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First Trimester Pregnancy instructions

NAME

AGE

BIRTHDATE

PARTNER

ALLERGIES

GRAVIDA

PARA

EDD

BLOOD TYPE/RH

GBS STATUS

ANTEPARTAL VISITS

DATE OF VISIT

WKS GEST

WEIGHT

B/P SEATED

FETAL HEARTRATE

FETAL MOVEMENT? FETAL HEART RATE

CONTRACTIONS?

FUNDAL HEIGHT

QUESTIONS A CURRENT PROBLEM OR CONCERN THAT REQUIRES ACTION +if present O=if absent

NAUSEA AND/OR

VOMITING

VAGINAL

BLEEDING

VAG DISCHARGE WITH ITCH OR ODOR

BLADDER

SYMPTOMS

SEVERE HEAD

ACHE(S)

SWELLING OF

FEET, HANDS, FACE

OTHER PROBLEMS

NUTRITION

GOOD FAIR POOR

TAKING VITAMINS (IRON IF NEEDED)

All pregnant women should be taking a prenatal vitamin WITH iron as well as

Vitamin D3 2000 IU daily!!

Weight gain in pregnancy is inevitable. You are growing a baby and diet and exercise are two of the most important things you can do for yourself during your pregnancy. Where does the weight go?

Baby: 7 to 8 pounds (about 3 to 3.6 kilograms)

Larger breasts: 2 pounds (about 1 kilogram)

Larger uterus: 2 pounds (about 1 kilogram)

Placenta: 1 1/2 pounds (about 0.7 kilogram)

Amniotic fluid: 2 pounds (about 1 kilogram)

Increased blood volume: 3 to 4 pounds (about 1.4 to 1.8 kilograms)

Increased fluid volume: 3 to 4 pounds (about 1.4 to 1.8 kilograms)

Fat stores: 6 to 8 pounds (about 2.7 to 3.6 kilograms)

Your BMI	Recommended Weight Gain
Your BMI	Chart	Table
Below 18.5	28 to 40 pounds	28 to 40 pounds
18.5 - 24.9	25 to 35 pounds	25 to 35 pounds
25 - 29.9	15 to 25 pounds	15 to 25 pounds
30 and Above	11 to 20 pounds	11 to 20 pounds

Eat well and Exercise!

Keeping with a good exercise program will help keep your weight gain in the expected range and the exercise will help you with many of the changes in your body associated with pregnancy. Always remember to take your prenatal vitamins and vitamin D3 every day.

Taking Medicines During Pregnancy

There may come a time during your pregnancy when you’re feeling under the weather and aren't sure if you can take your regular over-the-counter (OTC) medication. Some medications are safe to take during pregnancy. But others are not, or their effects on your baby may not be known.

Over-the-counter medicines safe to use during pregnancy

Brand names and ingredients can change. Use the generic name (in parentheses) as the key for using these medicines. If you have questions or concerns, call your clinic or pharmacist.

Condition	Medicine
acne	Cetaphil® Gentle Skin Cleanser, CeraVe™ Hydrating Cleanser, Glytone® (benzoyl peroxide)
allergy	Alavert® or Claritin® (loratadine) Benadryl® (diphenhydramine) Zyrtec® (cetirizine)
constipation	Citrucel® or Unifiber® (methylcellulose) Colace® (docusate sodium) Fiberall® or FiberCon® (calcium polycarbophil) Metamucil® (psyllium) milk of magnesia (magnesium hydroxide) ClearLax®, MiraLAX® (polythylene Glycol 3350)
cough (alcohol-free syrup)	Vicks® Nature Fusion™ Cough (dextromethorphan hydrobromide) Delsym® 12-Hour Extended-release Suspension (dextromethorphan polistirex) Adult Robitussin® Peak Cold Cough and Chest (dextromethorphan, guaifenesin) Mucinex® (guaifenesin)
diarrhea	Imodium® (loperamide)
fever	Tylenol® (acetaminophen) Take 650 milligrams (mg) every four hours for temperature higher than 100.4 degrees F. If you have a fever for 12 hours, call your health care provider.
gas	Gas-X® Chewable Tablets or Maalox® Anti-Gas or Mylanta® Gas Maximum Strength Chewable Tablets (simethicone) Mylanta® Maximum Strength Liquid or Maalox® Advanced Maximum Strength Liquid (aluminum hydroxide, magnesium hydroxide, simethicone)
heartburn	Gaviscon® (aluminum hydroxide, magnesium carbonate) Maalox® tablets or Rolaids® or Titralac® or Tums® (calcium carbonate) Take less than 2,000 mg. Maalox® Advanced Regular Strength Liquid or Mylanta® Regular Strength Classic Liquid (aluminum hydroxide, magnesium hydroxide, simethicone) Pepcid® AC (famotidine) Zantac (ranitidine)
hemorrhoids	Anusol-HC® hemorrhoidal ointment or Preparation H® Hydrocortisone (hydrocortisone) Preparation H® (phenylephrine, pramoxine, glycerin, petrolatum) Tucks® pads (witch hazel)
nausea, vomiting, motion sickness	Emetrol® Syrup (phosphorated [phosphoric acid] carbohydrates [dextrose, fructose] syrup) Dramamine® (dimenhydrinate) ginger tabs (ginger) vitamin B-6 Take 25 mg four times a day. Sea-Band® Unisom® SleepTabs® (doxylamine succinate) Take one-half of 25 mg tablet and 25 mg of vitamin B-6 three to four times a day.
pain Call our office if your pain is in your abdomen (stomach).	Tylenol® (acetaminophen) Take 650 to 1,000 mg every four hours as needed. Do not take more than 4,000 mg in 24 hours. If you don't have relief in 24 hours, call your clinic.
rash Call our office if you have an allergic reaction, or no relief.	Aveeno® Soothing Bath Treatment (colloidal oatmeal) Caladryl® Clear® lotion (pramoxine, zinc acetate) or calamine lotion (calamine, zinc oxide) Cortaid® 1% (hydrocortizone) Gold Bond® Medicated Anti-itch Cream (menthol, pramoxine)
sinus congestion and cold	Clor-Trimetron® (chlorpheniramine) Coricidin® HBP Chest Congestion and Cough (dextromethorphan, guaifenesin) Ocean Mist® nasal spray (saline [sodium chloride] nasal sprays) Sudafed® (pseudoephedrine) Avoid in the first trimester. Avoid all products with phenylpropanolamine and phenylephrine.
sleep problems	Unisom® SleepTabs® (doxylamine succinate) Tylenol® PM (acetaminophen, diphenhydramine HCl)
sore throat	Cepacol® Maximum Strength Sore Throat Spray or Sucrets® lozenges (dyclonine hydrochloride) Chloraseptic® lozenges (benzocaine) or spray (phenol) Do not take longer than two days. Halls® or Robitussin® lozenges (menthol) Vicks® lozenges with honey (dextromethorphan hydrobromide)
vaginal yeast infection	Gynazole-1® (butoconazole), Monistat® 7 vaginal cream (miconazole) Gyne-Lotrimin® (clotrimazole) Monistat® 7 vaginal cream (miconazole

Continue reading below...

Things to avoid during Pregnancy

Medications like Motrin, or Ibuprophen, aspirin and tetracycline.

X-Rays and harmful things like alcohol, drugs and tobacco. If you are a smoker, this is the best reason to stop smoking and we can assist with resources and assistance.

Certain types of fish containing high mercury levels should be limited and undercooked or uncooked meats and fish should be avoided.

Cat feces and litter boxes, sand boxes

Hot tubs over 100 degrees and tanning booths

Unsafe sexual practices.

There are a number of genetic tests that can be offered based upon your risk factors but the most common offered are the screening for Cystic Fibrosis and the Quad screen.

The Quadruple screening:

A one-time blood test, usually done in the second trimester of pregnancy, to determine which women may be at higher risk of having a child with Downs Syndrome, trisomy 18 or an open neural tube defect. This test can detect approximately 86% of babies with genetic problems mentioned above.

The following web site is a good reference for more information.

https://www.acog.org/Patients/FAQs/Screening-Tests-for-Birth-Defects

The Cystic Fibrosis Screen:

Cystic Fibrosis (CF) is a genetic disease that causes the body to make a thick, sticky mucus that clogs the lungs and other organs, such as the pancreas. In the lungs, this mucus leads to many infections and damage to the lungs.

Approximately 1 in 3000 Caucasian newborns have CF.

1 in 29 Caucasian Americans carry one mutation of the gene

1 in 46 Hispanic Americans

1 in 65 African American and

1 in 90 Asian Americans have the CF gene.

There may be additional screening tests offered to you depending upon your personal or health risk status.

Your Pregnancy at a Glance:

New Ob Physical: A physical exam, (if needed) review of personal health, social, dietary and family histories will be reviewed

Lab tests may be drawn at that time to include but limited to:

CBC (complete Blood count)	Hepatitis B & C
RPR (syphilis)	Urine Drug Screen
Rubella (German Measles)	Cultures for Gonorrhea and Chlamydia
Urinalysis and Urine Culture HIV	Pap Smear (screening for cervical cancer if indicated)

We will offer and discuss genetic screening if desired.

You may choose between Traditional appointments or Prenatal Care Plus (PCP) for your care.

Prenatal Care-“Plus” is a program (at no extra charge) that brings together women who have babies due around the same time for prenatal care, sharing, socializing and learning- all at one convenient time. The program consists of 6 sessions, each lasting about 2 hours. The sessions begin about mid-pregnancy and concludes about a month before your due date. Think of these as six prescheduled appointments. The group is led by a nurse midwife, nurse practitioner or lactation consultant. You are seen briefly before you leave for measurements and fetal heart tones. If you have a need for an individual visit with your nurse midwife, be prepared to stay after so additional concerns can be addressed. Group size is limited so we encourage you to enroll early. These sessions are active and engaging but require planning on your part as well as following some simple "rules" so all participants can have the most productive sessions.

Please do not bring small children or pets to the sessions.

If you are sick for one of these sessions, please do not subject the rest of the group to your illness.

Be mindful of sidebar discussions and talking over each other. The midwife will lead the sessions and will facilitate discussions and it is important to all participants that discussions take place in a mutually respectful way.

Traditional care is one on one appointments with a nurse midwife at specific intervals during your pregnancy. If this is your first baby or first birth center birth, we encourage you to attend the alternate breastfeeding and birth classes below:

Breastfeeding Class with Helen Pastures, MPH, CLC

Childbirth Class with Jill Whitfield, CNM

An ultrasound may be scheduled to determine or correct your due date (usually before 14 weeks) and a second ultrasound will be offered around 18-20 weeks to examine the baby's anatomical structures and ensure that he or she is growing appropriately. Most insurance companies will cover 1 to 2 ultrasounds during pregnancy. Additional medically indicated ultrasounds may need to be pre-authorized.

Around 28 weeks, you will have blood tests for anemia and a gestational diabetes screen. A screen for HIV and syphilis per Georgia law will be done at this time. If your blood type is negative, an antibody test will be done on your blood and Rhogam will be given.

Between 35-37 weeks a screening test for Group B Strep infection is done.

Weekly appointments until the birth can be expected after the 36-38th week.

Resources are numerous and may sometimes be confusing. Well-meaning family and friends will offer their opinions and stories. Many websites on the internet have a wealth of information. A few recommended sites are listed below. These are by no means all-inclusive but they can certainly point you in the right direction.

www.themidwifegroup.com

Our Midwife Group Facebook page will provide information on events and classes available at the birth center and in the local community. This page also has numerous links where you can do more research into alternative options for your and your baby's care.

Remember, An informed pregnancy is an empowered pregnancy

Be part of the growing "Savannah Birth Center Groupies" Facebook page. This is a closed peer group for our friends to chat and network. Additional resources can be found our website and out facebook page.

SavannahBirth.com is a great local resource to locate birth professionals in our area.

General pregnancy and Childbirth

www.birthcenters.org

www.midwife.org

www.healthfinder.gov/HealthTopics/Category/pregnancy

www.marchofdimes.com

www.childbirth.org

www.EvidenceBasedBirth.com/VitaminK

www.foodpyramid.com/mypyramid/

Breastfeeding

www.lalecheleague.org

www.ilea.org

www.womanshealth.gov/breastfeeding/learning

Baby/Child Care

www.aap.org

Domestic Violence

www.domesticviolence.org/

www.aardvarc.org/dv/states/gadv.shtml

www.womenslaw.org/gethelp_state.php?state_code=GA

Depression

www.babycenter.com/0_depression-during-pregnancy_9179.bc

www.postpartum.net/

Immunizations:

www.cdc.gov

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First Trimester Pregnancy instructions

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