Perinatal Services

Perinatal and Maternal Services

Obstetrics is one of the most common reasons for hospitalization, and there are a number of considerations to keep in mind for any pregnant woman. At the North Texas Medical Center, we work to keep all women as comfortable as possible during their pregnancy and delivery.

Regular Check-Ups

Before you’re even pregnant, it’s a good idea to have a checkup with your doctor to ensure that your body is prepared for pregnancy and childbirth. Your doctor might run tests to make sure that you don’t have any unsuspected illnesses that could affect your pregnancy or hinder your chances of becoming pregnant. Your doctor can also recommend some good tips for exercise, lifestyle, and eating habits to ensure you’re on the right track. A number of studies have shown that pre-conception care increases your chances of becoming pregnant, while also lowering the risk of birth defects or miscarriage.

The first part of a pre-pregnancy checkup is collecting medical history of you and your partner through a conversation with your doctor.

You might also expect to have a blood test taken as well as a Pap-smear, to check for medical conditions that might affect your chances of conceiving or of having a healthy pregnancy. Some of the tests that your doctor might perform on you might include a thyroid test, a test for sexually transmitted diseases, and testing your immunity to chickenpox and possibly German measles.

Depending on your ethnic background, it’s also possible that your doctor might recommend tests such as sickle cell anemia, tests for Tay-Sachs disease, or thalassemia. Your doctor might also recommend that you update your vaccines, which is an important consideration before becoming pregnant.

However, updating vaccines is also something that must be carefully monitored, because some vaccinations will increase the risk of birth defects. You should still update your vaccines, but to be safe you should always wait at least 28 days before attempting to conceive, after you’ve updated your vaccinations.

Sonograms

Sonograms are imaging techniques that use sound waves to produce an image or video of a fetus in the uterus. Fetal ultrasound provides vital information to your healthcare provider that helps assess your baby’s development and monitors the progress of your pregnancy. Most often fetal ultrasounds are used to confirm pregnancy and estimate the baby’s length and weight. Sonograms can also be used to determine whether or not problems exist, or to help confirm a particular diagnosis.

Typically, the first ultrasound is conducted during the first trimester to determine how long you have been pregnant. Assuming there are no complications with your pregnancy, the next is generally performed during the second trimester. At that time, it will be possible to identify the baby’s gender. If any problems are identified during this, it might be necessary to conduct a follow-up or to perform additional imaging tests such as an MRI.

There are two main kinds of sonograms performed. The first is the traditional transabdominal ultrasound. During this procedure, a fetal ultrasound is conducted by moving a transducer to various locations over your abdomen, with the presence of a conducting medium like a gel assisting the process.

A more precise type of fetal diagnostic is the transvaginal ultrasound, and during this procedure a transducer is inserted into the vagina so it can emit sound waves and detect their reflections. These kinds of ultrasounds are generally used early on or if a transabdominal test was inconclusive in the information it provided.

There are also some specialized kinds of transabdominal ultrasounds used for various purposes. These include Doppler ultrasounds, fetal echocardiography, a 3D ultrasound, and specialized sonographic evaluation. Generally speaking, specialized sonographic evaluation is conducted when a fetal abnormality is suspected. 3D ultrasounds are used to detect neural tube defects or facial abnormalities. Doppler ultrasounds can provide detailed information about the blood flow in an infant. Fetal echocardiography provides a very detailed picture of an infant’s heart and is generally used to rule out or confirm a congenital heart defect.

Customized Birth Plans

There’s a lot that happens during an infant’s birth that is outside your control, but by creating a birth plan, you will have the advantage of making your wishes evident to medical personnel attending you. You should definitely have a conversation with your doctor about your birth plan, so that you’re both on the same page.

There are a number of factors to include in this birth plan, and you may want to formalize it into a document you can use as the basis for discussion with your doctor. One of the first considerations is your preference and concerns about vaginal or C-section delivery. You should also identify all those people you would like to be present either before labor or during the entire process.

You should also specify your environment preferences for delivery, for example dim lighting, quiet room, music playing, minimal vaginal exams, minimal hospital staff, wearing your own clothes, and a whole host of other details that may help make you feel more comfortable during the process. You may also want to specify the position you’d like to be in for the first stage of labor, e.g. standing up, lying down, walking around.

Another major issue many women feel strongly about is the kind of pain relief administered during labor. Some wish to have nothing at all administered, while others prefer to use breathing techniques, and still others would rather have an epidural or massage. By formalizing all these wishes into a birth plan, you can provide input into the process, and be more comfortable that your care team knows your preferences.