Welcome to OB Care |
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Congratulations on your pregnancy!Welcome! We'd like to tell you about how pregnancy care is provided through our office and give some simple suggestions and guidelines. Most pregnancies, deliveries and recoveries after delivery go well; we hope that your good efforts and ours can make that even more likely. Pregnancy testsPregnancy test kits available over the counter nowadays are quite reliable. The technology used today in inexpensive test kits wasn't even available in research labs not very many years ago. We feel comfortable using a positive result as confirmation of your pregnancy. However, if there is any question, if the test result is only weakly positive, or if you just can't believe it, please call, and we can arrange for a confirmatory test here in the office using either a blood or urine specimen. Making appointmentsOnce you're sure it's true, please call our office to
arrange appointments. You'll be given an initial appointment with a nurse to
take a careful medical and pregnancy history. While taking your history, if the
nurse encounters information that should be brought to your doctor’s
attention immediately, she will do so. An early ultrasound will be performed to confirm the gestational age and due date and to reassure both of us that the pregnancy is progressing well. On this early scan, twins (or more?) can almost always be seen if they are present. A general physical exam and a pelvic exam will be performed at this visit, and a Pap smear obtained if the interval since the most recent Pap test is appropriate. Subsequent prenatal careIf all seems to be going well at the first visit, you’ll be given an appointment every four weeks or so until approximately twenty-eight weeks. At these visits, blood pressure and weight will be measured and a urine specimen checked. We’ll listen to the baby's heart rate and ask you a number of questions to confirm that all is going well. At about 18-20 weeks, we usually perform a second ultrasound examination. At this mid-trimester sonogram, more anatomic detail can be seen and a number of serious problems ruled out. Although the fetal gender can often be noted accurately, this is not the primary reason for the scan. A twenty-eight week test for diabetes is administered to all patients. This involves not eating or drinking for at least three hours prior to the visit, then drinking a known amount of a glucose-containing solution. At one hour after partaking of this luscious concoction, a blood sugar measurement is obtained. Meanwhile, we’ll see you for the routine visit items and answer questions. If you pass this initial screen for diabetes, as most do, no further testing is usually necessary. If your screening value is too high, a confirmatory three-hour glucose tolerance test is arranged. Although most patients subsequently pass this test, it serves to identify those with gestational diabetes who need more intensive follow up. At about thirty-five weeks, we’ll perform a screening test for the presence or absence of Group-B Streptococcus in the vaginal tract. This lets us know which patients need antibiotics in labor to help prevent the very rare problems that can occur with newborns born to colonized mothers. Also at thirty-five weeks, we’ll begin to see you in the office every week until delivery. We can always see you for a problem. Patients with true emergencies can be seen at all hours of the day, whether in the Emergency Room at Rex Hospital or in our office during business hours. Less emergent problems will also be evaluated as quickly as possible, usually here in the office. You may reach our office or the doctor on call 24 hours per day, seven days a week, by calling our office number, 781-9555. If you are not called back promptly, please repeat the call. Many patients have unrelated medical problems during their pregnancies. We’ll be happy to see you, evaluate the problem and provide treatment in many cases. However, such care may not be covered by your insurance plan. We recommend you check your benefits with your individual insurance plan prior to scheduling any unrelated care during your pregnancy. Diet and weight gainDon’t be discouraged if you weigh more by the end of the pregnancy than you ever have in your life. If added up, all the weighty items that have to do with gestation (baby, placenta, fluid, added blood volume, etc.) account for 15 to 20 pounds. In addition, it appears that some amount of maternal weight gain is normal and perhaps helpful. We would encourage a weight gain of between 20 and 30 pounds. If your pattern seems unusual, we’ll give some suggestions or even refer you to our nutritionist for further help. While an adequate weight gain helps to ensure a normal outcome, excessive gain increases the likelihood of diabetes and blood pressure problems, as well as needlessly increasing fetal weight, on the average. In addition, more aches and pains during the pregnancy may be experienced, and you’ll have more to lose between pregnancies. ExerciseAdequate exercise in pregnancy is helpful, both physically and mentally. Some forms of exercise are discouraged for obvious safety reasons (no water skiing, jumping horses, kick boxing, etc.), and others for comfort, but in general, moderately vigorous exercise can and should be continued during pregnancy. You should take care not to overheat and to stay well-hydrated during exercise. There may be times when you will be asked to forego exercise for other reasons during your pregnancy. MedicationsAs a general rule in pregnancy, check with us prior to taking medications. You’ll be given a list of over-the-counter remedies that we feel are safe during pregnancy. Prenatal classes and pain relief during laborEspecially for your first pregnancy, prenatal education classes may be helpful. They’ll provide another source of information, especially concerning labor and delivery. Be sure to sign up early, as there are limited spaces in classes offered in the area. You’ll be given a list of currently available classes when you meet with the nurse. During labor, we will follow your lead in regard to administering medication for pain or epidural anesthesia, both of which are easily available at Rex Hospital. PediatriciansThere are many excellent pediatricians in the Triangle area. We’ll be happy to give you suggestions for offices that are geographically convenient for you. You’ll find proximity to be important during your baby’s first several years; there is often a set of tire tracks worn into the road between your house and the pediatrician’s office. All pediatricians’ offices that we are aware of offer opportunities at no charge to visit their facility and talk with one or more of their doctors prior to your delivery. However, these are not mandatory. When you arrive at Rex Hospital in labor, your nurse will ask you which pediatricians will be caring for the baby, and this is the first necessary notification of your choice. In most cases, your pediatrician will not attend the delivery but will see your baby soon thereafter. In case of a problem, he or she can be notified and come to the hospital on short notice. There is a neonatologist in the hospital 24 hours a day to deal with a child’s unexpected emergencies after birth. Rex Birth CenterOur physicians deliver at the Rex Birth Center, located adjacent to Rex Hospital on Lake Boone Trail. |
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