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McFarland Clinic PC
www.mcfarlandclinic.com
Congratulations
You’re pregnant! We at McFarland Clinic are happy for you and want to help make this a
wonderful experience. These informational materials have been carefully compiled by our
providers to give you what we believe is the very best information currently available regarding
pregnancy. Please feel free at any time to ask your provider any questions you may have;
there is no such thing as a silly question where your pregnancy is concerned.
Each woman is unique and each pregnancy is special. We strive to ensure that you are
comfortable with the information and care you are given. Please don’t fall prey to the many
“horror” stories you may hear about pregnancy. One woman’s experience is not every
woman’s experience. Please allow us the opportunity to answer any questions and allay any
concerns you may have.
If the answers to your questions cannot be found in these materials, call our office at
239-4414, or call the First Nurse service (239-6877 in Ames and 800-524-6877 within the state
of Iowa). First Nurse is available 24-hours a day, seven days a week and will answer your
health-related questions. You also may request to speak directly with the doctor on call.
Also within these pages, you will find information regarding insurance, obstetrical visits, and
nutrition. Supplements have also been provided with additional information.
A support person is welcome to attend any and all prenatal visits with you. Children may come
for visits, but keep in mind we DO NOT provide babysitting service. You will be responsible for
your children and their actions during the visits. We want this to be a special experience for all
involved.
McFarland Clinic PC
Appointments
During your pregnancy, you will be seen for many appointments. Following is a description of how
your appointments will be scheduled. Each pregnancy is unique, so your schedule may be different
from someone else’s. Always arrive 10 minutes before your appointment time as you will need to
check in at the Business Office first.
Today’s Visit: The first visit with the prenatal nurse will involve sharing information regarding your
health and past pregnancies. Material involving this pregnancy will be reviewed. During the visit, you
will be talking with our credit department regarding your insurance.
10-12 weeks: Your provider will see you at about 10 to12 weeks gestational age. At this appointment,
you will have a physical examination, listen to baby’s heart and have blood and urine lab tests done.
12-28 weeks: Between 12 and 28 weeks, you will visit your provider once a month. Each
appointment will involve checking your blood pressure, weight, and listening to the baby’s heart tones.
20 weeks: At approximately 20 weeks, you will be scheduled for an ultrasound exam.
Please follow instructions to prepare for this important exam.
28-36 weeks: You will have an appointment every 2 weeks. Additional blood tests will be done at
approximately 28 weeks. Following is a list of instructions for tests done at this time.
1. Hemoglobin – iron level
2. Indirect coombs – antibody screen
3. One hour glucose – gestational diabetic screen
4. RhoGAM work-up, if Mom is Rh Negative
There is no preparation for any of these tests. You may eat normally, avoiding excess
sweets. Check in at the reception desk 10 minutes before your appointment time.
When you arrive at the lab they will check a fresh urine to make sure you are not spilling
sugar (you still need to bring your first voided specimen). Next, you will be given a
dextrose liquid (Trutol) to drink. This is a very sweet beverage that needs to circulate in
your body for one hour, then the lab tech will draw the blood from your arm.
During the hour between drinking the dextrose liquid and having your blood drawn,
please report back to the OB Department so your provider can see you for your prenatal
appointment.
36 weeks: You will begin to see your provider every week. At one of these visits, a vaginal/anal
culture for Group B Strep infection will be done. Your healthcare provider will begin
vaginal exams at some point to evaluate the cervix for dilitation/effacement. Usually this
begins about two weeks before your expected due date.
When You Come for Your Obstetrical Appointments:
Before each of your appointments, your providers would like you to provide a “clean-catch” urine
specimen. At least four hours should have elapsed between your last urination and the collection
urination. The best time is upon arising in the morning. Containers will be given to you at each visit.
1. Upon arising in the morning, cleanse the vaginal area as follows:
A. Spread lips of vagina with fingers.
B. Rinse area well with plain water.
C. You may find using a clean paper cup for collection and transfer a small amount to the provided container helpful.
2. Keep vaginal lips spread and begin urinating between spread fingers.
3. After urinating a small amount, collect specimen (one or two ounces).
4. Place in a plastic bag. Refrigerate specimen until you leave for your obstetrical appointment.
5. Please give specimen to the nurse when you go to the exam room for your appointment.
Symptoms You Should Report to Your Provider:
1. Vaginal bleeding
2. Swelling of the face or fingers
3. Severe, continuous headaches
4. Visual disturbances
5. Pain in the abdomen, or menstrual-like cramps
6. Persistent vomiting
7. Chills and fever
8. Sudden escape of water from the vagina
Any of the symptoms above could indicate a
serious problem requiring immediate attention.
Do not wait until your next, regularly-scheduled
appointment to inform your provider of any of
these symptoms, please call our office
immediately.
Exercises for Pregnancy and Childbirth
Kegel Exercises
Kegel exercises strengthen the muscles around the vagina, urethra, and rectum. Your ability to
control these muscles will be increased if you practice these exercises.
• How to do Kegel exercises
1. To locate these muscles, stop and start your urine when you use the toilet.
2. Try to tighten the muscles a small amount at a time, thinking of an elevator going up to the
10th floor; then release very slowly, one floor at a time.
3. As you tighten the muscles, you should feel the area from your urethra, where urine exits the body, to the rectum lift slightly.
• When to practice
• Practice while you sit, stand, walk, drive, or watch TV.
• Do these exercises 3 times each day. Start with 5 reptitions and work up to 10 to 15
repetitions, 5 to 10 times a day.
Knee Press
The knee press strengthens and stretches your inner thighs and stretches your lower back. It also
improves your circulation.
• How to do the Knee Press
1. Sit on the floor and pull your feet together with the soles touching. Bring your feet as near
to your body as you can with comfort.
2. Keep your back straight. Press your knees slowly and gently to the floor.
Hold your knees in this position and count to three.
• When to practice
• Practice the knee press several times a day. This can be
done sitting on the floor with good
back support while you are watching TV.
• Slowly work up to doing this exercise for 2 to 3 repitions,
2 to 3 times a day.
Abdominal Strengthening Exercises
Abdominal exercises will strengthen and stretch your abdominal (stomach) muscles and improve your
circulation. Exercises done while lying on your back should only be done during your first 3
months of pregnancy.
• How to do Abdominal Strengthening Exercises
• Leg Raises
1. Lie on your back with your feet flat on the floor. Press the small of your back into the
floor.
2. Bring one knee as close as you can to your chest.
3. Raise your leg in the air.
4. Bend your knee and return your foot to the floor.
5. Do the same exercise with your other leg.
• When to practice
• Repeat this exercise 5 to 10 times each day.
(Exercises done while lying on your back should only be done during your first 3 months of pregnancy.)
• Knee Reach
1. Breath out as you come up and breath in as you return to a starting position with
this exercise.
2. Lie on your back with your feet flat on the floor.
3. Lift your head and shoulders as you move one knee
toward your nose. Bring your knee as close as you can
to your nose. Keep your neck in a relaxed position, as
if you have an orange tucked under your chin. Do not
jut your neck forward.
4. Do the same exercise with your other leg.
• The Pelvic Rock
Pelvic rock exercises will strengthen your abdominal
muscles and help relieve backaches.
• How to do the Pelvic Rock
There are three ways to do this exercise. You will use a new position for each
exercise.
•Each time you do this exercise, tighten your abdominal muscles.
•Tuck your buttocks under so the small of your back is pushed back as far as
possible.
• If this causes any back discomfort, discontinue the exercise.
• Position 1 (only do this exercise during your first 3 months of pregnancy)
1. Lie on your back with your feet flat on the floor.
2. Tighten your lower abdominal muscles and your
buttocks so the small of your
back is pressed onto the floor.
3. Repeat this exercise slowly and evenly.
Breath out as you press down and in as you relax.
• Position 2
1. Stand with your back against a wall.
2. Tighten your abdominal muscles and tuck in
your buttocks so the small of your back is flat
Position 1
against the wall.
3. Put your hands on your hips to feel your hips rock
back toward the wall.
4. Breath out as you press against the wall and in
as you relax.
• Position 3
1. Get on your hands and knees and keep your arms
straight.
2. Tighten your abdominal muscles and tuck your
buttocks under. Your back will hunch up a little.
Then relax your muscles.
3. Do this exercise slowly and evenly. Breath out
as you tuck and in as you relax.
Position 3
The Calcium Connection
The nutrient calcium is essential in a healthy pregnancy and the development of a healthy baby.
During your pregnancy, keep these facts in mind:
• Dairy foods are the best source of calcium, however orange juice and certain cereals may
contain calcium.
• Pregnant and breast feeding women need extra calcium for their own bone health, as well as that of their baby (and for baby’s developing teeth).
• Pregnant and breast feeding women under the age of 25 need the amount of calcium in
5 cups of milk each day. Even if you have reached your adult height, your bones can be
come stronger.
• Pregnant and breast feeding women over the age of 25 need the amount of calcium in four
cups of milk each day.
• Your doctor may ask you to take a prenatal supplement that includes calcium. Remember, a supplement is not a substitute for a nutrient-rich diet. Your vitamin pill does
not take the place of calcium-rich foods.
The Connection Between High Blood
Pressure and Calcium
♥ High blood pressure complicates 6 out
of 10 pregnancies.
♥ In pregnancy, high blood pressure cuts
down the flow of blood to the baby.
♥ Studies show that choosing 4-5 daily
servings of calcium-rich foods can lower
your chances of developing high blood
pressure during pregnancy.
♥ If you have blurred vision, headaches,
and excessive swelling in your legs,
hands, and feet, contact your provider.
These are common signs of high blood
pressure during pregnancy.
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If you have trouble digesting milk...
• Drink milk more often, in 1/2 cup servings • Drink milk
with other foods at a meal or snack • Choose other
calcium-rich foods that may be easier to digest such as
buttermilk, cheese, and yogurt • Try lactose-reduced
milk • Ask your doctor about enzyme products that
can be added directly to milk.
Your Family’s Diet: A Daily Juggling Act
Food Groups
Eat More of These
Milk, Cheese, Butter, Oil
Nonfat fortified milk, skim, milk, low-fat
yogurt, buttermilk (make with skim milk),
low-fat cottage cheese, cheese containing
less than 5% butterfat, margarine (soft
tub or stick made with corn, cottonseed,
soybean, safflower or sunflower oils
only), corn oil, sunflower oil, safflower oil,
peanut oil, soybean oil
1% or 2% low-fat milk, frozen yogurt,
low-fat, hard cheese, ice milk, soft
margarine, mayonnaise, skimmed,
evaporated milk (good for cooking in
place of cream or whole milk)
Whole and chocolate milk, canned
evaporated whole milk, buttermilk,
whole cream, hard and cream cheese,
sour cream, high-fat ice cream, butter
shortening, lard, bacon, fat, eggs
Fresh or fresh-frozen fish, tuna, crab,
scallops, chicken turkey, Cornish hen
(without the skin), lean veal
(Trim off fat)
Flank steak, beef filet, leg of lamb, sirloin,
pork (whole rump, center shank), ham
(center slices), rib eye, ground beef, pork
loin, boiled ham, chicken frankfurter
(Trim off fat) Corned beef (brisket),
hamburger (lean), steaks (club
and rib), rib roast, breast of lamb,
spareribs, ground pork, deviled ham,
breast of veal, regular frankfurter, cold
cuts, fried chicken (w/skin or prepared
w/saturated oil) duck and goose,
sausage and bacon, liver, heart, and
other organ meats, sardines.
Vegetables
(Fresh is best, raw or steamed)
Asparagus, bean sprouts, beets, broccoli,
brussels sprouts, cauliflower, cabbage,
carrots, eggplant, green beans, string
beans, squash (summer), zucchini,
cucumbers, watercress, lettuce,
corn, peas.
Canned vegetables (some are high in salt;
check label), frozen vegetables (without
added salt), canned vegetable soups (read
label for salt content), stir-fried vegetables
prepared in small amount of polyunsaturated fat
Vegetables fried in butter or other
saturated fats, frozen vegetables
(processed with salt, such as mixed
vegetables), vegetables made with
cream and butter sauces
Fruits, Fruit Juices
Apples/apple juice, apricots (fresh or
dried), bananas, berries, cherries, dates,
figs, grapes, oranges, peaches, plums,
grapefruit raisins, prunes, fresh fruit
juices without added sugar
Fruits canned in juices, fruits canned in
water, fruit ice
Fruits canned in heavy syrup, fruit
drinks, glazed fruit (all fruits to which
sodium, coloring or sodium benzoate
has been added)
Starches
Whole-wheat, rye, pumpernickel, raisin
breads, cornmeal, whole wheat pasta,
brown rice, potatoes (sweet or white),
yams, pumpkin, beans and lentils, grits,
wheat germ, oatmeal, puffed rice
White bread, refined pasta, white rice
refined unsweetened cereal, low-salt whole
wheat crackers made with soybean oil
Instant potatoes, other prepared
potato products (these are high in
salt), french fires, commercially
prepared foods such as macaroni
and cheese, lasagna, pizza, cheese
blintzes, sweetened cereal, sweet
rolls, salted crackers made with
palm or coconut oil
Fresh fruits and vegetables, dried fruits,
low-fat yogurt, popcorn (unsalted,
unbuttered), home-made oatmeal cookies
(make with safflower, cottonseed, or corn
oil), raisins and raw apples
Low-fat or part-skim cheese, ice milk,
peanut butter, unsalted peanuts, walnuts,
almonds, pecans (fat content is mainly
monounsaturated)
Commercial cakes, cookies, pies,
candy, ice cream, soda, potato and
corn chips, salted peanuts, pretzels
Natural herbs and spices, fresh onion,
garlic powder, pepper, lemon juice,
tomato, lettuce, onion, cucumber
Unsalted, low-fat salad dressing,
home-made dressing made with
polyunsaturated oils (safflower,
corn or cottonseed)
All are high in salt: Steak sauces,
soy sauce, salt, garlic, celery and
onion salts, meat tenderizers, celery
seed, horseradish, commercial salad
dressings, salted meat gravy, chili
sauce, butter sauce
Meat, Fish, Poultry
Snacks, Desserts, Nuts
Dressings, Sauces, Condiments
Moderate Amounts of These
Eat Less of These
Nutrition During Pregnancy
Food Group
Milk or milk products
Servings
4
Meat and substitutes.
Nutrients Provided
Calcium, protein and
riboflavin.
Importance to Fetus
Fetal skeleton formation; fetal tooth
bud formation; rapid fetal tissue
growth; amniotic fluid; placental
growth and development.
2-3
(total
6 oz/day)
Protein, iron, B vitamins,
folic acid.
6 or more
Vitamin A
(eat at least one serving
every other day).
Vitamin C
(eat at least one serving Essential for cell development; tooth
bud formation; bone growth; helps
daily).
eyesight.
Fiber
(eat a variety of raw
and cooked vegetables).
Carbohydrates.
Fruits and vegetables
Fetal tissue growth; increased
hemoglobin; fetal liver iron storage.
Grains
6 or more
Fetal tissue and placental growth;
Carbohydrates, Fiber
(use whole-grain), B vita- increased hemoglobin; development of
central nervous system.
mins, iron and zinc.
Other
Eat
only in
moderation
Sugar, Fat and
Carbohydrates
These foods have a lot of sugar and fat,
but few essential nutrients. They may
be used to add calories to your diet; but
be sure to include the recommended
number of servings from the food groups
listed above.
During pregnancy, most nutrient requirements will be met eating a wide variety of common, popular
and nutritious foods. Refer to the following guidelines for recommended serving sizes and number of
daily servings.
8 oz. skim milk
8 oz. lowfat milk
8 oz. buttermilk
2-3 oz. cooked meat,
poultry or fish
2 oz. cheese ✪
1/2 cup
1/2
cottage cheese ✪
chicken breast
If you do not tolerate milk,
consult your physician or registered dietitian for alternative
calcium-rich foods.
1.5 oz. cheese
8 oz. yogurt
1 chicken leg/thigh
2 eggs
1 cup cooked
legumes or
dried beans
1 pork chop
2 T. peanut butter
2-3 oz. turkey
(✪ = not a good iron source.)
Fruit Serving - 1 small piece of fruit, 1/2 cup fruit juice, 1/2 cup fruit
or 1/4 cup dried fruit, such as:
apples
cantaloupe ∆ ©
apricots ∆
grapefruit ∆ ©
bananasgrapes
oranges ©
peaches
pears
pineapple
strawberries ©
watermelon
Vegetable Serving - 1/2 cup cooked vegetables/1 cup raw, such as:
beets
carrots ∆
green leafy
peas
broccoli ∆ © corn
veg. (spinach) ∆ potatoes
cabbage ©
green beans
green pepper ©
tomatoes
(∆ = good source vitamin A // © = good source vitamin C)
bagel
1 slice bread
1/2 cup cooked cereal
1 cup flake cereal
1 dinner roll
1/2 English muffin
1/2
3 sq. graham crackers
1/2 hamburger bun
1 muffin
1/2 cup pasta
3 cups popped
popcorn
2 small cookies
1 T. jam or jelly
1 tsp. margarine, oil or butter
10 snack chips or french fries
Small servings of desserts
15 pretzel sticks
1/3 cup rice
1 roll
6 saltine crackers
2 small taco shells
1 4-inch waffle
cup ice milk or lowfat
frozen yogurt
1 T. salad dressing
1 tsp. sugar
1/2
One of the indications of an adequate diet in pregnancy is an appropriate weight gain. If you are at or near the
desirable weight for your height and bone structure when you become pregnant, a weight gain of 25 to 35 pounds
during your pregnancy is recommended. The pattern of weight gain varies some by individual. About 2 to 4 pounds is
an average gain during the first trimester, with about 1 pound a week during the remainder of the pregnancy.
Other Nutrition Information
Fish:
Avoid shark, swordfish, king mackerel, albacore tuna or tilefish as they contain high amounts
of a form of mercury that may harm an unborn child’s or baby’s brain or nervous system.
Limit fresh water fish caught by family and friends to one serving each week.
Enjoy up to 12 ounces of other cooked fish each week such as shellfish, canned fish, cod,
haddock, pollock, and salmon. These fish contain DHA, an omega-3 fat, that is important in
development of the brain, nerves and retina.
If you do not eat seafood, talk with your provider about a DHA supplement safe to take during
pregnancy.
Listeriosis:
Listeriosis is an illness caused by bacteria found in certain foods. Symptoms can include fever,
chills, muscle aches and backpain. The disease can cause serious problems for the fetus,
including miscarriage or stillbirth.
To prevent listeriosis, wash all fresh fruits and vegetables before using them. Avoid the
following foods:
• Unpasteurized milk and soft cheeses
• Raw or undercooked meat or poultry
• Prepared meats, such as hot dogs or deli meats, unless they are reheated until steaming hot.
Don’t Forget Water! Water is an essential nutrient that is commonly overlooked. It assists in
digestion and transport of food. Water is the main substance in cells, blood, and other vital body
fluids. It also aids in maintaining body temperature. You should drink six to eight 8-ounce glasses of
water and non-caffeine liquids every day.
Snacks: Snacks should be nutrient-rich. Good choices include fresh fruit and vegetables, yogurt,
low-fat cheese, ice milk, cereal, and low-fat crackers. Remember, a healthy lifestyle and wise food
choices during pregnancy can help your baby get a healthy start in life.
Commonly Used Drugs that are
Safe to Use in Pregnancy
General Aches and Pains:
-Tylenol (acetaminophen) regular or extra-strength; Tylenol PM
* Do not use Aspirin or Ibuprofen (Motrin, Advil, Aleve, Naproxen)
Colds/Allergies
-Decongestants containing phenylephrine, Sudafed (pseudoephedrine)
-Robitussin, Robitussin-DM or Dextromethorphan
-Cough drops, throat lozenges, Vicks
-Benadryl, Dramamine
-Zicam, Mucinex
-Claritin, Zyrtec
-Allergy shots
*Do not use Airborne
Heartburn, Stomach Upset
-Pepcid, Tagamet, Zantac, or Prilosec OTC
-Tums or Rolaids
-Maalox or Mylanta
*Do not use Pepto- Bismol or Baking Soda
Constipation
-Metamucil, Citrucel, Fibercon, Milk of Magnesia, Colace, Miralax
*Do not use laxatives (Ex-lax, Correctol, etc) or mineral oil (unless approved by physician)
Diarrhea
-Imodium
Hemorrhoids
-Preparation H or Tucks
Nausea
-Benadryl, Dramamine
-Ginger and Ginger products (high concentrated sugar drinks like Ginger Ale)
-Seabands for your wrists
-Unisom half tablet and Vitamin B6 (25 mg) in the evening
*Do not use any herbal supplements or anything containing herbal ingredients
Flu shots are recommended in pregnancy.
Use local anesthetics for dental work.
Ask your provider about: medicated facial products or prescribed topical medication
Prescribed antibiotics by a healthcare provider
-Amoxicillin, Ampicillin, Z-pack, Zithromax, other penicillin type antibiotics, Clindamycin, Flagyl
(metronidazole), Bactrim, Keflex and Cephalosporin
For any other prescribed medications, please contact McFarland Clinic OB-GYN.
Common Concerns During Pregnancy
Symptom
Suggestions
Nausea
• Eat dry crackers, toast, or cereal before getting up or when feeling sick
• Eat five or six small meals a day
• Drink lots of water between meals, but not during meals
• Avoid strong food smells
• Avoid greasy or spicy foods
Tender Breasts
• Wear a support bra
• It may help to wear a bra 24 hours a day
Leaking Breasts
• Wear nursing pads or tissues in your bra
Frequent Urination
• Limit fluids before bedtime
Fatigue
• Fatigue is common early and late in pregnancy
• If advised, try to exercise each day to keep from getting so tired
• Lie down at least once a day
Constipation
• Eat raw fruits and vegetables, prunes, and whole grain or bran cereals
• Exercise helps; walking is very good
• Never hold back a bowel movement
• Drink at least 2 quarts of fluid each day • A cup of hot water three times a day may help
• May use Metamucil, Colace, Fibercon, Miralax, Citrucil or Benefiber if necessary
Hemorrhoids
• Try to keep bowel movements regular
• Take short rests with hips lifted on a pillow
• Sit on firm chairs or sit with legs crossed
• Practice the Kegel exercises
• May use Preparation H or Tucks
Low Backache
• Rest often
• Use good posture
• Move around; do not stand in one place too long
• Use a footstool for your feet
• Place a pillow between your knees while sleeping
• Keep your knees higher than your hips
• Wear low-heeled shoes
• Use the pelvic rock exercise
• Call for information about prenatal cradle (maternity support garment)
Vaginal Discharge
• Bathe the outer vaginal area often with warm water only
• Use non-perfumed soap only occasionally
• Do not use vaginal sprays, powders, or feminine hygiene products
• Never douche during pregnancy
• Do not use colored or perfumed toilet paper
• Wear cotton panties
• Avoid pantyhose, girdles, and tight pants
• If these hints do not help, talk with your health care provider about
the problem
Common Concerns During Pregnancy
Symptom
Suggestions
Heartburn
• Stay away from greasy and spicy food
• Eat smaller meals, but eat more often
• Do not lie down just after eating
• Elevate the head of the bed (with pillows) while sleeping
• May use Tums, Maalox, Mylanta, Pepcid AC or Zantac
Dizziness
• Change your position slowly
• Get up slowly after you have been lying down
• Eat regular meals/drink plenty of liquids
• Do not stay in the sun
• Report to your health care provider if dizziness is persistent
Varicose Veins
• Avoid stockings or girdles with elastic bands
• You may use support hose
• Put support hose on while lying down
• Take short rests with legs raised
• Raise your legs when you sit down; do not cross your legs
Shooting Pain Down Legs
• Change positions: If you are sitting, stand up; if you are standing, sit
down
Lower Leg Cramp
• Elevate legs often during the day
• Point toes upward and press down on kneecap
• Apply a heating pad or hot water bottle for relief
• Avoid heavy meals at bedtime
Trouble Sleeping
• Do not eat just before sleep
• To help you relax, try drinking milk
• Take a warm bath before you go to bed or practice relaxation exercises
Feel Faint When Lying
On Back
• Lie on your left side
Feet and Hands Swelling
• Lie on your left side for 30 minutes, three to four times a day
• Exercise often
• Drink more fluid
• Eat three servings of protein each day
• If you wake up in the morning with swelling, tell your health care
provider
Bleeding Gums
• Use a soft toothbrush and brush gently
• Drink more orange juice and eat more foods high in vitamin C
False Labor
• Change your position and your activity. If it is true labor, it will not stop
• True labor contractions will become more regular and closer together
• You usually feel true contractions more in your back
Feeling Good - Tips for Controling Nausea
The phrase “morning sickness” has sometimes been used to describe the queasy feeling of nausea.
However, this feeling can occur at anytime during the day. It usually goes away after the third month of
pregnancy. This uncomfortable feeling can be caused by hormonal changes or not eating enough.
Contact your doctor if you have further questions or concerns.
1. Eat dry cereal, toast or soda crackers before you get out of bed in the morning.
2. Get out of bed slowly. Avoid any sudden movements.
3. Eat five or six meals a day. Long periods without food may cause nausea to become more intense.
If you’re on the go, take food along.
4. When you feel like eating a regular meal, be sure not to overeat.
5. Drink fluids between meals rather than with them.
6. Eat lightly seasoned foods. Avoid cooking with spices that cause you to have an upset stomach.
7. Eat starchy foods like bread, pastas, potatoes, rice and crackers.
8. Avoid greasy and fried foods.
9. Open windows and use the exhaust fan to remove cooking odors.
10. Take a short walk everyday. Breathe deeply and enjoy the outdoors.
11. Allow lots of fresh air in your sleeping room.
12. Do not use medications unless approved by your doctor.
13. Do not smoke. Avoid smoke-filled rooms.
14. Be sure to eat a variety of foods daily including fresh fruits and vegetables, whole grains, lean meats
and beans and low fat milk.
15. Try motion sickness bands (Sea-Bands). These help in 50-60% of patients. You can purchase these
at your local drugstore.
16. Purchase lemon drops, Jolly Ranchers or mints. You may find these tart candies to be helpful to
pass the “waves” of nausea.
Quease Control Recipes
Ginger Lemon Tea
Ingredients: ½ cup fresh ginger root, grated finely; 3 lemons; ½ cup of honey; 2 quarts of water
Directions: Peel ginger and grate finely. Bring water to a boil; add ginger and the juice of the 3 lemons.
Remove from heat and steep for 20 minutes. Add honey and stir well. Strain through a cloth or a tea
strainer and chill thoroughly. Serve on ice for a real thirst quencher.
Ginger Smoothie
Ingredients: ¼ cup low fat vanilla yogurt; ¼ cup low fat vanilla ice cream; 2/4 teaspoon finely grated
ginger root; ½ teaspoon honey; 1-2 ice cubes
Directions: Combine ingredients in a blender. Pour into a tall glass and serve.
Other Important Tips
Flu
Our providers encourage you to get the flu shot when pregnant. All flu vaccines are acceptable except
FluMist.
Listed below are flu symptoms:
Fever (usually >101)
Sore throat
Headache
Runny or stuffy nose
Extreme tiredness
Body aches
Cough
Diarrhea and vomiting
What to do if you have these symptoms:
Call our office if you feel you have, or have been exposed to, the flu. We will want to get you started
on medication as soon as possible. If necessary, we will have to see your primary care provider,
urgent care or go to the ER.
Please DO NOT come to our department if you think you have the flu!! We do not want you to expose
other pregnant women!
Take the following precautions during flu season:
• Cover your nose and mouth when you cough or sneeze.
• Wash your hands often with soap or water. Alcohol based hand cleaners are also effective.
• Avoid touching your eyes, nose or mouth as germs are spread this way.
• Stay home if you are sick.
Guidelines on Exposures During Pregnancy
Paint products- latex-based paints are the safest
Pesticides-Avoid
Insect repellents are acceptable; consider wipes or creams. Avoid aerosols and use lower concentrations
of DEET.
For information on other exposures in pregnancy you can use MotherToBaby.org or call them
at 866-626-6847.
The above guidelines are general. You should discuss concerns with your provider.
Classes
There are several prenatal classes available for you and your family. Visit www.mgmc.org for classes
and events.
Understanding Your OB Ultrasound
Your provider will order an ultrasound during your pregnancy. The most common reason for having
an ultrasound is to determine that growth and development are appropriate. A routine screening ultrasound
is performed between the 18th and 21st week of pregnancy. This will provide valuable information about
health and wellbeing such as:
• Age and size of the baby
• Placenta
• Assess baby’s development and check fetal anatomy
• Multiples
• Rule out abnormalities
This exam may take 45-60 minutes.
Please let the technician know if you do or do not want to know the gender of the baby.
An ultrasound exam does not guarantee a normal baby. The ability to detect abnormalities depends on
many factors such as:
• Position of the baby
• State of development/age of the baby
• Maternal factors such as body tissue content
At McFarland Clinic OB Department, a “limited” or Level I exam is performed to rule out major
abnormalities. All anatomy may not be visualized at the complete exam and it may be necessary to have
a follow-up exam at a later date to complete the exam.
If you have a family history of an abnormality, or a possible abnormality is suspected on the routine scan
done here, your provider may recommend and refer you for a more detailed or Level II ultrasound.
It is necessary to drink 44 oz. of water in preparation for the exam. Please begin about 45 minutes prior
to the exam. This helps to define placental position and to check the length of the cervix. Please eat
something about 30 minutes prior to the exam as this encourages the baby to move.
In early pregnancy (6-12 weeks) if there is a suspected problem (a possible miscarriage or an ectopic)
a transvaginal ultrasound will be performed. A transducer is placed in the vagina allowing the baby and
pelvic anatomy to be seen more clearly. There is no preparation for this exam.
This is an exciting and happy time for you and we encourage you to bring family and friends. This is
usually not much fun for children under the age of 5 as they become easily bored. All children MUST
BE accompanied by an adult other than the patient.
With any OB ultrasound you have, you will receive pictures. At the screening ultrasound (18-21 weeks)
you will receive a CD as well as pictures. We hope you enjoy watching your baby on the ultrasound!
Pregnancy and Good Dental Health
Good dental care is an important part of the care you need as a mother-to-be. Pregnant women are
more susceptible to periodontal disease, and any pre-existing periodontal disease can become more
severe. Periodontal disease during pregnancy may increase your chance for a low-birth weight and
premature birth. If you experience any of the following symptoms of periodontal disease, please notify
your dentist immediately:
• Bleeding gums during brushing
• Red, swollen or tender gums
• Gums that have pulled away from teeth
• Persistent bad breath
• Pus between teeth and gums
• Loose or separating teeth
• A change in the way your teeth fit together when you bite
• A change in the fit of a partial denture
This means that along with having proper medical care during pregnancy, it is important to see your
dentist as well. We recommend visiting your dentist every six months. Remember daily oral care,
including brushing and flossing, is important during your pregnancy!
Please tell your dentist where you are in your pregnancy. Procedures are not advised in your first
trimester.
Bra Fitting Guidelines
Since every woman’s body changes in pregnancy, it is important to find a bra that fits properly and is
comfortable to wear. To determine your bra size, you need to take two measurements:
Body Size:
Measure around your ribcage, under your bust
Add 5 inches to that number
If your total is an uneven number, round up to the next even number
Cup Size:
Measure around the fullest part of your bust
Subtract your body size from this measurement
The difference determines your cup size
1 inch - cup size A
2 inches - cup size B
3 inches - cup size C
4 inches - cup size D
5 inches - cup size DD
It is best to wait to buy nursing bras in the last trimester to
assure a lasting fit. The bra should fit comfortably when you
fasten it on the middle row of the back hooks.
Important Information for
Obstetrical Patients
The McFarland Clinic providers charge one total fee for their professional services for prenatal care.
This total prenatal fee will be posted to your account at the time of your delivery.
Laboratory, x-ray, and other services will be additional charges and billed separately. Delivery will vary
depending upon the type of delivery and other services you receive. These services will be billed as
they are incurred.
Insurance Information
You, as a patient, are responsible for checking with your insurance company as to whether or not they
may require a pre-authorization prior to your hospitalization.
You must notify us prior to your delivery if this is necessary.
Also, if your insurance requires prior approval for any testing or procedures done during your
pregnancy, you are responsible to notify us of this need.
Frequently Asked Questions
Is spotting normal?
A little intermittent spotting can be normal, especially during the first trimester of pregnancy. A small
amount of blood may appear as the placenta is attaching to the uterine wall. Another cause might be the
breakdown of a small vessel on the cervix following intercourse. It is best to document any bleeding and
call our office if it is persistent or gets heavy enough that you need to wear a pad.
What about the occasional sharp pain I have in the pelvic or groin area?
This may be due to “round ligament” pain. These ligaments support the uterus. They will sometimes spasm
or cramp, causing discomfort. Usually, modification of your activity and avoiding sudden movement will
decrease the pain. This problem is very common between 12 and 20 weeks of pregnancy. However, if
any pain becomes persistent or increases in frequency or severity, you should call your doctor.
Why do I seem to have more headaches and what can I do to relieve them?
Headaches early in pregnancy may result from hormonal variation, nasal congestion, fatigue, eye strain,
anxiety or tension. In the vast majority of cases, however, no cause can be demonstrated. By midterm,
most of these headaches decrease in severity or disappear. Treatment is largely symptomatic. You
might try the following:
• Relaxation and rest in a darkened room
• Cool compress to forehead
• Tylenol if you are beyond 12 weeks of pregnancy
• If your headaches persist or are severe, you should call our office.
Is it ok to get a permanent or hair color?
Yes, however, your perm may not respond the same during your pregnancy. Don’t blame your stylist
if you don’t get as much curl with the permanent. Instead, blame your hormones. We do suggest waiting
until after the first trimester. Hair color may vary too.
At what point should I notify the doctor if I have a fever?
Please call us if your oral temperature is above 100.5 degrees.
Are there any restrictions on lifting?
We recommend limiting any lifting to less that 50 pounds. Also, do remember to use good body mechanics
to prevent unnecessary straining of the lower back muscles; bend at your knees rather than the waist
when picking something up.
May I paint or refinish wood?
If you feel it necessary to do some painting or refinishing, be certain you do it in a well-ventilated room.
Latex-based paints are the safest to use during pregnancy. Do not use oil-based paints.
Frequently Asked Questions
Why do I sometimes have a nosebleed or bleeding gums?
Nosebleeds are a common occurrence with pregnancy. They occur because of increased blood flow
to the mucous membranes. This problem happens more in winter months when heating systems in homes
make the air dry. Using a humidifier may help overcome this dryness. If the bleeding is frequent and
heavy, please call us. The gums tend to bleed easily because of pregnancy hormones causing some
swelling and tenderness. We recommend seeing your dentist during pregnancy and practicing good oral
hygiene. If you suspect a dental problem, contact your dentist.
Is an increase in vaginal discharge normal?
Yes. This can be common throughout your pregnancy. Increased blood supply and hormones cause
your vagina to increase its normal secretions. The normal acidic environment also changes, which
causes yeast infections to be more common. Try to wear skirts or loose-fitting clothing rather than slacks
and blue jeans. Wear cotton underwear. Call our office if your discharge smells foul or causes burning
or itching.
Can I douche?
No. You should not douche during pregnancy. Due to the increased blood volume and vascularity of the
cervix, it is now possible to introduce air into your circulatory system under pressure from the douche
solution. This can cause serious complications, even death.
May my husband and I continue to have intercourse during my pregnancy?
Yes, unless there is a specific problem with your pregnancy such as placenta previa, history of premature
labor, etc. You may find sexual activity becomes more awkward or difficult as time goes on. Different
positions for intercourse may be more comfortable. During the last month of pregnancy, you should
consult your doctor regarding whether or not you should continue.
Is it ok to use saunas or hot tubs?
No, we recommend that you do not use these during pregnancy. The high temperatures can cause
damage to your developing baby.
Can I prevent stretch marks?
No, but controlling the amount and rate of weight gain does help. Each individual’s skin has the ability
to stretch, but nobody knows how much. For that reason, you cannot avoid stretch marks, which are
most common on the abdomen and may occur on the thighs and breasts. It may help with the itching
that frequently accompanies these marks to massage the skin daily with lotion. It may be of comfort to
know that these will usually fade somewhat after delivery.
What are Braxton-Hicks contractions?
These contractions may be felt as early as week 20 of your pregnancy. They are more intense in women
who have had a previous pregnancy. The uterus is flexing its muscles, getting ready for the real
contractions of labor. Braxton-Hicks contractions are sometimes uncomfortable. They last anywhere from
30 seconds to 2 minutes. If you have discomfort with these contractions, try lying down and relaxing, or
getting up and walking around. Most often changing your position will stop the contractions. If you have
questions or concerns about any contractions you are experiencing, please call.
McFarland Clinic PC
www.mcfarlandclinic.com