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JORDAN & ASSOCIATES OB/GYN
A sensitive touch for women of all ages.
111 Medical Parkway ∙ 2nd & 3rd Floor ∙ Chesapeake,
Virginia 23320 ∙ 757-436-2424
BOARD CERTIFIED IN OBSTETRICS AND GYNECOLOGY
www.jordanandassociates.org

Dear New Mom/Parents,
Congratulations and welcome to our practice! Our goal is to provide you with the highest standard of care in the Hampton Roads area and for this to be a positive and unforgettable experience. Your husband, significant other, and family are welcome to accompany you to every visit. The following are a few tidbits of information that may answer questions regarding your expectations, ease your mind and provide calmness to an excitable time in your life.

At you Initial Prenatal visit, you will be provided with a goody bag which will include a Chesapeake Regional Medical Center Guide and registration form, to be
completed and mailed by the 28th week of pregnancy. You will also meet with one of our Billing Representatives to review your maternity benefits. Chesapeake Regional Medical Center {CRMC} is the Preferred hospitalfor Delivery.
You will also receive several samples of prenatal vitamins at this visit for you to try. At your next visit, please inform us which one you prefer, and a prescription will be written. Prescriptions are sent electronically to your pharmacy and will be there upon your arrival. If you experience nausea or cannot take a pill, oral spray
prenatal vitamins are available at the front desk for purchase.
ACOG guidelines are strictly followed. Routine prenatal visits are scheduled every 4 weeks until 28 weeks gestation, every 2 weeks until 35 weeks gestation and then
weekly until delivery.
If you are unable to keep any appointment, please call to reschedule since many tests are time sensitive. Also, our relationship will be a 10 month partnership in
your healthcare, and you have a responsibility to help us care for you and your unborn child. At each visit we will evaluate your urine & check for any indicators of problems that may arise such as Pre-eclampsia, Gestational Diabetes, or urinary tract infections. You will be weighed, have your blood pressure checked, abdomen measured for fetal growth, and the fetal heart beat auscultated beginning after 10 weeks of pregnancy. Visits to the office that are for reasons outside of the usually scheduled prenatal visits may not be included in you global insurance coverage. Please be diligent in researching your insurance coverage, and of course, our Finance Department will assist you. At one of your prenatal visits you will meet with a Billing
Representative and your financial responsibility will be outlined.
Your initial prenatal testing is usually performed at your 1st pregnancy visit, or after the fetal heartbeat has been heard. The OB profile of tests consists of a complete blood count, blood type and screen for antibodies, rubella immunity,
hepatitis B status, syphilis screen, vitamin D level, urinalysis, testing for HIV,
Gonorrhea and Chlamydia. The HIV test is not required but recommended by the
American Congress of Obstetricians & Gynecologists.
Ultrasound for dating and viability may be ordered, if needed. A morphology(anatomical) scan will be scheduled between 18-20 weeks to evaluate growth, development and, if obvious, the sex of your baby if it is your wish to know. The practice of JORDAN & ASSOCIATES OB/GYN has been recognized for its excellence in ultrasound and is accredited by the American Institute of Ultrasound in Medicine. All tests are billed, outside of your global prenatal services, through an outside laboratory in accordance with your insurance company’s policy. The primary laboratory that services our office is LabCorp. Since your insurance policy is based on an
agreement between you and your chosen insurance company, it is your responsibility
to inform our staff before any tests are performed if your insurance company
requires that labs are sent to another laboratory.
Early in the first trimester, you will begin to experience discomforts of
pregnancy including round ligament pain. This is an expected pain {in either or
both groin and lower abdominal areas} that occurs as the baby grows. Heating pad
is recommended. If you do not own one, microwavable heating pads that can
double as an ice pack are available for purchase in our office. Medication is not
recommended for this pain.

Genetic testing is available, including first trimester integrated serum
screening, Cystic Fibrosis screening, Hemoglobin electrophoresis and the AFP
Quad Screen performed between 15-20 weeks.
The integrated screening and AFP screen for the possibility of fetal abnormalities such as Down syndrome and Neural tube defects such as Spina Bifida. Screening tests may inform us whether or not additional testing should be offered. These tests
are not diagnostic on their own. In the event of an abnormal genetic screen result,
we may co-manage your care with Maternal Fetal Medicine at Eastern Virginia Medical School (EVMS). However, we will remain you Primary Obstetricians.
Once you are between 24-28 weeks gestation,
you will have a Glucose Tolerance Test (GTT) which screens for Gestational
Diabetes. Based on your risk factors, you may have this test earlier in your pregnancy. In preparation for this test, please do not eat or drink anything except water 2 hours prior to your test. If you are scheduled for this test, along with an OB visit to see a provider, please inform the front desk that you are here for you GTT, in addition to having your visit. Your Glucola drink can be provided upon your arrival. You must drink the Glucola within 5 Minutes. After 1 hour from drinki
ng the Glucola, your blood sugar will be tested. If your result is elevated (equal to or greater than 140mg/dl) you will be sent to the hospital or the preferred lab of your insurance carrier for a 3 hour GTT which will make the diagnosis.
If the results from your initial lab work reveal that you are Rh negative, you will receive Rhogam at 28 weeks gestation. First, an antibody screen will be
drawn (usually with your GTT) to ensure that you are a candidate for the Rhogam
injection. After delivery, if the baby is Rh negative like you, a 2nd Rhogam injection will not be necessary.
You are now 28-32 weeks; this would be the perfect time to schedule an
appointment for a 4-D ultrasound. Using the latest technology, we have the ability to allow you to view your unborn baby. A 4-Dimensional ultrasound is a 3-Dimensional picture in motion. This allows you to see your baby as it performs various movements such as yawning, sucking his/her thumb, or even smiling. This ultrasound scan takes approximately 20 minutes. Success of the scan depends on the positioning of your baby. Please feel free to ask the front office staff for addition information. If the baby is not in the optimum position and pictures cannot be successfully obtained, your fee minus a sitting fee will be refunded.
Don’t forget to sign up for the Prenatal, Postpartum/Infant Care and Fatherhood 101 classes taught by our Providers in the office. We also offer breast
feeding consultations. Classes are offered based on demand. Some of the topics
discussed are: stages of labor, pain management, and the postpartum period. Each
session is completed by a tour of CRMC. Chesapeake Regional Medical Center offers sibling tours for older children and Lamaze Classes all which are available at the Lifestyle Fitness Center (312-6132). Our classes are more personal and specific than the classes offered at other locations. Ask any staff member for more information. CPR classes are also available in the office, taught by the American Red Cross. CPR is also highly recommended so you and everyone caring for your newborn will be ready in an emergency.
By this point in your pregnancy, you should be choosing a Pediatrician. I
recommend that you first check the list of Doctors on your insurance plan, checking that their location is convenient for you, make a consultation appointment with them, and evaluate their policies, waiting area & add-on appointment scheduling practices. They do not have to be on staff at CRMC to be your designee. CRMC has 24 hour Pediatric coverage for emergencies, and this group will relay important information to your chosen Pediatrician, if necessary.
Iron supplementation or the addition of more iron containing food is
recommended at 28 weeks gestation to build your blood count prior to delivery.
Between 35-37 weeks gestation, a vaginal culture will be obtained for the presence of Group B Beta Hemolytic Streptococcus. This bacteria is normally found in approximately 40% of women however it may cause complications in the baby as she/he comes through the vaginal canal at delivery. If this is present, you will receive antibiotics upon admission to Labor & Delivery that will pass from you to your baby and help with her/his immunity to infection. Along with this testing, we will repeat your complete blood count and syphilis screening once again before delivery. HIV testing is again offered at this time as well.
Our Physicians receive after hour calls from Emergency Rooms and Labor &
Deliveries for obstetric and gynecological emergencies only. If a call is non-emergent you may be subject to a monetary fee. Please reserve all calls about
medications, scheduling or just “asking a question” to the daily office hours. On
call schedules may be shared with other Board Certified OB/GYN’s from time to time, with whom we fully entrust the care of our patients. There are 4 scenarios that should take you directly to the hospital without calling the answering service: 1) Decreased fetal movements. You should monitor fetal kicks after 28 weeks and proceed to Chesapeake Regional Medical Center if you do not feel 10 movements in 10 hours. 2) Bright red active vaginal bleeding. You may pass the mucous plug which has no association with onset of labor. This looks like mucous with a little blood streaked through it and usually passes in clumps or looks like jelly. 3) Rupture of membranes. If you continue to leak fluid and are unsure if it is urine or not, put on a pad and walk around for 30 minutes. If it continues to leak, you have most likely ruptured your membranes. Proceed directly to L & D. 4) Regular uterine contractions every 5 minutes for one hour. This should be time from the start of one
contraction until the start of the next contraction. Sitting in a warm bath will
minimize the pain. As we believe in education our patients, it is imperative that
you use these tools we are sharing. Do not waste time calling us to ask “what to do”.
Other than these emergent scenarios, your concern or question can be addressed in the office during regular business hours. A nurse will answer non-
emergent questions within 24-48 hours. Please leave specific contact information.
We will be happy to assist you and you may be worked into the schedule for that same day.
Dehydration is the most common reason for many false trips to the hospital.
If you believe you may be in early labor, drink a glass of water every 15 minutes as you time your contractions over a one hour period. If you are less than 37 weeks
you should not have more than 5 contractions in 30 minutes. If it is dehydration,
contractions will subside. It may take 18 hours for you to enter true labor.
Therefore, if you present to the hospital to rule out labor and no cervical change
occurs over 2-4 hours, you will be sent home with instructions on when to return.
Upon your arrival to L&D, you will be asked to sign in at the front desk. You will
then be assigned to a RN who will initially evaluate you according to specific
guidelines. She will call us for further orders (further observation, lab work,
admission or discharge home). You may not be visited by a Physician but realize
that the nurse is receiving orders from us.
Another reason for false labor is postcoital contractions. Semen consists of
prostaglandins which may stimulate contractions, usually not enough to stimulate
labor. This may also cause bleeding. You may continue to enjoy an active sexual
life unless bleeding occurs.
The Labor & Delivery experience is a unique & personal one. The hospital
recommends not more than 4 people in the delivery room during the actual
delivery. If an emergency arises, it may be necessary to ask your visitors to leave so that we may medically care for you and your baby. Space is limited when you
consider the need for additional nurses, and anesthesia team and your Obstetrician. Pain medication during your labor will be your decision. IV sedation is available until the appropriate time comes for an epidural, if you desire. Your decision for medication or epidural should not be FINALIZED until you experience labor. Also, ambulation, birthing ball, birthing bar, labor tub, mirror may be used upon request and if medically appropriate. Your delivery may be videotaped from the head of the bed after the baby’s head has been delivered. The baby will be placed immediately onto your abdomen unless you specify otherwise. After being assessed and wrapped in a blanket, your baby will be brought over to you for cuddling and breastfeeding if desired. If you’d like the baby to remain skin to skin, this is also an option.
During your labor, you may be connected to the fetal monitor intermittently
or continuously, depending on your risk status. The health of two patients must be considered at all times (you and your baby). You will be kept informed of your
status and/or any changes during this experience. In certain situations an
episiotomy may be necessary, but this practice is not automatic. Forceps, vacuum
assistance and cesarean sections are other techniques used, if medically necessary.
Each of these modalities may be a lifesaver. In the event of a cesarean section, the
person of your choice may join us in the Operating Room (if you do not undergo
general anesthesia and if it is not an emergency.) That person will either go with
the baby or stay with us while your surgery is completed. They may return to your
bedside in the Recovery Room as long as they keep on their sterile clothing. The
Pediatrician and Nursery Nurse will walk by the waiting room with your newborn
and call for family to follow them to the nursery if others are waiting.
Cord Blood banking is available to preserve stem cells from your child’s cord
blood. This is done as a precaution in case your child or family member needs
stem cell transplant in the future. Neither the collection nor storage is covered by
insurance policies but may be lifesaving in your family’s future. If you wish to
receive information, please inquire at one of your visits. The cost for Physician
collection is separate from the cost to store the cord blood with the company of
your choice. If the company you choose provides partial reimbursement for the
cord blood collection, you will be responsible for payment of the remaining fees
prior to your delivery. Please see a Billing Representative for details.
If you give birth to a male, it is your choice to have him circumcised or not. This is not medically necessary and is only performed on a voluntary basis. There are both possible benefits and risks to having the circumcision performed and it is recommended that you speak with your Pediatrician. This surgical procedure will
be performed with the use of topical anesthetics by your Obstetrician and follow
up is with your Pediatrician if anything changes.

Medications during your pregnancy & postpartum

No medications are recommended during the first 12 weeks of pregnancy. Natural remedies should always be attempted beforeusing any drug during your pregnancy. Not all natural remedies are safe and you should check with our office’s clinical staff if you have any questions.
Generally, if the medication is approved during pregnancy, they are safe in
the postpartum period if you choose to breastfeed. Please contact your
Pediatrician, since the baby is now their patient. Also, as a resource, use your
hospital Lactation Consultant and the Local La Leche League.

*Additional Office Services
For your convenience, we have the following services available to Patients, Family
& Friends {Men & Women} by appointment only:

*Massage Services:
Sports massage, Chair massage, Prenatal massage, Swedish massage, Deep Tissue Massage, Deep Tissue massage, Headache & Sinus massage, Honey & Clay Facial

*Complete Wellness Program
Evaluation & Counseling by our Certified Weight Management Consultant &
Master Personal Trainer.

*VEMMA-Vitamins Essential Minerals Mangosteen & Aloe Vera
Liquid multi-vitamins
Visit our website @ www.jordanandassociates.org