Choices Women’s Medical Center offers all services for our patients who think they are pregnant. Have questions? Scroll through the most frequently asked questions about pregnancy and prenatal care.
Feel free to contact us on chat (bottom right corner of this page), make an online appointment, or call us to make an appointment at 718-786-5000.
The only sure way to know is to get a pregnancy test. At Choices, you can get a free pregnancy test by appointment or walk-in. Free pregnancy tests are completely confidential for patients of all ages. Sometimes a person begins to suspect she is pregnant when she misses a period, notices her body beginning to change in different ways or develops other physical symptoms.
If you are in your childbearing years and your monthly period is a week or more late, you might be pregnant. However, a missed period can be misleading if you have an irregular menstrual cycle. Other common early signs can include:
Other, less-common signs include moodiness, bloating, light spotting, cramps, constipation, food dislikes, or nasal congestion. These signs, however, can indicate other things besides pregnancy. And you can be pregnant without experiencing them. So it’s all the more important to get a pregnancy test as soon as you suspect you might be pregnant.
There are many benefits to prenatal care. It will help you have a normal pregnancy and give birth to a healthy baby. Pregnancy can be an emotionally and physically demanding process, both joyful and stressful. Prenatal care, beginning as early in your pregnancy as possible, can address your concerns and identify and begin treating any possible medical conditions that might impact your pregnancy. Your appointments over the duration of your pregnancy with Choices professional staff will help you have the best pregnancy and childbirth experience possible.
If you do not have insurance or other resources, Choices can work out financing so that your prenatal care can be free or low-cost. No one will be turned away because of financial need. If you live in New York State you may qualify for Emergency Medicaid which covers all pregnancy-related services including prenatal care. To see if you qualify click here to take our Emergency Medicaid Quiz. We can sign you up on the day of your first visit and all costs will be covered. Choices also accepts many other forms of payment, and reasonable self-pay and sliding scale plans are available. We accept cash and all major credit cards. When you call for an appointment, ask to speak with one of our Financial Counselors.
Yes. If she needs financial help, she may qualify for New York State Emergency Medicaid which is available to people who live in NY State. When she calls for an appointment, she can ask to speak to one of our Financial Counselors.
As soon as think you may be pregnant, you should schedule a Confirmation of Pregnancy Appointment at Choices. Depending on the results, you will be given an Initial Prenatal appointment about 2-4 weeks after. This allows enough time for the fetus to grow large enough to be seen on an ultrasound, and a heartbeat is usually detectable, as well, through a sonogram.
There are many benefits of prenatal vitamins. Ideally, prenatal vitamins should be started approximately 3 months prior to conception (becoming pregnant). Starting these vitamins as soon as you start trying to become pregnant or as soon as you know you are pregnant will go a long way towards a healthy foundation for your baby. A good prenatal vitamin will have folate, B vitamins such as B12 and B6 and zinc. You should also take about 400mg of the essential fatty acid DHA for neurologic development and Vitamin D3 daily, which is especially important in the second and third trimester.
It is best to limit medications while you are pregnant. If you have a diagnosed, medical condition for which medication is necessary, please call your Choices provider immediately so we can discuss how to best manage your medications. There also may be times when medications are necessary for the relief of certain common conditions. Please call your Choices provider for advice.
After your Confirmation of Pregnancy Visit, you will have your Initial OB Visit where you will have a thorough review of your menstrual history and medical history and will discuss all current and previous medications. You will have an ultrasound either at the Confirmation of Pregnancy visit or Initial Visit.
Your mental health is very important to us. Our Prenatal Program includes meeting with a licensed Social Worker at various times throughout your pregnancy. From joyful anticipation to sometimes fearful concern, pregnancy is an emotionally complex process. Based on a psychosocial assessment completed at your initial visit, a Social Worker will work with you in identifying stressors and creating an individualized plan to address all of your concerns and prepare for the arrival of the baby. Six weeks after the birth of your baby, we will schedule your post-partum visit to ensure that you are having a healthy recovery from your pregnancy and where you will meet with a Social Worker again.
A doctor’s appointment will be scheduled every 4 weeks until 28 weeks, then every 2 weeks until 36 weeks, and every week after 36 weeks until delivery. The entire pregnancy is approximately 40 weeks. You will also be seen postpartum. Each pregnancy is different and may require more or fewer visits.
Typically, within the first two visits (Confirmation of Pregnancy or Initial Visit) you will have an ultrasound.
Around 18-22 weeks, an anatomy ultrasound is performed at a one of our high-quality referrals. This is a “high-resolution ultrasound” where details of the baby’s anatomy (skeleton, organs, spinal column, facial & head development, fingers/toes, organs, growth, fluid, placenta, etc.) is measured. The gender of the baby may be revealed at this appointment if requested.
A growth ultrasound may also be performed around 36 weeks for estimated fetal weight and fetal position. Ultrasounds will be performed for medical indications any time throughout your pregnancy if needed.
These are tests that screen for chromosomal problems. Down’s Syndrome (Trisomy 21), Trisomy 13 and Trisomy 18 are the most common chromosomal abnormalities. These tests are non-invasive and will not bring harm to mother or baby.
GYN-Horizon testing is for women and their partners who want to know what genetic conditions they may pass along to their babies. Patients who are thinking of becoming pregnant and who want to be tested will meet with a Choices Social Worker for an informational meeting. Women with questions about finances or insurance coverage will be referred to a financial counselor who will answer any questions you may have. Patients will give a blood sample and be asked to return to the clinic to receive results in 14-16 days. Patients who receive positive test results will be referred to a specialist who will guide them through their best options for moving forward.
Click here for more information on Horizon screening.
The test will determine if your baby is at higher risk of having Down syndrome and other common genetic conditions. Non-invasive and highly accurate, Panorama identifies more than 99% of pregnancies affected with Down syndrome and has the lowest reported false positive rate of any prenatal screening test for the commonly screened chromosomal abnormalities: trisomy 21, trisomy 18, and trisomy 13.
This test can be taken by women of any age and ethnicity who are at least 9 weeks pregnant. Panorama is an in-network provider with most health plans, including Aetna, Anthem, Cigna, and UnitedHealthcare. A comprehensive list of insurances can be found here. The cost of the test varies according to the prenatal screening panel selected and your specific insurance coverage. Based on previously approved claims, most patients pay between $100 and $200 out-of-pocket after their deductible.
For more information on Panorama Genetic Testing by Natera, visit their website.
Women can have a healthy pregnancy and delivery in their 30’s and beyond. A nutrient dense diet, moderate exercise, healthy sleep hygiene and stress management are each crucial.
Additional testing is offered to expectant mothers over the age of 35. Our office will aid you in scheduling an appointment with a genetic counselor. The genetic counselor will discuss any increased genetic risks and offer a more detailed test for genetic screening.
If any tests are abnormal your genetic counselor will inform you of further diagnostic options.
Most women will find out the baby’s gender at the anatomy ultrasound that is scheduled usually between 18- 20 weeks. However, if you decide to do some of the advanced genetic testing, the gender can be revealed as early as 10 weeks. There may be additional fees associated with this testing.
First Trimester (7-10 weeks) – Blood work that includes: blood count to screen for anemia, immunity to some childhood diseases, blood type & Rh factor, and some genetics. Urine culture will be collected, as well as bloodwork for STD’s, HIV, hepatitis B, syphilis, blood type, immunity to Rubella (an infection that may harm the fetus). Cystic Fibrosis, Sickle Cell disease/trait or hereditary anemia diseases can be screened for.
Third Trimester (30-34 weeks) – HIV and blood count screening is repeated in blood. (34-36 weeks) – Vaginal swab to check for Group B Streptococcus (GBS), bacteria that normally live in a woman’s vagina. Some women have more growth than others, which is nothing to worry about in non-pregnant women. However, if a baby is exposed to GBS during delivery he/she could get very sick. If you are positive for GBS, you will be administered antibiotics during labor.
A healthy woman, neither over nor underweight, should gain between 25-30 pounds during the entire pregnancy. However, some women may not actually gain this much and that is acceptable as long as they are eating a nutrient dense diet. The first trimester can be difficult because of increased nausea and stomach upset. Do not panic if you do not gain; you may even lose weight in the first trimester. If you are experiencing frequent vomiting, an anti-nausea medication may help. On the contrary some women may retain more water during pregnancy contributing to more weight gain. A nutrient dense diet is the best way to avoid excessive weight gain during pregnancy.
There are three main food-borne pathogens of concern for pregnant women:
Toxoplasma, Listeria monocytogenes and Salmonella enterica.
These organisms can be passed to the fetus and increase the risk for spontaneous abortion, stillbirth or perinatal complications. Pregnant women are more vulnerable to these pathogens because the immune system is compromised/less effective during pregnancy. Therefore, it is best to avoid raw fish, raw meat and unpasteurized dairy. Heating deli meats for 10 seconds is recommended. Sushi is commonly eaten by pregnant women in Japan and there is much controversy surrounding the recommendation that it should be avoided by American women. It is always best to act on the side of caution. Avoid high mercury fish such as shark, tilefish, king mackerel, and swordfish. Avoid CANNED albacore tuna.
The benefits of exercise during pregnancy have been well documented. Not only does a regular exercise program strengthen and tone the muscles, it helps relieve tension, as well as the aches and pains many women experience during pregnancy. Exercising while pregnant has also been shown to promote an easier delivery, a more rapid recovery, and maximizes metabolism. The aim of an exercise program during pregnancy is to establish and maintain a level of general good health and fitness. It should not be used as a means of weight loss. Pregnancy is never a good time to diet. There are, however, some activities that should be completely avoided during pregnancy. They include risky activities such as surfing, scuba diving, rough terrain mountain biking, skydiving, snow skiing, platform diving, and high-altitude mountain climbing. Activities that carry a high risk of falls or injury should be avoided. They include horseback riding, contact sports such as basketball, baseball, football, and volleyball, inline or ice-skating and racquet sports such as racquetball, tennis or squash.
If no exercise was practiced before becoming pregnant, consult your Choices provider before beginning an exercise routine. Almost any type of exercise is safe if done in moderation. Keep in mind, however, that pregnant women are more susceptible to injury due to hormonal influences that cause joints and ligaments to become more lax than usual. There are several, recreational activities that are excellent for beginner exercisers. They include yoga, brisk walking, golf, swimming, and stationary bicycling.
The following exercises should be avoided:
There are certain conditions in pregnancy, which would make it unwise to engage in an exercise program. Therefore, it is best to consult your Choices Provider for guidelines.
If any of the following conditions are present, exercise should be avoided completely:
Hormone levels are rapidly rising in early pregnancy, which may cause some unpleasant side effects. Most women have extreme breast tenderness or fullness and it is common to feel extremely tired. Nausea is very common and can be associated with unpleasant smells/tastes. Women will find that a food or smell they liked before suddenly becomes very displeasing or revolting. If excessive vomiting occurs, there are several safe medications that can be prescribed to help minimize this occurrence. Many women will experience unpleasant gastrointestinal problems such as bloating, feelings of fullness, gas and constipation. Small, frequent meals may help. Drink LOTS of water! This will help for many reasons. If you are constipated, try a stool softener such as Colace twice a day or magnesium citrate powder. Increased fiber in the diet may also help.
Do not put too much pressure on yourself in the first trimester. Eat healthful food as tolerated, but there may be days when nothing sounds appealing. Protein shakes are another good option if tolerable.
Bleeding when you are pregnant is never a good thing, but it does not always mean something terrible is happening. Always call us at 718-786-5000 ASAP if you experience bleeding during any stage of pregnancy.
First trimester bleeding/spotting in pregnancy can be common and does NOT always mean a miscarriage is imminent. Bleeding during implantation can be common and may resolve on its own. Also, the cells on a woman’s cervix change during pregnancy and bleed easily when touched, especially during intercourse.
When calling your Choices provider, be prepared to answer the following questions: Are you having severe cramps/pain with bleeding? Is the bleeding bright red or brown? Have you soaked any pads or is it just spotting? Have you recently had intercourse? More than likely we will have you make an appointment, so we can monitor the pregnancy and make sure you and the baby are still ok. If the bleeding starts after office hours, you may be instructed to go to the Emergency Room.
Second/Third Trimester bleeding may indicate a few things: the placenta could possibly be near your cervical opening, the placenta could be detaching, or possibly even early labor. Always call your doctor immediately if you experience any bleeding at this point.
Yes! You can continue having sexual intercourse if you have an uncomplicated pregnancy. Check with your provider if your pregnancy is considered high risk or if you have any concerns. In most cases, sex can be enjoyed throughout your pregnancy.
Some couples fear that intercourse will harm the pregnancy or cause a miscarriage; however, the baby is very well protected by the uterus and the amniotic sac (bag of water). Intercourse will not cause the bag to break or hurt the baby. It is always best to consult your Choices provider for specific information, but, in general, comfort should be the determining factor in regard to sexual activity.
It is best to observe the following precautions:
Occasional pain during pregnancy is a normal thing; the whole body is growing and stretching as the pregnancy progresses. Many women experience round ligament pain as early as the second trimester. These ligaments keep the uterus attached to your pelvic area; as your uterus and baby grow bigger these ligaments will stretch and pull. They attach near your pelvic bone so this pain can be felt from the vaginal area to mid abdomen. Your rectus muscles (abdominal muscles) will also be stretched apart to make room for a growing uterus. This pain can be felt in the pelvic area and sometimes around the top of the abdominal area. It is completely normal for the above pains to come and go throughout pregnancy. If you are ever concerned about the intensity of your pain call your Choices provider.
Back pain in pregnancy is another normal occurrence because the spine naturally curves more during pregnancy and puts more strain on your back. You can try to wear a belly band or use Aspercreme to help alleviate this.
Hemorrhoids are common during pregnancy, especially in the third trimester. Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They can become painful, itchy, and irritated. You’re more likely to get hemorrhoids if you’re constipated, because straining to have a bowel movement swells your veins. Your growing baby also puts pressure on the large veins behind your uterus. You should call your doctor if yours bleed or hurt a lot. Hemorrhoids usually go away soon after your baby is born.
Leg pain/nerve pain is also normal. As the uterus grows it compresses many nerves in your pelvic area that travel to your legs. Most women will have pain in one leg more than the other depending on how your baby is sitting.
Carpal tunnel syndrome is common during pregnancy due to the swelling of the tissues around your wrists. You may experience hand or finger pain and tingling, sometimes even numbness. Wearing a wrist splint at night may be helpful.
Varicose veins can occur during pregnancy, usually in the lower half of the body. This is because the uterus is compressing the veins that allow the blood from the lower half of your body to drain back up into your heart causing the blood to back up in the veins. This tends to get worse with each pregnancy. Some women may even get varicose veins in the vaginal region. These veins are usually harmless, although their appearance may be upsetting. Try wearing compression socks or tights to relieve the pressure. These will typically go away after the pregnancy is over.
Swelling in the legs and arms is very common during pregnancy. Your blood volume and tissues are all expanding as your baby grows and this may cause swelling. Some women swell earlier than others. Try to get off your feet as much as you can and wear compression socks or tights. Tell your doctor about this at your next visit to make sure it’s a normal occurrence.
Typically, women will start to feel regular fetal movements around 25 weeks. It may be earlier depending on number of pregnancies and size of mom and baby. After 25 weeks you should typically feel fetal movement at least one to two times per hour.
Most women will not need to worry about labor until after 37 weeks. Braxton-Hicks contractions may happen long before; these cause the uterus to tighten and are often painless. Your stomach may feel like a hard bowling ball for a few seconds and then go away. A labor contraction will feel unlike anything experienced before, most women describe it as a really bad menstrual cramp. It can start near your back and travel to your pelvic area. Labor contractions will be timed at regular intervals and progressively get stronger and closer together. Each woman will interpret labor pains a little differently; some women even say it feels like indigestion.
A physician or nurse can be reached at all times by calling 718-786-5000. After hours and on Sundays, an answering service will connect you with a Choices provider for emergencies. Please limit after-hour calls to emergencies only. Prescription refills, test results, and general questions should be directed to 718-349-9100 EXT. 105 during office hours: 8:00 am-5:00 pm Tuesday- Saturday.
The following concerns warrant a call to your doctor regardless of the time or day:
You may want to pack two small bags for the hospital or birth center: one for the items you’ll need during labor, and another for items that you won’t need until after you give birth.
*Your infant safety seat must be in place before you will be allowed to take your baby home.
*Do not bring jewelry, excessive cash, or credit cards or other valuables with you.
Please remember that Choices is part of this process and will expect a photo of your fabulous Little One on your first post-natal visit with us to add to our wonderful collection!