Prenatal visit expectations

Information sheet for expectant mothers for what office visits for prenatal care will entail. You may save and print the Prenatal Expectations form for your use.

WHAT TO EXPECT DURING YOUR PRENATAL CARE

1st OB VISIT

·       Schedule your first visit with your physician as soon as you find out you are pregnant.

·       Expect your visit to include some paperwork and the appointment may last approximately one hour.

·       During your first visit, we will review your medical and health history and obtain initial pregnancy labs.

·       Pap smears will be obtained when due (can be performed at any gestational age).

·       We will discuss the prenatal course and educate you regarding normal expectations and recommendations in pregnancy.

·       You will receive information about education materials for your pregnancy.

Call us at any time during your pregnancy if you have any of the following:

·       Bleeding

·       Severe pain

·       Fever (more than 100.4 F)

·       Painful urination

·       Blurry vision or flashing lights in front of your eyes

·       Severe headache that is not relieved by Tylenol

·       Vomiting that lasts more than 24 hours

·       Leaking fluid from vagina

·       Contractions that do not stop if you are less than 36 weeks pregnant, after you’ve rested and drank fluids

·       Decreased fetal movement

·       You feel something just “isn’t right”

FOLLOW UP OB VISITS

·       Routine follow-up OB visits occur every 4 weeks after your first visit until you reach 28 weeks of gestation.

·       From 28 to 36 weeks of gestation, your visits will be every 2 weeks, and after 36 weeks will be every week.

·       If you go beyond 40 weeks, or your due date, we will see you twice weekly to monitor your baby’s well-being.

·       Complications in pregnancy may require closer surveillance, there may be times where we wish to see you more frequently.

·       During your OB visits, we will be listening to your baby’s heartbeat, measuring your abdomen to assess for adequate fetal growth, and checking your blood pressure, weight, and urine.

·       We strongly recommend the influenza vaccine to all pregnant patients during the flu season, and the Tdap (tetanus, diphtheria and pertussis) vaccine after your 26th week of gestation.

1st TRIMESTER

·       First 14 weeks of gestation

·       OB visits every 4 weeks, unless otherwise specified by your physician.

·       Nausea and vomiting most commonly occurs during this trimester. To improve these symptoms try eating small frequent meals, avoiding dairy products, citrus, red meats, and fried greasy food. Saltine crackers, ginger snaps, and ginger ale improve these symptoms as well. Vitamin B6 (pyridoxine) may be able to help with these symptoms also, it is available over the counter.

·       Early ultrasound is recommended to determine an accurate due date, especially if you are uncertain of your last menstrual period. At least one ultrasound should be performed prior to 22 weeks of pregnancy.

·       First trimester genetic testing is offered between 10-14 weeks gestation. It is an optional, noninvasive evaluation that combines blood work and ultrasound to screen for risks of Trisomy 21 (Down’s syndrome), Trisomy 18, Trisomy 13, and sex chromosome abnormalities. There are tests available that can also tell the sex of the baby should you want to know. This is offered to women of all ages.

·       If you experience any vaginal bleeding or abdominal cramping during this trimester, please call our office.

2nd TRIMESTER

·       Begins at 14 weeks gestation, lasting until 28 weeks.

·       OB visits will occur every 4 weeks, unless otherwise specified by your physician.

·       2nd trimester screening is offered between 15-21 weeks gestation. It is an optional blood test, that when combined with 1st trimester screening can offer a useful screening for Trisomy 21 and open neural tube defects. It is noninvasive and there is no risk to the baby from this test.

·       An ultrasound will be performed to look at the anatomy of your baby at about 18-22 weeks of pregnancy.

·       Tdap vaccine will be recommended after 26 weeks gestation, even in previously vaccinated women. This is because the baby, when born, is unable to be vaccinated with Tdap, but will gain passive immunity from the mother for a short while after birth.

·       A diabetes screening test is performed between 24-28 weeks gestation, or earlier if you have a history of gestational diabetes or a strong family history and other risk factors. It requires the consumption of a flavored drink that is high in sugar and to have your blood drawn an hour later. An elevated blood sugar level >135 will indicated the need for further testing.

3rd TRIMESTER

·       Begins at 28 weeks gestation

·       OB visits with your physician will be about every 2 weeks until 36 weeks, or as specified by your physician.

·       If your blood type is Rh negative (Rh-) you will be given Rhogam. Rhogam “blocks” the formation of antibodies, and prevents breakdown of the fetal red blood cells. If you have Rh(-) blood type, this medicine may also be given at other times in your pregnancy such as after amniocentesis or following the birth of a Rh(+) baby.

·       Between 34-36 weeks gestation, we will do a Group B strep test. It is a noninvasive vaginal and peri-rectal culture that is used to test for presence of GBS bacteria to determine if antibiotics are needed during labor. The presence of the bacteria does not indicate an infection, and as many as 20-30% of women are colonized with this bacteria. Its presence increases the risk of pneumonia (lung infection), sepsis (blood infection), or meningitis (infection of the brain or spinal cord) in the newborn, if not treated with antibiotics in labor.

·       During this trimester we will repeat labs to check your hemoglobin levels in preparation for delivery, as well as testing that is recommended by the CDC which includes standard testing for syphyllis and HIV.

·       We will discuss labor pain management options during this trimester, you are welcome to ask any questions you may have regarding your options.

·       During this trimester, you will select your pediatrician. We can offer you our recommendations if desired.

·       At 40 weeks gestation (due date), if you are still pregnant, we will see you in the office to discuss further management.

LABOR AND DELIVERY

·       If you believe you are in labor, please call our office and one of our providers will talk to you and give you options. If you believe you are experiencing an emergency, go straight to the emergency room.

·       When arriving in the hospital, bring your photo ID, insurance card, and your support person with you.

·       Occasionally, during flu season, children under 12 are not allowed in certain patient care areas of the hospital, please plan accordingly.

·       Your newborn will be examined and followed by a pediatrician or family practitioner.

·       Patients that have a vaginal delivery will often stay 1-2 days after they deliver.

·       For patients that have scheduled cesarean deliveries, they are often able to go home 2-3 days after surgery.

·       If any concerns arise after your delivery, your physician may ask that you stay an extra day or two.

·       During your hospital stay, one of our providers will see and check on you daily. If any issues arise, the nursing staff will be in contact with your provider to discuss your further care.

·       The day of your discharge, you will be provided with prescriptions that are usually sent electronically to your pharmacy, and you will be provided with further discharge instructions as well as when to follow up at the office.