Doctor’s Note for Fake Pregnancy

A weaker immune system

It was initially thought that during a pregnancy a woman’s immune system is weakened making her susceptible to infections. However, as with most things concerning the human body, it is not that simple and newer evidence suggests that a woman’s immune system is in a state of flux during her pregnancy, where at some points it is not as aggressive as normal and other times not.

This variable immune status during pregnancy is vital to accommodate the developing baby – for different reasons at different stages of pregnancy. For instance, in the early stages of pregnancy, the immune system has to adjust to allow for implantation of what is, after all, a foreign body. At other times, the immune system needs to adjust again but in a different way, for example when a woman’s body is preparing for labour.

This, of course, is an over-simplified explanation, but the point is that having a fluctuating immune system does put you at higher risk of the complications of COVID-19, such as respiratory difficulties and even pneumonia.

The first thing to stress is that women should still attend all their antenatal hospital appointments unless told otherwise by their doctor or midwife.

For now, there is no reason to change your birthing plan, whatever that may be, if you have one. A birthing plan lays out what you are hoping for the birth – for example, whether you want to have your baby at home or in hospital, and what sorts of pain relief you might want to have.

However, if you develop symptoms that are consistent with coronavirus – a persistent dry cough or a high temperature – you must self-isolate and speak with your doctor or midwife.

Certainly, women who have other health conditions and are pregnant need to be extra vigilant and consider social distancing if not self-isolation during their pregnancy. Women who develop diabetes – a condition known as gestational diabetes – as a result of their pregnancy should also take care and limit social contact.

Being diagnosed with gestational diabetes already puts you in a higher-risk pregnancy group even without the coronavirus, because it increases your chances of complications during pregnancy and birth. Furthermore, high levels of blood sugars for a prolonged period of time – the result if gestational diabetes is not diagnosed and managed properly – can weaken your immune system further.

For otherwise healthy pregnant women, given how the strength of their immune system varies during the trimesters, it would be prudent to take precautionary measures and consider social distancing where possible.

As a lot of pregnant women live with partners and perhaps have older children too, the same advice applies to them – practice social distancing so you do not put your pregnant wife, mother, sister or aunt at risk.

This might include working from home (for those who can do this), cutting back on social contact and avoiding crowded spaces.

General advice for pregnant women to help ensure a healthy pregnancy and as good immunity as possible is to stick to a good diet rich in iron (dark green leafy vegetables, fish and eggs) and folic acid (beans, pulses and green, leafy vegetables). A daily, pregnancy-specific multivitamin tablet may also help.


Is Breast Pain Normal During Early Pregnancy?

Breast pain may be one of the first signs of pregnancy. During this period, your breasts are beginning to prepare for a big job: Making milk to feed your baby! In addition, the ligaments that support your breasts will begin to relax (along with the ligaments in other parts of your body), and this will account for some of the pain.

In most cases, breast pain is nothing to worry about, but make sure that you contact your doctor if you experience breast pain with a fever, as this may indicate an infection.

There's usually no reason to stress, even in the first trimester. Worry only increases the risk, so if you're anxious, please relax!

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Early pregnancy symptoms vs. PMS: Whats the difference?

Most early pregnancy symptoms before your period are strikingly similar to the side effects of PMS. However, you’ll only notice changes in your areolas (they’ll look darker, wider and bumpy) if you’re pregnant. A consistently elevated BBT and creamy vaginal discharge post-ovulation are also both relatively reliable signs of conception, but they’re certainly not foolproof.

Otherwise, the only way to know if other early pregnancy symptoms (nausea, tender breasts, fatigue, bloating, sensitivity to smell, etc.) are due to a baby or PMS is to hold out until you can take a pregnancy test.

Early Signs of Pregnancy

How Do I Get a Doctors Note from PlushCare?

All PlushCare doctors are highly qualified and experienced to provide online diagnoses and treatment for telehealth patients. 

To get a doctor’s note from PlushCare, you would start by making an appointment with an online PlushCare doctor. During your video or phone appointment, the doctor will help review your symptoms, medical history, and current medications. If the doctor deems a note to be medically necessary, then they will send you a doctor’s note.

PlushCare is HIPAA-compliant; we value your privacy and use secure electronic record systems to keep your personal health information safe.

Just click here to make an appointment and receive a doctor’s note for work, school, or any other commitments in your life. Our nationwide doctors commonly write doctor’s notes for all types of conditions and 97% of conditions are successfully treated on the first visit.

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First Trimester Prenatal Screening Tests

First trimester screening is a combination of fetal ultrasound and maternal blood testing. This screening process can help determine the risk of the fetus having certain birth defects. Screening tests may be used alone or with other tests.

First trimester screening includes:

  • Ultrasound for fetal nuchal translucency. Nuchal translucency screening uses an ultrasound to examine the area at the back of the fetal neck for increased fluid or thickening.

  • Ultrasound for fetal nasal bone determination. The nasal bone may not be visualized in some babies with certain chromosome abnormalities, such as Down syndrome. This screen is performed using an ultrasound between 11 and 13 weeks gestation.

  • Maternal serum (blood) tests. These blood tests measure two substances found in the blood of all pregnant women:

    • Pregnancy-associated plasma protein A. A protein produced by the placenta in early pregnancy. Abnormal levels are associated with an increased risk of chromosomal abnormality.

    • Human chorionic gonadotropin. A hormone produced by the placenta in early pregnancy. Abnormal levels are associated with an increased risk of chromosomal abnormality.

When used together as first trimester screening tests, nuchal translucency screening and maternal blood tests have a greater ability to determine if the fetus might have a birth defect, such as Down syndrome (trisomy 21) and trisomy 18.

If the results of these first trimester screening tests are abnormal, genetic counseling is recommended. Additional testing, such as chorionic villus sampling, amniocentesis, cell-free fetal DNA or other ultrasounds, may be needed for an accurate diagnosis.

Which Pregnancy Pains Should I Worry About?

In some ways, the first trimester of pregnancy is the "riskiest." Although it is true that the loss of a pregnancy is most likely during the first three months, I'm here to reassure you that most of the aches and pains you experience are natural and normal.

Before I proceed, however, I want to make it clear that miscarriage is a risk of early pregnancy, and so you should contact your doctor if you are concerned about pains that you feel. Any pain which is sharp or accompanied by bleeding should prompt a call to your doctor and possibly a visit to be examined.

When to See a Doctor Immediately

Particularly if you're a first-time mother, you should contact your doctor when you experience pain during your pregnancy. In most cases, your doctor is going to reassure you. However, if you are experiencing the following, you should consider seeing a doctor immediately via an urgent care facility or your local women's hospital.

  • Cramping with bleeding
  • Severe leg pain
  • Inability to keep foods down due to nausea
  • Pain during urination

If you have additional symptoms accompanying what may otherwise be normal pain, contact your doctor immediately. Aside from the obvious risk of miscarriage, or chemical or ectopic pregnancy, another risk you need to be wary of is a urinary tract infection. A simple urine test can confirm a UTI and you will be prescribed a pregnancy-safe antibiotic.

Routine physical examinations

  • Weight and height. Early on in the pregnancy your doctor or midwife will check your weight and height. This is to see if you are significantly underweight or overweight which may increase the risk of developing problems during pregnancy. Usually, after then your weight or height need not be measured again during pregnancy.
  • Assessing the growth of the baby. This is done by a midwife or doctor during routine antenatal checks. They use a tape to measure from the top of the growing womb (uterus) to the bone at the bottom of your tummy (pubic bone). If need be, an ultrasound scan can more accurately keep an eye on growth if it does not seem to be progressing normally.
  • Blood pressure. This is measured regularly during routine antenatal checks. Together with a urine test to detect protein, this screens for a complication of pregnancy called pre-eclampsia. See the separate leaflet called Pre-eclampsia.
  • Examination of the baby’s position. At about 36 weeks of pregnancy a doctor or midwife will examine your tummy (abdomen) to feel the baby to detect if the baby is lying bottom-down (breech). If so, treatment to turn the baby to a head-down position may be considered.

If you are otherwise healthy, other physical examinations are not routinely done. For example, routine vaginal or breast examinations used to be done in the past, but are not necessary. (They may be done if you have symptoms which warrant examination.)

When to Get a Note From Your Doctor

You should get a doctor’s note when you have a condition or appointment that will interfere with your ability to attend work or school normally. 

This may include:

  • Illness
  • Injury 
  • Extended absence 

Glucose Testing

Glucose testing is used to measure the level of sugar in your blood.

A glucose challenge test is usually conducted between 24 and 28 weeks of pregnancy. Abnormal glucose levels may indicate gestational diabetes.

What is involved in a glucose challenge test?

The initial one-hour test is a glucose challenge test. If the results are abnormal, a glucose tolerance test is needed.

How is a glucose tolerance test performed?

You may be asked to only drink water on the day the glucose tolerance test is given. Although the specific details of each procedure may vary, a typical glucose tolerance test includes the following steps:

  • An initial fasting sample of blood will be drawn from your vein.

  • You will be given a special glucose solution to drink.

  • Blood will be drawn at various times over the course of several hours to measure the glucose levels in your body.

A final point

The above tests are the usual routine tests offered to all pregnant women. If you have symptoms or problems which suggest pregnancy complications, various other examinations and tests may be advised. See your midwife or doctor if you have any concerns about your pregnancy, or if you wish to discuss any tests in more detail.


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