During Pregnancy

• Routine and high-risk obstetrics
• Preconception counseling
• Prenatal testing
• In-office 3D/4D fetal ultrasounds (medical and elective)
• Treatment for pregnancy with medical complications, such as diabetes, hypertension, thyroid issues, etc.
• Optimizing prenatal care for women older than age 35 and mothers with pre-existing conditions
• Care for multiple births
• Counseling and management of miscarriage and recurrent pregnancy loss
• VBAC (Vaginal Birth After Cesarean Delivery) for those who meet safe criteria
• Postpartum sterilization
• Newborn male circumcision

We also have a referral relationship with Maternal Fetal Medicine for specialized testing and consultation.

We deliver exclusively at UNC Rex Healthcare.

We are pleased to have our own obstetrical and postpartum care coordinators who will be with you through every stage of your pregnancy. They will be able to answer any questions.

First Trimester: Confirmation of Pregnancy (COP) appointment followed by nurse intake visit (which includes lab work) and comprehensive exam (including a first sonogram, Pap smear if due, vitals, and a discussion of genetic screening options).

14-26 weeks: Continue monthly visits. An anatomy scan is performed at 18-20 weeks.

26-28 weeks: You will do a one-hour glucose tolerance test to evaluate for gestational diabetes. Bloodwork will be drawn and you will receive an injection if your blood type is Rh-negative. You will also receive your Tdap immunization vaccine to protect your newborn from pertussis (whooping cough) infection. Your visits will now be every 2 weeks.

35-36  weeks:  Discussion of vaginal delivery consent, circumcision consent if having a boy, and having Group B streptococcus culture. Group B streptococcus is also known as a Group B Strep Infection, which can sometimes be found in a pregnant woman’s vagina. It is possible to pass the infection along to your baby during delivery.

Your doctor will perform weekly visits including cervical exams from now until delivery. They will evaluate you for labor and discuss the timing of delivery as you get closer to your due date.

We offer a wide variety of childbirth and pregnancy-related classes through the Rex Family Birth Center. 

Childbirth classes will fill up quickly, so we strongly urge you to use the link below to sign up in your first trimester for classes to be taken in your third trimester.

You can review, register and sign up for these classes by reviewing the Class Calendar. This includes class descriptions as well as location, dates and times.

The class information line is 919-784-2145.

If you have had a previous delivery by C-section, you have 2 choices:

1. You can have a scheduled C-section
2. You can have a vaginal delivery (VBAC).

Risks of VBAC:

Some risks of VBAC include blood loss and infection.  A more rare but serious risk with VBAC is that the scar on your uterus may rupture or break open.  Although this is rare, it could cause serious harm to you and your fetus.  Some women may be at high risk of uterine rupture and VBAC should not be tried.

The physicians at Associates in Women’s Healthcare will help you determine if VBAC is a safe option for you and your baby. We can also determine the probability that you could deliver vaginally if you were not able to in the past.

Pregnancies may be considered high risk due to health conditions that exist in the mother prior to pregnancy, or due to conditions that develop during pregnancy.

High-risk factors that can exist prior to pregnancy include:

• Older age
• Being over or underweight
• Having problems in previous pregnancies
• Having chronic medical conditions like high blood pressure, diabetes, bleeding/clotting disorders, or epilepsy

High-risk conditions that can develop during pregnancy include:

• Gestational diabetes
• Pregnancy-related high blood pressure, including preeclampsia
• Preterm labor
• Twin pregnancy

We work with the high-risk specialists at both UNC and Duke to help manage any high-risk conditions that may exist or develop during pregnancy and keep you and your baby as healthy as possible.

A miscarriage is the loss of a pregnancy during the first 20 weeks. A miscarriage in any trimester is a loss, and we understand that it is an incredibly emotional and painful time for a woman and her partner.

You may wonder why this happened or even blame yourself. But it is important to know that a miscarriage is nobody’s fault and often it cannot be prevented.

Miscarriages are more common than many understand. In fact, 1 out of 4 women will experience a miscarriage. It is usually your body’s way of ending a pregnancy that had a bad start, most of the time that bad start being a mismatch in genetic information.

Miscarriages are usually chance events, and your chances for future successful pregnancies are very good even with a history of one miscarriage.

If you have had two or three miscarriages in a row, you may want to discuss this with your doctor to see if you have any health problems that may be causing recurrent pregnancy losses.

If you have had pregnancy loss after 20 weeks, you should discuss this with your doctor. We recommend preconception visits for these women in particular, so that we may review the information and identify any possible causes.

We understand the devastation that comes with pregnancy loss and would work together with you to plan steps to reduce your risk of this happening again.

Today, women with such high-risk pregnancies are carefully and closely monitored with routine ultrasounds and/or fetal heart rate monitoring. If potential problems arise, early delivery may be indicated.

While we focus mainly on the mother and the baby during pregnancy, we know that the rest of the family has questions too. Please look at our blog for topics relating to the changes affecting the pregnant patient, as well as FAQs regarding sex, exercise, and immunizations.