Focus on Women provides complete, family centered and sensitive care for you during your pregnancy and after birth. We recognize that the relationship with your OB doctor is very special, and your doctor, with rare exception, will be present at your baby’s birth instead of relying on an on-call provider. Our relationship with you is also very special.
First OB Visit
Welcome to Focus on Women and congratulations on your pregnancy. On your first visit we will review your history and establish a expected birth date. We will discuss your anticipated pregnancy course along with any risk factors and cautions unique to your pregnancy. An ultrasound may be ordered soon to confirm the due date. Beyond the standard laboratory tests you will be offered a number of optional tests such as screening for cystic fibrosis, down syndrome and spina bifida. Other tests may be offered depending on your history and age, such as first trimester screening and amniocentesis. We look foreword to getting to know you and to help you have a healthy pregnancy and a safe delivery.
During the beginning months of your pregnancy you will be seen once a month. Twice monthly visits begin at 28 weeks and weekly visits can be expected towards the end of the pregnancy. On each visit the baby’s growth and health will be evaluated, and you will have ample time to address your questions or concerns. Between regular visits we are always available to discuss problems or evaluate you in the office.
The Second Trimester
Welcome to the second trimester! Hopefully by now you are feeling a little better. The third and fourth months can feel a little weird. The first trimester symptoms are fading but you are not yet showing nor can you feel movement. Do not fear – you are still pregnant and all of these things will come soon. The average time for feeling the baby move is about 20 weeks, but it may be even longer until you are certain that is what you are feeling.
Some normal things to feel during this time are crampy or sharp pains on the sides of the uterus. These are spasms and stretching of the ligaments on the side of the uterus. Pain that is severe, continuous, along with bleeding are not normal and you should call. Many people notice an increase in headaches and acne at this time as well. A severe headache which Tylenol does not help is reason to call. Spina bifida screening is done at 16 weeks, and an ultrasound is usually done between 18 and 20 weeks. This is your first real peek at your baby. We should be able to determine the gender – unless you don’t want to know. Then our lips are sealed!
Toward the end of the second trimester you will finally start to look and feel pregnant. A trip to the maternity store may be in order. You also need to adjust how you sleep – avoiding sleeping directly on your back because it may affect your blood pressure. A little tilt one way or the other is sufficient. You can (and should) continue to be active and exercise.
The Third Trimester
By now you are truly feeling pregnant (how much so may depend on the Arizona month!). Your thoughts are probably turning towards delivery and finally getting to meet your baby. At this point much of your baby is fully formed, but a lot of growing needs to happen. You may experience new discomfort as the baby grows. Staying active will help your body to adjust.
Some cramping and practice contractions (Braxton-Hicks) can be normal. Contractions that have a pattern and last for more that an hour need attention. Once again, rest and drink fluids and if the symptoms continue, call us.
Swelling of the feet and ankles can start at this time (again the degree may depend on the Arizona month. Drinking fluids and elevating your feet when possible will help. A sudden increase in overall swelling, especially if accompanied by other symptoms such as a severe headache may indicate pregnancy induced hypertension and means you should call.
A physician is always available during the day. If you are having concerning symptoms at night, the office phone number will transfer you to an answering service and an on-call physician will return your call. If you are in labor, your physician will be notified.
After 37 weeks you are considered full term and periods of contractions are expected. Regular contractions that become 5 minutes apart for an hour or longer means its time to call the doctor. If you suspect that your water is broken or leaking, you experience heavy bleeding, more that the slight amount expected after exams or intercourse, or have concerns over the baby moving, you should call the doctor or go to the hospital.
High Risk Pregnancies
Our physicians are experienced in treating a range of high risk pregnancies, including diabetes in pregnancy, history of pre-term labor, history of toxemia, incompetent cervix, twin pregnancies, pregnancy following in-vitro fertilization, frequent pregnancy loss requiring heparin in pregnancy, use of progesterone to prevent pre-term labor.
All ultrasounds are done in our office by an experienced and certified ultrasonographer. Ultrasounds are then reviewed by your doctor, and are usually done at the same time as your prenatal visit. 3D/4D ultrasounds are also available.