At Premier Healthcare for Women, we are dedicated to helping our patients navigate through this special time. We are honored to go through this journey with you!
We provide continuous and complete obstetrical care, from pre-pregnancy planning, the pregnancy confirmation to the birth of your baby and through the healing of the postpartum period. The full range of obstetrical services include the ultrasounds (sonogram), genetic testing, and fetal monitoring for low to high-risk pregnancies.
We work to help guide you through the entire process with our compassionate and dedicated team.
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Premier Healthcare for Women
We are dedicated to educating patients on what steps they can take to be healthy prior to pregnancy. If you plan on becoming pregnant, it is important to let your doctor know so that you will be best equipped for a healthy pregnancy.
As soon as you discover you are pregnant, whether it is your first or your last, schedule your prenatal care with us. Pregnancy is a time full of questions, preparations, and excitement. Premier Healthcare for Women will be with you to provide care every step of the way. Our practice is an intimate and compassionate environment with state-of-the-art facilities. We embrace evidence-based medicine which aims to improve women’s prenatal care. Our team is here to ensure you have individualized health care for you and your baby.
We treat each patient as an individual, not a number. As women and mothers, we understand and respect the enormous trust you put in your caregivers at this miraculous time in your life.
Cord Blood Banking
What is Cord Blood Banking?
Cord blood banking involves collecting blood left in your newborn’s umbilical cord and placenta and storing it for future medical use. Cord blood contains potentially lifesaving cells called stem cells. The stem cells in cord blood are different from embryonic stem cells.
For cord blood storage, you have two main options:
• You can donate your baby’s cord blood to a public cord blood bank for anyone who needs it.
• You can pay to store your baby’s cord blood in a family cord blood bank for your family’s use.
Cord blood is a rich source of blood stem cells. Stem cells are the building blocks of the blood and immune system. They have the ability to develop into other types of cells, so they can help repair tissues, organs, and blood vessels and can be used to treat a host of diseases.
Cord blood stem cells have been used successfully to treat more than 70 different diseases, including some cancers, blood disorders, and immune deficiencies. Among these are leukemia, aplastic anemia, thalassemia, Hodgkin’s disease, and non-Hodgkin’s lymphoma. (Cord blood stem cells have also been used to treat sickle cell anemia, but that procedure is not yet on the FDA-approved list.) Cord blood transplants are also used to treat rare metabolic disorders that would otherwise be fatal for infants (Krabbe disease and Sanfilippo syndrome, for example).
Cord Blood Banking Options
A public bank through MD Anderson Cancer Center (MDACC) is available for cord blood donation. MDACC staff at the hospital are available to consent you for cord blood donation and help with the cord blood collection process at the hospital. You do not need to pre-register for the donation prior to admission to the hospital. Once you are admitted for delivery, the MDACC staff will come to your room to register you if you desire to donate your cord blood.
Multiple reputable cord blood collection companies are available for patients who want to store their cord blood. You do need to register for this service prior to delivery. Most companies have a registration process that you complete, and they then will mail you a collection kit to your home. You then bring the collection kit to the hospital for your delivery. After collection, your cord blood company arranges a courier to pick up the cord blood from the hospital.
Understanding Pregnancy Loss
As women and mothers, we understand how devastating pregnancy loss can be, even if it is very early. We know that a bond is formed as soon as the pregnancy test is positive, and we cannot help but make plans surrounding the baby’s due date and all the exciting possibilities about the baby’s future. When the pregnancy doesn’t continue the disappointment and grief can be overwhelming. Not only have we lost the pregnancy itself, but we also suffer the loss of those hopes and dreams. If you are going through the process of miscarriage, we are here to help guide you through both the physical and emotional aspects of your loss. Several of your caregivers here at Premier Healthcare for Women have been through this themselves, so we truly understand how you feel.
The facts about miscarriage may not give you much solace at this time. It is important to know that 15% of diagnosed pregnancies end in miscarriage. Many more than that miscarry before we even recognize that we are pregnant. So pregnancy loss is very normal, and it is unlikely that there is anything wrong with you or your partner that caused this to happen. Most miscarriages occur before 8 weeks, and most often the baby has a chromosomal problem that causes the growth to stop at an early stage. Chromosomal problems occur right after conception when the cells are dividing and a mistake in cell division occurs. For this reason, there is nothing you (or we) can do to change the outcome, it happens at the time of conception, and it just takes us a few weeks to be aware of it.
It is important to remind yourself that whatever you did, or did not do, it was not your fault.
If you are in early pregnancy (less than 8 weeks) and have vaginal bleeding or cramping at home, you may not be sure if you are having a miscarriage. If this happens, please call us, and we will give you instructions. Often, we may tell you to rest at home and come in the next day for an ultrasound. Patients often ask if they need to go to the emergency room. We generally recommend waiting until office hours, so you do not have to be subjected to the cold and clinical ER environment. Since there is, unfortunately, nothing we can do if you are in the process of a miscarriage, it is okay to wait until the next day to be seen. We are not minimizing the problem by not sending you to the ER. There is simply nothing that anyone can do. Hopefully, by doing an ultrasound the next day, we will reassure you that everything is okay, since sometimes bleeding in early pregnancy can be normal.
If you have questions that are not addressed here, please let us know.
After one miscarriage we do not recommend any testing to evaluate for problems because it is so rare that anything is wrong.
We know that going into the next pregnancy is very scary, but try to have faith that the majority of the time the second pregnancy is fine.
While 15% of pregnancies don’t make it, 85% do, so try to keep that in mind.
There is no evidence that waiting any specific period of time after a miscarriage is necessary. If you are ready to try again right away, that is fine. It is a good idea to wait until you have one normal period on your own, which may occur 4-6 weeks after the miscarriage, then start trying if you are emotionally ready. (If you have not had a period 6 weeks after a miscarriage, do a pregnancy test because some people get pregnant again before they have their first period.)
LABOR & DELIVERY
Labor & Delivery
Our care does not end at 40 weeks. Our team is ready to be by your side during labor and delivery – vaginal birth or a cesarean section – to make your birth experience wonderful, unique, and safe.
We deliver at the Woman’s Hospital of Texas, the first facility in Texas dedicated solely to the health of women and children.
They offer state-of-the-art pregnancy, maternity, and pediatric care.
After Vaginal Delivery
You will usually be discharged 24-48 hours after you deliver. Insurance companies do not allow you to stay longer unless you have a medical problem. We will give you prescriptions for Ibuprofen 600 mg (or you can take 3 over-the-counter strength tablets at one time) and Norco (Tylenol with non- codeine narcotic), which you can take as needed. It is ok to take both together if necessary.
We also recommend staying on your prenatal vitamin if breastfeeding, and taking an additional calcium supplement daily.
If you have stitches it is normal to have some discomfort for about 2 weeks. After that, all the stitches dissolve and do not need to be removed.
Depending on what type of suture was used, you may feel some suture material for 1-4 weeks.
Bleeding after delivery will continue for 4-8 weeks but should get lighter after the first few days. You may have a return of bright red bleeding 7-10 days after delivery; this is normal if it is similar to a period or less.
You may pass some clots of blood since blood tends to pool in the vagina and will form a clot that comes out when you stand up or move around, and sometimes bleeding seems heavier when you are active for the same reason. Call us if you are bleeding for more than a heavy period for more than a few hours (for example, repeatedly filling a pad more than once an hour).
It is normal to have an increased swelling in your feet and legs in the first few days postpartum. This will resolve in a few days and is caused by the excess fluid in your system after delivery, both from the pregnancy itself and the fluids you were given in labor.
You will usually be discharged 2-4 days after you deliver. Insurance companies do not allow you to stay longer than 4 nights after delivery unless you have a medical problem. We would like to see you in the office approximately 2 weeks after delivery.
We will give you prescriptions for ibuprofen 600 mg (or you can take 3 over-the-counter strength tablets at one time) and Norco (Tylenol with a non-codeine narcotic) which you can take as needed. It is ok to take both of these together if necessary. We also recommend staying on your prenatal vitamin if you are breastfeeding and taking an additional calcium supplement daily.
It is normal to have some discomfort for about 2-4 weeks. All the stitches dissolve and do not need to be removed. You will notice small tapes or steri-strips over the incision. If possible, these need to be left in place for 2 weeks to reduce the risk of scar separation. If they fall off on their own before 2 weeks, that is fine, but do not remove them deliberately. We will take them off at your 2-week postpartum visit. It is normal to have some swelling, mild redness, and superficial bruising around the incision.
Call us if the redness or bruising seems to get worse or expand. We recommend wearing a supportive garment over the incision if you feel swollen to apply gentle pressure. Even Spanx or similar underwear will work. It is normal to see a small amount of bleeding or clear drainage from the incision. If you see more than a small amount of bleeding or drainage, please call us to schedule an appointment for an incision check.
Post-Partum Pregnancy Prevention
Occasionally patients will begin to ovulate (and therefore be fertile) as soon as 6-8 weeks postpartum. Exclusively breastfeeding patients have a low risk of pregnancy in the first 6 months. Still, we recommend starting some form of birth control as soon as you are sexually active (condoms) if you do not want to become pregnant again right away. We will discuss other birth control options with you at your postpartum visit.
Postpartum depression is a serious condition that generally starts 4-8 weeks after delivery. We all feel a little overwhelmed or tearful at times. However, if a sad or depressed mood continues for several days and starts to affect your function (for example if you stop getting out of bed, stop taking appropriate care of the baby, or stop doing other normal activities), or if you have thoughts of hurting yourself or the baby, it is important to seek immediate help.
Breast milk does not normally appear for 3-5 days after delivery. Initially, the baby will be sustained by colostrum which is small in volume but high in nutrition. When your milk comes in, you may feel that your breasts grow very large and firm. Occasionally you can get a low-grade temperature elevation (99-100) when your milk comes in.
If your breasts are engorged (remain very full, painful, and firm without milk being released), applying hot compresses, standing in the hot shower, and gentle massage can help. If you have not experienced significant milk production by the 5th day postpartum, please call us so we can offer assistance.
If you feel that your milk volume is low (less than 1 ounce /hr total, or 3-4 ounces every 3-4 hours when pumping), please refer to our information on increasing milk production in the section below.
It is normal to experience some pain after any type of delivery, both vaginal and c-section. However, it should improve greatly as the days pass after delivery and your body heals and recovers from pregnancy and delivery. Upon discharge from the
hospital, you will receive pain medications, including ibuprofen (anti-inflammatory) and Norco (a non-codeine narcotic pain medication).
It is important to use and alternate between the two options as they treat pain and inflammation differently. It is important to use these only until you do not feel severe or intense pain. We are no longer using Tylenol with codeine (T-3) or Tramadol in the postpartum period. There is concern that these medications could cause sleepiness in the newborn breastfed infant. If you do not feel that your pain from delivery is improving with the pain medications, it is important to notify us to schedule an early postpartum follow-up.
Please call us if you have a fever greater than 100, persistent and very heavy bleeding, severe pain, or any other problems that we can assist with.
Increasing Milk Supply
Congratulations on your new baby and for your breastfeeding efforts! This can be a very challenging yet very rewarding experience. We would be honored to help you in any way that we can.
Please understand there is no perfect answer on how to increase your milk supply, there are many reasons your milk supply may be low, and this is simply meant to educate you on options that we support and can prescribe if appropriate.
There are many non-prescription or natural products that have been utilized for many years, which we also encourage.
• Drinking plenty of fluids. You should be drinking non-caffeinated beverages and using the restroom frequently and noticing clear, light colored (dilute) urine.
• Drink mother’s Milk Tea 3 -5 times per day.
• Fenugreek 3 capsules 3 times per day. This herbal supplement has been around for many years and is used frequently by lactation specialists. You will typically notice an increase in your milk supply in 48 -72 hours.
• Some pediatricians also suggest drinking malt. You can have this in the form of malted milk 2-3 times per day.