Welcome Packet & Pregnancy Guide Congratulations on your pregnancy! You’re pregnant – congratulations from our Gynics Associates OB/Gyn physicians and staff. This is an exciting time in your life and we are pleased to share this experience with you. Our goal is to provide the highest quality of health care available to each and every woman in any stage of the life cycle in a respectful, caring and positive manner, within a welcoming and professional environment. We believe that in order to provide this quality care, we must work together as a team. No single person can provide this care alone; therefore each and every person is a highly valued member of the Gynics Associates team. Patients cared for in such an environment can be assured that they are cared for by a team with one common goal – an enjoyable obstetrical experience and the delivery of a healthy, happy baby! Gynics Associates has four qualified and experienced OB/Gyn physicians: Robert Crumb, Cynthia Coyne, Delia DeLeon, Allison Urrutia, and Courtney Wiener. Our physicians are specialists in routine and high risk obstetric care. Each Gynics Associates physician is Board Certified/Eligible by the American Board of Obstetrics and Gynecology. Our practice also includes an Advanced Nurse Practitioner, Natalie Baldwin who enhances our ability to deliver individualized and personal care to all of our patients. 1 Our Physicians Dr. Robert Crumb Having grown up with a father in the petroleum industry Dr. Crumb graduated from Jakarta International School in Indonesia. He then attended Texas A&M University graduating with a degree in Biochemistry. After transferring from the University of South Alabama College of Medicine in Mobile, Alabama Dr. Crumb graduated from the University of Chicago, Pritzker School of Medicine. He then completed his residency training in Obstetrics & Gynecology at the University of Chicago Hospitals. Dr. Crumb completed a Master of Public Health degree by distance education from the University of London School of Hygiene and Tropical Medicine. Dr. Crumb is Board Certified, and a Fellow in the American College of Obstetricians​ and Gynecologists. His practice includes Obstetrics including High Risk Populations, Pediatric and Adolescent Gynecology, Menopausal Medicine, Advanced Minimally Invasive Surgery, Complicated Open and Pelvic Gynecological Surgery, and Ultrasound. His practice philosophy is to provide Personalized, Expert, and Compassionate Care. While not working, Dr. Crumb enjoys spending time with his wife and college aged children. Dr. Delia DeLeon Dr. Delia Gonzalez DeLeon completed her undergraduate degree at North Carolina State University where she double majored in Biological Engineering and Biomedical Engineering, summa cum laude. Dr. DeLeon then returned to Texas to pursue her medical degree at the University of Texas Southwestern Medical Center in Dallas. She was fortunate to complete her Obstetrics and Gynecology residency here in Austin where her family resides. Her passion for women’s health is realized in the sincere and caring relationship she builds with every patient. She believes creating a trusting and comfortable environment is of the utmost importance. She is committed to learning and utilizing ​ the newest and most advanced technologies to better serve her patients. She is particularly interested in minimally invasive procedures, including the DaVinci Robot and Single Incision Laparoscopy (SILS). She enjoys listening to live music around town, watching movies, and spending time on Lady Bird Lake with family. 2 Dr. Allison Urrutia As the eighth of twelve children, Dr. Allison Urrutia’s interest in obstetrics began at an early age. She was born in Ohio and relocated to Austin upon completion of medical school at Northeastern Ohio Medical University. She completed her training in Obstetrics and Gynecology at the University of Texas Southwestern in Austin in 2011. While in training, she began her family with the birth of her two children, Emma and Oliver. Dr. Urrutia is committed to building a trusting relationship through each office visit. By creating a warm and inviting atmosphere, her patients feel at home. Dr. Urrutia’s obstetric practice includes expertise in both routine and high risk pregnancy care. Her gynecologic expertise includes preconceptual counseling, contraceptive management, infertility evaluation and treatment, treatment of abnormal pap smears, menstrual problems, menopause and hormone replacement therapy, pelvic organ prolapse and urinary incontinence. Dr. Urrutia is board certified and a Fellow of American Congress of Obstetrics and Gynecology. Her practice interests include minimally invasive surgery. She is certified in DaVinci Robotic surgery and SILS (Single Incision Laparoscopic Surgery). Dr. Urrutia is fluent in English and in Spanish. Dr. Cynthia Coyne As a Miami native with a Hispanic background, Dr. Cynthia Coyne is familiar with cultural diversity. She moved to Texas for her OB/Gyn training at the University of Texas Health Science Center at Houston where she graduated in June 2017. After four years in Houston, and meeting her husband - an ER physician, she sought to stay in Texas. She is honored to be a part of Gynics Associates in Austin, the city where her husband attended undergraduate school. Her main focus in OB/Gyn is to provide an environment where women can be open about their private concerns. Her interests include family planning, contraception, cervical dysplasia, health care maintenance, abnormal uterine bleeding, minimally invasive surgery, urinary incontinence and menopause. She is excited to be a part of the hill country, enjoying yoga, swimming and salsa dancing. Dr. Coyne is fluent in English and in Spanish. 3 Dr. Courtney Wiener Dr. Courtney Wiener was born and raised in Austin, Texas. She received her undergraduate degree in Neuroscience and Behavioral Biology at Emory University and then went on to earn her medical degree from the University of Texas San Antonio as a member of Alpha Omega Alpha and Gold Humanism Society. She completed her residency training in Obstetrics and Gynecology at Baylor College of Medicine in Houston. Dr. Wiener is thrilled to be home practicing with a group dedicated to providing compassionate, patient focused care with the highest level of medical scholarship. She is privileged to provide obstetric and gynecologic care through all stages of life and become partners in her patient's health. Her clinical interests include adolescent health, family planning and contraception, dermatologic disorders of the vulva, and minimally invasive gynecologic surgery. Dr. Wiener loves exploring new restaurants around Austin, spending time with her two brothers, running at Town Lake, and listening to live music. 4 Contact Information Gynics Associates Main phone number: 512-451-3131 Our website: www.gynics.com ​ Office hours: Monday through Friday, 8:00am to 5:00pm Dr. Robert S. Crumb Jamee, MA Extension 3 Dr. Delia G. DeLeon Maria, MA Extension 2 Dr. Allison A. Urrutia Gloria, MA Extension 1 Dr. Cynthia D. Coyne Mary, MA Extension 4 Dr. Courtney Wiener Extension 5 Khat, MA Please note, prescription refills and appointment changes will be handled during office hours only. ​ Julie Roth, OB financials Direct Line 512-350-2582 For Medical Emergencies Only: After hours and on weekends, call the Medical Exchange 512-483-9022 5 TABLE OF CONTENTS Welcome .. 1 ………………………………………………………………………… Our Physicians 2 …………………………………………………………………… Contact Information .. 5 …………………………………………………………… Estimate of Benefits .. 7 …………………………………………………………… Medicaid .. 9 ………………………………………………………………………… FMLA and Short Term Disability . 10 ……………………………………………… Prenatal Appointment Schedule . 11 ……………………………………………… How Your Baby Grows .. 12 ………………………………………………………… Getting Prepared .... 15 ……………………………………………………………… Common Problems 17 ……………………………………………………………… Medications 20 ……………………………………………………………………… Travel .. 21 …………………………………………………………………………… Nutrition . 23 ……………………………………………………………………… … Exercise .. 26 ………………………………………………………………………… Work 28 ……………………………………………………………………………… Sex 29 ………………………………………………………………………………… Smoking, Alcohol & Street Drugs ... 29 ………………………………………… … How To Tell When Labor Begins 32 ……………………………………………… Postpartum Depression 34 ………………………………………………………… Hospital Regisstration .. 37 ………………………………………………………… Check List ... .. 38 …………………………………………… ………………………… Notes ... .. 39 ……………………………………………………………… …………… 6 OB Estimate of Benefits The following information should provide answers to some of the most frequently asked questions regarding the cost of prenatal care and delivery. Julie, our OB financial counselor, will meet with you to go over your individual estimate at your second or third OB visit or sooner if requested. 1. What should I expect for costs with my prenatal care and delivery? Gynics Associates charges each pregnant patient an OB Global Fee, which ​ ​ includes routine/non-complicated prenatal visits, delivery and one postpartum visit: *Vaginal Delivery $3,342.00 *Vaginal Delivery after a cesarean section (VBAC) $3,520.00 *Cesarean section delivery $3,784.00 2. What is NOT included in the OB Global Fee but may be covered by my insurance? These services are billed separately from the Global Fee. Initial OB office visit charge Ultrasounds, Fetal Non-Stress Tests and Biophysical Profiles Newborn circumcision Laboratory testing, genetic testing Medications Shots/injections ER visits Hospital fees: St. David’s Medical Center 919 E. 32nd St. Austin 78705 Austin Anesthesiology Group fees 3. What should