Clinical guidance

Having a Healthy Pregnancy

Published January 20, 2022


All of the following symptoms are normal in pregnancy. If any are very worrisome or bothersome, contact your OB or Firefly team:

  • Nausea (sometimes with occasional vomiting) – this typically improves or resolves by 12 weeks
  • Fatigue & Lethargy– feeling like you canʼt get off the couch or that you want to nap a lot more? This is normal. Your energy will typically return by the second trimester, but may decline again
  • Constipation - getting backed up is common. Increase your fluid and fiber intake as much as you can tolerate. When all else fails, try Miralax, 1-2 capfuls daily, Senna 2 tablets nightly, or Colace 1 cap, 1-2x/day as needed to help keep you regular.
  • Mild abdominal cramping - (similar to menstrual period cramps) are normal in pregnancy as the embryo implants into the uterus and the uterus begins to expand. Severe cramping, bleeding, or leaking of fluids different from typical discharge, should be reported to your OB immediately.
  • Sleep disturbance – try OTC Unisom
  • Heartburn – Hormones relax your ligaments in preparation for baby. The sphincter of the stomach also relaxes, sometimes causing heartburn and reflux. Use Tums and eat small, frequent meals. Avoid acidic, fried/fatty, and spicy foods, and do not lie down within 2 hrs of eating.
  • Taste & Smell - can become stronger and more intense. Some foods may start to taste different or smell more pungent, which can be good or bad if you are experiencing nausea.
  • Mood changes – you might feel more down, anxious, forgetful, or irritable while pregnant. This can be normal. If it feels different, persists, or seems to interfere with your quality of life–reach out to your provider, we can help!
  • Body changes - start mentally preparing for your body to change. It is common for your hips to widen and your back to ache as this happens; a heating pad or warm bath/shower can be very soothing. It is also not uncommon for your hands and feet to get 1⁄2-1 size larger as hormones relax your ligaments, causing them to widen and stretch. These may or may not return to your previous size after you give birth.

Nausea Tips:

  • Eat often and regularly. Whatever you can tolerate. Usually simple carbohydrates are best.
  • Take prenatal vitamins with food or at bedtime if they make nausea worse. Look for easy to chew/digest gummies with folate and without iron.
  • Stay hydrated. Fill a 32oz bottle and drink at least 4/day. Mix in an electrolyte beverage, like Vitamin Water Zero.
  • Citrus flavors, and even sucking on a lemon, can help.
  • Try ginger tablets and/or ginger ale.
  • Vitamin B6 tablet and 1 tablet Unisom nightly as tolerated
  • Sometimes this is caused by heartburn or reflux. Try taking OTC Tums
  • Take a walk outside – as hard as it feels, the fresh air and light exercise can help.

Things to Avoid:

  • New, intense exercise and abdominal crunches
  • More than 300mg caffeine daily
  • Alcohol, Marijuana, Tobacco, Stimulants (including for ADHD), recreational drugs, topical CBD
  • NSAIDs: ibuprofen, Advil, Motrin, Aleve (Tylenol is safe during pregnancy) *Any medications should be cleared by your provider before taking
  • Retinol skin products
  • Non-mineral sunscreen
  • Cold cuts, processed meats, Nitrates/Nitrites, so unpasteurized cheeses, raw fish, undercooked eggs and meat (both should be well done)

Things to Do:

  1. Exercise! Continue exercise as you normally would, so long as you listen to your body and do not push your limits. You may fatigue sooner. Squats, core (pilates, c-curve and pelvic floor based), prenatal yoga, and hip strengthening and stretching exercises are encouraged and will keep you strong in preparation for childbirth.
  2. Have sex. Though you may not feel up to it, it is safe during all stages of pregnancy–and late in pregnancy, may help to induce labor. Just listen to your body, you may need to go slow, add lubricant, or mix up positions to feel comfortable. Note: some mild cramping after orgasm can occur; this is normal.
  3. Download an app, like “What to Expect” to give you weekly updates about your body and baby
  4. Ask questions, take a breastfeeding, childbirth, and parenting class as you near the end of term. Consider a birth plan. Ask your providers any and all questions or concerns you may have. It is important to feel empowered and comfortable as you prepare for baby!
  5. Take care of YOU, first and foremost. Reach out if you need help. Lean on others –your partner, your family, your friends, as much as possible. Offload any and all tasks! Listen to your body and be a little selfish during this time.
  6. Best pregnancy books:
    “Expecting Better”
    “Birth Without Fear: The Judgment-Free Guide to Taking Charge of Your Pregnancy, Birth, and Postpartum”
    “Secrets of the Baby Whisperer”
  7. Get vaccinated. Be sure you are up to date on all vaccinations. While with child, your immune system weakens to protect the pregnancy. It is of utmost importance that you–and all those around you–are fully vaccinated and well.

Firefly is here to help

Virtual primary care allows you to take back control of your health at your convenience. Be sure to reach out to your care team with any questions through the Firefly app.