Appointments

 We welcome new obstetric and gynecologic patients. For your first visit, we request that you arrive a few minutes early to fill out our registration and medical history forms. Alternatively, to save time, you may wish to download and print them, fill them out at home, and bring them with you. In addition, please make sure you bring your insurance card or information with you, along with a form of payment if you have a copay. 

If you are new to our practice and have problems you would like reviewed, please request that the pertinent portions of your medical records be forwarded to us. We can then review them ahead of time, and spend your appointment discussing your current needs. Most physicians require written authorization to release your medical records, so please allow adequate time to have them copied. You may want to keep a copy for yourself as well. Please review our Privacy Practices.

We see patients Monday through Friday from 9:00 a.m. to 5:00 p.m. Special accommodations can sometimes be made for early morning and late appointments. We appreciate your understanding if we happen to be running late or have to change your appointment due to an emergency. Feel free to call ahead to check on any delays. In addition, we appreciate your timely arrival, so that other patients will not be unnecessarily delayed. If you need to cancel or will be late, please call our office as soon as possible. 

This is a brief list of advice and tips to keep in mind throughout your pregnancy: 
 

1. Prenatal Vitamins:  
Begin taking one daily as soon as prescribed. If first trimester nausea prevents you from taking prenatal vitamins comfortably, take plain folic acid instead. Do not take any extra vitamins (especially vitamin A) unless advised by us. 
 

2. Calcium: 1200mg  
At 16 weeks, calcium begins going to fetal bones. If you are not drinking/eating 3 to 4 8oz servings of low fat milk/yogurt daily, begin a calcium supplement. You may take Os-Cal 500 mg twice a day or 3 to 4 Extra Strength Tums daily. You may also drink calcium fortified orange juice or Viactiv chews. 
 

3. Iron Supplements:  
At some time in the second half of your pregnancy we may advise you to take extra iron (Feosol capsules, SLO-Fe or 325 mg Ferrous sulfate, once or twice daily). 
 

Do not take iron within 2 hours of calcium or dairy products. 
DO take iron with orange juice, this will aid in the absorption of iron. 
4. Omega 3 Fatty Acid Supplement (300mg of DHA per day) 
Omega 3 fatty acids are found in cod liver oil capsules. Having a sufficient amount during pregnancy has been linked to increased length of gestation, less pre-term labor, higher birth weight, and a reduced risk of developing Pre-eclampsia. It is also thought to be important for fetal/infant brain and retinal development. This is especially true during the latter half of pregnancy and lactation. Therefore if you are breastfeeding, you should continue supplementation as long as you are lactating. Try to find a supplement that does not contain additional vitamin A or D. One brand we found is called "NSI DHA" and is sold on the Internet at: www.vitacost.com or by calling 1-800-793-2601. You may also purchase "Expecta" which is over the counter at most pharmacies. 
 

5. Constipation:  
Avoid or "treat" constipation by: 
 

Drinking at least 4 12oz glasses of water a day 
Eating adequate amounts of fruit and vegetables daily (not juice). 
Adding more fiber to your diet e.g., unprocessed bran (Quaker Oats) or Fibercon, Citrucel, Metamucil as per package instruction or stool softeners (Colace 100mg twice a day). 
6. DO NOT TAKE ANY PRESCRIPTION MEDICATIONS OR LAXATIVES UNLESS CLEARED BY THE OFFICE! 
 

7. Tylenol is fine to take if you have a headache. If you have a fever, we want you to take Tylenol to get your body temperature back to less than 100.4°F. 
DO NOT TAKE ASPIRIN, ADVIL, ALEVE, NUPRIN OR MOTRIN. 
 

8. Food Precautions: 
 

Avoid deep sea fish i.e.: Shark, Swordfish, King Mackerel and Tile fish (mercury levels). 
Limit your consumption of Tuna (7 ounces/week) and shellfish to no more than twice a week (mercury levels). 
No raw oysters, mussels, clams (hepatitis). 
No goat cheese or imported cheeses (Listeria sepsis) unless packing clearly states the product is pasteurized. 
No raw meat (Toxoplasmosis) 
No alcohol 
CAFFEINE: One serving a day is acceptable. Herbal tea and decaffeinated coffee are fine. 
Minimize junk food. Including candy and potato chips. 
Use your calories for nutritious foods, limit juice (empty calories). 
DO drink 4 12oz glasses of water daily (in addition to other liquids) even if you have no problem with constipation. Your body requires at least this amount to accommodate your growing blood volume and to avoid premature uterine contractions. 
9. NO SMOKING 
 

10. If you get a cold / flu or upper respiratory tract infection: 
You may take plain Sudafed (for congestion) and /or Robitussin DM (for cough). 
 

11. No hot tubs, saunas or Jacuzzis. 
 

12. Always wear your seat belt: 
Protect your abdomen and therefore the uterus, placenta, baby from trauma caused by steering wheel impact. 
 

13. No exercise after 13 weeks that could involve falling or putting the uterus at risk for impact trauma: i.e., no city bicycling, skiing, skating, horseback riding or aggressive racquet sports. 
 

No scuba diving (baby can't decompress) 
No water-skiing 
14. Exercise in moderation: 
 

You may exercise up to the level at which you can still carry on a normal conversation 
Limit the intense part of your exercise to 20 minutes 
Swimming and walking are the best pregnancy exercises 
Use common sense: if it hurts, don't do it; if you're not feeling well, then rest 
15. Signs of premature labor or preterm cervical dilation - 
CALL THE OFFICE IF YOU HAVE ANY OF THESE SYMPTOMS: 
 

Menstrual like CRAMPS - felt low in the abdomen may be constant or may come and go 
Lower, dull, BACKACHE - may radiate or travel to the sides or front of the abdomen 
Pelvic PRESSURE - it may feel as though the baby's going to "fall out" 
Stomach CRAMPS - feeling like "gas pains" with or without diarrhea 
Uterine CONTRACTIONS - 6 or more per hour: may be painless 
Increase or change in vaginal DISCHARGE - may be pink or brown tinged mucous or watery 
A general feeling that something is not right 
Vaginal BLEEDING 
16. Weight gain:  
Appropriate weight gain is an important part of a healthy pregnancy. 
 

For Singleton pregnancy: 
Typical total weight gain should be 25-35 pounds. It is recommended that you gain ½ pound per week to 24 weeks, (for a total of ~12 pounds), and then 1 pound per week until delivery. Your doctor may recommend more or less weight gain depending on your pre-pregnancy weight. 
 

For Twin pregnancy: 
Total weight gain should be 40-50 pounds. It is recommended that you gain 1 pound per week to 24 weeks (for a total of ~24 pounds), and then 2 pounds per week until delivery. 
 

17. Treatment for Pregnancy-Related Leg Cramps:  
It is common for pregnant women to experience painful leg cramps.They are most common in the second trimester of pregnancy. Most of these cramps are due to a deficiency of the mineral Magnesium. The best form of supplementation is Magnesium Gluconate. This supplement is generally available at most Healthfood stores. 
 

18. Over-the-counter medications that are OK during pregnancy: (take them sparingly) 
For cough: Robitussin DM 
For congestion/allergy symptoms: Sudafed, Dimetapp, Claritin 
For diarrhea: Immodium AD 
For headache: Tylenol, (NO aspirin, Motrin, Advil, etc.) 
For minor muscle aches/pain and back pain: Tylenol, heating pad, (NO Aspirin, etc.) 
For heartburn: Tums, Rolaids, Mylanta, Zantac, Pepcid AC 
For yeast infection: Monistat, Gyne-lotrimin 
 

For insomnia: Benadryl 
For hemorrhoids: Anusol cream, Preparation H, Tucks pads  
Antibiotics: Penicillin, Augmentin, Ampicillin, Keflex, Erythromycin, Z-pak, Macrobid 
 

While these recommendations are not all encompassing, we hope they will provide you with some general guidelines throughout your pregnancy. If you have any questions please call us at 366-5594.