Our
friendly staff are always ready to assist you. Melissa is at the front
desk.Our clinical team consists of Jennifer, Maureen,Tammy,and Kelly
lend support and advice at office visits and on the telephone. Nicole
is available to assist with billing questions.
Childbirth Classes at St. Elizabeths
By Weston Ob/Gyn
We
recommend attending childbirth classes to provide you with another
resource for information about your pregnancy and delivery. In
addition, you will tour Labor&Delivery and the postpartum floors
before the 'big' day.We recommend signing up early (~20 weeks) to
optimize the time schedule that works best for you and your partner. For TOURS without taking classes at St. ELizabeths please call 617-562-7018. The phone number to register is 617-562-7095. The schedule is as follows for CHILDBIRTH WEEKLY CLASSSES: Sunday 6-8pm Monday 7-9pm Tuesday 7-9pm Wednesday 7-9pm The upcoming series start and end on the following dates and the cost is $125. BREASTFEEDING CLASSES These classes are available the first monday of every month from 7-9pm and cost $10. SIBLING CLASSES This take place on the first saturday every other month from 10am-noon and cost $15/family. LABOR REFRESHER CLASSES These occur on the second monday of every other month from 7-9pm and cost $25/family. SATURDAY ACCELERATED LABOR CLASS
This is the one day accelerated childbirth class.This is designed for
those families that cannot come on a weekly basis.It is an intensive
course that occurs on the last saturday of each month from 8am-4pm and
the cost is $125. INFANT CPR COURSE This course is self explanatory and occurs on the second thursday of each month from 7-9pm. The times and Dates and Fees are all subject to change, so please call and confirm! We hope all this information has been helpful to you!
Safe Medications in Pregnancy
By Weston Ob/Gyn
There
are many medications that are considered SAFE in pregnancy.If you need
further information,please feel free to refer to our FDA and CDC
Weblinks under our patient information or call the Pregnancy Hotline at
800-322-5014. Please keep this list handy to review if/when these symptoms appear!
HEADACHES/BOWELS Tylenol Tums Mylanta/Maalox Milk of Magnesia Preparation H Anusol HC
If calling for a prescription, please have your PHARMACY NUMBER available so that we may serve you more efficiently.
AVOID ASPIRIN OR IBUPROFEN
Newly Pregnant Informational Guidelines
By Weston Ob/Gyn
We
look forward to guiding you safely and happily through your pregnancy.
We have assembled this information as a useful resource for you.
Naturally we welcome any and all questions you or your partner may
have. We anticipate that through your vists you will become well acquainted with all of us during your pregnancy.
By now you have had a blood test to confirm your pregnancy and may have
also had your "New Ob" exam as well. If you have not had a recent
annual exam,this visit will be a comprehensive one, and a pap smear and
cultures will be obtained. If this visit is between 10-12 weeks,we
generally are able to hear the baby's heartbeat through your abdoman.
This will help establish your due date. The schedule of prenatal visits will usually be every: every 4 wks until~28 wks(depends on timing of specific blood tests) every 2 wks until ~36 wks every week until you deliver every 3-4 days if you go beyond your due date
If your have a high risk pregnancy such as twins,preterm
labor,diabetes,or high blood pressure,then we will recommend more
frequent visits. One of the many benefits of St.Elizabeths Medical
Center is that the Maternal-Fetal_Medicine physicians(MDS with extra
training in high risk deliveries)are readily available for
consultations and they also perform many of the ultrasound screenings
which lends further reassurance. 10% of all pregnancies have some type
of high risk component either during the pregnancy or the delivery.
Another goal we have is to evaluate you,your partner and your family
histories to see if your baby is at increased risk for certain birth
defects.There is a BACKGROUND Birth Defect risk of 4% for all
pregnancies--but this includes minor problems such as skin
tags/birthmarks,undescended testes to major problems like mental
retardation, cardiac anomalies,etc.Unfortunately,this baseline risk has
remained unchanged nationally despite the availability of state of the
art ultrasound and prenatal screeening. Your partner is welcome at
any visit,but if availability is difficult,then there are a few
important ones. The 10-12 wk visit to officially 'hear' the baby's
heartbeat through your abdomen is special.Once heard, the risk of
miscarriage diminishes dramatically.At the 36 wk visit, we discuss
labor,medications and any special requests you may have. We
recommend regular EXERCISE while you are pregnant to maintain tone and
aerobic capacity.This will also help ensure appropriate weight
gain,which can decrease your risk of developing diabetes,
preeclampsia/toxemia and even your risk of a cesarean section.Women in
good shape generally push better and more efficiently.We recommend
regular aerobic exercise 4 times per week for 30-45 minutes each
time.This can include aerobics,jogging,swimming,Nordik Trak,stationary
bike,stairmaster or others. Please make sure to monitor your heartrate
at peak exertion to keep it below 140 beats/minute. (count your pulse
for 15 seconds and multiply by 4) Also, build your exercise program
gradually if this exercise is new for you.Most of all enjoy it!
Dietary Management of Hyperemesis
By Weston Ob/Gyn
Nausea
and/or vomiting may occur in the early months of pregnancy. The
severity can vary. It usually peaks from 6-12 weeks of gestation and
disappears by the 16th week. Hormone production in pregnancy is
believed to be responsible for these symptoms. The following meal plan
gradually increases intake to promote tolerance without the need for
medications. This diet is not adequate in major nutrients until the
final stages. Use of this diet over extended periods of time will
require additional supplementation. General Guidelines: * Eat small frequent meals and snacks(avoid having an empty stomach for long periods) * Take liquids 1-2 hrs after meals(try non-cola carbonated drinks and low acidity juices) * Get up slowly and avoid sudden movements * Avoid greasy and fried foods * Avoid highly seasoned foods,pepper,chili,garlic,etc * Before rising in the morning,eat dry crackers or cereal *Drink spearmint,raspberry leaf or peppermint tea * Do not take Iron/Vitamins on an empty stomach,try them with meals or hold off altogether for 1 week then slowly reintroduce * Open windows for fresh air(seasonal) * grilling outside to eliminate odors is very helpful *ginger powdercapsules 250 mg 3x/day has helped certain patients *Pyridoxime (vit. B6) 25 mg 3x/day *wrist bracelets with pressure at P6 neguian point can be helpful
Small frequent feedings each day with increased volume as tolerance
improves is the goal. With improvement,the diet can be progressed
through the following stages: 1.Begin with very bland carbohydrates ie. dry toast,mashed potato,dry cereal,english muffin,bagel 2.Next add simple low-fat proteins ie.plain turkey,chicken, lowfat cheese,hard boiled egg-avoid yolk early on, skim milk 3.Gradually add bland low fat foods ie. applesauce,sliced peaches,carrots,winter squash 4.Last steps are to increase fat and fluids ie. soups,juices
Spina Bifida/Downs Syndrome Screening
By Weston Ob/Gyn
The
Maternal Serum Alpha-Fetoproein(MSAFP) test is an optional blood test
which will be offered to you between 16-18 weeks of your pregnancy
along with a 12 week blood test and Nuchal fold Ultrasound. Maternal
serum screening tests may help to detect several types of birth
defects,such as DOWNS SYNDROME or SPINA BIFIDA. There are also birth
defects that these tests may not detect.There is a background risk of
major and minor birth defects of ~ 4%.For many types of birth defects,
there are no screening tests. The MSAFP test is a SCREENING TEST,
not a diagnostic test, and therefore it cannot give you a 'yes' or 'no'
answer to whether you child has either of the above. A screening test
can only assess your'risk'of having a child with a certain birth
defect. If your screening test shows a higher than average risk,then
further tests will be offered to you to aid in the diagnosis. Most
women with abnormal screening tests actually have 'normal' babies.
The MSAFP test is designed to screen for the presence of open neural
tube defects(NTD).These defects occur with an overall incidence of 1-2
in every 1000 livebirths.About 90% of all babies with NTDs are born to
parents who have no known personal or family history.Spina bifida('open
spine') is an incomplete closure of the spinal cord.Some people with
spina bifida have only minor problems. In others,it may cause leg
paralysis,loss of feeling,lack of bowel/bladder control,scoliosis,
hydrocephalus(water on the brain),mental retardation and even
death.Anencephaly(failure of the development of the cranial vault)is a
lethal condition and babies are either stillborn or die soon after
birth.MSAFP screening enables us to identify 90% of anencephalic
infants and 80% of infants with spina bifida. If your MSAFP level
is elevated, your baby may be at higher-than-average risk for an open
neural tube defect. However,MSAFP levels can be elevated for many other
reasons such as incorrect dates,twins,RH disease, fetal demise and
other congenital anomalies.If your MSAFP test is elevated,you will
receive counseling and be offered a repeat test,ultrasound exam +/or
amniocentesis.These further tests are for optaining a diagnosis.
The MSAFP is also used in conjunction with 3 other blood markers and is
now called the Quad screen test.The other markers are human chorionic
gonadotropin(HCG) and unconjugated estrio(uE3)and Papp A.These 3 are
used together to identify pregnancies at risk for Down Syndrome along
with Trisomy 13 and 18.You are at increased risk for having a baby with
Downs syndrome if your AFP levels are lower than normal.This test will
detect 60%-70% of Down Syndrome fetuses. The results will compare your
risk with the risk of a 35 yo woman.If your risk is the same or greater
than that of a 35yo woman,then an amniocentesis will be offered. An
ultrasound exam can help show whether the estimated gestational age is
correct,which can affect the accuracy of the MSAFP calculated
risk.Ultrasound cannot tell if the fetus does or does NOT have Down
Syndrome. Maternal serum screening tests can give you an idea of
your own risk for having a child with certain birth defects.A normal
test does not guarantee that your child will not have birth defects.It
may reassure you that the risk is not increased. An Abnormal test
result does not necessarily mean that your child will have birth
defects,but further testing should be considered.It is your personal
decision whether to undergo the MSAFP/TRIPLE screen test.
Drug Exposures and Pregnancy
By Weston Ob/Gyn
The
following phone number is the resource we encourage you to use for any
environmental or drug exposures during pregnancy. They will mail you
recent national data regarding any concerns you may have. If your
exposure is chemical in nature(medications, cleaning or hair products
etc), then have the bottle handy. PREGNANCY HOTLINE-800-322-5014 Monday- Friday 9 am - 2 pm
The
following is the number you should feel free to use liberally for any
drug exposure while breastfeeding. They are based in Rochester, N.Y.
and unfortunately not an '800' number. They are very friendly and
informative.You may want to call them while still pregnant and resolve
any possible questions BEFORE you deliver.
In Nonbreastfeeding women, the average time to first ovulation is 45 days with the range from 25-72 days.
In breastfeeding women exclusive, ovulation can be suppressed for up to
6 months in 98% of patients IF daytime feedings do not extend > 4
hrs and nighttime feedings no > than 6 hrs with minimal supplemental
feedings.
Dietary Sources of Iron
By Weston Ob/Gyn
Menstruating
and childbearing women require higher iron requirements than men. This
can be accomplished by increasing your iron-rich foods such as
meat,liver, prune juice, dried peas and beans and fortified cereals.
Another easy tip is to increase your Vitamin C rich foods such as
orange juice, etc at separate times from your meat intake. Vitamin C
assists in the conversion of ferric iron to ferrous iron which is the
type that can be more easily absorbed and become functional for you.
