Chicken pox:
If you had chicken pox, there is not increased risk if exposed during pregnancy. If you have not had the chicken pox and are exposed, please call the office.

Circumcision:
Existing evidence demonstrates potential medical benefits for newborn male circumcision. However, these dates are not sufficient to recommend routine circumcision. Most common complications from circumcision include local infections and bleeding. Local anesthesia is given. For care after the procedure, the penis is cleaned with warm water and petroleum jelly is placed over the surgical sit. The petroleum jelly keeps the penis from sticking to the diaper. This will be necessary for 4-7 days after the procedure.

Dentist:
Regular dental cleanings are recommended. Contact your healthcare provider if you need other dental procedures. You can have Novocain with no epinephrine if you are not allergic to Novocain. X-rays are permissible if necessary as long as a lead shield is used over your abdomen.

Diet:
Pregnant women should follow a well-balanced diet. You should not consume more than 12 ounces of fish or shellfish that are low in mercury such as shrimp, canned tuna, salmon, Pollock and catfish. Pregnant women should not consume albacore tuna as it is high in mercury. Pregnant women should eat canned light tuna. Pregnant women should also avoid shark, swordfish, king mackerel and tile-fish. You should not consume under cooked meats or seafood. Avoid eating deli meats and hotdogs unless it is heated until steaming. Avoid eating soft cheeses such as feta, Brie, Camembert, blue-veined cheeses and Mexican style cheeses such as queso fresco, queso blanco and panela.

Exercise:
Most physical sports and activities can be enjoyed throughout pregnancy if done in moderation. Walking, stationary biking, swimming, yoga, and water aerobics are good examples of safe activities. Try to limit your maximum heart rate to about 140 beats per minute. Hydrate yourself well before, during, and after exercise. Avoid exercise with the risk of falling or abdominal trauma such as horseback riding, skiing, ice skating, scuba diving, gymnastics and contact sports.

You should stop exercise and call your health care provider if you experience any of the following signs:

• Dizziness or fainting
• Increased shortness of breath
• Irregular or rapid heartbeat
• Chest pain
• Trouble walking
• Swelling or pain in the calf
• Vaginal bleeding
• Headache
• Uterine contractions that are not relieved with rest
• Decreased fetal movement
• Leakage of fluid from your vagina

Fetal Movement:
You can begin to feel your baby move between 16 and 20 weeks. First time moms may not feel their baby move until 20 weeks. If you have had a baby before, you may feel this closer to 16 weeks. We recommend pregnant women begin fetal kick counts at 28 weeks. Record how long it takes your baby to move 10 times. If it takes less than 2 hours, this is reassuring and you can stop counting for that day. Repeat daily. If you do not feel 10 movements in 2 hours, wait a few hours and repeat again. If you do not note 10 movements in 2 hours, call your healthcare provider.

Hair Products:
It is believed that permanents and hair dye are safe during pregnancy.

Hot Tubs:
Avoid hot tubs and saunas or baths greater than 90 degrees.

Parvovirus (Fifth’s Disease):
If you have been exposed to parvovirus B19, you should call the office. You will need testing to see if you are immune.

Rh negative:
During your first prenatal visit, labs are drawn and your blood type and Rh factor will be determined. Each person’s blood type will either be A, B, O, or AB. Rh refers to the type of protein on the surface of red blood cells. You are either Rh-positive or Rh-negative. If you are Rh-negative, you will need RhoGam at 28 weeks. For more information, visit americanpregnancy.org

Signs of Labor:

• Contractions every 4-5 minutes that are painful for at least 1-2 hours.
• Bloody Show”-spotting or bloody mucus, especially after vaginal exam. Call your physician if you have bleeding that is heavy like a menstrual period.
• ldquo;Water Breaks”-you may have a gush of fluid and will continue leaking fluid without control.
• “Losing your mucus plug”-is when you have a stringy, mucusy discharge that may be tinged with blood. THIS IS NOT AN INDICATION OF LABOR.

Travel:
If you travel longer than 1 hour, stop at least every 2 hours to empty your bladder and walk to improve circulation and decrease the risk of blood clots. Make sure to wear your seatbelt below your belly at all time. Most airlines allow travel until about 32-36 weeks of pregnancy. Stay well hydrated while flying and walk in the aisle every 1-2 hours to improve circulation. If you plan to travel outside the U.S., please discuss with your healthcare provider.

Weight Gain:
Normal weight gain during pregnancy is 25-35 pounds for someone of normal weight (BMI 18.5-24.9). For underweight women (BMI <18.5), recommended weight gain is 28-40 pounds. For overweight women (BMI 25-29.9), recommended weight gain is 15-25 pounds. Obese individuals (BMI >30) should gain 11-20 pounds.