Maternity Services

If you are transferring your established obstetrical care to Atlanta Obstetrics and Gynecology Specialists, we need you to have your records sent to us prior to being accepted as a transfer patient. Once your records are reviewed, you will be contacted about the nextsteps prior to your first visit. Our insurance department must verify your benefits before your first visit.

If you have a positive pregnancy test result at home, call Atlanta Obstetrics and Gynecology Specialists to schedule an appointment for your obstetrical assessment. If you are not yet taking prenatal vitamins, call for a prescription or you can use a reputable over-the-counter prenatal vitamin containing iron and folic acid.

We encourage you to sign up for our office patient portal platform known as “Follow My Health.” Our website has several links to this helpful tool. The program allows you access to your medical information so that you can easily make an appointment, ask a question, and review your own lab results. If a lab result is abnormal, we will contact you.

There are some basic recommendations that you should follow once you become pregnant and leading up to your first OB appointment:

1. 1. Avoid smoking, alcohol, and recreational drugs: All of these activities increase the risk of miscarriage, bleeding, delivering smaller babies, premature babies, babies with developmental delays, and other serious complications. Also avoid second-hand smoke.
   2. Limit caffeine: Moderate caffeine consumption (less than 200mg per day) is not shown to be a major contributing factor in miscarriage or preterm birth. The relationship of caffeine to growth restriction remains undetermined.
   3. Artificial sweetener safety: Avoid substitute sweeteners similar to saccharine (the pink package). It does cross the placenta and there is not enough data collected on its safety. You can use Equal or Splenda in limited quantities, however recent data suggests artificial sweeteners may be associated with glucose intolerance.
   4. Avoid NSAIDS: NSAIDS are a group of pain and anti-inflammatory medications that can be purchased over the counter. This includes Motrin, Advil, Ibuprofen, Aleve, and aspirin. There are certain conditions in which a daily baby aspirin is recommended. Tylenol as directed is safe to take in pregnancy.

It is very important that you feel comfortable with your obstetrical care and providers. The physicians at AOGS are a close and collaborative obstetrical group who practice respectful and evidence-based medicine. When you go into labor, the physician on call will attend your birth. During prenatal visits, you may choose to see one or as many different providers as you like. We encourage you to see more than one of the physicians to get to know everyone in the practice.

The core staff of physicians at Atlanta Obstetrics and Gynecology Specialists who you will see during your prenatal visits deliver at the Northside Hospital Atlanta campus. However, we employ a group of staff physicians that deliver at the Northside Cherokee and Forsyth locations. You will discuss these options at your visit.

We calculate the age of your pregnancy from the 1st day of your last normal and reliable period. The average pregnancy lasts for 40 weeks. We will use your last period to calculate your estimated delivery date. However, if this due date does not match with the due date generated by your earliest ultrasound within so many days, your due date will be changed to reflect the ultrasound due date. Depending on your gestational age you may have a physical done which could include a pelvic exam. Each visit you will be expected to leave a urine sample so always come with a full bladder. At various times you will have blood work drawn so always try to be well hydrated before your visits. After 10 weeks we regularly listen to the fetal heart beat with a device known as a Doppler. Routine ultrasounds are done in the first trimester to confirm your due date and the pregnancy viability and again at 19-20 weeks of pregnancy to evaluate the fetal anatomy. Additional ultrasounds are performed when medically indicated.

Heartburn is very common and cannot always be avoided. Staying away from highly seasoned foods does help. Eating smaller, more frequent meals and not going to bed immediately after eating may also help. Medications such as Tums, Zantac or Pepcid are fine to take during pregnancy.

There is nothing that you can do to completely prevent morning sickness, but keeping food in your stomach by eating small frequent meals does help. You may find that if you eat and drink at the same time, your nausea will be worse so first eat and then drink. Don’t drink large amounts at one time; drink frequent small amounts instead. Avoid spicy highly seasoned foods. Carbohydrates seem to work best in the prevention of nausea. There are safe medications that can be prescribed for nausea and vomiting. For most women nausea subsides by 12-14 weeks of gestation.

All meats should be well cooked. All raw fruits and vegetables should be washed well. Deli meats need to be reheated in a microwave or grilled before eating. Soft cheeses need to be made of pasteurized milk. Fish is safe but you should avoid those that are high in mercury such as Swordfish, Shark, Tilefish or King Mackerel.

Fish and shellfish can be an important part of a balanced diet. It is a good source of high quality protein and other nutrients and is low in fat. The FDA and EPA are advising pregnant women and nursing mothers to eat the types and amounts of fish and shellfish that are safe to prevent harm to the development of their baby or young child. Methyl mercury exposure in the womb is caused by a mother’s consumption of fish and shellfish that contain methyl mercury. This can adversely affect a baby’s growing brain and nervous system. If you follow the advice given by both the FDA and EPA you will gain the positive benefits of eating fish but avoid any developmental problems from mercury in fish. To protect your baby follow these 3 rules

1. Do not eat Orange Roughy, Shark, Swordfish, King Mackerel, or Tilefish.
2. Levels of mercury in other fish can vary. You can safely eat up to 12 ounces (2 to 3 meals) of other purchased fish and shellfish a week.
3. Check local advisories about the safety of fish caught by family and friends in your local rivers and streams. Some local lakes and streams may be contaminated and fish from these areas should be avoided.

For additional information on the recommendations on fish and shellfish in your diet, you can go to the web site https://www.epa.gov/

If you have cats and have no one who can change the cat litter, then you must wear gloves to prevent any feces from touching the skin. Cat feces carries a bacteria called toxoplasmosis that can be dangerous to the pregnancy should you contract this bacteria. If you garden, wear gloves to prevent contact with the soil because the soil can also contain certain bacteria. Wash all raw fruits and vegetables well before eating them.

Avoid Hot tubs and saunas: If you are sweating, it’s too hot for the baby.

Avoid Herbs. Please do not use herbal preparations without first making sure they are allowed. Some herbal preparations can be very harmful and have even been known to cause a miscarriage.

You may have peppermint, ginger, and chamomile tea.

Low impact aerobics are safe to do. No free weights over 20 pounds. Water aerobics are very good and are offered in many locations. Pregnancy yoga is a good muscle exercise. Walking is one of the best types of exercise. If you play tennis, we recommend doubles. Never get over heated or so winded that you cannot talk. Remember to keep hydrated and avoid getting overheated by coming in and out of the sun more often. Wear heavy sunscreen, especially on your face.

You should sign up for the classes and the tour of Northside Hospital at 20 weeks gestation. You should begin the classes at 7 months gestation. Try to get the hospital tour before you reach 8 months gestation.

If you have a problem after office hours you can reach our on-call physician by calling the office phone number: 404 252-5196. An attendant will take down all of your information and page the physician on call. The physician will call you directly at the number you provide. Remember to keep your phone line open so the MD can reach you.

You should call the office for vaginal bleeding if it appears similar to a period. It is pretty common to spot, especially if you had a pap smear or a pelvic exam in the past 72 hours. Spotting is also common after intercourse.

Call us promptly with any of these symptoms: a fever over 100. 4 F, persistent headaches, persistent swelling, constant abdominal pain, nausea and vomiting-especially if you cannot keep down food or liquids. Also, call if your baby is not moving normally.

First-time moms may not recognize fetal movement until at least 20-24 weeks. Mom’s who have had other babies may recognize movement a few weeks sooner. At this early gestational age, you will not feel all of the movements.

High risk pregnancy means that you have a medical condition prior to pregnancy that requires additional testing or a condition of the baby or the mother that develops during the pregnancy that requires additional testing. Your age at delivery may also make your pregnancy high-risk.

Most pregnant women need to start wearing maternity clothes by 16-20 weeks.

A good time to begin preparing the nursery is beginning at about 7 months. Get on the registry at baby stores so friends can see what you need. You should have your car seat and know how to install it by 35 weeks gestation.

In short, the answer is: It depends. If you are considering a Vaginal Birth After a C/Section (VBAC) please talk to one of our providers as early as possible regarding our approach to VBAC deliveries.

All pregnant women should be offered prenatal assessment for chromosomal disorders by screening or diagnostic testing regardless of maternal age or other risk factors. Prenatal genetic tests are intended to screen or diagnose genetic chromosomal disorders present in the fetus. All pregnancies are susceptible to spontaneous genetic chromosomal disorders no matter how healthy the mother may be. Screening tests are reserved for low risk women under the age of 35. Screening tests are designed to give you the likelihood of there being a problem with the fetus. A diagnostic test is a more invasive procedure however it provides a more definitive answer regarding the presence of a fetal chromosomal abnormality. There are 2 first trimester and 1 second trimester screening tools available to estimate the risk of trisomy 13, trisomy 18 or trisomy 21 (Down Syndrome) affecting your fetus. The cell free DNA (cfDNA) screen or the First Screen-Nuchal Translucency are these first trimester screens. The AFP 4 is an alternative test offered in the second trimester. Diagnostic procedures are offered to women at risk for a chromosomal pregnancy complication. The CVS is offered in the first trimester and the amniocentesis is done in the second trimester. Your provider can review with you what option if any is right for you.

Prenatal genetic screening is mere blood work designed to assess if a non-pregnant patient or an expectant mother is at increased risk of having a fetus affected by a genetic disorder. For example we routinely screen for sickle cell anemia. In addition you can choose to be screened for disorders like cystic fibrosis, muscular dystrophy and many more inheritable disorders. Certain ethnic backgrounds are at an increased risk to carry genes related to genetic disorders.

GBS is a bacteria found in the vagina or urinary tract. At 35 to 36 weeks of pregnancy you will be tested to see if the bacteria is present. If so IV antibiotics are administered during labor to reduce the risk of a GBS infection in the newborn. Sometimes your initial urine culture will indicate the GBS bacteria is present. In that case you will be treated with oral antibiotics at the time the urine results are noted and again during labor.

Travel in pregnancy can be safe and enjoyable as long as you follow a few simple guidelines and you do not have pregnancy complications that could be worsened by travelling. The best time to travel is mid pregnancy (14-28 weeks of pregnancy). Most airlines allow travel until the 36 week of pregnancy. However some International airlines restrict travel as early as 28 weeks. Always check with your carrier. Try not to drive more than 6 hours a day. You should wear a seat belt while driving or riding in a car. Make sure if you cruise you avoid destinations where the food or water may not be safe. Some smaller cruise lines might not employ medical staff so avoid this potential. If you are planning a trip out of the country discuss it with your provider and travel agent first. Allow plenty of time to get any shots you may need. No matter how you travel wear loose, comfortable clothing, drink plenty of water and walk frequently to avoid blood clot formation in the legs or lungs.

Beware of places which may be a source of the Zika infection. The Zika virus is a mosquito-borne virus, however it can be transmitted in humans by other means. It has been associated with severe neurological outcomes in exposed fetuses. Travel to locations where ongoing Zika viral outbreaks are reported should be avoided if you are pregnant or you and your partner are thinking about pregnancy. For more information before traveling refer to:

http://www.cdc.gov/zika/

Please discuss your travel plans with your provider before purchasing your trip to avoid non-refundable payments. Bringing a copy of your prenatal records in case of an emergency is advised. Remember to pack your medications in carry-on luggage.