PLEASE CALL US!!! The FAQ headings below are just a guideline and do not replace the fact that we are here 24 hours a day, 7 days a week. If you notice any of the following warning signs, please call the midwives right away at (908) 852-3443. If the office is closed, the answering service will page the midwife on-call.

• Bleeding from the vagina (flow like a period or filling a pad in an hour).
• Nausea or vomiting that does not stop for more than 24 hours.
• Marked decrease in the amount of urine passed.
• Pain or burning while passing urine or blood in urine.
• Fever-temperature over 100.4.
• Unusual or strong pain in any part of the body.
• Discharge from your vagina that causes itching, soreness, burning or foul odor.
• A gush of fluid from your vagina - note color, any odor and whether the baby is moving.
• Sudden swelling of face, hands, or ankles along with sudden weight gain.
• Blurring of vision or spots before your eyes.
• A severe headache.
• A change in the usual activity of your baby.

• What is my due date?
• What can I do about Morning Sickness or Nausea?
• What can I do about Constipation?
• What are hemorrhoids and what can I do about them?
• What can I do about heartburn?
• How can I treat colds and congestion?
• What can I do for headaches?
• What can I do for insomnia?
• What was the Gestational Diabetes Screening Breakfast Menu?
• Do you have A Suggested Reading List of great books to read during pregnancy?

• What should I pack to go to the hospital?
• What are some signs and symptoms of preterm labor and what whould I do if I am experiencing any of them?
• How do I know whether my labor is real or false and how do I know when to go to the hospital?

• How can I care for my breasts if I choose not to breastfeed?
• What can I expect with postpartum bleeding or Lochia?
• What can I do to soothe afterbirth pains?
• I'm nervous about using the bathroom, what can I expect in the first days?
• What should my activity level be?
• What should I plan to do about birth control?
• How do I know if I have an infection?
• What are the postpartum blues and how do I know if I need help?
• When should I plan to follow up with an office visit?

• How do I get a good start with breastfeeding?
• How can I care for my nipples?
• How do I know if I have Mastitis?

Pregnancy

What is my due date?
Try this Due Date Calculator!

What can I do about Morning Sickness or Nausea?
Nausea is caused by high levels of pregnancy hormones. It can range from occasional nausea to vomiting many times daily. During this time it is important to stay hydrated and to consume enough sugar. Avoid foods and vitamins that make you sick. Call if are keeping nothing down for more than 24 hours. Things to Try:

• Ginger Ale, Ginger Capsules, Ginger Root
• Vitamin B6 50mg/day
• Dry Crackers or Toast before getting out of Bed
• Protein Snack at Bedtime
• Coke Syrup
• Tried and True Yankee Recipe Makes Morning Sickness Extinct!

• Increase fiber-fruit, vegetables, whole grains
• Increase water consumption
• Prune juice, prunes, raisins
• Increase exercise
• Roxann's bran muffin recipe
• If necessary - Citrucel, Metamucil, FiberCon

• What they are: varicose veins in the rectal opening.
• What they do: cause burning, itching, irritation, bright red bleeding.
• What you can do: apply tucks pads, witch hazel, ice packs. Keep bowel movements regular and soft. Avoid straining and standing for long periods of time.

• Decrease size of meals
• Have your drinks separate from meals
• Sit up after eating
• Papaya capsules after the first trimester
• Calcium based antacids (do not exceed maximum dose on bottle)

• Increase fluids and rest.
• Vitamin C supplement 1000mg/day.
• Echinacea 2-3 capsules 2-3x per day
• Use Tylenol Cold, Sudafed and Robitussin DM only when absolutely necessary.
• Call if symptoms persist or a fever over 100.4 develops. You may need to see your primary physician.

• Stay well hydrated
• Extra strength Tylenol(acetaminophen)
  2 tablets every 4 hours as necessary
• Avoid aspirin and ibuprofen
• Take a nap or a bath
• Have a protein snack like nuts or cheese

• Limit pysical exercise at bedtime
• Warm bath
• Warm milk
• Chamomile tea/sleepytime tea
• Do not lay in bed awake - get up and when you are sleepy again repeat bedtime routine
• Tylenol PM - 2 tablets when absolutely necessary

• 4 oz. of unsweetened juice (orange, grapefruit, or apple)
• 2 eggs - scrambled, poached or boiled
• 2 slices of toast (not diet) with butter or one slice of toast (not diet) with butter and one cup of insweetened dry cereal
• 8 oz. glass of milk (whole, low-fat or skim)
• Coffee or tea, unsweeted (optional)

Remember, you must fast at lease 4 hours prior to the test - preferably from midnight with the test done in the am. One hour after finishing the breakfast - have your blood drawn at the lab.

Do you have A Suggested Reading List of great books to read during pregnancy?
Suggested Reading List:

• The Thinking Woman's Guide to Better Birth by Henri Goer
• Natural Childbirth the Bradley Way by Susan McCutcheon
• Birthing From Within by Pam England and Rob Horowitz
• Acupuncture in Pregnancy an dChildbirth by Zita West
• A Child is Born by Lennart Nilsson
• The Pregnancy Diet - A Healthy Weight Control Program for Healthy Women by Eileen Behan
• Spiritual Midwifery by Ina May Gaskin
• The Complete Book of Pregnancy and Childbirth by Sheila Kitzinger
• Pregnancy Fitness - Fitness Magazine
• Baby Catcher - Chronicles of a Modern Midwife by Peggy Vincent
• Gentle Birth Choices by Barbara Harper
• Birth Your Way by Sheila Kitzinger
• No More Morning Sickness by Miriam Erick
• Ina May's Guide to Natural Childbirth by Ina May Gaskin
• Active Birth by Janet Balaskas
• Eat Well and Lose Weight While Breastfeeding by Eileen Behan
• Yoga For Pregnancy by Rosalind Widdowson
• Pregnancy After Loss by Carol Cirulli
• The Birth Partner by Penny Simkin
• The Art of Natural Family Planning by John Kippley
• Mothering Magazine (www.mothering.com or call 1-800-984-8116)

We would appreciate any book donations for our lending library. Thanks!

Labor and Delivery

What should I pack to go to the hospital?

• Old nightgown or comfortable shirt, lightweight robe to wear in labor. Hospital gowns are available on the maternity unit.
• T-shirt or sports bra if you are more comfortable being covered in the jacuzzi.
• All other participants to wear clean clothing.
• Slippers and socks.
• Swim shorts for father or coach.
• Toiletries such as toothpaste, toothbrush, comb, shampoo.
• Camera, music-tapes or cd's. Please bring own player.
• Lip moisturizer.
• Light foods and fluids for mother in labor: honeyed, sugared teas; Gatorade or other sports drinks, juices, soups, broths, crackers, jello, sodas, lollipops, yogurt, bottled water. (Soda, saltines and graham crackers are generally available on the maternity unit.)
• Snacks for attending friends and families if desired.
• Clothes for the baby: t-shirt, going home outfit, receiving b lanket, sweater, coverall, and hat. (Choose according to weather)
• Supportive bra. Nursing bras are usually one-cup size larger than pregnancy cup size.
• Car seat for baby's trip home.
• If considering a waterbirth, bring a small fish net and nightlight.
• Plan for live-in help for at least 3-5 days after arriving home.
• NEW MOTHERS SHOULD DO NOTHING BUT REST AND CARE FOR NEW BABY!!

What are some signs and symptoms of preterm labor and what whould I do if I am experiencing any of them?

• Menstrual-like cramps (constant or occasional).
• Low, dull backache (constant or occasional)
• Pelvic pressure (feels like the baby is pushing down).
• Abdominal cramping (with or without diarrhea).
• Increase or change in mucous vaginal discharge.
• Uterine contractions every 10 minutes or more often (may be painless).
• Call your doctor right away if you're bleeding or you feel water leaking from your vagina.

• Stop what you are doing.
• Lie down on your left side for one hour.
• Drink 2-3 glasses of water or juice.
• Call your health care provider or go to the hospital if the symptoms get worse during that hour.
• Return to light activity if the symptoms go away after that hour. Do not do what you were doing when the symptoms began!
• If the symptoms come back after an hour of rest, call your provider. Never ignore your symptoms or assume they aren't important.
• Be sure to tell your provider at your next prenatal visit what symptoms you had and what you did about them.

What can I expect with postpartum bleeding or Lochia?
Lochia or postpartum bleeding will decrease every day for the next 10 days. The color will change from red/dark red to pink mucousy discharge for a couple of weeks. If the flow becomes heavy and bright red bleeding occurs: stop what you are doing, empty your bladder, put your feet up, breastfeed (if nursing) and call us after 1 hour if the bleeding continues to saturate your pad after 1/2 to 1 hour. What are some things I can do to soothe the perineum as I heal?

Rinse the area with the water bottle every time you go to the bathroom as long as you are bleeding. As sutures heal they become dry and can feel tight - this is normal. Use the Dermoplast spray provided by the hospital. Most sutures take 2 weeks to dissolve.

What can I do to soothe afterbirth pains?
Each pregnancy allows for increased cramping after birth, especially with breastfeeding. Motrin at 400mg every 6 hours, an empty bladder, and warm compresses to abdomen may improve discomfort. Empty bladder and lay stomach down with pillows supporting abdomen as this should keep uterus firm and minimize cramping.

I'm nervous about using the bathroom, what can I expect in the first days?

• Urination: Keep bladder empty. Sensation of fullness may not return immediately after birth, so during waking hours, empty bladder every 2-3 hours.
• Bowel Movements: Regular bowel movements can be promoted by eating high fiber foods, plenty of liquids and trying 1 galss of cold prune juice before bed and 1 glass of warm/hot prune juice first thing in the morning. tucks pads and witch hazel for wiping can help. Hemorrhoids can be prevented with regular bowel movements. Witch-hazel and sitz/tub baths (no perfumed gels) can promote healing also. Also try Roxann's bran muffin recipe
.

• No driving 1-2 weeks postpartum as indicated by midwife.
• Lift nothing heavier than your newborn for the first 2 weeks.
• Keep stairs to a minimum.
• Leisurely walks outside during pleasnt weather conditions are great for both you and the baby. NO power walking until 6 weeks postpartum.
• Let housework go. You need to heal and care for the baby.

What should I plan to do about birth control?
We prefer that you abstain from intercourse until your 6 week postpartum visit. However, use condoms with a lubricant should you resume sexual activities prior to this visit. We'll discuss birth control options with you at your 1 week postpartum visit.

How do I know if I have an infection?
*****CALL US IMMEDIATELY WITH*****: fever, abdominal pain, heavy red bleeding, severe calf pain, or odor to your discharge.

What are the postpartum blues and how do I know if I need help?
Postpartum blues normally last a couple of days beginning on day 3-7 postpartum. CALL US you feel depressed, anxious, can't get out of bed, feel as if you cannot care for your baby or yourself.

When should I plan to follow up with an office visit?
We like to see al of our mothers and babies at 1 and 6 weeks postpartum. Please call our office to schedule these appointments.

How do I get a good start with breastfeeding?
Begin by nursing every 2 hours for the first 5 days to establish milk supply. Expect your baby to nurse more frequently at the 2 and 6 week mark due to growth spurts.

A healthy diet is important! You will need to plan on an extra 500 calories more than your normal intake to maintain your weight. Continue you prenatal vitamins. Drink to satisfy thirst. If you have a poor appetite, try Ensure or Carnation Instant Breakfast.

How can I care for my nipples?
After nursing, squeeze colostrum and apply to the nipple/areola and let air dry. Apply a small amount of Lansinoh cream to the areola area and let air dry. Maintain a good latch on and positioning during each feeding.

How do I know if I have Mastitis?
CALL US IMMEDIATELY WITH THESE SYMPTOMS: A sudden fever (100.2 or higher) flu-like symptoms, or a firm reddened area of the breast. This is most common around 2 weeks postpartum and requires antibiotics.