After over 30 years of practicing obstetrics, here are the most common pregnancy questions I hear every day!

What are the most common early symptoms of pregnancy? 

Missing a period is usually the first sign of a new pregnancy, although women with irregular periods may not initially recognize a missed period as pregnancy. During the first few weeks of pregnancy, many women experience a need to urinate frequently, extreme fatigue, nausea and/or vomiting, and increased breast tenderness. All of these symptoms can be normal and are expected in the beginning of new pregnancy.   

How many months is a normal pregnancy?

Pregnancy is 280 days (40 weeks or 10 “lunar” months) from the first day of your last menstrual period. 10 lunar (4 week months) months which a 40 weeks. A lunar month is 29.5 days.

The 40 weeks is further broken down into 3 trimesters.

When does the first trimester start and end?

The first trimester is from week 1 to the end of week 12.

Why am I so exhausted during the first trimester?

Feeling exhausted is a classic symptom of an early pregnancy.  In fact, it is often the very first symptom women notice when pregnant.  Women experience overwhelming fatigue and find they cannot get enough sleep.  These symptoms of feeling exhausted occur as a result of the hormonal changes caused by progesterone.

Is gas a common sign of an early pregnancy?

Very early in pregnancy, complete chaos with bowel function occurs.  Hormonal changes and prenatal vitamins create bowel pandemonium causing bloating, gas and constipation.

How common is cramping seen during the first trimester of pregnancy?

Cramping is a common symptom early in pregnancy as the uterus begins to grow.  The cramping should feel similar to the mild cramping you may experience with your period.  If the cramping becomes more intense and associated with other symptoms such as vaginal bleeding, nausea, vomiting or fever you should contact your health care provider.

How common is vaginal spotting seen during the first trimester of pregnancy?

Any bleeding during pregnancy is scary. When the embryo implants itself in the uterine lining there can be normal bleeding or spotting described as implantation bleeding.  Implantation bleeding is common occurring in 30% of pregnant women.  

The type of bleeding is classically light red, brown or pinkish. Implantation bleeding typically lasts for 2-7 days.

The main difference between normal implantation bleeding and an abnormal pregnancy is the amount of bleeding you experience and severity of uterine cramping.  Implantation bleeding is light or “scanty” in appearance with mild uterine cramping.  An abnormal pregnancy is associated with heavy, bright red bleeding with clots and severe uterine cramping.

I just found out I am 6 weeks pregnant, why am I feeling so anxious?

Early hormonal changes in pregnancy can make you feel more emotionally fragile and sensitive.  Anxiety, depression and feeling emotionally vulnerable may be your first sign of pregnancy. 

Can you get a period if you are pregnant? 

Just around the time you are due for your next period is the same time the embryo implants into the lining of the uterus causing spotting or light bleeding lasting 1-2 days and mild uterine cramping.  Implantation bleeding occurs in about 30% of pregnancies and is often the first sign of pregnancy. Implantation bleeding is not a period.

What should you do if you suspect you’re pregnant?

Ideally you want accurate and reliable results when determining if you are pregnant or not. Delay pregnancy testing as close to your expected period as possible. The most accurate results will be if you miss a period and get a blood test to confirm pregnancy.  Getting a blood test where you measure the HCG (Human Chorionic Gonadotropin) levels will give you the most reliable results, but this would be done at your health care providers’ office.  HCG is a hormone only produced by fetal cells confirming pregnancy.

When do I go see my once I find out I am pregnant or miss a period?

Typically, you will be seen by your obstetrician or healthcare provider sometime between 6 to 12 weeks from your last menstrual period (LMP).

What happens during my first OB visit?

During your first prenatal visit, your obstetrician or healthcare provider, will perform a physical exam, including a breast and pelvic exam. Vaginal cultures and a Pap smear will be taken along with an OB panel of blood that includes a genetic panel.

What kind of genetic screening can I do for the baby in the first trimester?

Genetic screening tests can be invasive or noninvasive. A safe and noninvasive way to find out the chromosomes of the baby is a blood test called noninvasive prenatal testing (NIPT). NIPT involves taking maternal blood between 10-14 weeks to determine if the baby has abnormal chromosomes including Down’s (trisomy 21), Edward’s (trisomy 18) and Patau (trisomy 13).  NIPT can also test for gender. The NIPT is cost effective, no risk to the baby and has a 98% to 99% accuracy rate. 

What about Chorionic Villi Testing (CVS) for genetic testing?

CVS is an invasive test to learn the chromosomes or gender of the baby. Chorionic villi testing is traditionally offered to pregnant women over 35year or who are high risk for chromosomal abnormalities.

Chorionic Villi Testing (CVS) is done between11-14 weeks and involves a needle that is inserted through the vagina or uterus under ultrasound guidance to collect cells from the placenta.   The placental tissue removed is tested for chromosomal analysis. 

Why do you feel dizzy when you’re pregnant?

Feeling dizzy is a common and normal symptom of pregnancy, especially in the first trimester.  It happens as a result of all the hormonal, blood volume, structural and blood sugar fluctuations throughout pregnancy.  Some of these changes ultimately affect your blood pressure which can reduce blood flow to the brain and cause bouts of dizziness. When lying on your back after 20 weeks the uterus will put unwanted pressure on the large vessels carrying blood to the heart reducing the flow to and out from the heart causing dizziness.  When you have not eaten regularly your blood sugar levels drop and can also cause dizziness. In the third trimester it’s common to feel dizziness as a result of abrupt movement due to all the blood volume changes.

Is dizziness dangerous for you or the baby?

It can only be dangerous for the baby if it occurs frequently enough where it leads to fainting, falling or not eating enough calories which would have a potential negative affect.

How can you prevent or reduce dizziness from happening during pregnancy?

You can prevent dizziness by making sure to follow some of these suggestions:

• Eat every 2 to 3 hours and avoid long periods of time between meals.
• Avoid hot baths, showers or Jacuzzi’s.
• Avoid lying on your back after 20 weeks for more than 20 minutes.
• Avoid getting up or going down too quickly. 
• Avoid standing on your feet for long periods of time.  
• Wear Ted Hose stocking to help the blood circulation in your lower legs when standing for long periods of time.

Can I drink caffeine during pregnancy?

Caffeine can be consumed in a safe way in pregnancy.  It was thought that moderate caffeine consumption > 200mg/day (12oz cup of brewed coffee) was thought to be a contributing factor in miscarriages and preterm labor. The good news for coffee drinkers is the studies currently do not show that drinking a 12 oz cup of coffee will lead to an increase miscarriage rate or affect your pregnant in the slightest way.   It’s recommended to limit your caffeine intake to 1 cup of coffee or 2 cups of tea/day during pregnancy.  Also know how much caffeine is contained in the foods and beverages you eat so you can keep the quantity under 200mg/day which is considered a safe amount before and during pregnancy. 

The bottom line is all the medical research suggests that having a 12-oz cup of coffee or 2 cups of tea a day is safe for your growing baby.

What foods should I avoid during pregnancy?

 Food concerns during pregnancy include raw vegetables, unpasteurized juices, liver, and undercooked meat, poultry, or eggs. Food poisoning can occur when eating raw vegetables, unpasteurized juices, and undercooked meat, poultry, or eggs that can be linked with Salmonella and Escherichia coli bacteria.  Cooking properly and thoroughly kills bacteria in the majority of foods.   Eating raw fish, such as sushi, has not been recommended in pregnancy since it can carry certain bacteria and parasites.  Mercury is very toxic and can cause problems to the fetus and to the newborn nursing infant.  Fish, such as shark, grouper, Chilean sea bass, halibut, swordfish, king mackerel, tuna and tilefish have increased mercury levels and cause the most concern for consumption by pregnant women. 

A pregnant woman can safely eat 12 ounces per week of varieties of fish thought to be low in mercury if they eat a variety of cooked, smaller fish. The safest fish that are low in mercury are shrimp, canned light tuna, scallops, oysters, squid and salmon.

What is the miscarriage rate for pregnancy?

Every pregnant woman has a 25% chance of having a miscarriage.  When the bleeding starts to look like a heavy period with blood clots and severe menstrual-like cramping then it’s time to be concerned that you are experiencing a miscarriage.  If heavy bleeding and cramping is associated with fatigue or dizziness it’s important to contact your health care provider to have a pelvic US, blood count and beta HCG (human chorionic gonadotropin) to make the correct diagnosis. 

When is a pregnancy considered safe? 

The majority of miscarriages happen during the first trimester.  Over 85% of miscarriages will happen by 6-8 weeks of pregnancy.   If you are not having any abnormal signs of pregnancy and have an US that shows cardiac motion after 12 weeks chances, are you have a healthy pregnancy. There are many complications of pregnancy that can occur in the second and third trimester that are based on maternal age and other preexisting medical conditions that can happen unexpectedly.

What is morning sickness?

Nausea is considered as one of the classic symptoms of pregnancy. It popularly known as ‘morning sickness’, although it can occur during the morning, noon, or night and affects about 80% of all pregnant women. 

In 2% of pregnancies, persistent nausea and vomiting can become so severe pregnant women can lose weight, become malnourished, and dehydrated where hospitalization is necessary.   

If you are unable to keep down liquids or solid foods for more than 24 hours you should contact your healthcare provider.

What causes morning sickness?

The actual causes of nausea and vomiting of pregnancy remains a mystery but theories include hormonal changes, imbalance in blood sugar levels and psychological factor

 Why do some women have morning sickness, yet some don’t at all? 

The actual causes of nausea and vomiting of pregnancy remains a mystery but theories include hormonal changes, imbalance in blood sugar levels and psychological factors.

How long does morning sickness last?

Morning sickness can begin as early as 2 weeks into pregnancy and

continue until 12 weeks.  

Is morning sickness a sign of a healthy baby/healthy mother?

What is interesting is women with mild nausea and vomiting during pregnancy experience fewer miscarriages and stillbirths than women without these symptoms.  So, for me, when a woman is really nauseous and has occasional vomiting, I know she is probably carrying a healthy pregnancy! 

How long does morning sickness last?

It is popularly known as ‘morning sickness’, although it can occur during the morning, noon, or night and affects about 80% of all pregnant women. 

What foods combat morning sickness?

The best way to avoid nausea during pregnancy is to eat frequently and often.  Don’t wait to feel hungry to eat. Ideally eat foods high in carbohydrates and low in fat.  Avoid foods that are spicy, salty or high in protein.  The BRAT diet is always helpful and consists of Bananas, Rice, Applesauce and Toast. Drink cold, clear and carbonated beverages in small amounts and as often as possible. 

Saltine crackers are also quite helpful!

What medications can women take to combat morning sickness?

The safest medication to take in pregnancy is called Diclegis.  It’s basically a combination of Benadryl and Vitamin B6. Zofran has been used in the past but is not as safe to take in pregnancy.

What are some natural remedies to combat morning sickness? 31

Vitamin B6 25mg taken 3 times a day has been effective for nausea and vomiting pregnancy.  It’s not clear how it works but has a great track record.

Ginger in different forms-ginger root boiled in water, ginger root tea, ginger lozenges, ginger nonalcoholic beer, gum or capsules works well. Ginger ale and ginger snaps are less effective but also do help with symptoms. It’s thought that ginger helps relax gastrointestinal muscles relieving symptoms associated with morning sickness.

Acupuncture and acupressure are easy and safe alternatives to help the woes of morning sickness. Acupuncture and acupressure use the PC6 pressure points to relieve mild nausea and vomiting.

How can pregnant women prevent morning sickness? 

There is really no way to prevent morning sickness.  You can do your best to manipulate the way you eat and drink to help you get through it. Morning sickness is a normal sign of a healthy pregnancy…a rite of passage so to speak. It suggests the pregnancy hormones are rising appropriately and your body is responding normally to the changes. Feeling miserable the first 12 weeks can be a soft sign to your health care provider that all systems are working normally. Reassuring women who don’t see a light at the end of the tunnel is important so they understand morning sickness is common, it’s short lasting and it suggests your pregnancy is off to a healthy start.

When should morning sickness be a cause for concern? 

 In 2% of pregnancies, persistent nausea and vomiting can become so severe pregnant women can lose weight, become malnourished, and dehydrated where hospitalization is necessary. Losing 10% of your normal body weight would be a concern for you and your baby.  This condition is called Hyperemesis Gravidarum.  Where expected morning sickness of pregnancy typically improves around 10 weeks, Hyperemesis Gravidarum continues up until 20 weeks of pregnancy. Hyperemesis tends to improve in the last half of pregnancy, but may persist until delivery.

Does stress increase morning sickness symptoms?

Many factors play a role in morning sickness for pregnant women. Normal hormonal changes cause a slowing of the digestive tract and relaxation of the intestinal muscles which all contribute to nausea and morning sickness during pregnancy.  Stress can also trigger and exacerbate morning sickness. 

What should someone do to reduce stress while pregnant?

Stress is inevitable, it’s how we deal with it that ultimately makes us more resilient and equipped to handle it and minimize morning sickness during pregnant.  I suggest creating daily rituals involving healthy habits which will help reduce unwanted stress. Regular exercise including yoga, meditation, biofeedback, practicing mindfulness, guided imagery, Tai Chi, massage, acupuncture and psychotherapy along with eating a healthy diet, drinking 8 to 10 -12 oz-glasses of water and sleeping at least 7 hours a night is helpful. Taking probiotics can also be helpful in minimizing gastrointestinal upset and improving digestive health. 

The BRAT diet is always helpful and consists of Bananas, Rice, Applesauce and Toast. Drink cold, clear and carbonated beverages, like 7-Up and Ginger ale, in small amounts and as often as possible. Cold foods, fruits, vegetables, Jell-O, popsicles, saltine crackers and pretzels should be added to your diet.

Find your stress-relieving activity and diet that works best for you!

What are the signs that something is wrong with an early pregnancy?

The classic signs of an abnormal pregnancy or impending miscarriage are vaginal bleeding, pelvic pain and uterine cramping.  If any of these symptoms are persistent it may represent an abnormal pregnancy. Following up with your health care provider will help you know if this is a healthy pregnancy or not.

What are the most important things to do or keep track of during the first trimester? 

Pay attention to how you are feeling and be aware of any potential warning signs of an abnormal pregnancy. Always bring your concerns and questions to the attention of your healthcare provider if you have any questions.

Continue taking your prenatal vitamin, eat a well-balanced diet, get plenty of rest and discuss any prescription medication with your health care provider before taking them.

How can you calculate how many weeks pregnant you are?

Your pregnancy will first be dated by your first day of your last menstrual period (LMP). Since there is variation and irregularities with LMP’s, a transvaginal ultrasound (US) may be a more accurate way to establish dating of a pregnancy. A transvaginal US is typically done in the first trimester to evaluate an early pregnancy and establish accurate dating of the pregnancy.

When is an Ultrasound (US) done during pregnancy? 

A pelvic or abdominal ultrasound take pictures of the baby using sound waves throughout pregnancy. If an US is done prior to 12 weeks, it may be done using a vaginal probe, also known, as a transvaginal US. If performed on your belly it would be an abdominal US. Typically, the best time to do an US to evaluate the health of a growing baby is between 18 and 22 weeks.  You may get other US’s during the pregnancy if there is a concern with the baby’s growth or well-being.

Is Ultrasound safe during pregnancy?

I am frequently asked if Ultrasound (US) during pregnancy is safe.  Pregnant women can take a sigh of relief knowing that there is no evidence showing that US is harmful to a growing baby at any time during pregnancy. The US performed during pregnancy uses high frequency sound waves to evaluate a pregnancy.  There is no harmful radiation used during an US. 

What can the US see during pregnancy?

Ultrasound can check many aspects of the health of the baby including:

• the number of babies
• the size of the baby
  • how well the baby’s heart works
  • how well other organs (such as the spine, brain and kidneys) are growing
  • the anticipated date of birth
  • whether there are problems with the mother’s uterus, fallopian tubes or ovaries
• to see what position the baby is in
  • to check the placenta (afterbirth)
  • to view how much fluid is around the baby
  • to check the baby’s growth and well-being
  • to check for signs of a possible genetic problem

Could a sudden cold be an early sign of pregnancy?  

Early symptoms of pregnancy can include a headache, a metallic taste in the mouth, fatigue, feeling lethargic and a stuffy nose which could be confusing signs of the common cold. Since early pregnancy signs typically include missing a period, nausea, breast tenderness and other longer lasting symptoms, this can help in differentiating between pregnancy and the common cold.

How does a pregnancy-symptom cold differ from a regular cold?  

Missing a period is usually the first sign of a new pregnancy, although women with irregular periods may not initially recognize a missed period as pregnancy. During the first few weeks of pregnancy, many women experience a need to urinate frequently, extreme fatigue, constipation, heartburn, nausea and/or vomiting, fluid retention, mood swings, headaches, back pain, increased breast tenderness and milky white vaginal discharge. All of these symptoms can be normal and are expected in the beginning of new pregnancy as a result of normal hormonal changes.  

The common cold is usually more short term and doesn’t include the majority of early pregnancy symptoms. The common cold symptoms are typically a runny or stuffy nose, cough, congestion, body aches, sneezing, low grade fever and sore throat. These symptoms are classic for the common cold and not for pregnancy.

What are other reasons for cold like symptoms? 

Other medical conditions that can appear like the common cold include COVID-19, allergies, an ear infection, pneumonia, asthma, sinusitis, and the flu. If symptoms persist longer than 7 days, you should contact your health care provider.

When does the second trimester start and end?

The second trimester is from week 13 to 26 week.

During the second trimester, the baby will grow from about 2.9 inches (7.5cm) in length, and weighing 1oz (30g) in week 13, to about 9 inches (23cm) in length and 28 oz (820g) at week 26.

What are the most common symptoms during the second trimester?

The second trimester also referred to as the “honeymoon period” is when you will feel the most energetic and less bothered by first trimester symptoms.  Your belly, breasts and waistline will continue to grow. Feeling more nasal congestion, dizziness, headaches, leg cramps, milky white vaginal discharge, painless Braxton Hicks contracts and brown skin changes—also known as melasma– on your body including your face, breasts and abdomen are common during the second trimester.

When should you start to feel movement during pregnancy?

 Most women feel the beginnings of “fetal movement” before 21 weeks gestation. In a first pregnancy, this can occur around 18-21 weeks gestation, and in following pregnancies it can occur as early as 15-16 weeks gestation. Early fetal movement is felt most commonly when the woman is sitting or lying quietly and concentrating on her body. She may also feel fetal movement after eating or drinking a sugary beverage.

When should you start kick counts?

Following your baby’s “kick counts” especially in the 3rd trimester is a way to ensure the baby moves 10 movements in an hour, at least twice a day. Fetal movement is noticed most often late at night between 9pm and 1am. If you notice there is less or decreased fetal movement during the day, you should drink a large glass of juice and lay on your left side to see if your baby will move with a sugar boost and blast of hydration.

Will your baby be active leading up to and during labor? 

 During labor you will continue to feel your baby move but it may be less noticeable or vigorous.  Since you are not typically eating or drinking during labor, the baby is not being stimulated as much by the usual nutrients and may not move as actively. Plus, you are contracting every 2 to 3 minutes so you are more aware of what is happening with your uterus and body as opposed to the movement of the baby.  The baby’s heart rate is being continuously monitored during labor so you know everything is fine unless the nurse or obstetrician tells you otherwise. Focusing on the movement of the baby during labor is less of a priority. 

 Should I worry if the baby seems to be moving less the closer I am to my due date?

It’s very common to feel a decrease in fetal movement a couple weeks before your due date but it tends to not be a true obstetrical concern. As the baby grows and gets larger the perception of movement will change and might be less noticeable as you get closer to your due date. If there is persistent decreased fetal movement, an ultrasound to check the fluid around the baby and non-stress test (NST) should be performed.  A lower amount of fluid around the baby is a concern that can lead to fetal distress and death.  Regular and frequent fetal movement directly correlates to the baby’s well-being. 

 If your baby is active during labor, how does that feeling differ from contractions? 

 Pregnant women get used to feeling the baby move during pregnancy. One or many areas of the uterus move when a baby is moving around.  When your baby moves it’s a comforting and memorable sensation.  During labor, uterine contractions involve a symmetrically tightening of this very large muscle.  The entire abdomen is noticeably disrupted by a contraction compared to only certain areas of the uterus that are affected with the movement of the baby.

What are Braxton Hicks contractions?

 Simply put, Braxton Hicks contractions are painless contractions where real contractions are painful.  When you experience a Braxton Hicks contraction you will see your uterus tighten and become hard, like a rock, but it is not associated with pain. Braxton Hicks contraction are so subtle, most pregnant women doesn’t realize they are having them.

Braxton Hicks contractions are a normal part of pregnancy and do not really prepare your body for labor.

 What do Braxton Hicks feel like? 

When you experience a Braxton Hicks contraction you will see your uterus tighten and become hard like a rock, but it is not associated with pain.  They occur irregular at intervals meaning there is no pattern to the frequency Braxton Hicks contractions.  They tend to be very subtle and most pregnant women don’t realize they are having them.

 Real uterine contractions start as menstrual cramp and continue getting more intense and painful, unlike Braxton Hicks contractions.

Do Braxton Hicks lead to labor? 

Braxton Hicks occur spontaneously and are completely normal throughout pregnancy especially in the third trimester. They don’t typically lead to going into labor unless they become regular in frequency and cause pain.

What are some common triggers for Braxton Hicks?

The uterus is one large muscle. Just like any muscle in your body, the uterus will flex when stimulated.  It contracts and relaxes for a number of reasons or for no reason at all.  Common reasons for the uterus to contract, unrelated to going into labor, is if you are dehydrated, exercising, after an orgasm, during sexual intercourse or have a full bladder.

Can you stop Braxton Hicks when they happen? 

If you can identify the common causes of Braxton Hicks contractions, then you can stop them from happening. As an example, if you are dehydrated and haven’t been drinking enough water throughout the day, you can rehydrate with water to stop them from happening. Emptying your bladder by peeing or resting during a workout can also calm the uterus and prevent BH contractions. 

What is the difference between Braxton Hicks contractions and real labor contractions?

Real uterine contractions start as menstrual cramp and continue getting more intense and painful, unlike Braxton Hicks contractions.

Are Braxton Hicks the same things as false labor?

“False labor” can occur before true labor actually begins.  False labor is described as irregular uterine pains or contractions that do not increase in severity and frequency. Contractions can occur every 10-20 minutes for a few hours and then stop all together. False labor creates a lot of confusion for expecting moms.  BH contractions should not cause you to feel pain so they are different than false labor.  If you have frequent BH contractions which increase in intensity and pain then this could be beginning of false or early labor. 

What are the most important changes that happen to the fetus during the second trimester?

During the second trimester the fetus continues to grow and starts looking like a developing baby on Ultrasound. From head to toe, limbs and organs are maturing and growing. Toenails, eyes, hair, skin, lungs and the central nervous system continue to form. Fetal movement can be felt in the early part of the second trimester if it’s your second pregnancy or by 21 weeks if it’s your first pregnancy.  The fetus starts to gain weight, sleeps a lot and can hear sounds and voices outside the womb.

During the second trimester, what are the most important things to do or keep track of?

During the second trimester the fetus is assessed for any genetic abnormalities, either through blood tests, an amniocentesis or on Ultrasound. Blood tests checking for gestational diabetes, anemia and any Rh-negative blood incapability may also be done during the second trimester. It’s an important trimester to make sure you are gaining the appropriate amount of weight, exercising regularly and getting adequate amounts of sleep.

What is the genetic testing available in the 2nd trimester?

An amniocentesis is an invasive form of genetic testing performed between 16 to 18 weeks.  A needle is inserted into the uterus removing amniotic fluid under ultrasound guidance to be tested for chromosomes and gender.  

What can be done about constipation during pregnancy? 

Definitely one of the more uncomfortable problems that can be exacerbated during pregnancy, constipation is a common complaint.  Between the hormonal effects of progesterone slowing down the motility of your intestines, the iron and calcium in prenatal vitamins, the displacement of the intestines by a growing uterus and the changes in our diets during pregnancy all lead to a disruption in bowel function.  Some have bowel changes consistent with a softer and more frequent stool, others have hard “rabbit” pellets and many others have bowel movements every 2-5 days.

Constipation during pregnancy can be prevented with the following lifestyle changes:

• • Drink plenty of fluids. Water is the best choice and I would recommend drinking at least 8-10, 8-ounce glasses a day. Fruit juice, especially prune juice, will help regulate your constipation.  Drinking warm liquids in the morning is also effective.
  • Physical activity and exercise should be a part of your daily routine.  Daily walks, lasting 30-45 minutes, and other aerobic activities can help prevent pregnancy constipation.  Exercising regularly aids in our digestion and makes you feel physically and emotional stronger and more energetic. 
  • Include more dietary fiber in your diet. Choose high-fiber foods, such as fruits, vegetables, beans and whole grains.  Fiber helps bring water into the intestines, softening the stool and allowing it easier to pass.  With your health care provider’s OK, consider a fiber supplement, such as Metamucil, Citrucel and Miralax.

• Stool softeners, such as Colace, moistens the stool allowing easier passage. I encourage most of my patients to take 50mg to 100mg of Colace two times a day throughout the duration of the pregnancy.  

• Cascara Sagrada is a natural laxative made of dried bark.  Take 1 to 2 capsules before bedtime with a large glass of water.  It’s a much gentler alternative then Sena.

Bulk forming laxatives such as fiber supplements are the gentlest on your body and safe to use during pregnancy.  Metamucil, Citrucel and Miralax are examples of this and are recommended throughout pregnancy.  Stimulant laxatives, such as Ex-Lax and Senokot are the hardest on your intestines and should not be used during pregnancy.

There are remedies and solutions for this serious and uncomfortable side effect of pregnancy. As always consult with your health care provider for recommendations on the safest route to follow.