Women Care Specialists - Obstetrics

Obstetrics Medical Questions

OFFICE: 636-936-8777 EMERGENCY: 800-759-9322 For all non-emergent situations (example: refill of prescriptions, lab results, chronic problems that have not changed, etc), please call the office during normal business hours. If you think you are in labor, go directly to the hospital and the hospital staff will contact us directly. For urgent calls, please use the exchange/emergency phone number. For a true emergency, please call 911.


  • What hospitals are you affiliated with?
    St. Luke’s Hospital 232 South Woods Mill Road Chesterfield, MO 63017 314.434.1500
    Mercy Medical Center     14528 S. Outer Forty, Suite 100 Chesterfield, MO 63017 314.251.6000
    Missouri Baptist Medical Center     3015 North Ballas Road St. Louis, Missouri 63131 314.996.5000
     
  • How often will I come in for appointments once I find out I am pregnant?

    Your appointments are scheduled approximately every 4 weeks until 28 weeks, every 2 weeks from 28 to 36 weeks, and weekly appointments after 36 weeks until that special delivery day.  These weekly appointments will involve internal examinations to see if you are starting to have any cervical dilation.  If you have other risks factors for the pregnancy, appointments may need to be more frequent.

  • What will be done at my first visit after I know I am pregnant?

    During your first visit, the American College of Ob/Gyn (ACOG) recommends certain tests which include (with every pregnancy) your blood type, blood count, cystic fibrosis, German measles immune status, HIV status, syphilis infection, urine culture for asymptomatic infections (infection without symptoms), and cultures for cervical and vaginal infections.  In addition, your cystic fibrosis genetic carrier test is recommended but this is only required with the first pregnancy OR if you have never had it tested in the past.  If you are 35 years old or greater at the time of your expected delivery OR if you have had a baby in the past with a genetic abnormality OR if you have a history of a genetic abnormality in your family, then you will be offered the option for genetic testing to determine if your baby could possibly carry an abnormal amount of chromosomes (ie-extra or missing chromosomes). You will also be given a list of over-the-counter medications which you can take for minor discomforts or colds during the next nine months.  Please put this list somewhere you will remember (i.e.-refrigerator door, etc).  You do not need to call us for permission to take these medicines.  If, however, the over-the-counter medications are not improving your symptoms within 72 hours OR if any symptoms continue to worsen, please call the office. After your first visit, our office coordinator (Denise Martin) will also contact your insurance company for you and get an explanation of benefits in regard to your maternity coverage.  We understand insurance company benefits can be very hard to understand and she will be happy to give you a courtesy call to explain your coverage to you after your 1st appointment.  If your insurance changes during the pregnancy, please call Denise so she can update your explanation of benefits. Your next blood test is optional and will be offered between 15-21 weeks.  This test is called a Tetra test (formerly Quad test/alpha feto protein (AFP).  This looks for proteins/chemicals in the blood that are present during a pregnancy.  Based on your history, the test calculates whether your baby could be at risk of having open spina bifida, Down’s syndrome, or Trisomy 18.  We understand this is a hard subject to think about but feel this is an important test to consider.

  • When will I have my first ultrasound?

    Your ultrasound will be scheduled for 20 weeks pending no other risk factors for your pregnancy.  This ultrasound is an anatomy scan which helps us determine if there could be a structural problem with the baby and also to determine the sex of the baby for those of you who would like to know.  We try to make every effort to determine sex of baby for you but sometimes position of the baby can make that difficult.  Unfortunately, not all abnormalities can be picked up on ultrasound (some heart defects or small holes in the heart, cleft palate, extra or missing fingers or toes, etc) including some serious abnormalities.  Again, all effort is made to identify abnormalities which can be identified.  Further ultrasounds are determined on a risk basis.

  • Is a 3-D/4-D ultrasound covered by my insurance?

    For those of you wishing to obtain 3-D/4-D ultrasounds, these are not covered under insurances unless a birth defect is identified in which this type of specialized ultrasound would help in the identification or treatment.  If you desire an entertainment 3-D/4-D ultrasound, this can be scheduled at the front desk for an additional charge.  Our ultrasonographers feel the best time to obtain this type of picture is between 28-32 weeks.  The total time allotted is 15 minutes and a CD with the downloaded images will be given to you.  Please remember, the baby’s position determines what pictures can be obtained but we try our best to obtain the best views.

  • What other screenings can I expect during my pregnancy?

    At 24-28 weeks, the ACOG recommends all women undergo screening for gestational diabetes.  Please schedule this appointment in the morning if possible so you do not have to make an additional trip into the office.  Instructions will be given to you between 20-24 weeks along with your testing material. At 35-37 weeks, the ACOG recommends screening for group B streptococcus (GBS) carrier status.  This will involve a swab of the vaginal area.

  • What Vaccines are SAFE during pregnancy?
          • Anthrax
          • Cholera
          • Diphtheria
          • Hepatitis A and B
          • Influenza (Encourage for all pregnant women)
          • Meningitis
          • Pertussis (“whooping cough”)
          • Plague
          • Pneumonia (pneumococcus)
          • Injectable polio (“salk”)
          • Tetanus
          • Typhoid
          • Thyphus
          • Tb skin test (tuberculosis)
    • What Vaccines are UNSAFE during pregnancy?
            • Measles
            • Mumps
            • Oral polio
            • Rabies
            • Rubella (“German measles”)
            • Varicella
      • What should I do if I am exposed to 5ths disease (parvovirus)?

        If you are exposed directly to someone with 5ths disease, please call the office during normal business hours (Monday & Thursdays 9am-6pm, Tuesdays & Wednesdays 9am-4pm, Fridays 9am-1:30pm) to arrange blood tests

      • What should I do if I am exposed to Chickenpox?

        If you have never had chickenpox or are unsure, please let your medical provider know so we can check your status through a simple blood test at your next office visit. If you are exposed to someone with chickenpox AND you have had chickenpox in the past, there is no need to do anything.

      • What should I do if I am exposed to Shingles?

        This is the same virus as the chickenpox virus, please see the above.

      • Is it ok for me to get the Flu Vaccine?

        It is recommended by the American College of OB/GYN that ALL women be vaccinated for the flu virus with one vial of the thimerosal-free flu vaccine.  This starts in October and ends in April. Pregnancy puts extra stress on your heart and lungs. Pregnancy can also affect your immune system. These factors increase the risk not only of getting the flu but of developing serious complications of the flu, such as pneumonia and respiratory distress. In turn, flu complications increase the risk of premature labor, preterm birth and other pregnancy complications. A flu shot can help prevent these potential problems. In addition, having a flu shot during pregnancy can help protect your baby after birth. Infants are at high risk of complications from the flu, but childhood flu vaccines can’t begin until age 6 months. If you have a flu shot during pregnancy, however, the antibodies you develop will pass through the placenta. In turn, these antibodies help protect your baby from the flu. When you get your flu shot, be sure to request the flu shot and not the nasal spray vaccine. The flu shot is made from an inactivated virus, so it’s safe for both mother and baby during any stage of pregnancy. The nasal spray vaccine is made from a live virus, which makes it less appropriate during pregnancy or while you’re trying to conceive. If you’re allergic to eggs, check with your medical provider before receiving a flu shot.

      • Is it ok for me to travel?

        It is safe to travel up to 34 weeks pregnant as long as there is no significant risk factors to your pregnancy. If you are high risk, please ask the medical providers for individual restrictions. If you are flying long distance or driving long distance, please wear support hose or perform calf exercises to avoid blood clots. There is NO travel allowed if you have a previa (placenta over your cervix) at your 20 week ultrasound.

      • Can I still get my hair highlighted, colored, or have a perm?

        You may color or highlight your hair after the first trimester (12 weeks) You may also perm your hair after the first trimester, but pregnancy may alter your outcome of the perm.

      • Can I go tanning?

        Not recommended during pregnancy

      • Is it ok for me to use a hot tub?

        Outdoor hot tubs – Not recommended during pregnancy Bathroom Jacuzzi – May use during pregnancy at bath temperature

      • Can I use mosquito repellant?

        Please use mosquito repellant if you are outside

      • Can I use tick repellant?

        Please use tick repellant if you are outside

      • Are there certain foods I should avoid while I am pregnant?

        Avoid undercooked meats and raw seafood Avoid gourmet soft cheeses Avoid all unpasteurized products Epazote – a herb/leaf that can be found in authentic Mexican dishes

      • Are there certain foods I should limit while I am pregnant?

        Limit all cooked seafood to 2 servings/week (1 serving = 6oz) (Yes…canned tuna is cooked) Limit caffeine consumption (no more than 2 servings/day)

      • Is it ok for me to have deli meat while I am pregnant?

        Yes… you may eat sandwiches with deli meat but look for the meats that turn over more frequently.  If the meat is prepackaged, placing the meat in the microwave for 20-30 seconds will destroy any harmful bacteria.

      • How much calcium do I need everyday?

        You need 1000mg of calcium/day (with vitamin D).  If you are drinking 2-3 glasses of skim milk/day, you are covered

      • Can I go to the dentist when I am pregnant?

        Yes….you may visit the dentist for all routine exams. X-rays are allowed with abdominal shielding All cavities and root canals are allowed to be repaired If pain medicine is required, any narcotic must be prescribed by the dentist. We do not prescribe for the dentist. Pregnancy increases risk for gingivitis and poor dentition can lead to preterm labor….so continue dental care.

      • Is there a certain way I should sleep while I am pregnant?

        You may sleep in any position that is comfortable for you (this includes sleeping on either side or your back/tummy.) If you begin to feel nauseated, then you have to change positions to your side. Otherwise…enjoy your nights sleep now for soon it will all change (for the good, of course).

      • What are the hospitals with which I can deliver or go to the ER if I am having issues?

        St. Luke’s Hospital Mercy Medical Center Missouri Baptist Medical Center If you are under 20 weeks and are having any problems that require you to go to the ER, please go to one of the above three hospitals which we are affiliated.  Unfortunately, we are unable to go to all hospitals and if you go to the ER of a hospital we are not on staff, you will be considered a walk-in and assigned to whomever is on call at that hospital.  Even if you do not think it is pregnancy related, we advise you to still go to one of the above hospitals in case it could involve your pregnancy.  After 20 weeks, if you are having a problem and need to go to the hospital, you should go to labor and delivery to be evaluated!

      • Before I deliver, what steps do I need to take as far as pre-registering or scheduling a c-section?

        1) Preregister by 24 weeks at the hospital you are scheduled to deliver;this can be done online.

        2) Pick a pediatrician by 24 weeks; If you need help with a referral, please let us know.

        3) Attend birthing classes at the hospital you are to deliver (for 1st time moms)

        4) If you have had a c-section and are wanting to try a vaginal delivery (VBAC), it is encouraged for you to attend a VBAC class.

      • I am 37 weeks or greater in my pregnancy, how or what reasons should lead me to go to the hospital I have chosen to deliver?

        1) You think you are in labor (regular contractions which are uncomfortable and occurring every 5 minutes, each contraction lasting one minute AND have been occurring for at least 1-2 hours)

        2) You think your water has broken or are trickling,

        3) Vaginal bleeding (although it is common to have some form of spotting or light bleeding if you have been examined vaginally in the office)

        4) You noticed a decrease in fetal movement

      • I am preterm (under 37 weeks) in my pregnancy, what reasons should lead me to go to the hospital?

        1) You think you are in labor

        2) You think your water could have broken or are trickling

        3) If you are having 6 or more contractions in an hour which do not go away with lying down and drinking 20 oz water

        4) Vaginal bleeding

        5) You noticed a decrease in fetal movement

        6) If you are experiencing pain which you can not explain

      • What are some useful links to Breastfeeding sites?

        Some useful breastfeeding sites are:

      • What is a Nuchal Translucency Ultrasound?

        A Nuchal Translucency Ultrasound is an ultrasound combined with blood work preformed around 12 – 13 weeks of pregnancy. Used as an early detection tool for genetic disorders including Down’s  Syndrome and Trisomy 18. The ultrasound is preformed to measure the nuchal fold (or thickness on the back of the baby’s neck). This measurement combined with maternal age and blood work values help determine a risk ratio for each individual pregnancy. Please see the OB Testing section of this website for further details.