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American Medical Association Family Medical Guide - American Medical Association [282]

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It can help control your blood pressure, reduce stress, prevent constipation, tone your muscles, and help you fall asleep. In general, you can continue any exercise you did before you were pregnant as long as it doesn’t overtire you or cause excessive straining. Maintain a heart rate of less than 140 beats per minute during exercise. Walking and swimming are good exercises for pregnant women. Avoid strenuous sports and sports in which you or the fetus might be injured. If you are an athlete, your doctor will closely monitor the growth of the fetus and your weight.


Work

Many pregnant women continue to work up until labor and delivery. If your doctor thinks that your job is too strenuous, he or she may recommend that you take a medical leave of absence if it is contributing to complications in your pregnancy. However, you probably can continue to work if you are healthy and have not been diagnosed with a condition that could cause complications during the pregnancy. Take a break a few times a day to stretch and walk, and don’t strain or lift heavy objects.


Travel

If you are traveling, bring your medical records with you, along with any special instructions your doctor has given you. Don’t take medications for motion sickness because they can trigger uterine contractions. Ask your doctor what you can do for motion sickness.

Discuss with your doctor the safety of any vaccinations you may need to have for foreign travel. Avoid traveling far from home or a hospital if you have had any problems with your pregnancy such as bleeding or if you are within 4 to 6 weeks of your due date. Traveling can tire you more than usual. If you are sitting for long periods, such as when flying, get up and walk around the cabin whenever you can, at least every 2 hours. Check with your doctor and the airline before making reservations for a trip. Most airlines will not allow women to fly during their last few weeks of pregnancy because of the risk of delivery.


Sex

You can safely have sexual intercourse while you are pregnant—it does not harm the fetus. Some women feel increased desire for sex during pregnancy, while others lose interest. As your uterus enlarges, you may want to experiment with more comfortable positions for intercourse, such as with you on top. If you or your partner finds that intercourse is less enjoyable or more difficult during pregnancy, find other ways of giving each other pleasure. Keep in mind that toward the end of pregnancy, nipple stimulation can trigger labor contractions.

Your doctor will advise you not to have intercourse if you are at risk of miscarriage (see page 522), premature rupture of the membranes (see page 528), preterm labor (see page 529), placenta previa (see page 527), or vaginal bleeding, or if you have been diagnosed with an incompetent cervix (see page 524).


Tender Breasts

Breast tenderness (caused by increased production of the hormone progesterone) is often one of the earliest signs of pregnancy. Your breasts become swollen and tender, and your nipples may be sore. Your nipples may also become more prominent. Breast tenderness usually subsides as pregnancy progresses. If you plan to breastfeed, buy several nursing bras, and wear them in your last trimester to provide extra support and minimize soreness.


Nausea

Nausea (sometimes accompanied by vomiting) occurs in about half of all pregnant women in the first 3 months of pregnancy. Some women are nauseated throughout their pregnancy. The feeling of nausea often comes on in the morning right after waking (called morning sickness), but can occur at any time of the day or night. Nausea usually begins during the first month of pregnancy and continues until about the 14th to 16th week.

The exact cause of nausea during pregnancy is unknown, but some doctors think that it may result from the rapid rise in the level of the hormone estrogen during pregnancy. Nausea and a mild amount of vomiting usually are harmless. However, in a small percentage of pregnant women, vomiting is so severe that it drains their body of fluids and minerals, harming

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