We ask that you restrict all medication use unless we have discussed it with you prior. The first trimester, which includes the first 13 weeks, are typically the most risky for any medication use.  Most over the counter medications are safe, a list is given  below. Obviously, we ask that you do not drink any alcohol and to avoid smoking if at all possible.  There are several medications that we may prescribe that have, over the years, proven to be very safe during pregnancy. However, we cannot guarantee utmost safety with any medication used today. If you are not feeling relief with the products listed below, please do not hesitate to call the office.  Colds and Congestion:  Should you have a minor cold, we ask that you please try Chlor-Trimeton tablets, 4mg every 4 hours. This can be purchased over the counter at any pharmacy.  Should you need a stronger decongestant type of medication, please call us.  Don't forget to drink plenty of fluids and rest. Other products that may help with cold and congestion during pregnancy are: Actifed, Sudafed, Benadryl, Tylenol Cold, Contact, Ayr Nasal Spray, Tylenol Allergy, Tylenol Sinus, Tylenol Flu, and Vicks. If you are not feeling relief with these products, please call the office.  Coughs:  Should you have a cough, you can take plain Robitussin or Robitussin DM Cough Syrup.  Do not use Triaminic.  Don't forget to drink plenty of fluids and rest. Constipation:  You can use either Colace tablets or Surfak tablets, available over the counter at any pharmacy.  We ask that you increase the amount of fluids that you are ingesting daily while using these products. If this is ineffective please call us.  Other products that may help relieve constipation are: Milk of Magnesia, Senokot, Peri-Colace, or Correctol as a stool softener or laxative. You may wish to include the following foods frequently in your meals to also help the problem of constipation: whole grain breads and unsweetened cereals (such as 40% bran flakes, raisin bran, rolled oats, and shredded wheat), raw and leafy vegetables, fruits (especially prunes and apples), and drink 6-8 glasses of water every day. Diarrhea:  You can safely use Kaopectate or Donnagel PG to help stop the symptoms of diarrhea. Headaches, Aches, and Pains:  These ailments are very common during the early part of your pregnancy.  It is safe for you to use Tylenol or Acetaminophen, however, do not take any type of aspirin products or ibuprofen.  If the headache is severe or not relieved by Tylenol, please call us. Heartburn or Indigestion:  Please feel free to take Maalox Plus, Riopan Plus, Mylanta, Rolaids, or Tums tablets. You can also reduce the symptoms of heartburn by reducing the amount of fat in your diet and eating frequent small meals rather than three large ones. Drinking a small glass of whole milk may also provide relief. Avoid tension during meals.  Avoid any type of preparations containing sodium or sodium bicarbonate.  Hemorrhoids:  You can use Preparation H, Wyanoids, Anusol cream, or suppositories for relief with hemorrhoids. Nausea and Vomiting:  During the early part of your pregnancy, you can safely use Emetrol solution, 1 teaspoon every 2 hours as needed. This can be purchased over the counter at any pharmacy. Should nausea and vomiting be severe, please call us.  Also, taking Vitamin B6, 50 mg twice a day OR 25mg three times per day, should also help decrease your nausea. Sore Throats:  If you are experiencing a sore throat, you can try Cepacol throat lozenges, Sucrets, or Chloraseptic throat spray.
	DID YOU KNOW . . .  Where Does the Weight Go? During pregnancy, most women should gain about 30 pounds.  Changes to your body (increased size of the uterus, breast tissue, blood volume, and body fluid) account for the largest part of your weight gain. To support a pregnancy, your body must store nutrients and increase the volume of blood and other fluids it produces. One of the reasons for the extra fat is to prepare you to produce milk for breast feeding. Here's where the 30 pounds are: 7.0 lbs: Maternal stores of protein, fat, and other nutrients 4.0 lbs: Increased fluid volume 4.0 lbs: Increased blood volume 2.0 lbs: Breast Enlargement 2.0 lbs: Uterus 7.5 lbs: Baby 2.0 lbs: Amniotic Fluid 1.5 lbs: Placenta (tissue connecting mother and baby that brings nourishment and takes away waste)
	Any of the following warning signs may indicate that you need to be seen without delay: Severe or persistent headaches with blurred vision or spots before your eyes. Fever greater than 101 degrees (Fahrenheit) Persistent or severe vomiting Marked swelling in your face Gush or steady stream of watery fluid from your vagina Contractions greater than 5 per hour, increasing in frequency before 35 weeks gestation Inadequate kick counts Marked decrease in urine output or difficult or painful urination
	Any of the following warning signs may indicate that you are in pre-term labor. Contact our office immediately if you experience the following: Four or more uterine contractions per hour (may be painless) Menstrual-like cramps felt low in the abdomen. These may be constant or may "come and go". Lower back pain that may radiate to the sides or the front - not relieved by a change of position. Pelvic pressure that feels as though the baby is going to "fall out" Stomach cramps that have the feeling of "gas pains", with or without diarrhea. An increase or change in vaginal discharge that may be pink or brown tinged, mucuosy, or watery. A general feeling that something is not right. you may not feel well, even without specific cause.
	We ask that you please make arrangements prior to actually going into labor with the hospital of your choice. As you probably know, we deliver at either Mary Immaculate Hospital or Riverside Hospital. They do request that you pre-register prior to arriving in labor. At the onset of labor, when your contractions are three to five minutes apart, your membranes rupture, or bleeding occurs, you should call our office up until 10:00pm at night (the answering service will pick up after hours). After 10:00pm, go directly to the hospital. They will admit you to Labor and Delivery and will contact the on call physician.