Answers to Your Questions






How soon after a missed period can I take a home pregnancy test and get accurate results?
Many home pregnancy tests (HPTs) claim to be 99% accurate on the day you miss your period. But research suggests that most HPTs do not consistently spot pregnancy that early. And when they do, the results are often so faint they are misunderstood. If you can wait one week after your missed period, most home pregnancy tests will give you an accurate answer. Ask your doctor for a more sensitive test if you need to know earlier.

When a home pregnancy test will give an accurate result depends on many things. These include:

  • How long it takes for the fertilized egg to implant in the uterus after ovulation - Pregnancy tests look for the hormone human chorionic gonadotropin (hCG) that is only produced once the fertilized egg has implanted in the uterine wall. In most cases, this happens about 6 days after conception. But studies show that in up to 10 percent of women, the embryo doesn't implant until much later, after the first day of the missed period. So, home pregnancy tests will be accurate as soon as one day after a missed period for some women but not for others.
  • How you use them - Be sure to follow the directions and check the expiration date.
  • When you use them - The amount of hCG in a pregnant woman's urine increases with time. So, the earlier after a missed period you take a HPT, the harder it is to detect the hCG. If you wait one week after a missed period to test, you are more apt to have an accurate result. Also, testing your urine first thing in the morning may improve the accuracy
  • Accuracy of Results - The amount of hCG in the urine at different points in early pregnancy is different for every woman. So, some women will have accurate results on the day of the missed period while others will need to wait longer.
  • The brand of test - Some home pregnancy tests are more sensitive than others. So, some tests are better than others at detecting hCG early on.
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What can I do to make sure my baby is healthy?
Some things you can do to take care of yourself and the precious life growing inside you include:

  • Take a multivitamin or prenatal vitamin with 400 micrograms (mcg) of folic acid every day.
  • Get early and regular prenatal care. Whether this is your first pregnancy or third, health care is extremely important. Your provider will check to make sure you and the baby are healthy at each visit. If there are any problems, early action will help you and the baby.
  • Eat a healthy diet that includes fruits, vegetables, grains, and calcium-rich foods. Choose foods low in saturated fat.
  • Unless your provider tells you not to, try to be active for 30 minutes, most days of the week. If you don't have much time, get your exercise in 10-minute segments, three times a day.
  • If you smoke, drink alcohol, or use drugs, STOP! These can cause long-term harm to your baby. Ask your provider for help.
  • Ask your provider before taking any medicine. Some are not safe during pregnancy. Remember that even over-the-counter medicines and herbal products may cause side effects or other problems. So ask your provider before taking these products too. For more information, click here.
  • Avoid hot tubs, saunas, and x-rays.
  • If you have a cat, ask your provider about toxoplasmosis. This infection is caused by a parasite sometimes found in cat feces. When left untreated toxoplasmosis can cause birth defects. Your provider may suggest avoiding cat litter and working in garden areas used by cats.
  • Don't eat uncooked or undercooked meats or fish.
  • Stay away from chemicals like insecticides, solvents (like some cleaners or paint thinners), lead, and mercury. Not all products have pregnancy warnings on their labels. If you're unsure if a product is safe, ask your provider before using it.
  • Avoid or control caffeine in your diet. Pregnant women should have no more than two servings of caffeine per day. Remember that teas, sodas, and chocolate may contain caffeine.
  • Stay active. Most women continue working through pregnancy. Few jobs are unsafe for pregnant women. But if you're worried about the safety of your job, talk with your provider.
  • Get informed. Read books, watch videos, go to a childbirth class, and talk with experienced moms. Ask your provider about childbirth education classes for you and your partner. Classes can help you prepare for the birth of your baby.
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What happens during a prenatal visit?
During the first prenatal visit, you can expect your provider to do the following:

  • Ask about your health history including diseases, operations, or prior pregnancies;
  • Ask about your family's health history;
  • Do a complete physical exam;
  • Do a pelvic exam with a Pap test;
  • Order tests of your blood and urine;
  • Check your blood pressure, urine, height, and weight;
  • Figure out your expected due date;
  • Answer you questions.
At the first visit, you should ask questions and discuss any issues related to your pregnancy. Find out all you can about how to stay healthy.

Later prenatal visits will probably be shorter. Your doctor will check on your health and make sure the baby is growing as expected. Most prenatal visits will include:

  • Checking the baby's heart rate;
  • Checking your blood pressure;
  • Checking your urine for signs of diabetes;
  • Measuring your weight gain.
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What if I am over 35 and pregnant? Should I be concerned for myself or my baby?
Advanced maternal age is defined as an expectant mother who will be 35 at the time of delivery. If you're over 35 and pregnant, you're not alone. Many women well into their 30s and beyond are delivering healthy babies. There's nothing special about age 35. However, it is the age at which certain issues are recognized in pregnancy.

Understand the Risks

Some of the risks associated with a pregnancy after 35 include a multiple pregnancy, a higher risk of pregnancy loss and a higher risk of delivering a baby with chromosomal abnormalities. Women that fit into the advanced maternal age category are also more likely to develop gestational diabetes and high blood pressure. Some of these risks may make it necessary for you to deliver your baby by cesarean section.

Make Healthy Choices

Seeking regular prenatal care during your pregnancy will help your provider monitor your health and your baby's health. Eating a healthy diet is extremely important to your baby's growth and development. We encourage women to take a prenatal vitamin with folic acid daily and to eat lots of protein and other essential nutrients. Staying active can help to improve your overall health and prepare your body for labor and childbirth.

Learn About Prenatal Testing Available

There are several screening and diagnostic tests available to you during pregnancy. Diagnostic tests, such as chorionic villus sampling, genetic amniocentesis and the first trimester screen, are tests that can provide definite results regarding the health of the baby. These tests are accurate and performed at different stages in the pregnancy. Screening tests, such as the maternal serum screening and ultrasounds, are tests that can provide information about whether you are at increased risk for certain conditions during the pregnancy. If you are interested in more information regarding screening or diagnostic testing during your pregnancy, please ask your health care provider at your next visit.

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What medications can I take during pregnancy?
Generally speaking, it is best not to take any medications during pregnancy, especially during the first 13 weeks. However, there is no evidence that the following medications are harmful and they may be used sparingly. Please follow dosage instructions on the label and call your provider if symptoms persist or you have questions.

  • Headaches/Colds: Tylenol and Extra Strength Tylenol
  • Allergies/Colds: Ocean nose spray, Benadryl, Sudafed, Actifed, Claritin
  • Sore Throat/Cough: Plain Robitussin, Cepacol spray and lozenges
  • Heartburn: Maalox, Mylanta, Riopan, Tums, Rolaids, Pepcid, Zantac
  • Constipation: Stool softeners, Metamucil, Fibercon, Citrucel, Colace, Surfak
  • Hemorrhoids: Anusol, Preparation H, Tucks
  • Diarrhea: Fluids, Kaopectate
  • Nausea: Fruit gum, Saltine crackers,
    Vitamin B-6 50mg 3 times per day
  • Yeast Creams: Monistat-7, Gyne-Lotrimin
  • Herbs & Supplements: Please check with your provider prior to use.
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What fish can I eat during pregnancy?
For a free "Fish Facts Print and Go Guide" click here

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What should I do if I suffer from depression before, during or after pregnancy?

What is depression?
Depression can be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. But true clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended time. Depression can be mild, moderate, or severe. The degree of depression, which your doctor can determine, influences how you are treated.

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How common is depression during and after pregnancy?
Depression that occurs during pregnancy or within a year after delivery is called perinatal depression. The exact number of women with depression during this time is unknown. But researchers believe that depression is one of the most common complications during and after pregnancy. Often, the depression is not recognized or treated, because some normal pregnancy changes cause similar symptoms and are happening at the same time. Tiredness, problems sleeping, stronger emotional reactions, and changes in body weight may occur during pregnancy and after pregnancy. But these symptoms may also be signs of depression.

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What causes depression?
There may be a number of reasons why a woman gets depressed. Hormone changes or a stressful life event, such as a death in the family, can cause chemical changes in the brain that lead to depression. Depression is also an illness that runs in some families. Other times, it's not clear what causes depression.

During Pregnancy these factors may increase a woman's chance of depression:

  • History of depression or substance abuse
  • Family history of mental illness
  • Little support from family and friends
  • Anxiety about the fetus
  • Problems with previous pregnancy or birth
  • Marital or financial problems
  • Young age (of mother)
Depression after pregnancy is called postpartum depression or peripartum depression. After pregnancy, hormonal changes in a woman's body may trigger symptoms of depression. During pregnancy, the amount of two female hormones, estrogen and progesterone, in a woman's body increases greatly. In the first 24 hours after childbirth, the amount of these hormones rapidly drops back down to their normal non-pregnant levels. Researchers think the fast change in hormone levels may lead to depression, just as smaller changes in hormones can affect a woman's moods before she gets her menstrual period.

Occasionally, levels of thyroid hormones may also drop after giving birth. The thyroid is a small gland in the neck that helps to regulate your metabolism (how your body uses and stores energy from food). Low thyroid levels can cause symptoms of depression including depressed mood, decreased interest in things, irritability, fatigue, difficulty concentrating, sleep problems, and weight gain. A simple blood test can tell if this condition is causing a woman's depression. If so, thyroid medicine can be prescribed by a doctor.

Other factors that may contribute to postpartum depression include:

  • Feeling tired after delivery, broken sleep patterns, and not enough rest often keeps a new mother from regaining her full strength for weeks.
  • Feeling overwhelmed with a new, or another, baby to take care of and doubting your ability to be a good mother.
  • Feeling stress from changes in work and home routines. Sometimes, women think they have to be "super mom" or perfect, which is not realistic and can add stress.
  • Having feelings of loss - loss of identity of who you are, or were, before having the baby, loss of control, loss of your pre-pregnancy figure, and feeling less attractive.
  • Having less free time and less control over time. Having to stay home indoors for longer periods of time and having less time to spend with the your partner and loved ones.
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What are symptoms of depression?
Any of these symptoms during and after pregnancy that last longer than two weeks are signs of depression:

  • Feeling restless or irritable
  • Feeling sad, hopeless, and overwhelmed
  • Crying a lot
  • Having no energy or motivation
  • Eating too little or too much
  • Sleeping too little or too much
  • Trouble focusing, remembering, or making decisions
  • Feeling worthless and guilty
  • Loss of interest or pleasure in activities
  • Withdrawal from friends and family
  • Having headaches, chest pains, heart palpitations (the heart beating fast and feeling like it is skipping beats), or hyperventilation (fast and shallow breathing)
  • After pregnancy, signs of depression may also include being afraid of hurting the baby or oneself and not having any interest in the baby.
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What is the difference between "baby blues," postpartum depression, and postpartum psychosis?
The baby blues can happen in the days right after childbirth and normally go away within a few days to a week. A new mother can have sudden mood swings, sadness, crying spells, loss of appetite, sleeping problems, and feel irritable, restless, anxious, and lonely. Symptoms are not severe and treatment isn't needed. But there are things you can do to feel better. Nap when the baby does. Ask for help from your spouse, family members, and friends. Join a support group of new moms or talk with other moms.

Postpartum depression can happen anytime within the first year after childbirth. A woman may have a number of symptoms such as sadness, lack of energy, trouble concentrating, anxiety, and feelings of guilt and worthlessness. The difference between postpartum depression and the baby blues is that postpartum depression often affects a woman's well-being and keeps her from functioning well for a longer period of time. Postpartum depression needs to be treated by a doctor. Counseling, support groups, and medicines are things that can help. Postpartum psychosis is rare. It occurs in 1 or 2 out of every 1000 births and usually begins in the first 6 weeks postpartum. Women who have bipolar disorder or another psychiatric problem called schizoaffective disorder have a higher risk for developing postpartum psychosis. Symptoms may include delusions, hallucinations, sleep disturbances, and obsessive thoughts about the baby. A woman may have rapid mood swings, from depression to irritability to euphoria.

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What steps can I take if I have symptoms of depression during pregnancy or after childbirth?
Some women don't tell anyone about their symptoms because they feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. They worry that they will be viewed as unfit parents. Perinatal depression can happen to any woman. It does not mean you are a bad or "not together" mom. You and your baby don't have to suffer. There is help. There are different types of individual and group "talk therapies" that can help a woman with perinatal depression feel better and do better as a mom and as a person. Limited research suggests that many women with perinatal depression improve when treated with anti-depressant medicine. Your doctor can help you learn more about these options and decide which approach is best for you and your baby. The next section contains more detailed information about available treatments.

Speak to your provider if you are having symptoms of depression while you are pregnant or after you deliver your baby. Your doctor or nurse practitioner can give you a questionnaire to test for depression and can also refer you to a mental health professional who specializes in treating depression.

Here are some other helpful tips:

  • Try to get as much rest as you can. Try to nap when the baby naps.
  • Stop putting pressure on yourself to do everything. Do as much as you can and leave the rest!
  • Ask for help with household chores and nighttime feedings. Ask your husband or partner to bring the baby to you so you can breast feed. If you can, have a friend, family member, or professional support person help you in the home for part of the day.
  • Talk to your husband, partner, family, and friends about how you are feeling.
  • Do not spend a lot of time alone. Get dressed and leave the house. Run an errand or take a short walk.
  • Spend time alone with your husband or partner.
  • Talk with other mothers, so you can learn from their experiences.
  • Join a support group for women with depression. Call a local hotline or look in your telephone book for information and services.
  • Don't make any major life changes during pregnancy. Major changes can cause unneeded stress. Sometimes big changes cannot be avoided. When that happens, try to arrange support and help in your new situation ahead of time.
How is depression treated?
There are two common types of treatment for depression.

  • Talk therapy. This involves talking to a therapist, psychologist, or social worker to learn to change how depression makes you think, feel, and act.
  • Medicine. Your doctor can give you an antidepressant medicine to help you. These medicines can help relieve the symptoms of depression.
Women who are pregnant or breastfeeding should talk with their doctors about the advantages and risks of taking antidepressant medicines. Some women are concerned that taking these medicines may harm the baby. A mother's depression can affect her baby's development, so getting treatment is important for both mother and baby. The risks of taking medicine have to be weighed against the risks of depression. It is a decision that women need to discuss carefully with their doctors. Women who decide to take antidepressant medicines should talk to their doctors about which antidepressant medicines are safer to take while pregnant or breastfeeding.

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What effects can untreated depression have?
Depression not only hurts the mother, but also affects her family. Some researchers have found that depression during pregnancy can raise the risk of delivering an underweight baby or a premature infant. Some women with depression have difficulty caring for themselves during pregnancy. They may have trouble eating and won't gain enough weight during the pregnancy; have trouble sleeping; may miss prenatal visits; may not follow medical instructions; have a poor diet; or may use harmful substances, like tobacco, alcohol, or illegal drugs.

Postpartum depression can affect a mother's ability to parent. She may lack energy, have trouble concentrating, be irritable, and not be able to meet her child's needs for love and affection. As a result, she may feel guilty and lose confidence in herself as a mother, which can worsen the depression. Researchers believe that postpartum depression can affect the infant by causing delays in language development, problems with emotional bonding to others, behavioral problems, lower activity levels, sleep problems, and distress. It helps if the father or another caregiver can assist in meeting the needs of the baby and other children in the family while mom is depressed.

All children deserve the chance to have a healthy mom. All moms deserve the chance to enjoy their life and their children. Don't suffer alone. If you are experiencing symptoms of depression during pregnancy or after having a baby, please tell a loved one and call you doctor or nurse practitioner right away.

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Should I breast feed my baby?
Yes! Breastfeeding is best for both baby and mom. A mother's milk has just the right amount of fat, sugar, water, and protein that is needed for a baby's growth and development. Most babies find it easier to digest breast milk than they do formula. Breast milk has agents (called antibodies) in it to help protect infants from bacteria and viruses and to help them fight off infection and disease. Human milk straight from the breast is always sterile.

Visit this link for more information.

Breastfeeding saves times and money. You do not have to purchase, measure, and mix formula, and there are no bottles to warm in the middle of the night. Breastfeeding also helps a mother bond with her baby. Physical contact is important to newborns and can help them feel more secure, warm and comforted. Nursing uses up extra calories, making it easier to lose the pounds gained from pregnancy. It also helps the uterus to get back to its original size more quickly and lessens any bleeding a woman may have after giving birth. Breastfeeding also may lower the risk of breast and ovarian cancers.

The U.S. Surgeon General Recommends Breastfeeding

The U.S. Surgeon General recommends that babies be fed with breast milk only - no formula - for the first 6 months of life. It is better to breast feed for 6 months and best to breast feed for 12 months, or for as long as you and your baby wish. Solid foods can be introduced when the baby is 6 months old, while you continue to breast feed.

Health Risks of Not Breastfeeding

Though breastfeeding is beneficial for both mother and child, it may not be possible or preferable for all women. The decision to breastfeed or formula feed your baby should be based on your comfort level with breastfeeding as well as your lifestyle.

Breast milk has agents (called antibodies) in it to help protect infants from bacteria and viruses. Recent studies show that babies who are not exclusively breast fed for 6 months are more likely to develop a wide range of infectious diseases including ear infections, diarrhea, respiratory illnesses and have more hospitalizations. Also, infants who are not breast fed have a 21% higher postneonatal infant mortality rate in the U.S.

Some studies suggest that infants who are not breast fed have higher rates of sudden infant death syndrome (SIDS) in the first year of life, and higher rates of type 1 and type 2 diabetes, lymphoma, leukemia, Hodgkin's disease, overweight and obesity, high cholesterol and asthma. More research in these areas is needed (American Academy of Pediatrics, 2005).

Babies who are not breast fed are sick more often and have more doctor's visits.

Also, when you breast feed, there are no bottles and nipples to sterilize. Unlike human milk straight from the breast, infant formula has a chance of being contaminated.

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