3rd Trimester
Q
I'm in my 3rd trimester. Is it safe for me to exercise? If so, at what intensity?
LP: Exercise is important to us all whether we are pregnant or not. I
Q
do not advise my patients to embark on a new, high impact exercise regime while pregnant, However, one can and should continue their regular exercise regime. Pregnant women should stay well hydrated and listen to their bodies. If something is causing discomfort, one should stop and rest. We also want patients to avoid having their heart rates go too high while pregnant. A good rule of thumb is if you can carry on a conversation while exercising then you are fine. If you are too out of breath to have a conversation while exercising, then your heart rate is too high and you need to slow down.
Q
I've been having contractions where my stomach gets rock hard. Are these Braxton Hicks, or should I call my doctor when this happens?
LP: During pregnancy, it is common for the uterus to
contract beginning at 6 weeks gestation. In the third trimester, contractions can become more frequent and occasionally more intense. Prior to 37 weeks gestation, I advise my patients to rest and drink lots of fluids if they experience 4 or more contractions in an hour. Patients are to call if the contractions persist as 4 or more in an hour after rest and hydration. After 37 weeks gestation, a woman is considered full-term and contractions regardless of timing or intensity are fine. I advise my patients to call if they are experiencing contractions every 5 minutes for 1-2 hours.
Labor & Delivery
Is there anything I can do prior to labor to avoid having an episiotomy?
LP: Episiotomy is a small incision made in the perineal region during birth to enlarge the vaginal opening. There are a variety of situations which require such intervention but episiotomies are no longer considered routine for all births. In fact, providers these days are taught techniques which help to avoid the need for episiotomy. Some providers suggest that patients practice perineal massage which is a technique to help prepare the perineal region for stretching during birth. There is controversy about whether or not this helps to decrease overall episiotomy rates.
Q
What is the average amount of time it takes to push the baby out?
LP: Up to two hours of pushing for a first baby is considered
normal. There are many factors which influence how long a woman will need to push. These include maternal effort, strength/ frequency of uterine contractions and position of the baby as it descends through the birth canal.
Lani Pincus, CNM, MS, NP
Lani is a certified nurse midwife and nurse practitioner OB/GYN, working in Brewster and Carmel with the Mid Hudson Medical Group. She recieved her Masters of Science from Columbia University, and was board certified by the American College of Nurse/ Midwives.
Serving the Hudson Valley for over 50 years. 845-231-5600 www.midhudsonmedicalgroup.com Issue 3 | bumptalkmag.com | bumptalk magazine | 9