By Geri Morgan CNM ND, Carole Hamilton MA CNM
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Extra resources for Practice guidelines for obstetrics & gynecology
A gain of less than 2 pounds per month after the first trimester increases the risk of infants born small for gestational age (SGA). III. Management A. Loss of weight or failure to gain appropriately: try to determine the reason and treat the patient accordingly. 1. Nausea or vomiting 2. Heartburn: lack of room in stomach 3. Fear of gaining weight a. Counsel and reassure patient. Explain distribution of weight gained during pregnancy. 51 b. Emphasize the importance of weight gain. Explore the body image and acceptability of a large body to the patient, partner, or others.
Daily requirement: Four servings of low-fat milk, cheese, or cottage cheese F. Fruits and vegetables 1. Reasons a. They provide many vitamins and minerals. b. Citrus varieties are high in vitamin C. c. They help prevent constipation. 2. Daily requirement: Five servings. ) G. Water 1. Reasons a. To keep up with expanding blood volume b. To avoid constipation 2. 50 H. Substances to avoid 1. Artificial sweeteners, especially aspartame, which can be associated with headaches and dizziness 2. Caffeine 3.
Disadvantages 1. Irregular bleeding: Occurs in 60% to 80% of patients the first 1 to 3 months after insertion. With continued use, this decreases to 12% to 17% after the first year. BCPs, preferably with levonorgestrel, can be used for 2 to 3 months to help with the adjustment. 2. Depression and mood swings 3. Weight gain: Progestin does not cause weight gain directly. It has been implicated in increasing appetite. Diet counseling may help. 4. Hair loss: Progestin changes the cycle of hair growth.
Practice guidelines for obstetrics & gynecology by Geri Morgan CNM ND, Carole Hamilton MA CNM