interested in having your baby at our birth center, please ...trisomy 13 (patau syndrome) occurs in...

37
Congratulations on your pregnancy and welcome to OBGYN North! We look forward to serving you and have prepared this notebook to help guide you through your pregnancy. Our physicians and nurse-midwives work as a team and you will likely meet all of us throughout the coming months. Both the doctors and the nurse-midwives attend births across the street at St David’s Women’s Center of Texas. Our nurse-midwives also welcome babies at Natural Beginning Birth Center, located within our office. If you are interested in having your baby at our birth center, please send an email to our nurse manager at [email protected] or press option 6 when calling our office so we can set up a private tour at your convenience. Genetic Testing Options…………………………………………………………………………………………………..3 Pregnancy Calendar…………………………………..................................................................................................5 Gestational Diabetes Screening………..…………...............................................................................................9 Prenatal Nutrition………………………………………............................................................................................10 Remedies and Medication………………………….…..........................................................................................13 Exercise…………………………………………….…….…............................................................................................1 4 Dental Care…………………………..………………….…............................................................................................14 Travel………………………………………….………….…............................................................................................14 Warning Signs……………………….……………….…..............................................................................................14 Preparing for Delivery/Childbirth Education…………..............................................................................16

Upload: others

Post on 29-Jul-2020

1 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

CongratulationsonyourpregnancyandwelcometoOBGYNNorth!Welookforwardtoservingyouandhavepreparedthisnotebooktohelpguideyouthroughyourpregnancy.

Ourphysiciansandnurse-midwivesworkasateamandyouwilllikelymeetallofusthroughoutthecomingmonths.Boththedoctorsandthenurse-midwivesattendbirthsacrossthestreetatStDavid’sWomen’sCenterofTexas.Ournurse-midwivesalsowelcomebabiesatNaturalBeginningBirthCenter,locatedwithinouroffice.Ifyouareinterestedinhavingyourbabyatourbirthcenter,pleasesendanemailtoournursemanageratLmonty@obgynnorth.comorpressoption6whencallingourofficesowecansetupaprivatetouratyourconvenience.

GeneticTestingOptions…………………………………………………………………………………………………..3

PregnancyCalendar…………………………………..................................................................................................5

GestationalDiabetesScreening………..…………...............................................................................................9

PrenatalNutrition………………………………………............................................................................................10

RemediesandMedication………………………….…..........................................................................................13

Exercise…………………………………………….…….…............................................................................................14

DentalCare…………………………..………………….…............................................................................................14

Travel………………………………………….………….…............................................................................................14

WarningSigns……………………….……………….…..............................................................................................14

PreparingforDelivery/ChildbirthEducation…………..............................................................................16

Page 2: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

PostpartumCare…………………………………………...........................................................................................25

PostpartumDepression……………………………...............................................................................................26

ContactingOBGYNNorth

Ourofficehoursare7a-4:30pMondaythroughThursdayand7a-3ponFriday

AfterHours: For emergencies or labor after businesshours, please call ourmainofficenumberat(512)425-3825.Ouransweringservicewillcontactusandwewillusuallycallyoubackwithin15minutes.Ifyouhavenotheardback,pleasecallagain.

Patient Portal:On the left side of our website, obgynnnorth.com you will see “PatientPortal”.Thisallowsaccesstoemailus fornon-urgent issuesandallowsyoutoviewyourownlabresults.

WhentocallforLabor

(512)425-3825

Pleasecallourofficeif:

Yoususpectyourbagofwatermaybebroken.Sometimesthebagcanleaksmallamountsofclearamnioticfluidoritmaycomeinagushthatwetsthebedorsoaksyourclothes.Putnothinginyourvaginaafteryouareleaking(notampons,nointercourse,etc).Only10%ofwomenstarttheir laborwiththewaterbreaking. IfyouareGroupBStrepnegative,youmaywaitathomeforupto12hours.However,wewanttotalkwithyouassoonasyourwaterbreakstoreviewyoursymptomsandcreateaplantogether.

Youhavecontractionsthatareregularlyspaced,andgettinglonger,strongerandclosertogether.Callusifthecontractionsare5minutesapartorcloser,lastforoneminuteandhavebeenthatwayforanhourormore. If it isnotyourfirstlabor callwhen the contractionsare regularand strong, lasting for a fullminute at regular intervals. Be guided byyourbodyratherthantheclockassubsequentlaborstendtobeshorter.

Somewomenprefertolaborathomeforaslongastheyfeelsafe.Pleasefollowtheguidelinesaboveandinformusthatyourwaterhasbrokenorthatactivelaborhas

Page 3: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

started.Wewillnotrequirethatyoucometothehospitalorbirthcenter,butwestillwanttobeinvolvedsowecanofferguidanceandbeprepared.

PrenatalGeneticTesting

Ifknowingthehealthstatusofyourbaby inearlypregnancywouldchangethecourseofyour plans or provide peace of mind, you might consider prenatal genetic testing.Fortunately,98-99%ofbabiesarebornwithoutmajorbirthdefects.

Weoffernon-invasivescreeningfor:

• ChromosomaldefectsincludingDownSyndrome,Trisomy13&18

• Neuraltubedefectsincludingspinabifida

• Recessive(Inherited)disease

Beforeyouagreetoanyprenatalgenetictesting,considerthefollowingquestions:

• Would a firm diagnosis affect how you handle the pregnancy or prepare for thebaby?

• Howimportantisthereassuranceofanormalscreeningtest?• Iftheresultofascreeningtestisworrisome,wouldyouchooseamoreinvasiveor

expensivediagnostictesttoconfirm?• If you decline diagnostic testing, howwill you handle the uncertainty about your

baby'shealth?

Chromosomal abnormalities. These defects occur randomly (not inherited) and thechanceofhavingachildwiththeseconditionsincreasesasawomangetsolder.

Trisomy 21 (Down syndrome) is the most common single cause of human birth defects, resulting in physical and mental limitations. The level of mental retardation varies but is usually moderate. Frequency increases with maternal age, occurring in approximately 1 per 1,500 live births in women in their early 20’s, 1 per 350 births at age 35 and 1 per 85 at age 40. Trisomy 18 (Edwards syndrome) causes serious medical and developmentalproblems and half of infants with this condition do not survive beyond the firstweekof life. It isdifficulttodeterminethefrequencyofTrisomy18becausemanypregnanciesaffectedendinanearlymiscarriage.

Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy 13 will often end in miscarriage or stillbirth. Due to the presence of several life-threatening medical problems, most infants born with Trisomy 13 die within their first week of life.

Page 4: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

Spinabifidaisanincompletedevelopmentofthebrainorspinalcord,occurringinthefirstmonthsofpregnancyandcansometimesbedetectedwithanultrasoundorbloodtest.Thoughrare,itisthemostcommonneuraltubedefectintheUnitedStates,affecting1,500to2,000ofthemorethan4millionbabiesborninthecountryeachyear.Complicationsofspinabifidacanrangefromminorphysicalproblemsincludinglimitedsensation,tomoreseriousissuessuchasnervedamage,lossofmusclecontrol,bladderorbowelcontrolproblemsandsometimesparalysis.Takingfolicacid(foundinallPrenatalVitamins)priortopregnancyandduringthefirst3monthsgreatlyreducestheriskofspinabifida.Recessive(Inherited)Diseases: Ifdesired, awomanonlyneeds tobe screenedonce inher life todetermine ifshe isacarrier forsome inheriteddiseases.Apositive testwouldindicate that her child is at risk of inheriting the gene and additional testing would besuggested. These tests can be collected before a woman becomes pregnant or any timeduringapregnancy.Thetestisalsoavailableformenandabloodsamplecanbecollectedinouroffice.

Acompletelistofdiseasesincludedisavailableuponrequest.Someofthemorecommondiseasesarelistedbelow:

Cystic Fibrosis (CF)affects themucus and sweat glands and can cause seriouslunganddigestiveproblems.ItismostcommoninthoseofEuropeandescentandboth parents would need to be carriers for the baby to inherit the disease. Anestimated1in29CaucasianAmericanshastheCFgene.

SpinalMuscularAtrophyareagroupofinheriteddiseasesthatcausemuscledamageandweakness,gettingworseovertimeandpotentiallyleadtodeath.Mostofthetime,achildmustgetthedefectivegenefrombothparents.About4outofevery100,000peoplehavethecondition.

FragileXisageneticconditioninvolvingchangesinpartoftheXchromosome.Itisthemostcommonformofinheritedmentalretardationinboys.Boysandgirlscan both be affected, but because boys have only one X chromosome, a singlefragileXislikelytoaffectthemmoreseverely.

Sickle Cell Disease results in damage to red blood cells. It can occur in anyethnicitybutismostcommonamongAfricanAmericans.Thediseasereduceslifeexpectancybythirtyyears,withmostpatientsdyingbeforetheyreachmiddleage.Approximately10%ofAfricanAmericansaresilentcarriersofsicklecelldisease.

Tay-SachsandCanavandiseasesaremostprevalentamongJewishfamiliesbutcanoccurinanyethnicity.Theseprogressiveconditionsresultinthegraduallossofmovementandmentalfunctionandareoftenfatalearlyinchildhood.

Page 5: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

PregnancyCalendar

Yourestimatedduedateiscalculated40weeks(280days)fromthelastmenstrualperiod,or38weeksfromconception.Althoughwecalculateaduedate,yourbabyactuallyhasaduemonth,witharrivaloccurringanytimebetween38-42weeksgestation.Wehonoryourbody’s natural schedule and do not induce for non-medical reasons. However, certainmedical issuesincludinghighbloodpressureordiabetesorcanweakentheplacentaandearly delivery is often beneficial. The following schedule can be used as a guide butindividualcircumstancesmaywarrantdeviations.8weeks(fromlastperiod)

Prenatal Care: Your first visit includes a health history and counseling,examination,ultrasoundandlabtests.Thisappointmentusuallylasts1hour.

Testing:Prenatal labwork (blood type, complete blood count, rubella immunity,HIV, hepatitis B, syphilis, antibody screen, urine culture and other testing asindicated)

PapSmear(ifdue)andtestsforsexuallytransmittedinfections

Baby’sDevelopment: Conceptionusuallyoccurs14daysafterthe lastmenstrualperiodwith implantation into the uterus 10 days later. The placenta forms by 4weeksandheartbeginstobeatby6weeks.By10weeksyourbabyisfullyformed,withatinyface,armsandlegs.

12-13weeks

OptionalTesting/Screening: If you elect to do genetic testing youwill be seenduring12-13weeksofpregnancyforabloodtestandultrasound.

14-16weeks

PrenatalCare:Yourbaby’sheartbeatcanbeheardwithahandhelddoppler.

Optional testing /screening:Blood screening for neural tube defects and Downsyndromeifdesired.

Baby’sDevelopment: Placentahas formedand is fully functioningby12weeks.Arms,hands,legs,feetandinternalorgansarefullyformed.

20weeks

PrenatalCare:Anultrasoundisdoneinourofficetoexaminethebaby’sanatomyand the locationof theplacenta. If yourbaby cooperates, you can likely learn thegenderofyourbabyduringthisultrasoundifyouchoose.Thisvisitgenerallylastsonehour.

Baby’sDevelopment: You usually feel your baby’smovements consistently now.Your baby is 8-10 inches long and weighs approximately one pound. The

Page 6: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

babybeginstohearsoundatabout20weeksandvernixbeginstocoverandprotectthebaby’sdelicateskin,whichiscoveredinfinehair.

24weeks:

Prenatal care: If you are expecting your first child, please signup for childbirthclasses.Webelievetheclassesaresobeneficial foremotionalpreparationthatwedo require them for first time parents. Select the method and location of yourchoice. Experienced parents may take a refresher class if desired but it is notrequired. It is highly recommended for first time parents to take a breastfeedingclass.Also,ifyou’reattemptingavaginalbirthafterc-sectionwehighlyrecommendourVBACclass.

Ateachvisitadoctorormidwifewillnowbegintoassessthegrowthoftheuterus(fundalheight)withatapemeasure,andthebaby’sheartbeatwillbeheardwithadoppler.

Baby’s Development: A 24 week baby generally weigh nearly 2 pounds andfingernailsandtoenailsarepresent.Hiccupsbeginaroundthistimeandyourbaby’seyescanopen.Yourbabybeginstoputonweightanditssizeisnowdeterminedbygeneticsandmaternaldiet,ratherthanjustgestationalage.

28weeks

Prenatal Care: As your baby grows, we may be able to determine your baby’spositionsimplybyfeelingyourabdomenwithourhands.Thebabymayalreadybeheaddownbut it isanothertwomonthsormorebefore itwillbe importanttobepositionedforbirth.

Testing/Screening:Bloodteststoscreenforgestationaldiabetes,anemia,syphilisandHIVaredrawninouroffice.Therearetwomethodsfortestingforgestationaldiabetes.Thefirstisa2hourbloodglucosetolerancescreeningcompletedatthe same time as your other blood tests listed above. Alternately, youmaychoose to check your blood sugarswith a glucometer 4 times a day for oneweek. However, you must complete gestational diabetes testing to continueprenatalcarewithourpractice.ExpectantmotherswithanRhnegativebloodtypewillreceiveadditionalscreeningandaninjectionofRhogamwilllikelybegiven.

Baby’sDevelopment:Beginnoticing thebaby’s active timesof day. Mostbabieshave3-4activetimeseachdayandsleep/restinbetween.Pleasecallusrightawayyoudonotfeel10movementsin2hoursathis/herusualactivetimes.

31weeks

PrenatalCare: Plentyof timewillbeallowed todiscussyourbirthplans tohelpcreaterealisticexpectationsandsupportyourvisionoflaborandbirth.

Page 7: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

Baby’sDevelopment: Taste buds are formed and your baby is forming layers ofhealthybodyfat.

34weeks

PrenatalCare:Wearecarefullyassessingyourbloodpressureandbaby’sgrowthateachvisit. It isnormalatthispoint inpregnancytohavemoreaches,painsandpressureasyourbodyexpandsandposturechangestoaccommodateyourgrowingbaby.

36-37weeks

PrenatalCare:Ifyouhavewrittenabirthplanafterfinishingyourbirthingclassesthisisagoodtimetoreviewitwithoneofourdoctorsormidwives.

Testing/screening:WescreenallpregnantwomenforGroupBetaStrepor“GBS”.Approximately 1/3 of women carry this bacteria. It usually does not cause aninfectiontothemother,butcanhaveseriousconsequencestoherbabyduringlabororshortlyafterbirth.Theexamisdonebyslidingasterileswabinthevaginaandanusandresults takeabout3-5days toreturn. If thebacteria ispresentyouwillreceiveantibioticsduringlabortoprotectyourbaby.YoumaynotdeliveratNaturalBeginningBirthCenterifyouchosetodeclineantibiotics.

Womenover35yearsoldwillbeginweekly testingatapproximately37weeks toassessthehealthoftheplacenta.Thisincludesaweeklyultrasoundtomeasurethevolume of amniotic fluid and a “non-stress test” or NST, where we listen to thebaby’s heartbeat for approximately twenty minutes. Once your baby is 37 weekgestation,youareeligibletodeliveratourbirthcenter.

Baby’sDevelopment:Thelastmonthofpregnancyisatimeofrapidgrowth.Mostbabies weigh approximately five pounds, have developed a suck reflex and areputtingonfattostabilizetheirbodytemperatureandbloodsugarafterbirth.

38weeks

PrenatalCare:Wewilllistentoyourbaby’sheartbeatanddiscusswhenandhowtocontactusforlabor.

Baby’sDevelopment: Yourbaby isnowtermandready fordeliveryany time inthe nextmonth. Most babieswill have strong lungs and a coordinated suck andswallowforefficientfeedingby38weeks.

40weeks

Thisisonlytheestimatedduedate,whichisreallyaduemonthandmanyhealthybabiesareborn7to10daysaftertheestimateddate.

41weeks

Page 8: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

PrenatalCare:Youwilllikelybeseentwiceaweekandyourproviderwilldiscussholisticmeansof encouraging labor.Wegenerally like to examine your cervix fordilationtohelpmakerecommendations.

Testing/screening:Youwillhave two tests inouroffice tohelpdetermine if it issafe to continue waiting for labor to start on its own. A non-stress test (NST) isperformedbymonitoringthebaby’sheartbeatfor20-30minswhileyourelaxinarecliner.Anultrasoundisdonetomeasuretheamnioticfluidvolume,atestwereferto as an Amniotic Fluid Index (AFI). If both are normal, we usually recommendrepeatingthetestsin3-4daysiflaborhasnotstarted.Ifeithertestisnotnormal,aninductionoflabormayberecommended.

Baby’sdevelopment:Ripe,plump,andreadyforbirth!Vernixisnearlygoneandthebaby’sskinmaybegintopeel.

41½weeks

Your cervix will likely be examined, an NST and AFI will be done and a plan toinduceat42weekswillbecreatedwithyou.MostwomenstartlaborontheirownsoinductionisnotacommonoccurrenceatOBGYNNorth.However,animportantpartofourjobistobepreparedandprotectthesafetyofyouandyourbaby.Thereareincreasedriskstothebabyifpregnancycontinuesbeyond42weeksgestation,sowegenerallyrecommendnaturalmeansofencouraginglaboratthistime.

42weeks

Itistimeforthebabytobeborn(ifithasnotalready).Differentmeansofmedicalinductions will be discussed with you if natural means have not brought oncontractions.NaturalBeginningsBirthCenterpatientswillbeginanoutofhospitalinductionandifthosemeansarenotsuccessfulwilltransfertothehospitalwithoneofourproviders.

SCREENINGFORGESTATIONALDIABETES

2hourGlucoseToleranceTest

• Stopeating8hoursbeforeyoustartthetestandtrytoavoidsugar/sweets/highcarbohydratefoods

• Onceyoustartthetestyoumaynothavegum,candy,coffee,tea,orfoodofanykind.

• Youmayeatanddrinkafteryour2hourblooddraw,pleasebringasnacktoeatafterthetestiscomplete.

Page 9: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• Youmayusethebathroomasneeded.Itdoesnoteffectthetest.

• Ifyouneedtodrinkwateryoumayhavesipswhilefasting(the8hourspriortoyourtest)butyoumaynotdrinkanythingduringthetest.

• Yourtestsresultswillbeavailablewithin1weekofthetest.

WhenyouarriveatOBGYNNorth

• Youwillhaveyourblooddrawnwhileyouarefasting

• Afteryourblooddraw,youwillbegivenabottleofglucosesolution.Drinkitasfastasyoucan;in5minutesorless.

• Wewilldrawyourbloodat1hourandat2hoursfromthetimeyoufinishdrinkingtheglucose

Afewmorethings:

• PleaseletyourmedicalassistantknowifyouwouldlikeatDap(pertussis)vaccine.Youwillreceiveitatyour28weekvisit

• IfyouareRHNegativeyouwillreceiveaRhogamshotfollowingyourglucosetolerancescreening

PrenatalNutritionTheamountofweightgainedduringpregnancyvariesbutaveragesapproximately25-35pounds. Balanced nutrition and exercise and steady growth of the baby are moreimportant than the reading on the scale. However, excessive weight gain can increasecomplicationswithpregnancyandbirth,includingthelikelihoodofacesareanbirth.Avoid substances thatmay be harmful to your baby including alcohol, illegal drugs andsmoking.Limityourintakeofcaffeinateddrinks.Itisgenerallyconsideredsafetodrinkonecup of coffee per day. Hydration is important andwater is always preferred over soda,sportsdrinks,juiceandtea.Werecommenddrinkingatleast64ouncesofwateraday.

In pregnancy, it is necessary to increase calories from high quality foods such aswholegrains,fruits,vegetables,proteinfoodsandfoodhighincalciumandiron.

Takingaprenatalvitaminwith400-1000mcg(.4mg-1gm)of folicaciddailyreducestheincidenceofcertainbirthdefects.Ifprenatalvitaminsworsennausea,replacethemwitha400mcgfolicacidsupplement,whichisusuallywelltolerated.Oncethenauseasubsides,thefolicacidcanbereplacedwithaprenatalvitamin.

Page 10: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

Protein Rich Foods: Think of protein in pregnancy as the hub of themeal and have aservingofproteinfoodatleastthreetimesperday.Thesefoodsinclude

(Approximateservingsize)

• Meats,poultry,fish sizeofthepalmofyourhand• Eggs 1-2eggs• BeansandPeas 1cup• NutsandSeeds ¼cup• NutritionalYeast 2-4tablespoons• Cheese ¼cup• Yogurt 1cup• Tofuortempeh sizeofthepalmofyourhand

Iron:Ironneedsincreasesignificantlywhilepregnant,dueinparttoa40%to60%expansioninbloodvolumethatoccursprimarilyinthesecondtrimester.Ironisneededtoproducehemoglobin,theproteininyourredbloodcellsthattransportsoxygentoothercells.Atestforanemiaisusuallyperformednearthebeginningofpregnancyandagainaround28weeks.

Increasingironandironabsorption:

• Foodsrichiniron:• Greenleafyvegetables(spinach,broccoli,kale,seaweeds)• Redmeats,oysters,clams• Driedfruitslikeapricots,peaches,prunesandraisins• Beans• Eggyolks• Blackstrapmolasses• Wholegrains• Alfalfa

• CastIron:Cookingwithcastironcanincreasetheironcontentby50%includinga cast iron skillet or an “iron fish” dropped into boilingwater for at least 10minutes

• VitaminCcontainingfoodsincreaseironabsorption:Oranges,tomatoes,redbellpeppers,strawberries,broccoli,mango,guava,andpapaya.

• Avoid caffeinated drinks, dairy, and calcium supplementswhen taking iron ortheprenatalvitaminbecausetheydeceaseironabsorption.

FolicAcid:Folicacid(VitaminB9)getsitsnamefromfoliageandisconcentratedinleafygreens.Folicacidisessentialtoyourbaby’sdevelopmentbecauseithelpsintheformationofthedevelopingbrainandspinalcord.Ahealthydietwillprovideadequatefolicacidanda supplementof 400mcgs/day (included inprenatal vitamins) is recommended.Dietarysourcesoffolicacidinclude:

• Lentils,beans,peas,chickpeas• Greenleafyvegetables,broccoli• Papaya

Page 11: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• Strawberries

Calcium:Calcium is an essentialmineral for normalmuscle and nerve function and forbuildingandmaintainingbonesandteeth.Eatfourservingsofcalciumrichfoodsperday.

• Foodsrichincalcium• Hardcheeses,yogurtandmilk• Leafygreenvegetables,seavegetables• Nutsandseeds• Cannedfishwithsoftbonessuchassardines,mackerelandsalmon• Blackstrapmolasses

• Supplements

• Need to be balanced with phosphorus and magnesium which occur naturally inmost foods. If you take a calcium supplement, it is best to take one that containsthesemineralsaswell.

• Avoidtakingcalciumsupplementsatthesametimeasironsupplements• Herbalsourcesofcalcium

• Alfalfa• RedRaspberry• Nettles• Dandelion

Herbs:Pleasecheckwithusbeforeusingherbal supplementswhileyouarepregnantorbreastfeeding.Ageneralguidelineislistedbelow.

• Safe• Herbsgenerallyusedforcookingsuchasbasil,oregano,rosemaryetc.incookingdoses

only(donottakecapsules)• RedRaspberryLeaf• PregnancyTeainmoderation

• Avoid• Angelica• BlackCohosh• BlueCohosh• Dongquai• Licorice• Siberianginseng• Uvaursi• Yarrow• Elderberry• Melatonin• Chicorytea• Kombucha• Eveningprimroseoil

*Otherproductstoavoid:

• Ibuprofen/Motrin–allNon-SteroidAnti-inflammatoryDrugs(NSAIDs)• Naproxen/Aleve–allNon-SteroidAnti-inflammatoryDrugs(NSAIDs)• Aspirin• Retin-A,Retinol,Salicylates• Tetracycline,SulfaandFloxindrugs

Page 12: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• Saccharin

FoodPrecautions

• Donoteatraworundercookedmeat,fish,shellfish,oreggs(sometimesraweggsareinhomemademayonnaiseorCaesarsaladdressing).

• Toprevent listeria infection,heatall luncheonmeat,pate’andhotdogs(evenifthelabelsaysprecooked)untilhot.Microwavecookingcanbepatchyandmaynotcompletelykilllisteriaunlesssteaminghotthroughout.

• Avoidfishthatconcentratemercury:swordfish,tilefish,kingmackerel,albacoretuna,andshark.

• Eatotherseafoodsuchasshrimp,salmon,catfish,oysters,anddarktunaonly2-3timesperweek(nomorethan12ouncesperweek).

• To prevent listeria infection cook all soft/cultured cheese such as Feta, Brie,Blue,andCamembertthoroughly.Donoteatthesecheesesunlesscooked.

• SafeOvertheCounterRemediesandMedications

Overthecountermedicationsthataresafeinpregnancy:Symptom Medication Options

Headache Acetaminophen(Tylenol)extrastrength,1gram(twotabs)every6hrsAspirinfreeExcedrinTension1tabevery6hrs

Sinus Congestion NetiPot(usesterilewater)MucinexPsuedephedrine(Sudafed)60mgs,2tabletsevery4hrs

Phenylepherine (Sudafed PE) 10 mg every 4 hrs **Use Sudafed sparingly

Allergies Diphenhydramine (Benadryl) 50 mgs (2tabs) every 4 hrs

Loratadine (Claritin) 10 mgs (1 tab) daily Cetirizine (Zyrtec) 10mgs (1 tab) daily

Chlorpheniramine (Chlor-Trimeton) 4 mgs (1 tab) every 4 hrs Clemastine(Tavist-1)1.34 mgs every 12 hrs Cough Dextomethorphen (Robitussin) 20 mgs every 4 hrs

Guaifenisen (Mucinex) 400 mgs every 4 hrs Tylenol Cold and Sinus 2 capsules every 4 hrs

Sore Throat Cepacol lozenges warm salt water gargles Nausea/Vomiting Doxylamine (Unisom) 12.5 mgs every 12 hrs + 50mg Vitamin B6

Dimenhydranate (Dramamine) 100 mgs every 4 hrs Emertrol Sea Bands

Heartburn Papaya Enzymes Tums 1000-3000 mgs every 2 hrs

Ranitidine (Zantac) 150 mgs every 12 hrs Cimetidine (Tagamet) 300 mgs every 6 hrs

Famotidine (Pepcid) 20 mgs every 12 hrs Prevacid

Upset stomach Maalox, 4 tabs as needed Mylanta, 4 tabs as needed Diarrhea Loperamide (Imodium) 4 mgs initially, then 2 mgs after each unformed stool

Constipation Natural Calm – 2tsp. 1-2 doses/day Docusate (Colace) 250 mgs every 12 hrs

Methylcellulose (Citrucel) 1 TBSP in 8 oz water every hrs 8 hrs Polycarbophil (FiberCon) 1 mg every 6 hrs Magnesium hydroxide (Milk of Mag) 60 mls daily Magnesium Citrate 150 mgs every 12 hrs

Gas

Mylicon Gas-X Phazyme

Page 13: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

Hemorrhoids Pramoxine (ProctoFoam) Anusol Witch Hazel (Tucks pads) Yeast Infections Miconazole (Monistat 5 day or 7 day cream) Insomnia (difficulty sleeping)

Diphenhydramine (Benadryl) 50 mgs (2tabs) at bedtime Doxylamine (Unisom) 25 mgs at bedtime

Skin rashes Hydrocortisone (Cortaid) up to 4 times daily

Diphenhydramine (Benadryl) spray or cream, several times daily Calamine lotion

Ifsymptomsdonotresolvein48hourspleasecallourofficeduringbusinesshours.

ExerciseExercise should be continued during pregnancy. It enhances mood and helps stabilizebloodsugar.Oncethenauseaandvomitingofearlypregnancysubsides,mostwomencancontinue their normal exercise routine. We encourage all women to walk at least 30minutesadayasaformoflowimpactbeneficialexercise.Onceyour“babybump”beginstoshow, avoid abdominal exercises such as sit-ups or crunches. As pregnancy progresses,sometimearound24weeks,youwillwanttostartavoidingrunningduetotherepetitivejarringmotion.Youwillnotharmyourbabybutitputsunduestressonyourloosejointsandpelvic floor andbladder.Walking, stationarybike, elliptical, swimmingandyoga arewonderful formsofexercisethatcanbedonethroughoutpregnancy. If it feelsgood,youcanworkouthardandbreakasweat,butavoidthesensationofbeingwinded.Drinkplentyofwaterduringandafteryourworkouts.

DentalCareGooddentalhygieneshouldbecontinuedthroughoutpregnancy.Dentalcleanings,fillings,rootcanalsandevenx-rayscanbedonewhileyouarepregnant.Itisnormalforyourgumstobecomemoreengorgedwithbloodandbleedeasilywhileyouarepregnant. This isanormal change andnot associatedwith gumdisease. If you are having extensive dentalworkdone,yourdentistmayrequestaletterfromuspriortobeginningyourdentalwork.

TravelTravelingduringyourpregnancy isgenerallyconsideredsafeduringthe firstandsecondtrimester for womenwith uncomplicated pregnancies.We generally do not recommendtraveling more than a few hours away after 35 weeks gestation. If you are planning totravel, please let us know so we can make proper assessments and recommendations.Drinkplentyofwatertohelpavoidbladderinfectionsandwalkaroundforafewminutesatleastevery2-3hourstohelppreventbloodclots.Ifyouareflying,pleasebeawarethatthechange in barometric pressure with landing can cause contractions that occurintermittently for a couple of hours. These are not usually labor contractions, but stayhydrated,allowotherstohaulyour luggageandrestwhenyougettoyourdestination. Ifthecrampsofcontractionsdonotgoawayafterafewhoursrest,pleasecallus.

WarningSigns

Page 14: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

Mostpregnanciesarehealthyanduncomplicated.Thefollowingaresymptomsthatrequireattentionandacalltoouroffice:

• Temperatureabove101degreesthathasnotberelievedwithhydrationandTylenol

• Vomitingordiarrheathatpersistslongerthan24hours• Faintingonmorethanoneoccasion• Leakingamnioticfluid• Contractionsorrhythmiccrampingmorefrequentthanevery10minsprior

to36weeksgestation.Firsthydrateandrestandifcrampingpersistslongerthantwohours,pleasecallus.

• Vaginal bleeding. Spotting lightly (requiring panty liner or less) is normalafter intercourse, a cervical examor as labor begins. If it is not related totheseevents,orisheavy,pleasenotifyus.

• Signsofpreeclampsia:• Suddenorsevereswellingofhands,lowerlegsand/orface• Sudden or severe headache, unrelievedwith rest, hydration and

Tylenol(acetaminophen)• Blurredvisionorothervisualdisturbances• Persistent and sudden upper right abdominal pain unrelated to

thebaby’smovements• Generallyfeelingsickor“toxic”

• Signsofcholestsasis:• Excessiveitching,especiallyonpalmsand/orsolesoffeet• Paininyourabdomen

• Lackoffetalmovementduringthebaby’sactivetime• By 28 weeks most babies have established fairly predictable

periods of rest and activity. Most babies are awake at theirmother’sbedtimeandsleepquietlyforstretchesofseveralhoursatatime.

• If your baby has not been active for most of the day (after 28weeks),restandpayattentiontothemovements.Pleasecallusifyour baby is not moving (flutters, rolls and gentle movementscount)atleast10timesin2hoursathis/herusualactivetime.

PreparingforDeliveryChildbirth Classes: Labor can be one of the most powerful experiences you will everencounter. It canbeempoweringoroverwhelming.Tohelpmake it apositive event,we

Page 15: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

require all first timeparents to takea childbirtheducationclass.There isno singlebestmethod toprepare you for to laborbut knowledge is power.Removing themystery andfeelingconfidentaboutthisnormalprocesscancreateabetterbirthexperience. Selectamethodof teaching that best suites yourphilosophy and schedule. We recommend thatyoustartinvestigatingoptionsaround20weeks(5months)andplantocompleteaseriesaround36weeks.Signupearly (manyclassesare full twomonthsbefore theystart)butdon’tattendclassestooearlyinyourpregnancy.Youmayconsiderthefollowingtypesofclasses.

ClassesofferedatOBGYNNorthConvenientlyheldinourwaitingroomandaretaughtbyShelleyScotkaandAmandaWyszkowskibothcertifiedchildbirtheducatorsandhighlyexperiencedlabordoulas.Toregisterpleasecallouroffice(512)[email protected] Childbirth: Four week series: This class is perfect for first time parents who need a comprehensive preparation for childbirth. We'll cover the physiology of labor and delivery, recognizing signs of labor, when to call your care provider, and the normal stages of labor. We'll learn and practice with your support person a variety of methods to cope with labor pain including breathing, relaxation, visualizations/meditation, touch and massage, positioning, and water therapy. We'll discuss what happens at the birth both in a hospital and birth center setting. What if medical interventions become necessary? We'll look at the possible interventions that are common, and cover the risks and benefits of each, including cesarean birth. We'll also review the recovery and postpartum periods, and what to expect for both you and your baby during that time. It's recommended you sign up for this series by 24 weeks and plan to begin the series by 32 weeks. $200

Labor Skills: One time 2.5 hour workshop: This workshop is designed for those who want to focus exclusively on natural ways to cope with labor pain, ideal for those who have birthed before and need a "refresher" or for those who just want to work on their labor skills with their partner. We'll discuss and practice relaxation, breathing, using visualizations/meditation, touch and massage, positioning and water therapy. We'll discuss the importance of the birth environment and creating an "oxytocin friendly" space for your labor. We'll give your support person plenty of ideas, tools and suggestions to help you get through labor, and review typical "challenging" scenarios during birth and how to get through them. Ideal anytime during the last trimester. Plan to sign up by 24 weeks. $50.

Planning your VBAC: One time 2.5 hour workshop: This class is designed for those planning a Vaginal Birth After Cesarean. We'll discuss the most up to date research on VBAC and review the benefits and risks. We'll look at ways to prepare for a successful VBAC both physically and emotionally, and offer you and your support person an opportunity to explore the emotions surrounding your previous birth experience. We'll talk about hospital protocols and learn what to expect during a VBAC labor. What if another cesarean becomes necessary? We look at the reasons why a repeat cesarean may become a necessity and ways to make that birth family centered. Ideal during the second trimester. $50.

Other Childbirth Education Classes and Programs offered in the Community

Page 16: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

1.Lamaze: The mission of Lamaze International is to “promote, support and protectnatural, safe and healthy birth through education and advocacy through the dedicatedefforts of professional childbirth educators, providers and parents.” Lamaze holds to sixHealthyBirthPractices:

• Letlaborbeginonitsown,• Walk,movearoundandchangepositionsthroughoutlabor,• Bringalovedone,friend,ordoulaforcontinualsupport,• Avoidinterventionsthatarenotmedicallynecessary,• Avoidgivingbirthonyourbackandfollowyourbody’surgetopush,• Keepmotherandbabytogether–It’sbestformother,babyandbreastfeeding.

LamazeclassareofferedacrossthestreetfromourofficeatSt.David’sNorthAustinMedicalCenter.Additionalhospitalbasedclassesincludebreastfeeding,newborncareandinfantCPR.Toregistercall(512)544-4226orvisitthefollowingsite:https://stdavids.com/service/register-for-classes.FreeLamazeclassesareofferedatAnyBabyCan, 6207SheridanAveAustin,TX78723,www.abcaus.orgor (512)454-3743.AnyBabyCanalsooffers free classes forbaby care,breastfeeding,safetyandchilddevelopment.2.BradleyMethod (www.bradleybirth.com): The BradleyMethod is a system of naturallabor techniques inwhichawomanandher coachplayanactivepart. It is amethodofincreasingself-awareness,teachingawomanhowtodealwiththestressoflaborbytuningin toherownbody.TheBradleyMethodencouragesmothers to trust theirbodiesusingnatural breathing, relaxation, nutrition, exercise, and education. The basic goals of theBradleyMethodare:

• Naturalchildbirth.• Activeparticipationbythehusbandascoach.• Excellentnutrition(thefoundationofahealthypregnancyandbaby).• Avoidance of drugs during pregnancy, birth, and breastfeeding, unless

absolutelynecessary.• Relaxation and NATURAL breathing - can be effective pain management

techniqueswithtrainingaccordingtotheNationalInstitutesofHealth.• "Tuning-in"toyourownbodyandtrustingthenaturalprocess.• Immediateandcontinuouscontactwithyournewbaby.• Breastfeeding,beginningatbirthprovidesimmunitiesandnutrition.

3.Hypnobirthing (www.hypnobirthing.com): TheHypnoBirthing®method of childbirtheducation is as much a philosophy as it is a technique. It is a rewarding, relaxing, andstress-freemethodofbirthing that teachesamother,alongwithherbirthingcompanion,the art and joy of experiencingbirth in an easier,more comfortable, andoftenpain-freemannerthatmostnearlymirrorsnature.HypnoBirthingproponentssubscribetothebeliefthatwhen awoman is given the proper preparation for childbirth, she and her birthingcompanion can experience a safe, serene, and satisfying birthing, free of the fear thatcausestensionandpain.Whenmindandbodyareinharmony,natureisfreetofunctioninthesamewell-designedmannerthatitdoeswithallothercreatures.

Page 17: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

4.BirthingFromWithin(www.birthingfromwithin.com):Thismethodofpreparationoffersasoulfulandholisticapproachtobirthpreparationthatintegratesintuitiveandacquiredknowledge.Theprimaryprinciplesare:

• Childbirthisaprofoundriteofpassage,notamedicalevent,evenwhenmedicalcareispartofthebirth.

• The essence of childbirth preparation is self-discovery, not assimilating obstetricinformation.

• Parents'individualneedsanddifferencesdetermineclasscontent.• Active,creativeself-expressioniscriticaltochildbirthpreparation.• The purpose of childbirth preparation is to prepare mothers to give birth-in-

awareness,nottoachieveaspecificbirthoutcome.• Pregnancy and birth outcome are influenced by a variety of factors, but can't be

controlledbyplanning.• Inordertohelpparentsmobilizetheircopingresources,it iscriticalforchildbirth

classes to acknowledge that unexpected, unwelcome events may happen duringlabor.

• Parents deserve support for any birth option which might be right for them(whetheritbedrugs,cesarean,homebirth,orbottle-feeding).

• Painisaninevitablepartofchildbirth,yetmuchcanbedonetoeasesuffering.• Pain-copingpracticesworkbestwhenintegratedintodailylife,ratherthan"dusted

off"forlabor.• Fathers andbirthpartnershelpbest asbirth guardiansor lovingpartners, not as

coaches;theyalsoneedsupport.

5.Advanced Comfort Strategies for Labor: This 2.5 hour hands-on workshop at St.David’sMedicalCenteron38thstreet, isdesigned for theexpectant familieswhowant tobuildontheirnaturalpainmanagementskills.Thoughtbyacertifieddoulaandchildbirtheducator,coupleswilllearntriedandtruestrategiestomanagepainincluding:

• Reviewingbasicrelaxationandbreathingstrategies• Usingvisualization,meditation,vocalizationandmantras• Creatingapeacefulenvironmentforlaborandbirth• Practicingpositionsthatpromotecomfortandprogressinlabor• Usingmassage,touchandacupressure• Managing“backlabor”andotherchallengesinlabor• Helpingyoursupportpersonfeelconfidentandprepared

Forscheduleandregistrationcall(512)544-4226orvisithttps://stdavids.com/service/register-for-classes

• Pediatrician:Pleaseselectapediatricianbythe34weekofyourpregnancy.Thebest

resourcescanbeyourfriendswhoseparentingstylesyourespect.Thepediatricianyouselect does not need to come to North Austin Medical Center. There is team ofwonderfuldoctorswhowillhelptakecareofyournewbornduringyourhospitalstay.Mostpediatricofficesofferanopportunitytomeettheirstaffpriortoyourbabybeing

Page 18: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

born.Donot assume they are acceptingnew clients. Callbefore yourbaby is born toestablisharelationship.

• Preregistration:ExpectantmotherscansavetimeandpreregisteratStDavid’sNorthAustin Medical Center by visiting https://stdavids.com/patients-visitors/patient-services/hospital-pre-registration.dot. A link is also provided via our website,obgynnorth.com.Preregistrationisideallydoneanytimefrom20-36weeksgestation.

• HospitalTour:TakingatouroftheWomen’sCenteratNorthAustinMedicalCenterishighly recommended if this will be your first birth there. Being familiar with theenvironmentcanhelpalleviateanxietyandfindingyourwayaroundbeforelaborstartsmakes the check-in process less stressful. Tours last approximately 60mins and areoffered every Saturday at 10:00 a.m., 12:00 p.m. and 2:00pm. To register for a tour,please call (512) 478-3627 or register online athttps://stdavids.com/calendar/index.dot.

• MeetandGreet–PleaseseeourwebsiteforthedatesofourproviderMeetandGreetandHospitaltourwithoneofourproviders.Thesealternatemonthsandtheschedulingstaffcanassistyouinsigningup.

• Doula: Youhavetheoptionofhiringadoula foradditional laborsupport.Adoula isa

trained labor support person (not a medical professional) who provides continuousphysical,emotional,and informationalsupportduring labor.Adouladoesnotreplacethe labor partner but provides experienced guidance and an additional set of hands.Postpartumdoulasareavailable toprovidesupportathome in theearlyweeksafteryourbabyarrives.Alistofover50localdoulascanbefoundatwww.centexdoulas.org.

• Circumcision: If you are having a son, you will need to decide if you want himcircumcised.This isanoptionalprocedureandoftenapersonaldecision.Someof thephysiciansatOBGYNNorthofferthisservice.Wedonotcircumciseatthehospitalpriortodischarge, and insteadwe complete theprocedure inour clinic in the earlyweeksafterbirth.Pleasecallourofficetoschedulethisafteryoudeliver.

• LeadProviderProgram:OBGYNNorth isproudtoofferaLeadProviderProgramtoall obstetrical patients. As a collaborative practice, our patients have always visitedwith all providers – both physicians andmidwives – who could possibly be at theirbirth. We also want to help patients feel continuity of care and grounding with aproviderwhoseesthemmoreconsistently.TheLeadProviderwillseeapatienteveryothervisit,whiletheinterveningappointmentswillbewiththeotherprovidersinthepractice.Thisoffersbothcontinuityandcollaboration.Eachproviderwillhavealimitto howmanypatientsmay be assigned to themper due datemonth to ensure equaldistributionofpatients. Weaskthatpatients identifywhotheywouldpreferas their

Page 19: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

LeadProviderby their20weekappointmentor earlier. If youhavequestions aboutthisprogram,pleaseletusknow.

• CordBloodBanking:Ifyouareconsideringdonatingorsavingyourbaby’sstemcellsortissuefromtheumbilicalcord,arrangementsneedtobemadebefore laborbegins.Screening and registration can take a few weeks so we recommend contacting thecompanyofyourchoicepriorto35weeksgestation.Cord blood stem cells have been used to treat somemetabolic disorders, cancer andblooddisorders.Promisingresearchsuggestsstemcellsmaybeusedtotreatimmunedisorders, brain injury, hearing loss, juvenile diabetes and spinal cord injuries. Statelawrequiresinformationbeavailabletoexpectantparents.Theirbrochureisavailableon line at: http://www.dshs.state.tx.us/mch/#Umbilical2.We are happy to provide apublishedversionuponrequest.TheStatesuggestthefollowingresources:

NationalMarrowDonorProgram-Listsofhospitalsthatacceptcordblooddonations.Phone:1-800-627-7692WebAddress:www.marrow.orgParent’sGuidetoCordBloodBanks-Informationforparentsoncordbloodbanking,andlistsprivateandpubliccordbloodbanks.WebAddress:www.ParentsGuideCordBlood.comSouthTexasBlood&TissueCenter-Informationontheprocessandbenefitsofcordbloodbankinganddonation.Phone:1-800-292-5534WebAddress:www.bloodntissue.org/texascordbloodbank

Wedonotrecommendanyonecompanyandencourageyoutoexploreyouroptions.Thismaynotbeanall-inclusivelist.Pleasevisittheirwebsitesforinformation,pricingandcurrentdiscounts.

• CordBloodRegistry(CBR) • Cryo-CellInternational • ViaCord • StemCyte • CorCell • LifebankUSA • FamilyCordBloodServices • Stembanc

8.Ourwebsiteshavealotofwonderfulinformationbeyondwhatislistedhere.Pleasevisitus atwww.obgynnorth.com and click on patient education and visit us atwww.natural-beginning.comandclickonpatienteducation.

LaboratthehospitalandbirthAtthehospital…

Page 20: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• Afteryouspeaktousonthephone,WEwillcallthehospitalandnotifythenursingstaffthatyouwillbearriving.WewillmeetyouinLaborandDelivery.

• The nurses will monitor the baby’s heart for 30 minutes and ask you questionsaboutyourhealthhistoryandlabor.

• Wewill likely examineyour cervix to assess laborprogress. Once it is confirmedthat labor iswellunderway,a saline lock (baseofan IV)willbeplacedandyourbloodwillbedrawn.

• Wewill likely encourage you to be out of bed,walking, showering, sitting on thebirthballetc.Wegenerallydointermittentmonitoringofthebaby’sheartbeatfor5minutesoutof every30minutes.Youareencouraged tobringabirthball,music,essential oils or your own gown/clothes for comfort. Your own pillow may alsoprovidegreatcomfort.

• Wewantyou todrink liberallybecauseyouwillnot likelyhave IVhydration.Youmaybringwhateverdrinksyouenjoyincludingboththosewithandwithoutsugarto provide energy. Manywomen prefer not to eat during labor because they areeither not hungry or are nauseated. If you are hungry during early labor, weencourageyoutoeatfoodsthatareeasilydigestedandnotspicyoracidic.

• Wewilllikelynotcheckyourcervixagainuntilyouoryourbabyshowsignsoflaborprogression. We try to avoid exams after your water is broken due to risk ofinfection.

• Anursewillassistyouduringlaborandwewillbeintocheckonyoufrequently(atleasteverytwohours).Weareavailablewhenyouneedus.

• Whenyouarereadytopush,youwillbefreetotrymultiplepositionstodeterminewhatworksbestforyou.Wearecomfortableassistingmothersstanding,squatting(squat bars available), hands-knees or side-lying.Wewill usually bewith you theentiretimeyouarepushing.

• Wecanusewarmcompressesandoliveoiltoassistthestretchingofyourtissuetohelpdecreasetearing.Episiotomiesarerareandweallowtimeforyourperineumtostretch.Occasionallyanepisiotomyisbeneficialinanemergency.

Whenyougivebirth…

• Ateachbirththereareusuallythreehealthcareprofessionals.AdoctorormidwifefromOBGYNNorthwill be therewithyou.Therewill be two registerednurses; anursetotakecareofyouaswellasanursetocareforyourbaby.Youmayhaveasmanysupportpeoplewithyouasyouwish,butweencourageyouto includeonlythosewhoaresupportiveofyourbirthpreferencesandwillofferencouragement,notbringstress.Ifyouwanttohaveayoungchildintheroom,youneedtohavea

Page 21: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

specified support person for the child so they can leave the room together if thechildfindsthebirthtoointense.

• Immediatelyafterdeliveryyourbabywillbeplacedonyourabdomenanddriedoff.Weprefertoleavetheumbilicalcordattacheduntilitstopspulsating,usuallyonetofiveminutesafterdelivery.Ifyouarecollectingyourbaby’sstemcellsforbanking,weneedtocutthecordwhileitisstillpulsingtoobtainanadequatevolumeofcordblood.

• Your baby will be assessed while resting on your chest or abdomen unlessintervention is needed to help your baby make the transition to breathing forhimself.

• WeassessyourindividualsituationtodetermineifPitocinwouldbebeneficialafterdeliverytoassistwithdecreasingvaginalbleeding.

Afterdelivery…

• Youandyourbabywillremain inyour laborroomfor1-2hours forrecoveryandevaluation.Thenursewillcheckyourvitalsignsandbleedingfrequently.Thebabywillbequicklyweighedintheroomandthenursewillhelpyouwithbreastfeeding.

• Whenyouarereadytogotothepostpartumroom,yourpartnerandbabyusuallygotothenurseryforafullphysicalexamandbath.Youmayaccompanyyourpartnerifyouchoose.Mostwomensettleintheirpostpartumroomandentrusttheirpartnerwiththeseresponsibilities.ThevitaminKinjectionanderythromycineyeointmentare hospital and state standards respectively and must be given in the first twohours of life. You may decline both if you are strongly opposed. Hepatitis Bvaccinationisoptionalforyournewbornduringthehospitalstay.Itcanbedeclinedordelayed.

• Because your placenta is an organ, Texas law requires the hospital to properlydisposeofit.Ifyouwanttokeepit,youmustgetacourtorderbeforelaborstarts.Pleaseseeourwebsiteforadetaileddescriptionofhowthisisaccomplished.

• Thestandardhospitalstayistwodaysafterdelivery.Ifyoupreferto leavesoonerthan36hours,youshouldmakearrangementswithyourpediatricianinadvanceasitisthebaby’sdischargethatgenerallycausesthedelay.

• Oneofourproviderswillseeyoueachdayyouareinthehospital. Weaskyoutoreturn to our office six weeks after your baby is born, or sooner for certaincircumstances. At this time we will discuss contraceptive options for those whodesireit.

Page 22: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

LaborandbirthatNaturalBeginningBirthCenter

• Afteryouspeaktousonthephone,wewillmeetyouattheofficeofOBGYNNorthtoevaluate you and your labor. If you are comfortablewith an exam,wewill checkyourcervixtoassesslaborprogress.

• Themidwiveswillmonitor thebaby’sheart for20minutesas longasyouarenotimminently delivering. Together you will determine if it is the right time to beadmittedtothebirthcenter.

• Once admitted to the birth center, your baby’s heart rate is monitored every 30minutesusingadopplerultrasoundandmorefrequentlyaslaborprogresses.

• You are encouraged to move freely throughout your room. We have birth balls,peanutballs,andotherbirthtoolstohelpwithpositioningandcomfort.

• Whenyouareready,yourbathwillbedrawnandyouarewelcometolaborinthetub.Ourtubshavesanti-jetsforyourcomfortandnumerousitemstomakelaboringinthewatercomfortable.

• Weencourage you to eat and drink throughout the labor process. Youmay bringwhateveryouenjoyincludingdrinksandsnackswithandwithoutsugartoprovideenergy.We encourage you to eat foods that are easily digested and not spicy oracidic.Thebirthcenterhasakitchenetteforyourconvenience.Pleasebringfoodforbothyouandyourpartner.

• Wewilllikelynotcheckyourcervixagainuntilyouoryourbabyshowsignsoflaborprogression. We try to avoid exams after your water is broken due to risk ofinfection.

Page 23: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• Whenyouarereadytopush,youwillbefreetotrymultiplepositionstodeterminewhatworksbestforyou.Wearecomfortableassistingmothersstanding,squatting,hands-kneesorside-lying.Manymothersenjoypushinginthetubaswell.

Whenyougivebirth…

• At each birth there are usually two healthcare professionals; yourmidwife and anurse. You may have as many support people with you as you wish, but weencourageyouto includeonlythosewhoaresupportiveofyourbirthpreferencesandwillofferencouragement,notbringstress.Ifyouwanttohaveayoungchildintheroom,youneedtohaveaspecifiedsupportpersonforthechildsotheycanleavetheroomtogetherifthechildfindsthebirthtoointense.

• Immediatelyafterdeliveryyourbabywillbeplacedonyourabdomenskintoskinanddriedoff.Weprefertoleavetheumbilicalcordattacheduntilitstopspulsating,usuallyonetofiveminutesafterdelivery.

• Your baby will be assessed while resting on your chest or abdomen unlessintervention is needed to help your baby make the transition to breathing forhimself.

• WeassessyourindividualsituationtodetermineifPitocinwouldbebeneficialafterdeliverytoassistwithdecreasingvaginalbleeding.

Afterdelivery…

• Following delivery, you and your baby will be evaluated often to ensure a saferecoveryfrombirth.Thenursewillcheckyourvitalsignsandbleedingfrequently.Shewill also regularlyevaluatebaby’s statusandvital signs.Bothyournurseandyourmidwife will be continuously available to assist with breastfeeding and anyotherneed.

• Atapproximately1-2hoursoflifeourmidwiveswillassessbabyfromheadtotoe,determinebaby’sweight,andadministerbirthmedicationsifyouwouldlike.

• Aftermother’s recovery is complete, approximately2hoursafterdeliveryof yourplacenta,wewill draw an herbal bath for you to relax in. Some families also likebabytojoinmomintheherbalbathwhichtheyarewelcometodo.

• Oftenourfamiliesresttogetherfor2-3hoursthengathertheirthingstopreparetogohometogether.

Athome…

• We will come to your home at 24-48 hours of life to evaluate how you aretransitioningtolifetogether.Wewillpreformafullassessmentofmomandofbaby,

Page 24: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

re-check baby’sweight, perform a lactation consultation, and complete the TexasNewbornScreenifyouwouldlike.

• At3daysoflifeyouandbabyreturntothebirthcenterforanotherevaluation.Wecompleteafullassessmentofmomandofbaby,re-checkbaby’sweight,performalactation consultation, and if agreeable we will complete a hearing screen andcardiacscreenonbaby.

• Wewillseeyouagainin6weeksafterdeliveryatOBGYNNorthtoevaluatehealinganddiscusscontraceptiveoptionsifyoudesireit.

Page 25: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

PostpartumCare

• Exercise: Youmay start gentlewalking for exercise at twoweeks postpartum.Takethebabyinaslingorstrollerandenjoysomefreshair.Waituntil6weekspost partum to start an exercise program such as running, biking, weights,swimming, or yoga. Pilates is excellent for restoring the vaginal tone andpreventingincontinence.

• Intercourse:Werecommendwaitinguntilafteryour6weekpostpartumvisittoresume intercourse. We will make sure your body is healed and discusscontraceptionwithyou.Throughoutyourbreastfeedingjourney,itmayhelpyoutofeelmorelubricatedtouseaniceoilduringintercourselikecoconutoiloralubricantsuchasAstroglideorKYLiquid.

• Read the section on Post Partum Depression and Anxiety. Share it with yourpartnerandanyoneelsenearyouafterbabyisbornsotheyknowthesignsandsymptoms to watch for. Isolation and sleep deprivation can increase thelikelihoodofexperiencingdepressionandanxiety.Seekoutotherparentswithchildren to socialize with; look for playgroups, postpartum exercise/yogaclasses, or La Leche League meetings. Austin has a lot of parents eager tonetwork inpersonoronlinegroups.Contactouroffice immediately if you feellike you are experiencing signs or symptoms of postpartum depression oranxietysowecanhelpyou.

• Sleep deprivation is hard. Breastfeeding moms usually need a daily naps for

several months. Recharge yourself with rest, having your partner andfamily/friendscareforthebabyattimesintheearlyweeksofmotherhood.

• Ifyouhaveasonanditisyourdesiretohavehimcircumcised,itwillbeinourofficeduringthefirstmonthoflife.

PostpartumDepressionandAnxietyHavinganewbabyisalifealteringevent.Althoughitisoftenajoyfulperiod,theremaybetimeswhenitisnot.Thesearesometipstohelpyouunderstandfeelingsad,overwhelmed,anxious,andhelpyoutorecognizewhenyoushouldaskforhelp.

Page 26: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

MaternityBlues/BabyBlues

Mostwomenwillhaveshortperiodsofmoodswings,tearfulness,orirritabilityduringthefirstweeksafterbirth,whichcanbeworsewhenyouaretired.Thisisanormaladjustmenttonewparenthood. Ifyouarenotsleeping,oryouarebecoming increasinglyupset,youshouldcallouroffice.

PostpartumDepressionandAnxiety

About1ofevery10womenwilldevelopseriousdepressionoranxietyduringthefirstyearafterbirth,moreofteninthefirstfewmonths.Havinganyofthesymptomsbelowdoesn’tmeanthatawomanisweakorafailureasamother.Motheringisalearningprocesswitheach child. If you have several of these symptoms that persist or recur, please call ouroffice.

• Feelingsofpanic• Lossofappetite• Fearthatyouwillhurtyourselforyourbaby• Feelingguilty• Feelingsofanxiousnessandinsecurity• Feelingoverwhelmed• Cryingdaily• Feelinglikeyouarenotnormalorrealanymore• Difficultysleeping—youcan’tsleep,evenwhenthebabyissleeping• Angry;feelinglikeyoumightexplode• Feelinglonely• Can’tmakedecisions• Inabilitytoconcentrateorfocus• Thinkingthebabymightbebetteroffwithoutyou• Racingthoughts,youfeelyoucan’tsettledownorrelax• Youareafraidtobealonewithyourbaby• Youareworriedallthetimeandnothinganyonesaysseemstohelp

PostpartumPsychosis

A small number ofwomenwill experience amore severe postpartum reaction inwhichthey losetouchwithreality.Womenwhodeveloppostpartumpsychosismayhearorseethingsthatarenotthere,orexhibitstrangeandsometimesdangerousbehavior.Thisisatrueemergencyandrequiresimmediatehelp.

WhoDoesthisHappento?

Postpartum depression and anxiety affect women from all walks of life. The cause isprobablyacombinationoffactors,includinghormonechangesthatoccurafterbirth,whichcanaffecthowthebrainfunctions.Womenwithahistoryofdepressionandanxiety(eventimesofjust“feelinglow”),afamilyhistoryofdepressionoranxiety,orstressfullifeeventsaremore likely to developpostpartumdepression and anxiety. Childbirth is amajor lifeevent,anditcantriggerreactionstopasttrauma.Ifyouthinkthatanyoftheserisksapplytoyou,talkwithusaboutitbeforeyourlaborandbirth.

Page 27: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

MoreInformation

• Weareheretohelp.Pleasecallourofficeifyouareexperiencinganyoftheabovesymptoms.(512)425-3825.

• PregnancyandPostpartumHealthyAllianceofTexasisaccessible24hoursadayandconnectswomenwithhealthcareproviderswhocanassistthem.http://pphatx.org.

• DepressionAfterDelivery,Inc.91EastSomersetStreetRaritan,NJ088691-800-944-4773(4PPD)www.depressionafterdelivery.com

• PostpartumSupportInternational927N.KelloggAve.SantaBarbara,CA93111CALL:(805)967-7636FAX:(805)967-0608www.postpartum.net

• AmericanCollegeofNurse-Midwiveswww.midwife.org/focus

SAMPLEBIRTHPLAN

____Itisourdesiretohaveanatural,non-medicated,intervention-freechildbirth.

____Itisourdesiretohaveepiduralanesthesia.

Weunderstandtheneedtobeflexible.Ourgoalistohaveasafe,healthybirth.Thankyouforinformingusofallchangesinmotherorbaby’sconditionthatwouldwarrantanyinterventionorcauseachangeinourplans.Wedesiretobeasinvolvedinthedecision-makingprocessaspossible.

____Werequestthatwebenotifiedofanyvisitorpriortoallowingthemintothelaborroom.

____Iprefertowalk,changepositions,haveaccesstomybirthingballandshowerasdesired.

____Iprefertoremaininbedtorestandconservemyenergy.

____Ipreferasalinelock,takeoralfluids,andonlyhaveanIVifnecessary.

____IprefertohaveanIVforhydration.

____Ipreferintermittentfetalmonitoring,onlycontinuousmonitoringifnecessary.

____Iprefercontinuousfetalmonitoring,hearingthebaby’sheartbeatiscomforting.

____Iprefernottobequestionedregardingthepainscale.IfIfeeltheneedfordrugs,Iwillask.

____IwouldlikeamirroravailableifIchoosetoviewthebirth.

____Iwouldliketobegiventheoptionoftouchingmybaby’sheadass/hecrowns.

____Mypartnerwouldliketheoptionofcuttingthebaby’scordafterpulsatingstops.

Page 28: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

____Mypartnerwouldliketheoptionofhelpingwiththebaby’sbirth,ifpossible.

____Weplantobankourcordblood,wewillbringthekit.___plantodonatecordblood

____Iprefertoavoidanepisiotomy:warmcompresses,oliveoil,andslowdeliveryifpossible.

Afterthebirth,ifpossible,Iprefer:

____Babyplacedskin-to-skin_____Cleanbabypriortoplacinginmyarms

____Breastfeedassoonaspossible_____Ineedtimetorecover,breastfeedlater

____Ideclineapacifier,formula,orsugarwaterforbaby

____Yes___NoHepatitisBinjection.Yes___No___Ifbabyisaboy,plancircumcision

GeneticTestingConsent

ThefollowinggeneticandspinabifidascreeningsareofferedatOBGYNNorth.Thetestingisoptionalandspecifictestsaredeterminedbytheageofthemother.Pleaseindicateifyouprefertoacceptordeclinegeneticandspinabifidascreenings.

AcceptDecline

Between11and13weeksacombinationofbloodtestandultrasoundisofferedtohelpdetermineyourbaby’sriskforchromosomaldisorders,suchasTrisomy13,18and21.

Additionaltestingisavailabletofamilieswhoseinitialscreeningindicatespotentialissues.TheseincludeinvasiveproceduressuchasAmniocentesisandChorionicVilliSampling(CVS).Becausetheseproceduresarenotrisk-freetothebaby,theyarenotroutinelyofferedtolowriskwomenandwillbediscussedonlyifothertestingindicatestheycouldbeuseful.RecessiveCarrierTestingisabloodtesttodetermineifapersonisacarrierofcertaininheriteddiseases.Itisavailablepriortoorduringapregnancy.Thisbloodtestdetermineswith99.9%accuracyifapersoncarriesthe

Page 29: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

geneforover100inheriteddiseases,includingCysticFibrosis,SpinalMuscularAtrophy,FragileX,Tay-SachsandSickleCellDisease.Resultsareavailablein2-3weeks.

Ihavebeengivenanopportunity todiscussgenetic testing. Iunderstandadditional informationaboutthetestingIhaveselectedwillbeprovidedtomeuponrequest.

____________________________________________________________________________________________________________

PrintedName Signature Date

Providerinitials_____________

Facility Fee We maintain contracts with most major insurance companies

Please contact our billing department for a personalized estimate

Prenatal,Childbirth,andBreastfeedingEducation• PreparedChildbirthClass–AfourweekclassseriesMondaysorTuesdaysfrom6:30p-9:00p

requiredforallfirsttimeparentsandavailabletoallmothersdeliveringatNBBC.Werecommendyoustarttheseriesat32weeks.

• LaborSkillsClass–thisisasinglesessionclassonSundaysfrom3:30p-6:00pforrepeatclientsormotherswhohavedeliveredbefore.

• GettingReadyClass–requiredclassforallclientswhoarenotparticipatinginBeginningTogether.Thisclassshouldbecompletedbeforeyour37thweekandisofferedevery3rdWednesdayofthemonthfrom6:30p-8:00p.

• PrenatalBreastfeedingClass–thisisa2hourclassleadbyStorkMaternityConsultingIBCLC.

• Accesstocomprehensivereferralnetworkofproviderswhosupportunmediatedchildbirth–includingchiropractors,acupuncturists,pediatriciansandmore.

LaborSupportandManagement• 24hoursaday7daysaweekaccesstotheoncallCertifiedNurseMidwife(CNM)startingat37

weeksandcontinuingafterbabyisdelivered.

Page 30: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• Minimalinterventioncareofmotherandbabythroughlabor,birth,andpostpartumrecoveryincludingSanijetbirthtubs,aromatherapy,IVhydration,oxygentherapy,NitrousOxidetherapy,infantimmediatelyplacedskintoskin,delayedcordclamping,breastfeedingsupport,andaherbalLeBoyerBathfollowingdelivery.

• AllNaturalBeginningBirthCenter(NBBC)CNMshaveprivilegestocontinueyourlabormanagementandbirthatSt.David’sWomen’sCenterofTexasatNorthAustinMedicalCenterwhichisdirectlyacrossthestreet(lessthan5minutebywheelchair)intheeventofatransfer.

• BecauseNBBCisapartofOBGYNNorth,youhavethepeaceofmindhavingmettheallfemaleOBGYNstaffwhowouldassistintheeventtheyareneededsuchasacesareansectionorassisteddelivery.Furthermore,youwillnothavetolocateanewpracticeifyourpregnancybecomeshigherriskandrequiresahigherlevelofcareeitherduringtheprenatalperiodorwhileinlabor.

• AllnewbornsareofferedstandardnewbornmedicationsincludingVitaminKandErythromycinointmentifyouchoose.

• AfullheadtotoeassessmentandBallardscoringarecompletedonbabyexactlyasheorshewouldreceiveinthehospital.

• NaturalBeginningisfullyaccreditedbyCABCandthereforemaintainsthehigheststandardsofqualityandevidencebasedmidwiferycare.

• WemaintainafullyequippedbirthcenterwithallnecessaryemergencymedicationsandequipmentaswellasastaffofhighlytrainedandCNMsandnurses.

PostpartumSupport

• 24hour,7dayaweekaccesstotheCNMoncall.

• Atapproximately24hoursoflifeoneofourexperiencednurseswillcometoyourhometoperformafullassessmentofmotherandbaby,providealactationconsultation,performaweightcheck,andcompletetheinfantmetabolicscreeningifyouchoose.

• 3daysafterbabyisbornyouwillhaveafollow-upvisitatthebirthcenterwithoneofourmidwives.Theywillcompleteafullassessmentofmotherandbaby,providealactationconsultation,performaweightcheck,completeahearingscreen,andcompleteanewborncardiacdefectscreen,ifyouchoose.

• Allrecordsareprovidedtoyourpediatricianofchoice.

• Accesstoacomprehensivereferralnetworkofpostpartumresourcesincludingbreastfeeding,counseling,andparentingsupportgroups.

PregnancyResources

Thisisnotanexhaustivelist.Forgiveusifweleftyouoff.IfyouwouldlikeyourcompanyaddedpleasecontactLMonty@obgynnorth.com

Page 31: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

Websites:

• TheChildBirthConnectionhttp://www.childbirthconnection.org/

• EvidenceBasedBirthhttps://evidencebasedbirth.com/

• LeLecheLeaguehttps://www.llli.org/

• KellyMomhttps://kellymom.com/

Books

• TheBirthPartner:ACompleteGuidetoChildbirthforDads,Doulas,andallotherlaborCompanionsbyPennySimkin

• SpiritualMidwiferybyInaMayGaskin• BirthMattersbyInaMayGaskin• InaMay'sGuidetoChildbirthbyInaMayGaskin• Bountiful,Beautiful,BlissfulbyGurmukhHYPERLINK"https://www.amazon.com/Gurmukh-Kaur-

Khalsa/e/B001KDGDSO/ref=sr_ntt_srch_lnk_1?qid=1530908052&sr=1-1"KaurKhalsa• Intothesehands;wisdomfrommidwivesbyGeradineSimkins• BirthingFromWithinbyPamEnglandandRobHorowitz• ExpectingBetterbyEmilyOster

• TheThinkingWoman’sGuidetoaBetterBirthbyHenciGoer

• TheUltimateBreastfeedingBookofAnswersbyJackNewman

• TheNursingMother’sCompanionbyKathleenHuggins

• BreastfeedingMadeSimple:SevennaturallawsfornursingmothersbyNancyMohrbacherandKathleenKendall-Tackett

Doulas

• StorkMaternityhttp://storkmaternityconsulting.com/

• CentralTexasDoulas-DoulaDirectoryhttp://centxdoulas.org/

• https://www.matriarchmothercare.com/

• SallyPierce-Leissnerwww.sallyleissner.org

• TheLivingWellhttp://www.the-living-well.com/

• ATXdoulashttps://www.atxdoulas.com/

• AustinDoulaCarehttp://austindoulacare.com/

• AustinBornhttp://www.austin-born.com/

• DoulasofAustinhttp://www.doulasofaustin.com/

• Birth360https://www.birth360.net/

Page 32: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• GALShttp://www.givingaustinlaborsupport.org/

PostpartumDoulas

• CentralTexasDoulas-DoulaDirectoryhttp://centxdoulas.org/

• TheLivingWellhttp://www.the-living-well.com/

• ATXdoulashttps://www.atxdoulas.com/

• AustinDoulaCarehttp://austindoulacare.com/

• AustinBornhttp://www.austin-born.com/

• StorkMaternityhttp://storkmaternityconsulting.com/

• DoulasofAustinhttp://www.doulasofaustin.com/

• Birth360https://www.birth360.net/

• GALShttp://www.givingaustinlaborsupport.org/

LactationSupport

• StorkMaternityhttp://storkmaternityconsulting.com/

• TheMilkMavenhttp://www.mamamilkmaven.com/

• AustinBornhttp://www.austin-born.com/

• MamaMantrahttp://www.themamamantra.com/

• SpecialAdditionMaternityandNursingBoutiquehttps://www.maternityandnursing.com/#

CommunitySupport/MomGroups

• PartnersinParentinghttps://www.pipaustin.org/

• AustinBornhttp://www.austin-born.com/

• StorkMaternityhttp://storkmaternityconsulting.com/

• MamaMantrahttp://www.themamamantra.com/

PrenatalMusic

• CenterforPrenatalMusic-GiselleE,Whitwell,certifiedmusictherapist.www.prenatalmusic.com

[email protected]

PrenatalYoga/Fitness

• JillBirthttps://www.jillbirtyoga.com/

• SoulStrongYogahttps://www.soulstrongyogatx.com/

Page 33: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• SummerGrenleeshttps://summergreenlees.com/

• YogaYogahttps://www.yogayoga.com/

• FitforMomhttps://austin.fit4mom.com/

• HelloMyTribehttp://www.hellomytribe.com/

• OnlinecoursesspecifictoprenatalyogawerecommendStephanieSnyderhttps://www.yogaglo.com/

• LilianJuneWellnesshttp://lillianjunewellness.com

Acupuncture

• SageAcupuncturehttps://reproductiveacupuncture.com/

• SongbirdAcupuncturehttp://songbirdacupuncture.com/

• BonaDeaHealinghttp://bonadeahealing.com/

• LightFamilyAcupuncturehttp://lightfamilyacupuncture.com/

• LotusChiropracticandAcupuncturehttp://www.lotusatx.com/

Chiropractors

• ThriveChiropracticCenterhttp://www.thrivechiroctr.com/

• PureLightChiropractichttps://www.purelightchiro.com/

• LotusChiropracticandAcupuncturehttp://www.lotusatx.com/

• VibrantLifeChiropractichttps://www.vibrantlifecc.com/

• AustinChiropracticandAcupuncturehttp://www.austintxchiro.com/

• ActiveLiveHealingCenterhttp://www.activelifemedicalcenter.com/

CraniosacralTherapyandMassage

• SallyLeissnerhttp://www.sallyleissner.org/

• NinaDavishttp://www.ninafdavis.com/

• GBKhalsahttp://www.gbkhalsa.com/

• SummerGrenleeshttps://summergreenlees.com/

• MantisMassagehttps://www.mantismassage.com/

PlacentaEncapsulation

• HillCountryPlacentashttp://www.hillcountryplacentas.com/

Page 34: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• WomanCrafthttp://www.womancraftaustin.com/

• MamaPeacehttp://www.mamapeace.com/

BirthandPregnancyPhotography

• MosaicBirthStorieshttp://mosaicbirthstories.com/

• AustinBirthPhotoshttps://austinbirthphotos.com/

• LeilaniRodgershttps://www.photosbylei.com/

• PaigeWilkshttp://www.paigewilks.com/

PelvicFloorTherapy

• SullivanPhysicalTherapyhttps://www.sullivanphysicaltherapy.com/

• HolisticPelvicFloorHealthandWoman’sEmpowermenthttp://www.awakenempowerheal.com/

• CentralTexasMFRhttps://centraltexasmfr.com/

• HumanaePhysicalTherapy

FrenotomyReferrals

• GreenApplePediatricDentistrywww.greenapplepedictricdentistry.com• CapitalOtolaryngologypediatricENTwww.capolo.com• AustinPediatricDentistrywww.atxkidsdentist.com• JulieAMartinezD.D.S,P.C.http://childrensdentistwoodlands.com/frenotomy.php• TinyTexansPediatricDentistryhttps://www.tinytexansteeth.com/

Post-PartumResourceList

Resources

PregnancyandPostpartumHealthAllianceofTexashttp://pphatx.org/

PostpartumSupportInternationalhttp://www.postpartum.net/

PostpartumProgresshttp://www.postpartumprogress.com/

OnlineCounselingServices

wwww.betterhelp.com–BetterHelpisanonlinecounselingservicewithsessionsfromthecomfortofyourhome.Newfamiliescanfindthisoptionconvenientandpractical.Yourplanincludesunlimitedonlinechatswithyourcounselor,ajournal,and1sessioneachweek.

In-PersonCounselingProviders

KelliFoulkrod,LPA,LPCIhttp://www.counselingfornewmoms.com/

Page 35: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

512-200-3359Dr.KarenSeroussi(psychiatrist),formerLCandpatienteducatorhttp://vibrantmindsclinic.com/kBio.html512-330-0428Elizabeth-AnneRains,MA,LPC2525WallingwoodBldg1,Suite216Austin,Texas78746Earains_lpc@yahoo.comMeganBarnesZesatiwww.meaganbarneszesati.commbztherapy@me.com512-590-2714JWorthKilcrease,MBA,MA,LPC,FTSpecializesinperinatalloss,childloss,orpregnancyafterloss4833SpicewoodSpringsRoad,Suite101Austin,Texas78759JuneWilliams,MA,LPC1101ArrowpointDrive,Suite207CedarPark,Texas78613940-613-3733June.k.williams@gmail.comLynnSpillar2224WalshTareltonLane,Suite110Austin,Texas78746512-329-9294DenaeRickenbacker,Psychiatrist11901WestParmerLane,Suite310CedarPark,Texas78613512-690-2075www.cedarparkpsych.comDianeNguyen,Psychiatrist1010RR620Suite107Lakeway,Texas78734512-502-4556www.drdianenguyen.comLindseyIrons,LPCIronscounseling&Supervision13625PondSpringsRoadSuite105Austin,[email protected]

Page 36: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

Dr.SaraGriesmerLicensedPsychologist512-553-1563office512-900-8994cellwww.psychologycenterofaustin.comwww.counselingfornewmoms.comKatiePendleton,LCSWN/WAustinLocation13625PondSpringsRoadSuite105Austin,Texas78729LakewayLocation1901RanchRoad620Lakeway,[email protected],LCSW603W.14thStreetAustin,Texas78701512-925-7766www.annafrancislcsw.comanna.francis.lcsw@gmail.comEllieGamble,LCSW5*926BalconesDrive,Suite200Austin,Texas78751512-971-7029ElaineCavoazos,LCSW8401ShoalCreekBlvd,Suite102Austin,Texas78757512-472-7878ext.304MargerySegalMargerySegal@WholeMovementCenterSpecializinginmovementtherapy,developmentalmovementre-patterning,psychotherapy,healingfrombirthtrauma

SupportGroups:CommunityBuilding

PIPPartnersinParentingwww.pipaustin.orgAnyBabyCan

• WeeklyonThursday10-11:30• Nocostorappointmentnecessary,walkinwelcomes,babieswelcome• FacilitatedbyDr.KellyBoydPsy.D.

Page 37: interested in having your baby at our birth center, please ...Trisomy 13 (Patau syndrome) occurs in about 1 out of every 16,000 newborns. Like Trisomy 18, a pregnancy affected by Trisomy

• Address:6207SheridanAve.Austin,Texas78723• Phone:512-454-3743• Website:www.anybabycan.org• NewParentHelpline512-334-4444

HelloMyTribehttps://www.hellomytribe.com/TheMamaMantrahttp://www.themamamantra.com/AustinBornhttp://www.austin-born.com/CircleCCommunityCenterPost-PartumSupportGroupMONDAYevenings6:30-8:00@CircleCCommunityCenter512-791-5886

Austin-“MamasforMamas”Mondays;[email protected]

HOPEgroupatRonaldMcDonaldHouse:LedbyJWorthKilcrease,MBA,MA,LPC,FTSpecializesinperinatalloss,childloss,pregnancyafterloss