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Having Your Baby with VirginiaMason Franciscan HealthMaternity Health Guide 132-2041, 8/20

CONGRATULATIONS ONYOUR PREGNANCY!Use this guide to help you prepare for your birth with Virginia MasonFranciscan Health. Let’s get started with the basics:My name:My due date:My partner’s name and phone number:My provider’s name and phone number:My baby’s health care provider’s name and phone number:NOTESMaternity Health Guide 2

Choosing a ProviderThe type of provider you choose depends on manyfactors including: your age, health and preexistingconditions, as well as your hopes for labor and delivery.Once you determine the type of provider you want, you’llbe able to choose the individual caregiver with whomyou feel comfortable and confident.OB/GYNSOB/GYNs can help you through pregnancy, childbirthand gynecological services through the rest ofyour life. Women who have had complications withearlier pregnancies, are expecting multiples or havea preexisting medical condition. Many women withlow-risk pregnancies also choose OB/GYNs for theirprenatal, labor and delivery care.MIDWIFERY SERVICESOur highly trained team of certified nurse midwives(CNMs) provide exceptional care for both motherand baby, from prenatal care through delivery andgynecological services through the rest of your life.Midwives provide a more holistic and traditionalapproach to childbirth, and are often trained in naturalpain management techniques and birthing methods.You don’t need to deliver at the Midwifery Center atSt. Joseph to enlist a midwife as your provider. Ourmidwives work in partnership with OB/GYNs and ifspecialty medical treatment or surgery is needed,you will receive care from a specialist. However,your midwife will continue to manage your care incollaboration with these specialists. Midwives can alsocare for women who desire to have a trial of labor aftercesarean (TOLAC).FAMILY MEDICINEA Family Medicine doctor can provide care for yourwhole family, and some Family Medicine physiciansalso provide Obstetrical and Newborn care. Theirknowledge of your family and health history allow themto provide Prenatal and Obstetrical care that is verypersonalized — along with the ability to care for babyafter he or she is born.CENTERINGPREGNANCY You don’t have to prepare for pregnancy on your own.Virginia Mason Franciscan Health offers a uniqueexperience of group-based prenatal care includingcheckups, conversation and valuable information. YourCenteringPregnancy meetings will take the place ofyour regular prenatal check-ups and allow you to bondwith a cohort of pregnant women with similar duedates. If you choose CenteringPregnancy you shouldstill consider taking a childbirth education class to befully prepared for your child’s birth.Maternity Health Guide 3

Prenatal Do’s and Don’tsThe first best thing you can dofor your baby is to practice goodprenatal care. This starts withregular prenatal appointments, butencompasses many choices youmake throughout your pregnancy.Your caregiver will provide you withguidelines for a healthy pregnancy,but here’s a start on what to do—and what not to do—when you’reexpecting.DO take prenatal vitamins.The American Congress ofObstetricians and Gynecologistsrecommends that all pregnantwomen take 600 micrograms offolic acid and 27 milligrams of irondaily. Eating folate and iron richfoods may be enough, but manywomen take a prenatal supplementto ensure they get enough. Prenatalsupplements contain many othervitamins and minerals, so youshould talk to your doctor aboutthe right ones for you.DON’T smoke cigarettes,use tobacco, drink alcoholor use drugs, including marijuana,all of which can cause seriousbirth defects. Ask your partner tosupport you by following healthypractices, too.DO maintain a healthy diet.Incorporate plenty of fruits,vegetables and whole grains.Opt for lean sources of protein,including meat, poultry, beans,eggs, soy products, nuts andseeds, and low-fat dairy productswhen possible. You may alsoneed to increase your calciumconsumption.DON’T lose sleep. Try tosleep seven to nine hoursevery night.DO exercise. Most expertsrecommend maintainingyour pre-pregnancy exercise level,preferably at least 30 minutes aday most days of the week. If youdon’t have an exercise routine, trygentle, nonweight-bearing exerciselike swimming or riding a stationarybike. Walking and modified yoga orPilates are also safe and healthyoptions. Talk to your doctor aboutcontinuing any higher-impactpre-pregnancy activities.DON’T neglect healthproblems. Diabetes and highblood pressure can complicate apregnancy, but your doctor can helpyou manage them.DO talk to the women inyour family about theirpregnancies. They are the bestresources and may alert you torisks and potential problems, andsuggest ways to deal with commonpregnancy discomforts.DON’T use hot tubs orsaunas. Studies have shownthat exposure to high heat duringthe first trimester can cause birthdefects, according to the AmericanAcademy of Family Physicians.DO drink lots of water tocombat common problemslike dehydration and constipation,and to help your body keep pacewith increases in blood volume.DON’T eat certain foods.Some foods can add toyour discomfort and may actuallyharm you and your baby. Caffeinecan cause irritability, insomnia,nervousness and dehydration inCONTINUEDMaternity Health Guide 4

the mother, and low birth weightin the baby. You may also want tosteer clear of raw fish, fish high inmercury, undercooked meat andsoft cheeses.DON’T change thecat box. Cat feces cancontain a parasite that leads totoxoplasmosis, which can causebirth defects in unborn children.Toxoplasmosis may also be foundin dirt contaminated by cat feces,so wear gloves when gardening.DO watch your weight.Women near their idealweight should gain an averageof 25 to 30 pounds duringpregnancy. Underweight womenmay need to gain more, whileoverweight women may be advisedto gain less. Pregnancy is notthe time to diet. The AmericanAcademy of Family Physicianssuggests gaining two to threepounds during the first 12 weeks,then one pound per week after that.DON’T expose yourselfto toxic substances, suchas cleaning solvents, lead andmercury, some insecticides andpaint. Read labels on householdproducts, which warn you if theyare harmful to pregnant women.And last but not least DO make sure to attendyour scheduled prenatal checkups and followyour prenatal care provider’s advice.High-RiskPregnancyThe name might give youpause, but there’s no need toworry. “High-risk” is simply thedesignation for pregnanciesthat carry an increased risk ofcomplications due to a varietyof circumstances, such as: Age of the mother Mother has a chronic medicalcondition Growth abnormalities inthe baby Previous premature birth Multiple gestations (twins,triplets, etc.)Our maternal-fetalmedicine teamof perinatologists arePAUSEand ReflectWhat other questions or concerns do you have about being pregnant?Jot them down here for your next appointment.specially trained in highrisk pregnancy care.They collaborate withyour provider ifcomplications ariseduring your pregnancy.Maternity Health Guide 5

Family Education ClassesWe are truly committed to helping you and your familyprepare for baby through a wide variety of prenataland parenting classes. The more informed you are,the better prepared you’ll be, and that increases yourchances of having the birth and newborn experienceyou’ve always hoped for.CHILDBIRTH PREPARATIONPrepare for labor and delivery. This classincludes labor coping techniques, phasesand stages of labor, cesarean birth, medication options,newborn care and more.TOOLS TO BUILD A BETTER BIRTHThis class is taught by trained andexperienced childbirth educators and doulas.This class offers hands-on practice of techniques,strategies and tools to increase comfort during laborand birth. You will find this class beneficial even if youare planning to use medications in labor. Class focus ison practical skills that everyone can use.CHILDBIRTH PREPARATION ONLINEE-CLASSIdeal for the busy 21st century parent, orwomen on bed rest, this class is well-suited for familieswith limited flexibility to attend classes in-person.Content includes instructive videos, interactive activitiesand access to handouts.ESPECIALLY YOURSThis is a personalized three-hour privatechildbirth education course for the expectantmother and her companion. Registered studentspersonally select class content after arranging thedate, time and location that best suits their schedule.A private tour of a Franciscan Family Birth Center isan option.WATERBIRTH BASICSThis free online class is required for patientsinterested in delivering in water at St. JosephMedical Center or the Midwifery Birth Center atSt. Joseph and St. Elizabeth Hospital in Enumclaw.Before registering, interested participants shoulddiscuss their intention with their health care providerto determine if they are a good candidate. Please notethat this class should be completed before 36 weeksof pregnancy.For complete details and to registerfor classes, please visit our website atchifranciscan.org/familyeducationMaternity Health Guide 6

CenteringPregnancy You have a unique choice for prenatal care through CHI Franciscan. Ourgroup-visit prenatal care program, CenteringPregnancy , offers the threemajor elements of prenatal care in a group setting: Instead of one-to-oneprenatal visits, you can get your prenatal care, plus helpful informationand peer support, through CenteringPregnancy.The program, which started at Franciscan Women’s Health Associatesat St. Joseph, received accreditation by the international CenteringHealthcare Institute in 2016. It’s also proven to decrease preterm deliveryand postpartum depression.CenteringPregnancy has a high patient satisfaction rate, and participantsare generally more engaged, better informed and ask their providers morein-depth questions about their pregnancy. As you bond with other momsand parents, you’ll benefit from the support of your group members andeven create a support system for postnatal support, which is justas important as prenatal support.Is CenteringPregnancy for Me?Whether this is your first or fourth pregnancy, if you’re interested inconnecting with other expectant moms, CenteringPregnancy is for you.Here’s how it works: 8 to 12 pregnant women with similar due dates participate in a groupdiscussion, starting around 12 to 16 weeks, led by a CHI FranciscanCertified Nurse Midwife (CNM) or Obstetrician (OB). Other clinicians and educators share helpful resources to use duringand after pregnancy. Your spouse and/or partner are welcome. Each group meets for 10, 90-minute sessions throughout your pregnancyand in the weeks after delivery. Sessions are typically covered by private health insurance andMedicaid, avoiding out-of-pocket costs.PAUSEand PlanWrite the date/s of your class here.CenteringPregnancy group visits take the place of your regular one-on-oneprenatal visits. You will receive blood pressure and belly checks, alongwith other health assessments, as appropriate.Maternity Health Guide 7