FREQUENTLY ASKED QUESTIONS
First Trimester
Second Trimester
Third Trimester
Labor and Childbirth
Post Partum
Pregnancy Loss
How Can I Tell if I am Pregnant?
If I am Breastfeeding, Can I Still Become Pregnant?
Can I Still Travel While I am Pregnant?
My Doctor Says My Cervix is Backwards. What Does That Mean?
Can I Still Exercise While I am Pregnant?
How Will My Being Overweight Affect My Pregnancy?
Should I Have An Ultrasound? What Are The Risks?
Should I Have An Amniocentesis? What Are The Risks?
What Medicines Can I Safely Take In Pregnancy For A Cold Or A Fever or Diarrhea?
How Much Weight Should I Gain?
What Is A Maternal Screen Test And Should I Have It?
What Is A Glucose Challenge Test?
My Back Hurts. Why?
Concerns about worsening pain or contractions should be directed to your doctor right away.
I Get Uterine Contractions After I Exercise. Why?
I Feel Bloated All the Time. Why?
I Have Pain in the Calves of my Legs. Why?
My Baby "Balls" Up all the Time. Why?
My Hands and Feet are Swelling. Why?
What is a Birth Plan and Should I Have One?
What are My Different Options for Pain Relief in Labor?
Can I Have My Labor Induced?
Induced labor can take longer than natural labor to deliver a baby, but this is largely dependent on how dilated, soft, and effaced (thinned out) the cervix is at the start of the induction. All aspects of induced labor should be discussed with your doctor if an induction is being considered in your pregnancy.
What is Pitocin?
How Soon will I be Induced if My Pregnancy is Overdue?
I am Having Twins. Can I Still Have a Vaginal Birth?
How Long Will I Have Bleeding After Delivery?
When Can I Resume Sexual Intercourse?
My Doctor Says I Broke My Tailbone. What Can I Do?
How Should I Take Care of My Stitches if I Have a Vaginal Birth?
When Can I Resume Normal Exercises?
How Fast Will I Lose the Weight I Gained?
How Soon Can I Get Pregnant Again Following a Miscarriage?
Can Lifting Something Heavy Cause a Miscarriage?
What is a D&C?
What is a Molar Pregnancy?
I Have Had Three Miscarriages. What Can I Do?
It is estimated that half of all women experience urinary incontinence at some point in their lives. In the past, treatments for incontinence were few - involving medicines with significant side effects and very invasive surgery with a prolonged recovery. However, Dr. Aichholz is now performing in-office bladder testing to evaluate the type of incontinence a patient may have and if needed, using novel new medications as well as outpatient surgery to treat women suffering from urinary incontinence. In-office testing is called urodynamics, and this 20 minute test is performed by a friendly, skilled Registered Nurse with many years of experience working with incontinence patients. After a diagnosis is made, Dr. Aichholz has had great success in treating urinary incontinence with new medicines and, if need, very non-invasive surgery easily done as an outpatient procedure with minimal pain afterwards.
Bladder health and evaluation begins with a series of questions such as:
These 10 questions help identify bladder problems. Please be assured that female urinary incontinence is a treatable condition when cared for by a caring and understanding health care team.
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Usual symptoms and signs are a missed menstrual period with nausea, breast tenderness, and extreme fatigue. Any bleeding after a missed period and a positive pregnancy test should be reported to the doctor's office immediately.
Yes, breastfeeding is not effective protection to prevent pregnancy. The reproductive cycle can ovulate while nursing. Barrier methods, Depo Provera, progesterone only birth control pills, or an IUD (Intrauterine Device) can all be used while breastfeeding to prevent pregnancy.
Yes, travel for the first half of pregnancy is fine. In the second half of pregnancy, your doctor may have restrictions on travel if risk factors are identified such as preterm labor, poor growth of the baby or maternal high blood pressure.
It is normal in 25% of women to have a "tilted" or "backwards" uterus and cervix. This does not indicate any problem for carrying a pregnancy or vaginal birth of the baby.
Yes. Exercise is encouraged in pregnancy and should be discussed with your doctor in prenatal visits. In short, try to maintain a program you are comfortable with, limit lifting of weight to 20 pounds and rest if you feel out of breath.
Being overweight early in pregnancy should be discussed with the doctor at the first prenatal visit. Diet modification under the supervision of an OB/GYN and dietician can result in a healthy pregnancy and an acceptable weight gain.
Ultrasound has not been shown to harm mothers or fetuses. This tool has been used for over 20 years in obstetrics and has dramatically changed OB/GYN. A normal, uncomplicated pregnancy will have an ultrasound exam done at about 20 weeks (5 months) of pregnancy.
Amniocentesis is a test that involves an obstetrician placing a needle into the abdomen through the wall of the pregnant uterus to remove a small amount of amniotic fluid surround the fetus. Women age 35 or older should consider having an amniocentesis to evaluate chromosomes of their baby at 16 weeks in the pregnancy. Risks of doing this procedure include bleeding, infection, rupture of membranes and failure to grow cells from the amniotic fluid obtained.
Tylenol (regular or extra-strength) can be taken every six hours for fever in addition to increased fluids by mouth. For nasal congestion and sinus problems, regular Sudafed may be used every six hours. An alternative to Sudafed is Chlortrimeton every twelve hours. In addition, Robitussin cough medicine is fine to use for coughing. Prescription medicines such as Clariton, Zyrtec, and Benadryl are also safe to use in pregnancy. For diarrhea, Kaopectate liquid or Immodium AD liquid are safe and effective to use.
Appropriate weight gain for a pregnancy should be discussed at the first prenatal visit. On average, 30 to 35 pounds total weight gain is good for most pregnancies. This can be broken down into 2 parts: 10 pounds in the first 20 weeks of pregnancy and 20 to 25 pounds in the second 20 weeks of pregnancy.
Maternal Serum Screen 5 (Penta Screen) is the second trimester prenatal risk assessment for neural tube defects, Down's Syndrome, and Trisomy 18. The detection rate for this test done on maternal blood drawn in the office is 83% with a 5% false-positive rate. The best time for this test to be done is between 16 and 20 weeks of pregnancy.
A GCT or Glucose Challenge Test is a blood test drawn at 28 weeks (7 months) of pregnancy to screen for gestational diabetes. All pregnant patients should be screened in the late second trimester and a positive screening test must then be followed by a Glucose Tolerance Test or GTT. A GTT is the diagnostic test for gestational diabetes and a positive test means gestational diabetes is present. After diagnosis, a special diet and exercise will be recommended.
Steady, constant lower back discomfort is very common in the third trimester of pregnancy. The enlarged uterus and extra weight of the pregnancy puts stress on the lower back and spine in addition to posture changes which can result in lower back pain.
Mild, irregular contractions that go away when exercise is over are not a problem. Contractions are thought to occur with states of dehydration, so it is a good idea to drink fluids while exercising. Continued, strong contractions that don't go away after exercise and drinking fluids should be reported to the doctor as soon as possible.
Feeling bloated in pregnancy is common and associated with high progesterone hormone levels in pregnancy. Also, GI motility is slowed, resulting in the inability to eat normal sized meals. Constipation commonly develops in pregnancy relating to reduced GI motility and iron in prenatal vitamins.
Calf pain is common in pregnancy and is thought to be related to the high estrogen levels of pregnancy. Massage, heat, and elevation of the lower legs may help with episodes of muscle cramping in the calves.
The baby "balling up" is probably a uterine contraction. Real uterine contractions last 30 to 60 seconds long and feel like uterine tightening or the baby "balling up." Real contractions may not hurt but will be associated with a pressure feeling with the contraction. One or two contractions over the course of a day would not be a concern, but regular contractions of 4 or more in an hour in a preterm pregnancy should be reported to your doctor immediately.
Increased swelling in the hands, feet and ankles is common in normal pregnancy. Some patients will develop "carpal tunnel" symptoms in the hands and wrists associated with increased third trimester fluid. The doctor may want to schedule more frequent office visits if blood pressure becomes elevated with increased swelling.
Some couples put together a list of wishes and preferences for labor as well as the birth of their baby. This birth plan can include anything that is medically reasonable and safe. Birth plans should be discussed with your doctor to make sure specifics about a birth plan are compatible with good medical care and provide for a safe birth.
Pain control for labor and the birth include several options. Early in labor, pain shots can be given either through the IV or under the skin. These medicines are narcotics for pain relief and will cross the placenta to the baby. This is acceptable as long as these medicines have adequate time to wear off before delivery as they can cause the baby to be depressed and not cry at delivery. Another option for pain relief is the epidural. Epidural anesthesia involves placement of numbing medicine in the epidural space outside the spine. This is done by the anesthesia department and is available 24 hours a day on Labor and Delivery. The epidural gives the advantage of no medicine crossing the placenta to the baby and labor is pain free. Also, the sensation of the urge to push can still be felt with epidural anesthesia.
Induction of labor is a common practice in modern obstetrics. The medicines available to induce labor are very effective and result in vaginal births in a high percentage of cases. Reasons to induce labor are many, such as being overdue, having an unusually large or small baby at term, high blood pressure in the mother, history of very fast labors, or living a great distance from the hospital and having concerns about making the trip in time to deliver safely.
Pitocin is the synthetic equivalent of the natural hormone oxytocin, which is made by the brain to produce contractions of the uterus. Pitocin is commonly used in modern day obstetrics to help make contractions stronger in natural labor, or to start uterine contractions for the induction of labor. Pitocin is administered through an IV and is very gradually titrated up by nurses so that contractions will become stronger. Also, great care is taken to make sure the baby is tolerating these stronger contractions in labor.
It is recommended that all pregnancies be delivered by 42 weeks gestation, or 14 days past the due date. Induction of labor can be done 10 to 12 days past the due date if fetal testing looks good on the baby while waiting for labor or for the cervix to dilate.
Yes. As a rule, if the first twin is head first for delivery, the position of the second twin can be manipulated either to a head first delivery or for a total breech extraction of the second twin. This method of delivery is less traumatic for the mother than a Cesarean Section delivery and allows for a much easier recovery. Twins delivered vaginally do just as well as those delivered by C-Section. However, if the first twin is not in a head first position, i.e. breech or transverse lie, then a Cesarean delivery is recommended.
It is normal to have small amounts of dark red or brownish bleeding for up to six weeks after delivery. However, bleeding should taper off dramatically the first 2 weeks after a vaginal birth and be gone 2 weeks after a Cesarean Section delivery. Increased levels of activity may increase bleeding in the first month after delivery.
Sexual intercourse should normally be delayed until after the six week check-up following the delivery.
Complete or partial fracture of the tailbone occurs in a very low number of patients delivering vaginally with their first baby. Sitting is usually the greatest problem and requires use of cushions, a heating pad, and pain medicine for up to 8 weeks after the birth. The bone heals by itself and should not be a problem in future births.
If stitches are placed after a vaginal birth, they should be kept clean using sitz baths (soaks) in the bathtub three times a day. The warm water helps the tissue heal faster and reduces swelling. Ice packs are helpful while at the hospital just after the birth but should not be continued at home. Epifoam can be placed on stitches for discomfort. Also, Tucks can be kept cold in the freezer and placed onto painful stitches as often as needed.
Strenuous physical exercise can be resumed 6 to 8 weeks after delivery. This allows for any bleeding after delivery to have resolved and stitches from either a vaginal birth or a Cesarean section to completely heal.
Weight loss after delivery takes from 3 to 12 months depending on diet, exercise, body type, amount of weight gained in pregnancy and lifestyle. Reasonable goals should be set with help from the doctor.
The emotional loss after miscarriage probably takes longer to resolve than the physical or medical issues. After a first trimester miscarriage with or without surgery to treat it (D & C), the body should resume a normal reproductive cycle in 6 to 8 weeks. If a normal menstrual period occurs 6 to 8 weeks after miscarrying, couples may begin trying to conceive again. Prenatal vitamins with folic acid should be continued as well. Sometimes couples need longer amounts of time to allow for emotional healing after loss of a pregnancy.
A normal, healthy pregnancy should not result in miscarriage after lifting something heavy in the first trimester. Attempts should be made to not lift anything heavier than 20 pounds while pregnant, but this mostly applies to the second and third trimester to avoid injury to the lower back.
D&C stands for "Dilation and Curettage", where the cervical canal is dilated with instruments and then the pregnancy tissue is removed from the uterus either with suction or instruments. This outpatient procedure is used to treat miscarriages or retained pregnancy tissue in the uterus after a birth.
Molar pregnancy is a rare condition where the uterus is filled with grape-like sacs instead of a fetus and placenta. The condition requires ultrasound for diagnosis and a D&C for treatment.
Three losses requires a work-up for answers as to why the miscarriages occur. Tests include blood work, HSG dye test, genetic analysis of pregnancy tissue if available and checking chromosomal tests.