Obstetrics

+ Prenatal Care

This is a very special time, and we want to make it a positive experience for you and your family. We have physicians within our group who deliver babies. The on-call physician will attend your delivery. We encourage our patients to pick 1-2 primary providers to allow us to establish a relationship and continuity of care.

Listed below are the recommended visits during your pregnancy. We welcome and encourage your partner to attend visits with you.

• 6 – 8 weeks — Pregnancy confirmation appointment with a Nurse Practitioner which may include

  • Pregnancy test and dating ultrasound
  • Review of your health and family history
  • Routine prenatal blood tests
  • Discussion of genetic testing options
  • Review of pregnancy care in our office

• 10-12 weeks — The initial OB appointment. This visit will consist of a prenatal lab panel and a complete physical exam by the physician. Optional first trimester screen ultrasound and labs drawn. Pelvic exam, optional blood tests to assess for genetic conditions. Please allow 30 minutes for this visit. Please allow 90 minutes if you are planning to do the first trimester (NT) screen.

• 16 weeks — Optional quad screen or AFP drawn (15-min. appointment with doctor or nurse practitioner).
• 20 weeks — Screening ultrasound (60 min.) plus an appointment afterward with the doctor or nurse practitioner (15 min.).
• 24 weeks — Schedule with a nurse practitioner (15 min.).
• 28 weeks — One-hour glucose test. For women who are Rh-factor negative, additional tests are drawn and Rhogam is administered.
• 32 weeks — 15-min. appointment with the doctor or nurse practitioner.
• 34 weeks — 15-min. appointment with the doctor or nurse practitioner.
• 36 weeks — 15-min. appointment with the doctor or nurse practitioner. A Group B strep culture will be obtained.
• 37 weeks — 15-min. appointment with the doctor - initiation of discussion for timing and options for induction of labor
• 38 weeks — 15-min. appointment with the doctor - initiation of discussion for timing and options for induction of labor
• 39 weeks — 15-min. appointment with the doctor.
• 40 weeks — 15-min. appointment with the doctor.
• 41 weeks — One week past your estimated due date (15-min. appointment with the doctor). Discussion and plans for delivery (induction of labor).

+ Prenatal Screening

Panorama testing - cell free DNA test to assess for chromosomal imbalances.

There is a wide array of screening tests in pregnancy. Screening tests are performed to assess a person's risk for a condition affecting pregnancy and the fetus. These tests do not provide a diagnosis, instead identifying couples who should be offered diagnostic testing.

Examples of conditions for which screening is possible are Down syndrome, Trisomy 18, and cystic fibrosis.

Nuchal translucency

This is a screening test used to identify pregnancies at higher risk for Down syndrome and Trisomy 18. It involves a combination of ultrasound and blood testing to determine these risks. The test is performed between 11 weeks to 13 weeks 6 days (after a prior ultrasound has been performed to verify dating of the pregnancy). The results are available in 7 to 10 days.

Quad test

This test provides a similar risk assessment for Down syndrome, Trisomy 18, and neural tube defects (spina bifida and anencephaly). It is performed between 15 and 20 weeks, and results are available in 7 days. Given the higher chance for detection with the nuchal translucency test, the quad test is less frequently used.

Carrier testing

Recessive conditions require two mutations (one from each parent) for the disease to be present. Individuals with one copy of the mutation are called carriers. Each individual is born with multiple recessive mutations. Ethnicity can provide a clue for certain conditions. Two conditions are considered prevalent enough to offer universal screening for patients: cystic fibrosis and spinal muscular atrophy. Couples electing to pursue testing can have their blood tested to identify their status. If the woman is a carrier, we recommend testing her partner. Amniocentesis would be offered to couples identified as carriers.

Those couples identified with an elevated risk (for Down syndrome or Trisomy 18) are referred for genetic counseling and diagnostic testing (such as amniocentesis or chorionic villus sampling) with perinatologists (high-risk obstetricians).

+ Labor and Delivery

At WHC, we pride ourselves on providing comprehensive obstetric care, individualized to each patient’s unique situation and needs. We care for our families and deliver only at The Mother Baby Center. The Mother Baby Center's affiliation with Abbott Northwestern Hospital and Children's Hospital-Minneapolis enables us to offer high-risk obstetric care, as Children's Neonatal Intensive Care Unit (NICU) is one of the best in the nation.

Here is an overview of what to do and what to expect when the big day finally arrives:

If you think you are in labor, call our main number: 612-775-7880 [option 1]. During office hours, you will speak to one of our nurses, who will answer any questions that you might have and direct you to the clinic or the hospital, if appropriate. Our after hours triage nurses will review your situation and make recommendations. This may include contacting Labor and Delivery about your arrival or paging the on call physician.

A labor and delivery nurse will do an initial assessment of you and your baby. The nurse will then contact our on-call doctor. If the decision is made to admit you to the hospital, you will be seen by the doctor immediately or in a timely fashion, depending on the circumstances.

Our doctors share the on-call schedule, so your delivering doctor may not be your primary doctor. You will be delivered by a WHC physician (and a well-rested one!).

After delivery, you will be seen every day while you are in the hospital by a WHC nurse practitioner or physician.

+ Postpartum Recovery

Postpartum Recovery discharge happens 24-36 hours after uncomplicated vaginal delivery. After delivery at The Mother Baby Center, you will be visited by one of our physicians or nurse practitioners during their daily rounds. Patients frequently are discharged on the second morning after a vaginal delivery, and often the third morning after a cesarean delivery. Lactation support is available both in the hospital and afterward in the outpatient clinic at Abbott. Home health nursing visits can also be arranged.

Routine postpartum care involves a 6-week postdelivery visit at a WHC clinic. For those patients who deliver by cesarean, a 2-week postoperative visit is recommended. The postpartum visit is similar to a routine annual exam. Pap smears are performed as appropriate, and contraception options are reviewed.

For those patients planning an intrauterine device (IUD) for contraception, insertion can be done at the 6-week visit. We ask that you mention this when scheduling the appointment so that adequate time is allowed. It is also important to know your level of insurance coverage for this procedure before the office visit, since this can vary by individual policy.

Acute visits during the postpartum time can be arranged for concerns such as heavy bleeding, breast infection (mastitis), postpartum depression, or anxiety. Our nurses can answer postpartum questions and facilitate evaluations when needed. The on-call physician can address urgent concerns after hours or on weekends.