What To Know: Resources For Pregnant Patients

Obstetric Care in Richmond VA

Congratulations on your pregnancy and thank you for choosing VPFW for your obstetric care! We are excited to care for you during this special time.

Every pregnancy deserves the very best support and resources. Your dedicated VPFW team is here to answer your questions and help you maintain your health during pregnancy so that you and your baby can have the strongest start possible.

We’re here when you need us

Access our Patient Portal for routine visits, test results, medical records, and non-urgent questions and concerns. We will schedule your next routine appointment at the end of each visit. Please call us if you need assistance setting up your patient portal access.
Call us at 804-897-2100 for more urgent medical questions or concerns. Choose Option 2 to speak with a phone nurse. We also offer same-day appointments if you need to come in for any problem you might be experiencing.
After hours, call our on-call physician at 804-897-2100 for serious medical concerns or if you think you are in labor when our office is closed. You will be directed to our answering service upon calling, and our on-call physician will be contacted. If our on-call physician has not returned your call within 15 minutes, please call us again. If it is an emergency, go to the hospital or call 911.

Timing of lab work, ultrasounds and appointments

Please bring your insurance card to all appointments so that you are prepared should your physician order any lab work.

Appointments

8 – 28 Weeks Appointments every 4 weeks*

28 – 36 Weeks Appointments every 2 weeks*

36 – 40 Weeks Appointments every week*

*Unless your physician states otherwise. If you have any complications, your doctor may need to see you more often.

Labs and ultrasounds

8 Weeks Ultrasound & routine lab evaluation

11-13 Weeks Ultrasound testing, if applicable, and lab work for chromosomal defects

16-19 Weeks Optional genetic testing (can be discussed with your physician)

20 Weeks Anatomy ultrasound

24-28 Weeks Pregnancy diabetes (glucose) testing and other blood work as applicable

28 Weeks Rhogam injection if your blood type is Rh negative

28-36 Weeks Tdap vaccine

36 Weeks Group B strep culture

Early pregnancy precautions

Early pregnancy (less than 20 weeks) marks the beginning of many physical changes you will experience over the next few months. Many of these changes are normal symptoms of pregnancy.

Cramps: Cramping of the lower abdomen, which may feel like menstrual cramps, is very common as your uterus stretches and your baby grows. However, if the cramps are accompanied by vaginal bleeding, pain on one side of the abdomen, or severe pain in any part of the body, please call our office.

Bleeding: A small amount of bleeding may occur following your pelvic examination or after having intercourse. This is not cause for alarm. If, however, you experience heavy bleeding or pass solid material, please call our office.

Nausea and vomiting: Many women experience nausea, particularly during the first few months of pregnancy. This is normal and can be remedied by eating bland foods and drinking carbonated beverages. If your vomiting is so severe that you are not able to hold down liquids, please call our office.

What treatments are safe for morning sickness and minor discomforts during pregnancy?

Not all over-the-counter medicine or treatment is safe for pregnant women to consume.

If you are experiencing morning sickness, you can take over-the-counter vitamin B6, 10-25mg three times per day to help with nausea. You can also take Unisom to help with sleep and morning sickness.

Please see the list of treatments that are approved for the minor discomforts during pregnancy, such as allergies, colds, constipation, cramping, diarrhea, fever, headache, heartburn and indigestion, sore throat, urinary tract infection, and more.

See full list of treatments approved for minor discomforts during pregnancy >

Nutrition during pregnancy

Your diet should include a variety of healthy foods and beverages in order to provide the nutrients your baby needs for growth and development.

The American College of Obstetricians and Gynecologists (ACOG) recommends a balanced diet of whole grains, fruits, vegetables, protein, and dairy. In addition to this, pregnant women need more calcium and vitamin D, folic acid, iron, and protein than women who are not pregnant.

Calcium and vitamin D help to build a baby’s bones and teeth as well as skin and eyesight.

Folic acid helps to prevent birth defects of the fetal brain and spine.

Iron is necessary to make more blood to supply the baby with oxygen.

Protein helps build the baby’s organs.

Prenatal vitamins are recommended to supplement a balanced diet so that you get the extra amounts of vitamins and minerals needed during pregnancy to ensure proper development.

Increased water intake will help support fetal circulation, amniotic fluid, and a higher blood volume needed in order to transport vitamins and nutrients to your baby.

What to eat and what to avoid: ACOG’s recommendations

ACOG has specific recommendations for diet and nutrition during pregnancy, which include:

which food sources supply the necessary nutrients, vitamins, and minerals you and your baby need
how much of each vitamin and mineral you need per day and when you might need to supplement with prenatal vitamins
what foods to avoid to prevent listeriosis (which can lead to miscarriage, stillbirth and premature delivery) and mercury (which can lead to birth defects)
how much weight you should be gaining during your pregnancy

ACOG’s recommendations for nutrition and diet during pregnancy>

During pregnancy, it’s important to avoid tobacco, alcohol, marijuana, illegal drugs, or prescription medications for nonmedical reasons. If you are struggling with substance use, talk to your provider about finding help or go to startyourrecovery.org to find a treatment program near you.

Exercising during pregnancy

Pregnancy is not a disability, and the more active you are, the easier childbirth can be. If you exercised before pregnancy, you may continue to exercise, making some adjustments in activity and weight restrictions as your pregnancy progresses. Getting out and walking most days of the week is beneficial.

You should avoid contact or high-risk sports. If bleeding or cramping occurs, increase water intake and decrease activity. Do not use hot tubs or saunas.

ACOG’s recommendations for exercising while pregnant >

Prenatal screening and genetic testing

There are options for screening and diagnostic testing of cystic fibrosis and chromosomal abnormalities during your pregnancy. Testing may or may not be covered by insurance, depending on a couple’s age, family history and other factors.

Prenatal screening for cystic fibrosis >

Prenatal screening for chromosomal abnormalities >

Please check with your insurance company for coverage of the tests. This is the patient’s responsibility. Check out LabCorp’s cost estimator for prenatal and pregnancy testing.

Flu shot and Tdap vaccines

The flu shot and the Tdap vaccines are safe and encouraged for pregnant women because they provide protection for both the mother and baby. The flu shot can be given at any time during pregnancy.

Flu shot FAQ’s for pregnant women >

Tdap FAQ’s for pregnant women >

Preterm labor

As your pregnancy progresses through weeks 20 to 36, you need to be aware of the following signs and symptoms of preterm labor:

Regular contractions: You will often have irregular contractions. Regular contractions, however, are not normal and may signal the onset of preterm labor. If you have six or more within an hour, increase hydration and rest. If they continue into a second hour, please call our office.
Rupture of membranes: Your membranes can rupture before you go into labor, when labor begins, or during labor. If your membranes rupture (water breaks) you will experience an uncontrollable surge of clear fluid from the vagina. If this occurs, please call our office.
Bleeding: As stated previously, a small amount of bleeding may occur following your pelvic examination or after intercourse. This is not cause for alarm. If, however, you experience heavy bleeding or pass solid material, please call our office.
Lack of fetal movement: Your baby should move every day. You can encourage movement by lying down on your left side with your hand on your stomach to feel the movement, by drinking fluids, or by eating. If none of these techniques cause fetal movement, or if you perceive fetal movement to have decreased, please call our office.

Pregnancy to-do list

Thankfully babies don’t come right away so you can use that time to get prepared. From signing up for baby classes and touring the hospital, to prepping meals and packing your hospital bag – we have a great guide to help you be as ready as you can be.

Read our pregnancy to-do list>

Planning for maternity leave

The typical amount of time allowed for disability leave after a delivery is 6-8 weeks, depending upon the type of delivery and other contributing factors. This is the amount of time that our physicians feel is necessary for the body to heal after a delivery.

This is different from FMLA leave, which allows up to 12 weeks every 12 months for the birth of a child. If your employer is required to follow FMLA laws, it will be up to you to decide how much time you wish to take under this regulation.

Please keep in mind that your employer’s policies will determine whether your disability leave and/or your FMLA leave will be paid leave or leave without pay. We cannot extend your disability leave beyond what is medically appropriate in order to extend your paid leave.

Patients occasionally ask to be taken out of work prior to delivery. Please keep in mind that we are only able to do so when there is a medical condition that necessitates being out of work. In most instances, a healthy pregnancy does not warrant being out of work.

Disability paperwork

If you have any disability or FMLA papers that need to be filled out by your physician, please leave them with the front desk staff at your earliest convenience. Please be aware that it may take up to one week for the forms to be completed. There is also a $30 form fee* that needs to be paid prior to the forms being completed. This may be paid by cash, check, or credit card. A copy of the completed forms will be kept in our files.

While we realize how important it is to complete the forms and return them to you in a timely manner, filling them out does take time away from our ability to see and provide care for our patients. Thus, form fees are standard practice among medical providers.”

*The form fee has increased from $20 to $30 as of Feb. 1, 2023.

Can I travel while pregnant?

Please discuss travel plans with your physician. Flying is not recommended after 35 weeks for routine pregnancy, and travel in the last four weeks of pregnancy is generally not recommended. Avoid heavy lifting, including anything as heavy as a suitcase. If you are traveling, plan frequent stops (at least every 2 hours) and walk around for a few minutes to reduce the risk of blood clots. Make sure to drink plenty of water. Before you travel, refer to the CDC.gov website for up-to-date information on areas at risk for the Zika Virus.

Birth plans

Having a birth plan can be nice but be willing to stray from it if things do not go as “planned.” You can have expectations of what you would like, and this is helpful for your OB to know, but the primary goal and birth plan should be “healthy baby, healthy mom.”

Sometimes babies have a plan of their own (and don’t consult with you first). We have to accommodate their plans – and that may mean having a c-section when you wanted a vaginal birth, getting an epidural when you planned a natural childbirth, or having an operative delivery when the plan was for you to deliver with only maternal pushing. When it means the health and safety of you and your baby, it’s important to be willing to adjust your plans.

Heading to the hospital

If you suspect that you are in labor or if you suspect membrane leakage, it is important that you follow these instructions:

The first thing you should do, regardless of time of day, is call our office at 804-897-2100.
If your call is during normal business hours, please select Option 2 for a phone nurse.
If our office is closed, you will be directed to our answering service, which will contact our on-call physician.
If our on-call physician has not returned your call within 15 minutes, please make a second call to our office, or call our answering service directly at 804-965-7933. If it is an emergency, go to the hospital or call 911.
After you have discussed your symptoms and other important information with the physician, they will, if it’s appropriate, direct you to the hospital where we can best meet your needs.

VPFW would like to remind you that it is your responsibility, as the insured party, to be aware of the benefits offered by your insurance policy. Insurance policies may provide different levels of coverage depending on which network of hospitals, such as Bon Secours (St. Mary’s Hospital and St. Francis Medical Center) or HCA (Johnston-Willis Hospital and Henrico Doctors’ Hospital), you choose to use. If you have a strong preference for a specific hospital, we encourage you to discuss this with your physician as early as possible during your pregnancy.

We appreciate your cooperation and assistance in helping us provide the best care possible to all our patients. If you have any questions or concerns, please feel free to address them with either your physician or a staff member at Virginia Physicians for Women.

Who will deliver my baby?

Your OBGYN will do his or her best to be there to deliver your baby. If your physician is not available to be there, you will still be in good hands. We always have a VPFW physician on call, and we also have a partnership with a trusted group of board-certified OB hospitalists and certified nurse midwives at each of the hospitals where our patients give birth. It is our goal that each of our patients receive the best care possible before, during, and after the delivery of their baby.

Newborn screening

While most babies are born healthy, some infants are born with a serious but treatable medical condition. These conditions can be present in any family, even those without a family history of them. Newborn screening helps health professionals to identify and treat these conditions before they make a baby sick.

Newborn screening usually happens 24 hours after your baby is born before you leave the hospital. It’s a three-part test, including a heel stick, hearing test, and pulse oximetry. Here’s what to expect:

Baby’s First Test – What to Expect >

Unmarried Parents: Establishing Paternity of Your Child

In Virginia, if parents are not legally married at the time of birth, the biological father’s name will not appear on his child’s birth certificate unless they establish paternity. The biological father does not have any legal rights to the child until paternity is established. Even if the parents live together and/or plan to marry, the couple must establish legal fatherhood to guarantee the child’s rights.

Unmarried parents will be given the opportunity to establish paternity for their baby at the hospital, free of charge. The hospital’s birth registrar will present the Acknowledgement of Paternity (AOP) form to unmarried parents. Parents must present a photo ID and sign the AOP form in front of the birth registrar for the birth registrar to notarize the form. If the father is not able to sign the form at the hospital, a meeting can be scheduled with the birth registrar after hospital discharge. There is no fee to complete the form at the hospital or within seven days of discharge from the hospital. After seven days, there will be a nominal fee to complete the form.

Learn more about establishing paternity and why it’s important >

Feeding my baby

When deciding how you want to feed your baby, the one thing to remember is that a happy baby is a fed baby. Whether you decide to breastfeed or use formula is your decision, and we support whatever works best for your family.

The American College of Obstetricians and Gynecologists has an excellent guide to breastfeeding as well as a handout on Breastfeeding Benefits.

Thank you for choosing VPFW!

Congratulations again and thank you for choosing VPFW as your medical provider. We are honored to be part of your pregnancy journey. We’ll be here when you need us!