The hallmark of midwifery care is our expertise during pregnancy and birth. We believe that pregnancy and birth are fundamentally normal, yet profound life-changing events. We also understand that no two pregnancies or births are ever the same. You can expect the following from the midwives of Greenville Midwifery Care & Birth Center …
Extra time spent with you during appointments. We want to get to know you and provide you with complete information so you may make informed choices about your pregnancy and birth.
Support for your choices in childbirth and assistance in developing a personalized birth plan. We encourage you to share your desires, hopes and dreams for your birth and will do everything we can to facilitate the process for you.
Continuous support during labor and birth. Whether your plan includes natural birth in a warm pool of water or epidural anesthesia, our midwives will be there to provide physical, emotional and psychological support.
Postpartum care and breast-feeding assistance. Midwives are champions of breastfeeding and will be available for assistance and support for as long as you need us.
Continuity of care. You will have the opportunity to meet each one of the midwives during your prenatal visits. We feel strongly that your birth should be attended by someone you have come to know and trust.
You’ve entered an exciting time of anticipation and preparation. Whether this is your first baby or a subsequent pregnancy, you have many decisions to make. The midwives of Greenville Midwifery Care & Birth Center are honored to support families throughout pregnancy, birth, and postpartum.
Once your pregnancy has been confirmed, the prenatal period officially begins. Prenatal care involves a series of regular exams and evaluations with your midwife. In an uncomplicated pregnancy, most women will see the midwife once a month until the 32nd week of pregnancy. At this point, you will be seen every two weeks. As you anticipate your baby’s arrival during your last month of pregnancy, you will have a visit with the midwife every week.
The initial prenatal visit is often the longest and is facilitated by our nurse. During this first visit, a detailed family history and lab work will be performed. The nurse will calculate your baby’s due date, which will serve as a reference point in future visits as the baby’s growth is assessed. During your first prenatal visit, the midwife will perform a complete physical examination that includes a pelvic exam and a pap smear, if needed. All prenatal visits include a measurement of your weight and a recording of your blood pressure.
This test determines your blood type (O, A, B or AB) and whether or not you have the Rh factor (Rhesus factor) on your blood cells. Rh is an inherited trait that refers to a specific protein found on the surface of red blood cells. If your blood has the protein, you are Rh positive. If your blood lacks the protein, you are Rh negative. If you are Rh negative and your baby is Rh positive, your baby could develop a life-threatening anemia.
This test detects unusual antibodies that can cause damage to your developing baby. If present, special tests and monitoring may be needed during pregnancy. If you are Rh negative and havent started to produce Rh antibodies, you will receive an injection of a blood product called RH immune globulin. This immune globulin prevents your body from producing Rh antibodies during your pregnancy.
Complete Blood Count (CBC)
This test checks your blood to determine if you have normal amounts of certain blood cells in your body. Abnormal levels of certain blood cells can be indicative of a disease process such as infection or anemia, or clotting disorders.
A specimen is obtained and sent to the lab to test for infection or the overgrowth of bacteria that could lead to urinary tract infection.
Rubella (German Measles)
A blood test to determine if you are protected from Rubella. Most adults have developed immunity to this virus through vaccination as children. Rubella contracted during pregnancy can have serious consequences for the developing baby such as heart problems, hearing and vision loss, intellectual disability, and liver or spleen damage.
A test for exposure to syphilis. Syphilis is a sexually transmitted disease that can be transmitted to the developing baby during pregnancy. Untreated babies can have health problems such as cataracts, deafness, or seizures, and death. Treatment for syphilis can be started early in the pregnancy so that the baby is not affected.
Hepatitis B (HBV)
A test for infection with the Hepatitis B virus which can cause severe illness, liver damage and even death. Many people are infected and don’t know they have symptoms. The virus is highly contagious and easily passed to the baby during the birth process. Must test negative to labor or birth in water.
Hepatitis C (HCV)
A test for infection with the Hepatitis C virus. The chances of your baby catching Hepatitis C from you are about 1 in 20. Hepatitis C can also cause liver damage and severe illness. Must test negative to labor or birth in water.
Human Immunodeficiency Virus (HIV)
A test that checks for the virus that causes AIDS. If you have HIV infection, special medications can be given during pregnancy and birth which can reduce the chances of you passing the virus to your unborn child. Mother must have a negative HIV screen to labor or birth in water.
Chickenpox contracted for the first time during pregnancy carries significant risks to the mother and baby. For example, 10-20% of pregnant women who get chickenpox will develop pneumonia. If contracted during the week prior to the baby’s birth, the baby can develop chickenpox shortly after birth, with the chance of death as high as 30%. Fortunately, most adults are immune to the virus. However, if you are unsure whether or not you had chickenpox as a child, we will order a test to determine immunity.
Hemoglobin (Hgb) Electrophoresis
A blood test for Sickle Cell Anemia, Thalassemia, and other genetic causes of chronic anemia. Certain ethnic groups are at higher risk for having these conditions. Women of African descent will receive automatic testing at the first prenatal visit. Women of southeast Asian or Mediterranean descent who demonstrate anemia with the first prenatal blood count will also be tested.
During this visit you will have an exam performed by one of our midwives. Testing may include:
This is a screening test for abnormal cells on the cervix that can lead to cervical cancer. It is recommended that a woman receive a pap smear every 2-5 years, depending on age and risk factors.
Chlamydia and Gonorrhea
These are sexually transmitted diseases that if left untreated can cause severe pelvic infection, miscarriage, and infection in the newborn.
After your first two prenatal visits, you will begin routine visits with your midwife or one of our nurses. Below are testa that may be performed at specific points in your pregnancy.
Ultrasound for Fetal Anatomy
A screening test for physical abnormalities in the developing baby. Like all screening tests, ultrasound cannot detect every potential problem that could occur with a developing baby. However, most major physical abnormalities can be found during this exam. Fortunately, most ultrasound results reveal a normally developing baby.
Changes in carbohydrate metabolism during pregnancy can lead to the development of diabetes during pregnancy (gestational diabetes). Because there is no certain way to predict who will develop gestational diabetes, it is recommended that all women be screened for this disorder. Low-risk women will be screened between 24-28 weeks; women with increased risk will be tested earlier in pregnancy.
The standard screening test is called a glucose challenge test (GCT). You will be given a drink that contains 50 grams of glucose. A blood test will be performed one hour later to measure the amount of glucose (sugar) in your blood. An elevated glucose level could be indicative of gestational diabetes. In this case, a 3-hour glucose tolerance test (3-hr GTT) will be performed to determine if you have developed gestational diabetes.
A blood test (either by blood draw or finger-stick sample), measures the amount of oxygen saturation and hemoglobin on the blood cells. Decreased levels of these are indicative of iron-deficiency anemia.
Group B Strep (GBS)
A vaginal/rectal swab is sent to the lab to check for the overgrowth of the Group B strep bacteria. Group B Strep is normally found in our intestines as part of the normal gastrointestinal flora. Women who are found to be GBS-positive are said to be colonized with the bacteria. This simply means the bacteria is present in the womans body in amounts significant enough to yield a positive test result. For some women, the amount is large enough to show up in the urine during pregnancy. There are no symptoms of being colonized with GBS, and it usually does not lead to infection. However, because babies immune systems are immature, they are more prone to developing severe infection if exposed to the bacteria during birth. For this reason, it is recommended that any woman who is GBS-positive receive intravenous (IV) antibiotics during labor to decrease the risk of transmission from mother to baby.
Fortunately most healthy, low risk women will have normal, healthy babies. Although these conditions are rare, all babies are at some risk of developing chromosomal disorders there is no such thing as zero risk. Deciding whether or not to test for these conditions is a personal decision and only you can choose whats right for you.
At your first visit with our nurse, you will obtain written information about each one of these tests. Please review these prior to your first visit with the midwife so you are prepared to ask any questions you may have about these tests.
10-14 weeks First trimester screening
This is a screening for Down syndrome, trisomy 13 or trisomy 18. This test involves blood work and an ultrasound. The blood tests measure the amount of two substances normally present in the mothers blood stream during pregnancy – PAPP-A (pregnancy-associated plasma protein A) and free beta-hCG (human chorionic gonadotropin the pregnancy hormone. Abnormally high or low levels could signal a problem. The ultrasound is to measure the fluid behind the babys neck (nuchal translucency or NT). An increased NT may mean a higher chance for a chromosome problems.
This is an optional test to determine whether or not you are a carrier of the cystic fibrosis gene. Cystic fibrosis is a life-threatening disease that primarily affects the lungs and digestive system. Some people are carriers of the gene even though they do not have the disease.
This is blood test that can be performed as early as 10 weeks. It detects fetal chromosomal abnormalities such as trisomies 21, 18, and 13 to rarer abnormalities such as trisomies 16, 22, and other chromosomal disorders. This test is available for increased risk pregnancies with one or more of the following conditions:
-Advanced maternal age
-Personal history of chromosomal abnormalities
-Fetal ultrasound abnormality suggestive of chromosomal abnormality
-Positive serum screening test
15-20 weeks Quad test
This test measures the levels of four substances in the mothers blood AFP (alpha fetoprotein), HCG (human chorionic gonadotropin), unconjugated estriol (an estrogen hormone), and dimeric inhibin A. These levels are then used to calculate the risk of chromosomal or neural tube abnormalities in your baby. If this test indicates a high probability, your care provider may recommend an amniocentesis.
16 weeks Amniocentesis for genetic screening
This test is voluntary and may be recommended for certain high risk patients or if one of the other screening tests returns an abnormal result.
Ultrasound at 18-22 weeks
This ultrasound is an ultrasound that examines the general appearance of the baby to assess for major abnormalities brain, heart, spine, kidneys, stomach, legs, arms, chest, hands, feet, etc. And, of course, should you choose to find out, it will also tell you whether you are having a boy or girl. This test is also a screening test.
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Group prenatal care is used in many settings across the United States, primarily through a program called CenteringPregnancy. Group prenatal care allows you to meet with other women who share similar due dates and combines prenatal care with a discussion and support group.
Group prenatal care allows women to:
- Gain power and confidence throughout pregnancy
- Receive in-depth health education (beyond what is possible in a traditional model of care)
- Strengthen their community networks during their transition to motherhood
- Be more knowledgeable as health care consumers
Women who have participated in group prenatal care have:
- Higher levels of satisfaction with prenatal care.
- Lower numbers of inductions and medication use in labor.
- Higher levels of pregnancy knowledge.
- Fewer emergency room visits during the pregnancy.
Group prenatal care will begin at about 16-20 weeks. You and 8-10 other women, all due around the same time, will meet at our office. After checking in at the front desk, you will go to the meeting room immediately (no waiting for your appointment!).
When you arrive, a nurse will greet you. There will be time to weigh yourself, take your blood pressure and record this information on your record. You’ll have time to socialize with the other women and read about various health topics.
The midwife will measure your abdomen and listen to the baby’s heartbeat in a semi-private corner of the room. Any personal concerns will then be addressed.
Once everyone is assembled, the group session will begin. It will last about an hour. The nurse-midwife and nurse will sit with you and guide a conversation on a variety of topics about pregnancy, labor, birth and parenting.
Your entire session will last two hours. The schedule for visits is arranged before the first class. This allows you to have all of your prenatal visits booked well in advance.
In general, your group will meet every month for a few months and then every two weeks until the end of your pregnancy. Your midwife, nurse and group of women will be the same throughout your pregnancy. As you can imagine, some groups of women choose to continue to get together on their own after the babies are born.