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Obstetrics

Pregnancy is an exciting time, but it can also be stressful.  Knowing that you are doing all you can to stay healthy before and during pregnancy gives your baby a healthy start in life, and will help you to have peace of mind.

Preconception Care

What is Preconception Health?

Preconception health is a woman’s health before she becomes pregnant. It focuses on the conditions and risk factors that could affect a woman if she becomes pregnant. Preconception health applies to women who have never been pregnant, and also to women who could become pregnant again. Preconception health looks at factors that can affect a fetus or infant. These include factors such as taking prescription drugs or drinking alcohol. The key to promoting preconception health is to combine the best medical care, healthy behaviors, strong support, and safe environments at home and at work.

What is Preconception Health Care?

Preconception health care is care given to a woman before pregnancy to manage conditions and behaviors which could be a risk to her or her baby. There are many topics covered under preconception care.

  • Folic acid supplements to prevent neural tube defects.
  • Rubella vaccinations to prevent Congenital Rubella Syndrome.
  • Detecting and treating existing health conditions to prevent complications in the mother, and reduce the risk of birth defects:
    • Diabetes
    • Hypothyroidism
    • HIV/AIDS
    • Hepatitis B
    • PKU
    • Hypertension
    • Blood diseases
    • Eating disorders
  • Reviewing medications that can affect the fetus or the mother, such as epilepsy medicine, blood thinners, and some medicines used to treat acne, such as Accutane.
  • Reviewing a woman’s pregnancy history – has she lost a baby before?
  • Stopping smoking to reduce the risk of low birth weight
  • Eliminating alcohol consumption to prevent Fetal Alcohol Syndrome, and other complications.
  • Family planning counseling to avoid unplanned pregnancies.
  • Counseling to promote healthy behaviors such as appropriate weight, nutrition, exercise, oral health. Counseling can help a woman avoid substance abuse and toxic substances. It can help women and couples understand genetic risks, mental health issues (such as depression), and intimate partner domestic violence.

Good preconception health care is about managing current health conditions. By taking action on health issues BEFORE pregnancy, future problems for the mother and baby can be prevented. Preconception health care must be tailored to each individual woman.

Why are there new recommendations on Preconception Health
and Health Care now?

There have been important advances in medicine and prenatal care in recent years. Despite these advances, birth outcomes are worse in the United States than in other developed countries. Many babies are born prematurely or have low birth weight. In some groups of people, the problems are actually getting worse.

Experts agree that women need to be healthier before becoming pregnant. While this is not a new idea, there has not been an organized effort to promote preconception health and health care until now. The recommendations shown here have been developed by local, state, and federal government agencies, with help from national medical organizations and groups such as the March of Dimes. They offer guidance to individuals and their families, health care providers, planners, and policy makers. The goal is to improve the health of women so that babies can be born healthier in the future.

How long before becoming pregnant should a woman start
preparing for pregnancy? What are the five most important
things she should do before pregnancy for her and her baby’s health?

Every man and woman should prepare for pregnancy before becoming sexually active, or at least three months before conception. Women should begin some of the recommendations even sooner – such as quitting smoking, reaching healthy weight, and adjusting medications. Planning for pregnancy is also a good time to talk about other concerns. Issues such as intimate partner domestic violence, mental health, and previous pregnancy problems need to be discussed. Although men and women can do much on their own, a health care provider is necessary for finding and treating existing health problems. They can also help a woman improve her health before pregnancy.

The five most important things a woman can do for preconception health are:

  1.  Take 1,000 mcg of folic acid a day for at least 3 months before becoming pregnancy to reduce the risk of birth defects.
  2. Stop smoking and drinking alcohol.
  3. If you currently have a medical condition, be sure these conditions are under control. Conditions include but are not limited to asthma, diabetes, oral health, obesity, or epilepsy. Be sure that your vaccinations are up to date.
  4. Talk to your doctor and pharmacist about any over the counter and prescription medicines you are taking, including vitamins, and dietary or herbal supplements, you are taking.
  5. Avoid exposures to toxic substances or potentially infectious materials at work or at home, such as chemicals, or cat and rodent feces.

What can men do to support the preconception health
of their female partners and their future babies?

Men can make a big difference in promoting good preconception health. As boyfriends, husbands, fathers-to-be, partners, and family members, they can learn how their loved ones can achieve optimal preconception health. They can encourage and support women in every aspect of preparing for pregnancy.

There are other ways men can help. Men who work with chemicals or other toxins need to be careful that they don’t expose women to them. For example, men who use fertilizers or pesticides in agricultural jobs should change out of dirty work clothes before coming near their female partners. They should handle and wash soiled clothes separately.

The family health histories of men are also important when planning a pregnancy. Understanding genetic risks from both sides enables providers to give more accurate advice. Screening for and treating STIs (sexually transmitted infections) in men can help make sure that the infections are not passed to female partners. Men can improve their own reproductive health by reducing stress, eating right, avoiding excessive alcohol use, not smoking, and talking to their health care providers about their own medications. It is also important for men who smoke to stop smoking around their partners, to avoid the harmful effects of second-hand smoke.

What should I expect my health care provider be doing
at a preconception visit?

Health care providers have a lot to cover during an appointment, so it’s always a good idea to make a list and bring up any issues on your mind. Do this even if the health care provider doesn’t ask about them. The first thing to discuss is your plan for pregnancy. If you tell your provider that you might become pregnant in the near future, there will be a number of things to discuss.

Your health care provider should:

  • Review your family’s medical history. This includes your previous experiences with pregnancy, fertility, birth, and use of birth control methods.
  • Ask about your lifestyle, behaviors, and social support concerns that affect your health. Do you smoke, drink alcohol, use drugs, or have psychological problems, including depression? Do you have nutrition and diet issues? Concerns about health conditions in your or your partner’s family? Are there issues around intimate partner domestic violence? What are the medications you are taking? Are there chemicals, solvents, radiation, or other potential risks at your workplace or home that could harm you or your baby?
  • Schedule health screening tests – Pap smear, urinalysis, blood tests. Your provider needs to know your blood type, Rh factor, and whether you have diabetes, hypertension, sexually transmitted infections, or other conditions.
  • Review your immunization status and update them if needed.
  • Perform a physical exam, including a pelvic exam and a blood pressure check.
  • Based on your individual health, your health care provider will suggest a course of treatment or follow up care as needed

Becoming a parent is a major commitment filled with many challenges and choices. Making healthy choices before you become pregnant is an important step to a healthy and happy pregnancy.

Date: April 12, 2006

Content source: National Center on Birth Defects and Developmental Disabilities

Source: Patient education material from the American College of Obstetrics and Gynecology.

 

Obstetrical Care

 

 

What is Obstetrical Care?

We at WomanHealth would like to congratulate you on your pregnancy, and share with you our plan for Obstetrical care.  Once you have confirmed your pregnancy, we schedule your first appointment with one of our Nurse Practitioners. We will review your history, do a physical exam and discuss vitamins and lab tests.  After the first appointment, we will schedule your first ultrasound within the first 12 weeks to confirm the due date.Prenatal visits are scheduled by appointment according to where you are in your pregnancy. If you need an additional appointment for a problem we will schedule one for you.  If any complications arise before your first visit, please call the office and we will make arrangements for you to be seen.You will be seen for your prenatal care by our staff of Physicians and Nurse Practitioners.  You will have the opportunity to meet each Physician during your pregnancy.  Our deliveries are done at The Birthplace at Lowell General Hospital.

The physician assigned to the Labor and Delivery area when you are admitted to the hospital will deliver your baby.

If You Have an Emergency or Concern

We are available by phone 24 hours a day, 7 days a week.  When calling the office with a problem or concern, please identify yourself as a pregnant patient. If the office is closed, our answering service will contact the doctor on call.  If you do not get a return call in a reasonable time frame, please call back to confirm the message was received.  If you have a medical emergency, proceed to the Emergency Department at Lowell General Hospital or closest emergency facility.

 

General Pregnancy Information and Helpful Links

Tips to Keep You and Your Unborn Baby Healthy

  • Folic Acid: Folic acid is a B vitamin that can help prevent major birth defects. Take a vitamin with 1,000 micrograms (mcg) of folic acid every day, before and during pregnancy.
  • Smoking during pregnancy is the single most preventable cause of illness and death among mothers and infants. Learn more about the dangers of smoking and find help to quit.
  • Alcohol: When you drink alcohol, so does your unborn baby. There is no known safe amount of alcohol to drink while pregnant.
  • Vaccinations: Talk to your doctor about vaccinations (shots). Many are safe and recommended during pregnancy, but some are not. Having the right vaccinations at the right time can help keep you and your baby healthy.
  • Flu and Pregnancy: If you’re pregnant, a flu shot is your best protection against serious illness from the flu. A flu shot can protect pregnant women, their unborn babies, and even their babies after birth.
  • Infections: You won’t always know if you have an infection—sometimes you won’t even feel sick. Learn how to help prevent infections that could harm your unborn baby.
  • HIV: If you are pregnant or are thinking about becoming pregnant, get a test for HIV as soon as possible and encourage your partner to get tested as well. If you have HIV and you are pregnant, there is a lot you can do to keep yourself healthy and not give HIV to your baby.
  • Diabetes: Poor control of diabetes during pregnancy increases the chance for birth defects and other problems for your baby. It can cause serious complications for you, too.
  • High Blood Pressure: Existing high blood pressure can increase your risk of problems during pregnancy.
  • Medications: Taking certain medications during pregnancy might cause problems for your baby. Talk to your doctor about any medications you are taking. These include prescription and over-the-counter medications and dietary or herbal supplements.
  • Environmental and Workplace Exposures: Some workplace hazards can affect the health of your unborn baby. Learn how to prevent certain workplace hazards. If you are worried about a specific substance, please call the Pregnancy Environmental Hotline at (800) 322-5014.
  • Genetics: Understanding genetic factors and genetic disorders is important for learning more about preventing birth defects, developmental disabilities, and other unique conditions in children.
  • Genetic Testing: If you are worried about passing a disorder to your child, talk to your doctor about doing some blood tests (genetic tests) before the baby is born.
  • Family History: Family members share their genes and their environment, lifestyles, and habits. A family history can help identify possible disease risks for you and your baby.
  • Genetic Counselor: Your doctor might suggest that you see a genetic counselor if you have a family history of a genetic condition or have had several miscarriages or infant deaths.

The Birthplace at Lowell General Hospital

The Birthplace offers expectant families everything they are looking for in a childbirth experience: highly specialized, maternity care with the comfort and personal attention of a community hospital.Through its affiliation with Tufts Medical Center and Floating Hospital for Children at Tufts Medical Center, The Birthplace has some of the best obstetricians in the area including Maternal Fetal Medicine Specialist available for diagnostic testing and consultation for high risk pregnancies. We also staff 24/7 neonatology coverage for those infants that require a higher level care.

With comfortable, home-like rooms and highly personalized nursing care, The Birthplace offers a nurturing experience like no other. The Birthplace provides:

  • Highly specialized prenatal care, including a Maternal Fetal Medicine specialist (perinatologist) and genetics counseling for women with high risk pregnancies.
  • Around-the-clock neonatologists for babies born prematurely or sick and needing a higher level of care in the Level II Special Care Nursery.
  • Highly trained and experienced physicians and Registered Nurses.
  • An experienced anesthesiology team available 24/7.
  • Pediatric specialists on-site 24/7.
  • Certified lactation consultants, breastfeeding classes and support available to every new mom.
  • A full range of childbirth education and parenting programs, including Hypnobirthing, sibling preparation, prenatal yoga and a New Moms support group.

Helpful Links

Pregnancy Environment Hotline: (800) 322-5014

Toll free number that provides information on the effects of drugs, medications, infections and other environmental exposures in pregnancy.