1st appointment – You will meet with the doctor who will go over your pregnancy and medical history, order prenatal labs and an ultrasound, start you on prenatal vitamins, and answer any questions you may have. Plan on having a breast exam, PAP smear and pelvic exam that are routine for the first visit.
Second trimester genetic screening is offered from 16-21 weeks gestation. This screens for Down’s syndrome, Trisomy 13 and 18, and openings in the spinal cord. This is done by the QUAD screen which is blood work on the mother. If this result is abnormal, you will be offered genetic counseling, a detailed ultrasound, and the option of having an amniocentesis to determine the exact genetic makeup of the baby.
Ultrasound for the anatomy of the fetus is done at 20-22 weeks. This is a good time to get a look at the development of many of the organs, such as the heart, lungs, kidneys and brain. If the baby cooperates, they may even be able to determine the sex of the baby if you are interested.
At 24-28 weeks, you will be asked to do a screening for diabetes of pregnancy. You will be asked to drink a special sugary soda, followed by getting your blood drawn one hour later. If your diabetes test is abnormal, you will be asked to do a three hour diabetes test.
At 36 weeks, a vaginal culture will be done for Group B Strep. This is a bacteria that is normal in some women. If you have this bacteria, all it means is that you will be treated with antibiotics during labor to protect your baby during birth.
Up until 30 weeks you will be seen every 4 weeks.
Weeks 30-36, you will be seen every 2 weeks.
Weeks 36-delivery, you will be seen weekly.
The longest we will let you go past your due date is 1 week.
Some people choose to have their labor induced. The earliest this can be safely done without other maternal or obstetric indications is 39 weeks. Your doctor will discuss this with you if you are interested.
This may be altered to fit your specific needs as determined by your doctor.
We encourage drinking at least 6-8 glasses of water per day; this will need to be increased in the summer months.
Average weight gain during your pregnancy should be 25-35 pounds depending on your body type. You only need 300 extra calories per day while pregnant. Remember: you are not eating for two - sorry!
You can eat most foods.
You should avoid uncooked fish. Please avoid shark, mackeral and tile fish altogether.
You can eat lunch meat as long as it is cooked.
Try to eat a balanced diet.
If you exercised before you got pregnant, you may continue to exercise. If you want to start exercising now, you may start with aerobics, walking, biking, and an elliptical machine. You may also lift light weights. We recommend that you keep your heart rate below 140. Remember, if it hurts, don’t do it!
Although no medications are completely safe during pregnancy, these are a list of some medications that are considered safe during pregnancy. If you have any questions on what you can take, please ask!
HEADACHE/BACKACHE: Tylenol or Extra Strength Tylenol (avoid Motrin, Advil, Ibuprofen, Aspirin and Aleve)
CONGESTION: Sudafed, Actifed, Tylenol Cold, Benadryl, Claritin
COUGH: Plain Robitussin; Chloroseptic Throat Spray
HEARTBURN: Tums, Rolaids, Mylanta, Maalox, Pepcid, Prilosec, Tagamet
NAUSEA/VOMITING: Emetrol, Dramamine, Vitamin B6
CONSTIPATION: Colace, Fibercon, Metamucil, Dulcolax
DIARRHEA: Imodium AD
HEMORRHOIDS: Preparation H, Anusol cream or suppositories
Do not clean the kitty litter box (risk of toxoplasmosis)
Do not use hot tubs, saunas or whirlpools that are over 100 degrees
Avoid smoking, alcohol and recreational drug use
Limit caffeine (1-2 cups a day), salt and NutraSweet
Small, frequent meals
Saltine crackers
Ginger ale or ginger snaps
Vitamin B6, 1 tab in the morning and 1 at night
Don’t eat and drink at the same time
If you have severe vomiting (multiple times per hour, decrease in your urine output), please notify us
Decreased fetal movement – if you are not feeling the baby move as usual, we recommend that you drink a 32 ounce glass of water and lie down on your left side and count how many times that baby moves in one hour. The baby should move 6-10 times during that hour. If you still aren’t feeling the baby move well, you should go to the hospital. This is effective only after you are feeling the baby move on a regular basis.
If you have bright red bleeding where you are having to change a pad every hour or it is heavier than you are comfortable with, go to the hospital.
If you feel a gush of fluid from the vagina or a persistent leaking, you need to be seen to see if your water is broken.
If you start having contractions that are painful (can’t walk, talk or laugh through them), lasting about one minute each, and are coming every 3-5 minutes for a couple of hours, you need to go to the hospital. If you are under 36 weeks pregnant, you need to go to the hospital sooner because we will need to stop your labor at that point.
If you have a headache for several hours that doesn’t get better with Tylenol and is associated with blurry vision or upper abdominal pain, you need to go to the hospital.
Some couples decide to bank their babies cord blood. The stem cells from the blood of the baby’s umbilical cord can be used in the future if your baby has a medical problem that can be treated with stem cells. This is a personal decision. It is associated with an initial cost plus a yearly storage fee. More information can be found on the websites of the following companies:
CBR – Cord Blood Registry: www.cordblood.com
ViaCord: www.viacord.com
I also do pediatric care. If you are planning on having me be the pediatrician, I will plan on seeing your baby within 2 days after getting discharged from the hospital.
If you are interested in birthing, parenting or lactation classes, they are offered at each hospital – contact the hospital by 20-24 weeks for more information.
Dr. Munn is affiliated with the local hospitals. Please let us know where you wish to deliver.
Mountain View Hospital in Payson
Spanish Fork Hospital in Spanish Fork
And if you need, we can also go to Utah Valley Hospital