Welcome

Welcome to Loudoun Community Midwives. We are pleased you have chosen to partner with us for your prenatal care experience. We hope that these pregnancy health tips will help you have a more comfortable, healthy pregnancy.

Medication in Pregnancy & Pregnancy Health Tips

A simple rule of thumb to follow concerning medication use in pregnancy – Don’t use medications unless truly necessary. Here we discuss some common health conditions that may occur during pregnancy and offer some suggestions for over-the-counter medications or alternative therapies. Please be aware that no pregnant women sign up for drug research studies – who would? So therefore, there are FDA Categories of Risk in Pregnancy, which simply categorize the level of risk shown from different types of drug research. Almost NO drugs are Category “A”, essentially proven safe. The over-the-counter remedies listed here are those that are mostly Category “B”, with no proven dangers, generally in studies done on animals. They also include time-honored natural remedies and things that most physicians concur are acceptable for occasional use as labeled. If you do not see a medication on the list that you feel you must take, please call us in advance so that we may discuss it with you. You can also look it up on Web-MD!

Nausea

Consume dry bland foods, such as toast, crackers, Melba toast, Lorna Doone cookies, popsicles, Italian ice. Try to consume food high in carbohydrate and protein and low in fat. Small, frequent meals tend to stay down better than three large meals. Take fluids separately from solids and try to keep hydrated by taking small sips of fluids very frequently. Some suggestions include decaf or herbal teas, Gatorade, Kool-aid, lemonade, flat ginger ale. If prenatal vitamins aggravate nausea, take them at night, or split them in half and take half in the morning and half at night. If they continue to aggravate nausea, let us know so we can discuss an alternative for you. Avoid carbonated drinks, caffeine, milk, fatty foods, greasy or fried foods. Avoid acidic foods, such as apples, oranges, tomatoes, lemon juice, etc. Herbal teas can have a soothing effect on an upset stomach, such as peppermint, anise, and ginger. Ginger is particularly helpful for nausea and can be obtained in capsule form at the local health food store. Do not exceed the dosage recommended on the bottle. Another alternative therapy is acupressure wrist bands (i.e. Seabands), which may help decrease nausea. Vitamin B6 may be taken to reduce nausea: 50-100mg per day.

  • Medications: Doxylamine succinate (Unisom) can be taken at bedtime (25mg) and twice a day (12.5mg) for relief of nausea. However, this can be sedating. Doxylamine can also be taken in conjunction with Vitamin B6 in the above dosage and has been shown to be highly effective for decreasing nausea.

Heartburn

Avoid chocolate, fried foods, spicy and fatty foods, carbonated drinks, citrus juices, peppermint, alcohol, caffeine, and smoking as all of these may exacerbate heartburn. Avoid tight-fitting clothing. Avoid large meals. If your heartburn is worse at night, avoid eating just prior to going to bed and you can elevate the head of the bed on blocks 6 inches. Avoid aspirin containing medications, such as Pepto Bismol. Papaya fruit is a known alternative treatment for heartburn.

  • Medications: There are a variety of over the counter medications you may take for heartburn. These include: Tums, Mylanta, Maalox, Riopan, or Rolaids. With pregnancy in the third trimester, very severe and persistent heartburn and/or upper abdominal pain can also be a symptom of other serious complications (please mention this type of discomfort to your midwife, or page us if concerned).

Headaches

Headaches can be caused by a number of things from stress to certain food ingredients to sinus congestion to poor vision. Often identifying and eliminating or treating these conditions will relieve headaches without the use of medications. If your headaches are unrelieved by conservative measures, if they are severe, if they are associated with changes in vision, or if you have a history of high blood pressure, please call us.

  • Medications: Acetaminophen, Tylenol (regular or extra strength), and Anacin 3 are all considered acceptable for occasional use. Avoid all aspirin-containing products, as well as nonsteroidal anti-inflammatory drugs (i.e. Advil, Ibuprofen, Motrin, Aleve, etc.).

Constipation

Drink a minimum of 8-10 glasses of water per day. Increase fiber in diet, such as bran cereals, green leafy vegetables, spinach, prunes, raisins, raw fruits and vegetables. Please be aware that your prenatal vitamins containing iron or iron supplements may be contributing to your constipation. The hormones of pregnancy often contribute to constipation as well.

  • Medications: Colace, Peri-Colace, Metamucil, Fiber laxatives, Fibercon, Perdiem, Citrucel, and Sennekot for occasional constipation.

Eating yogurt daily can promote bowel and vaginal health as well as regularity, or taking a daily pro-biotic, such as acidophilus capsules. We carry a very good, high quality pro-biotic called Florajen 3 at our offices for this reason (30 day supply or 60 day supply).

Sinus Congestion/Cold/Respiratory Allergies

Increase fluid intake (minimum 8-10 glasses of water per day) and rest. Try a humidifier or a cool mist vaporizer. Breathe Right Strips may help relieve nasal congestion associated with pregnancy. If cold/symptoms persist for greater than one week, if you have a fever greater than 101 degrees, or if you have a severe sore throat, please call us or your primary care provider. Homeopathic remedies which are available in over-the-counter potencies (6x-30C) from health food stores are considered gentle, nontoxic and okay in pregnancy and breastfeeding. These are pharmaceutically prepared micro-doses of natural substances which treat specific sets of symptoms with minimal side effects. The homeopathic remedy Oscillococcinum may be taken AT THE FIRST SIGN of any cold or flu symptoms (3 doses in the first 24 hours). It will generally make all the symptoms less intense and shorten the duration of the cold. There have been three double blind, placebo-controlled trials done by independent researchers using Oscillo to treat people with the flu. They found that the best results happened if it was taken within 48 hours of onset of the flu. 10-15 granules is a dose – you do not have to take the whole vial as a dose.

  • Medications: If sinus congestion is associated with respiratory allergies, and you have taken Zyrtec or plain Claritin in the past, you may continue to take them safely in pregnancy. Nasal congestion may be treated with Sudafed or Chlor-Trimeton. Sore throat may be treated with Sucrets, Cepacol lozenges, Chloraseptic Spray or lozenges. Cough may be treated with plain Robitussin or Robitussin DM. Ricola cough drops or other menthol cough drops are safe to use. A Neti Pot is a small pot used to rinse the sinuses with salt water, naturally clearing irritants out. They can be purchased at health food stores and some supermarkets such as Wegmans.

Hemorrhoids

To avoid hemorrhoids, eat plenty of fiber and drink plenty of fluids which will help to avoid straining and constipation. Straining and constipation can irritate the rectum and cause hemorrhoids. If heavy bleeding occurs, please call us. Comfort measures include warm, shallow baths.

  • Medications: Preparation H, Tucks, Anusol, and glycerine suppositories to lubricate stools.

Diarrhea

Avoid spicy or fried foods, avoid fruits and vegetables, avoid fruit juices or carbonated drinks, and avoid milk and all milk products. Fluid intake should be increased. Gatorade or decaf tea are good choices. A bland diet such as fish, turkey, or chicken should be eaten. If diarrhea persists, the BRAT diet consisting of bananas, rice, apples, and toast should be followed. Call us if your diarrhea lasts longer than two days.

  • Medications: Kaopectate, Imodium

Edema/Fluid Retention

Avoid fast foods and decrease salt and sodium intake. Avoid Chinese, Mexican and Italian foods as well as seafood, cheese and deli-processed foods. Cranberry juice and all melons are natural diuretics. Increasing your fluid intake of water and non-caffeinated beverages also acts as a natural diuretic. If you have access to a swimming pool, submersion under water for 45 minutes to one hour will have a diuretic effect. For foot edema, elevate your legs above your waist for 20 minutes at a time, several times a day. Support pantyhose made especially for pregnancy may also help (you will need a prescription for these). Pharmaceutical diuretics are not recommended.

Other important reminders

  • Nose bleeds and gum bleeds are common during pregnancy due to hormone changes.
  • Avoid alcoholic beverages.
  • Quit smoking!
  • No saccharin – Saccharin is an artificial sweetener with effectively no food energy which is approximately 300 times as sweet as sucrose or table sugar, but has a bitter or metallic aftertaste, especially at high concentrations. It is used to sweeten products such as drinks, candies, cookies, medicines, and toothpaste.
  • Limit caffeine and NutraSweet to only once per day.
  • If painting, use latex paints only.
  • Pregnant women are more susceptible to listeriosis due to a weakened immune system caused by hormonal changes of pregnancy. This infection can lead to premature delivery, miscarriage, and severe illness in your newborn. Please avoid eating unpasteurized soft cheeses like feta, Camembert, Brie, blue-veined cheeses, and Mexican-style cheeses. Do not eat refrigerated pate or meat spreads. Do not eat refrigerated smoked seafood unless it is in a cooked dish.
  • Avoid raw eggs, raw meats, sushi, and raw dairy products.
  • Pregnant women should not eat shark, swordfish, tilefish, king mackerel, or fresh tuna due to risk of high mercury levels, which may damage the unborn child’s developing nervous system.
  •  Fish that contain the lowest levels of mercury and are safe to consume in pregnancy. These include canned tuna, shrimp, Pollock, salmon, cod, catfish, clams, flatfish, crabs and scallops. Please limit servings to 12 ounces per week, with typical servings being 3-6 ounces apiece.

Things we DO encourage

Remain active with low-impact exercise: swimming, walking, hiking, yoga, dance, and the gym are all encouraged. Be sure the practitioner or teacher is trained and certified for pregnancy such as chiropractic care, massage, yoga and acupuncture.

Loudoun Community Midwives
19465 Deerfield Avenue, Suite 205
Lansdowne, Virginia 20176
Phone: (703) 726-1300
Fax: (703) 726-9612
Loudouncommunitymidwives.com