OBSTETRICS

Obstetric Care

Dr. Finberg is a dedicated and experienced physician. He is committed to providing you with the best medical care possible throughout your pregnancy.

The First Prenatal Appointment

The first prenatal care appointment is exciting and busy. Dr Finberg will take a detailed medical history, including a discussion of any pre-existing conditions, medication use, and whether or not changes to your current health regimen need to be made. You will also receive a physical and pelvic exam, and your projected due date will be determined by ultrasound. Dr. Finberg will also order an OB lab panel, which includes blood and urine tests.

Routine OB Care Visits

After the first prenatal appointment, you should have follow up appointments once every four weeks during the first two trimesters. Upon entering the third trimester, appointments should be scheduled for once every two weeks and visit frequency should increase to once a week for the last month of pregnancy, unless Dr. Finberg determines otherwise.

OB Ultrasounds

Nuchal Translucency Screening: The NT scan ideally is done when you're between 11-13 weeks pregnant, because this is when the base of your baby's neck is still transparent and the best time to scan for the fetal nasal bone. (The last day you can have it is the day you turn 13 weeks and 6 days pregnant.) The Nuchal Translucency scan uses ultrasound to assess your developing baby's risk of having Down syndrome (DS) and some other chromosomal abnormalities, as well as major congenital heart problems. It's usually offered along with a blood test in the first trimester. The NT scan is not invasive and is usually performed by an abdominal ultrasound.
Fetal Anatomy Ultrasound: This ultrasound is typically preformed around 18 to 20 weeks to assess fetal development and at this point you can usually find out the sex of your baby. This ultrasound is usually the second one done in pregnancy unless Dr. Finberg determines that you need an additional ultrasound, but that will be determined on an individual basis.

High-Risk Pregnancy

Many conditions affecting a mother or her baby before, during or after pregnancy can designate a pregnancy as high risk.

Pre-existing medical condition. There are many pre-existing medical conditions that may need to be monitored in relation to pregnancy (e.g., diabetes, lupus, renal disease and hypertension (high blood pressure.)
Genetic Risks. Preconception genetic screening has become more common in recent years as technology has advanced and testing has become more accessible. If you have family members with a certain disease or if you belong to an ethnicity that has a greater risk of developing specific conditions (such as sickle cell disease or Tay-Sachs disease), genetic screening can be used to assess your and your partner’s risk of being a carrier. Also, common genetic conditions, such as cystic fibrosis or spinal muscular atrophy, can be screened for with a blood test.
Diabetes. If you have diabetes before you become pregnant, you will likely be referred to a diabetic specialist to co-monitor your condition and determine the proper medications. Preconception counseling is ideal. Developing diabetes during pregnancy (gestational diabetes) is very common, and Dr. Finberg will likely be able to care for you without a maternal-fetal medicine consult. If a diabetic specialist is consulted for gestational diabetes, he or she will manage your health with nutrition counseling, glucose monitoring and, possibly, medications.
Pre-eclampsia. Pre-eclampsia is a condition unique to pregnancy where you have high blood pressure in conjunction with protein in your urine and edema (swelling of the skin). In some women with pre-eclampsia, liver or platelet abnormalities are present. The only treatment for pre-eclampsia is delivering your baby, so this is a condition that requires very close monitoring to balance maternal complications against the risks of delivering your baby early.
Hypertension. If you have hypertension before pregnancy, Dr Finberg will monitor your baby’s growth and may require consultation if problems arise. Some medications commonly used outside of pregnancy to treat hypertension are contraindicated in pregnancy.
Multiples. Pregnancies with twins or higher-order multiples have a greater risk of complications. Women with multiple pregnancies are more likely to develop pre-eclampsia or go into preterm labor. Twin pregnancies have a higher risk of fetal anomalies and growth problems, especially if they share a placenta. If you have a multiple pregnancy, Dr. Finberg will closely monitor the pregnancy by performing additional ultrasounds. He will recommend how and when your babies should be delivered.

Cesarean Sections

A cesarean section (also referred to as a c-section or C/S) is a surgical procedure designed to deliver babies when it is not possible or safe for the birth to take place vaginally (sometimes called “natural birth”). In the United States 32 percent of all babies are delivered via cesarean. C-sections are often planned in advance, but occasionally complications during delivery require an unexpected cesarean section. In many cases, it is possible to plan for a cesarean section prior to labor and delivery. C-sections are often required if the baby is in a breech position (feet or bottom down), is too large, or is a multiple birth (twins or more). Cesarean sections may also be scheduled in advance if the mother has a history of previous c-sections or presents with other medical or obstetric complications. Occasionally, an issue may develop during labor that necessitates an unexpected cesarean section. For instance, if the labor does not progress properly or the baby’s head does not descend, a vaginal delivery might not be possible. Dr. Finberg may also decide that a c-section is needed in order to avoid a risk to the mother or if the baby is in distress.

Postpartum Care

Having a baby is a life-changing event, both emotionally and physically, and proper postpartum care is crucial to your recuperation after giving birth and to your adjustment to life as a new parent. For the first two weeks after giving birth, allow yourself to focus on caring for yourself and your child. Your body needs to recover after the physical stress of pregnancy, labor, and delivery. For the first few weeks after you give birth, give yourself time to rest and take special care of your body as it heals from nine months of pregnancy and delivery,

Postpartum Medical Check-Ups: Dr. Finberg will need to see you for your postpartum checkup, usually two to six weeks after you give birth. This appointment provides an opportunity to discuss any questions or concerns you have, including contraception, physical recovery, and your emotional well-being. Call our office to schedule a doctor’s visit before leaving the hospital or soon after going home.
Postpartum Depression: After having a baby, some women may experience overwhelming feelings of frustration, inadequacy, fatigue, and worry. These are normal emotions related to becoming a new parent and these feelings may also be further compounded by ordinary life stresses, such as finances, feelings of isolation, and being overwhelmed by other work or home responsibilities. If you are experiencing difficult emotions try to be patient with yourself – take time to adjust to your new life. If depression persists or increases and you are experiencing thoughts and feelings that go beyond the normal anxieties of being a new parent, or if you think your feelings are impairing your ability to care for yourself and your family, call us immediately.

For accurate information on specific topics link to: www.acog.org