FRIDAY, May 2 (HealthDay News) -- Pregnancy is hard work, and it's even harder when you're working while pregnant.

"By anticipating and planning for some of these challenges, working mothers-to-be can enjoy these nine months both on the job and off," Dr. Tamara Kuittinen, an emergency medicine physician at New York-Presbyterian Hospital/Columbia University Medical Center and an expecting mother, said in a prepared statement.

Colleague Dr. Laurie Zephyrin, an obstetrician/gynecologist, advises that pregnant working women bring any questions or concerns to their doctor, especially if they are older than 35 since those women run a higher risk for complications like preterm labor and preeclampsia.

"There are no signs or symptoms that you shouldn't discuss during your pregnancy. This will help us catch any potential problems that can be prevented or treated in order to keep you and your baby safe and healthy," Zephyrin said in a prepared statement.

Here are answers to what the two doctors said are the 10 most common questions about working while pregnant:

• How do I fit in doctor visits? Visits start as monthly, then increase until they are weekly in your final month of pregnancy. Schedule appointments during your lunch break or find a doctor offering early and late hours. Don't skip visits. Regular, proper prenatal care lowers your risk of having a baby born with low birth weight or other problems.
• Is it safe to see the dentist? Contrary to popular belief, dental hygiene during pregnancy is very important. Some studies link poor dental hygiene with preterm labor. However, tell your dentist that you're pregnant and avoid X-rays, if possible.
• What can be done about morning sickness and fatigue? Morning sickness usually occurs only in the first trimester. Cope with it by drinking and eating in small amounts throughout the day. If you can't keep down fluids, you should see your doctor. Eating balanced meals, taking prenatal vitamins and taking short naps may help with first trimester fatigue.
• What can I do about insomnia? Insomnia is especially common in the second and third trimesters, when the increased size of your belly can cause back pain. Sleeping on your side may help. Try hugging a full-body pillow and staying on a regular sleep schedule. If you wake up, do something productive and focused like paying bills or reading a book.
• Can I still drink coffee? You should reduce your caffeine intake as recent research shows that excessive caffeine may increase your miscarriage risk. You don't have to go cold turkey, but try to reduce when you can. Remember caffeine is present in some sodas and teas as well.
• What should I eat? Fruits, veggies, grains, protein and dairy are all essential. Keep a list of the food groups that you should get daily on the refrigerator with a list of specific foods in each group that you enjoy. Avoid fish high in mercury, including shark, swordfish, king mackerel, tilefish and albacore tuna.
• Can I still hit the gym? Talk with your doctor about your exercise programs at your first prenatal visit. If you have a normal, low-risk pregnancy, it's safe to keep up your routine. In fact, it helps beat stress and keeps baby healthy by improving blood flow. However, you may need to lessen the intensity or change methods as your pregnancy progresses. Your joints and ligaments are looser during pregnancy, so exercise that emphasizes stretching like yoga and Pilates may open you to more injury. Remember -- walking is a fantastic exercise and stress reliever.
• Can I travel? The best time to travel is between 14 and 28 weeks of your pregnancy unless you have a high-risk condition. Consult with your doctor first, especially if going to foreign countries. Keep a detailed copy of your pregnancy record with you at all times. If sitting for a long time during travel, try to get up for a walk at least once an hour to decrease your risk of forming blood clots in your legs. Also, consider wearing support or pressure stockings.
• What if I get sick? Check with your doctor before taking any medication, even over-the-counter drugs. Stay away from natural remedies and supplements like echinacea that have not been studied on pregnant women. Urinary tract infections are common in pregnancy, so contact your doctor if you experience burning and irritation during urination. If your temperature is above 100.4, see your doctor.
• How do I plan for delivery while still working? Get your due date from your doctor and know the signs of labor. Have a game plan: suitcase ready with key items you will need in the hospital, someone at the ready to drive you to the hospital and take care of any of your other children while you're away. Research your job's maternity leave policies early on. Plan to return to work only when you're physically and emotionally ready.

More information

The U.S. Department of Health and Human Services has more about prenatal care.

-- Kevin McKeever

SOURCE: New York-Presbyterian Hospital/Columbia University Medical Center, news release, April 25, 2008

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