Obstetrics

Our goal is to educate our patients so that they may make well-informed decisions in regards to their obstetrical care, delivery methods, anesthesia available, infant feeding choices and postpartum contraceptive choices.

Please see "Articles" for a list of safe medications you may take during your pregnancy.

PRENATAL VISITS: From this point on, your prenatal visits will be weekly unless otherwise informed by your caregiver. Your weekly exam may include an internal examination to evaluate changes in your cervix. It will be evaluated for softening, amount open (DILATION), and thinning (EFFACEMENT). In addition, the baby's position (PRESENTATION), and level of descent into the pelvis (STATION) will be evaluated. If your baby is in the breech position, the possibility of having the baby turned (VERSION) may be discussed by your caregiver. It is likely that you may experience bleeding following your internal exam --THIS IS NORMAL. Initially, the bleeding may be bright red and heavy, but should quickly lessen to spotting. This may continue for several days and may contain a few small clots. Call us if you have continual heavy bleeding, which is bright red, if you are passing clots larger than a quarter, or if your bleeding continues to be heavy like a menstrual period. Do not use tampons. We do not need to be called about passage of the mucous plug-you can let us know at your next visit.

WHEN TO CALL US:

    1. Heavy bleeding as discussed above
    2. Leaking of water or gush from the bag of water
    3. Contractions of frequency identified by your caregiver
    4. Significant change in fetal movement (decrease or no fetal movement longer than 6 hours)

FETAL MOVEMENT:  Always call if you experience a significant change in fetal movement.  This includes decreased movement or no fetal movement in greater than 6 hours.  If the baby is less active than normal, have a snack (such as juice) and lay down on your left side with your hand on your abdomen.  Count any movement that you feel inside or with your hand.  You should count at least 4 movements in a half hour.  We want you to be in touch with what is normal for your baby and notify us when you are concerned.

ANY RESTRICTIONS:  Restrictions vary from patient to patient and may include restrictions related to tub bathing, swimming or sexual activity. 

WHAT TO DO WHEN GOING TO THE HOSPITAL:  After regular business hours (8 pm), check in through the Emergency Room so they can notify the unit and provide you with a wheelchair.  Otherwise, go to admitting (Central Registration) during regular daytime hours.

ANY TIME YOU ARE IN DOUBT, CALL THE OFFICE.  WE ARE HERE TO HELP YOU!!!

 

Working during pregnancy

The great majority of expectant mothers can continue to work until late in pregnancy without any problem.  Sometimes, however, the physical changes entailed in pregnancy or the demands of a woman's job can create workplace difficulties.

Please let your care provider know if you have any concerns in this regard.  We usually are able to suggest simple steps to deal with fatigue, "morning sickness" or aches and pains that can be particularly challenging while you are at work.

The last few weeks of your pregnancy:

The following information is provided to answer some of the most common questions and let you know what to expect during your last few weeks of pregnancy. Be sure to review the information available in your book, which you received from the office early in pregnancy. Should you have any questions or concerns, please feel free to call the office at any time. If you call after office hours, the answering service will page the provider on call. We do not charge for Obstetric calls.

OB Fees

GLOBAL OBSTETRICAL PACKAGE: Most insurance companies require that we bill "globally" for your obstetrical care and delivery.  What this means is that all of your routine prenatal visits and your delivery are billed to the insurance company together after your delivery.  You will be asked to pay for your "initial obstetrical visit" at the time of your visit.  At that time, the staff will explain our payment procedures. 

The fee for your delivery can vary based upon whether you have a normal spontaneous vaginal delivery, a VBAC (vaginal birth after caesarean), a caesarean section, a breech birth, a multiple birth, or an obstetrical delivery with complications during the prenatal period.

LABORATORY PROCEDURES: During the course of your pregnancy there are lab testes that will be required and lab tests that are optional.  These will be billed to your insurance company as they are completed.

Required Labs: 

    • Obstetrical Panel:  CBC, Urinalysis, Blood Group & Blood Type, RH facto, Antibody screen, Rubella, Syphilis, and Hepatitis.
    • 1 Hour Glucola

Optional Labs:

    • HIV

MISCELLANEOUS PROCEDURES: You will receive a Pap Smear during your initial OB visit if you have not had one recently.  There is also a possibility of having a Pap Smear done while you are pregnant.  If you have had a history of abnormal Pap Smears, or the smear taken at your initial visit shows an abnormality, you will have another Pap Smear during the pregnancy.  These are not included in your global obstetrical fee and you will be responsible for paying at the time of service unless we have agreed to bill your insurance carrier for this.

 

If you are a patient that is considered to be "at-risk" for birth defects, you will be advised to have an amniocentisis.  This is an optional test and the nurse will fully explain this procedure if it pertains to you.  There will be a charge for the doctor or technician to perform the ultrasound, you will have a reasonable, definite amount set up and paid in regular installments.

 

Pre-Certification

We will contact your insurance company to pre-certify your pregnancy and verify your maternity benefits.  The fee quotes are assuming you have a normal spontaneous vaginal delivery.  The fees are different with twin pregnancies and cesarean sections.  Please note that the fees quoted only cover services rendered by our physicians and / or midwife and do not cover laboratory services or hospital services.  The laboratory and hospital will bill you separately for the services they render.  We will supply the laboratories with your primary insurance information.