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Your Schedule For Prenatal Care:
During our pregnancy, you will have many visits with the Medical Doctor (M.D.) and Nurse Practitioner (RN, CNP). You will be seen most often by the primary physician of your choice; however, you may feel it would be beneficial to see each of the physicians in the group at least once. Because we practice as a group, call coverage is alternated amongst the doctors and you may be delivered by the physician on call.
Since insurance coverage varies significantly, it is your responsibility to check your particular policy.
The following schedule is a general guideline for an uncomplicated pregnancy, we certainly hope is your experience. Appropriate changes will be made when needed. Scheduling may vary within one to two weeks.
WEEK 6-8:
Nurse Practitioner Visit: Initial visit for diagnosis of conformation of pregnancy. Menses is 2-4 weeks late. Please bring in your first-morning urine for pregnancy testing. A pelvic examination will be performed for evaluation of uterine size. Information will be given regarding prenatal classes, diet, nutrition, vitamins, and activity. Routine laboratory blood tests will be performed including CBC, Blood Type, Rh Factor Rubella Test, Serology (test for syphilis), Antibody Tests, HIV Screen, and Hepatitis-B Screen.
WEEKS 11-12:
MD Visit: An appointment should be made with your primary physician, if possible. A physical exam, Pap smear, assessment of uterine size and pelvic structure will be performed. Confirmation of a fetal heartbeat by doptone will be performed. Your due date, or EDD (Expected Date of Delivery) is set. Maternal assessment of weight, blood pressure, and urine will be checked at each visit. Other tests such as Amniocentesis and Quad Screen may be discussed. Lab results from your prior visit will be reviewed.
WEEK 16:
NP or MD Visit: Fetal and Maternal Assessment including: Uterine size and growth, maternal weight, blood pressure, urine and general health status is evaluated. An optional Quad Screen blood test may be drawn for screening of fetal neural tube defects and trisomies. You may want to check your insurance for the Quad Screen test as not all insurance companies will pay for this particular test. We advise that you register for your prenatal class as soon as possible.
WEEKS 20-21:
NP or MD visit: Ultrasound study for fetal assessment and confirmation of gestational age. Please drink 32 ounces of water one(1) hour before your appointment and DO NOT EMPTY your bladder until after your ultrasound. Please note: the ultrasound is done to assess fetal well-being and estimate size and to confirm your due date. It is not always possible to determine the gender and ultra sound is not always 100 percent correct. Repeat ultrasounds can be done later in the pregnancy; however, these are usually reserved for specific medical indications. Repeat ultrasounds desired for gender determination are not generally covered by your insurance; however, we will make an effort while your are in the clinic at future appointments to have a quick ultrasound just to check the gender at not cost to you. (No appointment for this ultrasound is required).
WEEK 24:
NP or MD Visit: Maternal and Fetal Assessment. You will be given instructions for diabetic screening which will take place at your next visit.
WEEKS 26-28:
Nurse Practitioner Visit: Topics to be discussed are nutrition, prenatal classes, and emotional adjustment to pregnancy. Blood will be drawn for diabetic screening, repeat antibody test and hemoglobin screening. RhoGAM will be given if the mother is Rh-negative and the baby's father is Rh-positive. Preterm labor symptoms will be reviewed and possible interventions discussed.
WEEK 30:
NP or MD Visit: Usual fetal and maternal Assessment. A pelvic exam may be performed to screen for possible preterm cervical dilatation.
WEEK 32:
Nurse Practitioner visit: A discussion of labor and delivery and alternatives for labor management. Maternal and fetal evaluation including a cervix check may be performed. Partners are encouraged to attend this visit. There will be an opportunity for you to express any concerns, expectations, or "wishes" regarding your labor and delivery experience.
WEEK 34:
M.D. or N.P. Visit (Primary Physician, if possible): Further discussion of labor and delivery. Maternal and fetal evaluation will be performed. A pelvic examination may be performed at this visit and each subsequent visit.
WEEK 36:
M.D. or N.P. Visit (Primary Physician, if possible): Fetal and maternal assessment. signs of onset of labor are discussed. A vaginal/rectal culture for Group-B Strep (GBS) may be performed.
WEEK 37:
M.D. or N.P. Visit (Primary Physician, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed.
WEEK 38:
M.D. or N.P. Visit (Primary Physician, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed.
WEEK 39:
M.D. or N.P. Visit (Primary Physician, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed.
WEEK 40:
M.D. or N.P. Visit (Primary Physician, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed. Discussion of possible post-maturity. Delivery, hopefully.
WEEK 42:
M.D. or N.P. Visit (Primary Physician, if possible): We would like to plan for you to have your baby this week.
POSSIBLE ADDITIONAL TESTS AVAILABLE WHICH MAY BE RECOMMENDED
(To be discussed with physician):
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Ultrasound - Other than at 20 weeks
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Tests of fetal well-being; Non-stress testing (NST), Biophysical Profile
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Amniocentesis
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Toxoplasmosis titer, CMV titer
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