Confirmation of Pregnancy email vs appointment: When any time in early pregnancy. Why in person - only if insurance requires a note confirming pregnancy or if you know you require an ultrasound or labs early on. Why via phone/email to initiate the registration process and to save a space as sometimes the number of clients we can take per month is limited.
Initial Prenatal Visit - When schedule for 10-12 weeks. What review past medical care, confirm pregnancy by listening for baby/fetal heartbeat, maternal vital signs, collect labs (pap, blood and urine if needed), review genetic testing options and send referrals if needed. Orientation to the practice and routines of care. Collect insurance information for varication of benefits.
Return Prenatal visit - When 16ish weeks. What review labs (if we have not via phone already), review varication of benefits/insurance coverage and make payment plan arrangements if needed. Collect maternal vitals signs and listen to baby/fetal heartbeat. Send ultrasound order for the fetal anatomy scan.
Fetal Survey When - 18-22 weeks. What this is the one standard ultrasound for the pregnancy, some women may have more prior to this or after, but most do not. During this can we see the location of the placenta, confirm the due date and see all the anatomical parts of the baby carefully and closely. Some women may meet with Maternal Fetal Medicine during this time as well based on health factors of the mom or baby.
Return Prenatal visit - When 2-4 weeks after the fetal survey. Why maternal vital signs, baby/fetal heartbeat, review ultrasound findings, review prenatal class options, preparation for 3rd trimester labs (red blood cell recheck and gestational diabetes screening review). Some teaching on preparing for birth.
3rd Trimester Visit - When 26-28 weeks. What maternal (weight and blood pressure) and baby (heart beat and measurements) vital signs. Blood work reassessed, and diabetes screening completed. Home birth vs birth center must be decided and consents signed. Billing progress reviewed. Prenatal classes should be started by now.
Return Prenatal visit - When every 2-3 weeks until 36 weeks, then weekly from 36 weeks to birth or 41 weeks. What maternal (weight and blood pressure) and baby (heart beat and measurements) vital signs. GBS culture collected at 36 weeks. Review when to call with labor signs, routines for early labor vs active labor. Choose pediatricians, review typical newborn care, consents all signed and completed. Payment collected in full by 36 weeks. Occasionally: follow up ultrasounds.
*for home birth clients, the 36 week visit will take place at your home. During this visit, supplies will be delivered, and transport plan will be reviewed.
Postdates visits - When Every 2-3 days from 41 weeks until delivery. What This may include both office visits and ultrasounds and maternal fetal medicine consultations.
Postpartum: Most visits from birth to two weeks are home visits. During this time we support breastfeeding, assess mom and babe, complete the birth certificate, and routine newborn screenings.
Office visits should take place for Mom at 2 and 6 weeks. Baby should be seen by Peds at 2 to 6 weeks.