Baby Talk at Palomar Health

If you're expecting a baby or trying to conceive, you probably have dozens of questions about what to expect during this exciting life event. You've come to the right place for answers to your pregnancy and prenatal care questions. We asked 16 Palomar Health-affiliated obstetrician/gynecologists some of the most-asked pregnancy questions from women just like you. From conception to cord blood and exercise to emotions, our skilled physicians keep you informed every step of the way.


Helen Chang, M.D.

Helen Chang, M.D. | Palomar Health

What problems or symptoms are important to tell my doctor about during pregnancy?

During the first trimester, tell your doctor if you have any bleeding, severe cramping or one-sided pelvic pain which may be signs of miscarriage or ectopic pregnancy. Also, report any persistent nausea, vomiting or inability to keep fluids down for more than 24 hours. During the second trimester, report any frequent uterine tightening or contractions which can be signs of premature labor. Tell your doctor if you have any bleeding, leakage of fluid and decrease in fetal movement as well. During the last trimester, watch for signs of toxemia such as headache, blurred vision, excessive swelling and high blood pressure.


Duane Buringrud, M.D.

Duane Buringrud, M.D. | Palomar Health

What food should I eat and/or avoid during pregnancy?

Generally, pregnancy requires an extra 300 calories per day of nutrition. Iron and folate are the most important supplements for women before, during and after pregnancy. Pregnant women should limit their caffeine intake to less than an equivalent of three cups of coffee a day. And, to avoid the risk of high levels of mercury, women should limit eating fish to two servings per week with shrimp, salmon and catfish being the preferred choices.


Maria L. Castillo, M.D.

Maria L. Castillo, M.D. | OB/GYN| Palomar Health

Is it safe to have sex during pregnancy?

Sexual intimacy is a normal and healthy part of a committed relationship. Unless your health-care provider advises you otherwise, sex during pregnancy is safe for you and your baby. Your baby is well protected by your abdomen and by a cushion of fluid in your womb. However, if your pregnancy is considered high-risk, you may need to be more cautious than other women.


Josue Leon, M.D.

Josue Leon, M.D. | OB/GYN|Palomar Health

I had three glasses of wine at a party before finding out I'm pregnant. Should I be worried?

It is known that alcohol can harm the fetus. The quantity at which this damage occurs has not been established. My advice is to avoid any further drinking for the remainder of pregnancy and schedule a visit with your doctor as soon as possible informing him or her about the inadvertent use of alcohol early in pregnancy.


Nicole Nguyen, M.D.

Nicole Nguyen, M.D. | OB/GYN | Palomar Health

I read about saving my baby's cord blood for the future. What do you recommend?

I recommend banking cord blood if there is any family history of diseases that are treatable with cord blood. There is a list of more than 80 diseases that have been successfully treated. (Click here to see a list from the Cord Blood Registry.) If there is no family history, then the decision to bank your baby’s cord blood should be made based on whether or not you have the financial capability to make the investment.


Brano Cizmar, M.D.

Brano Cizmar, M.D. | OB/GYN|Palomar Health

I'm 5'6" and weigh 145 pounds. How much weight should I gain during pregnancy?

Recommended weight gain during pregnancy depends on a woman’s habitus and body mass index (BMI), which is calculated using weight and height. Your BMI is 23.4 (normal weight category). Pregnancy weight gain in this category should be 25 – 35 lbs. Women that are underweight (BMI < 18.5), should gain 28 – 40 lbs. Overweight patients (BMI 25 – 29.9) should limit their weight gain to 15 – 25 lbs. Even smaller weight gain (11 – 20 lbs) is recommended for obese patients (BMI > 30).


Gregory Langford, M.D.

Gregory Langford, M.D. | OB/GYN | Palomar Health

How long will my morning sickness last? What can I do for relief?

“Morning sickness” is very normal and affects 70 percent of pregnant women. The typical onset of morning sickness is in the first 4 – 8 weeks of pregnancy with improvement by 16 weeks. Some patients find relief through eating more frequent, small snacks and avoiding foods that provoke nausea. Simple things like Vitamin B6, ginger and acupressure can also help. Medications may be indicated when dehydration and weight loss occur.


Robert Lasting, M.D.

Robert Lasting | OB/GYN | Palomar Health

I’m at risk for gestational diabetes. What do I need to do to take care of myself and my baby?

Gestational diabetes is very common, affecting up to 14 percent of pregnancies in the United States, and is easy to treat. In most cases, treatment may only require monitoring your blood sugar (glucose) levels, maintaining a healthy diet and making sure you get regular physical activity. Only a small percentage of women may require a pill or insulin. It’s important to remember that most women with gestational diabetes can have healthy pregnancies and healthy babies with the proper monitoring and treatment.


Timothy Maresh, M.D.

Timothy Maresh, M.D. | OB/GYN | Palomar Health

I’m 38-years old and want to have a baby. Is my age a concern, and what can I do to help ensure a healthy pregnancy?

After age 35, once you and your partner have had six months of unprotected intercourse and no pregnancy has occurred, it is recommended that you have an evaluation for infertility. A preconception visit with your OB/GYN is a good start. You should start on folic acid as soon as possible, and I recommend maintaining healthy habits such as avoiding smoking, drugs and alcohol.


Karen E. Kohatsu, M.D.

Karen Kohatsu, M.D. | OB/GYN | Palomar Health

I’m concerned about my baby’s risk for genetic problems. What screenings are available?

Your concerns regarding genetic problems are common in most mothers to be. In general, birth defects can affect 2 – 5 percent of all pregnancies. Fortunately, major defects are rare. There are many prenatal tests that can be offered to you in both the first and second trimesters of your pregnancy that can screen for specific problems and others that can definitively detect genetic disorders. Depending on your specific risk factors, your physician can discuss the various tests available in your situation.


Ying Chang Chen, M.D.

Ying Chang Chen, M.D. | OB/GYN | Palomar Health

My first baby was born by Cesarean section. Can I have a vaginal delivery with my second pregnancy?

You may try to have a vaginal delivery with your second pregnancy if your previous Cesarean section was not a classic Cesarean section (vertical uterine incision); your current pregnancy is not multiple gestations, breech or a large baby; and you are willing to assume the serious risks that may occur to you and your baby associated with trial of labor.


Elizabeth Cerrone, M.D.

Elizabeth Cerrone, M.D. | OB/GYN | Palomar Health

What types of exercises are best during pregnancy?

I would recommend patients continue doing any or all exercises they have done prior to pregnancy, but to stay away from exercises lying flat on the back or abdomen. Be sure to keep your heart rate around 140 bpm to allow adequate blood flow and oxygen to baby and mother. For women who do not exercise regularly, I advise them to begin with walking, swimming or yoga classes designed for pregnant women.


Hanh Le, M.D.

Hanh Le, M.D. | OB/GYN | Palomar Health

I think I’m healthy, why do I need to take vitamins during pregnancy?

During pregnancy, the demand on a woman’s body to nurture the fetus is elevated. This requires increased caloric intake and essential vitamins and minerals – especially iron, calcium and folic acid. During pregnancy, the amount of iron required in the body increases. Typically, the iron content of most diets is not sufficient enough to supply the increased amount, so a prenatal vitamin containing at least 30 mg of ferrous iron, 800 mg of folic acid, and 400 IU of vitamin D is recommended.