Congratulations on your pregnancy! We are here to guide you through every stage of your pregnancy and assist with the delivery of your new baby.
It is very important to start prenatal care as early as possible - the sooner good care begins, the better for the health of both moms and their babies. You should call to schedule your first examination during the first 6 to 8 weeks of your pregnancy, or when your menstrual period is 2 to 4 weeks late. Like most practices, we typically do not schedule your first visit before 8 weeks, unless there is a problem.
What should I do before my first appointment?
Start a prenatal vitamin with folic acid, calcium, and iron. In addition, you may want to consider a supplement containing 200 mg of the omega-3 fatty acid docosahexaenoic acid (DHA) if you do not get enough omega-3 fatty acids, or Essential Fatty Acids (EFAs), in your diet.
Abstain from alcohol and tobacco.
Avoid undercooked foods, including meat and fish. Raw fish and meat can carry parasites and other microbes that could cause potential harm to the mother and fetus. While these infections are extremely rare, it is wise to avoid raw meat and fish.
Avoid unpasteurized dairy and meat products. Unpasteurized cheeses and deli meats can carry Listeria, a bacterium that can cause miscarriage and fetal infection. While this is extremely uncommon in the USA, it is wise to avoid regular intake of unpasteurized dairy products or deli meats.
Talk with your doctor about chronic conditions such as diabetes, hypertension, asthma, depression, or any other condition as it could affect your pregnancy.
Talk with your doctor about prescription medications and if they pose any risk to your developing fetus. In some cases, you may need to change or eliminate certain medications, especially during the first trimester (12 weeks) to reduce risk to the fetus.
- Avoid Aspirin and Ibuprofin products (i.e. Advil, Motrin, Aleve). If you need a pain reliever, Tylenol is considered safe during pregnancy.
Please contact our office if you experience vaginal bleeding that is more than spotting, persistent cramping, any severe pain, fever higher than 101F, or vomiting that is preventing fluid intake for more than 24 hours.
Your First Visit
During your first visit, you'll be asked a lot of questions about your health and habits that may have an impact on your pregnancy. It's important to try to remember the date of your last menstrual period so your provider can estimate the duration of your pregnancy and predict your delivery date.
You can expect a full physical, including a pelvic exam and Pap smear. An ultrasound will be performed to confirm the pregnancy and verify the expected due date. You can also expect to provide a urine sample, and a blood sample will be ordered to complete a number of tests, including a complete blood cell count (CBC), blood typing, and screening for Rh antibodies and a number of infections/diseases.
During this visit you will also talk about testing for genetic disorders and prenatal testing options that can identify diseases and the presence of certain developmental or chromosomal abnormalities in the fetus.
High Risk Pregnancy
Our team of providers is experienced in identifying high-risk pregnancies. You may be considered high risk if you:
- have a chronic condition like diabetes or heart problems
- have an increased risk of preterm labor
- are older than 35
- are pregnant with more than one fetus
- have some other complicating factor that might put you in a high-risk category
If you are deemed high risk, you will be referred to specialists known as Maternal Fetal Medicine physicians (MFM). MFM doctors are obstetricians that have taken additional training through an MFM fellowship. Our patients can schedule appointments with MFM of Central PA here in our office.
Routine Visits and Testing
If you're healthy and there are no complicating risk factors, you can expect to see your health care provider:
- every 4 weeks until the 28th week of pregnancy
- then every 2 weeks until 36 weeks
- then once a week until delivery
You will see a different member of our midwife team at each visit so they can get to know you and so you can become comfortable with them. This is important because when it comes time to deliver your baby, the midwife on call will be the one to assist you through labor and delivery.
At each examination, your weight and blood pressure are recorded. You will also be asked to provide a small urine sample to be tested for sugar and protein. Protein in your urine may indicate preeclampsia, a condition that is characterized by a sudden rise in blood pressure, excessive weight gain, and fluid retention.
Screening for diabetes usually takes place at 12 weeks for women who are at higher risk of having gestational diabetes. That includes women who:
- have a family history of diabetes
- have previously had a baby that weighs more than 9 pounds
- are obese
All other pregnant women are tested for diabetes at 24 to 28 weeks. This test involves drinking a sugary liquid and having a blood glucose test (which involves having blood drawn) after an hour. If the sugar level in the blood is high, further testing might be done to diagnose gestational diabetes.
The size and shape of your uterus may be measured, starting at the 22nd week, to determine whether the fetus is growing and developing normally. Your baby's heart rate will also be measured.
You can expect to receive several ultrasound examinations throughout the duration of your pregnancy. Ultrasound scanning is used to:
- determine whether the fetus is growing at a normal rate
- record fetal heartbeat or breathing movements
- see whether you might be carrying more than one fetus
- identify a variety of abnormalities that might affect the remainder of the pregnancy or delivery
- Ultrasound services are provided right here in our office for your convenience.
Preparing for Labor and Delivery
We are a hospital-affiliated practice which means your baby will be born at Evangelical Community Hospital’s obstetrics unit, The Family Place.
A Preadmission Visit at The Family Place is scheduled at about 36 weeks into your pregnancy. This visit will help orient you to the obstetrics unit and allow you to complete most of the necessary paperwork before admission to the Hospital.
During this visit, you will be asked to identify the pediatrician or physician who will be caring for your baby once you are discharged from the Hospital. If you do not have a pediatrician or family doctor, please see the section titled Choosing a Pediatrician.
Birth Care Services
When you are admitted in labor, one of our midwives will be present at The Family Place to provide supportive care during the labor process and deliver your baby. We believe in accommodating your needs, whether that means a natural birth or the use of epidurals. Our midwives work closely with our team of physicians and should it become necessary, they will involve them in the birth process at any point.
In the event of a scheduled or emergency cesarean section, your baby will be delivered by one of our physicians