Constipation is incredibly common during pregnancy; in the 19th century, some people called pregnancy the Disease of Constipation. The good news is that all the remedies and treatments you might normally use for constipation are still safe during pregnancy. You should start by increasing your water and fiber intake. Many women will add daily use of MiraLAX or a generic equivalent to their diet. This is a gentle agent that is non-stimulating and safe to use during pregnancy. If it has been a few days since your last bowel movement, you may need to stimulate a bowel movement from below. Try using a suppository (e.g., glycerin or Dulcolax), and if this doesn’t work you can repeat it in two hours.

If these over-the-counter remedies are not helpful, talk to your doctor.

You’ve probably heard the folktale that a lot of heartburn means that your baby will have a lot of hair; this probably isn’t true, but dreams of a well-coiffed baby undoubtedly won’t make your pain any better.

Heartburn aka acid reflux aka GERD is a common problem during pregnancy and gets worse throughout the third trimester for most women as the uterus grows and puts more pressure on the stomach. If you have occasional symptoms, avoiding trigger foods and using TUMS may be enough. For persistent symptoms, it is okay to use over-the-counter medications like TUMS, Gaviscon, Maalox, or Mylanta, as well as OTC or prescription antacid medications such as proton pump inhibitors (omeprazole, pantoprazole) and antihistamines (cimetidine).

Click here for a list of medicines that are safe to use during pregnancy.

Most itching in pregnancy is related to dry skin. A good lotion can go a long way in reducing or eliminating itching related to this problem. In some cases, itching confined to one area may be related to a reaction to something; we call this contact dermatitis. If you suspect this is the case, try to avoid whatever you came into contact with and think about any new lotions, detergents, or anything coming into contact with your skin or clothing. Consider using an antihistamine or an over-the-counter steroid cream to resolve the rash.

In rare cases, itching all over the body that is not associated with a rash can be due to intrahepatic cholestasis of pregnancy (ICP). ICP is an important diagnosis to not miss and your doctor may need to check some labs to make sure you don’t have this. If you do, she will prescribe medicine to improve the situation and she will likely deliver you a couple of weeks earlier than normal.

Lastly, if you have little red dots, plaques, or raised bumps that develop and are itchy during pregnancy, you may have polymorphic eruption of pregnancy (PEP). It most commonly shows up on the belly or legs. We treat this similarly to other rashes with topical steroid creams, antihistamines, or oral steroids if necessary, and soothing baths/lotions/loose clothing can help with the itchiness. When the itching gets really bad, trying cold ice packs to calm it down can be very helpful.

The answer to this question depends on how far along you are. If you are less than 20 weeks’ gestation or so, you are probably too early to feel any fetal movement. First time moms don’t typically report feeling movements (quickening) for the first time until 20 weeks or so; women who have had children before often feel the first movements two or three weeks sooner (around 17-20 weeks). Even after these gestational ages, it is still common to go a few days without feeling fetal movement until about 24 weeks or so.

After 24 weeks, you should expect to feel some movement every day, but how much movement you feel varies from pregnancy to pregnancy. You or your partner may not be able to feel the baby with a hand on the outside of your belly simply because you have an anterior placenta or the baby is turned and kicking in the other direction.

If you are concerned that you have not felt enough fetal movement and you are more than 24 weeks’ gestation, then lie down on your left side and concentrate on feeling for movements. You should feel at least six movements of some sort in the first hour; if you have felt some movements but not six, then continue counting for another hour. You should feel at least 10 movements during those two hours. Because of fetal sleep cycles, it’s not uncommon for it take two hours to feel the ten movements. Ideally, this is done during the baby’s active time. For many women, the baby’s active time is shortly after they have eaten dinner. So, maybe try eating a little something if you don’t reach the six kicks in an hour, and then extend to counting for the two hour mark. If you don’t reach 10 movements in two hours, then this is a reason to go to the hospital or office and be evaluated.

You might have read on the Internet that you should do “kick counts” every day. Most pregnant women do not need to do this as the practice may actually be harmful overall to the pregnancy. Only do daily kick counts if your doctor has told you to do it for a specific reason.

The short answer is no. Though there are a lot of products marketed to pregnant women who are willing to spend a lot of money to prevent stretch marks, none of them have good scientific data showing they work. Some products cite their own small studies, but they are usually poorly done or so small that it cannot be considered good evidence. Companies like to exploit new moms, so be leery. We don’t want that for you. Save your money. If your belly is dry and it feels good to use a nice lotion or other skincare product, go for it! But know that it will not prevent stretch marks. We promise the second we see something come out that is effective and has good data behind it, we’ll be the first to tell everyone.

Ah, the joys of pregnancy! If constipation, hemorrhoids, and heartburn weren’t enough to make you feel glorious, just wait until your legs start swelling.

Most swelling or edema in pregnancy is normal. Swelling is common; about 60% of women will have significant lower extremity swelling and a large number of these women will also have swelling in their hands that make rings too tight and wrists hurt. Much of the conventional wisdom about swelling during pregnancy is related to a concern for the development of preeclampsia, but swelling is so common that in most cases this is not a concern at all. Your doctor checks your blood pressure at your regular visits to make sure that you’re not developing hypertension, which is the chief sign of preeclampsia.

Most leg swelling is related to the uterus blocking the return of blood from your legs. As the uterus gets bigger, it blocks the veins that drain blood from the legs back up to the heart, and gravity doesn’t help with this process. Since there are no pumps in the legs, the blood tends to pool and this leads to swelling. You may be able to make this temporarily better by elevating your legs, particularly while laying on your side. But for most women who are up and working throughout the day, there is little opportunity for this. Wearing a pair of support hose, compression stockings, or compression socks may help tremendously.

If your hands are swelling, you may have symptoms of carpal tunnel syndrome which is also very common during pregnancy. Wearing an over-the-counter wrist splint at night on one or both wrists will lead to significant improvement of these painful symptoms.

One common myth about swelling is that a woman should drink more water when she is swelling to make the swelling better. This is simply untrue. If you’re having significant swelling in your legs, you may also find that you are lightheaded or having woozy episodes because your water content has left your blood vessels and gone into your soft tissues; in this case, drinking more water may help you not feel as dizzy, but it will not affect how swollen you are.

Back pain in pregnancy is almost universal. The bigger the belly, the more curved the spine, and the worse the back pain. As your center of gravity moves forward with your ever increasing belly size, your hips rotate forward, the curvature of your back changes, and the muscle groups you use to maintain your posture change. Because you are not used to using these muscle groups to stay upright, and because all of your muscles are doing more work than normal carrying around the extra weight, the result is chronic muscle strain, sprain, and fatigue.

Things to try include using acetaminophen to treat the pain and if you are less than 20 weeks’ gestation, you can still use nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen or Naprosyn occasionally. A heating pad on the back, heat releasing patches, or a nice bath may also help a lot.

Exercise can help tremendously. Gymnasts and ballet dancers rarely complain of back pain during pregnancy because they have well-developed back musculature and core abdominal muscles. Exercises that help strengthen the back and core abdominal muscles can provide relief and prevent worsening problems as the pregnancy goes on. This includes things like Pilates or Yoga.

Many women benefit from wearing a back brace or pregnancy support belt (belly band). These devices tend to change your center of gravity slightly and help redistribute the load. Typically, these are most helpful in the third trimester. Even if you did not need one in your first pregnancy, keep in mind that during your second or third pregnancy you carry the baby differently in your pelvis and it may be beneficial this time around.

Massage can be beneficial and some women may need help from a physical therapist. Your doctor can let you know if physical therapy or, in some cases, pelvic floor physical therapy, might be appropriate for your symptoms. In some cases, we may prescribe muscle relaxants but these tend to be sedating. Still, they can be useful at night.

It’s unusual for back pain during pregnancy to require any testing or other treatments. However, if you have a history of chronic back pain or orthopedic abnormalities, be sure to tell your doctor or midwife. Various pains, particularly back pain, pelvic pain, and round ligament pain, are common in pregnancy.

Here is a list of things that can help relieve pains:

• Stretch and do strengthening exercises like Pilates or Yoga
• Wear a pregnancy support belt
• Use Tylenol
• Use warm compresses or pads
• Wear low-heeled shoes with good arch support
• Avoid lifting heavy items by yourself
• Elevate one foot on a support if you must stand for a long period of time
• Bend with your knees, not at the waist
• Try to sleep on your side with one or two pillows between your knees
• Place a board under your mattress to make your bed firmer

Literally 97% of pregnant women complain of shortness of breath at some time during their pregnancies. Most of the time, this is related to some of the pulmonary physiologic changes of pregnancy that give women the sensation that they are not breathing in deeply or moving as much air with each inspiration, but their actual oxygen status remains unchanged. It is normal to feel as if you are not breathing as deeply or for your rate of respirations to increase with less vigorous activity while pregnant.

Rarely, difficulty breathing is a sign of a more serious problem. If you’re having trouble catching your breath even while resting or if you have symptoms of low oxygen levels, like changes in the color of your skin or confusion, then you may need to seek medical care immediately. Women who have underlying asthma may also have shortness of breath related to uncontrolled asthma during pregnancy and this would be a reason to seek immediate medical attention. Also, if you notice that you can’t sleep without propping your head up with several pillows, you need to talk to your doctor.

Otherwise, if your shortness of breath is just with exertion and becomes improved with rest, this is likely normal.

Pregnancy is good and bad for headaches.

The good news is, migraine headaches are uncommon during pregnancy. Most chronic migraineurs thoroughly enjoy pregnancy because it is one of the few times in their lives when they don’t suffer from migraine headaches.

The bad news is, other types of headaches, particularly tension headaches, can become more common during pregnancy with the musculoskeletal strains, tensions, anxieties, and stresses associated with pregnancy.

You can always use acetaminophen at any time during pregnancy for headache. If you’re less than 20 weeks’ gestation, you can still use ibuprofen or Naprosyn. Other medications like Excedrin Migraine can also be used on a limited basis. A good massage, a relaxing bath, or just a good night’s rest may be the cure for a tension headache.

Sometimes headaches have other causes, like sinus infections or allergies. If you suspect that your sinuses are the problem, try an over-the-counter antihistamine and if this doesn’t work, talk to your doctor.

Some women have caffeine withdrawal headaches, especially in the first trimester. These headaches are all too common if you have recently cut out all caffeine because you’re pregnant. Remember that you can have up to 350 mg of caffeine per day. You may need to add a little bit of caffeine back in order to prevent headaches. Caffeine is also a treatment for some tension headaches as well. Taking your acetaminophen with a serving of caffeine may be just what the doctor ordered.

Sex is safe during pregnancy and often a lot of fun. Most couples enjoy the body’s changes during pregnancy, but sometimes women can find sex painful and problematic.

Some women find it difficult to relax because they’re worried that sex may be harmful to the pregnancy; this is an unnecessary fear – sex is not associated with any negative outcomes during pregnancy. Most of the time discomfort and pain during sex is just related to your changing anatomy and body shape. Familiar positions may become uncomfortable because your belly is in the way and more penetrating positions may become less desirable because your uterus has started to take space away from the upper part of your vagina. Usually, a little creativity can be both fun and problem-solving. Rear vaginal-entry positions, with the help of a few pillows or a wedge cushion, can solve several problems at once. The woman on top, as long as it’s not too penetrating, can also be pleasurable for both and it can allow you to determine the angle of entry and the depth of penetration to a degree. Finally, if you lay on your side and draw your top leg upwards, this can allow your partner to straddle your bottom leg and enter at a 90° angle from the normal. This side saddle approach allows for complete control over the angle of entry and allows you to control the depth of penetration with your top leg.

Unfortunately, acne tends to get worse during pregnancy. Blame your hormones and your beautiful, oily glow of pregnancy. Still, there are a few things you can do. It is safe to wash your face with benzoyl peroxide during pregnancy. Benzoyl peroxide is the common ingredient in most over-the-counter acne remedies. Check the label.

If you wash your face at night and then go and lay down on your pillow from last night, you may find that you have re-contaminated your face with last night’s oils and bacteria. One evidence-based trick is to place a fresh, clean towelette over your pillow each night that you remove in the morning. This towelette can collect the new nightly skin oils and bacteria and not allow them to saturate into your pillow and pillowcase. Just change it each night. Oral retinoids (e.g., Accutane) should be avoided during pregnancy due to the severity of birth defects that a fetus may develop as a result of exposure. Many other acne treatments are not safe during pregnancy. Ask your doctor before trying any other remedies.

Oral retinoids (e.g., Accutane) should be avoided during pregnancy due to the severity of birth defects that a fetus may develop as a result of exposure. Many other acne treatments are not safe during pregnancy. Ask your doctor before trying any other remedies.

Due to some of the physiological changes of pregnancy, it is common for women’s resting heart rate to be about 10 to 15 beats per minute faster while pregnant. Pregnant women are also more likely to have bigger increases in their heart rate with exertion since they are doing more work while pregnant. This increased work starts even in the first trimester, as pregnant women have a blood volume expansion of over 40%. It doesn’t stop there, as pregnant women also do more work, moving around an extra 30 pounds or more in the third trimester.

As the uterus gets larger, the heart is pushed upwards and rotated to the left. This changing position of the heart allows women to become more aware of their heart beating and sometimes this is alarming because they don’t normally perceive that their heart is beating in their chest. Couple this with the fact that the heart may be beating faster than normal, then this can be quite anxiety-provoking. But if your heart rate isn’t too fast at rest and you don’t notice that it is beating irregularly, don’t worry too much. If you feel like your heart rhythm is irregular or your heart rate is persistently fast and staying that way, talk to your doctor.

If you failed your 1-hour glucose screen AND your 3-hour glucose tolerance test, then you have gestational diabetes.

Hopefully, you’ll get a chance to talk to a dietitian. In the meantime, try to cut down (if you can, cut them out completely) the simple sugary items from your diet: sodas, cookies, cakes, candies, and other sources of sugary carbs. Paying attention to portion size is the best thing you can do. Try to make your plate ½ greens, ¼ grains, and ¼ protein for every meal. If you’re not already, add in four to five 20 minute walks or other cardiovascular exercise sessions per week.

You’ll need to check your blood sugar several times per day, at least initially. You should check your blood sugar first thing in the morning (a fasting blood glucose), and then check it two hours after each large meal – breakfast, lunch, and dinner. Your fasting blood sugars should be below 95 and your blood sugars after meals should be below 120. If your blood sugars are running higher than this, you may need to take medicine to help lower your blood sugars.

Is also helpful, in the beginning at least, to track what you are eating. This can help your dietitian and your doctor decide if there are some things you should do differently in your diet. It can also help you understand why your blood sugar might spike – for example, after delicious pizza.

Probably. Pregnant women have more vaginal discharge than nonpregnant women. It is common for pregnant women to wear a panty liner while pregnant because of this discharge. Most of this discharge is physiologic and represents cervical mucus. The more babies you’ve had, the more likely you are to experience this discharge. If your discharge has a bad odor, itches, or is green in color, tell your doctor to make sure it’s not an infection. Otherwise, expect to have some discharge throughout pregnancy.

Nobody likes a hemorrhoid. Hemorrhoids don’t even like hemorrhoids. Unfortunately, they are common during pregnancy and become more common in the third trimester. All of the normal over-the-counter remedies for hemorrhoids are perfectly fine to use while pregnant, including Preparation H and Anusol-HC. Tucks pads, which are pads infused with witch hazel, are also effective. Many women will use the pads in combination with one of the creams.

Most hemorrhoids get significantly better after delivery, though they may get worse with pushing. Sitz baths with added witch hazel may be your best friend in the postpartum period.

Rarely, hemorrhoids become thrombosed and need to be dealt with surgically as an emergency. You should suspect that a hemorrhoid has become thrombosed if you have new, different severe pain that prevents you from being able to sit down. If you’re worried about this, ask your doctor immediately.

Perineal massage a few weeks leading up to delivery may decrease the chance that you tear, but it does so by causing unwanted (and permanent) relaxation of the vaginal tissues. It isn’t worth it. During labor, your doctor or midwife may provide some slight pressure on the perineum while you are complete and pushing. This can be seen as a massage, but in reality we are just helping to slowly stretch some of those muscles in the pelvic floor as the head begins to descend. This encourages the tissues to relax rather than contract right back after a contraction and push the baby back after the progress you just made with your pushing. At the actual moment of crowning of the baby’s head, studies have shown that a grip of the perineal tissues (applying counterpressure to the stretch of those tissues) can help prevent significant tears at the time the head delivers out of the vagina, the moment when most tears occur.

Yes. Especially if you’ve already had children, you might notice that your milk comes in early or that you have occasional leakage, even in the first trimester. Even if you haven’t had a baby yet, it’s not uncommon at all for you to leak some milk. If this is a persistent problem (or an embarrassing one), you might need to change up your bra or wear nipple shields so that your nipples are less stimulated.

You're not alone. Most women struggle at some point with breastfeeding. Click here to read our primer on breastfeeding and if you still having questions afterwards, ask your doctor or lactation consultant.

Cytomegalovirus (CMV) is a virus related to the herpes viruses. It is so common that up to 85% of adults in the United States have been infected at some point in their lives.

Usually, CMV is a mild disease that does not cause any serious problems in healthy children and adults. Most people get flu-like symptoms or cold-like symptoms for a few days, if they develop any symptoms at all. However, some people, including immune-compromised women and newborn babies of women infected with CMV during pregnancy, can have serious complications and even death.

Pregnant women infected with CMV for the first time during pregnancy can pass the virus to their unborn babies. The virus can also pass from mother to baby in vaginal secretions during delivery and in breast milk after birth. The virus can pass from person to person through blood, saliva, breast milk, and urine.

Up to 40% of babies born to women who are newly infected with CMV during pregnancy will become infected. Not all infected babies will have symptoms at birth.

Newborns with CMV are likely to be born early and weigh less. Other possible problems include a small brain (microcephaly) or other nervous system disorders that can cause seizures, deafness, mental retardation, or death. This infection can cause the liver and spleen to become larger than normal, as well as jaundice, and blood disorders. Newborns with CMV may have a rash that consists of small bruises called petechiae and larger bruises known as purpura. Some of these findings can be detected with ultrasound, but most cannot.

A baby born to a mother who was already infected with CMV before she became pregnant is less likely to be born with CMV due to some preexisting immunity. Only 0.5% to 1.5% of such babies are infected (compared to 40% of babies born to mothers who were infected during pregnancy), and their problems tend to be less severe.

There are currently no treatments for maternal or fetal CMV infection.

The pediatrician may order blood tests for babies with low birth weight, jaundice, small brains, or other problems that can be associated with congenital CMV. The diagnosis needs to be confirmed by testing blood or tissue from the infant within three weeks of birth to be accurate.

Young, healthy pregnant women usually do not need to be tested because they do not need to be treated specifically for CMV. They usually recover over a period of weeks. In some instances, blood tests may be done to confirm the cause of the illness, since similar symptoms can be caused by the Epstein-Barr virus (EBV) and even human immunodeficiency virus (HIV). Some of the antibody tests used to test for CMV have a high false-positive rate and the testing needs to be repeated to be reliable.

Pregnant women who care for young children should take these precautions to reduce the risk of CMV:

• Wash hands often with soap and water, especially after changing diapers. Wash well for 15 to 20 seconds.
• Do not kiss young children under the age of five or six on the mouth or cheek. Instead, kiss them on the head or give them a big hug.
• Do not share food, drinks, or utensils (spoons, forks, or knives) with young children.

If you are pregnant and work in a daycare center, reduce your risk of getting CMV by working with children who are older than two and a half years of age, especially if you have never been infected with CMV or are unsure if you have been exposed.

Some amount of bleeding during the first trimester is very common, affecting about one-third of pregnant women. Avoid sex if you are bleeding until you can discuss the bleeding with your doctor or it resolves. Bleeding increases your risk of miscarriage, but, surprisingly, not by very much. 

If you are having heavy bleeding and cramping, you need to be seen. Bleeding later in pregnancy may be a sign of labor or other problems. It can also be normal. A lot of women will spot later in pregnancy, especially if their cervix is starting to slowly make change. Always discuss heavy bleeding with your doctor immediately. This is almost never a reason to go the emergency department, but it is a reason to be seen in the office in the next day or two.

Anything you normally do when you feel that way! Sit or lay down, have someone get you some water and food, and give yourself some time to let the feeling pass. Laying on your left side is best so that your uterus rolls off of the blood vessels bringing blood back to your heart. The most important thing is avoiding falling down and hurting yourself. So, as soon as you feel woozy or dizzy, sit or lay down on the ground or in a chair.

Most of the time, the problem is a lack of blood to your head. When you’re pregnant, blood tends to collect in your legs. Your blood vessels relax to allow for increased blood volume and your uterus puts pressure on the vena cava, which is the large vein that draws blood back from your legs to your heart. These factors mean that more blood stays in your legs and that blood has a harder time getting back to your heart. Because of this, there is relatively less blood going to your head sometimes and this may make you feel like you are going to faint.

Blood moves up from your lower extremities with movement of the muscles in your legs. The veins in your legs run through the muscles; when the muscles work, they squeeze the blood upwards back to your heart. So moving your legs helps whereas standing very still may contribute to you passing out. You also may want to wear compression socks to help blood flow and reduce swelling. You should certainly try to maintain good fluid and food intake throughout the day to keep your energy up. Also avoid heat like hot showers. Your blood vessels will dilate even more when you are hot and a really hot shower in the morning could cause you to pass out. Conversely, you might feel better with a cool rag on the back of your neck.

There are lots of skin changes that might happen during pregnancy; some are due to physiologic and hormonal changes and some are more serious. Let’s talk about some of the more common ones.

Spider angiomas. These are little vascular spots that can show up on your skin during pregnancy. They are typically not concerning and will go away when you are no longer pregnant. The only time we would be concerned by them is if you have a history of liver problems or if you began having symptoms that would be concerning for a liver problem (which is rare). 

Linea nigra. This is a normal dark vertical line that can arise from your belly button down towards your pubic bone. It develops because of certain hormonal changes but it will fade away partially once the baby is born. During pregnancy, the placenta develops a hormone called melanocyte-stimulating hormone (MSH). This extra MSH stimulates some cells to make extra melanin which causes these cells to get darker.

Darkened areolae and darkened armpits. There are a lot of changes that may occur with the breasts during pregnancy. The nipples and areolae may become a darker shade due again to extra MSH. Similarly, the color should fade back to near its usual color after the baby is born. While this is completely normal, any redness of the breast should be investigated further by your doctor. The same thing goes for the arm pits. You may notice that they are darker, and may even look a gray or brown color. This is normal and will fade mostly back to normal as well once the baby is born. 

Melasma. Another case of hyperpigmentation in pregnancy! Are you kidding me?! Are you noticing a theme yet? Unfortunately, this one occurs on the face and women typically do not like it. It will appear as a gray or brown patchy/spotty or general change in the coloration of the face. What may be more upsetting to hear is that we don’t have a good treatment for it. If it’s still present a few months after you’ve delivered, talk to your doctor about possible treatments. You can prevent it from getting worse by using sun protection like sunscreens, hats, etc. Any sun exposure can make it worse. 

Polymorphic eruption of pregnancy (PEP). PEP is a rash of pregnancy that can occur during the third trimester on the abdomen and sometimes upper thighs. This previously was called pruritic urticarial papules and plaques of pregnancy (PUPPP). It will be very itchy and look like plaques, red bumps, or even hive-like. It can start out in the stretch marks and is not harmful to you or baby, but can be very annoying for you because of the itch. Treatment is a topical steroid cream that your doctor will prescribe for you, and possibly an oral antihistamine (e.g., Benadryl) to control the itch. Cool wet compresses and oatmeal baths may help with the itching.Pemphigoid gestationis. This rash can occur during the second or third trimester or sometimes right after delivery. This can have similar features to PEP but can extend further on your body beyond legs and thighs. It may develop blisters as well. The treatment is the same as it is for PEP. There are some other causes of rash and itching as well, including atopic eruption of pregnancy and pustular psoriasis of pregnancy. Remember, if your main symptom is intense itching without a rash, be sure to discuss intrahepatic cholestasis of pregnancy with your doctor as this requires medical treatment and earlier delivery.

Unfortunately, there has not been quality evidence showing that chiropractic alignment will help with delivery. Until there is solid evidence supporting it, we don’t recommend it. One thing often recommended is the “Webster technique.” This is supposed to ensure that the breech or transverse baby is head down by the end of the pregnancy. Most babies will be head down by 37 weeks’ or so and this technique is no better than random chance at making sure your baby is head down at term. Don’t waste your money.

Cutting out smoking completely is very difficult for most patients, but doing so can drastically reduce the risks to your pregnancy and your own health. There are a number of nicotine replacement therapies (NRT) such as: nicotine gum, patches, tablets, lozenges, inhalers (not the same thing as a vape), sprays, and strips. 

E-cigarettes are not a good option because they are not licensed or controlled for safety in pregnancy and we have no evidence that they are any safer in the long-term than cigarettes. 

Giving up smoking cold-turkey is hard. If you can give yourself time to quit gradually during the time when you are trying to get pregnant, this might be more effective. This involves reducing the number of cigarettes you smoke by one or two every week until you are completely off of cigarettes.

If you are pregnant and trying to stop smoking, you can also try substituting cigarettes with one of the NRTs mentioned above. This could mean using a patch and quitting all cigarettes or using an inhaler or gum and replacing a single cigarette here and there as you cut down. The goal is to get you to stop and stop for good, rather than quit for a week, and then fall off the bandwagon and start up all over again. 

When you are tempted to smoke, try the following:

• Delay the act of smoking as long as you can (and substitute it with an NRT if you can)
• Deep breaths
• Drink water
• Do something else (something with your hands is best)

We have medications that can help with the urges. Talk to your doctor to see if these are right for you.

In the first trimester, certain hormones your pregnant body makes can stimulate urine production and the urge to pee. As the baby grows and the uterus expands, the bladder, located directly in front of the uterus, gets compressed. This means the bladder probably holds less urine before you develop the urge to pee. These forces conspire together to make pregnant women pee a million times a day. It is important to remember that if you feel you are peeing an unusual amount with burning, you might have a UTI. Talk to your doctor about doing a urine culture.

What can help you stop peeing so much, you ask? First, don’t stop drinking fluids. You need them to stay hydrated! But you can cut down on them right two to three hours before you go to bed to avoid so many nighttime interruptions. Avoid caffeine drinks if you can. In the third trimester, try positional changes to avoid compression of the bladder by the uterus.

Mood swings are common in pregnancy and may be self-limited. Pregnant women are tired, often anxious about the pregnancy and the changes of life occurring, and are busy preparing for a new baby. There isn’t too much we can do for you here. But, it is important to distinguish an occasional mood swing from depression or anxiety. If you feel like your mood swings are uncontrollable and really, really bad, you should discuss them with your doctor so they can make sure that something more serious isn’t going on. The best way to take care of perinatal mental health problems is by catching them early. Many pregnant women, however, just have some overwhelming moments and don’t necessarily have an underlying mood disorder like depression or anxiety.

The best thing to do for these sorts of mood swings is personal soothing techniques. This might mean setting aside some personal time during your day or week, talking to your friends and family about things they can do to help you, or finding a confidant or therapist to talk things through with.  Mood swings are a part of pregnancy. There are a lot of changes going on with your body and your life. It is important to know that you can do this, and your doctor and your support system should be there to help every step of the way.

REM (rapid eye movement) sleep is the term we use for deep restful sleep when people experience vivid dreams. Pregnant women actually experience more REM sleep and therefore may feel like they have more vivid dreams as well as more frequent dreams. Their sleep is also disrupted more often due to things like discomfort, restless legs, frequent urination, etc. Restless sleep can also lead to an increase in hypnagogic hallucinations, which are the abnormal sensations that occur right as you are falling asleep (like a sensation of falling, strange smells, etc.).

The result of all of this is that pregnant women tend to remember more of their dreams. Sometimes, our anxieties play themselves out in dream scenarios so it’s not uncommon for your dreams to contain content that might be disturbing (things like losing the pregnancy or your child being hurt or injured in some way). If you find that the content of your dreams is particularly disturbing, talk to your doctor