Healthy Pregnancy
An affiliate of Pocono Medical Center
Physician Associates: OB/GYN Practice Locations Pocono Medical Building 1 175 East Brown Street, Suite 108 East Stroudsburg, PA 18301 570-421-3401
Handbook
Mountain Healthcare Center 100 Community Drive, Suite 205 Tobyhanna, PA 18466 570-895-4331 447 Office Plaza 200 Plaza Court, Suite B East Stroudsburg, PA 18301 570-426-2700
Pocono Medical Center Main Number: 570-421-4000 General Information: 570-476-3367 Physician Referral Service: 1-800-851-0268 Emergency Line: 1-888-273-0571 www.PoconoMedicalCenter.org Free patient and visitor parking is available 24/7 across the street from the hospital. Free valet parking is also available at Main Entrance A of the hospital Monday through Friday, from 6:30 a.m. to 4:30 p.m. Valet service is not available at the ER.
FPO
If you’re in labor when you arrive at the hospital, you should go directly to the ER. We will immediately take you to the Labor and Delivery floor. An affiliate of Pocono Medical Center
An affiliate of Pocono Medical Center Help In an Emergency Need to reach a physician outside the normal PMC Physician Associates: OB/GYN office hours of 8 a.m. to 4:30 p.m.? Please call our emergency line at 1-888-273-0571.
healthy Pregnancy
Notes for Me. Questions for My Doctor. Track notes, questions, and answers here to help keep all of your information in one place.
Congratulations!
w
hat wonderful news to learn that you’re having a baby! As you and your family prepare for this most exciting occasion, we are honored that you have chosen our Pocono Medical Center (PMC) family to share in this amazing experience. We hope you will take a moment to familiarize yourself with all that PMC offers. From our new Neonatal Intensive Care Unit (NICU) to our recently added perinatology services for high-risk moms, we’re committed to providing world-class care for you and your newborn—close to home. Please rest assured that you’re in the most capable and caring hands. Our multispecialty PMC Physician Associates practices are committed to caring for your family like their own: with compassion, respect, integrity, and a dedication to quality care that is second to none. In this packet, you will find helpful information on how to keep you and your baby healthy throughout your pregnancy, as well as what to expect during labor and delivery. We’ve also included advice on how to care for your newborn and yourself when you return home. Our staff and physicians remain available to answer any questions or concerns you may have. On behalf of our PMC family, let me extend our warmest regards for a healthy pregnancy. And thank you again for choosing PMC to care for you on this most wonderful journey. It brings us all great joy to have our family caring for yours. It is my honor to serve,
Kathleen E. Kuck President and CEO Pocono Medical Center
What to Expect… H o w
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t’s normal to feel a little nervous throughout your pregnancy. Knowing how to stay healthy and protect your little one can help calm your nerves. Try these tips: • Schedule regular checkups. Each visit is important—even if you feel fine. • Don’t take any medicine unless your doctor says it is safe. Aspirin and some herbal products, dietary supplements, and prescription drugs could harm you or your baby. • Keep habits that are good for you, like not smoking and avoiding alcohol and illegal drugs. Also try to avoid people who are smoking. Secondhand smoke is harmful, even when your baby is in the womb. • Stay active. Moderate exercise, like walking, may help you sleep better; combat backache, constipation, and swelling; and endure labor pains. Talk with your doctor before starting an activity. • Follow your doctor’s advice on how much weight you should gain during pregnancy.
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PMC Nurse-Family Partnership Specially trained nurses provide free in-home visits to programeligible mothers, teaching prenatal and infant care, as well as parenting and lifestyle skills. Please call 570-426-1688 or visit PoconoMedicalCenter.org.
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Eating for 2 Your unborn baby draws nutrients from your body. And it’s never too early or too late to start eating healthy. You should also take 400 micrograms of folic acid every day and drink plenty of water. In addition to the ones listed below, ask your doctor what foods will help your baby grow. Food Types
Servings
Serving Examples
Grains
6 to 9
1 slice bread or ½ cup cooked rice, pasta, or cereal
Dairy
4
1 cup low-fat or nonfat milk or yogurt, 1½ oz. cheddar cheese, or 2 oz. American cheese
Meat and Beans
3
1 egg; 2 tbsp. peanut butter; or 2 to 3 oz. cooked lean meat, poultry, or fish
Vegetables
3 or 4
1 cup lettuce, ½ cup raw or cooked carrots, or ¾ cup vegetable juice
Fruits
3 or 4
1 medium apple or banana or ½ cup chopped fruit
Foods to Avoid Unpasteurized milk and soft cheeses, such as feta, blue cheese, and queso blanco Raw sprouts, especially alfalfa Fish high in mercury, such as shark, swordfish, king mackerel, and tilefish Raw or undercooked poultry, fish, eggs, or meat, including hot dogs and deli meats
Dealing With Stress
Getting Comfortable
While you may not always be able to avoid stress, you can take steps to manage it. • Live well. Eat a balanced diet, exercise, and get plenty of rest. • Set limits. Make time for what you care about —and say “no” to less important things. • Consider alternatives. Try massage, aromatherapy, or deep breathing: Inhale slowly to a count of 4, then exhale slowly to a count of 4. Repeat 5 to 10 times. • Do what works for you. Listen to music, read a book, or call a friend. • Seek help if you feel overwhelmed. Talk with your doctor, a therapist, or other professional for help getting back on track.
There are a number of ways to tone down discomfort so you can focus on the future joys of motherhood. Morning sickness (nausea and vomiting) • W ith your doctor’s OK, switch to a prenatal vitamin that doesn’t have iron in it. • Have 5 or 6 small meals throughout the day, instead of fewer, larger meals. • Drink ginger ale, nonalcoholic ginger beer, or ginger tea. Back pain • Raise one foot on a stool or box when standing. • Wear low-heeled shoes with good arch support. • Sleep on your side with your upper leg bent and supported by a pillow. • Shift your sitting or standing position frequently.
healthy Pregnancy
Care and Support Prenatal visits—the trips you make to the doctor before your baby is born—are a key part of taking care of yourself and your child. Your first visit is likely to take a bit longer and include more tests to detect potential health problems. A typical visit may include screening tests to check: • Your weight, blood pressure, or urine for sugar and protein • Your baby’s position, growth, and heart rate Based on your health history and results from screening tests, your doctor may advise you to have certain diagnostic tests. These tests can help confirm if you or your baby has a health problem.
3 Common Diagnostic Tests Test
Summary
Timing
Ultrasound
> Uses sound waves to create an image of your baby’s internal organs > Aids in verifying your due date and the baby’s age and sex > Helps monitor your baby’s development
nytime, as A advised by your doctor
mniocentesis A (Amnio)
> Uses a long, thin needle to get a small sample of fluid from the sac protecting your baby in the womb > Helps detect chromosomal disorders, such as Down syndrome, and neural tube defects, such as spina bifida > Usually offered to women who will be 35 or older at delivery or had abnormal results on certain screening tests
ypically T between week 15 and 20, if advised by your doctor
horionic villus C sampling (CVS)
> Uses a catheter and syringe to retrieve a tissue sample from the placenta > Helps detect chromosomal abnormalities and other genetic problems > Usually offered to women with an increased risk for chromosomal abnormalities or who have a family history of certain genetic defects
ypically T between weeks 10 and 12, if advised by your doctor
Preregister for Your Stay You should preregister 2 months before your estimated due date. Simply call 570-476-3312 or visit our Central Registration Department, located on the hospital’s first floor. Use the main hospital entrance, located near the Starbucks inside PMC.
Help from PMC We offer a host of support services to ensure the safest, healthiest pregnancy possible for you and your baby, including: • Three conveniently located PMC Physician Associates: OB/GYN practices • Comprehensive Pregnancy & Diabetes Program • On-site lactation consultants • Hospital-grade breast pumps for patient use • On-site, certified child-seat safety inspector to help ensure a safe arrival home • Prepared and Refresher Childbirth education classes • Breast-Feeding classes Learn more about our classes and view the To Your Health calendar at PoconoMedicalCenter.org. For information about our Pregnancy & Diabetes Program, call 570-476-3395.
Proud Member of the Spirit of Women® Coalition PMC is committed to providing women’s health care, education, and community outreach that meets the highest standards of excellence. To learn more about upcoming Spirit of Women events or to become a Spirit member, visit PoconoMedicalCenter.org/spirit.
Labor and Delivery
W hat to Expect A
s you near your due date, you’re likely to feel both excited and a bit scared. Learning about what to expect can help you focus on the joy.
Signs and Stages Labor is a series of contractions, or muscle spasms, of the uterus that help the cervix open (dilate) and thin. This in turn allows the baby to move through the birth canal. Labor often starts 2 weeks before or after an estimated delivery date. It lasts about 12 to 14 hours for a first-time mom. If you’ve
given birth in the past, labor may be shorter this time. Signs of labor vary from woman to woman. Just days before going into labor, you may notice a “bloody show.” This is when a small amount of mucus, slightly mixed with blood, passes from the vagina.
Referred to as “water breaking,” fluid may gush or leak from the vagina when the fluid-filled sac protecting your baby in the womb breaks. You should contact your doctor as soon as this happens. Many women go into labor within 24 hours.
3 Stages of Labor Name
Description
First Stage
Latent Phase > Typically the longest phase, during which you’re admitted to the hospital > Contractions occur 5 to 20 minutes apart; pain usually starts in the back and moves to the front > Cervix opens up to 3 or 4 centimeters Active Phase > Contractions are more severe, last longer, and occur 3 to 4 minutes apart > Cervix opens 4 to 7 centimeters Transition Phase > Contractions are very strong, last 60 to 90 seconds, and occur every few minutes > Cervix opens 8 to 10 centimeters
Second (Pushing) Stage
> Begins when the cervix is completely open and ends with the delivery of the baby > May take between 30 minutes and 2 hours for a first pregnancy
Third Stage
> Delivery of the placenta takes place after the baby is delivered and usually lasts a few minutes
Labor and Delivery
What Is False Labor? With a few weeks to go before your due date, you may have cramps called false labor or Braxton Hicks contractions. Unlike true labor, the time between each muscle spasm does not get shorter or stronger over time. Pain is limited to the front of your body, instead of starting in the back and moving to the front. These cramps may go away if you walk or rest.
Ways to Reduce Discomfort As a mom-to-be, you have a lot of choices to make, from names to nursery colors. One decision that’s even more important is how to manage labor pains during the big event. You may find meditation, massage, or rhythmic breathing helpful at the start of labor. You may also choose to use pain medicine to help soothe strong contractions. Depending on your health history, epidural anesthesia, delivered near the spinal cord, may be an option. This eases pain in the lower part of the body. Talk with your doctor about the risks, side effects, and benefits of each pain-relief option. You may also want to take a Prepared Childbirth class to help ease your mind as you get closer to your delivery date.
Delivery Options In deciding whether to have a cesarean or vaginal birth, talk with your doctor about your current health and health history. For the majority of women, a vaginal birth is typically considered safer and healthier. A cesarean may be better if: • You’re expecting multiples—twins, triplets, or more • The bottom part of your baby’s body is closest to the birth canal (breech position) • You have had a previous cesarean with a vertical incision • You have a medical condition that may make vaginal birth unsafe, such as diabetes, high blood pressure, or an infection such as active herpes • The placenta, which supplies oxygen and nutrients to the baby, blocks the opening of the uterus After labor has started, other situations may also make it necessary to have a cesarean in order to protect your baby.
H ow to Prepare O
nce labor starts, your focus should be on staying calm and getting safely to the hospital. One thing you can do to make your big day a positive experience is to have a plan ready in advance.
Choose a Birth Companion A birth companion can help you cope with labor and delivery, regardless of whether you have a vaginal or cesarean birth. For example, studies show that moms-to-be whose birth partners were sensitive to how they felt during a cesarean birth were less likely to later remember the pain they felt after the procedure. Whether you choose your husband or partner, a parent, or a friend, your birth
companion needs to be someone you feel comfortable having present during labor and delivery. If you plan to attend a Prepared Childbirth class, your partner should go, too. The class will provide you both with details on what to expect and offer stress-management techniques. Remember to share your wishes, such as what type of pain management you want, with your partner before you go into labor.
Install Your Car Seat Early Don’t wait until you’re leaving the hospital to install your car safety seat. Follow the directions that came with your car seat and place it in the backseat, facing the rear of the car. Not sure you’ve correctly installed your car seat? Have one of PMC’s on-site child-seat safety inspectors doublecheck it for you. Call 570-476-3414 for more information.
Childbirth Classes For information on Prepared and Refresher Childbirth classes, visit PoconoMedicalCenter.org and view the To Your Health calendar.
Hospital Checklist As you get closer to your due date, pack a bag you can grab on the way out the door. Include the following items: Insurance card and preregistration information Address book with key contacts Clothes to wear, such as a nightgown or robe and slippers Toiletries, such as a toothbrush Glasses and/or contact lens supplies, if needed Books, magazines, music, or other items to entertain and relax you Extra pillow Nursing bra and pads Clothes for you and your baby to wear home
Going Home
Caring for Yourself... C ar i ng
for
T
he first couple of months after giving birth can feel overwhelming. If you’re a new mom, there’s a lot to learn. Experienced mothers need to care for their new baby and their older children. To stay on top of all this, you need to watch out for yourself, too.
3 Tips for Busy Moms 1. Put a priority on sleep. Close your eyes whenever your baby naps. The dirty dishes or laundry can wait. Ask a relative or friend to help out around the house for a while. 2. Pay attention to your body. You will go through changes after giving birth. Some may cause discomfort. For constipation, drink lots of water and eat fresh fruits and vegetables. If your breasts feel achy, try wearing a supportive bra. 3. Check in with your doctor. It’s just as important for you to visit the doctor as it is
for your new baby. You should have a postpartum checkup after giving birth. Your doctor will examine you and make sure your body is recovering. This is also a good time to ask when you can begin exercising again and when it’s safe to have sex. While many new moms feel irritable and sad at times, these “baby blues” often pass within a week. If you’re sad or upset most of the day for at least two weeks, you might have postpartum depression. Talk with your doctor right away.
Y our
B aby
Know Your Newborn Even well-prepared moms may be surprised by a few things that are normal in newborns: • Cord Color—Your baby’s umbilical cord stump will turn yellow and then brown or black, before falling off on its own. • Soft Spots—Two areas, called fontanels, on your baby’s head will remain until the bones in the skull knit together. When your child cries, they may bulge. The soft spots may also pulse along with your baby’s heartbeat. • Rashes—Tiny white bumps, or milia, on your baby’s face will go away in a few weeks. Scaly whitish patches on the scalp, known as cradle cap, usually clear up in a few months.
Breast-Feeding Basics Breast milk has nutrients your baby needs and even helps protect against infections. But breast-feeding is good for you, too. • Breast milk is completely free and ready, no matter where you are. • Breast-feeding helps you lose the weight you gained during your pregnancy. • When you breast-feed, you build a special bond with your baby.
If you choose to breast-feed, it takes practice—just like any new skill. Proper positioning will make it easier: Sit up or lie on your side. With your free hand, make a “C” around your breast with your thumb on top and the other fingers below. Tickle your baby’s lips with your nipple until baby’s mouth opens wide. Place your nipple and about 1 inch of your breast all the way in baby’s mouth as you pull baby’s body close.
Breast-Feeding Class This class helps make your experience a positive one. For dates, view the To Your Health calendar online at PoconoMedicalCenter.org.
Skin Care Tips • P revent dry skin. Bathe baby every 2 or 3 days and apply a petroleumbased moisturizer. • Clean your newborn’s eyes, nose, and outer ears gently with a cotton ball dipped in warm water. Don’t use soap. • Clean all areas that touch the diaper with a damp washcloth. Or use alcohol-free baby wipes. Apply a zinc-oxide or petroleum-based cream to prevent diaper rash.
Care and Support
Your Experience at PMC F
or nearly 100 years, PMC has served as Monroe County’s sole community hospital. Backed by more than 200 of the area’s finest physicians and more than 1,900 dedicated staff members, PMC has grown to become a national leader in health care excellence. In 2010, we received our second consecutive Distinguished Hospital Award for Clinical Excellence™ by HealthGrades®, the nation’s leading independent health care ratings organization. This award places us in the top 5 percent in the nation for overall clinical quality based on our patient outcomes.
Care at Every Stage of Your Life PMC is dedicated to providing services that address your unique health care needs at every stage of your life. To learn more about our three convenient Physician Associates: OB/GYN practice locations or to make an appointment, visit MyPMCdocs.com.
World-Class Specialists and Staff
State-of-the-Art Technology
Our physicians and staff embrace a team approach to caring for you and your baby. PMC’s highly experienced OB/GYN team includes board-certified: • Obstetricians • Midwives • Perinatologists—doctors specializing in high-risk pregnancies • Neonatologists—doctors specializing in newborn infant care PMC’s certified registered nurses and physician assistants also work closely with our doctors and midwives to ensure exceptional care for every patient, every time.
In 2010, PMC opened the doors to a brand-new Neonatal Intensive Care Unit (NICU). Our NICU provides more than peace of mind; it provides a crucial lifeline should your precious arrival need advanced care. The NICU is staffed by specially trained neonatologists and neonatal nurses who have access to state-of-the-art technology for providing immediate, on-site care for at-risk newborns.
Your Lifelong Health and Wellness Partner A healthy community helps raise healthy kids. In addition to offering a host of free screenings, PMC offers regularly scheduled Prepared Childbirth and Breast-Feeding classes. A number of other courses and innovative health education programs, like Spirit of Women, are also available. For more information, visit PoconoMedicalCenter.org and view the To Your Health calendar.
Trimester Milestones Use this space to track information and special memories throughout each trimester of your pregnancy.
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