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The First Prenatal Visit

Please allow extra time for your first prenatal visit.  During your initial visit, your provider will go over your past medical and obstetrical history.  You will undergo a physical examination and have blood drawn. Prenatal laboratory testing includes a urine pregnancy test, a urine culture, pap smear if it is due, Gonorrhea and Chlamydia testing will be done.  Blood work includes determining your blood type, testing for anemia, testing for Hepatitis and syphilis, and evaluating immunity to Rubella. If needed, an Ultrasound will be done.

Your provider will give you an overview of what to expect in a normal pregnancy.  We will also discuss any risk factors you may have and alert you to signs and symptoms of possible problems that might arise. We will answer any questions you may have regarding your pregnancy.

Subsequent Visits

 

Your nurse will check your blood pressure and weight each visit.  We will collect a urine specimen and check for sugar and protein.  Your provider will evaluate the growth of the baby and listen to the heartbeat.  We will discuss the progress of the pregnancy and review what needs to be done to prepare for your child’s birth. Please discuss any problems and ask questions you may have.  

Screening Tests

Screening tests can identify whether  your baby is more likely to have certain conditions such as chromosomal abnormalities or spina bifida (a malformation of the spinal cord).  These tests do not tell you if your baby has one of these problems but rather they indicate if the risk is higher than average. If the test comes back showing that the baby is at higher risk, more testing would need to be done. These tests are optional. A review of your history and a discussion with your provider can help you make the decision as to whether you want to have these tests done.  

Cell Free DNA (NIPT—Non-Invasive Prenatal Testing)

Can be done after 10 weeks of pregnancy.  It involves drawing a tube of blood from the mother.  The lab is able to extract some of the baby’s DNA and determine if the baby is at risk for Downs syndrome, Trisomy 18, Trisomy 13 and will also look at the sex chromosomes to determine if there are any abnormalities.

Sequential Screen or NT Screen

This test has two steps done at the same time between 10 and 13 weeks.  It involves drawing a tube of blood from the mother which checks levels of two hormones, and an ultrasound to measure the nuchal translucency (fluid beneath the skin behind the baby’s neck).    This test determines if the baby is at risk for Downs Syndrome and Trisomy 18.

AFP Tetra or Quad Screening

This test involves drawing a tube of blood from the mother between 15-22 weeks of pregnancy.  It measures four different substances in the mother’s blood. This screens for Downs Syndrome, Trisomy 18 and Spina bifida.  

Diagnostic Testing

If one of the optional screening tests indicate that the baby may be at a higher risk of a birth defect, a diagnostic test may be performed.  Women over age 35 are also offered this testing. These tests are more invasive but can help to determine if the baby has a specific problem. These tests are optional and only done if  desired by the patient. Your provider and a Perinatologist (high risk pregnancy doctor) will provide the information necessary to assist you in deciding if you want to proceed with the testing.  

Preparation for Delivery

As your pregnancy progresses there are several items that need to be done:

  • Preregister at the hospital you will be delivering at.  There are forms in our office or you can go to the hospitals website to register.
  • Register for prenatal classes if you choose to take them.  We encourage classes if this is your first pregnancy. These classes are offered at the hospital.
  • Choose a pediatrician.  The pediatrician will care for the baby after birth.
  • Make an appointment with the Maternity Navigator/Coaordinator at the hospital you will be delivering at.  

Premature Labor Precautions

Premature labor occurs before 37 weeks.  Signs and symptoms would be more than 6 contractions in one hour, severe cramping  or spotting. Please call our office if you experience any of these issues.

Labor Symptoms

Once you are full term (37 weeks+) the signs and symptoms that may indicate you are in labor are:

When contraction are 5 minutes apart, go on at this rate for at least one hour and are painful.  You time from the beginning of one contraction (pain) to the beginning of the next contraction.
If you have a sudden gush of fluid or a trickle of fluid indicating that your water has broken.  If there is ANY question whether your water has broken or not please call.

On Call Policy

At night and on the weekends we always have a physician on call.  Please call for emergencies only during this time. All other calls should be handled during business hours.  

Services after hours are provided through the use of an on-call schedule. Each of our physicians participates in the on-call rotation to ensure a doctor is available at all times. Because of their call schedule, a physician other than the provider you normally see may be taking care of you. The physician on call will be the one managing your labor and will be there for the delivery. Please let your provider know during your prenatal visits if you would like to meet the other providers before delivery.

In The Hospital

Women who have a vaginal birth typically stay 2 nights after delivery.  For women who have a Cesarean Section (C-section), most women stay 3 nights after delivery.  Our providers will see you during your stay and prepare you to go home.

Postpartum Visits

The postpartum visit is usually scheduled 6 weeks after a vaginal birth or 2 weeks after a Cesarean birth.  Women who have Cesarean births are later seen again at around 6 weeks after birth.

At the postpartum visit an exam is done to make sure you are healing well.  Birth control options will also be discussed.

After Hours and Emergency Services

In extreme emergencies, call 911 immediately.

Otherwise there is a doctor on call  that will handle all other problems. Please contact the on call physician if you think you are in labor or are having any emergent problems that might require you to go to Labor and delivery or the Emergency Department.   

To contact the physician on call—Call 913-384-4990 and follow the prompts.  Please call for emergencies only during this time. All other calls should be handled during business hours.