Your Schedule

Physicians: Russell L. Wavrin, M.D., Mary Anne Jacob, M.D., Juan C. Angelats, M.D., Daniel T. Chow, M.D., Jennifer L. Schwab, M.D., Paige E. Persch, M.D.

Certified Nurse Practitioners: Jaimi L. Anderson, APRN, CNP, Vicki I. Buth, APRN, CNP, Heidi Helleck-Sprang, APRN, CNP, Shirley J. Jarcho, APRN, CNP

Your schedule for prenatal care

During your pregnancy, you will have many visits with the Medical Doctor (M.D.) and/or Nurse
Practitioner (RN, CNP). You will be seen most often by the primary physician of your choice;
however, you may feel it would be beneficial to see each of the physicians in the group at
least once. Because we practice as a group, call coverage is alternated amongst the doctors
and you may be delivered by the physician on call.

Since insurance coverage varied significantly, it is your responsibility to check your particular

The following schedule is a general guideline for an uncomplicated pregnancy, which we
certainly hope is your experience. Appropriate changes will be made when needed.
Scheduling may vary within one to two weeks.

WEEKS 6-8:

Nurse Practitioner Visit: Initial visit for diagnosis of confirmation of pregnancy. Menses is 2-4 weeks late. A pelvic examination will be performed for evaluation of uterine size. Information will be given regarding prenatal classes, diet, nutrition, vitamins, and activity. Routine laboratory blood tests will be performed including CBC, Blood Type, Rh Factor, Rubella Test, Serology (test for syphilis), Antibody Tests, HIV Screen, and Hepatitis-B Screen, as well as Pap smear, chlamydia, gonorrhea. Other tests such as first and second trimester screening for Down’s syndrome, as well as cystic fibrosis screening, may be discussed.

WEEKS 11-12:

MD Visit: An appointment should be made with your primary physician, if possible. A physical exam, assessment of uterine size and pelvic structure will be performed. Confirmation of a fetal heartbeat by Doptone will be performed. Your due date, or EDD (Expected Date of Delivery) is set. Maternal assessment of weight, blood pressure, and urine will be checked at each visit. Other tests such as Amniocentesis and Quad Screen may be discussed. Lab results from your prior visit will be reviewed.

WEEK 16:

NP or MD Visit: Fetal and Maternal Assessment including: Uterine size and growth, maternal weight, blood pressure, urine and general health status is evaluated. An optional Quad Screen blood test may be drawn for screening of fetal neural tube defects and trisomies. You may want to check your insurance for the Quad Screen test as not all insurance companies will pay for this particular test. We advise that you register for your prenatal class as soon as possible.

WEEK 20-21:

NP or MD visit. Ultrasound study for fetal assessment and confirmation of gestational age. Please drink 32 ounces of water one (1) hour before your appointment and DO NOT EMPTY your bladder until after your ultrasound. Please note: The ultrasound is done to assess fetal well-being and estimate size and to confirm your due date. It is not always possible to determine the gender and ultrasound is not always 100 percent correct. Repeat ultrasounds may be done later in the pregnancy; however, these are usually reserved for specific medical indications. Repeat ultrasounds desired for gender determination are not generally covered by your insurance; however, we will make an effort to determine the gender at your 20-week ultrasound, if you desire.

WEEK 24:

NP or MD Visit: Maternal and Fetal Assessment. You will be given instructions for diabetic screening, which will take place at your next visit.

WEEKS 26-28:

Nurse Practitioner Visit: Topics to be discussed are nutrition, prenatal classes, and emotional adjustment to pregnancy. Blood will be drawn for diabetic screening, repeat antibody and hemoglobin screening. RhoGAM will be given if the mother is Rh-negative and the baby’s father is Rh-positive. Preterm labor symptoms will be reviewed and possible interventions discussed.

WEEK 30:

NP or MD Visit: Usual fetal and maternal assessment. A pelvic exam may be performed to screen for possible preterm cervical dilatation.

WEEK 32:

MD or NP Visit (Primary Provider, if possible): Maternal and fetal evaluation will be performed. A pelvic examination may be performed at this visit and each subsequent visit

WEEK 34:

Nurse Practitioner Visit: A discussion of labor and delivery and alternatives for labor management. Maternal and fetal evaluation including a cervix check may be performed. Partners are encouraged to attend this visit. There will be an opportunity for you to express any concerns, expectations, or “wishes” regarding your labor and delivery experience. If you are having a baby boy, circumcision will be discussed. If you request, the circumcision will be performed by your obstetrician in the hospital. You should check with your insurance to see if this is covered.

WEEK 36:

MD or NP Visit (Primary Provider, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed. A vaginal/rectal culture for Group-B Strep (GBS) may be performed.

WEEK 37:

MD or NP Visit (Primary Provider, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed.

WEEK 38:

MD or NP Visit (Primary Provider, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed.

WEEK 39:

MD or NP Visit (Primary Provider, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed.

WEEK 40:

MD or NP Visit (Primary Provider, if possible): Fetal and maternal assessment. Signs of onset of labor are discussed. Discussion of possible post-maturity. Delivery, hopefully.

WEEK 41:

MD or NP Visit (Primary Provider, if possible): Fetal testing, “Non-Stress Test” (NST) and/or “Biophysical Profile” (BPP) may be performed when you are “post-dates”. Possible induction of labor will be discussed.

WEEK 42:

MD or NP Visit (Primary Provider, if possible): We would like to plan for you to have your baby this week.