FREQUENTLY ASKED QUESTIONS
What is a pap smear? A pap smear is a simple test that screens for cancer of the cervix. It involves collection of cells from the cervix to be examined under a microscope.
When should I start getting pap smears? Updated guidelines from the American College of Obstetrics and Gynecology (ACOG) in 2009 suggest that women should have their first pap smear at age 21.
How often do I need to get a pap smear? It is recommended to get pap smears at least every 2 years in your 20s. After age 30, it is common to test for the high-risk subtypes of Human Papilloma Virus (HPV) with the pap smear. If both pap and HPV tests are normal, you can space the pap smear screening to every 3 years. However, you will need more frequent screening and possibly a biopsy of the cervix if a pap smear result is abnormal.
Do I still need to get annual female exams if I do not need a pap smear every year? Yes, it is still recommended to have a yearly well woman exam. ACOG actually recommends that the first gynecologic visit for young females occurs between the ages of 13 and 15. Depending on your current health care needs, there may also be exams performed. The decision to perform an exam is based on your age, any problems you are having, or if you are sexually active. Exams may include a pelvic exam, pap test, sexually transmitted disease testing and a breast exam.
Your well woman exam is the time for you to discuss any questions or health problems you are having such as birth control, preventing or treating sexually transmitted infections or issues related to menstruation.
Should my daughter get vaccinated against Human Papilloma Virus? HPV is the most common sexually transmitted infection in the United States. It is estimated that up to 80% of people are exposed to this virus at some time in their life. Though it is transient in most cases, persistence of various subtypes can lead to cervical cancer, genital warts, and anal cancer. There is also evidence now that HPV is involved with mouth and throat cancers, the incidence of which has tripled in the last 30 years. ACOG, Centers for Disease Control (CDC), American Cancer Society, US Preventative Task Force all recommend routine vaccination of girls from age 11 to 12. There are two HPV vaccines available, and they can be given from age 9 to 26 in a series of three injections typically given over 6 months. We at Legacy Women’s Health advocate HPV vaccination.
How far along am I? For women with monthly menstrual cycles, the age of the pregnancy is counted from the first day of your last cycle (the day you started bleeding on your period). You are 40 weeks in the average egg cycle from preparation in the ovary to the end of pregnancy. Assuming you ovulated 2 weeks after your last cycle started and conception occurred at week 2 of the egg cycle, your baby should be born about 38 weeks later. If you have an irregular cycle, your due date will be based on measurement from your first ultrasound.
What can I start doing for the pregnancy before seeing the doctor?
1 - If you are not already on a prenatal vitamin, start taking one a day as soon as you discover you are pregnant. These can be bought without a prescription, and some brands even come with a stool softener and DHA, a supplement known to improve brain and eye development in babies.
2 - Eat a well-rounded diet with a variety of foods to get all the nutrients you need. Daily servings recommendations include 6-11 servings of breads and grains, 4 servings of fruit, 5 servings of vegetables, 4 servings of dairy products, and 3 servings of protein sources (meat, poultry, fish, eggs or nuts).
3 - Make sure you consume at least 6-8 glasses of fluids daily including water, low fat milk, fruit juices or soymilk.
4 - Avoid foods such as shark, swordfish, king mackerel, tilefish (also called white snapper), and albacore tuna because of they contain high levels of mercury. You should not use the artificial sweetener Sweet & Low because it is made of saccharin, which can cross the placenta. Beware of soft cheeses (feta, Brie, Camembert, blue-veined, and Mexican-style cheeses) which are often unpasteurized and may cause Listeria infection. Also, do not eat raw fish (clams and oysters) or meats.
5 - Caffeine has been associated with doubling the risk of first trimester miscarriages; thus, we advise you to limit caffeine intake to no more than 200mg daily in the first trimester and 300mg afterwards. A 12oz cup of brewed coffee has 200mg of caffeine, but other sources of caffeine include tea, some sodas, and chocolate.
6 - Drinking alcohol in pregnancy increases the risk for miscarriage and premature birth and can cause a wide range of physical and mental birth defects, so you should avoid alcoholic beverages.
7 - Finally, do not smoke and avoid second hand smoke. The nicotine, carbon monoxide, lead, arsenic and tar in cigarettes can lessen the amount of oxygen to your baby. Babies born to women who smoke are more likely to be born with a birth defect (like a cleft lip or palate), be born prematurely, have low birth weight (for gestational age), and have lifelong disabilities (like cerebral palsy, mental retardation, and learning problems). If you do smoke, it is imperative that you completely give up this harmful habit forever, not just during pregnancy; children exposed to cigarette smoke can have slow lung growth and often suffer from asthma, bronchitis, pneumonia, ear infections and respiratory symptoms. Young children of smokers are also more likely to die from Sudden Infant Death Syndrome (SIDS).
Can I keep my cat? Cats that go outside can be exposed to toxoplasmosis via wild food sources. You can be exposed to this parasite if you change the little box of an infected cat. Cats that never go outside are at a very low risk of contracting toxoplasmosis. Loving your cat is perfectly safe while you are pregnant, but to be on the safe side, have someone else change the litter box! Also, wear gloves while gardening and wash your hands afterwards. Congenital toxoplasmosis is a serious condition associated inflammation of the brain (encephalitis) and eyes (chorioretinitis) and can affect the neurologic system, heart, liver, and inner ears.
Can I get my hair colored? Highlights added to your hair with foils are considered safe in pregnancy as they do not sit on your scalp, and so are not absorbed into the bloodstream. There are no studies that prove the safety of color products during pregnancy; therefore, it is our best advice to choose processing that does not sit on the scalp. Also, avoid treatments with heavy or noxious fumes and long periods (more than 15 minutes) under hot lights or a dryer.
Can I exercise? Yes, and you absolutely should if there are no pregnancy complications. Regular exercise can prevent excessive weight gain, improve your posture and decrease some common discomforts such as backaches and fatigue. There is evidence that physical activity may prevent gestational diabetes/pregnancy-related hypertension/postpartum depression, relieve stress, and build more stamina needed for labor and delivery. The American College of Obstetrics and Gynecology recommends that you engage in 30 or more minutes of exercise 4 to 5 times weekly during pregnancy. A general rule of thumb is to pace yourself and slow down if you cannot carry on a conversation without stopping to catch your breath. Do not let your heart rate exceed 140 beats per minute for a sustained period of time. You should not exercise if you are bleeding or spotting, have a low-lying placenta, have a history of premature births or early labors, or have a weak cervix. Exercises to avoid in pregnancy include anything involving holding your breath, falling (like skiing and horseback riding), hard contact/jarring motions/rapid direction changes/extensive motions/deep knee bends/waist twisting movements while standing (softball, football, basketball and volleyball). You should also not exercise in hot, humid weather.
Can I take baths? Normal temperature baths (98-100 degrees) are safe during pregnancy. Avoid exposure to higher temperature hot tubs or saunas, especially in the first trimester to reduce the risk of spina bifida. If you have frequent yeast infections or recurrent infections, you may want to switch to showers.
Can I travel? As long as you have an uncomplicated pregnancy, feel free to take trips by car or plane up to 30 weeks gestation. We do not recommend leaving the country unless it is absolutely necessary. Be sure to have a contingency plan in place at your destination and take time to stop and stretch along the way. You have an extra half-gallon of blood in your body when you are pregnant and relaxed blood vessels to accommodate it; consequently, you are at greater risk for blood clot formation when you sit for long periods of time. Plan to stand up and walk around for five minutes or so every 2 hours to avoid clot formation and to encourage a rich oxygen supply to the placenta. When flying in an airplane, you are even more at risk for a blood clot because the increased air pressure can lead to dehydration faster. So make sure you stay well hydrated on such trips.
Can I paint the baby’s room? Water based paints are safe to use when you are pregnant. Make sure your room is well ventilated, and take frequent breaks to rest and stretch your muscles. As your baby grows, your center of gravity shifts, making you a bit less stable on your feet. We recommend letting someone else paint those hard to reach places.
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