Am I in labor? And other frequently asked questions

How do I know if I am in preterm labor?

• Labor usually consists of regular, painful uterine contractions that increase in intensity and frequency over time. If you are 34 weeks or less, you should come to the hospital if you have eight contractions in two hours despite resting and drinking liquids. You do not need to call us to let us know you are coming. There is always a doctor at the Birthing Center to help you.
• If you are leaking amniotic fluid, you need to be evaluated.
• Babies should be active. If your baby has not moved 10 times within two hours, you should come to be evaluated.

How do I know I am in labor when I am full-term?

• Come to the hospital when the contractions are persistent over an hour or two, depending on how far away you live. You do not need to call us to let us know you are going. There is always a doctor at the Birthing Center to help you. 
• If you are leaking amniotic fluid, you need to be evaluated.
• Babies should be active. If your baby has not moved 10 times within two hours, you should come to be evaluated.
• If you have bleeding in excess of streaks of blood in a mucous plug, you should be evaluated.

Reasons to Come to the Hospital

If you experience any of these symptoms, you should come to the hospital immediately:

• Contractions* every five minutes for one hour if greater than 37 weeks.
• Contractions* every 10 minutes for one hour if less than 37 weeks.
• Your water breaks.
• Vaginal bleeding – soaking a sanitary pad each hour.
• Vaginal bleeding like you’re having a period.
• Decreased fetal movements (less than 10 movements in two hours).
• Vomiting for 24 hours.
• Any kind of fall, car accident or abdominal trauma. 

* Time contractions from the beginning of one contraction to the beginning of the next contraction. 

Reasons to Call Your Doctor

If you experience any of these symptoms, check with your doctor:

• Headaches that don’t go away with Tylenol.
• Pain in the upper abdomen.
• Vision changes.
• Symptoms of urinary tract infection (burning with urination).
• Fever greater than 100.5°F by mouth. 

What do I do if I am pregnant and having vaginal bleeding?

• Vaginal bleeding is never normal during pregnancy and needs to be evaluated.
• If you are in your first trimester and the bleeding is light and painless (no cramping) call during our business hours between 8:30 a.m. and 5 p.m., Monday-Friday, and ask to be seen that day.
• If you are past your first trimester go immediately to the Birthing Center at UK Chandler Hospital to be evaluated. If the bleeding is heavy, or accompanied by fever or pain, go to the nearest emergency facility immediately.
• You do not need to call us to let us know you are coming. The nurses will contact us if necessary.

What medicines can I take when I am pregnant?

Prescription medications should be reviewed with your physician or midwife during your appointments. A list of over-the-counter medications can be found below.

What should I do for a stomach virus?

• Viruses usually pass within 24 hours.
• It is important not to get dehydrated. Electrolyte solutions such as pedialyte can be helpful.
• Over-the-counter medications that are safe to consider are listed below.
• If you have symptoms that persist beyond 24 hours, please contact our office during regular business hours. After business hours, consider evaluation at the UK Birthing Center at Chandler Hospital.

What should I do for a bad cough, cold or congestion?

• Most upper respiratory infections are from a virus, and antibiotics don’t help.
• Try extra fluids and rest.
• Over the counter medications may be helpful in treating the symptoms. Please see our OTC list for recommendations.
• If you have fever or the symptoms persist for longer than one week, please see your primary care provider.   If you have a fever over 100.4°F, you need to be evaluated. 

What can I do for constipation?

Constipation is very common in pregnancy.

• Increase fluids and exercise. Make sure you are drinking at least 8 ounces of water a day.
• Make sure you are getting plenty of fiber – 25-30 grams a day. Fiber from fruits, vegetables, and supplements (like Fiberchoice or Benefiber) is helpful.
• Take stool softeners (Colace) regularly or try Miralax according to package directions.

What can I do for nausea and vomiting in the first trimester?

• The goal is prevention as advised with six small meals, increasing protein and complex carbs to keep blood sugar stable.
• Make sure you are drinking plenty of fluids.
• Allowing yourself to become hungry can make nausea worse.
• Consider a change of prenatal vitamins. You can temporarily substitute a single children’s chewable vitamin with iron and discuss with your provider at your next visit.
• Try ginger pops or ginger ale to settle the stomach. 
• Try to keep foods bland.
• Preggie Pops can be helpful.
• Over the counter emetrol or supplemental vitamin B6 may help. 
• If it becomes intolerable, discuss prescription nausea treatments with your provider during regular business hours.

Why do they call it “morning sickness” when it lasts all day?

No one really knows what causes the nausea of pregnancy, but it affects over half of all pregnant women. It is thought to be related to the high hormone levels of pregnancy, like human chorionic gonadotropin (hcg) and estrogen.  The high progesterone level also relaxes a pregnant woman’s esophagus, so that she is more likely to have reflux and gagging. 

Symptoms of nausea may be brought on by hunger or swings in blood sugar. Many notice that their nausea is worse when they are tired. Some moms report that smells may make their nausea worse. Sometimes, even a vitamin is a trigger, but vitamins are necessary during pregnancy. There are some women who make extra saliva during pregnancy, and this constant swallowing makes them sicker.

The worst week of morning sickness is usually in the middle of the first trimester. By the second trimester, your body will have some relief. If you need relief sooner, here are some things to try:

• Get lots of rest.  Fatigue can cause nausea even when you are not pregnant. 
• Try frequent small meals that include some protein or fat.   The old advice of eating crackers may help temporarily, but a little cheese and turkey on the crackers will bring longer relief by keeping blood sugars stable. Sipping on flavored beverages all day long not only improve hydration, which makes you feel better, but may also help those with excess saliva production. 
• Antacids. Tums contain calcium, and are good for pregnancy. In some cases, the heartburn and gagging is helped by 20 mg of Pepcid every day. 
• Antihistamines. Doctors often prescribe antihistamines like phenergan to help with nausea, but Benadryl (diphenhydramine) 25 mg as needed every six hours may also help.    
• An older remedy for nausea was one-half of a Unisom tablet (doxylamine 12.5 mg) every six hours.  Remember that any antihistamine may cause fatigue; see the first bullet point.
• Vitamin B supplementation.   Some people have less nausea with extra vitamin B6, 50 mg every day.
• Ginger. Ginger snap cookies, ginger ale and candied ginger have all been said to improve nausea, though this evidence is not conclusive.
• Prescriptions have improved over the last 10 years. Doctors often recommend Zofran, Kytril, Reglan, Compazine or others to help with the nausea. Of course, all have side effects that should be discussed with a physician. 

The extreme form of morning sickness is called hyperemesis. It causes relentless vomiting and can result in dehydration, weight loss and nutritional deficiencies. While vomiting occasionally is common, hyperemesis occurs in less than 2 percent of pregnancies. Hyperemesis needs to be treated aggressively with medications and fluids, and should not be ignored. 

Can I maintain my exercise routine during pregnancy?

We encourage you to exercise at least three to four days a week for 45-60 minutes. You can typically do whatever you are accustomed to doing. If you have not previously exercised, slowly build into exercise. You do not have to monitor your heart rate. As long as you can still have a conversation, you are fine. If you are so out of breath it is difficult for you to speak, you are overdoing it. We recommend that, as your baby grows, you consider the risks to the baby during activities such as contact sports and even bicycling.

Can I travel?

It is okay to travel as long as you are not experiencing any complications in pregnancy. We recommend you stop air travel at 36 weeks. Once you are showing, some airlines require a note to fly. If you travel by car or airplane after 36 weeks, you need to be willing to deliver wherever it is that you are choosing to go. Do not visit remote locations without services available. In car travel, you will want to stop every 1 ½ to 2 hours for a bathroom break and a 10- to 15-minute walk, which prevents blood clots. You should also stay hydrated.

It is okay to have hair colored, permed or straightened?

Make your stylist aware of your pregnancy because it can affect processing.

Do you advise staying out of the sun?

If you are in the sun, make sure you use sunscreen. You want to increase the SPF that you typically use. You are more likely to burn in pregnancy. Tanning lotions and sprays are okay, but tanning beds are not.

Can I take a dip in the hot tub or relax in the sauna?

Do not use a hot tub or sauna during pregnancy.

Can I get a massage?

Massages are okay throughout the entire pregnancy.

Should I worry about my pets?

Due to health concerns, you need someone to change your cat’s litter box for you. If you garden or work in the yard, make sure you wear gloves because neighborhood cats may be using the bathroom in your garden or flowers. No restrictions with dogs. If you have reptiles or fish, make sure to wash your hands thoroughly after handling.

Is it okay to use latex paint?

Latex paint is okay. Do not use oil-based paint. You want to be gone from your home for at least 24 hours if oil-based paint is used in your home.