Obstetrics
When you and your partner become pregnant your whole life changes and is never the same again. We hope to make you feel safe all through pregnancy and delivery. You and your baby are both our clients, and you both deserve the most careful attention. You also participate by discussing your concerns and we try to answer your questions intelligently.
We hope to assist you in your birthing experience so that it may be joyful and positive. We have triage nurses and a nurse practitioner with extensive experience in pregnancy, labor, and delivery care ready to answer your questions at all times. After office hours you may call our nurses directly. They can assist you with questions and concerns, call in prescriptions or contact the on-call physician if needed.
Our main office number is: 719-282-8066. Our after-hours number is: 1-877-990-7678.
Routine Prenatal Care
The First Visit
We schedule your first prenatal visit for about 6-8 weeks after your last menstrual period. Your provider will take a complete medical history to uncover any major risk factors for your pregnancy. You will have an initial physical exam either at that visit or the next. Lab tests appropriate to your pregnancy will be ordered. We will check to see which lab your insurance plan approves and give you directions to that lab. Some of the tests we are required to discuss and offer to every pregnant woman may include:
- Testing for the cystic fibrosis gene, or sickle cell trait
- Tests to estimate your risk of having a baby with chromosome problems such as Down Syndrome or Trisomy 18
- HIV testing
Information is also given in writing to you so you can make an informed decision as to whether or not you desire such testing. We counsel you in safety issues, dietary concerns, seat belt use, travel in pregnancy, and things you can do for the common problems of pregnancy. We ask if you desire to use pregnancy-prevention methods after you deliver, and which methods you and your partner prefer. If you have high-risk factors, we discuss specific management and care plans with you and your family. (See HIGH-RISK PREGNANCY)
An ultrasound, if not already done, will be scheduled for a separate time to establish your due date and pick up serious early problems. Between 18 and 20 weeks of pregnancy, an ultrasound is offered in order to examine the baby's basic anatomy. If an ultrasound is required because of problems in pregnancy after 20 weeks, we arrange those as needed and as approved by your insurance. Other handouts include information about common over-the-counter medications (see SELF MEDICATION IN PREGNANCY) and their use in pregnancy, the normal frequency of OB visits and what to expect at the hospital when you enter for delivery.
Feel free to write down your questions and bring them with you to all of your visits! After your visit our billing department will go over your insurance coverage with you since it is often complicated and confusing these days. If you are self-pay, we can set up payment plans to fit your needs.
The Next Visits
At every visit we weigh you, take your blood pressure, check the baby's heart beat, and measure the size of the uterus. We check your urine for infection, protein, and sugar. We ask if you have any questions or concerns. (There is no such thing as a stupid question!)
We discuss specific topics that apply to your stage of pregnancy. In a normal, uncomplicated low-risk pregnancy, your due date is 40 weeks after your last menstrual period. Over the course of the pregnancy you can expect to observe this schedule of office visits:
- From 4 weeks to 28 weeks, you are seen every 4 weeks
- From 28 weeks to 36 weeks, you are seen every 2 weeks
- From 36 weeks to delivery, you are seen every week
For the first trimester, up to 12 weeks, our major concerns are maintaining a normal diet, controlling annoying symptoms such as nausea and vomiting, constipation and leg pains. In the second trimester, 13 to 28 weeks, our major concerns are normal fetal growth, testing for diabetes and screening for preterm labor.
The Second Trimester
At the start of the second trimester (about 28 weeks) we discuss how to detect and prevent premature labor. (See WARNING SIGNS OF PRETERM LABOR.) We ask you to start doing routine fetal movement counts. We discuss pain relief in labor and give you information about an unexpected C-section. We recommend at about 30 weeks that you take a tour of Memorial Hospital North's labor and delivery facilities. You can contact Memorial at 364-5000 to arrange a tour of this beautiful state-of-the-art hospital. If you wish to take childbirth classes this is also the right time to sign up for them.
Near Term
Beginning about 36 weeks, we do vaginal exams in order to make sure the baby is head-first and check your cervix to see if delivery is near. We review what to expect in labor, delivery, and postpartum. If you are considering induction, we review that in as much detail as possible.
After Delivery
About 6 weeks after you deliver your baby (two weeks if you have a C-Section), we ask you to return for a postpartum visit. We do a complete physical exam and Pap smear if needed. We talk about the postpartum blues and depression. We discuss any contraceptive methods you might choose to use. And, we take this time to admire your baby! This is the time we give thanks for the entry of another soul into the world.
