Pregnancy is a totally new and exciting experience — one that will probably bring up a lot of questions for you. But are there any discussions you should definitely bring up with your doctor at your first prenatal visit? Start with these crucial questions you’ll want answered in the nine months leading up to labor.

What over-the-counter medications are safe?

You'll likely need some non-prescription medication at some point during your pregnancy, whether it's to ease a headache or a bad case of heartburn — and your practitioner should provide a list of recommended OTC meds that are safe to take. While it's important to check with your own doctor first, these typically get the green light:

  • Acetaminophen (Tylenol) for headache, pain or fever
  • Vitamin B6 and doxylamine (Unisom) or Diclegis for nausea and vomiting
  • Chlorpheniramine and tripelennamine for cold and allergy symptoms
  • Fiber supplement for constipation
  • Saline nasal spray for allergies, but check with your doctor for the dosing and brand. The same goes for saline sprays and nasal strips.

What about prescription meds that I might take?

This is definitely a subject you’ll want to go over with your OB/GYN. It's also imperative to note that you should never stop taking any of your meds without talking to your doctor first.

The best plan is to see your doctor before pregnancy to review all your current medical conditions and medications and decide whether it makes sense to continue your current meds, switch to a different medication or try a different treatment plan altogether. Depending on your case, you may be referred to a maternal-fetal medicine specialist.

Do I need to change my beauty routine?

It depends. If your beauty routine includes prescription products — especially those with retinol, or vitamin A, like isotretinoin (Accutane) or Retin A — you’ll want to talk to your doctor about changing your routine while expecting. Excessive amounts of Vitamin A can increase the risk of birth defects.

You’ll also do well to avoid experimentation. Your skin is often more sensitive during pregnancy so this is probably not a good time to try new products.

How much weight should I gain?

Your pre-pregnancy body mass index (BMI), which is calculated based on your weight and height, usually determines how much weight you should gain during pregnancy. Your doctor should give you a range to gain by trimester and will check at each appointment that you're on track, but here's the standard breakdown of weight gain by BMI:

  • A BMI of less than 18.5: 28 to 40 pounds
  • A BMI between 18.5 and 24.9: 25 to 35 pounds
  • A BMI between 25 and 29.9: 15 to 25 pounds
  • A BMI greater than 30: 11 to 20 pounds

Carrying twins? In that case, your weight gain target will likely change. Currently, the Institute of Medicine recommends the following for moms of multiples based on BMI:

  • A BMI between 18.5 and 24.9: 37 to 54 pounds
  • A BMI between 26 and 30: 31 to 50 pounds
  • A BMI greater than 30: gain 25 to 42 pounds

That said, everyone’s pregnancy will look different and that includes pregnancy weight gain. If you have questions, don’t hesitate to talk to your practitioner, who will help you come up with a plan to make sure that you’re gaining a healthy amount of weight.

What should I eat and avoid eating?

A pregnancy diet full of nutritious, whole foods — think lots of vegetables, fruit and lean protein — is ideal. Your doctor will also likely recommend a prenatal vitamin to ensure you’re getting enough calcium, folic acid and other nutrients. As for what to steer clear of? Avoid raw fish, soft cheeses, unpasteurized milk or juice, and some fish that are high in mercury, such as swordfish and orange roughy.

What exercise is okay during pregnancy?

Staying active during pregnancy keeps both you and your baby healthy and helps ease pregnancy symptoms from water retention to anxiety. What's more, many fitness activities are safe during pregnancy, including walking, swimming, yoga and strength training. If you were a regular at any particular class before you got pregnant, it's likely okay to continue attending it, though you should make sure to check with your doctor first.

In general, you'll need to be a little extra careful. Avoid rough exercises where you're more likely to fall (your sense of balance is a bit off when you're expecting), strenuous ab exercises and prolonged periods of time flat on your back, especially in the second half of pregnancy. It's also best to avoid exercises that make you more prone to dehydration and overheating (like Bikram yoga).

What vaccinations should I get?

The vaccines you get during pregnancy can depend on particular risk factors, such as having a chronic illness or working or traveling in places with a higher chance of exposure. Two vaccines are must-haves during pregnancy:

  • Adult Tdap is recommended for every pregnant mother any time between 28 weeks. That's because very young babies are vulnerable to whooping cough, a contagious respiratory illness that can lead to pneumonia and even death — and babies can only receive their own first dose of the DTaP vaccine at 2 months. But by getting vaccinated during pregnancy, you help pass some immunity on to your child.
  • The influenza vaccine offers importanted protection againist common seasonal viruses and H1N1, especially since your immune system is weaker and particularly vulnerable to these illnesses during pregnancy. And with nine months to go, your pregnancy will inevitably overlap with some part of flu season. This annual vaccine typically comes out around August each year, but you can still get it later in the fall and winter.

And if you haven’t already received the COVID-19 vaccine before your pregnancy, the Centers for Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) recommend it for all eligible recipients, including pregnant and lactating people.

How long can I work when I'm pregnant?

Depending on the nature of your work, you can likely keep at it until you deliver — though if you have a particularly physically strenuous job or pregnancy complications your practitioner may recommend some restrictions for your safety and your baby's.

It's also important to discuss any emotional stressors you experience at work with your doctor, who can help you determine if you should avoid them or find other ways to cope.

What pregnancy symptoms are normal, and what's an emergency?

The answer to this question can vary, depending on how far along you are.

First trimester

In the first trimester, some nausea, occasional vomiting, fatigue and breast tenderness are common. A small amount of vaginal spotting can also be normal. That said, red-flag symptoms you should watch out for include: an inability to keep any food or liquids down, heavy vaginal bleeding or cramping, or severe abdominal pain. If you experience any of those symptoms, call your doctor immediately.

Second trimester

Once you’ve moved onto the second trimester, you may begin to have some typical pelvic pressure or lower abdominal stretching. However, if you suddenly experience severe pelvic pressure or pain, vaginal bleeding or increased vaginal discharge, call your practitioner.

Third trimester

Finally, in the third trimester, it’s very common to have occasional uterine contractions and pelvic pressure. Plus that first-trimester fatigue may reappear once more.

And as you near your due date, you’ll want to watch out for signs of labor, which includes contractions, your water breaking or a “bloody show” (the loss of your mucus plug, which is often a good indicator that labor is imminent).

Your practitioner should prep you on what to do if you think you’re going into labor (he or she will probably advise you to call when contractions are five minutes apart, for example), but you should always call your doc if:

  • You’re experiencing severe pain.
  • Your water breaks, especially if the fluid looks greenish or brown. This can be a sign that stool, also known as meconium, is present in the amniotic sac, and it can be dangerous for baby to ingest.
  • You’re experiencing sudden swelling, blurred vision or a severe headache, all of which can be signs of preeclampsia (a sudden onset of high blood pressure).

Can we discuss my birth plan?

While a birth plan isn't necessary (and, when the big day arrives, you may not end up following some or even a lot of it), many women make one to familiarize themselves with the labor and delivery process and to make sure everyone involved is aware of their personal preferences.

Reviewing your birth plan with your doctor prior to labor provides an opportunity to discuss expectations (especially if you have a high-risk pregnancy, where you may have more restrictions during birth to stay safe) and review concerns you and your doctor may have regarding your experience.

What should I expect during my labor and delivery?

Your labor and delivery can vary a lot depending on where you deliver — whether that's at a hospital, birthing center or home. A nurse or provider will perform cervical exams intermittently to determine cervical dilation and effacement. He or she may also recommend interventions for your well-being and your baby's, including IV and electronic fetal monitoring, which should be explained to you as the need arises.

Discussing ahead of time also allows you to review pain management options (like the epidural) so you can plan for the options available to you through various stages of labor.

Who will deliver my baby?

Who ultimately brings your baby into the world depends on your physician's practice. Some have a number of OB/GYNs on-call, and you'll get whoever that person is when you go into labor. In other practices, you'll always be with your own doctor. So be sure to ask how it works for your delivery so you're okay with what goes down on delivery day.

What's the likelihood I'll need a C-section?

Since about 1 in 3 women delivers by C-section, it's an important question to ask your doctor — especially if you're hoping for an unmedicated birth. Reviewing your personal risks with your provider prior to labor helps guide your expectations. While the answer is unique in each case, common risk factors for C-sections include:

  • Maternal obesity
  • Gestational diabetes
  • Suspected macrosomia (larger than average baby)
  • Post-term pregnancy (going past your due date)
  • Previous cesarean delivery
  • Advanced maternal age (i.e. you're 35 years old or older)

What should I know if I want a VBAC?

If you delivered a baby via C-section, you may have heard that it can be challenging to have a vaginal birth after cesarean (VBAC) with a subsequent labor and delivery. But many women are candidates; research on women who attempt a trial of labor after cesarean (TOLAC) has found that 60 to 80 percent have a successful vaginal delivery.

Your doctor will want to know some things about you to help you decide if a VBAC is appropriate, like the type of C-section you had, current medical conditions and the estimated size of the baby.

It’s also important to make sure the hospital has measures in place to make VBAC safe. These include 24-hour in-house obstetrics and anesthesia teams, as well as the ability to perform an emergency C-section, if necessary.

Not everyone is a good candidate for a VBAC. If the reason you had a previous C-section hasn’t changed — for example, your pelvis is too small — it’s likely you’ll need another, but if you’ve got your heart set on a VBAC, definitely talk to your practitioner about it.

What support can I get if I want to breastfeed?

Breastfeeding isn’t always easy, making this an essential question for all women who are considering it. A number of practices encourage and support breastfeeding moms and babies, like skin-to-skin contact immediately after delivery and rooming in with baby 24 hours a day.

Discuss lactation consultants and breast pumps with your doctor too, both of which are now guaranteed to new moms under the Affordable Care Act (though who/when/when/where you have access to may vary), along with other support services both during your hospital stay and after you go home.

The bottom line: Don’t be afraid to call your practitioner if you’re unsure about anything. He or she knows this is likely a new experience for you, and can help you figure out what’s normal and what’s not.