1. How do I select the best doctor to deliver my baby?
The best way to find a good doctor is through word of mouth. Ask your girlfriends, co-workers, neighbors, etc. If you are new to the community, call the hospital’s Labor & Delivery department and ask the nurses whom they recommend. Once you have gathered a list of names, you need to narrow it down. Unfortunately in today’s society, your insurance company may dictate which doctors and hospitals you select. So be sure to check your insurance book listing. You may also narrow the list by location or gender of the doctor, if you desire.

2. When should I begin prenatal vitamins?
Ideally, you should begin your prenatal vitamin several months before you even become pregnant. Or, at the end of your first prenatal visit, the doctor or nurse practitioner will give you samples and/or a prescription for prenatal vitamins. Unless you are suffering from extreme “morning sickness,” it is a good idea to begin the vitamins immediately. That’s because many pregnant women (or women in general for that matter) don’t always eat a well-balanced diet. A good prenatal vitamin will give you the extra supplements that you may not get from your diet.

3. What is “morning sickness?”
Nausea and vomiting during the first trimester is often called morning sickness. The truth is, it can occur any time of the day. It is very common, occurring in about 70 percent of all pregnancies. Rising levels of pregnancy hormones cause the symptoms. Typically, symptoms begin around week six, peak at week ten, then subside by about week 14. Most cases of morning sickness are not harmful to you or the fetus.

4. What over-the-counter medicines can I safely take?
Most doctors recommend that if possible, try to avoid all medications during the first trimester. That’s because the fetus is developing major organ systems during that time period. However, during the second and third trimester, certain over-the-counter (OTC) medications may be considered. It is a good idea to ask your doctor before taking any medication.

5. When do I get an ultrasound and what is involved?
Your ultrasound prenatal visit is one of the highlights of your pregnancy. It is so exciting to see your baby for the first time. The ultrasound prenatal visit usually occurs at your doctor’s office and is performed by an ultrasound technician. The technician is not a doctor but is highly skilled at viewing the fetus by ultrasound. Occasionally, you will see your doctor during this prenatal visit also.
An ultrasound is a procedure used to view the baby. Typically, you are asked to recline on the exam table, lights are dimmed, and gel and transducer are applied to your belly. The transducer uses ultrasonic waves to project an image of your baby onto a television-like monitor. There is no pain to either you or the baby. The whole procedure takes about 30 minutes.

6. Am I okay even though my legs and feet are so swollen that my shoes don’t fit?
There is considerably more blood and fluid in your body when you are pregnant compared to when you are not pregnant. The pregnant uterus also presses against some of your body’s major blood vessels, making circulation less efficient. This is usually most noticeable in your arms, hands, legs and feet. However, some women notice an overall puffiness.
Swelling alone is not a concerning sign. However it can be quite uncomfortable and a nuisance when rings, watches, shoes, etc. no longer fit properly. Some women remove their rings to avoid them from becoming stuck on their fingers. Many women buy larger shoes or opt for open-toed shoes if practical.

7. How often should I be feeling the baby move?
Most often women feel their unborn baby move for the first time between 16-20 weeks. The feeling is often described as a fluttering that comes and goes quickly. Over time, the movements become stronger and more predictable. By the third trimester, fetal movement should be fairly regular and consistent. Many women notice that their baby seems to move the most at the end of the day, when they are trying to go to sleep. However, some babies seem to be more active than others for unknown reasons. You will soon become familiar with the pattern of activity that is normal for your baby.

8. What is a birthing room?
The birthing room is the room in the hospital where you will labor and eventually deliver your baby. After the delivery, you and your baby will recover in this room. In some hospitals you stay in this same room until you are discharged to your home a couple of days later. In other hospitals, you are moved from the birthing room to a different room about one to two hours after you delivery. In this case, you will spend the remaining couple of days in your postpartum recovery room. Modern hospitals have gone out of their way to make the birthing room environment as homey and comfortable as possible.

9. What about pain management during labor?
The most important point to remember about pain relief is that you know your options and keep an open mind. Many women have expectations that their labor will happen a certain way, with predetermined beliefs about their need for pain relief. In reality, the labor process frequently does not occur according to plan. This is especially true for your first baby.
The need/desire for pain relief during labor varies greatly from woman to woman and from labor to labor. Some labors are quick and tolerable. Others drag out for many hours. Different women have different tolerances to pain. Women with supportive and nurturing coaches may need less pain relief than those without them. You probably won’t know what you want until you are actually in the situation.

10. When and why would the doctor cut an episiotomy?
An episiotomy is an incision made on your perineum (the area between the vagina and the rectal area) for the purpose of enlarging the outlet for delivery. The incision is usually made as the baby’s head is crowning, bulging from your vagina and almost ready for delivery. The purpose for the episiotomy is to provide additional room for the baby’s head and to avoid major tearing. Years ago, routine episiotomies were cut in almost every delivery. Today most doctors only cut them if it appears that significant additional room is required for delivery. Most medical professionals agree that a straight surgical incision is preferable to a large jagged laceration.

Susan Warhus, M.D., is the author of Countdown to Baby— Answers to the 100 Most Asked Questions About Pregnancy and Childbirth (Addicus Books).