At Chatfield Women's Care, prenatal care is one of our specialties. Prenatal care refers to the care you get while you are pregnant. Women who receive prenatal care are more likely to have a healthy baby. Babies born to mothers who did not receive any prenatal care are three times more likely to be born at low birth weights than those whose mothers did receive prenatal care, according to the Health Resources and Services Administration's Maternal and Child Health Bureau.
During prenatal care, we monitor the health and progress of your pregnancy and identify any potential problems before they become serious. Choosing a healthy lifestyle throughout your pregnancy is the most important thing you can do for yourself and your baby.
To learn more about the tests and office visits as well as helpful information for your first trimester, keep reading.
Important Dates and Tests
Pregnancy generally lasts for 40 weeks. The following is our recommended prenatal visit schedule for pregnancies without complications. Depending on your pregnancy, we may recommend additional visits:
From 0 to 28 weeks See your doctor every 4 weeks. From 28 to 36 weeks See your doctor every 2-3 weeks. After 36 weeks See your doctor every week.
Here are some of the important dates and tests along the way.
First Visit. Your first prenatal visit will include a review of your medical history, physical exam and Pap test, and lab work for syphilis, blood type with Rh status, Rubella immunity, Hepatitis B, HIV and thyroid screen. A urine culture also will be done, as well as a cervical culture for Chlamydia and gonorrhea.
First Trimester Tests. During the first trimester, you may elect to have a cystic fibrosis screening and Down Syndrome screening. These are optional and may not be covered by all insurance plans. Talk to your doctor about the benefits and risks of these tests and whether they make sense for you.
16-Week Visit. Optional Quad or Penta Screen blood tests to screen for neural tube defects and chromosomal abnormalities. Women who will be 35 or older at the time of delivery may choose to have an amniocentesis, which tests a sample of the fluid surrounding the baby to examine the baby's chromosomes for abnormalities.
20-Week Visit. A level-1 ultrasound is performed to confirm the growth of the baby and your due date. At this time, the baby's gender often can be determined.
28-Week Visit. You'll have a blood test for gestational diabetes and anemia. If you tested Rh negative during your first blood test, you will now receive an antibody screen. If you are Rh negative, you may have blood that is incompatible with your babies' blood. Don't worry, though, a simple RhoGAM injection prevents any problems.
36-Week Visit. Group B strep vaginal culture is done.
Download a printable PDF of our Prenatal Visit Plan
Women who have diabetes before they get pregnant need to work with their physicians to monitor glucose levels and control the disease. It is important for diabetic women to have their disease under control before becoming pregnant in order to reduce the risk of birth defects.
But women who have never had diabetes can develop gestational diabetes, which means they have high blood sugar (glucose) levels during pregnancy. This condition affects about 4 percent of all pregnant women, according to the American Diabetes Association.
In pregnant women, hormones from the placenta block the insulin in their bodies. If your body cannot make and use the insulin it needs for pregnancy, glucose cannot leave the blood and be used as energy.
Gestational diabetes typically affects the mother late in the pregnancy. Poorly controlled or untreated gestational diabetes can harm the baby. Extra blood glucose can go through the placenta, giving the baby high blood glucose levels. Because the baby is getting more energy than he or she needs, that extra energy is stored as fat. The baby may have an increased risk for obesity and for type 2 diabetes later in life. A mother who experiences gestational diabetes also is at increased risk for developing type 2 diabetes after her pregnancy. Controlling blood sugar levels can also reduce the risk of birth defects.
Treatment, which includes diet modification and physical activity, is designed to keep blood glucose levels equal to those of pregnant women who don't have gestational diabetes. Treatment also may include daily blood glucose testing and insulin injections.
Visit the American Diabetes Association to learn more about gestational diabetes.
At Comprehensive Women's Care, we make every effort to support you in providing the labor and delivery you have planned. We respect your pain management choices and want your birth experience to be what you desire.
When deciding whether to breast-feed or bottle-feed your baby, there are no right or wrong answers. Every woman and every family is different. The most important factor is to ensure your baby gets proper nutrition by choosing the method that is best for you.
At Comprehensive Women's Care, we know you have a lot to factor into your decision and respect each family's choice. Keeping in mind that breastfeeding for any length of time is beneficial, we encourage new Moms to consider this option.
For many new moms, breastfeeding provides an instant bond to the baby. But more importantly, healthcare providers say breast milk is the healthier option. Consider these benefits:
- Protective nutrients for baby. Breast milk naturally has the right balance of nutrients for your baby. Some of these nutrients help protect your baby from common childhood illnesses and infections such as diarrhea, ear infections, pneumonia and sudden infant death syndrome. Breastfed babies are also less likely to develop asthma.
- Lower cancer risk. Moms who breastfeed have been shown to have a decreased risk of breast and ovarian cancers.
- Lower risk of PPD. Women who breastfeed may have a lower risk of postpartum depression.
- Reduced obesity risk. Kids who are breastfed for six months are less likely to become obese later in childhood or adulthood.
- It's free. Families can save between $1,200 and $1,500 in formula in the first year.
While breastfeeding is a natural life process, that doesn't mean it's easy for everyone. It can take time, patience and practice for the baby to properly "latch" and for you to learn when your baby is finished. It also takes practice to learn how to pump and to get accustomed to the new routine.
After your delivery, lactation experts at Littleton Adventist Hospital are available to help you get started. Once you're home, our office will continue to support you in this important effort.
It's important to know that breastfeeding does not "come naturally" for most women. It can be painful until the baby learns to latch properly or until your nipples become tougher. Don't let this discourage you and know that these problems are temporary.
Once you begin nursing, there are some problems that can arise that are easily treated. You should aways notify your physician immediately of any changes in your breasts.
Engorgement. Within three days of delivery, your breasts begin producing a lot of milk. That also causes more blood flow to the breasts, which makes them full and swollen. For some women, this fullness is uncomfortable and even may extend into the armpit. This is engorgement. It typically passes within a couple days with frequent nursing and pumping. If you are experiencing flu-like symptoms or a fever, be sure to call us. This can be a sign of infection.
Plugged milk duct. If your body makes milk faster than you're feeding or pumping, it may result in a plugged milk duct. Symptoms include redness, swelling or a small, hard lump in the breast. The lump may be tender or even sore to the touch. Continuing to frequently nurse and pump will likely make you feel better. You may also want to try rest, heat and massage. If the symptoms don't subside, call us. Without treatment, a plugged duct can develop into mastitis.
Lactation mastitis. This infection typically occurs in the first three months after delivery. With mastitis, women experience breast pain, swelling, warmth or redness of the breast, fever or feeling ill. When you notice these symptoms, call us. Antibiotics are frequently used to treat the infection.
Thrush. This common, yet harmless, yeast infection occurs in a baby's mouth and can affect your nipples during breastfeeding. You might notice your nipples are itchy, pink, red, shiny or burning, or you may experience a shooting breast pain during or after nursing. You might also notice symptoms in your baby, such as white patches inside the lips or cheeks, or crying when nursing or sucking on a pacifier if those white patches are painful. Call your doctor for an accurate diagnosis. Treatments include prescription antifungal medications.
(Sources: U.S. Department of Health and Human Services, National Institutes of Health)
After your baby is born, Comprehensive Women's Care provides complete postpartum care. In addition to making sure you are healing properly after delivery, we can address any of your postpartum questions
Download a printable PDF for more information on post-partum care.
Here are a few common issues women face after giving birth.
Sleep. Newborns sleep a lot - but not all at once. So, early on in your baby's life, he or she will wreak havoc on your sleep schedule. Plan ahead, and take turns with your partner getting up with the baby to help limit sleep deprivation. You may want to consider asking a family member or good friend to stay with you to help in the first few weeks. And when the baby is sleeping during the day, get some shut-eye yourself. The chores can wait.
Exercise. At last, you have your body back to yourself, and you're eager to get back to your pre-pregnancy routine. Exercise is good for you, but be careful. If you had a Cesarean section or a complicated vaginal birth, you may need to wait a few weeks to re-start vigorous activity. Talk to your doctor to make sure you're ready for exercise, and when you return to the gym, take your time and ease into a routine. After all, it might take a while to feel like your energetic self again-especially as you adjust to caring for a new baby and less sleep.
Diet. During pregnancy, you increased your caloric intake to support your baby's growth and development. After your delivery, you should begin thinking about shedding those extra pounds. Remember, though, that proper nutrition is the key to regaining your pre-pregnancy weight. This is especially important if you are breastfeeding as your baby depends on what you eat to get all of his or her nutrients. Lean proteins, whole grains, low-fat dairy and lots of fruits and veggies are essential to a healthy diet.
Returning to work. For a number of women, returning to work can be an emotional experience-feeling overwhelmed or even guilty is not uncommon. As you consider returning to work or staying home, remember that you're not only making the best decision for your baby but for your overall family.
Before you return to work, consider what you'll need to be happy and successful. Establish your return date and talk to your boss about any accommodations you might need-such as working from home or changing to a part-time schedule if that's permitted.
If you're breastfeeding, make sure you're able to pump during the day. As part of the new federal Affordable Care Act, employers are required "to provide reasonable break time for an employee to express breast milk for her nursing child for up to two years after the child's birth. The employer must make reasonable efforts to provide a place, other than a toilet stall, for the employee to express breast milk in privacy."
Depression. Three out of four new mothers will experience the "baby blues"- fleeting mood swings and crying spells. For most women, this is a normal reaction to fluctuating hormones and will pass within a few weeks.
But about 10 percent of new moms will experience postpartum depression, which is more severe and can last up to a year. This, too, is a normal result of hormonal fluctuations and lifestyle changes and can be treated. You do not need to have experienced depression before to be affected by postpartum depression. It is very important for your health and that of your family to acknowledge the issue and seek help.
Whether you are experiencing the initial "baby blues" or something more serious, it's important to call us so that we can assess the situation and provide help.
Here are the symptoms of postpartum depression and the baby blues.
Baby Blues Symptoms (lasting only days or weeks)
- Mood swings
- Decreased concentration
- Trouble sleeping
Postpartum Depression Symptoms (intense symptoms or lasting more than two weeks)
- Loss of appetite
- Intense irritability and anger
- Overwhelming fatigue
- Loss of interest in sex
- Lack of joy in life
- Feelings of shame, guilt or inadequacy
- Severe mood swings
- Difficulty bonding with the baby
- Withdrawal from family and friends
- Thoughts of harming yourself or the baby. (If you have these thoughts, be sure the baby is in a safe place and call for help immediately.)
Porter Adventist Hospital, a sister hospital to Littleton, offers comprehensive inpatient and outpatient mental health services, including counseling for women suffering post-partum depression. For more information, call 303-778-5774.
Mental Health America of Colorado offers a free support group for moms with postpartum depression. For more information about A Mother's Wing, call 720-208-2220.
For teenagers, pregnancy is a scary time. Teen moms not only have all the normal issues of pregnancy, but they also have to deal with school, peers, family and making tough decisions about their babies.
At Comprehensive Women's Care, we understand teenagers' need for respect, privacy and compassion. We help counsel young women through this time and help them understand their options. And we understand the unique medical needs of teen girls as well, specializing in providing them the prenatal care they need.
If you are a teenager who thinks she might be pregnant, or a parent seeking resources for your daughter, here are a few things you should know.
Professional prenatal care is essential. One-third of girls age 15 to 19, and half of girls younger than 15 don't receive prenatal care during the first trimester. Some teens fear negative reactions at home and therefore keep the pregnancy a secret. But to ensure a healthy mother and baby throughout the pregnancy, prenatal care is critical. Pregnant teens are at higher risk for premature labor, anemia and high blood pressure, and babies born to teen mothers are at risk for premature birth and low birth weight. Without prenatal care, the risk for complications increases.
Self-care matters, too. Teen mothers are less likely to know or understand the implications of a healthy lifestyle. It's essential that every pregnant woman-including teens-take prenatal vitamins; avoid smoking, alcohol and drugs; and if still sexually active, use a condom to lower the risk of sexually transmitted diseases.
Eat well. Many teens may skip meals or try to avoid weight gain either to hide their pregnancy or simply in an attempt to remain thin. However, proper nutrition is crucial for the health of the mom and baby. This means getting enough calories for the baby to develop as well as eating healthy foods like fruits, vegetables, lean meats and low-fat dairy. During the first prenatal appointment, we work with teen moms on a safe and healthy nutrition plan.
Get support. For teens, pregnancy is often an unintended consequence that is fraught with emotions for the teen parents and their families. These families may benefit from professional counseling to provide them with the support they need to work through this time. We can help refer you to the appropriate resources.
In addition to consulting with Comprehensive Women's Care, you may wish to explore some other resources. Here are a few to get you started:
Online Pregnancy Center
Pregnancy brings about an array of questions for expectant moms and dads. To help you find the answers easily and quickly, we offer our Online Pregnancy Center.
This guide provides you with expert advice on a wide variety of maternity questions when you want information fast. However, you should never hesitate to call our office at 720-528-0800 with any questions-no matter how small-or for additional information.
In the Online Pregnancy Center, you will find great tips, expert advice and interactive tools to help you navigate your way through your 40 weeks of pregnancy. Prepare for your baby's arrival by clicking on the topic of Labor and Delivery. Let the Cervical Stages During Labor tool guide you through your body's response to the birthing process, watch the Vaginal Birth video, the C-Section video, view the Epidural Series and much, much more.
Trying to become pregnant? Use the ovulation calculator to find your fertile days.
Want to know your due date? Check out the due date calculator.
Think you might be pregnant? Know the signs of pregnancy.
The physicians at Chatfield Women's Care choose to deliver at Littleton Adventist Hospital, and we take great pride in this partnership.
Why We Choose Littleton
Here are just a few of the reasons our doctors-and the families we serve-prefer Littleton Adventist Hospital:
- Moms rank Littleton among the top in the nation for satisfaction with their birthing experiences. To help ensure each family the experience they desire, Littleton Hospital has created a customized Birth-Day Wishes program. This program provides a free pre-birth consultation where expectant parents can outline their delivery preferences.
- Littleton's BirthPlace accommodations include 15 private, individual birthing suites, dedicated surgical suites for Cesarean births, and hydrotherapy tubs and aromatherapy. Sleeping accommodations are available for the mother's spouse or birth partner, along with cable television, DVD players and free wireless internet access.
- Littleton has the highest level Neonatal Intensive Care Unit in the south metro area (Level III B), to care for the most critically ill, premature or multiple birth infants. The 14-bed, state-of-the art NICU offers each baby and family a private area designed for each baby's individualized development care. Each family station includes a chair, sink, utility cabinets and fridge for the parents' use.
- The NICU team includes experienced neonatal nurses, perinatologists (doctors specializing in fetal-maternal care), neonatologists (doctors specializing in the care of sick newborns), pediatricians, 24-hour in-house neonatal nurse practitioners, developmental specialists and respiratory therapists. Consultation with other neonatal specialists is also available 24-hours a day.
- Moms have 24-hour access to obstetrical anesthesiologists as well as alternative anesthesia/analgesia options.
- Littleton's nurses are among the area's most experienced, averaging 15 years of service in maternity nursing.Patients enjoy one-to-one or one-to-two ratio to skilled, experienced nursing staff.
- The BirthPlace at Littleton uses OBIX Perinatal Data System for electronic fetal monitoring (EFM). This high-tech system provides a continuous stream of information.
- Specially trained Certified Nurse-Midwives (CNM) are on staff to offer personalized care for pregnancy, labor and delivery and postpartum concerns.
- Breastfeeding classes and on-site lactation consultants help coach new moms.
Download a printable PDF of Why We Prefer Littleton Adventist Hospital
Women's Care Services
To stay healthy at any age, we all need a healthy diet and plenty of physical activity. And, of course, no smoking. But beyond a healthy lifestyle, women need to make sure they get the right health tests at the right times. By getting the appropriate screenings, you can detect diseases, such as cancer, diabetes and heart disease, early—when they are the most treatable. And in an annual well woman exam, your gynecologist can help make sure nothing else is amiss.
Don’t wait until you suspect there’s a problem. By being proactive, you can head off some health issues before they start. Here are the gynecological tests women need.
Test Why Have It When to Start Frequency Pap Test This test can find pre-cancers before they develop into cervical cancer. Three years after a woman begins having sex or age 21 (whichever is earlier).
Annually. Women 30 and older who have had three consecutive normal test results may only need to be tested every two to three years (American Cancer Society)
Those who’ve had a total hysterectomy (removal of the uterus and cervix) may opt to stop having Pap tests, unless they have the surgery as a treatment for cervical cancer or pre-cancer.
Clinical Breast Exam Detects any abnormalities in the breast tissue. In your 20s. At least every three years in your 20s and 30s; but preferably, annually during your well woman exam. (American Cancer Society) Mammogram Detects breast cancer in its earliest stage. Age 40 for most women. If you have a family history of early breast cancer, your doctor may recommend a baseline mammogram at a younger age. Annually. (American Cancer Society)
And remember — these aren’t the only screenings you need. Your primary care doctor can talk to you about things like heart health tests and colon cancer screenings.
Adolescent and Teen Health
Seeing an Ob/Gyn for the first time can be unnerving for a young woman. At Chatfield Women’s Care, we understand this and create an atmosphere where teens and adolescents feel comfortable talking about their health concerns. We recommend that adolescents start seeing an Ob/Gyn at about age 13. By starting at this time, girls can develop a personal and trusting relationship with a women’s health provider before becoming sexually active.
Talking with a health care professional before becoming sexually active can actually help a girl be more comfortable since it is not personal at that point. This relationship can help educate teens about the importance of safe sex and birth control. And if she has a women’s health provider, a young woman has a safe place to turn if she’s concerned about sexually transmitted diseases.
The HPV Vaccine
One recent advance in women’s health was the release of the human papillomavirus (HPV) vaccine, which protects women from most cervical cancers. There are two vaccines on the market — Cervarix and Gardasil. In addition to providing cervical cancer protection, Gardasil also defends against most genital warts.
The vaccines are given in three doses over six months, and should be administered between the ages of 11 and 26. For the most benefit, girls should receive the vaccine before they become sexually active.
A Chatfield Women’s Care professional can talk to you about the benefits and risks of this vaccine.
Are you having irregular periods? Feeling emotional or depressed? Getting hot flashes? Losing your libido? You may be entering menopause.
But never fear. Menopause doesn’t have to be miserable. At Chatfield Women’s Care, we believe in finding the treatment option — or combination of options — that makes sense for each woman, her individual needs and her lifestyle.
What Is Menopause and Its Symptoms?
Menopause occurs when a woman’s ovaries stop producing eggs. During this transition period, a woman’s body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether.
Common symptoms of menopause include:
- Heart pounding or racing
- Hot flashes
- Night sweats
- Skin flushing
- Sleeping problems, such as insomnia
Learn about other symptoms of menopause.
What Are My Treatment Options?
For women who experience hot flashes, night sweats and mood swings, there are many options including herbs, acupuncture and hormone replacement therapy. Although some studies have linked HRT to an increased risk for heart attacks, strokes and breast cancer, these medicines can be used in a way to minimize risk. We work carefully with women to create a customized plan that takes into account her health history, her symptoms, the severity of symptoms, age and other factors.
Would Bioidentical Hormones Have Less Risk?
You may have heard the phrase “bioidentical hormone therapy.” This term describes a medication that contains hormones that are chemical duplicates of those produced by women.
While some of these synthetic hormones are FDA-approved (like those in traditional HRT), there is concern about “custom-compounded” medications that are specific to a patient. These drugs are not FDA-approved, and don’t appear to have a greater benefit or less risk than traditional HRT. We can help you understand the benefits and risks of all forms of hormone replacement therapy, including bioidentical hormones.
Is Hormone Replacement Therapy Necessary?
No, it’s not. In fact, if your symptoms are not extreme, or if your risk for heart attack or stroke is higher than average, you and your doctor may choose not to use HRT.
The good news is that other medications, such as low-dose antidepressants, can help with mood swings, hot flashes and other symptoms brought on by menopause.
And if you’d prefer to skip medication therapy altogether, there are lifestyle changes that can make a big difference.
- Avoid caffeine, alcohol and spicy foods
- Dress lightly and in layers
- Get adequate calcium and vitamin D in food or supplements
- Get plenty of exercise
- Perform Kegel exercises daily to strengthen the muscles of your vagina and pelvis
- Try relaxation techniques such as yoga, tai chi or meditation
Minimally Invasive Gynecological Surgery
We know that no one wants to have surgery. But sometimes it’s unavoidable. When surgery is necessary, you’ll rest easier knowing your physician is using minimally invasive surgical techniques that can help reduce the pain and get you back on your feet quicker.
Minimally invasive gynecological (GYN) surgery eliminates the need for a large incision, and that means patients recover faster — with less pain and scarring. Depending on the type of surgery, most patients can go home the same day and resume full activities within weeks or even days. Studies have also shown that this type of surgery minimizes blood loss during the procedure and reduces the chance of a post-operative infection.
Here’s just one comparison:
Traditional, Open-Abdominal Hysterectomy
6- to 8-inch incision
Performed as an inpatient procedure, requiring a two- to four-day hospital stay
Four to six weeks of recovery time
May take one year until fatigue is gone
Minimally Invasive GYN Surgery
Incision(s) are about a quarter of an inch
Performed as an outpatient procedure, with patients typically going home the same day
About two weeks of recovery time
Takes about six weeks to feel normal
We specialize in the following minimally invasive procedures:
- Advanced laparoscopic and hysteroscopic surgery
- Laparoscopic hysterectomy
- Vaginal hysterectomy
- Incision-less tubal ligation
- Endometrial ablation
- Urinary incontinence surgery
- Pelvic organ prolapse surgery