Obstetrical Care

I attended the delivery of the first of several thousand babies in medical school in 1983, and obstetrics has been a truly joyous part of my profession in the years since. As a mother of three, I can appreciate many facets of pregnancy from different perspectives. My staff and I do all that we can to provide excellent prenatal care, delivery, and postpartum care in a pleasant and caring environment.

Obstetrics FAQs- These are some of the things we will discuss during the initial visit and subsequent prenatal care.  There are links to more information on the Patient Education page. If you have further questions, please ask.  My staff and I are a phone call away, and my pager is always on for true emergencies.

Prenatal visits - In a typical pregnancy, we start with every four week visits during the first two trimesters, and after about 28 weeks, will shorten the interval between visits so that they occur every week dueling the last 4 weeks before the due date.  Fathers are welcome to attend anytime.

Nutrition - Most people need only about 200 extra calories a day during pregnancy, with a goal of gaining about 25 pounds.  In reality, many people gain closer to 40 lbs., requiring extra effort afterwards to love the rest. When my mom was pregnant with me, mothers were scolded if they went over 12 lbs., thankfully, times have changed!

Exercise - Healthy moms should continue to do moderate exercise.  Labor is an endurance test of sorts, and people feel better if they remain active.  I usually recommend keeping heart rate under 130 or so, a maintenance workout rather than training. Sports that would involve potential for falls abdominal trauma such as water- or jet-skiing, kick boxing, downhill skiing, etc should be avoided.

Sex - Unless some problem develops during the pregnancy, sex can continue for most people. However, experts are advising pregnant women to abstain from intercourse or use condoms to prevent the transmission of Zika virus.

Genetics - Testing is optional and depends on the ethical approach of the parents.  If one cannot imagine terminating a pregnancy under any situation, it probably makes little sense to do genetic testing.  In women over 35 years old or with high-risk factors, genetic counseling and discussion of prenatal screening such as amniocentesis, chorionic villus sampling, cell-free DNA, and other blood and ultrasound tests can be offered.  Screening tests for the lower risk population such as the full integrated screen will be discussed.  Other tests for a genetic disease like cystic fibrosis and Tay Sachs disease are available.

Ultrasound - I typically do one for accurate dating early in pregnancy, and a detailed anatomical scan about 18-19 weeks along.  Medical needs may dictate others.

Listeria -  a bacteria found in soil, it should not be in our food supply, although in recent years, some outbreaks have occurred in meat packing plants or in fresh produce.  If eating deli meats or hot dogs, heat the meat until it steams to kill the bacteria.  Wash produce that will be consumed raw in your own clean water.  I advise people to avoid raw sushi, uncooked meats like kibbe, or unpasteurized cheeses to avoid food borne disease.

Viral infections - Those who have had chickenpox or varicella zoster, or have been vaccinated against it, should be safe around those with chickenpox or shingles.  We check rubella titters and will let you know if immunity is present or whether you must avoid rubella and be revaccinated.

Postpartum Adjustment 
Click here for information regarding postpartum adjustment

Preconception Issues
Click here for information regarding good health before pregnancy

Pregnancy/Labor and Delivery
There are many websites that contain information regarding pregnancy and childbirth. The March of Dimes website is very complete and easy to navigate, and we feel it contains a lot of very useful, accurate information. Click here for information regarding pregnancy/labor and delivery

Medications that can be safely used during pregnancy and breastfeeding
(List is in PDF format and you need Acrobat Reader to view and print)

Click here for information on the Beaumont Hospital - Royal Oak Family Birth Center and the Karmanos Birth Center

See the Patient Education page for up-to-date links for Zika as information is changing rapidly. The CDC currently recommends pregnant women not travel to areas where the virus is found.

Vaccines - The CDC recommends healthy pregnant women be vaccinated against influenza and get the TDap (tetanus, diphtheria, pertussis vaccine) in the last trimester of every pregnancy in order to protect against illness and boost antibody levels crossing the placenta for the baby.

Vitamins - Pregnant women should take a prenatal vitamin and continue it while nursing and between pregnancies to protect against birth defects.

Medications -  There are many drugs that can safely be used in pregnancy and there is a short list of over the counter meds on the website.  Inform other prescribers of your pregnancy and verify the safety of your prescriptions.

Fish contains excellent nutrients important to brain development.  But because fish can be so often polluted, my recommendation is often to limit or avoid fish and take the vitamins with added DHA. Click here for FDA.gov page of on eating fish while pregnant. Click here for information on fish safety in Michigan.

Labor and Delivery - Childbirth preparation classes, and tours of Royal Oak Beaumont Family Birth Center can be arranged.  While many of my patients use epidurals, and I was extremely grateful for them during my own three deliveries, I look to my patients to determine what they want during labor. The birth process is unpredictable, and I strive to keep my Cesarean section rate as low as I can, and hope that each delivery can be safe, healthy, and joyful. The last time I checked, I had delivered about 3500 babies, and consider myself very fortunate to have been in attendance at the unique and miraculous births of so many families.

Sleep - Pregnancy and early childhood are sleep disrupters.  All the books say we should sleep on our sides to improve flow to the uterus.  Let me assure you that, when you awaken flat on your back, you are NOT a bad mom, and the human race goes on despite it!  If, however, you ever feel light-headed on your back, flip to the side to get the uterus off the vena cava.

Parenthood - Welcome to the next adventure, as children are a great joy in life.  Start thinking of getting life insurance, starting the college savings plan, and searching for your baby's pediatrician, who will be a wealth of information to parents.

In pregnancy and parenthood, there is no such thing as a stupid question.  Read and educate yourself, and I encourage patients to write down questions for discussion at prenatal visits.

Nine months will be over in no time!!!