Prenatal visits begin in the first 3 months of pregnancy so you should call and schedule your appointment as soon as you miss a period. We can do a urine pregnancy test in the office if you need one. The first visit will take at least an hour and includes your history, a physical exam including a pelvic and the time to answer your questions. Your follow up visits are every 4 weeks until 28 weeks(7 months), then every 2 weeks until 36 weeks (9months) then every week until delivery. Regular visits include assessing your weight, blood pressure and baby’s heartbeat and growth .Health maintenance education and having fun are included! We encourage you to write down your questions as they occur to you; this is a good way to start a pregnancy diary. We believe the only dumb question is the one you don’t ask! We encourage your partner to participate in all your visits if you desire. 40 weeks verses 9 months are confusing; here’s how it works: 8wk = 2mo 24wk = 6mo 40wk = due date 12wk =3 mo 28wk = 7mo 16wk = 4 mo 32wk = 8mo 20wk = 5mo 36wk = 9mo Your due date is relative – babies don’t have a calendar in there and they don’t always listen to what their Midwife (or parents) say! The average pregnancy is 280 days from the first day of your last menstrual period (with a 28 day cycle) or 266 days from conception if you do not have a regular 28 day cycle. So the due date is an educated guess and you are considered full term (ready) when you are between 2 weeks before the due date until 2 weeks after the due date.(Mexico has a better system – they give due months – less stressful waiting!) Adolescent care – many young women have difficult menstrual cycles and need help to control painful or irregular periods. We also are sensitive to the stress of the first pelvic exam and provide time for you to discuss your concerns. Education on abstinence or birth control options, sexually transmitted disease prevention and treatment can be provided. Focus is on the individual needs of the individual girl. Young Adult – during these years, in addition to pregnancy care, we provide annual exams and pap smears, birth control, STD testing and treatment, breast exam and general health screening. Education focus is on maintaining your health, diet and exercise tips and disease prevention strategies. Midlife and beyond - Peri-menopause and the menopausal years are a joyous and challenging time of life. For women of this age, we continue to provide the gynecological services of the young adult years and can offer a range of support and information on hormone replacement therapy, alternatives to standard medical treatment as well as education on health maintenance as you age. Enloe Medical Center is where all of the nurse-midwives attend women in labor. The hospital is a level II center for low and intermediate risk women and infants. The maternity unit is family centered and provides couplet care to mothers and babies. This means for a healthy woman she and her infant are kept together at all times and a nurse is assigned to care for them as a couplet. All labor rooms are birth rooms so on admission you will labor, deliver and recover in the same room before being transferred out to the postpartum unit where you will stay with your newborn until discharge. To find out more about Enloe please visit their web site at http://www.enloe.org/guide_to_services/maternity_services.asp and click on the links to: ··Maternity Unit · Prenatal Education · Lactation Services · Breastfeeding/Maternity Store · Babies Online · Special Services Your midwife will be with you when labor gets intense to provide professional support, expertise and care during labor, will delivery your baby and will usually stay to help you with giving the first bath and assisting with breastfeeding. If complications arise she will call in her back up MD to assist with the birth as needed. A Nurse-midwife may not assist a birth by artificial or forcible means, so in the event of a cesarean section or vacuum assisted birth, the MD will assume care and your midwife will continue to provide nursing care until the baby is born. We believe that it is your birth, your body and your baby so you should do it your way if that is safe. This means we will try to educate you on the pros and cons of all birth options including various pain relief measures, and will work with you to make informed healthcare decisions that are right for you and your baby at the time. Nurse-midwives provide health care to women through out the lifespan including well woman care to women at midlife. We follow established protocols for prescription hormone replacement therapy if it is indicated, but also can provide information on alternative treatments for the common discomforts at this time of life. Lisa Catterall is a certified menopause clinician, having received certification in 2003 from the North American Menopause Society. You may access their very informative website at www.menopause.org.