A nurse will call to review your obstetrical, medical and surgical history. She will guide you on what to expect during prenatal care and answer any questions. You may start feeling nauseous. Keep well hydrated, eat small light meals every 2-3 hours, and call your doctor if you are unable to keep any liquids down for more than 24 hours. You may also notice increased breast tenderness and slight pelvic cramps as your pregnancy starts.  

Before pregnancy or as soon as possible, take 400 mcg of folic acid daily to help prevent spina bifida (A Neural tube defect in which the baby's brain or spine may not be formed correctly). You can get this amount in a women's one-a-day multivitamin or any prenatal vitamin. 

Eat a well-balanced diet low in fatty foods. Once pregnant, avoid uncooked foods, such as sushi, raw meats and unpasteurized dairy. You can continue normal activities but should avoid anything that could cause abdominal trauma. 

Your provider will give you a list of safe over-the-counter medications, including acetaminophen, Pepcid, vitamin D, Unisom, and vitamin B6. 

Most providers offer noninvasive prenatal testing after 10 weeks. It detects fetal cells that have shed from the placenta and screens for genetic conditions such as Down syndrome (trisomy 21), trisomy 18, and trisomy 13. It can also determine the baby’s sex. This cannot screen for all chromosomal or genetic conditions. 

Most travel is safe during pregnancy, but depending on your medical history, your provider will discuss any limitations. 

Yes, unless your provider advises against it due to bleeding complications or placenta concerns. 

Most patients will have a SonoSite (a bedside handheld ultrasound) to confirm pregnancy in the first trimester. If you are unsure of your dates or have a history of miscarriage or bleeding, your provider will determine when you need a formal ultrasound, usually between six and eight weeks from your last menstrual period. 

Most first-time mothers feel movement around 19 to 22 weeks. Those with prior pregnancies may notice movement earlier, usually by 18 weeks. 

The fetal anatomy scan, or fetal survey, is a transabdominal ultrasound that checks the baby’s head, heart, abdomen, arms, legs, amniotic fluid, placenta position, and maternal ovaries. 

Continue your usual workouts if you tolerate them, stay hydrated, and keep your heart rate under 150 bpm for extended periods. Optimal weight gain is 10 pounds in the first 20 weeks, then one pound per week for the next 20 weeks. Underweight patients may need to gain up to 40 pounds, while overweight patients should aim to stay under 20 pounds.

Bleeding is always a concern—contact your provider if it happens. If you experience persistent clear fluid leaking from the vagina, your provider should check for infection or amniotic fluid leakage. 

All patients are screened for gestational diabetes between 24 and 28 weeks with a 50 gm Glucola test. Those with a history of gastric bypass, gestational diabetes or PCOS may be tested earlier. Gestational diabetes occurs when placental hormones interfere with maternal insulin release. 

Prenatal education classes help prepare for labor and birth preferences. Classes at Southern NH Medical Center are available which include a labor and delivery tour, and a virtual tour is also available online. Pampers.com also offers free birth and newborn care classes. 

Most vaccines are safe during pregnancy and are strongly recommended. Tdap is offered between 32 and 37 weeks. Flu and COVID vaccines are available from September to March. The RSV vaccine is offered between 32 and 36 weeks from September to Jan. 31. 

Use the 5-1-1 rule: If you have contractions every five minutes, lasting one minute each, for at least one hour, call your provider to determine when to go to the hospital. 

After prenatal classes, start creating a birth plan. Discuss it with your provider in the last month of pregnancy. 

Preterm labor signs can be subtle but typically involve persistent, regular contractions. Contact your provider if contractions occur more than six times per hour for over two hours. Increased vaginal leaking or bleeding before 36 weeks also requires immediate attention. 

If you had a previous C-section, your provider will discuss whether to schedule another or attempt a vaginal birth. Repeat C-sections are typically scheduled after 39 weeks. First-time C-sections are scheduled based on medical necessity and baby readiness. 

The postpartum period, or fourth trimester, can be challenging as you care for your newborn while recovering. You will feed your baby every two to three hours, leading to sleep deprivation. Hormonal changes may cause emotional shifts. Expect light to moderate bleeding. Vaginal birth may cause perineal soreness, which can be relieved with ibuprofen or Tylenol. Breast engorgement can be painful; Lansinoh ointment may help, and cold cabbage leaves can relieve swelling if not breastfeeding. 

Call your provider if you experience heavy bleeding (soaking a pad every hour for more than two hours), increased abdominal pain, fever, chills, a persistent headache unrelieved by Tylenol or drainage from a surgical incision.