Deliveries are performed at either Norton Suburban Hospital or Baptist Hospital East. Within Women's Health Care, we are able to provide the following comprehensive medical services:

  • Routine and limited high risk obstetrical care.
  • Fetal ultrasound assessment includ­ing state-of-the-art real-time 4D ultra­sound imaging .
  • Genetic counseling and amniocentesis.

 

Congratulations on your pregnancy! We want you to have an enjoyable experience. The following instructions are compiled to help you during the next few months. If specific problems arise, please call our office for further advice.

During your pregnancy, we will ask you to meet each physician since your baby will be delivered by the doctor on call when your labor will occur. You will also be scheduled to see our nurse practitioner. Your pre-natal visits are scheduled as follows:

Every 4 weeks until approximately 30 weeks. Every 2 weeks until approximately 35 weeks. Every week after 35 weeks until delivery.

This schedule represents regular visits only. If any complications will arise, your doctor will make the appropriate follow-up recommendations. You will have a complete physical examination and prenatal routine blood work at your first visit. You will also have the opportunity to meet with our OB nurse - she will be your first contact for any questions or concerns during regular office hours. We encourage after-hour calls for emergencies only. These are the top 4 reasons to call us ANYTIME:

  • If your "bag of water" ruptures.
  • If your contractions are lasting for more than 1 hour, they are getting closer and stronger.
  • If you are bleeding and you did not have a pelvic exam at the office.
  • If you did not feel your baby moving as usual.


During each visit, you will be weighed, your blood pressure and urine will be checked. Fetal heart tones will be checked at every visit starting at 12 weeks. The physician will measure your abdomen and answer any of your questions. She will do any counseling needed and will inform you of any upcoming tests. You may not have any pelvic exam until 35 weeks, unless indicated. An ultrasound evaluation of your baby's anatomy will be performed between 18-20 weeks. We will be happy to find out the sex of your baby, if you wish and if possible. We do have a real time 4D ultrasound machine: it is still recommended to evaluate the fetal anatomy in 2D and we do use the 4D if any anomaly is suspected. Because of the high demand, it is possible to have an elective 4D ultrasound performed between 26 and 30 weeks. It is not covered by your insurance and it does not substitute the 2D evaluation. For any specific information, please inquire with our ultrasonographer.

Please choose a pediatrician and the delivery facility (Norton Suburban or Baptist Hospital East) by your 30th week of pregnancy.

 

Circumcision

If you are having a boy and you have chosen to have him circumcised, we will perform the procedure the day after delivery. Although circumcision is widely performed, it is an elective procedure with potential complications: bleeding, infection, urethral and penile injuries. We do use local anesthesia.

 

General pregnancy recommendations

Hot tubs and Saunas
 Studies have shown that there is an increased incidence of miscarriage if a sauna is used during the first three months of pregnancy. We recommend against using the sauna during the entire pregnancy and not using a hot tub during the first three months of pregnancy. After the first three months of pregnancy, limit the hot tub to 100 degrees temperature. The danger to the fetus appears to be from raising the mother's core body temperature. Warm baths and showers are safe throughout pregnancy.

Diet
 Avoid raw meat, unpasteurized milk or cheese (Brie, Camambert, blue, havarti and other), raw eggs, alcohol, tobacco. Do not eat more than 12 oz. of cooked fish per week, and never eat any shark, tilefish, swordfish, fresh tuna or king mackerel, since they have a high content of mercury. We recommend increasing your calcium intake to 1500 mg/day. We recommend 1 mg/day of Folate (Folk Acid). This is provided in the prenatal vitamins. Drinking 6-8 glasses of water/day and eating fruits and vegetables is recommended. There is no contraindication to using NutraSweet™ and Splenda in moderation during pregnancy.

Caffeine
 Caffeine should be limited to less than 300 mg/day.

Weight
Each pregnancy weight gain is different. You will usually gain about 1 pound per month during the first trimester, and then about one pound per week during the second and third trimesters. Normal pregnancy weight gain is 25-35 pounds.

Exercise
 We encourage you to continue your normal exercise routine. We advise 30 minutes of moderate exercise on most, if not all, days. Be careful to not injure yourself during the later part of pregnancy when your balance changes and your ligaments loosen. DO NOT EXERCISE if you have bleeding, cramping, abnormal pain or other high risk factors relating to the pregnancy. Soccer, ice hockey, skiing, horseback riding and water skiing are strongly discouraged due to risk of falling. Scuba diving is not safe at any time during pregnancy.

Alcohol
 Fetal Alcohol Syndrome (FAS) is the leading known cause of mental retardation. It is preventable. Please DO NOT drink during your pregnancy or use any illicit drugs such as amphetamines, cocaine, marijuana, or hallucinogenic drugs.

Smoking
 Smoking while pregnant increases the incidence of low birth weight babies, placental abruption, miscarriage, and pre-term labor. It also increases your baby's risk for future ear infections, frequent colds and SIDS. Please do not smoke during your pregnancy.

Dental Work
 Local anesthesia injections are safe. Use a lead apron if X-rays are necessary. Pain medications and most antibiotics are safe (your dentist will prescribe correctly).

Herbal supplements
 We do not recommend any herbal supplements during the pregnancy. Most have not been studied, so no safety record is available. If you are taking a supplement, please bring it to your appointment and discuss its use with your physician.

 

Medication Use in Pregnancy

The following medications have been taken during pregnancy and have not been shown to cause birth defects. Even so, we recommend not using any medication unless necessary. If you take a medication routinely for a medical problem and are unsure about the medication, please contact our office prior to discontinuing that medication. Take all medications according to the manufacturer’s directions listed on the bottle unless otherwise directed by your physician.

  • Antacids (Mylanta, Maalox, Pepcid AC, TUMS, Zantac)
  • Antibiotics (Keflex, Macrodantin, Macrobid, Amoxicillin, Penicillin)
  • Antihistamines (Benadryl, Claritin, Dimetapp, Tavist, Zyrtec)
  • Anti-nausea medications (Phenergan, Zofran, Scopolamine patch)
  • Cough drops/lozenges/syrups (Cepacol, Robitussin, Vicks)
  • Decongestants (Actifed, Sudafed, Entex)
  • Laxatives (Dulcolax)
  • Nasal sprays (Afrin, Beclovent, Flonase, Nasonex, Neosynephrine, Saline, Ventolin)
  • Stool softeners (Colace, Citracell, Fibercon, Metamucil)
  • Thyroid medicine (Synthroid, Thyroxine)
  • Tylenol (Extra-strength, Regular)
  • Yeast medications (Monistat, Gyne-Lotrimin, Femstat, Terazol)
  • Insect repellent containing DEET (no more than 10% concentration)
  • Medication you should NEVER take during pregnancy includes: Acutane, Lithium, Tetracycline, Vibramycin, Valproic Acid
  • Other medications may be safe or have minimal risk but should be discussed with your physician prior to taking the medication.

 

Cord Blood Collection

What is the value of cord blood? Stem cells from umbilical cord blood can be used to treat various genetic disorders that affect the blood and immune system, leukemia, certain cancers, and some inherited disorders of body chemistry. To date, more than 70 disorders have been treated with stem cells. Future research may use stem cells from cord blood to treat and cure Parkinson's disease, childhood diabetes and heart disease.

Should I sign up for cord blood collection? The chance that your child will need the blood is extremely small. It is still considered to be a risky and experimental procedure. The American College of OB-Gyn and the American Academy of Pediatrics do not currently endorse cord blood collection unless you have another family member who may need a stem-cell transplant. Other families who may benefit from cord blood collection include a family history of blood diseases and children of mixed-ethnicity parents who may have difficulty finding a genetic match at public storage banks. Considerable research is being done at this time that may increase the number and types of conditions that are being treated with stem cells from cord blood.

 

UPON THE ARRIVAL OF YOUR BABY.

Contraceptive Options

Breastfeeding

  • Withdrawal Method - removal of the penis from the vagina prior to ejaculation. Success rate is about 72%.
  • Vaginal Spermicide - foams, suppositories, tablets, or jellies inserted into the vagina before intercourse. Success rate is about 79-95%.
  • Condom - a rubber sheath worn over the penis during genital contact. It acts as a barrier to transmission of semen and/or organisms that may cause sexually- transmitted diseases (non-latex condoms do not act as a barrier for HIV). Success rate is about 88-98%.
  • Diaphragm - a vaginal barrier method used in combination with spermicidal cream or jelly. Success rate is about 82-94%.
  • IUD (intrauterine device) - a small device placed in the uterus that doesn’t allow the fertilized egg to implant in the uterine wall. Success rate is about 98%. Two lUD’s are available. The Mirena IUD lasts 5 years and the cooper T lasts 10 years.
  • Minipill - progesterone only oral contraceptive - Used frequently while nursing because it does not decrease the quantity of breast milk.
  • Depo Provera (Contraceptive Injection) - a hormonal injection that stops ovulation and prevents sperm from entering the uterus. It is given every 12 weeks (3 months) and starts working within 24 hours after injection. Success rate is 99.5%.
  • Vasectomy (Male) - an incision is made over the vas deferens on each side of the scrotum. The ducts are cut and tied. The procedure is usually performed by a Urologist in his office under local anesthesia. A sperm count is necessary after the procedure to confirm its success.
  • Tubal Ligation (Female) - a surgical procedure to sever the fallopian tubes. This procedure can be performed at the time of cesarean section or later as an outpatient surgery. An anesthetic is required for the surgery.

Non breastfeeding

  • Oral contraceptive pill (OCP) - A cyclic pill of both estrogen and progestin. It suppresses ovulation, diminishes growth of the endometrium, and increases the thickness of mucus around the cervix, preventing the passage of sperm through the cervix. Success rate is 98-99.5%.
  • Nuvaring - a vaginal ring that secretes both estrogen and progesterone in the vagina and from there absorbed systemically; it prevents ovulation and implantation. It is as effective as the OCR.
  • OrthoEvra (Contraceptive patch) — a weekly combination patch of estrogen and progesterone that works like the OCR.
  • Rhythm - determining probable fertile period during a menstrual cycle, using body temperatures and graphs, and avoiding intercourse during these fertile times. Success rate is about 70%.
  • All the methods described in the "breastfeeding" section.

 

OB ULTRASOUND

You will need to arrive 10 minutes early in order to complete your registration at our front desk.

Your current insurance card is required and co-payment may be needed depending on your insurance plan.

Ultrasound Preparation

  • 14 weeks gestation and less are scanned vaginally and there is no prep
  • 14 weeks gestation and above are scanned abdominally. We ask that you drink 8 ounces of fluid, finished 30 minutes prior to the appointment time in order to have a full bladder.
  • Navel rings must be removed prior to abdominal ultrasounds.
  • Biophysical Profiles - We ask that you eat a snack or a meal 30 minutes before you arrive at the office.
  • Increase your fluid intake for the 2 days prior to your scan.

Ultrasound Policies
 Children under 6 years old must be accompanied with an adult.  Only two people are permitted to accompany the patient.  The PDA and ATOM (American Institute of Ultrasound Medicine) will not permit the making of videotaped for personal use, however, thermal pictures may be provided if possible.

3-D/4-D Ultrasound
This is an elective ultrasound and not covered by any insurance It is a 30 minute scan and scheduled at 26-30 weeks gestation Fee is 150.00 You receive proofs and (2) 4x6 photo quality pictures

Please keep in mind not every picture is a 'textbook picture". A baby must be lying in a good position with an adequate amount of fluid hi front of the face to generate a picture. A patients weight also plays a role on the quality of the picture, heavier patients tend to have "fuzzier" pictures. A limited anatomy assessment is also done at this time, but no measurements are taken and therefore no weight is given. Since we don't know how cooperative the baby will be, there is a partial fee (time and room occupancy) if the baby chooses not to be photogenic.

Any balances on your account must be paid prior to or on the day of your 3D/4D ultrasound appointment.

If you choose not to keep your appointment please cancel 24 hours in advance or you will be charged a "No Show Fee".

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