The goal of our practice is to provide you with comprehensive care for your pregnancy. As a patient, you have the choice of being followed through your pregnancy by either the midwives (if low risk) or the physicians.

You will be asked to identify the hospital of your choice for your delivery. Our physicians deliver at both the Finley Hospital and Mercy Medical Center. Kathe and Deb deliver at Finley Hospital exclusively.
We ask that you have a pregnancy test in our office or an outside laboratory to confirm the pregnancy. After confirmation is received, we will set up your first appointment to gather a thorough medical history, a family history, and past pregnancy history. We also go over general educational materials and answer any questions you may have. This appointment is generally scheduled 8-10 weeks after the first day of your last period. If the midwives will follow you, we ask that you identify this at the time of scheduling so we can schedule this interview with the midwives. For physician patients, this appointment is held with our Registered Nurses.

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The next appointment is routinely scheduled around 12 weeks after your last period. This is a complete physical examination by either the physicians or midwives. This includes a breast exam, a Pap smear, and standard STD testing. Following this appointment, you will be scheduled for appointments at 4-week intervals until you reach 28 weeks. From 28-36 weeks, you will be scheduled every two weeks, and weekly thereafter.

At your regular prenatal visits, we will weigh you, check your blood pressure, check your urine, measure uterus size, and listen for baby's heart sounds. We will also check for swelling or any other problems that may arise. You are encouraged to let us know about any bleeding, fluid leakage, pelvic pressure, headaches, visual changes, swelling, pain in urination or constipation. Ultrasounds are generally ordered between 16 and 20 weeks. They may be ordered at any time based on the individual circumstances of your pregnancy. We typically have patients go to either Finley Hospital or Mercy Medical Center for their ultrasounds unless we can get the information we need with our office ultrasound.

We ask that you rotate your appointments among the physicians or the midwives. This assists the providers to become acquainted with all patients in case they are on call when you have a question or go into labor. For example, if you select physicians, you will begin with a health interview with the nurses, have a physical exam and two follow-up visits with one of the doctors, then schedule appointments with the other three over the latter part of the pregnancy.

If you are a midwife patient, you may begin with a health interview and physical with Deb, then alternate seeing Kathe and Deb for the remainder of the pregnancy. Midwife patients also see the physicians on two occasions during your pregnancy, and this can be for two of your routine visits.

MEDICATIONS IN PREGNANCY / LACTATION
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During your prenatal and lactating period, the best policy is to avoid all medications, (especially in the first 3 months!) except your prenatal vitamins.  However, when you are troubled by certain common discomforts, there are a number of over-the-counter medications we recommend that are considered safe during pregnancy and/or with breastfeeding. Please take the adult dose recommended as listed on the medication.

ALLERGIES
Diphenhydramine  [Benadryl]
Chlorpheniramine [Chlor-trimeton]
Claritin
Zyrtec

COMBINATION ALLERGY / DECONGESTANT
Actifed [Pseudoephedrine plus Triprolidine]

CONSTIPATION
Docusate Sodium [Colace]
Metamucil
Fibercon
Fiber pills / supplement
Milk of Magnesia
Dulcolax suppository usage should be once a week or less. 
    * Increase your fluid and fiber intake

COUGH
Guaifenesin [Robitussin Plain or DM] 
Mucinex Plain or DM

DECONGESTANT (Stuffy nose)
Pseudoephedrine [Sudafed]
Saline nasal spray
Oxymetazoline [Afrin] nasal spray (has a rebound effect if used for more than 3 days).
Do not take any drugs containing phenylephrine HCl, i.e. Sudafed PE.

DIARRHEA
Loperimide [Imodium A-D]. 
Do not take Pepto-Bismol or Kaopectate as it contains salicylates (aspirin).

DIFFICULTY SLEEPING
Benadryl
Tylenol PM
Unisom

HEADACHE
Acetaminophen [Tylenol] 
Do not take Aspirin [acetylsalicylic acid] or aspirin- containing products unless prescribed
Do not take Ibuprofen [Motrin, Advil, Nuprin] during pregnancy, but can be taken while nursing, as very little is excreted in the breast milk.

HEARTBURN

Maalox
Mylanta
Riopan
Gelusil
Pepcid AC – may increase to 20mg 2x daily
Rolaids
Tums

HEMORRHOIDS
Anusol
Preparation H
Tronolane
Tucks

NAUSEA / VOMITTING
Unisom
Vitamin B6

SORE THROAT
Chloraseptic lozenges or spray
   * If you have a fever and sore throat, you may need to be checked for strep throat. 
Do not take Chloraseptic liquid -  it contains a high percentage of alcohol.

VITAMINS
Do not take mega doses of unprescribed vitamins.
           
If you have questions about specific medications or if symptoms continue after use of the above medicines, please call the office (563-557-5959) between 8am and 4pm Monday through Friday.  If the office is closed, please ask to talk to the provider on call.