The first day of your missed period is considered 4 weeks of pregnancy. Hopefully, you were anticipating pregnancy and have already started on a good prenatal vitamin. We ask you to get good rest, hydration, nutrition, and exercise at home. This is a perfect time to confirm your pregnancy visit with your midwife or OB. We ask that this appt is made between 7-8 weeks gestation.

Confirmation of pregnancy will include a urine pregnancy test, U/S scan to confirm dates and early OB education and introduction to practice and pregnancy. You will be signed up for a pregnancy prep course that is 1.5 hrs of education on embryogenesis and the first trimester of pregnancy expectations.

New Ob visit includes wellness exam, labs (CBC/Platelets/hemoglobin/hematocrit/Blood type/Antibody screen/syphilis/hepatitis/HIV/gonorrhea/chlamydia/trichomonas, and urine screen). There is an option for first-trimester screening (a maternal serum screen that test for markers that are associated with chromosomal abnormalities alongside an NT (Nuchal translucency test that measures the nuchal fold, which is a screening tool for chromosomal markers) there is also another screen called NIPS (Non-invasive perinatal screening) that is looking at fetal free cells in maternal serum, which is the most accurate of screening that looks for 3 specific chromosomal abnormalities as well as fetal sex chromosomes. These are options for screening that can be done after 10 weeks of gestation.

Repeat OB visits; these are mama and belly checks where we are discussing the second trimester. We review body changes, common discomforts in the pelvis, and remedies/stretches. This is an introduction to spinning babies, and second-trimester testing is offered to r/o spinal defects if desired. We will schedule the anatomy US that looks at all the major organs and development to also screen for any abnormalities. We also do early diabetes screening and thyroid labs on patients with certain risk factors. This is the visit you will schedule for the mind and movement group class that reviews exercise, mind, and movement in the second trimester.

Repeat OB visits where we check fundal height (uterine growth), weight, urine, blood pressure, and fetal heart tones. We address any concerns the mom may have and continue reinforcing dietary, exercise, sleep, and spirituality as a means of disease prevention in pregnancy. The patient will be signed up to attend a postpartum group class that sets expectations for postpartum behavioral health, caring for your baby, and brief breastfeeding tips

Welcome to your third-trimester visit. In this visit, we review third-trimester precautions (Preterm labor, fetal movement). We discuss prepared childbirth classes, birth preferences, delayed cord clamping, vitamin K, erythromycin, golden hour, pediatricians, flu/covid/tdap vaccines recommendations, and introduce the three sisters of balance. Visits are now every 4 weeks in the 3rd trimester. This is the visit we routinely screen for gestational diabetes and repeat labs to recheck for anemia, blood type, and antibodies, and for some higher-risk patients rescreened for STIs such as vaginal and blood diseases. We reviewed prepared childbirth class options and highly recommended attending one in the early third trimester.

Mama and baby are checked every 2 weeks in the third trimester for weight gain, blood pressure, FHTs, and fundal height. Depending on the risk and patient preference, some people choose to do a third-trimester scan that looks at the growth in the last trimester as well.

Visits become weekly now in the last month of pregnancy. We follow mom and baby closely, helping to prepare for the upcoming birth experience through weekly belly and mama checks. We assure the baby is head down through hand maneuvers or bedside US scans. We review impending labor signs, warning signs, and mental preparation for birth.

I like to see my patients every 2-3 days in the 41st week of pregnancy to help the mother navigate the stressors that go along with the last few days or weeks of pregnancy. We often utilize non-stress tests or biophysical profiles to assess the fetus's well-being, which allows us to await with confidence the arrival of the baby patiently or have the necessary screenings to make informed decisions about the delivery plan.