• Depending on your insurance coverage, copays and deductibles will vary from policy to policy.

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• At 36 weeks pregnant you will have a Group B Strep (GBS) culture done; this will be billed to your insurance as an office visit PER the insurance company. Most policies will require you to pay your copay and or deductible.

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• During your pregnancy if you need to be seen for anything other than OB care your insurance will be billed for services rendered. Example: cold, urinary tract infection, etc. Most policies will require you to pay your copay and or deductible.

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• Many employers ask for disability forms to be filled out for maternity leave. There is a $20.00 charge per paperwork, which is due before your paperwork will be filled out. Turnaround time is a FIRM 7-10 business days.

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• Insurance companies will usually cover ONE ROUTINE ultrasound per pregnancy. This will be performed between 19-20 weeks of pregnancy. Most policies will require you to pay your copay and or deductible. Under any circumstance your policy covers only one ultrasound regardless, we will always appeal this with your insurance company to get this covered. Most policies will
  require you to pay your copay and or deductible for your ultrasounds.

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• Please take note that your very first ultrasound and visit known as an OBI Talk, to confirm pregnancy and under no circumstance is this considered routine prenatal care. Most policies will require you to pay your copay and or deductible.

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• All genetic testing done in office is billed from an outside lab, Women First is not responsible for knowing your insurance coverage for these tests. All payments and questions will be directed towards the company that processes the test.

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• The genetic services we offer are through Integrated Genetics. If you have any billing questions or concerns, please feel free to visit the integrated genetics website: www.integratedgenetics.com/transparency or call 844-799-3243

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• The tests you can ask about include:

  • Inheritest Society Guided Panel – $299
    (Parent’s genetics)

  • MaterniT 21 PLUS Core + SCA – $299

  • MaterniT 21 Genome – $499 (Baby’s genetics)

We always encourage our patients to eat nutritiously; not only for your benefit, but now for your developing baby.  Pregnant women typically need an extra 350 calories/day.  Typical weight gain is 25-35 lbs.  In addition, 1500 mg of calcium/day (from dairy products or supplement) is recommended, as well as drinking plenty of water.  Caffeine should be avoided as much as possible.  Drinking one cup of coffee/day is okay, but you should not exceed this amount regularly.  Raw or undercooked food should always be avoided.  These include:  undercooked meat, deli meats, batter or dough with raw eggs, sushi, and unpasteurized products, including cider and some soft, imported cheeses.(i.e. feta, brie, and blue cheese).  We do not recommend any alcohol.

Smoking is dangerous to your health whether you are pregnant or not. It can increase the risk of miscarriage, small babies and placental abruption. If you can’t stop, the less you do the better. NONE IS BEST.

They include the following:

Fever: Tylenol (NO ASA) regular or extra strength in the normal adult dosage
Gas: Gas-X, Tums, Phazyme
Heartburn: Tums, Rolaids, Maalox, Nexium, Protonix, Pepcid AC, Prevacid, Zantac (NO Prilosec)
Headaches: Tylenol, Category C = Fioricet, Vicodin, Tylenol #3, Stadol NS
Hemorrhoids: Preparation H, Anusol HC, Tucks Pads, Analapram HC 2% Rx
Insomnia: Unisom tabs, Benadryl, Tylenol PM, NO Melatonin

If you are unsure, please call our office before taking anything.

It is safe to continue exercising during pregnancy.  In fact, being in good physical shape has several benefits.  Besides helping you feel and look your best, studies have shown that labor and delivery is sometimes “easier” and can actually be shorter for women in good physical shape.  Once the baby is born, you may return to your pre-pregnancy size and/or shape quicker if exercise is part of your routine.  When exercising, your pulse should not exceed 140 beats per minute and you should not go “anaerobic” meaning your heart rate should not be more than 85% over its resting rate. Drink plenty of water and avoid getting overheated.  After 15 weeks, avoid such activities as skating, rollerblading, etc. where there is a chance of falling.  Brisk walking and swimming are two popular choices during pregnancy.

Some seafood contains high levels of Methyl mercury which can harm the development of an unborn child’s nervous system.  The types of fish that are harmful are the larger varieties, such as Shark, Swordfish, King Mackerel, and Tilefish.  Thus, pregnant women, nursing mothers and children should not eat these four types of fish.  Fresh inland waters may also contain higher levels of Methyl mercury due to natural or industrial causes.  You should contact the EPA for current advice on fish consumption safety of inland lakes.  Pregnant women may enjoy other varieties of fish/seafood as a part of healthy diet including shellfish, canned fish, smaller ocean fish, and tuna fish.  If you choose albacore tuna, you should limit your intake to 6 ounces per week due to the increase in Methyl mercury.  Otherwise, the FDA recommends that a healthy diet for pregnant women contains 12 ounces of cooked fish/seafood per week.

Yes.  Travel is generally safe up to 35 weeks.  If traveling by car for long periods of time, be sure to stretch your legs regularly.  It is also very important to wear your safety belt.  Just adjust the strap below your abdomen so it is comfortable.  If you have extended travel plans, it’s best to discuss this with your physician.  Travel after 35 weeks is discouraged (unless absolutely necessary) because the risk of rupturing your membranes (bag of water) or going into labor is increased.

Moderate use of these is safe in pregnancy.

Necessary dental care can and should be done during pregnancy.  This includes cleanings, filling of a cavity or root canal if necessary.  Dental x-rays when necessary for treatment can be done with abdominal shielding.  Local anesthesia is O.K.  Antibiotic prophylaxis when indicated should still be done (No Tetracycline).

In general, it is safe for a pregnant patient to paint (latex or oil based) or to supervise the painting.  Do not use paint with lead based paint or paint with mercury in it.  The biggest risk to a pregnant patient would be falling off the ladder trying to paint a higher spot.  So keep both feet on the ground and paint in a well ventilated area.  If redoing an older home and there is a question about the paint base (lead or mercury) it is better not to be around when sanding etc. is being done.  Also, avoid all paint removers.

To date there is no evidence that either of these processes can cause birth defects.  If you feel that one or both of these treatments will improve how you feel, then it is probably O.K. to do, but wait until after the first trimester.  This is when the organs are being formed and any chemical exposure could theoretically cause a problem.  Highlighting is also O.K.  Perms may not take as well.  Use of hairsprays and aerosol deodorants are safe if used in a well ventilated area.  Avoid excessive or purposeful inhalation (huffing) this can be dangerous for mom and baby.

Hot tubs are safe during pregnancy if the temperature is not higher than 98 degrees Fahrenheit.

Sexual intercourse is safe during pregnancy, up to delivery, unless told otherwise by your physician.  Notify our office if you experience any vaginal bleeding at any time during your pregnancy.  Notify us immediately if you are not feeling regular fetal movement.

Braxton Hicks contractions (commonly called “false labor”) are often confused with real labor.  While Braxton Hicks contractions can be painful, they are not regular and usually don’t last very long.  True labor is characterized by regular uterine contractions. Regular means occurring every 4-5 minutes, lasting 45-60 seconds for a period of 1-2 hours or more.  In either case, call our office (248-584-7600) before going to the hospital.  You may also experience the rupture of membranes (water).  This can be a sudden gush of fluid from the vagina or it may be gradual leaking.  Notify us immediately if you suspect your water has broken.

Our FMLA (Family and Medical Leave Act) & STD (Short Term Disability) process. It takes roughly 7-10 business days for your paperwork to be completed. Per
government standards you are given 15 days from the date you apply to have it completed and returned to either your employer or the department that handles the claim for your time off. They allow you to submit the paperwork just one month prior to your delivery date. There is a $20 charge for the initial time your paperwork is completed and $20 per revision(s) made to the paperwork.

Please refer to the link below with the government standards if you need more information on this topic:

https://www.dol.gov/general/topic/benefits-leave/fmla

If you have any further questions or concerns about this, please contact our office.