Pregnancy

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Obstetrics (Pregnancy)

Having a baby is a special time in a woman’s life. It’s important to know that your Dominion Women’s Health team is with you every step of the way, from family planning throughout pregnancy, labor and delivery, followed by post-partum care.  Our doctors, nurse practitioners, and nursing team wants to be sure you have a great experience whether it is your first baby or your fifth!  Our physicians for women are experienced and compassionate individuals.  Patient reviews to see for yourself why you have made a great decision to choose Dominion Women’s Health to care for you and your baby.

Having Your Baby

One of the hallmarks of the care that we deliver while you are pregnant is a family-centered approach. We encourage your spouse or partner and family to participate in your care, including attending appointments, sonograms, labor, and baby’s birth. It’s really up to you about how much, when, and even who participates, but be assured we’ll support your decision. There may be times, where limits are set to protect your health and well-being and your baby’s. And please let us know if you change your mind at any time, we’re here for you and your baby.

As part of our obstetrics care, we also offer important services such as prenatal nutritional counseling and lactation (breastfeeding) consulting. Breastfeeding is considered the “gold standard” in newborn and infant nutrition. Learn more about it at the Centers for Disease Control’s (CDC) Breastfeeding page.

Before You’re Pregnant                                                                                                    

A healthy pregnancy starts before you’re pregnant. If you’re thinking about starting a family, let’s talk about what you can do now to prepare yourself for conception, pregnancy, and delivery. Ideally, we’d like you to see us at least 3 months before you try to conceive. A check-up before getting pregnant is an especially good idea because the first 8 weeks of pregnancy are critical to fetal development.

During a pre-conception exam, you have a GYN exam and we go over your medical history as well as your family’s and biological father-to-be’s medical history. It’s important to identify health conditions that may be inherited or could cause complications. If there’s the possibility of genetic risks, we may suggest genetic counseling so you’re aware of those risks for your baby and what they entail. We also go over lifestyle, nutrition, exercise, and other factors that impact your health, and we set a course for any changes. If you’re using birth control, we help you with a plan to discontinue it.

One of the most important things we ask of all moms-to-be is to start taking 400 micrograms of folic acid daily. It’s a powerful defense against certain birth defects. For more information on the importance of folic acid, please visit the CDC’s Folic Acid page.

Prenatal Care and Exams

From the time your pregnancy is confirmed, you’ll have regular physical check-ups and tests throughout. How often you have them may change as you get closer to delivery. During early pregnancy, you may also undergo the following testing:

• Complete blood count (CBC) and blood type
• Urinalysis and urine culture
• Rubella, hepatitis B and C
• Sexually transmitted diseases (STDs)
• Human immunodeficiency virus (HIV)
• Tuberculosis (TB)

These tests give us a lot of information so we can prepare for possible complications or take preventive steps. For example, a urinalysis can detect high levels of glucose which could be a sign of diabetes; high protein levels may be a sign of preeclampsia.

During the first trimester, you have a sonogram which gives us a look at how the fetus is forming and growing, what age it is, and other information. This is also when you get your first glimpse of baby (or babies). You may have more than one sonogram during your pregnancy depending on what we find that might need to be watched.

Later in pregnancy, you usually undergo more lab tests including:

• Rh antibody test. Rh is a protein that can be on the surface of red blood cells. If you have it, you’re Rh positive, if not, you’re Rh negative. If you’re Rh negative and your fetus is Rh positive, your body can produce antibodies that can damage your baby’s red blood cells.
• Glucose screening to detect gestational diabetes.
• Group B streptococcus (GBS). GBS is a bacteria that lives in the rectum and vagina. It’s usually harmless but can be passed on to a baby during birth. Most babies who get it don’t have problems, but a few can become sick.

Special testing is usually done when the fetus is at greater risk of problems–usually at about 32 weeks–that can increase the risk for pre-term labor or cause complications in situations including:

• High risk pregnancy.
• Fetal growth or Rh problems.
• Decreased movement of the fetus.
• Pregnancy that goes beyond 42 weeks.
• Carrying twins or multiples.

Some tests may need to be done weekly or more often.

Fetal Monitoring

Tests used to monitor fetal health include:

• Movement counts. Also called “counting kicks,” it’s a simple test you can even do at home.
• Non-stress test. This measures fetal heart rate while at rest. It’s done in our office and takes about 20 minutes.
• Biophysical profle (BPP). A combination of fetal heart rate and ultrasound, BPP helps evaluate fetal health in 5 areas: heart rate; breathing movements; body movements; muscle tone; and the amount of amniotic fluid surrounding the fetus.

High Risk Pregnancy

We specialize in high risk pregnancy care. Your Dominion Women’s Health team has years of experience behind us to care for you and support you during a high risk pregnancy. What does “high risk” mean? Basically it means there are factors that could raise the risk of complications. It doesn’t mean there will be problems, just that you may need more prenatal care and monitoring to minimize or avoid complications.

Examples of high-risk situations are:

• Age. Very young women and women over age 35 tend to be at greater risk.
• Weight. Being seriously under- or overweight raises health risks.
• Previous problems. Complications in a prior pregnancy, for example gestational diabetes, raises the risk in a current pregnancy.
• Carrying multiples. Being pregnant with twins or more requires extra care and fetal monitoring.
• Existing health conditions. Diabetes, high blood pressure, and other chronic conditions create added risk.

 

 

Pre-Term Birth

Most pregnancies last 40 weeks. Pre-term birth is when a baby is born between 32 and 37 weeks. Babies born before 32 weeks are considered to be “early pre-term.” If you’re at risk for pre-term birth, we’ll discuss the situation with you. The earlier a baby is born, the greater the risk for health problems including disabilities. Sometimes medications can be given to prolong pregnancy or you may need support such as bed-rest or hospitalization for the remainder of your pregnancy. Depending on the risk, you may need to deliver your baby at a hospital with a high-level neonatal intensive care unit (NICU). NICUs have special equipment and a medical team of physician specialists called neonatologists, and nurses with advanced training in neonatal care. Our physicians are affiliated with hospitals that have NICUs.

Labor and Delivery

As your pregnancy moves along, we’ll also talk about some things in advance of your delivery, like pain relief and anesthesia. We’ll also discuss whether you’ll have a vaginal or cesarean (c-section) delivery. You may know in advance if you’re having a cesarean delivery but it can also be a last minute decision in certain situations. If you’ve had a cesarean delivery before, it doesn’t necessarily mean you can’t have a vaginal birth this time.

Situations for Cesarean delivery include situations like:

• Delivering twins, triplets, or more.
• Labor fails to progress, for example the cervix isn’t opening enough for vaginal delivery.
• Baby’s at risk, for example the umbilical cord becomes pinched.
• A very large baby.
• Baby’s in the breech position.
• Mother’s health issues such as diabetes, high blood pressure, or HIV.

The doctors at Dominion Women’s Health who has cared for you throughout your pregnancy makes every effort to deliver your baby. When labor begins and it’s time to go to the hospital, please call us. If it’s after hours, call the main number and our answering service will help you.

Questions or Concerns? Call Our Nurse

If you have any questions or concerns, don’t hesitate to call our nurse. As your pregnancy progresses, please note that it’s extremely important to call right away if you:

• Haven’t felt 5 movements in an hour twice a day.
• Can’t get your baby to move.
• Have a general sense of not feeling well.
• Have symptoms of pre-term labor.

If you have any of the following symptoms please contact us immediately:

• Contractions every 10 minutes or more.
• Feeling like the baby is pushing down.
• Cramps that feel like your period
• Low, dull backaches.
• Vaginal leaking of clear pink, or brownish fluid.