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Microsoft word - important mom to be information.doc
We are pleased that you have chosen Southeast Women’s Center to work as a partner with you in providing your prenatal care. Good prenatal care is extremely important for a healthy, safe and happy pregnancy. It requires your knowledge and cooperation as well as the know-how and vigilance of your caregivers. You play the most important part in the health and well-being of both you and your baby. It is important that you understand what is happening during your pregnancy and how you can influence these events in a positive fashion. This information booklet, in addition to your book provided by the office, will provide valuable information about pregnancy, including normal changes, signs and symptoms of problems, and things you can do to maintain the best health for you and your baby. It is important that you read and understand this information and refer to it frequently as the events in your prenatal care unfold. We firmly believe that an informed, well-educated patient is one of the greatest assets in obstetrical care. Another important aspect of your prenatal education comes from classes and through your relationship with your physician and our office staff. Please feel free to discuss with us during your visits any questions or concerns that arise. If you have an urgent problem, we are always available by phone. Our primary concern is for the health and well-being of your unborn child and your safety during pregnancy. There may be times when we request that you do things that are not easy or convenient; however, our intent is always to do what is best for you and your baby.
There will probably be times you will need to contact the office between your scheduled
visits. Calls relating to routine matters, questions, and problems should be limited to office
hours (8:30am – 5pm). One of our nurses will be happy to assist you. Our nurses are
specially trained to help you with questions, concerns and minor problems. Telephone calls
after hours should be limited strictly to urgent problems or emergencies.
instructions are provided when calling our main office number after 5pm. Our main office
number is: 919-938-4040.
Once paged by the hospital, the physician will return your call as
quickly as possible. If he/she hasn’t returned your call within a reasonable time, or if you
think you are in labor, please call Johnston Memorial Hospital~ Labor and Delivery at: 919-938-7346.
The nurses on labor and delivery can usually give you instructions for when
to come for expected delivery.
Your physician may not carry all the important facts about every patient, so when calling
after hours, please begin the conversation with the important information about yourself
such as, “This is Sally Jones, I am expecting my second baby October 4th and my problem
is…” Please talk to the physician yourself. Having calls relayed through a third party is very
cumbersome and often results in inaccurate information being transmitted to the physician
and distorted advice being relayed back to you.
Whenever you call you should have the name and telephone number of your pharmacy at
hand in case it is necessary for a prescription to be phoned in. It is also good to have a pencil
and paper ready in case you need to write down any instructions. If it is necessary for the
physician to see you after office hours, you will be asked to come to the emergency room or
the Women’s Pavilion at the hospital. Please, always call the hospital or doctor before
going to the hospital.
If you have a problem that may necessitate an office visit, please call as early as possible. Do
not wait to call at the end of the day
. If you call at the end of the day, there may not be an
appointment available, necessitating an emergency room visit which is far more
inconvenient and expensive for you.
Prenatal Office Visits
Your initial visit is usually the most extensive. During this visit a complete medical history is taken. In addition, specimens for many laboratory tests are collected, educational materials are provided for you and a nurse/childbirth educator will discuss your general condition and other aspects of your pregnancy and prenatal care that may be important. You will also be given prescriptions for any medications that should be used routinely during your pregnancy and any special instructions. Your “due date” or EDC is also estimated on our first visit. Due dates are simply based on the average length of pregnancy. Labor is likely to occur anytime within two weeks before or after this estimated date.
You will have follow-up visits throughout your pregnancy. On these visits your weight, blood pressure and urine will be checked. Your examination will determine the growth of the pregnancy, position of the baby the heartbeat. On some visits examinations or special tests may be necessary. During your last few visits your pelvic exam will be repeated to detect the position of the baby and the readiness of the cervix for labor. Routine exams occur on the following schedule: every four weeks during the first six months; every two weeks during the seventh and eighth month and weekly during the last month.
*Complications or certain risk factors may require additional visits and screenings. This
may result in additional charges.
Our office works on an appointment system. Please try to be here at the appointed time to
minimize your waiting and the waiting of others. If you find it necessary to change an
appointment, please try to notify our office at least one day in advance.
We are happy to have your partner accompany you for your appointments. Unless absolutely necessary, you may not want to bring young children to the office, as we do not have the necessary personnel to supervise them during your exams.
Your obstetrical fee includes a six-week postpartum examination. We will help you decide on a contraceptive method at this time. This exam will be with the physician who delivered you.
It is very important that you have regular examinations at least once a year when not
pregnant. This should include a cancer screening test - generally referred to as a PAP
SMEAR test. Hospital
We deliver all our patients at Johnston Health. For information on hospital charges, please contact the hospital at (919) 934-8171.
It is important for you to know your maternity benefits with your insurance. Please be aware many insurance companies require pre-certification prior to surgery, delivery or admission to the hospital. Many insurance companies limit the length of stay for each hospitalization depending if you had vaginal or caesarean delivery. We will be happy to help you with insurance questions that you may have regarding maternity and hospital benefits. Please notify our office of any changes in your insurance plan or benefits that occur during your pregnancy.
Based on benefits received from your insurance carrier, a monthly payment arrangement will be provided to you from billing department. We call this your “OB Estimate”. You are obligated to us for the stated fee and this amount must be paid by week 28th of your pregnancy.
Obstetrical Fee Information
We have separate fees for a Vaginal delivery and for a C/Section. These fees include your routine prenatal care, delivery and the post-partum exam. Your obstetrical fee does not include charges for lab work, non-pregnancy related visits, ultrasounds, non-stress tests, circumcision, anesthesia, hospital or any other tests or exams required for your care and the care of your baby. These services are NOT included in the obstetrical fee: 1. Circumcision of a male infant 2. Rhogam injection 3. Additional Injections (Flu, etc.) 4. Ultrasounds ** 5. Fetal stress test and non-stress testing 6. Amniocentesis, diagnostic 6. Glucose Screen/Blood Sugar 7. Genetic Testing 8. Hemoglobin
Routine Lab Work for Obstetrical Clients
These are the times when blood will be drawn from your arm:
1. OB interview: CBC- complete blood count, Rubella, Blood Sugar, Hepatitis B, Antibody
screen, Blood type, RPR- syphilis screen, HIV screen- with consent. *Sickle cell when
*Urinalysis done today
2. 16 weeks: Maternal AFP/HCG/UE3 screening test, “Triple screen”
(to screen for Neural Tube Defects and Down Syndrome)
3. 24-28 weeks: Diabetes Screening—1 hour Glucose Tolerance test
Hematocrit to check red blood cell counts. (these are finger stick)
*Rhogam given for Rh neg. Other tests:
Beta-Strep Culture: done 34-36 weeks, vaginal culture to test for Group B Step, which is
very common and easily treated. If you have a positive Beta Strep culture you will be given
antibiotics while in labor.
Ultrasounds/Sonograms: Most patients will have a routine ultrasound done at about 20
weeks gestation. At 20 weeks, all of the baby’s organs should be developed and visualized
on ultrasound. It is helpful to confirm appropriate growth of the baby and check the
placenta. Not all insurance companies will cover a routine ultrasound. If your physician
suspects any kind of complication you may have more than one ultrasound. If there is a
medical indication for you ultrasound, your insurance will be filed. We also offer 3D
ultrasound to our patients at our office. This service is not covered by insurance, but the
experience includes photographs. Of course your family is encouraged to attend ultrasounds
of all types to promote bonding between family and the unborn child. Please ask us
is you have questions about our ultrasound services.
Medications acceptable during pregnancy
The following lists of medications are considered relatively safe during pregnancy and may
be taken if necessary. Some of the medications are not approved by the FDA for use during
pregnancy and should be taken sparingly and only when symptoms really warrant their use. No one can absolutely guarantee the safety of these medications during pregnancy, especially in the
first three months.
However, we have seen very few problems with their use and feel the
margin of safety is taking them is acceptable.
Nausea: Frequent small meals, suck sour candy, juice bars. Drink ginger ale, keep crackers by bedside eat upon waking. Emetrol, Dramamine 25mgs. And/or Aqua Band or “Sea Band” (wrist band) Do-it-yourself Bendectin: 25mg of B6 with 12.5 (1/2) Unisom tablet up to three times per day, no more- may cause drowsiness *Very common first trimester, usually subsides by 12 weeks, if severe call office Headaches: Take 2 Tylenol, Extra Strength or any acetaminophen product every four hours. Allergy/Headache: Corcidin, Claritin, Contact Severe Cold and Flu Congestion: Saline nasal mist, Alka-Seltzer Plus allergy, Alka-Seltzer Cold and Cough Medicine (no liqui-gels) Cough: Robitussin, Benylin Expecorant Liquid, any cough drops
Constipation: High bulk diet, lots of liquids, Metamucil, Branlax, Fibercon, Milk of
Magnesia, Senekot, Colace
Heartburn/Gas pain: Bland diet, Maalox, Gelusil, Mylanta, Tums, Rolaids, Digel,
Diarrhea: Kaopectate, Pepto Bismol or Donnagel PG
Sore Throat: Warm salt water gargles 3-4 times a day. Chloraseptic Spray, Tylenol or and
brand acetaminophen, Cepacol, Sucrets.
Low back pain: Heating pad to low, warm tub baths, bedrest lying on you side, pelvic rocks
(ask nurse), Tylenol
Allergic rash, poison ivy, wounds, cuts, abrasions: Caladryl, Caldecort, Cortaid Lotion,
Bactine Antiseptic Spray, Hydrogen peroxide
Hemmorhoids: Preparation H, plenty of fluids, Tucks or With Hazel compresses, Anusol
cream or suppositories, Proctofoam
If you need to take any of these medications, you may do so without checking with us. USE
ONLY AS DIRECTED. If your symptoms don’t improve, call our office. At your next
prenatal visit, let us know what medications you have been taking. NOTE: Based on current research we can no longer recommend cold and allergy products
that contain Sudafed or any pseudoephedrine products.
1. Ruptured Membranes or “breaking of the bag of water” 2. Any vaginal bleeding more than a small spotting 3. Severe of persistent abdominal pain 4. Severe or persistent headaches 5. Fever greater than 101 degrees Fahrenheit 6. Severe persistent vomiting 7. Rapid change in swelling of the hands, face and feet
Things to avoid during pregnancy
• Drugs- street drugs of any kind • Alcohol • Smoking • Undercooked meat, litter box • Saunas/Spas • Saccharin • Avoid contact with sick children if possible
Age Specific Drug Therapy Patient Case A The PipelineRx pharmacist received an order for Ibuprofen 600mg TID (three times a day) for a geriatric patient. Ibuprofen is a Nonsteroidal Anti-inflammatory Drug (NSAID) and is used for mild to moderate pain due to inflammatory conditions. An NSAID is not recommended for use in the elderly due to its increased risk of gastrointestinal irritat
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