ARE YOU EXPECTING?

Are You Expecting?

Congratulations!
We are committed to giving you exceptional, personal care with a team approach.

Thank you for choosing us to care for you and the newest member of your family! This page contains information that will give you a preview of what to expect during your prenatal care with us.  If you have any questions, please feel free to call our office at any time.

We are committed to giving you exceptional, personal care with a team approach.  All of our clinical staff are knowledgeable and will answer your calls quickly.  You will meet all four of our doctors over the course of your prenatal visits.  One of them will return your call if you have any concerns or if you have an emergency in the evenings and weekends, so you will never see an unfamiliar face.

Some Basic Rules...

1. Check with your doctor on all prescription drugs.
2. Stay away from caffeine and alcohol.
3. Keep exercise to 30 min/day max and keep your pulse < 140 BPM.
4. Exercise to your individual abilities for a healthier pregnancy.
5. Stay away from areas where the Zika virus is known.

Patient Forms
Check our list for medications that are safe in pregnancy.  If you do not see it on the list then you can send us a portal question and we will advise.

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First Trimester
At your first visit, your doctor will determine your baby’s gestational age and estimated due date based on the date of your last period and an ultrasound.  Depending on how far along you are, you may see a heartbeat, arm and leg buds, and sometimes even spontaneous movement of the baby!  Your doctor will then review your medical history and any medications that you are taking.  You should always call and check with our office before starting any new medications during pregnancy, including over-the-counter medicines.  Your first visit might include a physical exam that includes a pap smear if needed and as determined by your physician.  Tests will be done to screen for anemia, diabetes, kidney disease, and sexually transmitted diseases.  You will also be offered screening for cystic fibrosis carrier status.

You have several options when it comes to screening for Down Syndrome or other chromosome-related problems.  The first trimester screen is available that tests for Trisomy 13 and 21 (downs sydrome).  Alternatively, you can opt for a second trimester screen that is only blood work.  If you have a family history of any particular medical disorder, or if you desire more advanced genetic testing, speak with your doctor to determine if additional screening is available or recommended.

Risk of Spina Bifida can be reduced by taking a prenatal vitamin daily that includes folic acid.  Screening for Spina Bifida is accomplished with a blood test and evaluation of your baby’s spine with ultrasound.

Typically, you will be seen every 4 weeks during the first and second trimester.  These visits are quick and easy.  At each visit, your blood pressure, weight, and sometimes the urine will be checked.  Your doctor will listen to your baby’s heartbeat and measure your abdomen to check your baby’s growth.

Morning sickness can be troublesome during the first few months because of a rapid change in your hormone levels.  It may help to eat smaller more frequent meals throughout the day.  Medications are available to help with your symptoms if needed.

Occasional travel is generally okay for uncomplicated pregnancies until the third trimester.  We recommend that you wear compression stockings, drink lots of fluids, and get up and stretch your legs once every hour

Sexual Activity and Exercise are also safe for uncomplicated pregnancies.  You can continue your pre-pregnancy activities as you can tolerate, but limit yourself to 30 minutes of aerobic exercise 3-5 days a week. If you were not exercising before pregnancy, a 30-minute walk 5 days a week is a good regimen.

These recommendations apply to patients with uncomplicated pregnancies under normal circumstances.  Please discuss your travel and activity level individually with your doctor.  For example, if you are a marathon runner, if you travel frequently for work, or if you have bleeding or preterm labor, your doctor may advise you differently.
Second Trimester
At 18-20 weeks, your baby’s anatomy will be evaluated with a comprehensive ultrasound.  We will look at your baby’s head, heart, abdomen, kidneys, spine, and limbs.  If you would like, we typically can determine the sex of your baby at this time, depending on his or her position.

You should begin to feel your baby move around 20-24 weeks.  This is the time to begin planning your birthing classes, looking for pediatricians, and getting your nursery ready!

Third Trimester
You will have a 1-hour glucose tolerance test at around 28 weeks to check for gestational diabetes.  After 30 weeks, your doctor will begin seeing your more frequently.  Braxton-Hicks contractions are common at this time.  If you have vaginal bleeding, leaking of fluid, regular or painful contractions, or if your baby is not moving well, be sure to call and let us know.

An additional test for Group B Strep is performed at 36 weeks, and you will be seen weekly at this point.  At each visit, you doctor will check your cervix to look for any progress toward labor.  Forty weeks is your due date!  If you have not gone into labor by 41 weeks, your doctor will likely induce your labor, as it us usually considered dangerous to go more than one week overdue.

And then, it feels like it all happened so fast.  Your baby is here, and you have a face to behold, and fingers and toes to count!  But it is just beginning – the diapers, the sleepless nights, and soon they’re asking to borrow the car keys!

 Pregnancy Related Q&A's

When should I make my first OB appointment?
Call the office when you have a positive home pregnancy test. You will be seen in the office at 6-8 weeks for your first OB appointment. This appointment will include an ultrasound to confirm your due date, blood work, cultures and a pap smear.

How often will I be seen during my pregnancy?
For an uncomplicated pregnancy you will be seen according to the schedule below:
6-28 weeks: Every 4 weeks
28-36 weeks: Every 2 weeks
36-40+ weeks: Weekly until delivery
Postpartum visit will be at 6 weeks after delivery for both vaginal and cesarean deliveries

How many days will I be in the hospital after delivery?
Women who deliver vaginally will be in the hospital for 2 days after delivery. Those that have a cesarean section will have a hospital stay of 3-4 days after delivery.

How much will having a baby cost?
Our office calls and confirms your OB benefits at your first OB appointment. They will call you to inform you of what out of pocket expenses are due before delivery. The benefits we confirm through your insurance company only cover those services rendered by us and not anesthesia or your hospital stay.

What tests are performed during my pregnancy?
At your first OB appointment an ultrasound to confirm your due date is performed. In addition, blood work, cultures and a pap smear are done. The blood work includes a sexually transmitted disease panel, cystic fibrosis screen, rubella immunity, blood type and blood count. Cultures include a urine culture and gonorrhea/chlamydia culture. These results will be discussed with you at your next visit unless an abnormality is noted.

A first trimester screen is offered between 11-14 weeks. This screen includes maternal blood work to evaluate the baby’s risk for Down Syndrome, Trisomy 13 and 18. This test is more accurate when done earlier in pregnancy and is an elective screening test done at an outside testing center. You will still require an office blood test around 16 weeks to test for spina bifida. If the patient opts out of doing this test, a maternal lab will be drawn between 15 and 20 weeks of pregnancy which will evaluate for the same chromosomal abnormalities in addition to the risk of a neural tube defect (i.e. spina bifida).  Once you know your estimated risk, you have the option of an amniocentesis which will provide a sample of DNA from the fluid surrounding the baby that is tested for those chromosomal abnormalities. There is a 1 in 200 risk of miscarriage following an amniocentesis. If a neural tube defect is suspected, a higher level ultrasound will be ordered to further evaluate this possibility.

An anatomy ultrasound will be performed at approximately 20 weeks gestation. At this time the heart, kidneys, spine, bladder, extremities, etc will be evaluated for any abnormalities so that further testing can be done early in the pregnancy. The gender of the baby can also be determined at this time if desired. There is no guarantee that any or all abnormalities will be identified on ultrasound.

At 26-28 weeks, a gestational diabetes screen is done via the 1 hour glucose tolerance test. This test will evaluate your body’s ability to metabolize sugar and is used to screen for gestational diabetes. If this screening test is failed, a 3 hour version will be done to definitively diagnose gestational diabetes. If you are diagnosed with this condition, we will follow your blood sugar levels and determine whether diet control or insulin is required.

At 35-36 weeks, a vaginal culture is done to look for Group B Streptococcus. If positive, antibiotics will be given to the mother at delivery to prevent an infection being transferred to the baby. This bacteria does not pose a threat to the mother or to the baby during pregnancy, but can increase the risk of pneumonia and meningitis in babies after delivery if exposed. According to a recent change in recommendations by the American College of Obstetrics and Gynecology (ACOG) it is now required that we offer patients a repeat HIV and Syphilis test in the 3rd trimester. This test can be deferred by the patient if desired.

What does the screening for gestational diabetes involve?
Patients must be fasting after midnight the night before their appointment. You will be given a 50 gram glucose drink to consume within 5 minutes. One hour after the drink has been finished; blood work will be drawn to evaluate your body’s ability to metabolize the sugar in the drink. If this test is failed, this does not mean you have gestational diabetes but that you are at risk for it. As a result, a confirmatory three hour version is done following a special diet for three days. This three hour version will determine whether you are diabetic and the need for further evaluation.

What are the signs of labor?
• Contractions that are regular and get closer together with time. They also increase in length and intensity as time passes. Once contractions are 5 minutes apart for at least one hour patients should go to labor and delivery on the third floor of the Memorial Herman Tower.

• Gush of fluid from the vagina. The fluid should be clear and odorless with blood potentially present as well. If your fluid has an odor or different color please inform the labor and delivery nurse once you arrive.

• Bright red bleeding.

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