Stephen J. Schueler, M.D.

Pregnancy Home Care

General home care for pregnancy includes:

Home care for common conditions during pregnancy includes:

Pregnancy Postpartum

Home care after delivery includes:

  • Avoid sitting for prolonged periods of time. Try using an inflatable donut pad for support.
  • Avoid touching the area of the episiotomy as much as possible. Remember to pat the area dry after bathing. Avoid wiping back to front: this can spread bacteria to the healing episiotomy site and introduce infection.
  • Avoid sexual intercourse for at least 4 weeks after delivery.
    • Breast-feeding full time can be an effective method of birth control for up to 6 months after giving birth. If you stop breast-feeding, you may wish to discuss birth control options with your doctor.
    • Your menstrual periods may not resume for several months after delivery, especially during breast-feeding.
  • Change your sanitary pad at least once every 4 to 6 hours. This can reduce the risk of infection.
  • If pain is severe, try using ice packs to the area. Sleeping on your side with an ice pack between your legs may be more comfortable.
  • Try warm baths for 20 minutes at a time several times a day. Let the vaginal area dry well before covering.
  • Use pads, not tampons, for vaginal discharge. Take showers or tub baths in a clean tub.
  • Your doctor may suggest a squirt bottle that will allow you to squirt warm water over the vaginal area to clean yourself off after urinating.
    • Sometimes using the squirt bottle during urination can help to reduce pain associated with urination.
  • Learn proper breast feeding techniques.
  • If you have no problems, your doctor will want to see you for a checkup 2 to 6 weeks after delivery.

What else can you expect?
  • No periods:
    • It is normal not to have menstrual periods for 1-2 months after childbirth. If you are breastfeeding, menstrual periods may be delayed longer. Use birth control methods as directed by your doctor, since it may be difficult to determine when you first become fertile after a pregnancy.
  • Breast engorgement:
    • This peaks several days after delivery. Breastfeeding is the best treatment for this condition. Medications can be given to decrease milk production in mothers who are not breastfeeding.
  • Difficulty urinating and constipation:
    • Usually resolves within a week after delivery.
    • Stool softeners can help, particularly if you had an episiotomy or suffered a vaginal tear.
    • For hemorrhoids, take stool softeners and apply topical hemorrhoid medications
  • Increased frequency of urination:
    • After pregnancy, your body will naturally rid itself of excess fluid: you may urinate more than usual.
  • Mild contractions:
    • Some women may experience mild pelvic pain for several days. These are caused by contractions of the uterus as it returns to normal size. The pain may be more severe in women who nurse their babies. This is because nursing stimulates the release of a hormone that causes the uterus to shrink.
  • Vaginal bleeding and discharge:
    • Vaginal bleeding is normal for about 6 to 7 days following delivery. You may also pass occasional blood clots. This will eventually turn pink, and then yellow after several days. Vaginal discharge may last for 1 to 2 months following delivery.
  • Vaginal pain and numbness:
    • This will eventually go away by itself.
    • Prolonged sitting or walking may be more painful.
    • A significant amount of the pain may be due to the episiotomy. This pain usually lasts for less than a week, but in some cases may persist for several weeks.

Pregnancy Breastfeeding Diet

The best diet during breastfeeding is similar to that during pregnancy, with some modifications. When there is a family history of eczema and other allergies, you may reduce the risk of allergies while breastfeeding by avoiding eggs, chocolate, licorice, peanuts, seafood and dairy products. Many medications, supplements, foods, and alcohol can pass into the breast milk and cause feeding problems in infants.

Food GroupServings Per Day
Dairy4 cups milk or equivalent
Meat2 servings (3-4 oz. each, 2% milk)
Grains4-5 slices or servings
Fruits/Vegetables4-5 servings

Good Snacks
  • Applesauce
  • Celery stuffed with peanut butter
  • Cubes of ham or cheese
  • Graham crackers and peanut butter
  • Granola bars
  • Hard cooked eggs
  • Low fat yogurt or cottage cheese
  • Raw fruits or vegetables
  • Small meat or cheese sandwiches

Other Dietary Considerations
  • Adjust total daily protein intake to 1.3 grams per kilogram of body weight. Two thirds of total protein intake should be of high biological quality, such as that found in eggs, milk, meat, or soy protein.
  • During pregnancy, maintain your calcium intake to 1,200-1,500 mg of calcium per day. Eat foods rich in calcium such as low-fat dairy products, broccoli, kale, and spinach greens, almonds, and soy milk.
  • Supplement your diet with 30-60 mg of elemental iron per day during pregnancy. Most ferrous sulfate pills with 325 mg of iron contain about 60-65 mg of elemental iron per pill.
  • Supplement your diet with 400-800 micrograms of folic acid per day.

Calcium Containing Food Sources
FoodServing SizeCalcium Per Serving
Sardines in oil3 oz370 mg
Milk1 cup290-300 mg
Swiss cheese1 oz (slice)250-270 mg
Yogurt1 cup240-400 mg
Canned salmon3 oz170-210 mg
American cheese1 oz (slice165-200 mg
Broccoli1 cup160-180 mg
Soybean curd (tofu)4 oz145-155 mg
Turnip greens1/2 cup, cooked100-125 mg
Ice cream1/2 cup90-100 mg
Kale1/2 cup, cooked90-100 mg
Cottage cheese1/2 cup80-100 mg
Corn bread2.5 inch square80-90 mg
Parmesan cheese1 Tbsp70 mg
Egg1 medium55 mg
Powdered milk1 tsp50 mg

Pregnancy Breastfeeding Drugs

Not all drugs are safe to use while breastfeeding. This is because some drugs will be concentrated in the breast milk and then passed to the infant. The chemical properties of the drug determine which medications will pass into the breast milk. Drugs that suppress lactation should be avoided. These include: bromocriptine, levodopa, trazodone, estradiol, and large-dose oral contraceptives.

It is important to review your medications with your doctor if you are breastfeeding. Make sure your doctor is aware that you are breastfeeding before you start new medications.

Dangerous medications include:

Unsafe medications may also include:

Drugs generally considered safe during breastfeeding include:

Pregnancy Vaginal Bleeding

Vaginal bleeding is normal after vaginal delivery, as well as after a C-section. Bleeding mainly occurs from blood vessels supplying the placenta. Many women are given a hormone (oxytocin or Pitocin) after passing the placenta, in order to help stop bleeding.

After delivery, vaginal bleeding is normal for about 1 week. Sometimes a few blood clots will pass during this time. Mild contractions of the uterus, which expel blood from the uterus, are common for several days after delivery. A pink or yellow vaginal discharge may continue for a month or two after a delivery.

Bleeding should be mild 4 to 5 days after delivery. Worsening bleeding after this time requires an evaluation. Passing large or painful blood clots after the first few days is also abnormal. Soaking more than 5 sanitary pads in 5 hours is also considered abnormal.

Bleeding may also occur with infection. Worsening abdominal pain, fever, and foul discharge are symptoms of infection.

Home care for postpartum vaginal bleeding includes:

  • Follow the post-partum instructions supplied by your doctor.
  • Drink plenty of fluids.
  • Change sanitary pads as needed.
  • Watch for signs of excessive bleeding.
  • Use pain medication as directed by your doctor.

Pregnancy Prenatal Diet

For optimal health of a mother and newborn, the mother should eat a healthy diet before, during, and after pregnancy. A healthy diet can increase your milk production and provide valuable nutrients for your baby.

During pregnancy, vitamins, minerals, and nutrients are transferred to the fetus through the mother's blood. These nutrients are essential for normal development of the baby's bones, tissues, and organs.

Maintaining a well balanced diet during pregnancy and breast-feeding will ensure that nutrients are readily available for normal growth and development of the baby.

Pregnancy Prenatal Medication Use

The use of any medication in pregnancy requires a consideration of the benefits versus the risks of the specific drug. No drug should be given unless it is clearly needed and the potential benefits outweigh potential risks. Do not take herbs or health supplements without the recommendation of an obstetrician. Many of these herbs can stimulate the uterus and can be harmful to the baby. Others may contain toxic or unknown ingredients.

Common drugs that are generally considered unsafe for use in pregnancy:

Consult your physician prior to using any of the following in pregnancy:

Pregnancy Prenatal Prevention Tips

In order to prevent harm to the fetus, consider:

Rubella Screening
This is a blood test that measures your immunity to German measles. Young women in the US have rubella antibodies in their bloodstream, if they received the MMR vaccine as a child. If you have had German measles in the past, then you are probably immune to another rubella infection. The rubella blood test determines if you are immune to this infection. German measles during pregnancy is associated with birth defects.

Weight control
A normal weight reduces health risks for you and your baby.

Stop smoking
Women who smoke during pregnancy tend to have babies that are underweight. If you smoke, quit before you become pregnant.

Avoid alcohol
Alcohol use during pregnancy can increase risk for birth defects and other complications.

Don't abuse drugs
Drug abuse can cause birth defects and increases your risk for miscarriage.

Family life
Make sure you have a strong relationship with your spouse. Having a baby rarely saves a troubled marriage and can increase your responsibilities at a time when you may not be ready. Get help for depression before you become pregnant.

Educate yourself
Read books and articles about pregnancy, labor, infant care, and child rearing. Take childbirth classes with your partner or spouse. Get prepared before problems develop.

Get tested for HIV
Although still not part of routine screening, the American College of Obstetricians and Gynecologists recommend HIV testing before pregnancy. The advantage of knowing your HIV status allows your doctor to reduce the risk of HIV infection in your baby. An antiviral drug therapy during pregnancy and labor may reduce your risk of passing HIV to your baby.

Get regular prenatal care
You should make an appointment for your first prenatal doctor's visit before you are 10 weeks pregnant.

Folic acid
Take prenatal vitamins with iron. It is important you get an adequate amount of folic acid. The American Academy of Pediatrics recommends that pregnant women take a vitamin that contains folic acid, in order to decrease the risk of birth defects, such as spina bifida. If you are pregnant, you should take 400 to 800 micrograms of folic acid per day.

Your prenatal vitamin may contain iron. If it does not, you should eat foods that are rich in iron. Dietary sources of iron may be found in lean red meats, liver, green leafy vegetables, and fortified cereals. Iron helps prevent anemia.

During pregnancy you should take 1,200 - 1,500 mg of calcium per day. Eat foods rich in calcium, such as low-fat dairy products, broccoli, kale, spinach greens, almonds, and soy milk. Calcium supplements (Tums) are available without a prescription.

Reduce caffeine intake
Reduce your caffeine intake. Caffeine can cause increased breast tenderness, may increase risk for miscarriage, and may cause your baby to be underweight.

Avoid toxic exposures
Avoid chemical vapors, paint fumes, and poisons, all of which can be toxic to you and your baby.

Avoid cat droppings
Ask someone else to empty the litter box. Cat feces may contain bacteria, called toxoplasmosis. An infection caused by this bacteria may lead to birth defects, and increases your risk for miscarriage. Wash your hands thoroughly after handling a cat.

Avoid certain foods
Eating raw meat or poorly cooked meat (or poultry) also increases the risk for toxoplasmosis infection. Other foods to avoid include raw seafood (oysters or sushi), meat pate, unpasteurized milk and soft cheeses, such as Brie or Camembert. These foods can contain bacteria that can harm the fetus.

Personal safety
Be conscious of your own personal safety. Wear your seatbelt (place it below your belly) and avoid activities that involve physical contact. Avoid hot tubs, saunas and steam rooms. These can raise your body temperature too high. Keep bath water below 100 degrees Fahrenheit.

Make a birth plan
Discuss all decisions with your doctor early, so you have a plan for how you want to deliver your baby.

Discuss an exercise strategy with your doctor: exercise should not be strenuous. Walking is a wonderful way to get exercise while you are pregnant. Try to perform exercise at least 3 times per week. Remember to perform stretching exercises after activity. Drink plenty of fluids during exercise, in order to avoid dehydration.

Go over your medications with your doctor, so that you are sure that they are safe during pregnancy.

Healthy Diet
During pregnancy, vitamins, minerals, and nutrients are transferred to the fetus through the mother's blood. These nutrients are essential for normal development of the baby's bones, tissues, and organs. Maintaining a well balanced diet during pregnancy and breast-feeding will ensure that nutrients are readily available for normal growth and development of the baby.

Pregnancy Prenatal Vitamins

Facts about prenatal vitamins:

  • The B-vitamins are important for metabolism and red blood cell production.
  • Folic acid is a very important B-complex vitamin in pregnancy.
  • Folic acid deficiency and vitamin B-12 deficiency result in a condition known as pernicious anemia.
  • Pregnant women and infants have an increased need for these vitamins.
  • Vitamin deficiencies during pregnancy can increase the risk for birth defects.
  • All pregnant women should take a folic acid supplement, in order to decrease the risk of birth defects, such as spina bifida.

Pregnancy Warning Signs

Notify your doctor for:

Continue to Pregnancy Complications

Last Updated: Sep 28, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

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