Is it normal that I’m cramping?

Almost all women have some cramping or other pains during pregnancy, particularly in the first trimester. This cramping is almost never anything to be worried about, particularly if you’re not bleeding. In the first trimester, the uterus grows rapidly and most of the cramping that a woman experiences is simply growing pains. As the uterus gets bigger, it becomes top-heavy and has a tendency to pull and tug from one side to the other. This will stretch ligaments, particularly the round ligaments, and cause either cramping or sharp pains. None of these symptoms put the baby at risk.

Sometimes cramping is not related to your uterus at all. Many women become constipated during pregnancy in the cramping that they experience is actually related to their bowels slowing down. Sometimes cramping is related to the bladder and might be a sign bladder infection, but almost always there will be other symptoms like burning when you pee.

In the second and third trimesters, cramping is often what’s cold Braxton-Hicks contractions. These are common and occur more often in subsequent pregnancies. They do not increase your risk of preterm labor.

Do I need to take anything besides my prenatal vitamin?

In most cases, the answer is no.

There is a whole industry that markets supplements in other products to pregnant women. Even among prenatal vitamins, from most women the only ingredient that is actually required is folate, and that folate is only necessary until the baby’s neural tube is closed, which happens early in the first trimester. The truth is, prenatal vitamins are best taken ended 2 to 3 minutes before pregnancy and provide little to no benefit past the first half of the first trimester. In fact, if you are beyond six weeks and prenatal vitamins are making you nauseous for constipated, there’s no reason for you to not stop them.

Aside from the folate in a prenatal vitamin, the other ingredients often found in these vitamins are not science based. Don’t get caught up on buying the most expensive prenatal vitamin because the company says it will make your child smarter or reduce the risks of pregnancy; this simply is not true.

In some cases, due to restrictive diets or pre-existing anemia or other risk factors, your doctor might ask you to take an additional supplement or medication.

I don’t understand my due date? When is the baby due?

How your due date is calculated is often confusing and different from what you expect. Pregnancy is 40 weeks or 280 days long, starting from the first day of the last menstrual period. This means that at the time of conception, a woman is already two weeks pregnant. This assumes that her menstrual cycles are 28 days apart.

Many times women do not remember the exact day of their last menstrual period, or they may not have menstrual cycles that are 28 days long, or they might’ve been on birth control at the time of conception. Sometimes women just ovulate a little bit late for the bleeding that they thought was there last menstrual period was actually something different, like implantation bleeding. All of these factors contribute to dating based on the last menstrual period being wrong about 40% of the time. Your doctor will compare the date derived from the last menstrual period dating to a date determined by an ultrasound, and in some cases your due date will be changed based on the ultrasound.

The first ultrasound performed that is able to give a measurement for the baby is always the most accurate for determining the due date. Sometimes, patients are confused because subsequent ultrasounds will show a baby that has a slightly different due date and they will wonder if they’re due date should be changed again based on these later ultrasound. The answer is no. The later ultrasound reflect a baby that is just a little bigger or smaller than the average for that gestational age or very just because of the margin of error.

Make sure you clarify at one of your first prenatal visit what your final estimated due date is; then, don’t get too fixed on that day. Only 2% of women deliver on their due date. Maybe we should’ve called it a due month.

How much weight should I gain?

Normal weight women gain 25-35 lbs during their pregnancies. Underweight women may need to gain more and overweight women less. For overweight women, dieting is safe and beneficial during pregnancy. Most weight gain comes in the second half of pregnancy and often women have gained no weight or even lost weight by 20 weeks; this is healthy. We check your weight at every visit, but don’t focus on how much you gain. We are usually not worried about you gaining too little weight but instead gaining too much. Excess weight gain increases the risks of pregnancy, including the risks of preeclampsia, diabetes, fetal macrosomia, and cesarean delivery.

Many overweight women will gain no weight for the entire pregnancy or even lose weight if they’re actively dieting. This is not a bad thing. Maternal weight gain when it is excessive is associated with excessive fetal size; but gaining too little weight during pregnancy will not make your baby too small if you are overweight at the start of the pregnancy.

Can I drink caffeine?

Yes you can.

As with most things in life, moderation is the key. Scientific studies have not demonstrated any problems with caffeine consumption during pregnancy until a woman consumes over 700 mg per day. That’s a lot of caffeine! To be safe, and to make sure that a woman never approaches that amount of caffeine consumption, we recommend that women limit themselves to 350 mg of caffeine per day.

Check out this list to learn how much caffeine is in common beverages. In general terms, the average cup of regular coffee and the average serving of a caffeinated soft drink. But beware: it is possible to overdo it with a large special order from Starbucks.

Why am I so tired?

Pregnant women are often excessively tired in the first and third trimesters, but probably for different reasons. In the first trimester, your body undergoes rapid physiological changes a company by high levels of hormones that conspire to exhaust you. Couple this with food aversion or nausea and vomiting, and the result for many women is complete exhaustion.

This tends to get better by the second trimester and then in the third trimester, particularly the last few weeks of pregnancy, exhaustion returns as you sleep less at night and carry around 30 extra pounds during the day. If you have another small baby or two at home already, then the effect is even worse.

What can you do? In the first trimester, work on minimizing the effects of nausea and vomiting of pregnancy. Keep your energy up by eating several small meals or snacks throughout the day and try adding vitamin B6 if you haven’t already. Naps sometimes feel like a good idea, but they often have the opposite effect then what you desire. Napping can interfere with your ability to get good rest at night and create a vicious cycle. Going for a walk for getting some exercise is probably a better idea and will improve your nighttime sleep.

Some women in the first trimester are excessively tired because they have cut caffeine completely out of their diets. Remember, you were still allowed to have up to 350 mg of caffeine today; so don’t feel too badly about having that cup of coffee in the morning or maybe after lunch.

Many pregnant women need to work on maximizing their sleep habits. Make sure you have a dark room, maybe with a noisemaker, like a fan or something else that makes background noise, to minimize interruptions. Try to use your bedroom for sleep only; don’t make a habit of watching TV from your bed or staring at your phone. Women in the third trimester often find every little uncomfortable spring in their mattress with their rounder bellies and hips. Try adding an extra layer of egg crate or a phone topper to your mattress and make sure you have a long pillow that you can hug with your legs.

Also, be sure to empty your bladder right before you go to sleep and if you find that you are awakening to pee several times a night, you might need to restrict water intake for 2-3 hours before going to sleep.

In rare cases, excess fatigue might indicate another problem like a thyroid abnormality or anemia; if you feel like you are more tired than the average pregnant woman, be sure to talk to your doctor.

What can’t I eat?

Good question. The truth is, you can eat just about anything you want. Visit our page here for a full explanation. But here’s the quick answer. Don’t eat:

  • Big fish with high levels of mercury (shark, swordfish, king mackerel, and tile fish).
  • Unpasteurized milk and soft cheeses
  • Raw or undercooked meats
  • Unreheated meats

Finally, make sure you wash your fruits and vegetables well before eating them. The absolute risk of the anything that happening from eating any of these foods is incredibly low. So you shouldn’t worry too much; but pregnancy isn’t the time to explore strange and new foods from uncertain sources.

I’m throwing up! Help!

Nausea and vomiting during pregnancy is no one’s idea of a good time. The good news is, nausea and vomiting is not associated with risk to the pregnancy; the bad news is, you aren’t nauseated and throwing up.

What can you do?

  • Eating several small meals per day and avoiding high fat foods may help.
  • Emphasize bland foods and avoid smells that are noxious.
  • Increasing protein and liquid content of your food maybe beneficial.
  • Ginger ale, ginger teas, or ginger capsules may be helpful.
  • Taking a vitamin B6 supplement 2 to 3 times per day alone or in combination with doxylamine at night may be beneficial.
  • Your doctor may need to prescribe you an anti-nausea medicine. There are several drugs that are safe in pregnancy to choose from.
  • Make sure that your acid reflux and constipation are treated as well; both can contribute to the problem.
  • In bad cases, you may need to be hospitalized for IV fluids and other treatments.

Hopefully, you should feel better by the end of the first trimester. If you don’t, or if the above remedies are not working, your doctor may need to investigate other causes of your nausea and vomiting apart from pregnancy. Typically, you shouldn’t be concerned as long as you can maintain your bodyweight or even lose a few pounds during the first trimester and as long as you can stay hydrated.