East Lake Outpatient Center
3890 Tampa Road, Suite 304
Palm Harbor, FL 34684
(Located at the intersection of McMullen Booth Road
and Tampa Road.  See Map.)

Phone: 727-789-9006  ●  Fax: 727-789-9122
 

   New Horizons Obstetrics and Gynecology Prenatal Care Information

In accordance with federal law, and our philosophy of respectful care, we cannot share ANY information about you, your status as a patient, or your condition without your consent. You can expect that information shared during a visit or phone conversation will remain confidential. If you want us to be able to leave messages at home or on your cell with test results or information, or you want us to share information with significant others, you must clearly state this in your chart. By law, we are allowed and often required to share information with our medical facilities, other providers involved in your care, insurance companies, and so forth. A signed medical release is required to send or obtain past or present medical records.

To Contact Us and our Call Coverage

Office Hours are Monday-Thursday 8am-4:30 pm, and Friday 8am-1pm. The phones are answered by the answering service from 1-2 pm on Monday, Tuesday, Wednesday and Thursday, and after 12:00 pm on Fridays. We are available for same day appointments if you are having a problem, and a physician and certified nurse-midwife is always on call 24/7 for emergencies. If you need to speak with us during office hours, please call 727-789-9006. A staff member will take your message. Urgent messages will be delivered to your provider immediately, otherwise messages are returned by the end of the day. After hours, call the office number and the answering service will take your message for the provider on call. Rarely, the answering service sends a page to the wrong person or we are in a complicated emergency. If you don’t hear back from us within 2 attempts, please call Labor and Delivery and Mease Countryside at 727-725-6851. The nurses in labor and delivery will always be able to answer a question and direct you to us directly should this occur. Please use discretion in paging us after hours and use this for emergencies only. If you think you need to go to the hospital after hours, please call and discuss your problem with a provider. We want to know when you are coming into the hospital, and we like to notify the hospital that you are on your way in. Please do not call us directly on our home or cell phones that may show up on your caller ID. Thank you.

All medical practices use other providers to help with night and weekend call. We share call with Suncoast Women’s care. Their practice model is the same as ours, with 2 physicians and 2 certified nurse-midwives and they are an all female team. They answer our pages when they are on call, and attend births when we are off. They value the same exceptional level of safe and satisfying care, and wonderfully compliment our all female health care team. We are very fortunate to have a wonderful working relationship with their practice.

Our Team Approach

The Physicians and Certified Nurse-Midwives (CNMs) work together as a team to provide you with clinical expertise and TLC for a safe, healthy, and happy pregnancy and birth. The CNMs routinely care for women with lower to medium risk pregnancies and are on call for all vaginal births. The physician cares for women with medium to high risk pregnancies and performs all Cesarean sections. The physician is available for emergencies at all times. Similar obstetrical models in Europe have resulted in the lowest maternal and neonatal mortality rates in the world. On occasion, your provider will be out for a delivery and rather than reschedule, you will be seen by another provider in the office.

Our Web Site

We are proud to bring you our own web site at www.newhorizons4women.com,  Here you can meet all of the office staff, see our personal photo albums, download instruction sheets such as for post partum home care, learn about our childbirth education and visit our birth photos page. The Links page has information on pregnancy information, laboratory/sonogram facilities, books, classes, and DVDs. We gladly accept photos of your new family for our web site.

Topics

Travel: It is generally safe to travel up until 36 weeks of pregnancy. If you plan any travel extending more than a 2 hour trip, please let us know. We advise special precautions and exercises to help avoid formation of blood clots. If you are going away for an extended stay for more than one week, please obtain a copy of your prenatal records in the event you may need emergency care while away.

Tobacco Use: If you are a smoker, pregnancy offers an optimal opportunity to quit. Most women are aware of the dangers of smoking in pregnancy, which include, but are not limited to low infant birth weight, decreased brain size, increased risk of miscarriage, placenta abruption (shearing of the placenta from the wall of the uterus), infant respiratory illness such as asthma, colds, bronchitis, ear infections, fussy babies/difficult to console, and sudden infant death syndrome (crib death). Women who quit smoking by 16 weeks of pregnancy give birth to infants with similar birth weights as nonsmokers. Risks to your health include cancer of the lungs, throat, esophagus, bladder, and cervix, cardiovascular disease, stroke and blood clots.

Simply telling women to stop smoking often does not work. You will need help setting a quit date, strategies to help you, ways to manage stress and appetite, and prevention of relapse. Our practice has resources to help you. You may not use nicotine patches and related products while pregnant.

When you quit smoking, be sure to save the money you used to spend on cigarettes and make a list of nice things you would like to purchase, and plan a celebration with friends and family to gain their support in your efforts.

Calling 1-800-U-CAN-NOW will give you further information as well.

Alcohol: Since there is no clear information on how much alcohol is considered safe in pregnancy, it is advised that women not consume any alcohol while pregnant. Consistent drinking of more than three to four drinks a day, and binge drinking have both been associated with fetal alcohol syndrome. If you are having difficulty not drinking, please let us know so we can give you resources for help and support.

Illicit/Recreational Drugs: These are dangerous at all times, particularly during pregnancy. If you are having trouble abstaining from drug or marijuana use, let us know so we can give you resources for help and support.

Indications for Ultrasound: You will receive a first and second trimester sonogram. Additional ultrasounds are ordered for medical reasons such as the baby measuring too small or too big, bleeding, etc. If you want to know the sex of your baby, usually this is detectable at the second trimester sonogram at 18-20 weeks. 4-D sonograms are available at some facilities; some offer a DVD service with this. The second trimester sonogram is done at an outside facility, depending on location and your insurance. We will help you go to a suitable facility for this.

Schedule of Prenatal Visits: Your first appointment with the Physician or CNM will be the longest and most detailed as we review your history, address your concerns, and formulate an individualized plan of care specifically for you. For low risk pregnancies, subsequent visits will be:

Every 6 weeks until 26-28 weeks, then
Every 2-3 weeks until 36 weeks, then
Every week until your baby is born, then
Postpartum visits as needed, often at 6 weeks.

Domestic Violence/Abuse: This includes fear of your partner, lying to cover up abusiveness, frequent criticism, threats, grabbing, shoving, hitting, partner keeping close tabs/setting limits on time away, fear of leaving, accusations of affairs/flirting, not allowing you to have your own money, forced or unwanted rough sex, destruction of sentimental and other personal property, manipulation with lies and threats, believing the partner is right or you deserve what he says/does to you. Domestic violence includes physical, emotional and sexual abuse. Abusive partners often increase violence during pregnancy and abuse their or their partner’s children. Typically abuse worsens over time. If you know or suspect you are a victim of abuse, we can help. We will not encourage you to leave unless you desire to do so and have a safe and well thought out plan. We can provide you with resources to help you begin a safe plan of help and support.

Seat Belt Use/Accidents: Wear your seat belt low, below your baby, near the pubic bone during pregnancy. If you are in an accident, a seat belt across the baby can increase trauma to the placenta or baby. Contact the office immediately if you are in an accident.

Childbirth Classes: We encourage you and your partner to attend childbirth classes. You have choices at area hospitals for Lamaze, breastfeeding, water birthing, and sibling classes. At www.tampabaybirthnetwork.com, you can browse for specialty type education classes.

Nutrition: A healthy and well-balanced diet is vitally important during pregnancy both to nourish the mother and the developing baby. You need to eat a variety of food from all of the food groups. If you have a special diet such a vegetarian or lactose intolerant, please discuss this with your provider for special recommendations. In general, home cooked food will be lower in fat, salt, calories, and preservatives and is healthier for you. Try your best to eat healthy with whole grains (whole wheat bread and brown rice for example), low fat dairy products, lots of fresh fruit and vegetables, eggs and lean meats. Juice is unnecessary and full of sugar.

Fish and shellfish are good sources of protein, omega-3 fatty acids, and other nutrients. However, pregnant women should not eat certain kinds of fish because they contain high levels of a form of mercury that can be harmful to the developing fetus. You should avoid eating shark, swordfish, king mackerel, or tilefish during pregnancy. These large fish contain high levels of mercury. Albacore tuna also is high in mercury (one can per week is OK) so you may want to choose canned chunk light tuna instead (2 cans per week is OK). Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish. Do not consume raw seafood while pregnant.

To prevent listeriosis, wash all fresh fruits and vegetables before using them. While you are pregnant, do not eat:

• Unpasteurized milk or soft cheeses such as feta, brie, blue-vein types, camembert. (Hard and semi-soft cheeses and other dairy like cream cheese, cottage cheese, yogurts, pasteurized milk are all OK)

• Raw or undercooked meat, poultry, shellfish

• Prepared meats, such as hot dogs or deli meats, unless they are reheated until steaming hot

Always be sure to wash your hands and any utensils, countertops, or cutting boards that have been in contact with uncooked meats.

Water: One of the most important self care aspects of pregnancy is to maintain good hydration. Pregnant women need to drink 10 glasses of water or more daily. This does not include other fluids such as milk, juice, or sodas. You should always have water with you wherever you go. An indicator of hydration is the color of your urine. Morning urine may be darker in color, but all other urine should be very pale or almost colorless. If your urine is dark, you are dehydrated and you need to keep drinking until it lightens up. Dehydration can lead to premature contractions, muscle cramps, and low fluid around the baby. Stay away from caffeine because it causes diuresis, or loss of more water than you take in.

Pica: During pregnancy, some women feel strong urges to eat non-food items such as clay, ice, laundry starch, or cornstarch. This is called pica. Pica can be harmful to your pregnancy. It can affect your intake of nutrients and can lead to constipation and anemia. Talk with your provider if you have any of these urges. He or she may be able to suggest other things you can do when you feel the urge to eat non-food items.

Recommended Weight Gain:

For a woman who is underweight, she should gain 30-40 pounds.
A normal weight woman should gain 25-30 pounds.
An overweight woman should gain 15-25 pounds.
A very overweight woman should gain 15 pounds.

Weight gains that are too much or too little can have negative consequences for the mother or baby. Your weight gain and nutritional intake is a very important aspect of a healthy pregnancy that is directly influenced by your behavior and lifestyle.

Check with your doctor before taking any vitamins, herbs, or other supplements that are not prescribed for you. They might be harmful during pregnancy. Just because a product is natural does not mean it is safe to use during pregnancy.

Exercise Guidelines: Pregnant women are advised to continue at least 30 minutes of aerobic activity per day for most days of the week, as are nonpregnant women, in order to reduce the risk of heart disease and diabetes. Exercise has many other benefits including better mood, increased energy, and fewer aches and pains. Pregnant women need to modify exercise routines to avoid injury, overheating and dehydration. Avoid jerky, bouncy, or high-impact motions that can cause serious shearing to the placenta. Falls are very common in pregnancy, so you need to take extra care to stay stable and balanced in your activities. Some of the best exercises for pregnancy including walking, swimming, ellipticals, stationery bikes, strength training, and yoga. Unsafe activities include running after 20 weeks, racquet sports, downhill skiing, scuba diving, contact sports, water skiing, and fast boating. Be sure to drink plenty of water, stretch before and after, and do not lay flat on your back after 20 weeks. Take caution in the hot Florida sun. A safe target heart rate is 140 beats per minute in pregnancy.

Hair Dye, Tattoos, Indoor Tanning, Hot Tubs, etc: Studies have not documented harm from hair dyes. Tattooing is not recommended in pregnancy. Indoor tanning is not recommended in pregnancy. Hot tubs and saunas can raise the core body temperature resulting in overheating and are not recommended.

Circumcision: The American Academy of Pediatrics (2005) states that “existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia (pain relief) should be provided.” New Horizons Obstetrics and Gynecology providers do not perform circumcisions. If you elect to have your infant boy circumcised, the infant’s pediatrician needs to be contacted to arrange this procedure after the birth. You should make sure that your pediatrician will perform circumcision. Let us know if he/she does not and we will refer you to a doctor that will do this for you.

Cats/Litter Boxes: To reduce the risk of the infection, toxoplasmosis, pregnant women should not change cat litter boxes through the pregnancy and during breastfeeding. If your cat goes outside, he/she has a higher chance of contracting this infection by ingesting infected rodents. If you have had your cat since it was a kitten and it never goes outside, it is extremely unlikely that he/she could transmit toxoplasmosis to you.

Dental Care: We want you to have dental care in pregnancy. It is safe to have most dental procedures, including xrays, performed in pregnancy. Gum inflammation, or gingivitis, is associated with preterm birth. Please brush your teeth two or three times a day and floss your teeth daily. Please see your dentist early if you have not had dental care in the last six months. If you need any cavities or other procedures, contact our office for a dental clearance note.

No Video: Mease Countryside Hospital rules prohibit video recording during births. You may take still pictures.

Prenatal Birth Defect Screening: There is a separate handout discussing this topic.

Morning Sickness: This is often a sign of a healthy pregnancy. Be reassured it is usually not serious and most often resolves by 12 weeks. However, if you are losing more than one pound per week, your urine is dark in color, you are dizzy or faint, you have a racing or pounding heart, or you are not keeping down at least 50% of your food and fluids for two days, call the office to be evaluated. Herbal teas such as ginger, chamomile, peppermint, and eating crackers and small frequent meals, acupuncture, motion sickness bands, or hypnosis also may help relieve symptoms. Check the New Horizons Medication Sheet for additional suggestions. If your nausea and vomiting are severe, you may need medical treatment. Your provider may prescribe certain vitamins or anti-nausea medications. Occasionally women need to be hospitalized with intravenous therapy.

Other topics: For advice on topics of pregnancy discomforts such as exhaustion, constipation, leg cramps, stretch marks, carpal tunnel syndrome, ligament pain, low back pain, anxiety, insomnia, headaches, etc, please refer to the American College of Nurse-Midwives web page at http://www.mymidwife.org/pregnancy_body.cfm.

Cord Blood Banking: Please refer to the separate handout that discusses this topic. Frequently asked questions about cord blood banking from the American Academy of Pediatrics are available from http://www.aap.org/advocacy/releases/jan07cordbloodfaq.htm.

Over the Counter Medicines and Pregnancy: Please refer to the separate handout for medicines for various ailments that are considered safe in pregnancy.

Late Pregnancy Concerns, Labor Preparation, Cesarean Section, and Post Partum Care:  These will be discussed later in the pregnancy.

Hospital Facilities: We attend births at Mease Countryside Hospital. A state of the art, newly opened unit with a neonatal intensive care unit, OB anesthesia, and options including water birthing, Mease Countryside offers choices to satisfy every birthing family. Even if you are not planning on having an epidural, you need to be educated on pain management options before labor starts and it is difficult to absorb this information. Everyone must register with anesthesia around your seventh month by calling (727) 725-6038. You can register online for hospital admission at www.measehospitals.com. At the home page, go to medical services, then select women and children. In addition, Mease Countryside offers tours of the labor and delivery unit. Reservations are required by calling 727-734-6060.

Work Issues/ Disability Forms: Work Issues: We will review your occupational situation and determine if any restrictions or modifications are necessary. For example, if you stand continuously, or must lift heavy objects, or work outdoors, you will need work modifications, or to stop working later in the pregnancy. If you anticipate you or your partner will be taking time off work with disability or family medical leave act, we will fill out paperwork as required. We request a one week turn around time and we charge a fee of $15.

Patient Satisfaction: One of the hallmarks of our practice is our mission statement: To treat everyone with dignity and respect. Our practice philosophy is to give care with a personal touch. Above all, we want you to feel you are a valued patient whose needs are taken promptly, seriously and with the highest level of care. If at any time you feel you receive less than superior service, we want to know. Please speak with a provider or the office manager if this should happen. Any issues that come to our attention are brought to a team conference for problem solving, a process known as continuous process improvement or total quality management. Using this management style, we stay proactive in providing you with excellent service for your pregnancy, your birth, and beyond. We want you to be happy and remain our patient for many years to come!

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