Work and Pregnancy:  For many years, employers considered pregnancy a liability, and it was not uncommon for pregnant workers to be dismissed.  Civil rights legislation now exists making it illegal for employers to terminate pregnant workers without cause.  This means that, in the absence of specific high-risk complications, workers are allowed (and usually expected) to work through their pregnancies.  Some large companies can place pregnant women with various discomforts in lighter duty jobs until after delivery.  Ask your employer about these opportunities.

We do not "disable" patients simply because they are pregnant, but will work with you to describe your condition to your employer.  It is then up to the employer to determine whether these complaints constitute a "disability" prohibiting the performance of duties.  Some complications (such as high blood pressure, bleeding, or premature labor) will require partial bed rest.  We will be more than happy to communicate specific recommendations to your employer if you are affected by such complications.

After a cesarean or vaginal delivery, you should expect to be able resume normal activities by six weeks, including work duties.  Some employers may allow (or expect) you to return to work even sooner.  In most cases, this will not cause any physical harm to you.  Please discuss your case with us if you wish to return to work before six-weeks postpartum.  Our staff will prepare a "return to work" release on your request.

Exercise:  During pregnancy, you may continue to participate in mild to moderate exercise regimes.  You should avoid exercise in the supine (lying flat on your back) position after the first trimester because this position is associated with decreased cardiac output, which can adversely affect the blood flow to the uterus.  You should modify the intensity of exercise according to your symptoms and stop exercising when you're tired.  Be sure to drink plenty of water before, during, and after exercise so you don't get overheated.  At one time, exercise recommendations were based on not exceeding a certain "target heart rate".  This is no longer the case.  Exercises involving the risk of abdominal trauma or falls should be avoided, especially during the latter half of pregnancy.

After delivery, the changes of pregnancy resolve gradually over four to six weeks.  Pre-pregnancy exercise routines may be resumed gradually as tolerated.

Sex and Pregnancy:  Unless you are experiencing complications such as premature labor or vaginal bleeding, intercourse is not harmful and may be continued throughout pregnancy.  You may experience discomfort in certain positions as pregnancy progresses and should not engage in any activity that causes pain.  Hormonal changes may cause vaginal dryness, which is often relieved by over-the-counter lubricants.  If you have specific concerns about any sexual activity, please don't be afraid to let us know.  We'll be glad to discuss the issues with you.

After delivery, sexual activity may be resumed when the pelvic tissues have healed.  This should not take longer than six weeks.  It is very common to experience decreased interest in sex for several months after delivery, but you can be optimistic that you will return to the pre-pregnancy baseline within a reasonable amount of time.

Genital Herpes:  Active genital herpes may pose a risk of passing the infection to the baby as it comes through the birth canal.  Therefore, cesarean delivery is advised if a woman has active lesions at the time she goes into labor.  Cesarean delivery is not necessary for those patients who have a history of lesions in the past, even during the current pregnancy.  It has been shown that medication taken during the last month of pregnancy can reduce the frequency of herpes outbreaks and hence the need for cesarean delivery.  These antiviral medications have been administered to many women so far, with no known adverse effects for either them or their babies.  If you have a history of genital herpes, please be sure to discuss this issue with us and consider preventative medication beginning at 36 weeks.  If you have a genital herpes lesion at the time you go into labor, notify the doctor on call immediately.