Highland OB/GYN Clinic, PA

2301 Robeson St. Suite 201

Fayetteville, NC28305

Phone (910) 485-1191 * Fax (910) 485-6006

Congratulations on your pregnancy! We are honored that you have chosen us to care for you during this special time!

We have prepared this packet of information for you and it covers a variety of topics, such as:

Frequency of expected appointments

Fetal development stages

Approved medications to take while pregnant and breast feeding

General pregnancy awareness information

Common pregnancy discomforts

Common pregnancy myths

Websites to search for reliable information

Circumcision information

Labor and Delivery information

Postpartum information

Birth control options to consider after pregnancy

CapeFearValleyMedicalCenter registration information

We encourage you to carefully review all of the information we’ve provided for you and please feel free to ask us any questions you may have!

Thank you again for giving us the honor of caring for you during your pregnancy!

Sincerely,

Dr. David Schutzer, MD

And the entire Highland Staff

Our office hours are:

Monday – Thursday from 8am – 5pm

Closed daily for lunch from 12 noon – 1pm

Friday from 8am – 12 noon.

You can contact us during normal business hours at:

(910) 485-1191

If you have an after hours emergency and need to speak to a Provider, please call the office and you will be routed to our after hours operator who will assist you.

You can also find us online at

and on Facebook! We post valuable information for you to both siteseach week!

The expected frequency of your appointments will be:

1-29 weeks every 4 weeks

30 -35 weeks every 2 weeks

36 weeks to delivery every week

It is very important that you notify us immediately with any changes to your address, phone number, preferred pharmacy and insurance.

As a courtesy to our patients we will file the insurance you provide us with. Any unpaid balances are the patients’ responsibility to pay. We will verify the pregnancy benefits of your insurance policy and a member of our insurance department will speak to you in reference to any amount that may be due for your care.

A few things you need to know

  • CapeFearValleyMedicalCenter is the hospital where your baby will be delivered. Included in this folder is information about the hospital and their birthing center. You will need to pre-register with the hospital and you can schedule a tour if you choose.
  • Childbirth classes and breastfeeding classes are offered through CareLink at CapeFearValley. We encourage you to take the childbirth class and the breastfeeding class, if you are planning on breastfeeding. If you’re interested please call 910-609-5465 for more information. We recommend that you register for the class by 28 weeks.
  • If you have a boy and choose to have him circumcised Dr. Schutzer will do the circumcision in the office. Once you are discharged from the hospital, please call us immediately and schedule an appointment for the procedure. Dr. Schutzer will not be able to do the procedure once the baby reaches 4 weeks of age so we encourage you to call and schedule the appointment immediately after being discharged from the hospital. We will verify your insurance benefits and you will be asked to pay your expected portion before the procedure is done. If you are filing Medicaid as your insurance, this is a non-covered procedure and the cost is $300.00,which is due before the procedure is done.
  • The internet is a valuable source of information for you during pregnancy. We encourage you to be cautious when reading information online however as some sites are not as reliable as others.

Here are a few that we recommend using:

  • – American College of Nurse Midwifes
  • – American Congress of Obstetricians and Gynecologists
  • – Online medical resource
  • – Centers for Disease Control and Prevention
  • – March of Dimes
  • – United States Department of Health and Human Services
  • – Nutrition Information
  • – Online Resource

Medications Relatively Safe to Take During Pregnancy and Breastfeeding

You may take the following medications without calling us first. However, please contact us if the medications do not begin to help after a few days, or you seem to be getting worse.

Allergies:-Claritin (plain)

-Benadryl

- Zyrtec

Colds or sinus:-Sudafed throughout pregnancy

-Actifed after the first 12 weeks of pregnancy and breastfeeding is

well established

-Tylenol (1 or 2 tablets) can be taken for minor symptoms

(We suggest only one dose in the morning and one in the evening.)

Coughs:-Robitussin (Plain) as directed through the day

-Robitussin DM at night

- Mussinex

Sore Throats:-Chloraseptic Spray

-Throat Lozenges

-Plain Tylenol

Constipation:- Benefiber

-Citrucel

-Fibercon

-Plenty of water and fruits

Diarrhea:-Kaopectate, as directed

-Clear fluids for 24 hours, then BRAT diet (bananas, rice, applesauce, and toast)

-Imodium AD (1-2 doses only)(If not resolved after second dose or 24 hours please call)

Gas:-GasX

-Phazyme

(NO Pepto-Bismol)

Insomnia:-Unisom, only one per week (Do NOT exceed 1 per week)

- Benadryl (Occasional use only)

- Tylenol PM (Occasional use only)

Heartburn:-Mylanta

-Tums

-Rolaids

-AlkaMints, as directed

-Zantac

- Pepcid

Hemorrhoids:-Preparation H

-Anusol

-Tucks

Nausea:-Mylanta, as directed

-Vitamin B6, 25mg to 50mg every 12 hours

-Dry toast, crackers, ginger ale, and/or small frequent meals of food

Tylenol can be taken for mild headaches and/or minor aches and pains.

DO NOT TAKE: Aspirin, Advil, Motrin, or Ibuprofen.

Be sure that if any other health care provider prescribes medication for you, that he or she is aware that you are pregnant.

Revised September 2012

Back Pain during Pregnancy

Back pain is a common concern during pregnancy. There are many reasons why back pain occurs in pregnancy; your gaining weight, you're walking in a different way and your hormones are relaxing the muscles in your body to help prepare for the baby's birth. There are a few simple things you can do to help treat and maybe even prevent, low back pain.

Practice good posture. As your baby grows, your center of gravity shifts forward. As you compensate in some way to avoid falling forward, you may stretch the muscles in your lower back — which can cause back pain. Enter the principles of good posture. Tuck your buttocks under, pull your shoulders back and downward, and stand straight and tall.

Sit and stand with care. Sit with your feet slightly elevated, and don’t cross your legs. Choose a chair that supports your back.

Change position often. Get up every hour for a quick stretch. Standing for long periods of time is perfectly safe during pregnancy. When standing, rest one foot on a low step stool or book and alternate feet every 15 minutes.

Keep your legs slightly apart – this helps with balancing your weight. Stand on a carpeted or cushioned floor or put a mat or a small rug on a hard floor.

Sleep on your left side and keep one or both knees bent. It may also help to place one pillow between your knees and another under your abdomen, or use a full-length body pillow. Lean forward to stand and use your leg muscles to lift you from a seated position when getting out of bed.

Lift properly. When lifting a small object, squat down and lift with your legs. Don’t bend at the waist or lift with your back.

Try to avoid sudden reaching movements or stretching your arms high over your head as this may stretch your muscles. Knowyour limits; don’t attempt to lift heavy objects, carry extra shopping bags or children.

Get the right gear. Wear low-heeled shoes with good archsupport. Wear maternity pants with a low, supportive waistband.

Consider using a maternity support belt or abdominal binder. Your Provider can provide information on this.

Try heat, cold or a back rub. Apply heat to your back. Soak in a warm bathtub, or use a hot water bottle or a heating pad on low setting. Some women find relief by alternating ice packs with heat. Rubbing your back also may help. Better yet, ask someone to rub your back for you.

Stay fit. Regular exercise can keep your back strong and may actually relieve back pain. With your health care provider’s OK, try swimming, walking or riding a stationary bike. Yoga and prenatal aerobics can provide needed strength and stretching. Keep your weight gain to between 15-40 pounds.

Try pelvic tilt exercises. Kneel on your hands and knees with your head in line with your back. Pull in your abdomen, arching your spine upward, like a cat. Hold the position for several seconds, then relax your abdomen and back. Repeat three to five times, working gradually up to 10.

Consider complementary treatments. For some women, massage therapy or chiropractic care provides relief. They may provide some comfort and are generally safe during pregnancy — as long as you’re receiving good prenatal care. Discuss your discomfort with your health care provider first to make sure you have muscular back pain, rather than an underlying condition.

Acetaminophen (Tylenol, others) is safe to use during pregnancy, but other pain relievers — including aspirin and ibuprofen (Advil, Motrin, others) — are not. Check with your health care provider before taking any medication to treat your back pain.

Back pain during pregnancy probably won’t come as a surprise, but that doesn’t mean you should ignore it. A low, dull backache may be a sign of preterm labor. And severe back pain or back pain that is accompanied by vaginal bleeding or discharge may indicate an underlying problem that needs attention. If you’re concernedabout your back pain, contact your health care provider as soon as possible.

Bleeding during Pregnancy

Vaginal bleeding or spotting during pregnancy can have many causes. Some are serious and some are not. Bleeding may occur early or late in pregnancy.

Many women have vaginal spotting or bleeding in the first 12 weeks of pregnancy. Bleeding of the cervixmay occur during sex. An infection of the cervix also can cause bleeding.Slight bleeding often stops on its own. However, bleeding during pregnancy may mean something more serious. You may have a higher chance of going into labor too early (preterm labor), having an infant who is born too small, or having a miscarriage.

How is bleeding during early pregnancy checked?

If you are bleeding in early pregnancy, your health care provider may do a pelvic exam. You will be asked how much blood you have passed and how often bleeding has occurred. Your health care provider also will ask whether you have had any pain, and if so, its location and severity.

A blood test may be done to measure human chorionic gonadotropin (hCG). This substance is made by your body during pregnancy. You may have more than one test because hCG levels increase throughout pregnancy. Your blood type also will be checked to see if you need treatment for Rh sensitization. Ultrasoundmay be used to find the cause of the bleeding. Sometimes the cause is not found.

When does miscarriage happen?

Miscarriage can occur any time in the first half of pregnancy. Most often it occurs in the first 13 weeks. It happens in about 15–20% of pregnancies.

What are the signs and symptoms of miscarriage?

The following signs and symptoms may indicate a miscarriage:

Vaginal bleeding

Cramping pain felt low in the abdomen (often stronger than menstrual cramps)

Tissue passing from the vagina

Many women who have vaginal bleeding have little or no cramping. Sometimes the bleeding stops and the pregnancy continues without concern. Other times the bleeding and cramping may become stronger, leading to miscarriage.

What causes bleeding late in pregnancy?

Common problems that cause light bleeding include an inflamed cervix or growths on the cervix. These may be treated with medication.Heavy bleeding usually involves a problem with the placenta. The two most common causes at this time are placental abruption and placenta previa. Preterm labor also can cause such bleeding.

What is placental abruption?

The placenta is attached to the uterine wall. It may detach from the wall before or during labor. This may cause vaginal bleeding. It often causes pain, even if bleeding is light or not seen. When the placenta becomes detached, the fetus may get less oxygen. Prompt care is needed.

What is placenta previa?

When the placenta lies low in the uterus, it may cover the cervix. That means it partly or completely blocks the opening. This is called placenta previa. It may cause vaginal bleeding. This type of bleeding often occurs without pain.

Can bleeding be a sign of labor?

Late in pregnancy, vaginal bleeding may be a sign of labor. A small amount of mucus and blood is passed from the cervix just before or at the start of labor. This is called “bloody show” and it is common. It is not a problem if it happens within 3 weeks of your due date. If it happens earlier, you may be going into preterm labor. Other signs of preterm labor include the following:

• Vaginal discharge

• Change in type of discharge (watery, mucus, or bloody)

• Increase in amount of discharge

• Pressure in the pelvis or lower abdomen

• Low, dull backache

• Stomach cramps, with or without diarrhea

• Regular contractions or uterine tightening

If you have any of these signs or symptoms, contact our office right away.

Common discomforts of Pregnancy

Discomfort / Why / What you can do to help / Notify your
provider if
Back pain / As the baby grows your posture changes causing strain on your lower pack. The pain is usually constant. / Wear low-heeled, supportive shoes.
Avoid lifting heavy objects.
Squat down with your knees bent when picking things up and avoid bending at the waist.
Don’tstand on your feet for long periods and place one foot on a stool or box for support.
Sit in a chair with good back support, or place a small pillow behind your lower back. Also place your feet on a footrest or stool.
To provide relief, apply a hot water bottle or heating pad on low setting or take a warm bath.
Maintain good posture.
Use a pregnancy support band. / Contact your health care provider if you have a low backache that comes and goes does not go away within one hour after you change position or rest. This might be a sign of premature labor
Braxton Hicks contractions / The muscles in your uterus can begin to tighten as early as the second trimester. Irregular, infrequent contractions are called Braxton-Hicks contractions. These are normal during pregnancy. / Lie down and relax. This will usually stop Braxton Hicks contractions. These contractions can appear for several months of your pregnancy. / Call your provider if the tightening continues, worsens or becomes more regular after lying down to rest as this may be a sign of labor.
Constipation / Constipation can occur because of changing hormones, increased pressure on the rectum from the growing uterus and taking extra iron during pregnancy. / Drink at least 8 glasses of water every day.
Eat prunes or prune juice.
High fiber foods like fruits, vegetables and whole grains.
Drink warm liquids, especially in the morning.
Daily exercise.
USE MEDICATIONS ONLY IF NATURAL METHODS DO NOT WORK / Contact your provider if you have not had a bowel movement in more than 5 days.
Discharge / An increased blood supply and hormones cause your vagina to increase normal secretions. Normal vaginal discharge is white or clear, non irritating, odorless and may look yellow when dry on your underwear or panty liners. / Wear cotton underwear and avoid tight fitting clothes.
Do not douche
Clean vaginal area often with non perfume soap and water.
Wipe yourself from front to back. / Contact your provider if you have burning, itching, swelling, odor, or if the discharge becomes bloody or has a change in color. These changes may be a sign of a vaginal infection like yeast or bacteria.
Dizziness and light-headedness / A growing uterus needs more blood flow to help the baby grow. This can cause a drop in blood pressureresulting in dizziness.Faintness and dizziness can also happen when you are not eating often enough and your blood sugar gets low. When your blood sugar levels are too low, you may feel dizzy or lightheaded. / Move around often when standing for long periods of time.
Try lying on your left side when you rest or sleep.
Move slowly when standing up and avoid sudden movements
Eat regular meals to prevent low blood sugar. / Contact your provider if you have any fainting spells.
Fatigue / It takes a lot of extra energy for your baby to grow, which may make you feel tired.