Seattle OBGyn

Seattle OB/GYN providers and staff are happy to answer questions during your pregnancy. Please see below for some common questions in pregnancy. If your question is not answered below, please call our ofﬁce during regular business hours and we will be happy to answer your question. If you have an emergency after regular business hours, you may call our main phone number directly to reach our answering service.

We offer a general information class you can attend prior to your first pregnancy visit. This orientation will introduce you to our practice and help answer some questions about what to expect in pregnancy.

Your First Pregnancy Visit:

“I’m pregnant” When do I need to be seen?

Congratulations! We recommend scheduling your first OB visit 8 weeks after the first day of your last menstrual period. We recommend being seen at this time for the most accurate dating by ultrasound.
Scheduling your first visit between 8 and 10 weeks gestation, will allow time for your provider to order genetic screening for your pregnancy if you desire.
If you are having any concerning signs or symptoms or have a history of multiple miscarriages or an ectopic pregnancy, please call our office.
You should avoid tobacco, marijuana and alcohol at all times in pregnancy.

What happens at my first OB visit?

For your initial intake OB visit, you will be seen by a Certified Nurse Midwife (CNM), a Nurse Practitioner (NP) or a Physician Assistant (PA-C).
This visit is much longer than any of your other OB visits. If you have not had an ultrasound yet in your current pregnancy, the provider will perform a vaginal ultrasound to confirm the dating of your pregnancy.
You will have a full physical with a Pap screen if you are due for one. The provider will also review your health history, medications, and your genetic screening options for your pregnancy.
The provider will order your initial prenatal panel blood work and collect a gonorrhea and chlamydia screen.

Warning Signs:

When should I call my provider?

During pregnancy you should call your provider if you have any of the following:

Vomiting 6 or more times in a 24 hour period or you feel you cannot maintain hydration.
Bright red vaginal bleeding with or without cramping.
You are concerned your baby is not moving as often as he/she normally does or is not moving at all.
If you have regular patterned tightening of your belly occurring every 10 minutes for an hour and you are less than 36 weeks of pregnancy. Or if you have painful regular contractions every 5 minutes for an hour and you are 36 weeks or more in your pregnancy.
You leak ﬂuid that is not urine or you leak ﬂuid that is not clear.

After delivery of your baby you should call your provider if you have any of the following:

A severe increase in pain • Onset of a fever 101 degrees or higher.
Bright red vaginal bleeding that does not stop. It can be normal to pass clots (even the size of a golf ball or small lemon).
You have thoughts of hurting yourself or your baby.
Please pay close attention to any additional warning signs you are given at the time of discharge.

Labor and Delivery

How can I tell if I’m in labor?

Labor is a different experience for every woman.
Your provider will review signs of early labor with you as you approach the end of pregnancy.
As a general rule, you should call your provider if you are are having painful, regular contractions every 5 minutes, lasting 1 minute long and this has been occurring for at least 1 hour. This is typically known as the “5:1:1 rule”.

Who will deliver my baby?

If you are a physician patient, you will be delivered by a physician from Seattle OB/GYN.

Where will I delivery my baby?

All of our providers deliver at Swedish Medical Center First Hill Hospital. We are an independent practice with privileges to deliver at Swedish Medical Center First Hill campus only.

Medication and Vitamins:

What medications are safe in pregnancy?

Always Avoid alcohol, cigarettes, marijuana, smoke-less tobacco and birth control pills in pregnancy.
Some women need medication in pregnancy. Always talk to your health care provider before you take any medicines, herbs or vitamins other than prenatal vitamins.
Don’t stop taking your current medication until your health care provider says it is okay.
It is usually best to avoid medications in pregnancy, especially in the first trimester.
Pregnancy may change the way your body processes medications.
If you are pregnant and seeking treatment from a provider other than your OB/GYN, notify your Seattle OB/GYN provider before starting any medication.
Many over-the-counter medications are safe if you need to treat a non-pregnancy related symptom. Always check the label on the over-the-counter medication for for any warnings about use in pregnancy.
Contact the Seattle OB/GYN office if you have any questions about medications in pregnancy.
Medications considered safe in pregnancy include
- Acne (prescription only)
- Allergies: Benadryl, Claritin, Zyrtec
- Antibiotics (prescription only): Erythromycin, Penicillin, Cephalosporin, Amoxicillin, Macrodantin
- Constipation: Docusate Sodium (stool softner), Bran, Citrucel, Metamucil, milk of magnesia
- Cough/Cold: Tylenol, Tylenol cold, Sudafed, Robitussin DM, cough drops without zinc or Echinacea, Nasal Saline Spray
- Heartburn/Acid Reflux: Tums, Rolaids, Omeprazole (Prilosec) - not recommended in the 1st trimester
- Insomnia: Unisom sleep tablets
- Nausea/Vomiting: Ginger (1 gram capsule/day); Diclegis (prescription only); Vitamin B6 (50 mg, three times/day) and doxylamine succinate (Unisom) 12.5mg one time at night.
- Pain relief: Acetaminophen (Tylenol)

Which medications should I avoid in pregnancy?

This is not an inclusive list but some common medications and supplements to avoid in pregnancy are:

Doxycycline, Tetracyclines, Retin-A, Accutane, Ciprofloxacin, Ibuprofen, Naproxen, zinc and echinacea.

Which prenatal vitamins should I take in pregnancy?

Prenatal vitamins are recommended to cover any nutritional gaps in your day-to-day nutritional intake.
Prenatal vitamins should contain a minimum of 400 micrograms (mcg) of folic acid and should be taken daily.
It is recommended you have 1200-1500mg of calcium daily in pregnancy.
There are a many different brands of prenatal vitamins that are acceptable to take in pregnancy.
Taking your prenatal vitamin at night may reduce symptoms of nausea.

Nutrition:

Can I have caffeine in pregnancy?

You do not need to stop drinking caffeine in pregnancy but it is recommended that you limit your caffeine consumption to ≤ 200 mg of caffeine per day. This is equivalent to 1-2 cups of coffee daily.

How much and what should I eat in pregnancy?

An additional 300 calories or the equivalent of one additional healthy snack per day should be added to your current nutrition.
Whole grains, lean meats, fresh fruits and vegetables, low-fat dairy products and minimally processed foods should be the basis of your diet in pregnancy.

How much weight should I gain in pregnancy?

The recommended amount of weight gain in pregnancy varies and will depend on your pre-pregnancy weight.
The recommended weight gain is based on your height/weight ratio which is called a body mass index. Depending on your body type, recommended weight gain will be between 11 and 40 lbs.
Your recommended weight gain during pregnancy will be discussed at your first visit.

What foods should I avoid in pregnancy?

Avoid shark, swordfish, king mackerel and tilefish due to high mercury contents.
Avoid raw or undercooked meats to reduce your risk of toxoplasmosis.
To lower your risk of exposure to listeriosis you should avoid non-pasteurized cheeses and imported soft cheeses such as brie, feta, and blue cheese.
If eating deli meats, luncheon meats, processed or smoked meats, it is recommended they properly reheated to steaming (approximately 160 degrees fahrenheit).
It is recommended you avoid refrigerated smoked seafood unless it is contained in cooked dish or reheated to steaming.

What are iron-rich foods?

There are two types of iron: heme iron and non-heme iron.
If you are pregnant it is recommended you have 27mg of iron a day.
Heme iron is the type your body absorbs best. Heme iron is found in the following foods:
- Beef (liver, ground, top sirloin), chicken (dark and light meat), turkey, sardines, shrimp, chicken liver and tuna (canned in water).
Non-heme iron is found in the following foods:
- Spinach, tofu, dried beans (cooked), raisins, tofu, cooked kale, dried apricots, white or whole- wheat bread, nuts, ready-to-eat cereal, oatmeal (fortified) and grits (white, enriched).

What is Listeriosis?

Listeriosis is a rare infection caused usually by eating foods containing the bacteria Listeria monocytogenes.
Pregnant women are approximately 10 times more likely to get listeriosis that the general population.
Symptoms can include flu-like symptoms such as fatigue, fever, chills and aches in pregnancy.
Listeria bacteria can be present in uncooked meats, fruits and vegetables; unpasteurized (raw) milk and cheeses; and processed foods such as deli meat and smoked seafood.

What is toxoplasmosis?

Toxoplasmosis is an infection caused by a parasite in the human body.
Toxoplasmosis is transmitted by eating undercooked red meat from an infected animal, consumption of insect-contaminated food, contact with the feces of infected cats and contact with infected materials or insects in soil.

Health and Wellness:

Can I exercise in pregnancy?

Daily activity is recommended and encouraged in your pregnancy.
Ideally, the best time to start an exercise routine is prior to your pregnancy. It is encouraged you continue your current exercise regime as tolerated in pregnancy.
Low impact exercise is encouraged throughout your normal pregnancy and should be discussed with your provider.
Avoid high-intensity or impact sports during pregnancy.
You should be able to carry on a conversation during your exercise.
It is recommended that you avoid saunas, hot tubs, steam rooms and hot exercises classes such as hot yoga and hot pilates during pregnancy.
If leaking of fluid, bleeding or suspicion of premature labor occur during exercise, the exercise should be avoided and you should notify your physician.

Can I travel during pregnancy?

You may travel in pregnancy and there is no known harm from commercial air travel.
It is best to be close to the hospital when you are nearing full term in your pregnancy.
Your physician may restrict travel if there are any complications in your pregnancy.
It is recommended you avoid travel to areas at risk with Zika infection.
Please refer to the cdc.gov website for the most up-to-date information about areas at risk for Zika infection.

What cosmetic products can I use in pregnancy?

Any products placed on the skin in pregnancy have the potential to be absorbed into your bloodstream and cross the placenta to the fetus.
It is okay to have a manicure and/or pedicure in pregnancy. Make sure you are in a well-ventilated area when applying polish.
Most non-prescription beauty products are safe to use in pregnancy when used according to the product labeling.
We do not know how all beauty products can affect a pregnancy since women are not submitted to testing of beauty products during pregnancy.
The law does not require cosmetic products or ingredients to have FDA approval before they are sold.
Not all “personal care products” are considered cosmetics.

Can I sleep on my back in pregnancy?

If you are a back sleeper, it is okay to sleep on your back in early pregnancy.
As your uterus becomes larger, it is recommended you sleep on your side or with one hip slightly propped up. This is to prevent compression of a major vessel by the weight of your uterus that supplies blood to your baby.
If you wake up on your back, simply roll over to your side.

Is it okay to paint the nursery while I’m pregnant?

It is considered safe to paint in pregnancy as long as the area in which you are working is well ventilated.

If you start to feel light-headed or dizzy, you should stop painting and get fresh air.

Avoid climbing on tall ladders.

Is it safe to get a massage in pregnancy?

It is safe to get a massage in pregnancy by a massage therapist that is certified in prenatal massage.

Do I need vaccines in pregnancy?

The Center for Disease control recommends getting a flu vaccine and a whooping cough (Tdap) vaccine in every pregnancy to help protect you and your baby.

Screening test and Bloodwork:

What does it mean if my blood type is “Rh negative”?

Your blood type either has a protein called the Rh Factor or it does not. If your blood type is missing the Rh factor it is considered Rh negative.
The Rh factor is inherited. The Rh factor can cause problems in your pregnancy if the your blood type is Rh negative and the fetus’ blood type is Rh positive.
During an Rh-negative woman’s first pregnancy, serious complications usually do not occur if her baby’s blood type is Rh positive.
If your blood type is Rh Negative, you will be given a shot in pregnancy to help prevent complications in future pregnancies.

What screening tests are performed in pregnancy?

Various screening tests are performed in pregnancy to monitor the health of the baby and the mother.
As an example, standard screening includes gonorrhea, chlamydia, HIV, syphilis, rubella, gestational diabetes, group beta strep.
Screening tests are non-invasive to your pregnancy and may include blood work or ultrasounds.
Genetic screening is offered to all pregnant patients, but is not a requirement. Genetic screening is discussed in detail at your first prenatal visit and the type of testing ordered will depend on your age and risk factors.

If I’m anemic in pregnancy what do I take?

You will be screened for anemia at your first prenatal visit.
If you are at risk for anemia, iron-rich foods or an iron supplement may be recommended.
It is recommended you have twice as much iron as you did before you were pregnant because iron is used in the production of blood.
The World Health Organization recommends between 30-60mg of elemental iron daily in pregnancy.

Iron Rich Foods:

There are two types of iron: heme iron and non-heme iron.
If you are pregnant it is recommended you have 27mg of iron a day.
Heme iron is the type your body absorbs best. Heme iron is found in the following foods:
- Beef (liver, ground, top sirloin), chicken (dark and light meat), turkey, sardines, shrimp, chicken liver and tuna (canned in water).
Non-heme iron is found in the following foods:
- Spinach, tofu, dried beans (cooked), raisins, tofu, cooked kale, dried apricots, white or whole- wheat bread, nuts, ready-to-eat cereal, oatmeal (fortified) and grits (white, enriched).

Frequently Asked Questions: Obstetrics