.) Liquids that you drink also take up space in your stomach, so they may also add to the problem.

Changes that take place in your body during pregnancy may worsen indigestion. Changes in your hormone levels slow digestion and relax the muscle that normally prevents the digested food and acids in your stomach from entering the esophagus. In addition, your growing uterus presses up on your stomach.

To help relieve heartburn, try the following:

Eat five or six small meals a day instead of two or three large ones. (A glass of fluid may be equal in volume to a small meal, so avoid drinking large amounts of fluids with meals.) Avoid foods that cause gas, such as spicy or greasy foods. Do not eat or drink several hours before bedtime. Wait two hours after eating before exercising.

Antacids may be helpful, such as Gaviscon. Liquid will be more effective than tablets. If the problem is frequent and only briefly relieved by antacids, speak with your doctor.

Very often pregnant women who are constipated also have hemorrhoids. Hemorrhoids are varicose (or swollen) veins of the rectum. They are often painful. Straining during bowel movements and having very hard stools may make hemorrhoids worse and can sometimes cause them to protrude from the rectum.

Do not take chemist cures while you are pregnant without first checking with your doctor or nurse. Hemorrhoids usually improve after the baby is born. Several things can help give relief or avoid the problem in the first place:

• Avoid getting constipated.
• Eat a high-fiber diet.
• Drink plenty of liquids.

It is not uncommon to develop a yeast infection during pregnancy. If such an infection does occur, it is safe for you to use over-the-counter products, such as Canestan. These are readily available at stores.

However, if you are early in your pregnancy, before 12 weeks, it is important that the cream be used externally only. After 12 weeks, it is safe to gently use the applicator internally.

No, your prenatal vitamins should be the only supplement used during pregnancy unless your provider specifically directs you to use an additional product.