Your Care:

Congratulations & Welcome! 

Having a baby is one of life’s treasured experiences for many women, and if you are happy and excited, we extend a hearty “congratulations” to you and your family!  Or, perhaps you have concerns that make this pregnancy feel . . . a bit challenging?  We especially welcome you, and we strive to offer you the very best of compassionate care!  Thank you for choosing Bethany Women’s Healthcare to share in this special, or challenging, time of your life.  We’re here to support you and guide you through the healthiest pregnancy you can achieve, and we will do everything we can to help make this a memorable season of your life!

Your First Visit

Let’s get right down to some important details, shall we?  Please see the PATIENT FORMS tab to download and read the following documents:

  • Welcome Letter
  • Notice of Privacy Policies for Bethany Women’s Healthcare

After that, please download and complete the following forms under the PATIENT FORMS tab:

  • Patient Registration Information Form
  • Patient Current Medication Information
  • Authorization to Release Medical Information (Page 1 of 2)
  • Acknowledgement of Review Notice of Privacy Practices and Patient Privacy Policy (HIPAA related) (Page 2 of 2)

Finally, bring your completed forms as well as the following to your first appointment:

  • Photo I.D.
  • Your current medical insurance coverage information including:
  • policy holder’s name and date of birth
  • plan name
  • address
  • phone number
  • ID numbers including the policy number, group number and the member ID number

If you have questions, and especially if you are unable to complete these forms at home, please bring all of the information noted above and arrive 30 minutes before your scheduled appointment so that our front office staff can assist you in completing the necessary information.

Be sure to bring a list of your current prescribed medications, vitamin supplements and herbal remedies including the dosage of each one.

Your timely cooperation is greatly appreciated.  Thank you!

Note: A parent or guardian must accompany all patients under the age of 18 to this appointment.

The paperwork helps us to gather a great deal of health information so that your appointment times can be as useful to you as possible.

During your first visit, you may have a physical exam including a pap smear.  We may also run a series of prenatal labs that will collect information about your health and that of your developing baby.  A urine specimen will be collected to monitor kidney function and a bacterial analysis will check for infection.  Treatment will be prescribed if necessary.

A blood sample will be taken to test your blood type and see if you carry the Rh factor.   Your blood will be tested for any serious infections including Syphilis, Hepatitis B and C, HIV and Rubella; and, your blood count will be an indication if you and your baby are getting enough oxygen.  All of the results will be ready to review with you at your next appointment.  NOTE:  Although the HIV testing is recommended for all pregnant women with the intention of providing the best care to mother and baby, you may choose to decline the HIV testing.

Timeline for Routine Visits

For the first 28 weeks of pregnancy, we would like you to schedule an appointment every four weeks.  Your baby will be growing and developing in significant ways, and it is important that you receive routine prenatal care.  Of course, we understand that there is NOTHING routine about this!  This is YOUR BABY and we are eager to monitor your health as your baby continues to grow and develop.  Should you fall into a high risk category for any reason or at any time during your pregnancy, we may request to see you more often.  We may also refer you to a specialist for additional monitoring.  At each visit, we will measure your weight, blood pressure, and heartbeat.  We will also regularly test your urine.

At approximately your 24 week appointment, in addition to your regular care, your provider will do a fundal height measurement to evaluate your baby’s growth.

From 30 to 36 weeks, we would like you to be seen every 2 weeks.  From 36 weeks until delivery, your appointments will be scheduled weekly.  It’s an exciting time and it won’t be long before your baby is actually here.

Routine Scheduled Tests

Throughout your pregnancy, several additional tests are scheduled at specific times:

Gestational Diabetes Screening

Diabetes is a health problem that results in too much sugar in the bloodstream and not enough in cells where it can be used for energy.  Gestational diabetes mellitus (GDM) is diabetes that occurs during pregnancy.  Women with GDM don’t make enough insulin during pregnancy.  This results in high levels of sugar in the blood, which is transferred to the baby.  The baby turns the extra sugar into fat, mostly around his or her belly.  That extra birth fat increases your baby’s chance of having obesity, high blood pressure, heart disease, or type 2 diabetes later in life.  The baby may also have difficulty being born if he or she is too big, and can have low blood sugars that require special care right after birth.

GDM screening is offered to all pregnant women at the beginning of the fifth or sixth month (26 – 29 weeks) because most women have some risk factors for GDM.  You will be given a sugar drink (Glucola) with specific instructions for how and when to drink it.  One hour after you finish the drink, your blood will be drawn.  Fasting is required the night before your screening.  Results will be available to discuss at your next visit. 

Group B Strep

Group B Strep is one of many common, normal bacteria that live in the human body without causing harm in healthy people.  Most women would never know they had GBS without a test during pregnancy.  Roughly 1 in 5 pregnant women test positive for GBS near the time of birth.  GBS is NOT a sexually transmitted disease, and it does not cause discharge, itching, or other symptoms.  It is not harmful to women or to a developing baby.

At the time of birth, babies are exposed to the GBS bacteria if it is present in the vagina which can result in pneumonia or a blood infection.  Full-term babies born to mothers who carry GBS at the time of birth have an increased chance of becoming very sick from GBS during the first few days of life.  Occasionally, moms can get a post-partum infection in the uterus.

Three to five weeks before your due date, during a regular prenatal visit, you will be tested for GBS.  The results will be discussed at your next visit.  Should you test positive for this bacteria, you will receive antibiotics during labor and delivery.

Optional Testing

Throughout your pregnancy, your health care provider will discuss optional prenatal testing with you.  Recommendations will be based on your personal health and your family history.  These procedures test for the potential of genetic diseases.  Questions you may have, including the risks associated with the testing, should be discussed with your provider.  If optional testing is recommended and you are interested in these tests, we recommend that you check with your insurance plan to see if these tests are covered before scheduling them.

Your Common Questions:

Your questions are important as we share the common goal of your healthy pregnancy.

We anticipate that you may have more questions than are addressed here and of course, we are happy to answer them throughout your pregnancy.  The following sections contain general information and are not intended in any way to be a substitute for discussing your concerns with your healthcare provider.  When in doubt, or if you are worried, PLEASE CALL!

Pregnancy brings a new perspective to your life, and things that you have never thought about or questioned before may now give you pause to wonder about, and sometimes feel concerned.  The following questions address some of the most common day to day concerns that our patients have:

Dental Care

Inform your dentist of your pregnancy and schedule a visit early in your pregnancy for a thorough professional cleaning of your teeth and gums.  Don’t neglect good oral hygiene, especially regular brushing and flossing.  You may experience increased sensitivity throughout your pregnancy.  During pregnancy, your mouth’s normal bacteria and acid-alkaline balance may change and you may become more prone to cavities.  Should you need x-rays, be sure a protective shield is worn.

Be sure to brush thoroughly after meals, or at least twice a day and floss regularly.  Vitamin C helps tooth and gum tissues remain strong, especially when taken as part of your daily diet.

Execerise

An active lifestyle is a wonderful benefit of good health.  Exercise can help improve your posture, strengthen important muscles, relieve tension and pressure, and help you relax!

If your pregnancy is uncomplicated, 30 minutes of exercise is recommended daily.  Choose an activity you enjoy like walking, jogging, biking, an aerobic class, yoga, pilates, or swimming.  Alternating your activities can keep it interesting.  Do what makes sense for you.  Toward late pregnancy, exercises done while lying on your back may be inadvisable.

There are also specific times when exercise should be avoided altogether.  Symptoms such as vaginal bleeding, leaking amniotic fluid, preterm labor, chest pain, regular uterine contractions, decreased fetal movement, headache, dizziness or general weakness are all concerns that should be reported to your health care provider and EXERCISE SHOULD BE AVOIDED.

Be sure to discuss your exercise regimen with your health care provider.  In addition to maintaining a healthy level of activity, specific exercises to strengthen your pelvic floor, improve your posture and strengthen your back and abdominal muscles may be recommended.  Relaxation techniques learned early on in pregnancy can serve you well as your due date approaches!

Fatigue: or “Why am I so tired?”

It is normal to feel more tired, especially in early and late pregnancy.  Fatigue is a natural effect of the hormones of pregnancy; and, caring for yourself while you are carrying your baby requires extra energy.  Anemia, which is not uncommon during pregnancy, can also be a cause of fatigue.  Here are some strategies that may help:

  • Get more sleep: earlier to bed and later to rise (when possible) with rest periods during the day.
  • A moderate amount of daily exercise, such as brisk walking, will stimulate circulation and bring oxygen and nutrition to your entire body.
  • Discuss your fatigue with your health care provider. Should you test positive for anemia, changes in your diet and /or an iron supplement can help.
  • Vary your activities if you can: if you tend to be on your feet for long periods of time, try to take short breaks and put your feet up; if you spend a great deal of your time sitting, take a break every hour or so to stand, stretch and walk around.
  • Ask for help from family or friends.
  • Many expectant moms get creative and use additional pillows to improve their comfort while sleeping. Sleeping on your side will maximize blood flow to your baby; avoid lying on your back which can cause your blood pressure to drop.
Fetal Movements: or “When will I feel my baby move?”

Your baby is developing muscles and exercising them throughout your pregnancy. During the fifth month, your baby weighs from one-half to one pound and is about ten   to twelve inches long.  While he or she has been moving around for some time now, the fifth month is when most mothers feel the baby’s movements for the first time.  This feeling is referred to as “quickening.”  At first, the movements are not regular and they feel like the fluttering of a butterfly: light and gentle. As your baby grows, you will feel movement more frequently.

Many mothers enjoy the bond they begin to form when they “count the kicks” as their babies kick, roll, jab or poke them!  All babies have frequent sleep/wake cycles and while they sleep often, most babies kick at least 10 times during a two-hour period.

Counting the Kicks is a reassuring way to make sure your baby is appropriately active. It is a recommended practice by the American College of Obstetricians and Gynecologists beginning in your 28th week of pregnancy. (Begin Counting the Kicks in your 26th week if you are high-risk or if you are expecting multiples.)

Keeping track of this information can be done using a kick chart or with an app, and it will be useful information at your regular prenatal visits.  Go to www.countthekicks.org for more information, to download a kick chart, or to check out their app.

To get you started, here are the basics:

  • Plan to count the kicks at the same time every day based on when your baby is usually active. This often happens after you eat a snack or a meal.
  • Pressing on your abdomen, going for a walk, or having a cold drink can “wake up” your baby. Sit with your feet up or lie on your side, and count each of your baby’s movements as one kick. Count until you reach 10 kicks.
  • The time this takes will usually be less than 30 minutes, but it could take as long as two hours.
  • Log your information.
  • After a few weeks of collecting information, you will see some variations but most of the numbers should be similar.
  • If you notice a significant change in your baby’s pattern of movement, especially a decrease, please call us to report this information. 
  • If you don’t feel 10 movements during your usual two-hour counting period, try to wake your baby up: drinking cold fluids, pressing on your abdomen or taking a quick walk.  Then repeat the kick count.
  • If you don’t notice any movements, please call us immediately. DON’T WAIT!
Hot Tubs, Jacuzzis, Saunas & Tanning Beds

The extreme heat from these sources, whether they produce moist heat or dry heat, can increase the risk of a baby developing a neural tube defect.  Avoiding these places for the entire first trimester is highly recommended.  In the second or third trimester, exposure to moist heat should be limited to 15 minutes or less.  Dry heat should continue to be avoided.  In addition to protecting your baby, avoiding these places while you are pregnant is much kinder to your own skin.  NOTE: Even when taking a regular tub bath, be careful that the water temperature is not higher than 100° F.

Pets: Can I care for them?

If your pets are cats, please let us know.  It is very important that you avoid any and all contact with cat feces during your pregnancy.  Toxoplasmosis, while rare, is a flu-like infection that can be extremely harmful, even fatal, for a baby in utero when contracted by a pregnant woman.  Severe brain damage, liver damage, and severe visual impairment including damage to the retina of the eye, or blindness are all concerns.

Get someone else to clean the litter box.  If you have an outdoor cat, or if stray cats use any part of your yard as their litter box, wear gloves when you do yard work or tend a garden.

Because cats and raw meat are the two most common sources of the parasites that cause the disease, please be sure that meat you consume is thoroughly cooked.  Omit raw meat and very rare hamburgers until after your baby is born.

Salon Treatments

Your ongoing personal care is important for your well-being.  Just remember that hair coloring and nail care should ALWAYS be done in large, well-ventilated areas.  If possible, avoid harsh treatments during the first trimester.

Sex

Unless you are having complications or sex becomes too uncomfortable, you can enjoy this time with your partner.  For some people, sexual desire increases during pregnancy; for others, it is diminished.  Talking with your partner about your feelings at this time will help both of you as adjustments become necessary.  As your shape changes, you may be more comfortable with different positions or techniques.

There are also specific times when a woman’s body and health should be respected and  sex needs to be avoided altogether.  Symptoms such as vaginal bleeding, leaking amniotic fluid, preterm labor, chest pain, regular uterine contractions, decreased fetal movement, headache, dizziness or general weakness are all concerns that should be reported to your health care provider and SEX SHOULD BE AVOIDED.

Travel

Seat belts should always be worn!  When traveling by car or air, position the belt under your abdomen as your baby grows.

If you are having an uncomplicated pregnancy, traveling is considered safe for the first 36 weeks.  Many mothers find that the 2nd trimester is the most comfortable time to travel:  the risk of miscarriage or undiagnosed problems is generally diminished, and the risk of premature labor is generally low.

While an uncomplicated pregnancy is not a reason to stay at home, please use common sense when making your travel plans!  Sitting for long periods of time (on planes, trains, cars or buses) can slow down your circulation.  You will feel more comfortable if you plan to move around whenever you can:  stretch your arms, legs, and body regularly.  Get up and walk around for a few minutes every hour or two.  If you are driving, pull over and get out for a short walk.  Be sure to drink plenty of water.  Planning high-risk locations or adventures should wait until another time.

If travel is absolutely necessary and you will be far from home, carrying a copy of your medical record is a useful precaution.   If you will be gone for an extended time, investigating locations (and insurance coverage) for appropriate medical care at your destination should an emergency arise, may be advisable.

If you are having complications, please discuss all travel questions and concerns with your health care provider.

NOTE:  If you are involved in a car accident, PLEASE CALL US IMMEDIATELY.  There is a real possibility that you and your baby may need to be monitored.

Am I in Labor?

Labor is the work your body does to birth your baby.  When contractions first start, they often feel like menstrual cramps.  Some women feel back pain.  As your body prepares for labor, contractions will come and go.  Sometimes early labor contractions are painful.

Please begin to time your contractions if rest, drinking plenty of fluids, and relaxing in a warm bath does not provide relief.  Start by counting the number of minutes from the start of one contraction to the start of the next contraction.  (There are phone apps  that can help with this.)

When contractions start:

If it is at night and you can sleep, then you should sleep.  If it happens during the day:

  • Change your activity. if you have been active , lie down and rest.  If contractions slow down or disappear, it isn’t time to call yet.
  • Take a shower or bath.
  • Eat a light meal.
  • Drink water. Not drinking enough water can cause false labor (contractions that hurt but do not open your cervix).  If this is true labor, drinking water will help you have strength to get through your labor.
  • Meditate or do relaxation yoga.
  • Get a back or foot massage.
  • Don’t panic. As labor goes on, contractions will get stronger, longer and closer together.  Your body was made for this.  You are strong, and you can do this!
When Should I Call?

Rupture of the membranes:  If you think your water has broken and the fluid is clear, expect contractions to begin within a few hours.  Rest, eat, and drink normally and wait for contractions to start.  Call your provider for an evaluation during office hours.  Call immediately if your bag of water starts to leak or breaks and the fluid is dark green, yellow or bloody.

Bloody show:  A small amount of bloody show is normal, especially when labor begins, you have had a pelvic exam, or if you have sex late in pregnancy.  This will look like red or pink mucous discharge.  Call immediately if you are bleeding as heavy as a period.

Contractions:  As you begin to have regular contractions, change your activity (as noted above).  If the contractions slow down or disappear, it isn’t time to call yet.

  • If this is your first baby, please call when contractions occur every 3 – 4 minutes and last at least 45 seconds for 1 – 2 hours. Time the contractions from the beginning of one to the beginning of the next.
  • If this is not your first baby, call when the contractions have been 5 – 6 minutes apart for 1 to 2 hours.
  • We may advise you to come to the office for an evaluation during normal office hours.

ALWAYS REMEMBER:  CALL BEFORE YOU GO TO THE HOSPITAL:  602-973-3200.

Your Learning Curve:

We believe that the healthiest, most satisfied patients are the best-informed patients.  We understand that you are experiencing one of life’s most profound events and that you may have questions from time to time.  We encourage you to learn as much as you can, and we’re happy to discuss your concerns anytime.