Content provided by: Virginia Women’s Center

Congratulations on your pregnancy! Whether you’re a first-time mother-to-be or experienced in pregnancy, our team at Virginia Women’s Center will be with you every step of the way. We believe that children are among life’s greatest blessings and it is a privilege to help bring them into your family. Each pregnancy and birth is just as special and unique for our medical family as it is for yours – we are excited and honored to begin this journey with you.

Understanding that pregnancy can be a time of combined excitement, anxiety and confusion, we hope that this infographic will help you know what to expect during your third trimester.

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Congratulations on your pregnancy! Whether you’re a first-time mother-to-be or experienced in pregnancy, our team at Virginia Women’s Center will be with you every step of the way. We believe that children are among life’s greatest blessings and it is a privilege to help bring them into your family. Each pregnancy and birth is just as special and unique for our medical family as it is for yours – we are excited and honored to begin this journey with you.

Understanding that pregnancy can be a time of combined excitement, anxiety and confusion, we hope that this infographic will help you know what to expect during your first trimester.

Virginia Women’s Center is an advertiser on Richmondmom.com

Infertility can be caused both by female factors and male factors. There are many causes of infertility, but there are also times when the cause cannot be determined. Some of the causes for female infertility include:

• Being overweight, underweight or having an eating disorder
• Intense exercise
• Age – the possibility of infertility increases with age
• Stress or depression
• Hormonal imbalance
• Brief or irregular menstrual cycles
• Substance abuse – smoking, heavy drinking, drug use
• Tumor or cyst
• Thyroid problems
• Damaged reproductive organs
• Sexually Transmitted Diseases (STDs)
• Tubal disease
• Endometriosis

If you are trying to conceive, you may consider having an evaluation for infertility if you experience the following:

• If you are under 35 and have not become pregnant after one year of having regular sexual intercourse without birth control
• If you are over 35 and have not become pregnant after six months of having regular sexual intercourse without birth control
• If your periods are not regular
• If you or your partner has a known fertility problem

Your OB-GYN can conduct a basic fertility evaluation. Depending on what is found, he or she may refer you to a physician who specializes in fertility – a reproductive endocrinologist. A physical examination can help determine what is preventing conception. There are a wide range of options available to assist couples in achieving a successful pregnancy. They include lifestyle changes, behavioral modifications, drug treatments and surgeries.

Additional Resources:

• American Fertility Association
• RESOLVE: The National Infertility Association
• American Society for Reproductive Medicine

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General travel tips:

• It is always best to speak with your health care provider about your ability to travel. If you have certain complications, it might be better for you to celebrate the season in town.
• Generally, the best time to travel is between weeks 14 and 28 of your pregnancy. This is typically the time when you are feeling your best and the risks of miscarriage or preterm labor are less. Many women are able to travel up until a few weeks before their due date, but again, it is best to discuss this with your health care provider.
• When you travel, make sure you drink enough water. This is especially important during air travel. It might also be helpful to bring healthy snacks with you so that you can keep your energy up.
• Choose comfortable clothing and footwear. Also remember to pack lightly or to check your bags, if possible. That way you won’t have to worry about lifting or carrying heavy suitcases.
• You may have to forgo some of your family’s planned winter activities this year such as skiing, snowboarding or ice skating. Contact sports or activities that put you at greater risk of falling should be avoided during pregnancy. However, this doesn’t mean you have to sit on the sidelines. Learn more about what kinds of exercises are beneficial during pregnancy.
• It is best to avoid taking a cruise while you are pregnant. Also, try not to pick destinations where medical care may be suboptimal or where returning home may be difficult.
• Before you go out of town, ask your health care provider for a copy of your prenatal record summary. In case you experience any complications while you are out of town, you can provide a health care provider or hospital with this important information. We also recommend you take your OB Passport with you during your trip.

Traveling by plane:

• Air travel is almost always safe for women with low-risk pregnancies up to 36 weeks gestation. You might be more comfortable if you select a seat near the front of the plane as the ride tends to be smoother. In addition, pick the aisle seat so that you can easily slip out to the restroom if needed.
• If you are traveling on a long flight, try to get up at least every hour to stretch your legs. This can also help reduce leg swelling and blood clots.

Traveling by automobile:

• If you’ll be taking a road trip this season, try to spend no more than five or six hours in the car each day. Make sure you take plenty of breaks to stretch your legs.
• When you’re in your vehicle (whether you’re on a road trip or just going to the grocery store), it’s important that you keep the airbags turned on and that you sit at least 10 inches back from the dashboard, if possible. Also, make sure you use both the lap and shoulder seat belt every time you’re in the car. Wear the lap belt low on your hip bones, not across your belly. Wear the shoulder belt across the center of your chest, between your breasts, instead of under your arm.

If you’re traveling this holiday season or any time during your pregnancy, we hope you have a safe and enjoyable trip.

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A nurse practitioner is a registered nurse who has completed specific advanced nursing education, typically a master’s degree, and is trained in diagnosing common and complex medical conditions. Nurse practitioners can provide a full range of services such as ordering, performing and interpreting diagnostic tests; diagnosing and treating acute and chronic conditions; prescribing medications and treatments; and managing overall patient care. At Virginia Women’s Center, our nurse practitioners are board certified by national professional organizations.

Women’s health nurse practitioners are specially trained and board certified in obstetrics and gynecology and collaborate with our physicians to provide services that include the following:

• Care before and after menopause
• Contraceptive care
• Evaluation and treatment of common vaginal infections
• Health and wellness counseling to patients of all ages, including family planning care and gestational diabetes consultations
• Annual exams, including Pap test
• Pregnancy testing and routine care before, during and after pregnancy
• Screening and referral for other health problems
• STD screening and follow-up

Women with medical conditions, especially those that require surgery, need the services of a physician. But when women have typical health care needs, a nurse practitioner can serve as their health care provider.

Nurse practitioners distinguish themselves from other health care providers by focusing on the health and well-being of the whole person, in addition to specific concerns. They work as partners with their patients, guiding them to make educated health care decisions and healthy lifestyle choices. Their aim is to educate patients on the effects their health choices can have on them, their loved ones and their communities.

To read the biographies of Virginia Women’s Center’s nurse practitioners, visit the staff page on their Website. To learn more about the care that nurse practitioners provide, read their comments here.

Additional links:

American Academy of Nurse Practitioners

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Laurie Tams, the genetic counselor at Virginia Women’s Center, works with mothers and couples to explain the array of prenatal testing options available and helps to interpret the test results. She works closely with the maternal-fetal medicine specialists and obstetricians.

If you and your partner are considering pregnancy or are newly pregnant, you might be amazed and/or overwhelmed with the number of prenatal testing options available. There are three different types of genetic testing that are offered during pregnancy.

1. Carrier testing of both parents will detect if either parent is a carrier of a certain genetic defect. A carrier test can be done before, during or after pregnancy and is performed by obtaining a blood sample which is then studied in a lab to detect a defective gene for a certain inherited disorder.
2. Screening tests are available to detect some birth defects during pregnancy. However, a screening test only shows if there is an increased risk that a defect will occur.
3. If a screening test or other factors raise concerns, diagnostic tests often can show whether certain birth defects are present.

For more detailed information on some of the carrier and screening tests available, check out the Focus on Health videos that are available on the Virginia Women’s Health website.

Reasons for Referral to a Genetic Counselor

Your obstetrician may refer you to Laurie Tams or another genetic counselor for one or more of the following reasons:

• You are planning to start a family and either you, your partner or a close relative has an inherited illness.
• You already have one child with a severe birth defect.
• You have had two or more miscarriages.
• You have delivered a stillborn child with physical signs of a genetic illness.
• You are pregnant and over age 34.

Genetic testing offers greater ability to diagnose and address birth defects during pregnancy. However, whether you want to be tested to see if your baby is at increased risk for birth defects or genetic disorders is a personal choice.

Some couples choose not to be tested for birth defects. Others find that testing and counseling can help them better plan for the future. Working with a genetic counselor can be reassuring and informative, especially if you or your partner has a known risk factor.

It’s important to keep in mind that the genetics field is expanding exponentially, so new developments—often complex—can come to light every day.

For more information, contact the Virginia Women’s Center.

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