Your journey through pregnancy and birth This page intentionally left blank Congratulations, you’re pregnant! Now what?? To help you organize your decisions and prepare you for pregnancy, the physicians, staff and maternity care coordinators at Samaritan Health Services have created this notebook. Bring any questions you have to your provider’s office during your prenatal visits, to your childbirth preparation classes and to the hospital when you deliver. Being prepared is a great way to fill the time until your baby comes home! — Samaritan Health Services 1 Table of contents The links in this notebook are interactive. Click on You can also press CTRL+F on your keyboard to search chapter links to be directed to the information you for a specific topic. are looking for. Links throughout the notebook are underlined. 1. Welcome, general information and 7. Labor and birth ...............................60 common terms .................................. 3 First signs of labor Maternity Connections When to call your provider Prenatal office visits What to bring to the hospital Glossary Pain medication options Labor and delivery complications 2. Prenatal testing .................................8 Testing by trimester 8. Care for new mothers ...................... 70 Ultrasound Comfort care Kick counts Postpartum concerns Emotional changes 3. Physical changes ............................. 16 Fetal growth 9. Feeding your new baby .................... 76 Changes in mother/weight gain Breastfeeding Common discomforts Pumping Bottle feeding 4. Staying healthy ............................... 28 Nutrition 10. Caring for your new baby ................. 92 Exercise General care Emotional changes When to call your baby’s provider Buying for your baby 5. Common concerns and questions ........................................42 11. Resources for expecting and When to call your provider new parents .................................. 100 Medications during pregnancy Willamette Valley Coastal communities 6. Complications ................................. 54 Complications in pregnancy Preterm labor warning signs 2 Welcome, general information and common terms • Your maternity care coordinator works with your • Do you know what edema is? How about doctor, nurse practitioner or nurse-midwife to preeclampsia? We have a glossary of medical terms coordinate your maternity care, prenatal education for you. We want you to understand the natural and community resources. Have you met her? Contact changes to your body during pregnancy and delivery. information is on the next page. They may also help you with terms you hear in your provider’s office or hospital. • What should you expect from routine office visits during and after pregnancy? Use this space to jot down questions or make a few notes of your own. 3 You’ll probably have a lot of questions as you begin your pregnancy. Even if you’ve been pregnant before, you Did you know … Your maternity care coordinator might welcome some “refresher” information. We hope works closely with community services including this guidebook will be a valuable resource for you. WIC, Healthy Start, Babies First and Maternity Case Management. Contact your maternity care The information in this guidebook is meant to be in addition coordinator at any time with questions or concerns. to the health care you receive from your health care provider. It is not in any way meant to replace your prenatal care. Albany: 541-812-4301 Corvallis: 541-768-6908 Lebanon: 541-451-7872 Newport: 541-574-4936 In the coming weeks and months, and with the help of your health care team and this guidebook, you’ll Services are also available in Spanish. be learning a lot about obstetrics (OB) — that specialized Albany: 541-812-4303 Corvallis: 541-768-5772 area of medicine concerned with managing pregnancy, Lebanon: 541-451-7872 labor and childbirth. Our goal is for you to have a positive and healthy OB experience. We’d like to begin by introducing you to a program called Maternity Connections. Prenatal office visits: what to expect Maternity Connections Now that you’re pregnant, you will visit the doctor’s Maternity Connections is a free program that will connect office quite often. In general, you can expect your visits you to the resources you may need before, during and to follow the routines listed on the next page. after your birthing experience. Through this program you’ll be assigned a “maternity care coordinator,” based Routine visit schedule on the hospital where you plan to deliver. • Initial (first) visit, then… Your maternity care coordinator is a nurse or social • Every four weeks until 28 weeks of pregnancy worker with experience in maternal/child nursing. She will work with your doctor, nurse practitioner or nurse- • Every two weeks between 28 and 36 weeks midwife to coordinate your maternity care, prenatal of pregnancy education and available community services. She also • Every week from 36 weeks until delivery will give you the necessary paperwork to fill out before your admission to the hospital. • Follow-up visit after six weeks Your maternity care coordinator will: • You may need to be seen more frequently for certain conditions during pregnancy • Help you learn more about community services and support groups available for pregnant moms and their families Did you know … Your first prenatal visit should • Help you design an educational plan for pregnancy be scheduled as soon as pregnancy is suspected. and your own personal birth plan Women should attend every prenatal care appointment, even if they are feeling fine. According • Help you determine which baby care and parenting to the March of Dimes, women who meet with their classes will help you feel comfortable in caring for health care provider regularly during pregnancy are yourself and your new baby less likely to experience pregnancy complications, • Help you learn more about the hospital’s procedures, have a lower rate of premature delivery and have your options and choices healthier babies. • Help you and your family as you prepare with confidence for the newest family member Visit routine • Complete physical exam, including medical and obstetrical history, at first or second visit 4 • Other visits may include: weight, blood pressure, which can cause jaundice in the newborn uterine measurements, check of fetal heart tones, Birth canal (vagina): Passageway from the uterus check of urine for protein and sugar through which the baby is born • Prenatal lab work and other tests as indicated in the Bonding: The attachment that develops between a “Prenatal testing” chapter of this book mother and father and a newborn baby Braxton Hicks (false labor): Irregular contractions of TIP: Eat a healthy diet that includes fruits, vegetables, grains, the uterus, often painless, noticed during pregnancy calcium-rich foods and protein. Choose foods low in saturated fat. Breech: Position of the baby in which the buttocks or feet are presented first Medical terms Centimeters: The unit of measurement describing the dilation (opening) of the cervix during labor Afterbirth: The placenta, membranes and fluids, which Cervix: The narrow neck-like end of the uterus which are expelled (pushed) from the uterus after delivery leads into the vagina Afterbirth pains: Contractions of the uterus following Cesarean birth: Delivery of the baby through incisions birth that help the uterus return to pre-pregnancy size in the abdomen and the uterus Amniocentesis: A procedure in which a small amount Circumcision: Surgical removal of the foreskin of of amniotic fluid is taken from the sac surrounding the the penis fetus and tested for various fetal abnormalities or lung maturity Colostrum: A yellowish fluid produced in the breasts at the beginning of milk production in small amounts Amniotic fluid: The clear liquid that surrounds the baby during pregnancy and for several days following birth inside the amniotic sac Complete cervical dilation: The cervix is effaced Analgesics: Medications that relieve or reduce pain (thinned) and dilated to 10 centimeters without causing unconsciousness Contractions: A tightening or shortening of the uterine Anesthesia, local: An injection into the perineum (area muscles during labor between vagina and rectum) to numb the tissues Contraction stress test (CST): A test in which mild Anesthesia, regional: An injection causing loss of contractions are induced in the mother, and during sensation to only a part of your body which the fetus’s heart rate is monitored using an Apgar score: Evaluation of the baby following birth; the electronic monitor, and evaluated in response to baby is checked for heart rate, respiratory effort, muscle the contractions tone, reflexes and color at one minute and five minutes Crowning: The time when the head of the baby is seen at after birth; a rating of 0–2 is given for each assessment the vaginal opening for a total score of 0–10 Dilatation (dilation): Gradual opening of cervix, Areola: The pigmented area, around the nipple of the measured in centimeters from 0–10 breast, which darkens during pregnancy Ectopic pregnancy: A pregnancy in which the fertilized Baby blues: A period following childbirth, usually no egg begins to grow in a place other than inside the more than one to two weeks, caused by sudden change uterus; considered a medical emergency in hormone levels and fatigue and characterized by emotional highs and lows. This is different than Edema: Swelling caused by fluid retention postpartum depression. (See section on postpartum Effacement: