Knowledge to make informed choices ...

What to expect when you are expecting ...

WELCOME TO EAST METRO OB- GYN SPECIALISTS!

Congratulations on your pregnancy and we are glad you chose our practice to be your obstetrical provider during this exciting time for you and your family. We offer complete obstetrical and midwifery care from conception to postpartum including in office lab and ultrasound for your convenience.

OB CARE- WHAT YOU CAN EXPECT

We understand that most people are anxious as well as very excited during this time of their life and have many questions. We know that it helps if you know what to expect over the next months. Although every patient is unique and there are variations in the exact care plan for everyone there is usually a basic pattern of care that is outlined here.

1st Visit- This is considered your new OB visit. The primary purpose is to obtain your full history and do a complete physical examination, including a pelvic examination with pap smear and cervical cultures. This is to help estimate your weeks of pregnancy and check for cervical cancer, gonorrhea and chlamydia infections. We will do a urine culture to check for possible urinary tract infections. Blood work will be drawn to check your blood type and Rh, a blood count to check for anemia and testing to establish immunity to rubella.We also check routinely for syphilis, hepatitis, and HIY. Your weight and height will be used to calculate your BMI which helps us determine your ideal weight gain for the pregnancy. This is a good time to discuss diet and exercise in order to meet these goals. We recommend all pregnant women take a prenatal vitamin supplement for the entire pregnancy if not already started pre conceptually. You may try the prescription vitamin samples we give you and get the prescription filled at the pharmacy or buy over the counter prenatal formula vitamins or use the ones that the county health department dispenses. You will be given a list of common "over the counter" medications that you may use during the pregnancy for various mild problems.

2nd Visit- Usually this is a combination ultrasound and OB appointment. We do an early ultrasound to verify viability of the pregnancy and dating. The early ultrasound will show us that the pregnancy is in the right place, how many fetus(s) there are, if they have a heartbeat yet, and how many weeks along the pregnancy is. You will then see a provider who will review this information with you and set a final due date. They will also review the results of your lab work from the first visit. This is a good time to discuss any concerns and problems you are having during the first months with pregnancy discomforts.

Following OB visits are usually scheduled 4-6 weeks apart during the first 28 weeks of pregnancy. They are scheduled to coincide with other routine tests, or
as needed for your situation. You will always submit a urine specimen to check for protein and glucose or check for infections if needed. Your weight will be recorded and followed for proper weight gain. Diet and exercise may be discussed to help you with your goal weight. Your blood pressure is taken and please notify the staff of any problems you are having and need to discuss. The provider will review your record with you, do a physical exam to check the growth of the uterus, position of the baby, the fetal heartbeat, and any other problem that needs to be evaluated on the visit.

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15-20 weeks- The AFP or Quad screen blood test will be offered to all patients to look for increased risk of genetic disorders such as Down's syndrome or open tube defects such as spina bifida. Cystic fibrosis screening is now an option during this time. You will be given detailed pamphlets with explanation of these tests and you may choose to participate in the screenings or refuse. If you have questions please feel free to ask your provider.

22 weeks- Comprehensive ultrasound. The comprehensive ultrasound is done in a combination visit at approximately 22 weeks. The ultrasound looks at fetal growth and normal development. The scan features an anatomy survey of vital organs and measurements. If the baby is "cooperating" and not shy you may be able to see a prediction of the sex. Remember this is just a prediction and not 100% so be careful about painting the baby room pink or blue. The physician will review the ultrasound pictures and results and decide if you need further testing with a specialist or if the results appear normal.

24-28 weeks- 1 hour glucose challenge test. This test is routinely given as a screen for diabetes in pregnancy. This visit requires a certain diet prior to the appointment and you will be in the office at least an hour in order to drink the glucose drink, and to draw the blood one hour later. You may see the provider and have your normal visit during that hour. If you "fail" this screening test you will be instructed to come for a 3 hour Glucose test in order to diagnose gestational diabetes. If you are diagnosed with diabetes in pregnancy you will get special instruction in diet, glucose testing and possible medication to control the disease. You may also need to see a specialist for further follow up.

Visits After 30 weeks- Most patients are seen every 2 weeks from 30-36 weeks. The GBS (Group B Strep)perineal culture is done between 35-37 weeks. These results will be available to the hospital when you arrive for delivery. An information sheet is available to explain the test and results to you.

36-40 weeks - Visits are weekly and include the usual care and careful monitoring of the fetal growth. If there is any unusual variance noted in projected baby size or question of position another ultrasound may need to be ordered. Vaginal exams start usually about 37-39 weeks to check for cervical changes or signs oflabor. These visits are very important not only to monitor maternal and fetal health but also an important time to ask questions and discuss delivery plans and options.

40-42 weeks - If you pass the projected due date, you will be monitored very closely until delivery. Most patients are seen twice a week and may be having fetal monitoring or ultrasounds weekly. During this time there will be discussion of plans for delivery.

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WHERE YOU DELIVER MATTERS ... TO YOU AND US.

Choosing where to give birth is an important decision for your family. Although location and convenience are certainly prime factors, it is also important to compare services carefully before making a final decision regarding which hospital to use. We strongly suggest that our clients tour both facilities and ask plenty of pertinent questions before deciding which best suits their individual needs.

The Birth Place at Rockdale Medical Center in Conyers provides comprehesive obsterical services that includes high risk care for mothers and newborns. The new East Tower at RMC has beautiful new antepartum, postpartum suites and a newborn nursery. The separate Labor and delivery area has LDR suites with tubs and 2 dedicated operating rooms and a recovery room for cesarean sections and emergencies. The staff and anesthesia are available 24 hours for emergency cesarean sections if needed. There is also a 12 bed neonatal intensive care unit in the department to handle preterm or sick infants. The on staff neonatologist and NICU RNs and Respiratory therapy in house has a great reputation for providing excellent care to these special infants.

The Birth Care Center at Newton Medical Center in Covington provides outstanding obstetrical care and contains eight beautiful labor, delivery, recovery and postpartum (LDRP) suites with Jacuzzi tubs. There is a dedicated operating room suite for caesarean sections. Anesthesiologists are on-call 24 hours per day for scheduled and emergency caesarean sections. Mother and baby stay together in the private LDRP suites to enhance the bonding experience. The BirthCare Center is equipped with a level II Neonatal Intensive Care Unit for babies who are preterm or sick. The Board Certified Neonatologists, NICU RNs and Respiratory Therapists on staff have excellent skills and experience for providing care for high-risk newborns. The staff is very attentive to new parents' needs, making your experience truly special.

Both hospitals have childbirth classes, tours and provide lactation consultation services. We send prenatal records to both hospitals and you may preregister at both in case in a special circumstance you need to go to one or the other for care. Feel free to discuss this choice with the doctor or midwife at your visits.

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