Every birth is different, as is every new mom. We’re committed to your health and safety, so we always want you to know when it’s best to check in with us. If you’re experiencing any of the following, please call us right away:

• Bladder infection – Pain, burning, urgency or blood when urinating
• Bleeding – Bright red bleeding from the vagina, especially if associated with contractions, pain or cramps
• Decreased fetal movement after 28 weeks – your baby’s movements slow down a lot
  • Drink some juice or water or have something to eat.
  • Lie down with your hand on your baby and count movements.
  • You should feel about 5 movements within an hour. If you don’t, call the clinic.
• Premature contractions more than 4 weeks before your due date – More than 5 contractions of your uterus within an hour, especially if there is a sudden increase in pelvic pressure or vaginal discharge, or if vaginal bleeding or back pain are present
  • Drink two full glasses of water.
  • Lie down on your side for 30–60 minutes with your hand on your belly so you can feel contractions.
  • If you continue to have more than 5 contractions in one hour, please call the clinic.
• Vaginal infection – Itching, pain or odor from a vaginal discharge
• Water breaking – A constant trickle or gush of fluid from your vagina, even if you’re not sure if your water has broken and you’re not having contractions

Other symptoms to report:

• Changes in your vision, such as flashes of light in the corner of your eye
• Constant abdominal pain
• Headache that doesn’t go away with rest or Tylenol

If you are in crisis or this is an emergency, please call 911.

Your first visit with a midwife or OB-GYN is typically scheduled between weeks 8-12. We confirm your due date during this appointment. A physical exam is also performed and a pap smear if needed.

Here is a brief overview of the routine blood work that’s recommended during the first trimester:

• Antibody screen to check for rare antibodies that could affect your baby
• Blood type and Rh factor screening
  • If your blood type is Rh negative, you may need a shot of Rhogam at 28 weeks and after delivery.
• Complete blood count to check for anemia, which is common during pregnancy
• Dating ultrasound to confirm your due date based on your last menstrual period
• Hemoglobin A1C to test for diabetes if you have risk factors
• Rubella test to see if you’re protected from rubella
• Screenings for syphilis, hepatitis and HIV/AIDS
• Urine specimen to test for infection

All tests are done with a single blood draw.

We offer several tests during the early stages of pregnancy that can help determine if your baby may be at risk for genetic concerns. Your age, family history or personal beliefs may help you decide if these tests are right for you. It’s good for pregnant people and their partners to talk about what the test results could potentially mean to them.

Weeks 14-27 make up your second trimester. Many people say that they start to get their energy back and feel great during this time. You also begin to feel your baby move.

Here is a brief overview of the tests that are recommended during the second trimester:

• Anatomy ultrasound: We suggest an ultrasound around 20 weeks. This is a good time to see the baby after most of the major organs develop. The placenta and the fluid around your baby are also checked. You can usually see if your baby is a boy or a girl, if you want to know.
• Anemia check: The same blood drawn for your diabetes test is also tested for anemia to see if you need to take iron during pregnancy.
• Diabetes check: At about 24-28 weeks, a blood test determines if you have gestational diabetes. If so, we teach you about diet changes and how to test your sugar levels.
• Pertussis, or whooping cough, vaccination is offered.
• Syphilis and HIV screening

Week 28 marks the beginning of the third trimester. Your baby continues growing. This can be a time filled with excitement to meet your little one.

Here is a brief overview of a test that we recommend during the third trimester:

• Group B streptococcus test: Group B strep is found in many people. In rare cases, a person who carries Group B strep can infect their baby during delivery.
  • We test you for this bacteria a few weeks before delivery, around weeks 35-37.
  • If Group B strep is present, we discuss using antibiotics during labor to protect your baby.

You may also receive a position check to make sure your baby is ready for birth.

You can always call us if you think it might be time but feel uncertain – we can help you decide.

If you’ve had babies before and your labor was fast, or you live far from the hospital, please talk with your provider to get guidelines that apply to you.

The easiest way to remember when it’s time to come to the hospital is the 5-1-1 rule:

• You have painful contractions every 5 minutes that last at least 1 minute for 1 hour.

There are exceptions to this rule. You should call us when any of the following occurs:

• Baby’s movement slows down
• Green or clear fluid leaks from the vagina
• Heavy bleeding, like blood running down your legs or soaking your underwear

After delivery, your energy and questions switch to adjusting to life with a new baby. The hospital support team spends time preparing you for the first days at home and continues to care for you during your postpartum visits.

Below are some common topics that come up after pregnancy and birth.

We encourage everyone to breastfeed their baby. Breast milk is usually the only food your baby needs for the first 6 months of life. It is ideal to continue breastfeeding until your baby is 1 year or older.

Lactation consultants at Providence Mother and Baby Clinics are very skilled and familiar with breastfeeding questions and concerns. They evaluate babies for jaundice, feeding difficulties and weight gain. They also assess milk supply, breast pain and breastfeeding positioning.

Prenatal, newborn and lactation consultations are provided. Same-day consultations are often available. Many of their locations include a store that carries a wide variety of maternity and breastfeeding supplies.

Breastfeeding benefits:

• Babies get sick less often.
• Babies have less chance of developing asthma, obesity, diabetes and other health problems.
• Sudden infant death syndrome (SIDS) is less common in breastfed babies.
• Some people find that breastfeeding helps them recover and lose weight more quickly after pregnancy.
• You also have a decreased chance of developing breast cancer later in life if you breastfeed.

Many new parents feel sad or nervous after their baby is born, often called the “baby blues.” These feelings are common. Signs of “baby blues” start a few days after the baby is born and usually go away in 1-2 weeks.

If your “baby blues” don’t go away or get worse, it’s called postpartum depression. When depressed, you may not be able to care for your baby or yourself. Severe depression usually goes away with treatment. But without treatment, it can last longer or get worse.

Call your doctor if:

• You have extreme anxiety or invasive thoughts.
• You feel more depressed, or your depression isn’t going away.
• You need to talk about your problems. You may call the social worker, or one of the other resources below.

Call 911 and seek care immediately if you feel like hurting yourself, your baby or others.

Additional resources for postpartum depression:

• Baby Blues Connection – A parent-to-parent support service based in the Portland area; they offer a 24/7 message line and support groups, providing many resources to help with postpartum adjustment.
• Postpartum Support International – An international organization that helps people and their families cope with perinatal mood and anxiety disorders, including postpartum depression.

• Breastfeeding centers
• Bringing baby home
• Common discomforts in pregnancy
• Food safety and exercise
• Medications in pregnancy
• Pregnancy and parenting classes
• Preparing for your delivery