5 Things I’d Never Do — Pregnancy Advice From an OB/GYN

What should you expect during pregnancy? Lots of very detailed dos and don’ts. Everyone has an opinion about whether it’s okay to eat tuna fish or take a bath, so sometimes it helps to get some overarching advice.

To provide you with some big-picture know-how, we asked MU Health Care OB/GYN Dr. Denicia Dwarica to participate in our “I’d Never” series. As a mom herself, Dr. Dwarica knows pregnancy well — both professionally and personally.

Here are five things she would never do during pregnancy:

1. Never Skip Prenatal Appointments

The purpose of prenatal appointments is to keep you and your growing baby healthy. Your OB/GYN uses these meetings to check for issues with growth and development and support you during pregnancy. And guess what. It works. People who don’t receive prenatal care are three times more likely to have a child with low birth weight.

Prenatal visits usually take place:

• Monthly for weeks four through 28
• Twice a month for weeks 28 through 36
• Weekly for weeks 36 to birth
• More often with high-risk pregnancies

“Prenatal visits are a privilege,” Dr. Dwarica says. “A lot of women don’t get time off to go to prenatal care visits or have more difficult pregnancies and don’t get the interventions they need. If you can go, take advantage of that care. And never be afraid to ask for time off for prenatal visits — you’re entitled to it.”

For women who need help paying for medical care during pregnancy, every state, including Missouri, has a pregnancy assistance program in place.

2. Never Push for Unnecessary Ultrasounds During Pregnancy

Even if you line up a dozen positive pregnancy tests, it’s natural to want an ultrasound to confirm the pregnancy. But according to Dr. Dwarica, over-the-counter pregnancy tests are so accurate that the ultrasound (and reassurance) you crave is typically unnecessary.

“People think they need to get an ultrasound to guarantee that the pregnancy is valid or going well,” Dr. Dwarica says. “But honestly, the first trimester is a delicate time of the pregnancy, and having an ultrasound isn’t going to determine whether the pregnancy succeeds.”

Even though ultrasounds are considered safe compared to other imaging tests, they aren’t without risk and should be avoided when unnecessary. In an uncomplicated pregnancy, ultrasounds are only needed a couple of times: to determine the due date and check the baby’s growth and development.

“If you have a healthy pregnancy, you’re less likely to need ultrasounds,” Dr. Dwarica says. “So it’s actually a good thing if you’re not having them frequently.”

She also cautions against getting 3D ultrasounds performed at a studio or without a referral from your provider. “You can’t ensure that your ultrasound is read and reviewed appropriately,” Dr. Dwarica says. “You may see something on the ultrasound that causes undue stress and have no one there to counsel you.”

3. Never Ignore Bleeding and Discharge During Pregnancy

Bleeding and discharge during pregnancy often reveal what’s happening inside your uterus. Ask your OB/GYN what to expect, and then pay attention so you can spot anything unusual.

“A lot of times, it’s not the incident but how long it’s occurring,” Dr. Dwarica says. “The big thing to pay attention to is any sort of bleeding.”

She adds that a little bit of spotting or bleeding in the first trimester can happen. But you should not have any bleeding during your second and third trimesters.

Toward the end of your pregnancy, shift your attention to discharge. Abnormal discharge can indicate that you ruptured your amniotic sac (broke your water), which doesn’t always happen as a full gush.

“Pay attention to see if it’s continuing or getting worse,” Dr. Dwarica says. “If you change your underwear or use a pantyliner, does it still feel like you’re leaking? If it’s not resolving, it’s a sign that something’s happening.”

4. Never Downplay the Fourth Trimester

Every person recovers differently after giving birth, depending on their health history, pregnancy and type of delivery. But experts have set the six-week mark as the optimal time for a postpartum check-in.

“At that time, some women feel better than others. But for the first six weeks after delivering a baby, women are very physically and emotionally vulnerable,” Dr. Dwarica says. “We call it the fourth trimester.”

The six-week postpartum appointment is essential to ensure you’re successfully navigating the fourth trimester without developing complications. Your OB/GYN will look for and discuss:

• Breastfeeding issues
• Acute infection (uterine tenderness, abnormal discharge, fever)
• Blood clots
• Blood pressure elevations
• Postpartum depression
• Plans for future pregnancy

The postpartum appointment is also an appropriate time to discuss birth control with your provider. Many OB/GYNs advise against having sex before that appointment — though the American College of Obstetricians and Gynecologists has no set restrictions on sex after birth.

The recommendation to wait four to six weeks after delivery to have sexual intercourse is for your safety, according to Dr. Dwarica. Getting pregnant too quickly after giving birth comes with serious health risks.

“A short interval pregnancy puts you at high risk for growth restriction and uterine rupture, especially if you had a C-section (Caesarian section),” Dr. Dwarica says. “And if you had a complication during your pregnancy, such as preeclampsia or gestational diabetes, getting pregnant again without treating those issues can be dangerous.”

5. Never Assume You Have to Deliver Your Second Baby the Same Way You Delivered Your First

First births don’t always go as planned. You may have hoped to deliver vaginally and ended up with a C-section. Or your vaginal delivery may have been traumatic or caused injury or damage down below. But no matter how your first delivery went, it doesn’t necessarily have to dictate how you’ll deliver another baby.

“If you’ve had a traumatic delivery due to a prolonged labor or a serious laceration or injury, you might consider not delivering vaginally the second time around,” Dr. Dwarica says. “A lot of patients don’t realize they have that option.”

People who had a C-section with their first child also have options. Research shows that vaginal birth after Caesarian section (VBAC) is successful up to 75% of the time. Some people even have a successful vaginal birth after two C-sections. But not everyone is a candidate for VBAC, so it’s an option you should discuss with your OB/GYN.

Next Steps and Useful Resources

Want to speak with an OB/GYN? Find one today.

Missed other installments of our “I’d Never” series? Check out:

• 7 Things I’d Never Do — Advice From a Urologist
• 5 Things I’d Never Do — Advice From a Colorectal Surgeon