Main content

    Learning About Your Health

    Patients' Frequently Asked Questions (PFAQ): Pregnancy & Reproduction

    What is the normal duration of "trying" before most couples conceive pregnancies?

    After six months of actively trying about 50% of couples are pregnant, and after a year of trying, 85% of couples are pregnant.

    Back to top

    What symptoms are normal in the first trimester of pregnancy?

    Most women experience some degree of fatigue, nausea, and breast tenderness during the first trimester of pregnancy. Other symptoms can include constipation, a pulling sensation on the sides in the lower abdomen, and cramps.

    Back to top

    What causes morning sickness?

    The cause of morning sickness has eluded researchers. The symptoms are undoubtedly mediated by the central nervous system, but the precise mechanism is unclear. Anthropologists believe the symptoms evolved so that pregnant women in the wild would not consume plants that were either poisonous or abortifacients.

    Back to top

    What are the statistics regarding age and fertility?

    New studies suggest that fertility begins to wane when women reach their early 30's, and even in the most fertile populations of women studied, only about 50% retain their natural ability to conceive by age 40; by age 45, that number falls to below 10%. It is also quite difficult to know which women are at risk for infertility. With most other medical conditions, physicians can take a personal or family history, run some lab tests, do some imaging studies, do a physical exam, and figure out who is at risk for contracting the condition. But with infertility, extremely healthy women are still at risk.

    Back to top

    What is the proper weight gain in pregnancy?

    Pregnancy weight gain depends upon your baseline height and weight. The bulk of the weight gain in pregnancy is blood volume and that increases by two thirds in a normal pregnancy. Taller, larger framed women should gain more weight than smaller women. The oft-quoted recommended weight gain of 25 pounds actually applies to the average woman who is 5'4" tall.

    Back to top

    What foods should I eat in pregnancy?

    Advice abounds on the issue of food in pregnancy, basic science simply recommends a well balanced diet. The most important dietary advice in pregnancy is to avoid food borne illnesses and toxins. There are 76 million cases of food poisoning each year in the United States! Women should avoid undercooked beef which can carry toxoplasmosis, predatory fish which can lead to mercury poisoning, and unpasteurized milk and cheese which often carry listeri, also alcohol should be avoided, and caffeine in doses greater than 150 mg/day.

    Back to top

    What percentage of the infertility cases are due to women's problems?

    Approximately 15% of infertility cases are unexplained or both a male and female problem, but in the remaining cases, half of the time the problem actually resides with the male, and only half the time with the female.

    Back to top

    What are my options if I do encounter fertility difficulties?

    Depending on your age and other factors, several tests can be performed. It is possible to perform a basic fertility evaluation in only 6 weeks. The basic evaluation includes a semen analysis, lab tests to evaluate thyroid function and ovarian reserve, graphs and tests to document the occurrence of quality ovulation, and sometimes an x-ray that demonstrates the potency of the fallopian tubes, and the shape of the uterus. Once a workup is completed, an infertility specialist can discuss treatment options.

    Authored By: Laurie Green, MD
    Reviewed By: Cheresa Ng, MD

    Back to top

    Gestational Diabetes

    What is gestational diabetes?

    Diabetes is a medical condition in which the body's blood sugar is too high. Gestational diabetes is diabetes that is diagnosed during pregnancy. With gestational diabetes, the hormones of pregnancy interfere with the action of the mother's insulin causing higher sugar in the blood than is normal. High blood sugar can cause many problems if it goes untreated. For this reason, all pregnant women need to be screened for diabetes between 24 and 28 weeks. Additionally, women who are diagnosed with gestational diabetes are at an increased risk for developing Type 2 diabetes in their lifetime.

    Back to top

    When is screening done for gestational diabetes?

    Women are screened for diabetes between 24 and 28 weeks. Women are screened according to risk categories.

    • Low Risk Women
      Low risk women are those who have no family history of diabetes, have a healthy body weight, do not belong to a high risk ethnic group, and have no other medical conditions that put them at increased risk for diabetes. In these women, screening for gestational diabetes is done between 24 and 28 weeks of pregnancy.

    • High Risk Women
      High risk women include those who are significantly overweight, have a family member with diabetes, have a history of impaired glucose tolerance including gestational diabetes in a previous pregnancy, have delivered a large baby (> 9 pounds), have used Metformin (Glucophage) prior to or during the pregnancy, have experienced a stillbirth without a known cause or a baby with congenital anomalies, or are of Native American ancestry. These women should undergo the screening test at their first prenatal visit and, if it is normal, repeat the test again at 24-28 weeks.

    Back to top

    What is involved with the screening test?

    For the screening test, women are asked to drink a 50-gram sugar soda within 5 minutes time. Their blood is drawn 1 hour later. They do not have to fast for this test and there are no special dietary restrictions. Women should remain seated throughout the entire hour and should not smoke.

    If the 1-hour test is abnormal (equal to or greater than 140 mg/dl but less than 200 mg/dl), a 3-hour glucose tolerance test is needed. This blood test is done in the morning. The woman must fast for 8 hours (but not more than 12). A fasting blood sugar test is obtained. Next, the 100-gram sugar drink is consumed within 5 minutes. Blood is drawn at 1, 2 and 3 hours after the drink. The patient should remain seated during the entire test.

    Back to top

    What can I expect based on the test results?

    A diagnosis of gestational diabetes is made:

    1. If the 1-hour test results exceed 199 mg/dl. The woman is then referred to the CPMC Diabetes and Pregnancy Program without proceeding onto the 3-hour test.

    2. If the fasting blood sugar is equal to or greater than 95 mg/dl or two of the three hour results are abnormal, then the woman is referred to the CPMC Diabetes and Pregnancy Program for full nutrition counseling and blood glucose monitoring. If only one abnormal result is obtained during the 3-hour test, the woman is referred to the CPMC Diabetes and Pregnancy Program for nutrition assessment only. However, the 3-hour test should be repeated in 2 weeks time.

    Back to top

    How will gestational diabetes affect my baby?

    High blood sugar can affect babies in various ways. High blood sugars can cause the baby to become overgrown and have a high fat deposition especially across the shoulders. This can make for a more difficult delivery as well as it increases the risk for a cesarean section. Infants of diabetic mothers, especially those with poor glucose control, are at higher risk for developing low blood sugar (hypoglycemia), jaundice and need for medical attention in the newborn period. Long term, these babies are at increased risk for developing obesity and Type 2 diabetes later in life.

    Back to top

    Is it safe to breastfeed when I have diabetes during pregnancy?

    Yes, as a matter of fact, breastfeeding is strongly recommended if you have been diagnosed with gestational diabetes. Women have a much better chance of keeping their blood sugars normal if they breastfeed as well as delaying or preventing Type 2 diabetes from developing. In addition, breastfeeding reduces the risk of obesity and Type 2 diabetes in the child. Again, breastfeeding is very important and strongly encouraged.

    Back to top

    If I'm a diabetic or have problems with high blood pressure, will my baby have these problems as well?

    Diabetes and high blood pressure are caused by many factors. Genetics and family history have a strong influence. Your children are at higher risk for developing diabetes or high blood pressure problems during their lifetime if there is a family history of these conditions. We do not have a single cure for either of these but diet and exercise are the cornerstones of treatment for both of these conditions and are strongly encouraged. Exercise does not need to be complicated or expensive — walking 4 times a week minimum for 30 minutes each time. During pregnancy, we recommend you exercise after their most difficult-to-control meal which tends to be breakfast or dinner.

    Authored By: Melinda Scully, MD
    Reviewed By: Per Sandberg, MD

    Back to top

    Preterm Labor

    Did I contribute in any way to developing preterm labor (for example, stress, exercise, or sexual intercourse)?

    In most cases, preterm labor is of an unknown cause. The truth is that we do not know how any given stress will impact a given person. Therefore, we do not think that any one factor has a cause and effect relationship with preterm labor.

    Back to top

    I'm not sure if I'm having contractions, what do they feel like?

    There is a range of sensations that patients experience when they are having contractions; from essentially nothing at all to very painful menstrual-like cramps in the lower abdomen. We often tell patients that they can feel a "firming" of the muscles or a "balling up" of the uterus. The uterus becomes firm and can feel like a "ball" under the skin. Sometimes, a persistent, dull, low backache is all that can be felt. However, research has shown that pregnant women have limited ability to distinguish between contractions and fetal movement. In many cases, what a patient perceives as a contraction is not a contraction. Therefore, while we still teach our patients to pay attention to contractions (or uterine tightening or cramping), repeated studies have shown that most contractions will be missed by the patient. A patient can never be completely sure if she is having contractions, and it is because of this that we encourage specific monitoring in physicians' offices or in the hospital when there is doubt.

    Back to top

    What are the signs of preterm labor?

    The signs attributed to preterm labor can also be a very normal part of a healthy pregnancy. The following list of signs is important if they are a change from your normal pregnancy experience. Call your health care provider, lie down, and monitor for uterine contractions in the presence of any of the following signs:

    • Painless uterine contractions that may occur every 15 minutes or less.

    • Menstrual-like cramps that come in waves or are constant.

    • Lower, dull backache often radiating to sides or front, which may be constant or rhythmic, and not relieved by a change in position.

    • Pelvic pressure or a feeling like "the baby is coming down."

    • Intestinal cramps that can feel like "gas pains" in the presence or absence of diarrhea.

    • Increase or change in vaginal discharge.

    • A general feeling that something is not right.

    Back to top

    Does bed rest help prevent preterm labor? What should a mother do to prevent it?

    All evidence shows us that there are absolutely no certain means to prevent preterm labor. When patients are diagnosed with preterm labor, it is controversial whether bed rest is helpful. We recommend to all our patients to limit activity and sometimes to be on strict bed rest, but we tell them at the same time that we are not sure it is any more effective than not doing it.

    Back to top

    Does having sex during pregnancy increase the chance of preterm labor?

    Having sex during pregnancy has not been shown to increase the risk of preterm labor in patients at low risk for preterm labor or delivery. Patients at high risk for preterm labor should speak with their doctor and they can reach a decision together.

    Authored By: Michael Katz, MD
    Reviewed By: Thomas Musci, MD

    Produced by the Center for Patient and Community Education in association with the staff and physicians at California Pacific Medical Center.

    Funded by: A generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

    Back to top