General Pregnancy Information

CenteringPregnancy®: Patients love doing Centering because they find it supportive, fun, and they feel more prepared for labor and birth.  You go through your prenatal care with a small group of other pregnant patients who are due around the same time as you. Patients say the group feels like a community of friends they can go to for support. You have a lot more time to ask questions and learn about topics that are important to you during your pregnancy. 

Due to the COVID-19 pandemic, we are now doing our Centering sessions through telehealth. You will have one-on-one appointments in the clinic with your midwife or doctor and will also have group telehealth sessions every 2 to 4 weeks.

In the group telehealth sessions, you have 1 to 2 hours to meet together with your midwife and group to learn about pregnancy, birth, and postpartum care. 

Research shows that people who do Centering are less likely to have a premature baby or a baby that is low birth weight. Ask your midwife of doctor if Centering is good option for you!

Midwifery individual care: Midwives specialize in normal pregnancy, birth, and the postpartum period. They provide prenatal checkups, schedule tests and ultrasounds, listen to your concerns, and provide support and information.

Obstetrician individual care: Our general obstetricians (OBs) provide care throughout pregnancy, birth, and the postpartum period. OBs are medical doctors who are also specialists in pregnancy.

High-risk obstetrician: Maternal Fetal Medicine (MFM) specialists are obstetricians who are experts in high-risk pregnancy. They give you care if you have a serious medical problem such as diabetes, high blood pressure, HIV, or if you’ve had complications with a previous pregnancy

Birth Sisters are women from the communities around Boston who are specially trained to give you support during pregnancy, birth, and after the baby comes.

They speak your language, listen to your needs and help you talk with your providers about your questions or concerns. They will:

• Meet with you before the baby comes.
• Stay with you through labor and birth.
• Support you at home after the baby comes.
• Help you with breastfeeding.

To learn more, call: 617 414 5168

Ten ways to stay healthy while you are pregnant:

1. Go to your prenatal visits (health care while you are pregnant).
2. Drink 8 to 10 glasses of water every day.
3. Eat healthy foods.
4. Exercise.
5. Get plenty of rest.
6. Do not use alcohol, cigarettes, or street drugs.
7. Wear your seat belt.
8. Go to a childbirth education group.
9. Learn to relax with deep breathing.
10. Talk about your questions and worries. Ask for help.

Ways Your Support Person Can Help

Your support person may be your partner, the father of the baby, a friend, or family member. Your support person can:

• Be a good listener.
• Go to a childbirth education group or prenatal visit.
• Ask questions at prenatal visits.
• Help with housework, errands, and cooking.
• Help with childcare.

Why do I need prenatal visits?

Prenatal visits help you and your provider to:

• Make sure your baby is growing well.
• Check you for problems in pregnancy such as high blood pressure, diabetes, infections, or anemia.
• Talk about questions or worries you may have.

How often will I have prenatal visits?

Expect 1 prenatal visit a month until you are 7 months. Then you will have a visit every 2 weeks until the last month. You will have a visit every week in the last month. Your provider may ask you to come more often for any problems you may have.

What happens at my first prenatal visit?

You will see a provider on your first visit. The provider may be a midwife, obstetrician, family medicine doctor, or nurse practitioner. Expect your provider to:

• Ask questions about your health history.
• Check your weight, blood pressure, heart, lungs, thyroid, and breasts.
• Check your uterus and cervix.
• Decide your baby’s due date.

Your provider will also order some tests.

These might be:

• A Pap test to check for cancer of your cervix.
• A test for infections in your vagina.
• A blood test to check for anemia, your blood type, and signs of infection.
• A urine test to check for protein, sugar, or infection.
• A test for tuberculosis (an infection in your lungs).
• HIV counseling and the choice to take an HIV test.

Will I have an ultrasound or other tests for my baby?

Your provider will talk to you about an ultrasound to check for problems in your baby. Your provider may ask you to talk with a genetic counselor. A genetic counselor will talk to you about the chance of your baby having a genetic problem like Down Syndrome.

Here are some facts about some tests for your baby:

• Ultrasound: An ultrasound uses sound waves to make a picture of your baby. Ultrasound can be used to check the:
  • Gestational age of your baby.
  • Heartbeat.
  • Growth of your baby’s heart, brain, spine, kidneys and other organs.
  • Position and size of your baby.

Please drink 6-8 glasses of water before your ultrasound appointment and do not urinate (pee) until your ultrasound is done. It is easier to see your baby this way.

• First trimester or 3-month screen test: You may have this test when you are in month 3. This test is an ultrasound and a blood test that tells the chance of some birth defects such as Down syndrome and Trisomy 18.
• Quadruple screen test: The quadruple screen is a blood test. It looks at 4 substances in your blood that may be related to some genetic problems or problems with your baby’s spine.
• MaterniT21: This is another type of blood test that checks for different possible genetic problems in your baby. You may be offered this if you are 35 years or older or for other reasons too. Our genetics counselors can help you decide if this test is right for you.
• Sickle cell test: This is a blood test for you, and sometimes for the baby’s father, to tell the chance of your baby having sickle cell disease. You can inherit (get it from your mother or father) sickle cell disease. Sickle cell disease is more common in people of African ancestry.
• Cystic fibrosis test: This is a blood test for you, and sometimes for the baby’s father, to tell the chance of your baby having cystic fibrosis. You can inherit (get it from your mother or father) cystic fibrosis. Cystic fibrosis is more common in people of Northern European ancestry.

What other tests will I have?

Tests at 6 months:

• Diabetes test (1 hour glucola test). This is a blood test to check for diabetes you can get when you are pregnant.
• A blood test to check for anemia. 

Tests at 9 months:

• Group B Strep (GBS) test. GBS is bacteria (germ) in your vagina that can make your baby sick. Women with GBS need antibiotics (medicine) during labor to lessen the chance that the baby will get sick.
• Another HIV test

Exercise helps you to stay healthy while you are pregnant.

Talk to your provider about how to exercise while you are pregnant.

Exercise can help you:

• Have stronger muscles for birth.
• Have more energy.
• Be in a better mood.
• Lower your stress.
• Prevent too much weight gain.
• Ease leg cramps and backaches.
• Help with constipation.

Even a few minutes of stretching each day can make you feel better and stronger. Try things like swimming, housecleaning, yard work, or a combination of these activities.

Try to exercise for 30 minutes every day. Drink plenty of water before and after you exercise.

Stop exercising if you feel:

• Pain.
• Dizziness.
• Shortness of breath.
• Uterine cramps like when you get your period.
• Contractions (your stomach gets tight and hard).

Dancing
You can dance anywhere!

Yoga
You can take a yoga class or practice with a yoga video.

Walking
Walk for 30 minutes a day. You can walk to the park, to the store, or to the bus stop.

Foods you need when you are pregnant:

Bread, Rice, and Cereal

• Eat 6 to 11 servings a day
• Have vitamins, minerals, and energy you need to grow a healthy baby

Meats, Beans, and Eggs

• Eat 3 to 4 servings a day
• Have protein that helps build your baby’s brain, muscles, heart, lungs, and other organs.

Vegetables

• Eat 3 to 5 servings a day
• Have vitamins, and minerals that keep you and your baby healthy.

Milk, Cheese, and Yogurt

• Eat 3 to 4 servings a day
• Have calcium that helps build your baby’s bones and teeth.

Fruits

• Eat 2 to 4 servings a day
• Have vitamins and minerals that keep you and your baby healthy.

Weight Gain During Pregnancy

• Gain 28 to 40 pounds if you are underweight.
• Gain 25 to 35 pounds if you are average weight.
• Gain 15 to 25 pounds if you are overweight.
• Gain 12 to 20 pounds if you are very overweight.

Talk with your provider about the best weight gain for your body.

Helpful Hints

• Water is good for you. DRINK 8 OR MORE GLASSES OF FLUID EVERY DAY.
• Avoid foods like cookies, chips, french fries, donuts, and soda. They fill you up but do not give you the vitamins and minerals you need to grow a healthy baby.
• Eat small servings of food every 2 to 3 hours. A small amount is 1 cup of cooked rice, 1 piece of fruit, 1 slice of cheese, or a piece of meat the size of the palm of your hand.
• Get folic acid early in pregnancy from leafy green vegetables, beans, citrus fruits, whole grain breads, and cereals. Folic acid lowers the chance of problems with your baby’s spine.
• Eat food with iron such as red meat, leafy green vegetables, beans, and cereal. Iron helps your blood carry oxygen to you and your baby.

Your feelings about sex may change during pregnancy. You may find sex very exciting. Or you may not enjoy sex as much as before. You or your partner may worry sex will hurt your baby.

It may not be easy for you to talk with your partner about your feelings. Or you may feel like your partner will not understand. Pick a time to talk when you are not making love. Try new positions. Find other ways to please each other.

Here are some facts about sex when you are pregnant:

• Gentle lovemaking will not hurt your baby.
• You can get an infection in your vagina from having sex with a partner who has HIV, hepatitis B & C, herpes, warts (HPV), chlamydia, gonorrhea, or syphilis.
• Infections may cause problems for your baby.
• Infections in your vagina may cause your labor to begin too soon.
• Using a condom will lower your chance of infection.
• Sex with one faithful partner will lower your chance of infection.

Here is a list of medications and remedies that are safe for you to take for minor discomfort in pregnancy.

• Aspirin
  * Your provider may recommend you take a baby aspirin (81mg) every day to prevent high blood pressure in pregnancy starting at 12 weeks. This is safe and good for you. Talk to your nurse, midwife or doctor about whether this is right for you.
• Antihistamines/Allergies
  • Zyrtec, Claritin, Benadryl, Dimetapp
  • Visine eye drops, Naphcon-A eye drops
• Constipation
  • Colace, Fibercon, Citrucel
  • Metamucil, Fiberall
  • Prune juice, dried prunes, apricots
• Coughs/Colds
  • Robitussin (cough)
  • Robitussin DM
  • Mucinex Cough (Guaifensin)
  • Chloraseptic/Cepacol
• Decongestants
  • Sudafed (pseudoephedrine), Robitussin
  • CF, Tavist D, Ocean Mist nasal spray (saline solution), 3-way nasal
    * DO NOT use Alka-Seltzer Cold & Flu
• Diarrhea
  • Imodium (1 dose – if it persists, please notify office)
  • Follow the BRAT diet (bananas, rice, applesauce, and toast)
    * Come in to see provider if you have a fever or you have not improved in 2-3 days.
• Heartburn, Indigestion, Gas
  • Tums, Maalox, Gas-X Mylanta, (safe to take after the first 12 weeks)
  • Tagamet, Zantac Acid, Gavison,
  • Pepcid or Pepcid AC
    * DO NOT use Pepto-Bismol, Rolaids, Kaopectate, Alka-Seltzer
• Hemorrhoids
  • Preparation H (safe throughout pregnancy)
  • Anusol
  • Tucks pads, witch hazel pads
• Insomnia (unable to sleep)
  • Benadryl, Tylenol PM (do not exceed recommended dosage), Unisom
• Nausea
  • Half (½) Unisom together with Vitamin B6, Small frequent meals, ginger ale, Vitamin B6, ginger, ginger tea, Sea Bands (form of acupressure on wrists)
    * Come in to see provider if unable to keep liquids down for more than one day or 24 hours
• Pain Medications
  • Tylenol (acetaminophen) for minor aches and pains, headaches
  • Tylenol Extra Strength – 2 tabs every 4 hours (not to exceed 4000 mg in a 24-hour period)
  • Codeine (by prescription only)
    * DO NOT use Advil, Aleve (unless your provider tells you otherwise)

Alcohol, cigarettes, and street drugs

• Alcohol (beer, wine, and liquor) can hurt your baby’s brain and body.
• Cigarettes can cause your baby to be born too early or too small.
• Secondhand smoke (the smoke from another person smoking) can hurt your baby.
• Street drugs can hurt your baby’s brain and cause labor to begin too early.

Do you need help to stop?
Smoking Cessation Program: 617 414 4847
Substance Use and Pregnancy Helpline: 617 414 4165

Chemicals

• Avoid breathing strong-smelling chemicals in your home or workplace. Chemicals include paint, cleaning fluids, and varnish.

Dirty cat litter

• Cat stool (poop) can have a virus called toxoplasmosis. Getting sick with this virus could harm your baby. Have someone else change the cat litter.

Hot tubs or saunas

• You may become too hot in a hot tub or sauna. This can hurt your baby’s brain and body.

Caffeine

• More than 2 drinks with caffeine a day may affect your pregnancy. Some drinks with caffeine are coffee, tea, and certain sodas.

Fish with mercury

• Fish is very good for you and you should eat it during pregnancy. Mercury is a poisonous metal found in some fish. These fish include shark, swordfish, and king mackerel. Avoid eating a lot of fish with mercury.

Foods with germs that could harm your baby

• Raw or under-cooked raw meat, fish, shellfish, and eggs. Unpasteurized cheese, milk, or juice.

Traveling while pregnant

• Most women can travel up to the last month of pregnancy. Wear your seat belt. Take breaks when driving. Get up and walk around every hour when flying. Drink plenty of water. Take a copy of your prenatal records with you.

Depression while you are pregnant

Some women feel sad or depressed when they are pregnant. Maybe you felt this way before you were pregnant. Maybe this is the first time you have felt this way. You may wonder why you feel sad when others tell you that you should feel happy to be pregnant. Pregnancy is a time of change, and change can be stressful. Too much stress can make you feel depressed, worried, or unsure.

Some signs of depression include:

• Feeling sad
• Sleeping all day or having trouble sleeping
• Changes in eating (eating too much or too little)
• Feeling anxious or worried
• Feeling grumpy or irritable

It is not your fault that you are depressed. With help, you can feel better. Talk to your provider to learn more about treatment.

Problems at Home

In some families, people hurt each other by hitting or using mean or hurtful words. Does this happen in your family? Being pregnant can make the hurting worse. Here are some ways to get help for yourself and your children:

• Talk with your provider
• Call the National Domestic Violence Hotline: 800.799.SAFE (7233)

Flu Vaccine Information

Go Get Your Flu Shot!

The flu is a virus that can cause newborn babies to be hospitalized. It spreads from person to person, usually by coughing or sneezing while in close contact with others. Unfortunately, babies do not start building their own protections against flu until they begin vaccinations at 6 months old. When you get the flu vaccine during pregnancy, you are protected and you pass antibodies to help protect your baby during the pregnancy and for the first few months of life. The flu vaccine is safe for you and your baby during pregnancy.

Learn more here: www.cdc.gov/flu/

Tdap in Pregnancy

Go get your Tdap vaccine!

Whooping cough (pertussis) is a very contagious disease that can be deadly for babies. It spreads from person to person, usually by coughing or sneezing while in close contact with others. Unfortunately, babies do not start building their own protections against whooping cough until they begin vaccinations at 2 months old. Avoid this gap in protection by getting the Tdap vaccine during the third trimester of your pregnancy. By doing so, you pass high levels of antibodies help protect your baby against whooping cough in the first months of life.

Learn more here: www.cdc.gov/pertussis/pregnant/