Is there a fee for no-show appointments?
Yes, if a patient does not show up for an office visit, a $75 fee will apply. The fee is $100 for sonography appointments.
How does pregnancy begin?
Fertilization, the union of an egg and a sperm into a single cell, is the first step in a complex series of events that leads to pregnancy. Fertilization takes place in the fallopian tube. Over the next few days, the single cell divides into multiple cells. At the same time, the small cluster of dividing cells moves through the fallopian tube to the lining of the uterus. There it implants and starts to grow. For 8 weeks after implantation, it is called an embryo. From 9 weeks after implantation until birth, it is called a fetus.
Learn how your fetus grows during pregnancy.
How does age affect fertility?
A woman’s peak reproductive years are between the late teens and late 20s. By age 30, fertility (the ability to get pregnant) starts to decline. This decline becomes more rapid once you reach your mid-30s. By 45, fertility has declined so much that getting pregnant naturally is unlikely for most women. It is thought that most of the decline in fertility is related to the decline in egg quality, which begins declining at age 32 but declines more rapidly after age 35.
Learn more about how age affects fertility and pregnancy.
Can I sleep on my back while I’m pregnant?
In early pregnancy you may be able to comfortably sleep on your back. However, as your uterus grows, lying on your back may compress a major blood vessel — the inferior vena cava– making you feel dizzy, short of breath, and possibly reducing blood flow to your fetus. If you have these symptoms, we definitely recommend not sleeping flat on your back.
Sleeping propped up on several pillows or on your side during your second and third trimesters may be best.
Health Concerns to be Aware of
What is whooping cough?
Whooping cough (Pertussis) is a very contagious disease that can be deadly for babies. It spreads from person to person, usually by coughing or sneezing while in close contact with others.
The TDaP vaccine protects against Tetanus, Diphtheria, and Pertussis. Although we are vaccinated against these illnesses as children, babies can not receive this vaccine until they are 6 months old. By getting vaccinated in the third trimester, you will share some immunity with your baby. We also recommend that close caregivers of the infant be up to date on their vaccine so that we can ensure no one around the baby gets or transmits pertussis.
Learn how you can help protect your baby from whooping cough.
Why should pregnant women be concerned about foodborne illness?
Pregnant women are at particularly high risk for foodborne illness because the mother’s immune system is altered during pregnancy. Such an alteration may make it harder for the mother’s body to fight off certain harmful foodborne microorganisms. It is most important to avoid contracting Listeria during pregnancy, as Listeria can cause miscarriage. Most other food-borne illnesses will be uncomfortable and can make you dehydrated, which should also be avoided.
Common Discomforts During Pregnancy
What causes back pain during pregnancy?
You can blame your growing uterus for your aching back. Your expanding uterus shifts your center of gravity and stretches out and weakens your abdominal muscles. This changes your posture and puts a strain on your back. Plus, the extra weight you’re carrying means more work for your muscles and increased stress on your joints. Finally, many of the hormones in pregnancy contribute to joint laxity. Back pain will not harm the fetus. Supportive maternity wear and physical therapy can help with this discomfort.
Learn more about back pain during pregnancy and how to manage it.
What are some of the common skin changes that occur during pregnancy?
Many women notice changes to their skin, nails, and hair during pregnancy. Some of the most common changes include the following:
- Dark spots on the breasts, nipples, or inner thighs
- Melasma—brown patches on the face around the cheeks, nose, and forehead
- Linea nigra—a dark line that runs from the navel to the pubic hair
- Stretch marks
- Spider veins
- Varicose veins
- Changes in nail and hair growth
Is it safe to travel during pregnancy?
In most cases, pregnant women can travel safely until close to their due dates. But travel may not be recommended for women who have pregnancy complications. If you are planning a trip, talk with your obstetrician–gynecologist (ob-gyn) or other health care professional. And no matter how you choose to travel, think ahead about your comfort and safety.
Learn more about traveling during pregnancy.
Is it safe to keep a cat during pregnancy?
Yes, you can keep your cat. You may have heard that cat feces can carry the infection toxoplasmosis. This infection is only found in cats who go outdoors and hunt prey, such as mice and other rodents. The infection is transmitted by handling cat feces, so you can still spend time with your cat. If you do have a cat who goes outdoors or eats prey, have someone else take over daily cleaning of the litter box or prevent contracting toxoplasmosis by wearing latex or nitrile gloves while cleaning the litter box. This will prevent you from being exposed to any cat feces. If you have an indoor cat who only eats cat food and doesn’t have contact with outside animals, your risk of toxoplasmosis is very low.
Is it safe to dye my hair during pregnancy?
Most experts think that using hair dye during pregnancy is not toxic for your fetus. There are different types of hair coloring, including:
- Permanent color
- Semi Permanent color
- Temporary color
These all contain chemicals. Studies on animals show that high doses of these chemicals do not cause serious birth defects. Also, only a small amount of chemicals from hair dye is absorbed through the scalp.
Is it safe to have sex during pregnancy?
Most sexual activity is safe for women having healthy pregnancies. This includes sexual intercourse or penetration with fingers or sex toys. The amniotic sac and the strong muscles of the uterus protect the fetus. If you have pregnancy complications or questions about what may be safe sexual activity for you, talk with your ob-gyn.
It is normal to have cramps or spotting after sex with penetration. Also, orgasm can cause cramps. If you have severe, persistent cramping, or if your bleeding is heavy (like normal menstrual bleeding), call your ob-gyn.
Of course, it’s up to you whether you feel like having sex. Some women do, and some don’t. During the first trimester, you may feel too nauseated and tired to have sex. But you may find that your sex drive comes back during the second trimester after morning sickness goes away and you have your energy again. It’s also normal for desire to wane again during the third trimester. Whatever your mood, talk with your partner.
As your belly grows, you can try different positions to find what is most comfortable for you. Let your partner know if anything feels uncomfortable, even if it’s something you’re used to doing.
Is it safe to use artificial sweeteners during pregnancy?
Artificial sweeteners can be used in pregnancy. There is no evidence that the artificial sweeteners aspartame (NutraSweet), sucralose (Splenda), acesulfame potassium (Sunett), stevioside (Stevia), or saccharin (Sweet ‘N Low) increase the risk of birth defects.
Data regarding saccharin are conflicting. Low (typical) consumption is likely safe.
Is it safe to smoke or consume marijuana during pregnancy?
When marijuana is smoked or eaten, the chemicals reach the fetus by crossing the placenta. Research is limited on the harms of marijuana use during pregnancy. But there are possible risks of marijuana use, including babies that are smaller at birth and stillbirth. Using marijuana also can be harmful to a pregnant woman’s health. The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women not use marijuana.
Is it safe to sit in a hot tub while I'm pregnant?
Hot tubs have the potential to increase maternal body temperature, which is considered a risk for miscarriage and birth defects, especially neural tube defects. One study of 1,063 women found that hot tub or whirlpool use after conception was associated with a twofold increased risk of pregnancy loss at less than 20 weeks of gestation. It is typically advisable to avoid hot tube use, especially during the first trimester.
Swimming pools are typically maintained below normal body temperature. Their use does not appear to be associated with birth defects or adverse outcomes.
Is it safe to use insect repellents during pregnancy?
Topical insect repellents (including DEET) can be used in pregnancy and should be used in areas with high risk for insect-borne illnesses.
What do I need to know about my blood pressure during pregnancy?
Hypertension or high blood pressure may develop in your pregnancy. Pregnancy causes the body to make more blood to support the baby’s growth. Your provider will monitor your blood pressure at each prenatal visit.
Sources: ACOG Hypertension/Preeclampsia in pregnancy
Labor & Delivery
When will I go into labor?
The average length of pregnancy is 280 days, or 40 weeks. But there is no way to know exactly when you will go into labor. Most women give birth between 38 and 41 weeks of pregnancy.
What types of medications for pain relief are used during labor and delivery?
Medications for pain relief include IV medications and epidural anesthesia. IV medications can be sedating to you or your fetus. Epidural anesthesia also has risks and benefits that your anesthesiologist can discuss with you. In general, American College of Obstetrics and Gynecology recommends that patients be offered an epidural when they desire one for pain relief, not determined by a certain cervical dilation.
Learn more about the various medications for pain relief. (Note: Speak with your provider about the options available at your delivering hospital.)
What is cord blood?
Cord blood is the blood from the baby that is left in the umbilical cord and placenta after birth. It contains special cells called hematopoietic stem cells that can be used to treat some types of diseases. It is only recommended to privately bank cord blood if a first degree family member to the infant has one of a list of very specific disorders.
Learn more about cord blood and cord blood banking.
When is a baby’s circumcision performed?
Circumcision may be performed before or after the mother and baby leave the hospital. It is performed only if the baby is healthy. If the baby has a medical condition, circumcision may be postponed.
Learn more about newborn male circumcision.
How is the baby's heart rate monitored in labor and delivery?
Fetal heart rate monitoring is the process of checking the condition of your fetus during labor and delivery by monitoring your fetus’s heart rate with special equipment. Depending on the hospital, there may be a different policy regarding fetal monitoring during labor. At a minimum, you will be monitored intermittently.
If I make a birth plan, will it be followed exactly?
While a birth plan is not necessary, we understand that expectant mothers may have specific desires for the birthing process. As the health and safety of mother and baby are our first and foremost priority, our team cannot guarantee complete adherence to any birth plan, but we will strive to accommodate as many elements of a prepared birth plan as possible into your birth experience. We encourage you to discuss your birth plan with your providers at your prenatal visits.
Postpartum & Breastfeeding
How long should I breastfeed my baby?
Infants aged 0 to 12 months either consume breast milk or infant formula as their source of nutrition. Exclusive breastfeeding is recommended for the first 6 months of a baby’s life; after that, new foods are introduced while breastfeeding is still continued as the main source of nutrition until the baby’s first birthday. You can keep breastfeeding after the baby’s first birthday for as long as you and your baby would like. If you do not breastfeed, formula will serve as the baby’s main source of nutrition for the first year of life. Formula and solid food recommendations should be discussed with your infant’s pediatrician.
Learn more about breastfeeding.
I’ve had breast implants. Can I still breastfeed my baby?
Most mothers who have had breast or nipple surgery are able to produce some milk, but not all of these mothers will be able to produce a full milk supply for their infants. Having a full milk supply is not necessary for a successful breastfeeding experience because it is possible to supplement in a way that supports breastfeeding.
Learn more about breastfeeding after breast surgery.
Why is postpartum birth control recommended?
If you are not using a birth control method, it is possible to get pregnant very soon after having a baby. Using a birth control method in the weeks after you have a baby (the postpartum period) helps you avoid an unintended pregnancy.
Learn more about your options: ACOG
What do I need to know about bladder dysfunction after pregnancy?
Bladder dysfunction, including urinary urgency or leaking urine can happen in pregnancy and postpartum period. Some of the causes include an infection or pelvic floor disorders such as weakening of the muscles. Kegel exercises can help strengthen the pelvic floor muscles. Your provider will assess your urinary function and decide if treatment is necessary.