Women who are pregnant for the first time often wonder what they can do and what they can't do during their pregnancy. In this episode of Daily Connections, Dr. Marian Schwartz answers some of these q
-Nothing is more exciting than your very first pregnancy, but at the same time, nothing is more confusing. With all the you can't eat this and you can't do that, what to expect when you're expecting isn't so clear. So, here to clarify a few of those pregnancy questions you all have is OB/GYN, Dr. Marlan Schwartz, with Tri-County OB/GYN Associates. Hi, Dr. Marlan. -Hello. How are you-- -How are you? -Okay. -Thanks for being on the show. -Sure. -So, these are a list of questions that we've gotten from our viewers. Everyone of them pregnant for the first time. -Okay. -A very scary thing for many people. So, why don't I just start going to the questions and you can give me some advice. How's that? -Okay. -So, when should a woman have her first prenatal visit? And after her first visit, how often should women see her doctor? -All right. Basically, you like to come to the first visit around six to eight weeks of pregnancy. -Okay. -You wanna get there relatively early now because there are a lot of tests and different kinds of things that we can do early in a pregnancy that are developing and newer things that we can test for and detect. So, you wanna try to get in there relatively early. After that, for scheduled visits, we usually see about once a month, every four weeks-- -Okay. -until about 28 weeks. -Got it. -Then, at that point, see every two or three weeks 'till about 35 weeks or so. Then the last month or so, every week. -Every week. -Right. -Okay. So, there's new technologies coming out to get in there a little earlier. -Yeah, there's some-- Yeah, there's some new testing in the first trimester, different blood tests, different things we can detect now. -Uh-huh. -And if we get you early enough to find out who's at risk, we may have to check the father of the baby to see if-- -Sure. -you know, he's carrying something. So, it's good to get in there relatively early to see what's going on. -So you can continue to progress. Good. -Right. -How about-- Does she need extra calories? -In this country, probably not. -Right. -In general, the recommendation is around 120 to 300 extra calories a day. -That's it. -But if you look at the recommendations, used to be gain around 20, 25 pounds in pregnancy, now, they keep raising it higher and higher,-- -Oh. -which I think is wrong. -Oh, okay. -We have found-- there's some studies that have been out recently that show-- -Uh-huh. -that if you're really at normal weight and certainly overweight, if you only gain 5, 10 pounds, that's fine. -Okay. -And I've always told my patients, "Gain, you know, 15, 20, 25 tops." -Really? Oh. -Now, if you come in really overweight, you can gain nothing or 5. -Okay. -Now, if you're underweight, that's different. Then, you wanna gain, you know, the higher level, around 25. -So, we wanna be careful with the weight. -Right. -Then, you don't wanna talk to me, my pregnancy, 'cause I gained a whole lot of weight, so I guess-- -Some people gain a lot and it's hard to lose it. -And it was. It took me two years. So, really, that's probably the key is. -Right. -Thinking about the losing after the babies. -You're gonna lose it. -All right. So, how about some-- are there some foods that we should avoid? -You know, you always hear all these different stories about various foods. -Sure. -The main-- The main thing is fish. -These days, that's the ticket. -Right. There are a few that are really no's -- shark,-- -Okay. -tilefish, swordfish, king mack. -Why? -Different levels of mercury and other kinds of contaminants that could be in there-- -Okay. -that can cause a problem. Now, the big question usually is tuna fish. -Right. -And if you look, you'll see all different numbers, but basically, the light tuna between 6 to 12 ounces a week is probably okay-- -Oh, okay. -which, in general, is basically one or two, say-- one or two lunches, you know, a week is probably okay. -It's plenty. -Right. -So, one or two lunches a week. -Right. -Now-- -I wanna add, you wanna be careful if you fish-- -Yup. -in local waters. You don't know what those fishes have, what the waters have. -[unk] -They need to check with local health department and find out-- -Got it. -you know, what that is. I'm talking about commercial,-- you know, commercial fish. -Sure. Wow. So, that's really what we need to be watching out-- -Right. -those fishes and the mercury level that maybe-- -Possibly cause a problem. -have been possibility. -We found like in Japan where they have a lot of fish. -Uh-huh. -There were more birth defects of certain types-- -Really? -in high levels of that. -Really? -But it probably takes a lot. -Probably,-- -Yeah. -they're probably eating-- -Right. -fish everyday. -Exactly. -So, one or two a week, not too bad. -It's probably not a problem. -Okay. Now, can she continue to drink coffee or tea? Caffeine. -Another [unk] question. -Yes. -Basically, there's no firm recommendation on that. -Oh. -There was something recently in the newspaper about coffee in early pregnancy causing miscarriages. Some people may have read that. -Oh, I didn't hear that. -Slight increase-- I generally tell people about two to four cups of coffee a day is probably fine. -Okay. -Not the large grande mochas, you know. -A whole coffee pot. -Right, yeah. -One cup is like [unk] -Right. For babies [unk] -Right. Right. You know, the typical cup of coffee, you can have two or three cups a day, that should be okay. -Okay. So, really just cut it down. Moderation is the key. -Common sense, moderation. -Common sense. -Right. -That's it. Don't drink a whole pot of coffee anymore. Have one. -Exactly. -And that applies to soda too then? -Even soda has caffeine. -Same thing. -Probably, a can of soda, I would guess, is probably comparable to a cup of coffee. -Cup of coffee. -Now, tea-- even though tea has more caffeine per green-- -Uh-huh. -whatever, when you drink tea, you're not drinking each-- -Green. -cup of coffee. -Right. -You're not drinking the whole thing. So, you can probably have little more tea. -A little less. -Iced tea is okay, you know. -Okay. So, maybe, we start to substitute a little bit. -Right. -If you're having coffee, change that for a tea-- -Right. -this time or something like that. -Exactly. -Okay. Are there any over-the-counter medications to avoid? -There's so many things out there I know. People say, I'm taking, you know, Robitussin. You know-- -Right. -there could be like 17 types of Robitussin. -Exactly. -And I have no idea what's in each type. -Uh-huh. -If you're taking a decongestant, that's okay. -Okay. -Antihistamines, you probably should avoid. -Now, why is that? -One of the-- One of the main things antihistamines do is they vasoconstrict. They make the vessels get tighter, smaller-- -Okay. -which can cause a problem with blood flow and other types of things. So-- -Okay. -Now, if you-- Oh, again, if you're really sneezing a lot-- -[unk] colds. -or you have bad allergy, you need antihistamine once in your pregnancy, I think you'll survive it. -Not a big deal. -You know, but you don't wanna be on the chronic, you know, Benadryl or whatever everyday. -Got it. -You don't wanna do that. -So, at that point, would I talk to my doctor and see-- -Right. -if there's any alternatives that aren't gonna affect. -Right. That's what we wanna do. -Okay. -We have a list-- If someone calls my office-- -Oh, okay. -we have a list of things that are okay-- -Oh, okay. -that the nurses can-- the receptionist can say, "Here's what's okay to do." -These things are okay. -Right. -Perfect. -If there's any problem, they can talk to me. -Great. So, that's good to know that there's-- -Right. -a call away-- -Right. -to get some advice too. -Right. -Now, how about aspirin and Advil? -Yeah. The aspirin and the so-called nonsteroidals or Advil and all-- -Okay. -those, in general, you should try to avoid during pregnancy. Now, there are some people with certain illnesses or diseases that we have them take aspirin every single day for the purpose-- -Right. -but that's a different thing. So, you probably can take some of those things-- -Okay. -but if you have a choice, you probably wanna avoid them. -Try not to. -So, I try to explain to people that it's probably safer to take a Percocet everyday than an aspirin everyday. -No. -You would think it's-- -Sure. -probably crazy, but because the ingredients inside of it-- -The effects-- -is probably safer than the chronic aspirin. -Wow. No kidding. Now, how about cat litter? Is it safe to change the cat litter? I know the answer to this one. -Yes. That's a no. -You tell me. -That's a no. Toxoplasmosis is basically a parasite that you get gets transmitted in either raw meat or in the feces from cats after going through the digestive problem. -A parasite is the ticket what may be in that. -Right. Basically, it's-- Right. So, if you are touching the litter-- -Uh-huh. -and that gets on your hands and you ingest it somehow. -Ingest, okay. -In an adult, it may not even cause any symptoms at all. But at a critical time during development, you can have a problem with baby's development-- their sight and hearing and various other things. -Wow. -So, on the one hand, very small percentage of cats will have it,-- -Okay. -but you don't know if your cat does. -So, stay away. -Stay away. Right. -Let somebody else do it. -Let somebody else do that for nine months. -Take a vacation. -Exactly. -Now, how about exercising? How about that? -Exercise is good. -Uh-huh. -There are people that come in that, of course, haven't exercised since they were in grade school and I tell them, "We're not gonna start now." -Right. -Those people, I tell them, to maybe walk or just do something, you know-- -Moderate. -in moderation. -Okay. -Now, people that are exercising, especially in the first trimester, I tell them to keep their pulse below about 140. -Okay. -You don't want your body temperature to get up-- -Got it. -and get your heart rate too high. -Okay. -But-- And as you move along, you'll be able to exercise for the amount of time you want. -Okay. -But your distance, of course, will be lessened which is fine. But a little bit of exercise periodically throughout the pregnancy is healthy. -It's a good thing. -Right. -Right. -People tend to do better in labor, better during their pregnancy-- -Sure. -and may even tend to recover quicker and better too. -Absolutely. -So, it's a good thing. -Now, we're running out of time, so I just wanna hit this one last question. How about-- Should pregnant women sleep on their sides versus their back? How about that one? I'm sure you get that a million thanks already. -Oh, yeah. A little bit of knowledge, you know. -Right. -I tell people that, you know, in a perfect world,-- -Uh-huh. -if you could lay in one position, probably the best would be on your left side-- -Okay. -because of the aorta and vena cava-- -Got it. -and blood flow back to the heart. But once you fall asleep, you're gonna go where you go. So, unless you wake up every 30 seconds and try to see where you're lying-- -Oh, I gotta move. -Yeah, yeah. -Right. -You've got problems. So-- -I'm not gonna have-- -I told people, you know, all over the world, people are sleeping and they sleep and most of the time, things work out okay. -Right. -That's the general thing of pregnancy, is that-- -Okay. -You know, for the most part, if you use common sense and don't go too crazy, you're gonna turn out everything okay. -You'll do okay. So, that's the ticket, common sense and-- -Moderation. -moderation. -Right. -Perfect. Thank you so much, doctor. -Okay. -Appreciate you being here. -My pleasure. -Awesome. -Thank you. -Thanks.