Information on OB and Prenatal Visits

You can expect your initial prenatal visit to take one to one and one half hours. Please bring the following completed forms to your first visit. During your appointment, we will review your medical history and will give you a complete physical examination. In addition, we will perform laboratory tests. Please arrive 15-20 minutes before your scheduled appointment time. Please remember to bring your current insurance card as well.

What to bring to your first visit:

• Prenatal Packet completed to the best of your ability
• Insurance Card

After your first visit, you will be scheduled a return visit every four weeks for the first seven months of your pregnancy. During the eighth month, you will be seen every two weeks, and weekly visits will be scheduled during the last month. At each prenatal visit you will be weighed, have your blood pressure taken, asked to give a urine specimen, and asked questions about any problems you might have. In addition, the physician or nurse practitioner will listen to your baby’s heart beat and measure the height of your uterus (to make sure your baby is growing at the rate it should be). Any questions you have will be answered during your visit.

If your pregnancy is considered “high risk” or if problems develop during the pregnancy, you may have more frequent visits. Please feel free to ask questions and to let us know of any concerns you have so that we might help you understand what is going on.

Sonograms (ultrasound examinations of your baby) are ordered if there is a medical indication (such as a uterine size that is larger or smaller than expected for a particular point of pregnancy). This will be discussed with you early in your pregnancy. These tests may be done in the office or at a Maternal Fetal Medicine Specialist.

Participation of your baby’s father in your labor and delivery is encouraged. You may both wish to take childbirth classes to help you know what to expect at that time. Classes are offered by Central Texas Medical Center and Resolute Health Hospital. These classes are usually taken during the last two months of your pregnancy. You may arrange to take classes elsewhere if you prefer. If your baby’s father is unable to participate in classes or be with you during labor and delivery, you may choose another person to be with you.

We realize that pregnancy is a family affair and encourage family members to accompany you to some of your visits. Fathers are encouraged to come to as many visits as desired. Children are welcome to come listen to their new sibling’s heartbeat, but on longer visits (such as the initial visit and those visits where special tests are done) you may want to arrange care for them. Occasionally a provider may request some time alone with you, but it is generally your decision to have someone in the examining room during your examinations. Due to limited space, please limit additional people in the exam room to one or two at a time.

At specific points during your pregnancy, special tests will be performed. We will screen you for gestational diabetes at 24 to 28 weeks, and for group B streptococcus infection at about 35 weeks. These tests may require some visits to be closer together than the schedule previously mentioned. Clinical Pathology Laboratory (CPL) is where we send most of the specimens collected in this office.

If your insurance requires you to use another lab, please notify us.

Additional Testing

Some additional tests that are performed at your request are testing for Cystic Fibrosis, Quad Screen, Ultra Screen, and Amniocentesis. Please check with your insurance company to make sure these tests are covered benefits.

We recommend that you start pre-natal vitamins, Omega 3 Fatty Acids (Fish or flaxseed Oil), and calcium 1200mg daily.

The following is a guideline of medications safe to use in pregnancy.

Please call the office if your symptoms persist or if your temperature exceeds 100.4

DO NOT take aspirin, ibuprofen, Motrin, Advil or Aleve – unless directed to do so specifically by one of the providers.

COLD/ALLERGY SYMPTOMS

Actifed, Sudafed, Tylenol Sinus, Tylenol Multi-symptom Cold (day and night liquids), Tavist, Claritin(D), Loratidine, Diphenhydramine (Benadryl), Chlor-trimeton

COUGH, SINUS SYMPTOMS

Zyrtec(D), Guaifenesin (Robitussin DM or CF, Humibid LA, Mucinex, Dextromethorphan (Benylin DM, Delsym, Vicks 44), Tessalon, Tessalon Perles, Neti Pot (must use distilled water only), Cepacol, Chloraseptic lozenges, Benadryl, Chlor-Trimeton; Vicks

HEADACHES OR PAIN

Regular or Extra Strength Tylenol (acetominophen)

INDIGESTION and/or GAS

Mylanta, Maalox, Riopan Plus, Tums, Rolaids, Tagamet, Zantac, Prevacid, Pepcid, Nexium, Prilosec, Simethicone, Carafate

CONSTIPATION

Bisacodyl (Correctol, Dulcolax, Feen-a-mint), Dialose plus, Milk of Magnesia, Ducosate Calcium, Colace, Surfak, Senokot, Metamucil, Psyllium, Fibercon, Benefiber

DIARRHEA

Kaopectate, Immodium

HEMORRHOIDS

Anusol HC suppositories, Preparation H

NAUSEA

Unisom, Vitamin B6, B-Natal, Preggo-pops. Begin with a trial of dry crackers, toast, rice, bananas, apples and Ginger Ale. Drinks with calories are best – Sprite, Coke, Gatorade. Multiple small meals are better. If you are unable to keep any food or liquids down for 24 hours, call the office.

RASHES/CUTS

Benadryl cream, Caladryl lotion or cream, hydrocortisone cream or ointment, oatmeal baths, Bacitracin, Neosporin, Polysporin

YEAST INFECTIONS

Fem-stat, Clotrimazole (Lotrimin), Miconazole (Monistat), Ticonazole (Monistat 1, Vagistat 1). If you have never had a yeast infection before, please make an appointment for evaluation.

LEG CRAMPS

Exercise leg and calf muscles by stretching three times/day. Increase milk and dairy products. Take Calcet or Fosfree, Viactiv calcium chews, or Tums with calcium or other calcium tablet.

STRETCHING PAINS OF UTERUS

Usually occurs between 12-20 weeks. Avoid quick sudden movements, bending over, lifting heavy objects, moving quickly in and out of a car, or anything that may cause a sudden stretching pain on uterine ligaments. Take Tylenol and rest with feet elevated. Try warm bath or heating pad on low back.

DENTAL

Dental care is encouraged. X-rays may be performed as necessary with proper shields. Local anesthetics are also safe.

LIMIT

• Caffeine – limit to no more than 16 ounces (total) daily in the first trimester
• Canned Tuna – limit to 12 ounces a week
• Fish – limit the following to no more than 2 servings a week; shrimp, crab, salmon, pollock, catfish, cod and tilapia.

AVOID

• Fish – Swordfish, shark, king mackerel, tilefish. Avoid raw or undercooked fish and shellfish (especially oysters and clams) and refrigerated smoked seafood (lox)
• Dairy – If label does not clearly say pasteurized, avoid Brie, Feta, Camembert, Blue Cheese, Queso Blanco, Queso Fresco and Panela
• Refrigerated pates and meats. Cook hot dogs and processed deli meats, such as bologna, until they are steaming hot or avoid them completely (fresh deli meats are fine)
• Raw or undercooked eggs – eggnog, raw batter (cookie dough), hollandaise sauce and Caesar salad dressing
• Unwashed fruits and vegetables
• Herbal teas
• Alcohol, tobacco, illicit drugs (such as marijuana and cocaine)

The physician who delivers your baby takes care of women only. You will need to choose a physician who cares for newborn infants before your due date. That physician will examine your baby shortly after discharge from the hospital following delivery. Hospital staffed pediatricians and neonatologists are present after delivery to take care of your baby while in the hospital. Our staff can provide you with the names of the pediatricians in town.

Since our physicians have families too, they need some time off and alternate taking call for the entire office during the week. However, a physician is always available to you, any time of the day or night. If you call our office number when the office is closed, you will reach our answering service. Please select the appropriate option for your needs. Leave your name, date of birth, telephone number and a brief description of what you need to speak to the physician about. This message will be relayed to the physician on call.

If you have questions or concerns between visits, call the office and talk to one of the nurses. They can often address your concern over the phone. If the nurse determines that you need to be seen, an appointment will be scheduled. Do not sit at home and worry about something when a phone call may set your mind at ease.