Headaches. The best treatment for headaches depends on the type of headache. If you are having recurrent headaches, we can assess your headaches and direct you to the most appropriate treatment. For simple headaches, try Tylenol first. Also caffeine works very well for most types of headaches. Laying down and relaxing with a warm or cold compress on your head may also help. If you suspect that your sinuses are causing your headache, then an antihistamine like Allegra, Zyrtec, or Claritin may help, but avoid those drugs with the “-D” component.
Bleeding. Some amount of bleeding during the first trimester is very common, affecting about one-third of pregnant women. Avoid sex if you are bleeding until we can discuss the bleeding or it resolves. Bleeding increases your risk of miscarriage, but, surprisingly, not by very much. If you are having heavy bleeding and cramping, you may need to be seen. Bleeding later in pregnancy may be a sign of labor or other problems. It can also be normal. Always discuss heavy bleeding with us immediately.
Contractions. Contractions can be very uncomfortable and worrisome but they are also very common and normal. Distinguishing between real labor contractions and so-called Braxton-Hicks (B-H) contractions can be confusing sometimes, but here are general guidelines. Real labor contractions are almost always very frequent, every 2-4 minutes apart; whereas B-H contractions are less frequent (7-20 minutes apart). Real labor contractions are very predictable and regular, B-H contractions less so and irregular. Real labor contractions are painful and get more painful over time; B-H contractions may be painful at times but the intensity decreases over time.
The best way to tell the difference between real labor and false labor is to give yourself some time and observe what is happening. Relax, drink some water, and see what happens over 2-3 hours. If, over that time, your contractions are occurring more frequently and just a few minutes apart, are lasting longer, hurting more, and very regular, then you may need to call us or go to the hospital. False labor tends to decrease in intensity over time and may go away altogether with rest in a few hours. Always call us if you are unsure, particularly if you are preterm.
Leaking fluid. Leaking fluid could be a sign that your bag is broken, and you should always go to this hospital if you suspect this. Usually, when your bag of water is broken, the leakage will be continuous and will saturate through your underwear. When pregnant, women are more likely to occasionally urinate on themselves and this can sometimes be surprising and mistaken for leaking amniotic fluid. Also, discharging a small amount of fluid over time could be a sign of vaginal infection that may need to be treated.
Decreased fetal movement. You shouldn’t expect your baby to move at all until around 20 weeks. Some women feel movement sooner than this, usually women who have been pregnant before. When you first start to feel movements, they may be inconsistent and you might go days without feeling movement. You shouldn’t necessarily expect to feel daily movements until about 23-24 weeks. When the baby’s movements have become regular and well-established, you can expect to feel at least 6 movements in one hour during the baby’s active time if you are paying attention to them. For many women, this active time is shortly after they have eaten dinner. If you don’t feel 6 movements in one hour but you are feeling some movements, then 10 movements over 2 hours is also acceptable. However, anything less than this is a reason to go to the hospital or office and be evaluated.
Nausea and Vomiting. Nausea and vomiting of pregnancy (NVP) affects two-thirds of pregnant women. Eating smaller, bland meals may help, especially early in pregnancy. Make sure that acid reflux or heartburn is treated as this can contribute to the problem. Surprisingly, the most effective treatments for NVP are over the counter. You should start with taking Vitamin B6, 25 mg, two or three times per day. If you are still having problems, then add Unisom SleepTabs at night, and perhaps half of a tablet in the morning. This combination relieves half of the symptoms of NVP. Ginger (three 250mg capsules a day and one before bed) sometimes helps women, too. If you are having trouble after this, talk to us. We may prescribe other anti-nausea medicines. The good news is that it usually gets better, with most women only having symptoms for about 35 days in the first trimester. Most mild cases of nausea and vomiting do not harm your health or your baby’s health. Nausea and vomiting is considered severe if you cannot keep any food or fluids down and begin to lose weight, requiring more intensive medical care than just anti-nausea medicines. If nausea and vomiting persists or even begins after the first trimester, it may be due to another cause which would need to be ruled out by your physician.
Heartburn. Avoid eating spicy, acid-producing foods and eat smaller, more frequent meals. Don’t eat right before bed. Sleep with your head slightly elevated if you are having trouble. Acid relievers like Tums, Gaviscon, Maalox, and Mylanta are all safe. So too are antihistamines like Cimetidine and proton-pump inhibitors like Omeprazole. You may need to take these medicines daily.
Constipation. Pregnancy is notorious for causing constipation. Increasing fluid and fiber intake can help tremendously. Beyond this, using Miralax daily or other drugs like Colace can help too.
Hemorrhoids. Treating constipation is the first step to helping hemorrhoids, which typically worsen during pregnancy and get better afterwards. Preparation H and Anusol are safe to use, as well as Tuck’s Pads or Witch Hazel.
Pain. Various pains, particularly back and pelvic pain, are common in pregnancy. Stretching and strengthening exercises can help, such as Pilates or Yoga for pregnancy. Wearing a pregnancy support belt can help as well. Taking Tylenol is safe and using warm compresses or pads may help too. You should wear low-heeled shoes with a good arch support. Avoid lifting heavy items by yourself. Elevate one food on a support if you must stand for long periods of time. Don’t bend at the waist, but with your knees. Try to sleep on your side with one or two pillows between your knees. Place a board under your mattress to make your bed more firm.
Of course, a massage would be wonderful and is safe during pregnancy, and some Chiropractors will take pregnant patients. We sometimes may prescribe muscle relaxants or physical therapy.
Seasonal Allergies. Allegra, Zyrtec, or Claritin are safe, but avoid those drugs with the “-D” component. Most other over allergies remedies are safe as well.
Here are some common questions about pregnancy problems: