Your OB physician usually sees you once a month until you are about 28 weeks. Then your provider will see you approximately every two weeks from 32 to 36 weeks. As a courtesy to other patients, if you are late for your appointment, you will be rescheduled.

During this time, your doctor will check your blood pressure, weight, urine, fetal heart tones and fetal growth. When you are about 36 weeks, you will be seen every week until you deliver. At this time, we are carefully watching for complications common at the end of pregnancy and watching for appropriate fetal growth.

Your physician may perform a pelvic exam each week starting at 36 weeks to assess your cervix for dilation. You may experience some spotting or light bleeding for a few days afteryour provider checks your cervix. This is normal, and you should not be concerned. However, if your bleeding becomes heavy, like a period, please notify our office.

Your spouse or family member is always welcome to accompany you to your appointment, but please limit the number of people you bring with you to one to two people. Our waiting room has very limited seating. Children or babies are welcome to attend the visits with you, however if they become disruptive to the appointment you may be asked to reschedule. We value your time and want you to get the most out of your time with your provider. If your child has been sick in the last 24 to 72 hours, please do not bring them to our office, this puts other patients and our staff at risk.

Believe it or not, partner abuse is more common in pregnant than in non-pregnant women. Please do not be offended if we ask screening questions at your visit. If you are in an abusive relationship, please let your physician know so that we may get you in touch with the resources you need.

Lab Work

Several lab tests will be ordered on your first prenatal visit. These tests include blood type, HIV, hepatitis, rubella, complete blood count and urinalysis. A Pap smear and cultures for sexually transmitted diseases are also usually obtained at your first visit.

The nurse will contact you by phone if any of the lab work is abnormal. Please refrain from calling to inquire about lab results as “normal” labs will be discussed at your next visit. If you wish, you may log on to the patient portal to check your lab results.

9 to 14 weeks

We offer first trimester screening for Down’s syndrome and Trisomy 18 & 13. This includes a fingerstick blood sample and an ultrasound. Most insurance companies cover most, if not all, of the cost for this test. It is optional, but we are pleased to be able to offer this to our patients.

15 to 19 weeks

Optional Quadscreen Assay – a maternal blood test to screen for neural tube defects, Trisomy 18 & 13 and Down’s Syndrome in the fetus.

24 to 28 weeks

One-hour glucose test, for gestational diabetes and a complete blood count (state mandated).

36 weeks

Vaginal culture for Group B strep and repeat HIV testing that is state mandated.

Ultrasounds

Your OB physician may do an ultrasound to verify your due date on your first prenatal visit. You will also have an ultrasound at 19 to 20 weeks to evaluate the fetal anatomy and insure adequate fetal growth. At this time, the sonographer will try and determine the sex of your baby, if you wish, and obtain some 4D pictures of your baby.A DVD is available for $3.45 at your ultrasound appointment. Our ultrasound machines are state-of-the-art, providing outstanding pictures in most cases.

The physicians and sonographers at Waco Center for Women’s Health have acquired national recognition with the American Institute of Ultrasound in Medicine. This accreditation is the hallmark of an ultrasound practice that meets nationally accepted standards of patient care, demonstrates consistent excellence, and is current with the latest ultrasound technology. In addition, our ultrasound technologists are highly trained and certified through the American Registry of Diagnostic Medical Sonographers (ARDMS).  For more information on these certifications, visit: www.aimu.org or www.adams.org.

We are proud to be one of the few practices in the Central Texas area to offer first trimester prenatal screening, including nuchal translucency certified by the Fetal Medicine Foundation.

The Last 6 Weeks of Pregnancy

Pelvic Exams

We will begin checking your cervix between 36 and 37 weeks to assess if it has started to dilate or thin out and to see what position the baby is in. You may have some spotting or light bleeding after exams.  This is to be expected and is not a cause for alarm. You do not need to call the office when this occurs. This spotting can last for several days.

Mucus Plug

You will begin to have an increase in vaginal discharge during the last month of your pregnancy, and you may lose your mucus plug. This does not mean that you are going into labor immediately. Many mothers lose their plug several days to weeks before labor ever starts. The discharge will get heavier the closer you get to your due date. You do not need to call the doctor when this occurs. However, if the discharge is accompanied by itching or a foul odor, there may be an infection present.

Contractions

You will begin having more “false labor” or Braxton Hicks contractions during this time. You will probably experience a lot of backaches, pelvic pressure and discomfort as the baby grows. You will have some sharp, stabbing pains in the lower abdomen as the round ligament gets stretched. These contractions and discomforts are entirely normal and will come and go throughout the day and night. You may notice them more at the end of the day when you are tired.

Tdap Vaccine

The Tdap vaccine vaccinates against tetanus, diphtheria and pertussis (or whooping cough).  This vaccine is recommended for all pregnant women after 27 weeks. Providence will administer this vaccine after delivery, if you have not received it prior. The vaccine is also recommended for all close contacts/ care providers of newborns.

Toxoplasmosis

Toxoplasmosis is a parasitic infection that can be transmitted to the fetus during pregnancy. To prevent infection, pregnant women should avoid raw and undercooked meat and contact with cat feces, i.e. cleaning the litter box.