Generations OBGYN Springboro Ohio

Your Pregnancy

WHAT TO EXPECT AT YOUR OFFICE VISITS

Before your first visit:

We ask that you stop by the office to pick up some paperwork to complete before your nurse interview. Please bring your insurance card, as our billing department will check your obstetric benefits with your insurance company.

Pregnancy Verification:

Your next visit will be with the nurse and physician at which time a urine pregnancy test will be performed to verify a positive pregnancy. The nurse will review your medical and obstetric history. You will also be asked to review information about cystic fibrosis screening, first trimester screening, and/or the AFP Tetra profile. We will schedule an ultrasound and order routine prenatal blood work (blood type, urine, rubella immunization status, hepatitis B, syphilis, HIV and complete blood count). This visit typically takes about 30 minutes.

Initial Prenatal Visit:

During this visit, the physician will review your history, ultrasound results and blood work. A physical exam is performed, including a PAP smear (if age 21 or older) and cultures for gonorrhea and chlamydia.

First Trimester:

Office appointments occur every 4 weeks. We offer first trimester genetic screening between 11-13 weeks gestation for Down’s syndrome and Trisomy 13 and 18. It requires an ultrasound and blood work on the mother. 

Second Trimester:

Office appointments occur every 4 weeks unless you are a high-risk pregnancy which may require more frequent visits.

Second trimester genetic screening is offered at 15-19 weeks gestation. This screens for Down’s syndrome, Trisomy 13 and 18, and openings in the spinal cord (Spina bifida). This screening test is blood work on the mother. Our patients with abnormal results are offered genetic counseling, a detailed ultrasound, and the option of having an amniocentesis to determine the exact genetic makeup of the baby.

We offer screening for cystic fibrosis. Cystic fibrosis is a disease that is usually diagnosed in the first few years of life. It causes problems with breathing and digestion. You can be tested to see if you carry this gene. If you test positive, then the father of the baby can be tested to determine the risk of your baby having cystic fibrosis.

Ultrasound for the anatomy of the fetus is done at 20-22 weeks. This is a good time to get a look at the development of many of the organs, such as the heart, lungs, kidneys and brain. If the baby cooperates, they may even be able to determine the gender of the baby if you are interested.

At 24-28 weeks, we ask that you complete a test that screens for diabetes. The lab provides a special sugary soda for you to drink, followed by a single blood test one hour later. At the same time, a complete blood count is drawn to look for anemia. If your diabetes test is abnormal, you will be asked to complete a three-hour diabetes screening test.

Third Trimester:

From 28-36 weeks in a normal pregnancy, your appointments are scheduled every 2 weeks. Beginning at 36 weeks, you will be seen weekly. During the third trimester, we ask that you follow fetal kick counts to assure the baby is doing well. This can be done by lying in the couch for an hour a day (preferably after a meal) and counting how many times the baby moves in one hour (babies should move at least 6 times in an hour).

At 36 weeks, a vaginal culture is obtained for Group B Strep. This is a bacteria that, while normal in some women, can cause a severe infection for the newborn. If you test positive for this bacteria, no treatment is needed for you, but you will be treated with antibiotics during labor to protect your baby during birth.

A full term pregnancy lasts 40 weeks. We recommend delivery no later than one week past your due date.

Some women request induction of labor. In a normal pregnancy without maternal or obstetric indications this is not performed until 39 weeks to allow for fetal lungs to develop. Your doctor can discuss this with you if you are interested.

DIET, NUTRITION, AND EXERCISE

•We encourage drinking at least 6-8 glasses of water per day; this should be increased in the summer months.

•Average weight gain during your pregnancy should be 25-35 pounds depending on your body type. You only need 300 extra calories per day while pregnant. Remember: you are NOT eating for two!

•You can eat most foods.

•You should avoid uncooked fish. Please avoid shark, mackeral and tile fish altogether.

•You can eat lunchmeat as long as it is warmed or cooked.

•Try to eat a well balanced diet.

•If you exercised before your pregnancy, you may continue to exercise. If you wish to start a new exercise program, consider light aerobics, walking, biking, or elliptical machine. You may also lift light weights. We recommend that you keep your heart rate below 140. Remember, if it hurts, don’t do it!

MEDICATION USE

•Not all medications can be considered completely safe during pregnancy. This is a list of medications that we consider to be safe during pregnancy. If you have any questions on what you can take, please ask!

•HEADACHE/BACKACHE: Tylenol or Extra Strength Tylenol (avoid Motrin, Advil, Ibuprofen, Aspirin and Aleve)

•CONGESTION: Sudafed, Actifed, Tylenol Cold, Benadryl, Claritin, Zyrtec

•COUGH: Plain Robitussin; Chloroseptic Throat Spray

•HEARTBURN: Tums, Rolaids, Mylanta, Maalox, Pepcid, Prilosec, Tagamet

•NAUSEA/VOMITING: Emetrol, Dramamine, Vitamin B6

•CONSTIPATION: Colace, Fibercon, Metamucil, Dulcolax

•DIARRHEA: Imodium AD

•HEMORRHOIDS: Preparation H, Anusol cream or suppositories, Tucks

THINGS TO AVOID

•Do not clean the kitty litter box (risk of toxoplasmosis)

•Do not use hot tubs, saunas or whirlpools that are over 100 degrees

•Avoid smoking, alcohol and recreational drug use

•Limit caffeine (1-2 cups a day), salt and NutraSweet

•Tanning beds – spray tanning is OK

•It is OK to have your hair colored or highlighted

FOR NAUSEA WE RECOMMEND…

•Small, frequent meals

•Saltine crackers

•Ginger ale or ginger snaps

•Vitamin B6

•Don’t eat and drink at the same time

•If you have severe vomiting (multiple times per hour or a decrease in your urine output), please notify us

REASONS TO GO DIRECTLY TO THE HOPSITAL:

•Decreased fetal movement – If you are not feeling the baby move as usual, we recommend that you drink a 32 ounce glass of water, lie down on your left side and count how many times that baby moves in one hour. The baby should move at least 6 times during that hour. If you still aren’t feeling the baby move well, you should go to the hospital. This is effective only after you are feeling the baby move on a regular basis.

•Vaginal bleeding - If you have bright red bleeding that requires you change a pad every hour or if it is heavier than you are comfortable with, go to the hospital.

•Leaking fluid - If you feel a gush of fluid from the vagina or a persistent leaking, you need to be evaluated for ruptured membranes (water is broken).

•Contractions - If you start having contractions that are painful (can’t walk, talk or laugh through them), lasting about one minute each, and are coming every 3-5 minutes for 1 - 2 hours, you need to go to the hospital. If you are under 36 weeks pregnant, you need to go to the hospital sooner to evaluate and treat preterm labor.

•Headache - If you have a headache for several hours that doesn’t improve with Tylenol or is associated with blurry vision or upper abdominal pain, you need to go to the hospital.

 

CORD BLOOD BANKING

Some couples decide to bank their babies cord blood. Stem cells from the blood of the baby’s umbilical cord may be useful in treating a future life-threatening disease. This is a personal decision. It is associated with an initial cost plus a yearly storage fee. More information can be found on the websites of the following companies:

•CBR – Cord Blood Registry: www.cordblood.com

•ViaCord: www.viacord.com

PEDIATRICIANS, PRENATAL CLASSES, HOSPITAL INFORMATION

•You should choose a pediatrician before the baby is born. We can provide a list upon request. You may want to talk to your family and friends for recommendations. Make sure you check that the pediatrician is covered on your insurance plan!

•If you are interested in birthing, parenting or sibling classes, they are offered at Southview Hospital – contact the hospital by 20-24 weeks for more information.  You can register online at http://www.kmcnetwork.org/southviewob/

•You are encouraged to sign up for the Parent Review (a weekly email that will tell you about each week of gestation and each week of the baby’s first year) www.theparentreview.com

•Your doctors are affiliated with Southview Hospital.  http://www.kmcnetwork.org/southviewob/

• Southview Hospital – Centerville, Ohio; tours of the maternity unit are conducted every Monday night at 7pm – just show up in the waiting room a little before 7pm for your tour – no appointment necessary.