Having a Baby

With access to cutting-edge technology and the ease of a private practice, our obstetrics practice is wide-ranging yet intimate and accessible.  At Lakeside OB/GYN, we believe that your involvement in your own birth process is the first and most important step toward a safe and satisfying delivery.  We can help you develop a birth plan that is consistent with your own needs and goals.  Because no two patients are alike, our approach to labor and delivery is equally as diverse.  While we support women who choose an epidural for pain relief, we are also advocates of labor support doulas, acupuncture and natural childbirth.  We are supportive of vaginal birth after cesarean (VBAC) deliveries.  We do not perform routine episiotomies and we are strong proponents of breastfeeding.

We know that having a baby is one of the most extraordinary events in your life.  In an environment of mutual trust and respect, we are confident we will help you achieve the birth experience that you envision.  Read below for answers to the most commonly asked pregnancy questions.

Congratulations on your pregnancy!

Call us to schedule your first appointment! 414-271-1116.  Call us when you have a positive home pregnancy test.  Tell us the first day of your last period and we will help you to schedule your first appointment, usually 6-7 weeks after the start of your last period, sooner if you are high risk for certain problems.

YOUR FIRST PREGNANCY VISIT
The goal of your first appointment is confirm the pregnancy, determine your due date and identify women who might be at increased risk for pregnancy complications.   An estimated due date will be set based on your last menstrual period.  Prenatal blood work and urine testing will be done to screen for anemia, blood type, and infection.  Dr. Trebian will discuss testing options for genetic disorders if applicable.  An ultrasound will be ordered for 8-10 weeks to confirm your due date.  Your first appointment takes about 15 minutes.  Allow 45 minutes if you are a new patient to our practice.  You will be provided with reference material for reading. Your next appointment will be scheduled about a week after your ultrasound and will allow adequate time to answer questions and discuss the anticipated course of care for your pregnancy.

HOW OFTEN WILL I BE SEEN DURING MY PREGNANCY?
Generally visits are monthly until 28-30 weeks, then every 2-3 weeks until 36 weeks and then weekly until delivery.  Women with complicated pregnancies may have more frequent visits.

ROUTINE PREGNANCY VISITS 
At each visit we check your blood pressure, weight, assess your baby’s growth and activity, and listen to your baby’s heart rate.  You will have an opportunity to discuss previous testing results, upcoming tests and ask any questions and concerns you may have.  Each visit is scheduled for 15 minutes with Dr. Trebian.  Please come a few minutes early to check in with Terri, use the restroom, and have your weight and blood pressure taken before you see the doctor. 

WHAT IS CONSIDERED AN EMERGENCY?
If you have bleeding, severe abdominal pain or cramping, please call our office at any time at 414-271-1116.  You should also call if you have a fever, painful contractions, think your water may have broken, or if you are in the third trimester and feel your baby’s movements have decreased.  If you have any other urgent issues call the office at any time of day or night, weekends or holidays.  If the office is closed, follow the menu prompts to reach the on call doctor.

Frequently Asked Pregnancy Questions

VITAMINS, NUTRITION, WEIGHT GAIN
Prenatal vitamins provide folic acid which has been shown to decrease the risk of neural tube defects when taken prior to conception and in the first trimester.  Iron which is in most prenatal vitamins will help prevent anemia or iron deficiency.  Woman who eat fish or take DHA or a Fish Oil supplement have been shown to have improved neurodevelopmental outcomes in their offspring.  The FDA recommends women eat a variety of fish twice a week and if unable to do so, take a dietary supplement.  The average weight gain during a pregnancy is 25-35 pounds.  Your ideal weight gain will depend on your starting height and weight.

WHAT FOODS SHOULD I AVOID?
Listeria:  Listeria can contaminate foods that otherwise look fine; avoid unpasteurized dairy products and fruit/vegetable juices.  Do not eat unpasteurized soft cheeses such as brie, feta, blue, goat, or camembert.  Avoid hot dogs and cold deli meats.  Listeria can be inactivated by high temperatures, however, so any of these foods should be safe if heated until steaming hot.  Do not eat smoked or raw fish.  Avoid raw sprouts — it is difficult to wash off bacteria.

Mercury:  Avoid the species of fish that are known to be high in Mercury (Shark, Swordfish, King Mackerel, Tilefish, Marlin, Orange Roughy and bigeye Tuna).  Eat up to 12 ounces (2 average meals) a week of lower mercury fish and shellfish.

Toxoplasmosis:  Do not eat raw or undercooked meat especially pork.  Also, avoid changing the cat litter and wear gloves when gardening or handling soil.

USDA Food Safety Information for Pregnant Women

WHAT CAN I DO TO MINIMIZE MY RISK OF DEVELOPING AN INFECTION WHILE PREGNANT?
Hand washing is the single most important thing you can do to minimize your risk.  Wash your hands after touching public surfaces, gardening, playing with cats, or handling raw meat.  Wash all fruits and vegetables, cook meats fully, and avoid handling soil and kitty litter.

It is recommended that everyone older than 6 months receive a flu shot every year.  This is especially important for pregnant women.  The flu shot is safe in every stage of pregnancy. 

Your doctor will recommend a pertussis vaccine against whooping cough between 27-36 weeks of every pregnancy.  This timing is to "share" the vaccine with the baby.  Babies younger than 6 months old can die from whooping cough. 

WHAT CAN I DO FOR NAUSEA?
Morning sickness is most common between weeks 6-12.  Try eating as soon as you are hungry and keeping something in your stomach at all times.  Eating small frequent meals, high in protein or carbohydrates and low in fat may help.  Take your prenatal vitamin at bedtime.  Acupuncture, acupressure, ginger and hypnosis have been found to be helpful by some women.  Vitamin B6 25mg taken two or three times a day has been shown to be helpful, or ask your doctor about the sleep medication Unisom taken once a day.  Prescription medications can be used if the over the counter medication do not help.  You should call your doctor if you cannot keep anything down for 24 hours or are urinating less than four times in 24 hours. 

WHAT CAN I DO FOR CONSTIPATION?
Drinking 6-8 glasses of water a day, eating a diet rich in fiber (raw fruits/vegetables, grains, prunes, apples), and regular exercise are all helpful.  Ask your doctor about taking a fiber supplement or a stool softener (colace, surfak).

IS IT OK TO EXERCISE?
Yes, exercise is good for you and your baby.  Most women can continue their pre-pregnancy exercise routine adjusting as needed for pregnancy conditions.  You should try to exercise for 150 minutes a week.  If you weren’t exercising before pregnancy consider walking for 30 minutes 5 times a week.  Take care not to get over-heated or dehydrated and alter your routine if it becomes uncomfortable.  Swimming is safe throughout pregnancy.  Hot tubs or saunas should be avoided as they can raise your core temperature.

IS IT OK TO HAVE SEX?
In the absence of pregnancy complications (Placenta previa, bleeding, ruptured membranes, preterm labor) it is safe to have intercourse throughout pregnancy.

HOW LONG CAN I WORK FOR?
Unless complications develop most woman can safely work until they go into labor.

SHOULD I WEAR A SEATBELT?
Yes, you should always wear a seatbelt.  Seatbelts provide more benefit than risk in the event of a collision.

WHAT MEDICATIONS ARE SAFE TO TAKE?
All patients should discuss any medication use with their doctor.  This includes over the counter medications and herbal supplements.  There are a few medications that are proven to cause birth defects or fetal issues, and only a few that are proven to be safe.  Most fall somewhere in between and many are thought to be low risk.  Therefore, it is prudent to minimize the number of medications taken, limit use of medication to situations where the benefit clearly outweighs the risk, choose medications with the best safety profile, and use them at the lowest dose and for the shortest duration that is effective.  Unless directed by your doctor, avoid aspirin, ibuprofen, and naproxen containing products.  Avoid any medications that contain alcohol. 

CAN I TRAVEL?
Air travel (on commercial pressurized aircraft only) is considered safe for most women with healthy pregnancies prior to 36 weeks.  Restricting travel if you are at risk for preterm labor or if you are over 36 weeks gestation is recommended.  While flying drink plenty of fluids.  Promote circulation by walking up and down the aisle and while seated periodically flex and extend your ankles and legs.  If you are planning a cruise please be aware that most cruise lines will not accept pregnant passengers after 24 weeks gestation.

CAN I COLOR MY HAIR?
There are no good human studies on occasional use of hair products during pregnancy.  Animal studies suggest minimal risk.  Exposure to hair dyes or hair products results in very limited systemic absorption. Therefore, these chemicals are unlikely to cause adverse fetal effects.

CAN I HAVE CAFFEINE WHEN I'M PREGNANT?
Low to moderate caffeine consumption during pregnancy is considered safe.  Pregnant women should limit their caffeine intake to less than 200 mg/day.  It is safest to stick to one "mug" (10-12 oz) or less of coffee per day.  Although research results have been conflicting, a few studies have suggested an increased risk of miscarriage with high caffeine intake (more than 300 mg/day) and an increased risk of stillbirth with more than 800 mg/day (that would be a lot!). 

SHOULD I GET A FLU VACCINE WHEN I'M PREGNANT?
The Centers for Disease Control and ACOG (the American Congress of Obstetricians and Gynecologists) recommend influenza vaccine for all women who will be pregnant through flu season (September-March).  Vaccination is important because pregnant women are at increased risk for severe illness due to influenza. Administration early in the flu season is optimal and vaccination is safe in any trimester.

SHOULD I GET A Tdap VACCINE?
Pertussis (also called whooping cough) is a highly contagious disease that causes severe coughing.  In newborns, pertussis can be a life-threatening illness and can be prevented with a vaccine called Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis).  All pregnant women should receive a Tdap vaccine between 27 to 36 weeks of every pregnancy.  Getting your Tdap vaccine is an effective and safe way to protect yourself and your newborn from whooping cough.  Family members and childcare providers should also be current on their Tdap vaccine. 

CAN I SLEEP ON MY BACK WHILE PREGNANT?
If you typically sleep on your back, it’s safe to continue doing so through mid-pregnancy.  After that, it’s best to avoid lying on your back for prolonged periods of time.  When you lie on your back, your enlarged uterus may press on the vena cava, the major vein that returns blood to the heart from your lower body.  Sleeping tilted to one side or another will help maximize blood flow to both you and your baby.  Try placing a pillow between your legs, under your hip, or behind your back to make your sleep position more comfortable.  Don’t be alarmed if you go to sleep on your side and wake up flat on your back.  Spending moderate amounts of time on your back does not have an adverse effect on your baby’s health.

DOES THIS PRACTICE SUPPORT NATURAL CHILDBIRTH?
Yes.  Our practice is very supportive of natural childbirth.  It is important to take childbirth classes to be knowledgeable about normal labor.  Learning about self-hypnosis or working with a labor support doula may be helpful for patients who want a natural childbirth experience.  

IS THIS PRACTICE SUPPORTIVE OF VAGINAL BIRTH AFTER CESAREAN (VBAC)?
Yes.  Attempting a vaginal birth after cesarean section (VBAC) is a safe and suitable choice for many women who have had a prior cesarean delivery.  If you are interested in VBAC, please discuss your circumstances with us, as certain factors may increase or decrease your chances of success.  It is also important to obtain the operation report from your cesarean delivery to make sure that there are no contraindications to a VBAC attempt.