Ask the ob/gyn

Dr. Samantha Berg, a board certified OB/GYN, weighs in on your pregnancy, delivery, and postpartum FAQs.

Congrats, mama! Everything they say is true. Your life's about to change in so many ways, starting with your body that's already doing the hard work of growing, shifting, and expanding to make room for a tiny human.

Maybe you already know this, but a good OB can be a great ally as you navigate this whole pregnancy thing. Trying to sift through all the conflicting advice out there on the internet, social media, and from well-intentioned friends and family members is, after all, exhausting. We like to keep things simple around here, so we cut to the chase and went straight to the expert.

Dr. Samantha Berg is a board certified OB/GYN who practices in San Diego. She had her first baby just about a year ago so long story short: she gets what you're going through. A wealth of knowlege + practical advice that actually works with our busy lives? Count us in.

If you have a question for Dr. Berg, submit it Wednesdays over on the 'gram. Then check back here as we add to our running list of community FAQs. Of course, if it's an emergency you know what to do. But if you're looking for an expert to weigh in on your non-urgent Qs, Dr. Berg's got you :)

pregnancy

Never grown a babe before? Here are some FAQs to explore before going down Dr. Google's rabbit hole.

This is a really personal decision. I usually recommend not telling anyone “early” that you wouldn’t feel comfortable telling them if there was a pregnancy loss. A lot of my patients feel comfortable telling more people after the first trimester (14 weeks). However, I’ve had patients share the news right away and also wait until much later. 

It's totally different for each person. Your OB/GYN provider will often discuss average ideal weight gain for your pregnancy based on your pre-pregnancy weight. 

This is different for every person/pregnancy. Often, you will show earlier in subsequent pregnancies. 

This is a very common question. In general, staying on an antidepressant often outweighs the risks to the pregnancy from the medication. However, there are some antidepressant medications that are preferred in pregnancy over others. Often, patients can be transitioned to these drugs prior to pregnancy. There are some psychiatric drugs that are contraindicated in pregnancy. I always recommend a discussion of risks/benefits with your OB/GYN early in pregnancy or if possible prior to pregnancy.

This is a really common fear. Early pregnancy can be really anxiety provoking. In general, the risk of miscarriage goes down in the second trimester.

Red discharge is usually bleeding and you should let your OB/GYN know so they can further evaluate you. 

There isn't an amount or type of alcohol that is considered safe in pregnancy.

It’s totally normal to have increases or decreases in libido, or no change at all. In general, it is safe to have sex throughout pregnancy, unless your provider has told you it is not safe (low lying placenta/placenta previa, or in certain situations where there is concern for preterm birth).

Screening for gestational diabetes (GDM) is recommended every pregnancy. Usually screening is done around 24-28 weeks. GDM is screened for because it is asymptomatic. It occurs in 7-10% of pregnancies.

I recommend to my patients that they start fetal kick counts at 28 weeks. I recommend doing kick counts once a day (usually after dinner is best). A normal kick count is 10 movements (doesn’t have to be a kick—swishes and rolls all count) in one hour. However, I recommend you ask your provider for their specific directions and recommendations for kick counts. 

I get this question often. The truth is, no matter what you do, labor can be hard. In general, I recommend staying active during pregnancy (walking is great) as this can put you in a good place mentally and physically for labor. 

delivery + postpartum

The main event will be here before you know it! Browse through these Q's to get a sense of what goes down. Disclaimer: just like every pregnancy, every labor is different too.

In labor, I expect regular, painful (have to breathe through them) contractions that continue for more than an hour. Braxton hicks contractions are often not very uncomfortable and do not occur at regular intervals or persist. 

I don’t routinely recommend doulas. However, I think for some patients they can be so helpful. I think this really depends on the experience you are looking for, what support you need, and where you are delivering.

A comfy robe, pajamas, sandals or slippers, chapstick. A couple of different size baby outfits for the baby to go home in (it is hard to know what will fit). Special snacks that you and your partner like :)

It is hard to say. There is no definitive time point from losing your mucus plug to when labor starts. 

There are medical and elective inductions. Your provider may recommend an induction for a medical indication (gestational diabetes, preeclampsia, advanced maternal age). Some patients choose an elective induction. This is usually done 39-40 weeks. If you are considering an elective induction, I recommend talking to your provider about the pros/cons.

Risk of tearing is higher with your first pregnancy. Certain ethnicities have a higher risk of larger tears. Also a larger baby can increase tearing as well. There is data that starting digital perineal massage at 34 weeks can reduce tearing. Episiotomies are not routinely recommended these days. They are sometimes used for situations to expedite delivery. 

Very common and normal. We don’t say anything, so you won’t necessarily know and do not need to worry about it :)

This is pretty standard these days. However, sometimes in an emergency situation, the cord is cut quickly.

You don’t want to put anything on it for two weeks. In general, I recommend keeping the incision clean and dry. After two weeks, some patients use silicone gel sheets or topical products with vitamin E for improvement of cosmetic appearance. 

There are hormonal changes postpartum that can cause night sweats/more sweating. This can sometimes be a different odor then you are used to. If the smell is "fishy" accompanied by large amounts of discharge, this is more consistent with bacterial vaginosis and you should see your OB/GYN.

When you breastfeed, you release oxytocin which makes your uterus cramp. This is normal and will lessen over time. 

Please don’t feel guilty. Fed is best. You are doing a great job feeding your baby... Formula mom over here! 

I recommend using lubricant. If there is discomfort trying a different position can be helpful. If it is uncomfortable, I usually recommend waiting another 1-2 weeks and then trying again if you feel like it. If you continue to have pain or are concerned something is abnormal, talk to your doctor!

Usually at your six week postpartum visit as long as there are no concerns with healing, your doctor will clear you for exercise.

Meet the expert
SAMANTHA BERG, MD

Dr. Berg is a board certified OB/GYN who completed her medical degree at Keck School of Medicine of the University of Southern California. She then completed her internship and residency at the University of Southern California/LAC+USC Medical Center. Dr. Berg’s private practice specializes in comprehensive healthcare for women, including obstetrics and general gynecology. She practices in San Diego where she currently resides with her husband and one-year-old son.