Caring for a woman through her pregnancy and her baby’s birth is one of the most satisfying parts of our practice. We encourage you to be an active partner in your pregnancy care by communicating your thoughts and concerns so that together we can develop your individualized birth plan. Our goal is to nurture your confidence in your ability to give birth as well as provide excellent medical support.
We are proud to offer choices in childbirth preparation and care. We support a wide range of options from natural childbirth to the use of anesthesia, depending upon your preferences and labor situation. We also support vaginal birth after cesarean (VBAC). For your convenience, fetal monitoring, ultrasound and lab services are available at all of our locations.
Our physicians coordinate and monitor the care of our expectant women. We provide care through pregnancy, during childbirth and up to six weeks following birth. In addition to birth support, services include family planning and education, nutritional counseling and pregnancy testing.
We welcome the opportunity to have a pre-conception visit to ensure that you are aware of actions you can take to optimize your health.
What you can expect at your initial prenatal visit
- You will have a physical exam and a review of your medical and obstetric history.
- A pap smear may be performed if one is due.
- You may have an ultrasound to confirm your due date.
- Your doctor will arrange for standard blood and urine tests that are recommended. These are generally tested in all pregnancies, and may include:
- Blood type and Rh factor
- Complete blood count to screen for anemia
- Thyroid hormone levels
- Hemoglobin A1c, to screen for diabetes
- Vitamin D level
- Infectious studies (HIV, Syphilis, Hepatitis B and C, Herpes, Gonorrhea, Chlamydia)
- Immunity to Rubella (German Measles)
- Urine culture to screen for bacteria in the urine
- You will be offered screening for genetic abnormalities including Down syndrome, and Spina Bifida, depending on your gestational age (see handout on prenatal genetic screening).
- If it is flu season, a flu vaccine will be recommended.
Subsequent Prenatal Visits
For a normal pregnancy, you will generally have appointments in the following schedule:
- 8-28 weeks: every 4-5 weeks
- 28-36 weeks: every 2-3 weeks
- 36 weeks until delivery: weekly
There are certain conditions that may require more frequent visits. Your provider will discuss these with you if they come up.
At every visit
- You may be asked to leave a urine sample to check for protein and glucose in the urine. All providers do not do this routinely.
- Discussion of your symptoms, concerns and questions.
- Measurement of blood pressure, weight.
- Monitoring of your baby’s heart beat.
- Measurement of the fundal height (size of the uterus).
There are certain tests that are done at specific times in your pregnancy. The timing may differ slightly based on individual provider and patient factors. Please let your provider know if you have any concerns about any of the tests that are offered
- Gestational Diabetes screen (known as the Glucose Challenge Test). You will be asked to drink a sugary drink and have your blood drawn after 1 hour.
- Complete blood count to screen for anemia.
- If you have an Rh negative blood type you will receive a Rhogam injection at this visit.
Prenatal genetic testing if desired (see separate handout for details)
Ultrasound to assess the baby’s anatomy. This is done at Northwest Hospital in Diagnostic Imaging (206.668.2778). You can often find out the sex of the baby at this ultrasound if desired, but it is not always possible.
You will be offered a TDaP (Tetanus, Diphtheria, Pertussis) vaccine at one of these visits. This is recommended by the Centers for Disease Control and Prevention (CDC) for all women in the 3rd trimester of pregnancy, regardless of whether your vaccine is up to date.
Vaginal and rectal swab to screen for Group B Streptococcus, a bacteria that normally lives on the bodies of about 20% of women.
36 weeks until delivery:
Your doctor may recommend a cervical exam at every visit. All providers do not do this routinely.
If you have not delivered by 41 weeks, we will order a non-stress test (NST) to monitor your baby’s well- being. This involves listening to your baby’s heartbeat for 20-30 minutes either in the office or at the Childbirth Center. We will also check the amniotic fluid level around your baby by ultrasound. We will begin to discuss the option of induction of labor at 41-42 weeks.
The above schedule is meant as a general framework for your prenatal care based on standards of care and expert recommendations. We are happy to discuss any of the above recommendations with you if you have any concerns and will try to personalize the schedule to meet your needs.
In addition to uncomplicated pregnancies, we care for women with high-risk pregnancies, such as those with previous miscarriages and those pregnancies accompanied by medical complications. We are also proud to continue to offer vaginal births for patients who have previously had cesarean sections.
When it comes time for your delivery, we believe that the care and facilities at Northwest Hospital & Medical Center are ideal. The Childbirth Center provides an intimate setting with private rooms so that the place you have your baby is the place you remain — you will not be shuffled from one room to another. A well trained staff and 24-hour anesthesia services complete the picture.