Miscarriages

Losing a baby is a life-changing event

A miscarriage is an unplanned loss of pregnancy before the twentieth week. At least 10-15% of all pregnancies end in miscarriage, and most happen during the first 15 weeks, many in the first ten weeks. Some women miscarry even before they know they are pregnant, and sometimes the only symptom is a late menstrual period that is heavier than usual.

There is help for handling this loss

• A Pregnancy and Infant Loss Support Group is held at United Hospital on the second and fourth Monday of every month from 5pm–6:30pm.

• A Pregnancy AFTER Loss Support Group is held at United Hospital on the first and third Monday of every month from 5pm–6:30pm.
  
  United Hospital
  333 Smith Ave N
  St. Paul MN 55102
  
  Pre-registration is requested for both support groups. Both are free of charge.

Questions?

Please call 651.241.6206. The team at Welia Health is here to support you.

Being safe

Medications

Please talk to your Welia Health provider about any medications or supplements you are taking if you are pregnant or thinking about becoming pregnant.

There may come a time during your pregnancy when you’re feeling under the weather and aren’t sure if you can take your regular over-the-counter (OTC) medication. Some medications are safe to take during pregnancy. But others are not, or their effects on your baby may not be known.

When you meet with your provider to confirm you are pregnant, ask what medications are acceptable to take and what medications you need to find alternatives for. Your provider will weigh the risks and benefits to help you know what’s safe.

Also, tell your provider about any alternative medicines or supplements you take, even if the label says “natural.”

Prenatal vitamins are safe and important to take when you’re pregnant. Ask your provider about the safety of taking other vitamins, herbal remedies and supplements. Most herbal preparations and supplements have not been proven to be safe during pregnancy.

If you get any new prescriptions while you’re pregnant, make sure the people who prescribe them know that you’re pregnant.

Generally, you should avoid taking any OTC medication while pregnant unless it is necessary.

To learn more, visit Treating for Two, a program developed by the Centers for Disease Control that aims to improve the health of women and babies by identifying the safest treatment options for common conditions before, during, and after pregnancy.

Smoking

Smoking may lead to serious health problems for your baby. If all smoking women would quit smoking during pregnancy, more than 5 percent of deaths among newborns could be prevented.

If you quit smoking, your baby will:

• Grow better because he or she will get more oxygen and food
• Have a better chance of being born full term and healthy
• Have a smaller chance of being miscarried or stillborn
• Have a smaller chance of dying of SIDS (sudden infant death syndrome)

If you quit smoking, you will:

• Have lowered chances of getting heart disease, cancer and lung problems
• Have improved blood flow, and the temperature of your hands and feet will return to normal
• Have a normal level of oxygen in your blood
• Be able to smell and taste food better
• Stop coughing
• Develop fewer wrinkles
• Save money

If you need help quitting tobacco, Welia Health offers a tobacco cessation program with one-on-one support from a Certified Tobacco Cessation Therapist. For more information or to schedule an appointment, call 320.225.3356. Services are available in Mora, Hinckley and Pine City. No referral is necessary.

Alcohol and drugs

There is NO safe amount of alcohol, marijuana or any street drug at any stage of pregnancy. Drinking any form of alcohol or using street drugs can harm a developing baby. The result can be stillbirth, miscarriage, low birth weight, birth defects, brain development issues and lifelong learning problems.

If you are concerned about any alcohol or street drugs you used before you knew you were pregnant, please talk with your provider. If you need help to stop drinking or using drugs, there are resources available.

If you are pregnant or are thinking about becoming pregnant, it is imperative that you don’t drink alcohol or use drugs. Alcohol and drugs pass through the placenta directly into your baby’s bloodstream. This can create lifelong problems for your baby, including physical and mental birth defects, heart defects, and problems in brain development and growth. Drinking alcohol increases your risk of miscarriage and preterm birth and can cause low birth weight.

Drinking alcohol while breastfeeding is also extremely unsafe; alcohol passes through breast milk directly to your baby.

If you are pregnant or breastfeeding and are having trouble not drinking alcohol, contact your provider about alcohol treatment programs or contact the National Council on Alcoholism and Drug Dependence at 1.800.622.2255 or www.ncadd.us.

Water

To make sure you stay adequately hydrated and to prevent constipation, hemorrhoids, and urinary tract or bladder infections, it’s important that you drink plenty of water while you’re pregnant. Aim for twelve (12) 8-ounce glasses of fluids each day, and try to choose water or low-fat milk whenever possible. You’ll need more fluid when you exercise, when the weather is hot, and if you’re ill with a fever. If your urine is colorless or light yellow, you know you’re drinking enough water.

Weight gain

Generally, a weight gain during pregnancy of 25 to 35 pounds is recommended. Do not diet or skip meals, especially during late pregnancy, because the baby has a continuous need for calories. Your baby is growing 24 hours a day, so try to spread out your food intake. If excess weight gain is a problem, substitute quality for quantity. Avoid foods that contribute many calories but have little nutritional value.

Talk to your provider about any questions or concerns you may have related to healthy weight gain during pregnancy.

Caffeine

Some studies show a relationship between excessive caffeine intake and an increased risk of miscarriage, especially in the first trimester. Because of that, some providers recommend limiting caffeine to no more than 200 milligrams a day during early pregnancy. The caffeine content of some popular beverages is as follows:

Exercise

• Is it safe to exercise during pregnancy?
  If you are healthy and your pregnancy is normal, it’s safe to continue or start most types of exercise during pregnancy. Swimming, stationary biking, brisk walking, gardening/yard work and modified yoga are often recommended. You may need to make a few changes, however, to ensure safety and comfort while exercising. Avoid activities that could result in falls, high impact to joints and abdominal strain—activities such as contact sports, heavy lifting, skiing, horseback riding, “hot yoga,” or pilates. If you are an experienced runner/jogger or racket-sports player, you should discuss these activities with your healthcare provider.

• What precautions should I take when exercising during pregnancy?
  Drink plenty of water to prevent dehydration, avoid becoming overheated, wear a sports bra and consider an abdominal binder later in your pregnancy as needed for comfort. Always consult your healthcare provider before starting a new exercise routine, especially during pregnancy. If you are pregnant with multiples or have the following conditions or pregnancy complications, you should not perform aerobic exercise during pregnancy: placenta previa after 26 weeks of pregnancy, preeclampsia, severe anemia, certain lung and heart diseases, cervix insufficiency or cerclage.

• How much should I exercise during pregnancy?
  The Centers for Disease Control and Prevention recommend that pregnant women get at least 150 minutes of moderate-intensity activity each week. This is best tolerated when split into intervals of 10-30 minutes. Moderate-intensity means you are moving enough to increase your heart rate and start sweating. You should still be able to talk normally but not sing. Monitor your heart rate; some experts recommend a sustained heart rate of no greater than 140 beats/minute during pregnancy. Stop exercising and call your healthcare provider if you have any of the following symptoms: vaginal bleeding, feeling dizzy or faint, shortness of breath before starting exercise, chest pain, headache, calf pain/swelling, sense of weakness, abdominal pain or contractions.

Adapted from the American College of Obstetrics and Gynecologists.

Saunas and hot tubs

Avoid sitting in saunas and hot tubs during the duration of your pregnancy. Both are very risky, as raising your core body temperature is hazardous to both you and your baby. There is a greater risk for dehydration, dizziness, lower blood pressure and birth defects, all symptoms associated with extreme heat situations.

HIV and AIDS

• Pregnancy and HIV
  Infected women may pass HIV, or human immunodeficiency virus, to their children before or during birth or through breast milk. HIV is the virus that causes AIDS or acquired immunodeficiency syndrome. It is spread when body fluids (semen, vaginal secretions or blood) from an infected person enter the body of someone who is not infected. HIV is the third leading cause of death for women aged 25-44. If you are infected with HIV, there are ways you can protect your baby and your health.

• Protect yourself from HIV
  
  • Do not have sex with multiple partners.
  • Always use a latex condom and water-based lubricant during sexual intercourse.
  • Always use a latex barrier when giving or receiving oral sex.
  • If you have a new partner after becoming pregnant, ask to be re-tested.
  • Do not share needles for piercing, applying tattoos or drug use.
  • Talk with your partner(s) about AIDS, sex and drugs.

• Get tested for HIV
  All pregnant women are routinely tested for HIV. Many women do not know they have been exposed to the virus because they don’t think they are at risk. The HIV test is a blood test that can be done during your prenatal visit. Tests are confidential, and results will go into your medical record.

• HIV test sites
  If you do not want to be tested for HIV at your provider’s office, there are public Minnesota HIV counseling and testing sites.
  
  • Hennepin County Red Door Clinic
    525 Portland Ave S 4th Floor
    Minneapolis MN 55415
    612.348.6363
    612.348.4729 TTY
  • Ramsey County Department of Public Health, Clinic 555 (formerly Room 111)
    555 Cedar St
    St. Paul MN 55101
    651.266.1255
    
    No matter where you are tested, all positive HIV results are given to the Minnesota Department of Health. The report is private. If you test positive, a representative from the health department will contact you to discuss your treatment options.
    
    For more information, call the Minnesota AIDS Line at 1.800.248.AIDS .

• If you are infected
  If you have HIV, see your provider about getting the care you need to stay healthier longer. There is a 25 percent chance you will pass the virus to your baby, but medication is available to significantly reduce this risk.

Dental hygiene

It is important to keep regular dental check-ups during pregnancy, but remember:

• X-rays can be done, but with extreme caution.
• Hormonal changes during pregnancy can increase the risk of developing periodontal disease (gum disease).
• Brush and floss regularly to prevent or reduce oral health problems. The bacteria in your mouth are connected to preterm conditions.

Toxoplasmosis

Toxoplasmosis is an infection caused by a microscopic parasite called Toxoplasma Gondii, which is commonly found in cat feces. Although the infection generally results in a mild illness, it is risky during pregnancy because the parasite may infect the placenta and unborn baby. Throughout your pregnancy, it is important that you:

• Avoid changing cat litter.
• Wear gloves when gardening or when around sandboxes that may have been contaminated by cat feces.
• Avoid stray cats, especially kittens.

Group B Strep

Group B strep (streptococcus, GBS) is a bacteria that can be found in the vagina and/or rectum. Approximately 25% of healthy adult women carry this bacteria, which is not a sexually transmitted disease. It can, however, be transferred from a pregnant woman to her baby during childbirth. If GBS is passed to a baby during delivery, there is a risk to the baby of developing a life-threatening infection. About 35 to 37 weeks into your pregnancy, your provider will test for Group B strep using a vaginal and rectal swab. If the results are positive, showing you are a carrier, you will be treated with antibiotics during labor, as this can significantly reduce the risk of passing this bacteria to your baby.

Genetic testing

Prenatal genetic testing is available at Welia Health. If you choose this testing, your blood will be screened for the most common genetic disorders and chromosomal abnormalities. The standard panel will indicate your carrier status for 29 hereditary disorders outlined in ACOG/ACMG* guidelines. It will also screen your baby for chromosomes 21, 28, 13, X and Y (gender).

For more information, visit www.natera.com/womens-health.

Note: some insurers do not cover genetic testing. Please refer to the details of your insurance plan.

* American College of Obstetricians and Gynecologists/American College of Medical Genetics and Genomics

Prenatal vitamins

To reduce your risk of having a baby with a neural tube defect (like spina bifida or anencephaly), it’s important to take a prenatal vitamin—especially during the first trimester of pregnancy. Prenatal vitamins are available over-the-counter or as a prescription from your provider. 

Vitamin ingredients

Prenatal vitamins should contain the following:

• Iron – 30 mg
• Calcium – at least 250 mg
• Folate – at least 0.6 mg
• DHEA or fish oil

Morning sickness

During the first trimester of pregnancy, excessive nausea and vomiting is caused by hormonal changes and by low blood sugar.

Steps to ease morning sickness

The following information can help you control nausea and vomiting at home.

Diet

• Try to eat six (6) small meals or snacks throughout the day. Smaller meals may be easier to tolerate than larger meals.
• Keep easy-to-digest foods such as crackers and pretzels with you during the day and at your bedside. Try having a little food or juice before getting out of bed in the morning.
• Choose lower-fat foods, which are easier to digest than higher-fat foods. High-fat foods may make nausea worse.
• Try sour-tasting foods like dill pickles or lemon drops or citrus fruits such as lemons, limes, grapefruit and oranges.
• Sit up after eating a meal.
• Avoid being around odors that make you feel nauseated.
• When you can eat without vomiting, begin to increase your food choices.
• Try to drink twelve (12) 8-ounce glasses of fluids each day.
• Drink fluids between meals. Recommended beverages include:
  • Water
  • Non-fat milk (white or chocolate)
  • Fruit juice or lemonade
  • Caffeine-free soft drinks (7up, Sierra Mist or ginger ale)
  • Broth
• Eat ginger or take ginger tabs, 250 mg, four (4) times per day
• Eat hard candies, especially lemon, mint or orange

Stay active

To help you avoid thinking about nausea, try to keep your mind and body active.

When to see a health care provider

If vomiting continues for more than 24 hours without slowing down, if you lose more than 10 pounds, or if you think you are dehydrated, go to the hospital, urgent care or clinic. Intravenous fluids may be necessary to treat dehydration. Signs of dehydration include a flushed face, extreme thirst, small amounts of urine, dark yellow urine, dry mouth, cramping in arms or legs, sunken eyes, dizziness, low blood pressure, fainting or rapid breathing.

Alternative therapies

Talk with your provider about trying alternative therapies in addition to your regular treatment. Options include acupressure, aroma therapy and homeopathy.

Medicine

Your provider may prescribe a medication to help control your nausea and vomiting. Before taking any medicine—prescription, over-the-counter, natural or herbal—talk with your provider.

A menu to combat morning sickness

Add more variety when you can eat without vomiting.

Breakfast

• 1 cup cooked oatmeal
• ¼ cup sliced unsalted almonds
• ½ cup sliced strawberries
• 1 teaspoon margarine or butter
• 1 cup of low-fat milk
• 1½ cups seltzer water or ginger tea

Morning snack

• 6 saltine crackers
• 1½ ounces string cheese

Drink 12 ounces of water by mid-morning.

Lunch

• ¾ cup of low-fat cottage cheese
• 1 cup of cubed cantaloupe
• 6 carrot sticks
• 1½ cups of ginger tea or lemonade

Afternoon snack

• 1 ounce pretzels
• 1 tablespoon of peanut butter

Drink another 12 ounces of water by mid-day.

Evening Meal

• 3 ounces cooked skinless chicken
• 1 medium baked potato
• ½ cup cooked carrots
• ½ cup chocolate pudding
• ½ cup 100% fruit juice

Evening snack

• 1 slice of whole wheat bread
• 2 tablespoon low-fat cream cheese
• ½ cup sliced cucumber
• ½ cup sliced tomatoes
• 1½ cups plain or seltzer water

Drink an additional 24 ounces of water by the end of the day.

Foods to avoid or limit during pregnancy

Some foods are toxic and can cause disease, premature labor, miscarriage and fetal death.

Beverages

• Alcohol of any kind – No amount of alcohol is considered safe during pregnancy
• Excessive caffeine (> 200 mg) – One 8-ounce cup of coffee contains 95 mg of caffeine
• Some herbal teas – Consult with your provider

Fruits

• Unpasteurized cider or juice

Vegetables

• Raw sprouts

Eggs

• Raw or soft-cooked eggs

Dairy

• Raw, unpasteurized milk or cheese
• Soft cheeses including Brie, Gorgonzola and blue cheese

Meat and poultry

• Raw or undercooked meat or poultry
• Uncooked processed meats, including deli meats and hot dogs
• Meat spreads and pâté

Fish

• Raw or smoked fish or seafood
• Fish with high mercury levels, including shark, swordfish, king mackerel and tilefish

* You may eat up to 12 ounces of lower mercury fish (shrimp, canned light tuna, salmon, pollock, catfish) per week or up to 6 ounces of albacore (white) tuna or locally caught fish per week.

Herbs, botanicals and supplements

• Consult with your provider

Stages of Pregnancy

Pregnancy lasts about 40 weeks, counting from the first day of your last normal period. The weeks are grouped into three trimesters. Find out what’s happening with you and your baby in these three stages.

What is my due date?

Calculate your estimated due date before you see your provider.

Nutrition

When you’re pregnant, you experience many changes. And as your body changes, so do its demand for nutrients. You need to get enough nutrients to support both yourself and your baby’s growth.

Simple steps for eating healthy throughout your pregnancy

1. When you eat a healthy, balanced diet, you and your baby both get the nutrition you need.
2. By eating a variety of healthy foods and taking prenatal vitamins, you should be able to get all the nutrients you need during pregnancy. Taking your vitamins with a small meal or snack will help you tolerate and absorb them better.
3. Any extra calories should be from nutritious foods, such as lean meats, low-fat or fat-free dairy products, fruits, vegetables and whole grain bread and cereals.

Daily meal planning guidelines

Water

To make sure you stay adequately hydrated and to prevent constipation, hemorrhoids, and urinary tract or bladder infections, it’s important that you drink plenty of water while you’re pregnant.

Aim for twelve (12) 8-ounce glasses of fluids each day, and try to choose water or low-fat milk whenever possible. You’ll need more fluid when you exercise when the weather is hot and if you’re ill with a fever. If your urine is colorless or light yellow, you know you’re drinking enough water.

Caffeine

Some studies show a relationship between excessive caffeine intake and an increased risk of miscarriage, especially in the first trimester. Because of that, some providers recommend limiting caffeine to no more than 200 milligrams a day during early pregnancy. The caffeine content of some popular beverages is as follows:

Calcium

• Putting the clamp on high blood pressure – Pregnancy-induced high blood pressure can happen in 10% to 20% of all pregnancies and, if not corrected, may lead to preeclampsia—a potentially life-threatening disorder of late pregnancy. If you can boost your calcium intake to 1,200 to 1,500 mg/day, you’re a step ahead in reducing your risk of pregnancy-induced high blood pressure and preeclampsia.

• Calcium-rich foods – Milk and milk products are the richest sources of calcium – one 8-ounce glass of milk provides 300 mg of calcium. As a mom-to-be, you can meet your calcium needs by drinking three (3) cups of nonfat or low-fat milk a day or by consuming other calcium-containing foods. Listed below are common sources of calcium and calcium counts.

Prenatal visits

Understanding the schedule of your provider visits and what they entail will help you achieve a healthy pregnancy.

Your weight and blood pressure will be checked at each appointment. Your provider will measure your abdomen to check your baby’s growth, listen to the baby’s heart rate, and examine you for any signs of health problems. Later in your pregnancy, your provider will determine your baby’s position by checking your abdomen. And you will receive prenatal education at each visit.

Your first trimester

Visit 1—weeks 4-9

• Clinic tests will confirm a positive home pregnancy test
• You may receive a prescription for prenatal vitamins
• Your provider will calculate your estimated due date and schedule a dating ultrasound if needed
• Your provider will talk about lifestyle factors, including foods to avoid, medication use, exercise, activities, stress, caffeine, exposure to toxic substances, smoking, drinking, and recreational drug use
• You’ll receive an introduction to our breastfeeding and prenatal classes, as well as to resources including WIC, Kanbec County Public Health, and the Beginnings Book

Visit 2—weeks 10-12

• You’ll be offered genetic screening (Progenity), and may be given diagnostic tests
• You may be able to hear your baby’s heartbeat
• You’ll receive a full physical with laboratory tests
• You and your partner will be encouraged to sign up for monthly prenatal classes.
  • Visit the Welia Health Calendar of events for detailed information

Your second trimester

Visit 3—weeks 15-16

• Regular check-up appointment

Visit 4—weeks 19-20

• Ultrasound to check for physical development, screen for possible abnormalities, and confirm official due date
• Flu vaccination

Visit 5—week 24

• Regular check-up appointment, including a diabetes test

Lactation counseling—weeks 20-30

• If desired, a visit with the clinic Lactation Counselor for breastfeeding education

Your third trimester

Visit 6—week 28

• Regular check-up appointment
• Birthing plan of care is discussed
• Tdap immunization is administered

Visit 7—week 32

• Regular check-up appointment

Visit 8—week 34

• Regular check-up appointment

Visit 9—week 36

• Regular check-up appointment

Visit 10—week 37

• Regular check-up appointment

Visit 11—week 38

• Regular check-up appointment

Visit 12—week 39

• Regular check-up appointment

Visit 13—week 40

• Regular check-up appointment and preparation for delivery

This is a timeline for what is considered a normal, non-high-risk pregnancy. Specific recommendations and referrals will be determined by your provider.

Learn more about the stages of labor >

When to call your provider

If you are pregnant and are experiencing any of the following symptoms, call your provider right away.

• Vaginal bleeding
• Abdominal/uterine cramping
• Fever over 100.5°F or 38°C
• Chills
• Weakness
• Persistent vomiting
• Back or shoulder pain
• Difficulty breathing

Call Welia Health at 1.800.245.5671 or 320.225.3625.

All about pregnancy

Congratulations on your pregnancy!

While it’s an exciting time, it’s also filled with a variety of emotions. The team at Welia Health is here to help guide you along your journey. We want you to have the safest and healthiest pregnancy possible.

To help prepare you for the months ahead, we offer a variety of resources and information to help you become more prepared and to have resources to turn to in between visits with your Welia Health team. Explore the links below and bookmark our website to turn to when non-urgent questions come up!

• Stages
• Prenatal visits
• Being safe
• Nutrition
• Prenatal vitamins
• Morning sickness
• Genetic testing
• Prenatal education
• When to call your provider
• Miscarriages
• Stages of labor
• Preterm labor

Looking for even more information about pregnancy? Try downloading one, or all, of these apps.

 

 

 

When to call us
Your Welia Health Birth Center team invites you to call us anytime during your pregnancy if you have questions or concerns, or an urgent need. We are here for you!