Microsoft word - important mom to be information.doc
We are pleased that you have chosen Southeast Women’s Center to work as a partner with you in providing your prenatal care. Good prenatal care is extremely important for a healthy, safe and happy pregnancy. It requires your knowledge and cooperation as well as the know-how and vigilance of your caregivers. You play the most important part in the health and well-being of both you and your baby. It is important that you understand what is happening during your pregnancy and how you can influence these events in a positive fashion. This information booklet, in addition to your book provided by the office, will provide valuable information about pregnancy, including normal changes, signs and symptoms of problems, and things you can do to maintain the best health for you and your baby. It is important that you read and understand this information and refer to it frequently as the events in your prenatal care unfold. We firmly believe that an informed, well-educated patient is one of the greatest assets in obstetrical care. Another important aspect of your prenatal education comes from classes and through your relationship with your physician and our office staff. Please feel free to discuss with us during your visits any questions or concerns that arise. If you have an urgent problem, we are always available by phone. Our primary concern is for the health and well-being of your unborn child and your safety during pregnancy. There may be times when we request that you do things that are not easy or convenient; however, our intent is always to do what is best for you and your baby. Telephone Calls
There will probably be times you will need to contact the office between your scheduled visits. Calls relating to routine matters, questions, and problems should be limited to office hours (8:30am – 5pm). One of our nurses will be happy to assist you. Our nurses are specially trained to help you with questions, concerns and minor problems. Telephone calls after hours should be limited strictly to urgent problems or emergencies. After hours instructions are provided when calling our main office number after 5pm. Our main office number is: 919-938-4040. Once paged by the hospital, the physician will return your call as quickly as possible. If he/she hasn’t returned your call within a reasonable time, or if you think you are in labor, please call Johnston Memorial Hospital~ Labor and Delivery at: 919-938-7346. The nurses on labor and delivery can usually give you instructions for when to come for expected delivery. Your physician may not carry all the important facts about every patient, so when calling after hours, please begin the conversation with the important information about yourself such as, “This is Sally Jones, I am expecting my second baby October 4th and my problem is…” Please talk to the physician yourself. Having calls relayed through a third party is very
cumbersome and often results in inaccurate information being transmitted to the physician and distorted advice being relayed back to you. Whenever you call you should have the name and telephone number of your pharmacy at hand in case it is necessary for a prescription to be phoned in. It is also good to have a pencil and paper ready in case you need to write down any instructions. If it is necessary for the physician to see you after office hours, you will be asked to come to the emergency room or the Women’s Pavilion at the hospital. Please, always call the hospital or doctor before going to the hospital.
If you have a problem that may necessitate an office visit, please call as early as possible. Do not wait to call at the end of the day. If you call at the end of the day, there may not be an appointment available, necessitating an emergency room visit which is far more inconvenient and expensive for you. Prenatal Office Visits
Your initial visit is usually the most extensive. During this visit a complete medical history is taken. In addition, specimens for many laboratory tests are collected, educational materials are provided for you and a nurse/childbirth educator will discuss your general condition and other aspects of your pregnancy and prenatal care that may be important. You will also be given prescriptions for any medications that should be used routinely during your pregnancy and any special instructions. Your “due date” or EDC is also estimated on our first visit. Due dates are simply based on the average length of pregnancy. Labor is likely to occur anytime within two weeks before or after this estimated date.
You will have follow-up visits throughout your pregnancy. On these visits your weight, blood pressure and urine will be checked. Your examination will determine the growth of the pregnancy, position of the baby the heartbeat. On some visits examinations or special tests may be necessary. During your last few visits your pelvic exam will be repeated to detect the position of the baby and the readiness of the cervix for labor. Routine exams occur on the following schedule: every four weeks during the first six months; every two weeks during the seventh and eighth month and weekly during the last month.
*Complications or certain risk factors may require additional visits and screenings. This may result in additional charges. Our office works on an appointment system. Please try to be here at the appointed time to minimize your waiting and the waiting of others. If you find it necessary to change an appointment, please try to notify our office at least one day in advance.
We are happy to have your partner accompany you for your appointments. Unless absolutely necessary, you may not want to bring young children to the office, as we do not have the necessary personnel to supervise them during your exams.
Your obstetrical fee includes a six-week postpartum examination. We will help you decide on a contraceptive method at this time. This exam will be with the physician who delivered you.
It is very important that you have regular examinations at least once a year when not pregnant. This should include a cancer screening test - generally referred to as a PAP SMEAR test. Hospital
We deliver all our patients at Johnston Health. For information on hospital charges, please contact the hospital at (919) 934-8171.
It is important for you to know your maternity benefits with your insurance. Please be aware many insurance companies require pre-certification prior to surgery, delivery or admission to the hospital. Many insurance companies limit the length of stay for each hospitalization depending if you had vaginal or caesarean delivery. We will be happy to help you with insurance questions that you may have regarding maternity and hospital benefits. Please notify our office of any changes in your insurance plan or benefits that occur during your pregnancy.
Based on benefits received from your insurance carrier, a monthly payment arrangement will be provided to you from billing department. We call this your “OB Estimate”. You are obligated to us for the stated fee and this amount must be paid by week 28th of your pregnancy.
Obstetrical Fee Information
We have separate fees for a Vaginal delivery and for a C/Section. These fees include your routine prenatal care, delivery and the post-partum exam. Your obstetrical fee does not include charges for lab work, non-pregnancy related visits, ultrasounds, non-stress tests, circumcision, anesthesia, hospital or any other tests or exams required for your care and the care of your baby. These services are NOT included in the obstetrical fee: 1. Circumcision of a male infant 2. Rhogam injection 3. Additional Injections (Flu, etc.) 4. Ultrasounds ** 5. Fetal stress test and non-stress testing 6. Amniocentesis, diagnostic 6. Glucose Screen/Blood Sugar 7. Genetic Testing 8. Hemoglobin Routine Lab Work for Obstetrical Clients
These are the times when blood will be drawn from your arm:
1. OB interview: CBC- complete blood count, Rubella, Blood Sugar, Hepatitis B, Antibody screen, Blood type, RPR- syphilis screen, HIV screen- with consent. *Sickle cell when indicated *Urinalysis done today 2. 16 weeks: Maternal AFP/HCG/UE3 screening test, “Triple screen” (to screen for Neural Tube Defects and Down Syndrome) 3. 24-28 weeks: Diabetes Screening—1 hour Glucose Tolerance test Hematocrit to check red blood cell counts. (these are finger stick) *Rhogam given for Rh neg. Other tests:
Beta-Strep Culture: done 34-36 weeks, vaginal culture to test for Group B Step, which is very common and easily treated. If you have a positive Beta Strep culture you will be given antibiotics while in labor. Ultrasounds/Sonograms: Most patients will have a routine ultrasound done at about 20 weeks gestation. At 20 weeks, all of the baby’s organs should be developed and visualized on ultrasound. It is helpful to confirm appropriate growth of the baby and check the placenta. Not all insurance companies will cover a routine ultrasound. If your physician suspects any kind of complication you may have more than one ultrasound. If there is a medical indication for you ultrasound, your insurance will be filed. We also offer 3D ultrasound to our patients at our office. This service is not covered by insurance, but the experience includes photographs. Of course your family is encouraged to attend ultrasounds of all types to promote bonding between family and the unborn child. Please ask us is you have questions about our ultrasound services. Medications acceptable during pregnancy
The following lists of medications are considered relatively safe during pregnancy and may be taken if necessary. Some of the medications are not approved by the FDA for use during pregnancy and should be taken sparingly and only when symptoms really warrant their use. No one can absolutely guarantee the safety of these medications during pregnancy, especially in the first three months. However, we have seen very few problems with their use and feel the margin of safety is taking them is acceptable.
Nausea: Frequent small meals, suck sour candy, juice bars. Drink ginger ale, keep crackers by bedside eat upon waking. Emetrol, Dramamine 25mgs. And/or Aqua Band or “Sea Band” (wrist band) Do-it-yourself Bendectin: 25mg of B6 with 12.5 (1/2) Unisom tablet up to three times per day, no more- may cause drowsiness *Very common first trimester, usually subsides by 12 weeks, if severe call office Headaches: Take 2 Tylenol, Extra Strength or any acetaminophen product every four hours. Allergy/Headache: Corcidin, Claritin, Contact Severe Cold and Flu Congestion: Saline nasal mist, Alka-Seltzer Plus allergy, Alka-Seltzer Cold and Cough Medicine (no liqui-gels) Cough: Robitussin, Benylin Expecorant Liquid, any cough drops
Constipation: High bulk diet, lots of liquids, Metamucil, Branlax, Fibercon, Milk of Magnesia, Senekot, Colace Heartburn/Gas pain: Bland diet, Maalox, Gelusil, Mylanta, Tums, Rolaids, Digel, Mylicon, gaviscon Diarrhea: Kaopectate, Pepto Bismol or Donnagel PG Sore Throat: Warm salt water gargles 3-4 times a day. Chloraseptic Spray, Tylenol or and brand acetaminophen, Cepacol, Sucrets. Low back pain: Heating pad to low, warm tub baths, bedrest lying on you side, pelvic rocks (ask nurse), Tylenol Allergic rash, poison ivy, wounds, cuts, abrasions: Caladryl, Caldecort, Cortaid Lotion, Bactine Antiseptic Spray, Hydrogen peroxide Hemmorhoids: Preparation H, plenty of fluids, Tucks or With Hazel compresses, Anusol cream or suppositories, Proctofoam If you need to take any of these medications, you may do so without checking with us. USE ONLY AS DIRECTED. If your symptoms don’t improve, call our office. At your next prenatal visit, let us know what medications you have been taking. NOTE: Based on current research we can no longer recommend cold and allergy products that contain Sudafed or any pseudoephedrine products.
1. Ruptured Membranes or “breaking of the bag of water” 2. Any vaginal bleeding more than a small spotting 3. Severe of persistent abdominal pain 4. Severe or persistent headaches 5. Fever greater than 101 degrees Fahrenheit 6. Severe persistent vomiting 7. Rapid change in swelling of the hands, face and feet
Things to avoid during pregnancy
• Drugs- street drugs of any kind • Alcohol • Smoking • Undercooked meat, litter box • Saunas/Spas • Saccharin • Avoid contact with sick children if possible
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