We typically see patients during their 8th week of pregnancy (about 4 weeks after a missed period). At this time, we perform an ultrasound of the early pregnancy. An office visit with one of our providers follows this ultrasound. We discuss the findings on the ultrasound, and welcome and orient you to our obstetric practice. An exam and labwork, with the option of genetic screening, is performed during the 12th-14th week of pregnancy. If you have a history of miscarriage or ectopic pregnancy, we may want to see you earlier for some bloodwork to give us early information about how the pregnancy is progressing.

Morning sickness is common in the first trimester. Try eating some toast or crackers before you get out of bed in the morning. Drink plenty of fluids and try to eat small, frequent meals. Try to eat bland foods that appeal to you and are easy to digest, and keep crackers or other bland snacks with you to eat throughout the day. You can also try food that contain peppermint or real ginger. If these suggestions do not help, please call our nurse line to discuss starting medication for nausea.

After the first trimester, you will want to avoid any exercise or activity that poses a risk of falling on your belly ( eg. horseback riding, road biking, skiing). However, you can continue most exercise throughout the pregnancy. Walking, swimming and prenatal yoga are all good options. Use common sense and listen to your body.

We recommend eating plenty of fish that is high in omega-3 fatty acids (eg. salmon, shrimp). Two servings per week is ideal. We recommend limiting fish that contains higher mercury levels. It is best to limit white (albacore) tuna to six ounces per week. We do not recommend eating shark, swordfish, king mackerel, marin, orange roughy, or tilefish while pregnant. Sushi and any food containing raw eggs, seafood, or meat can pose a risk of food-borne illness. It is safest to avoid these foods in pregnancy to decrease the chance of food poisoning.

Massage is safe in pregnancy, just be sure to notify the practitioner that you are pregnant. Some places do not offer massage in the first trimester, so be sure to check ahead of time. Hair dyes and nail services are generally considered safe in pregnancy.

Hot showers and baths are safe in pregnancy. We generally recommend avoiding hot yoga and hot tubs in the first trimester. After that, we recommend avoiding hot tubs or hot yoga that are >100 degrees. As always, please listen to your body and stop if you get dizzy or light-headed.

The Zika epidemic is relatively new, and information and guidelines are changing quickly. We recommend visiting https://www.cdc.gov/zika/index.html for the most up to date info. In general, we do not recommend travel to countries with endemic cases of Zika when you are trying to conceive or while you are pregnant. Travel within the continental US & Hawaii is considered safe.

It is safe to drink one 12-ounce caffeinated beverage per day.

In the third trimester, we recommend paying attention to fetal movements and learning what is normal for your baby. If you feel that fetal movements have decreased, you should perform a kick count. To do this, drink some cold water or juice and lie on your left side with a hand on your belly. Keep track of the number of movements, and you should feel ten movements within one hour. You can stop counting once you get to ten movements. If you do not get ten movements within an hour, please call our office.

In an uncomplicated pregnancy, it is safe to continue airline and car travel up to 34-36 weeks. You can use your judgement about how important the trip is to you. It is always a good idea to travel with a copy of your medical records.

A birth plan is optional. We are always happy to review birth plans, so feel free to bring yours to your visit anytime. We will make a copy and distribute to all the physicians.

For routine questions during business hours, please call 303-795-0890. For emergent questions during business hours, please call our emergency OB line (303) 730-9286. After office hours, you may call our main number (303) 795-0890, which will direct you to our answering service and page the doctor on call.

We recommend following the 5-1-1 guidelines. Wait until contractions are five minutes apart, lasting a minute, for one hour. This refers to painful contractions that you are needing to breathe through. We also recommend calling if you have a gush of fluid suggesting your water broke, or if you are bleeding like a period.