The Division of General Obstetrics and Gynecology has physicians with expertise in all areas of gynecology including surgical gynecology, menopausal medicine & hormone replacement therapy, management of abnormal bleeding, management of abnormal pap tests and HPV vaccination, contraception, sexually transmitted diseases, endometriosis, sexual medicine, pelvic floor dysfunction, pediatric and adolescent gynecology, and women's wellness.
We perform a variety of surgical procedures including abdominal, vaginal and laparoscopic hysterectomies, myomectomy (removal of fibroids), surgeries on ovaries and fallopian tubes including minimally invasive laparoscopic surgery, surgical sterilization, hysteroscopic procedures including removal of polyps and fibroids, dilation and curettage and endometrial ablation.
We also have faculty with expertise in obstetrics including singleton pregnancy and uncomplicated twin pregnancy. We manage ectopic pregnancy, recurrent miscarriage as well as molar pregnancies. Pregnant patients are cared for at Barnes-Jewish Hospital only. BJH Women & Infants
Obstetrics and Gynecology: Prenatal Visits
What to Expect:
Your first prenatal visit at the Washington University Obstetric Consultants practice is usually between 6 and 11 weeks after your last menstrual period. A detailed medical history reviewing risk factors for this pregnancy will be taken and a physical exam performed (including a pelvic exam and Pap smear).
The faculty of the Division of General Obstetrics and Gynecology are involved in the educational training of the medical students and OB/GYN house staff at Washington University School of Medicine. Our faculty staffs the resident's outpatient continuity clinic and attends on the inpatient gynecology service. Dr. Eric Strand is the Director of the Residency Program, and Dr. Tammy Sonn is the course master for the third year medical student clerkship in OB/GYN.
An ultrasound will be performed to confirm your pregnancy and dating, and we will make arrangements for any other necessary blood test and future ultrasounds. The overall plan for the rest of your pregnancy will be briefly reviewed, and your questions addressed.
- The ultrasound will be transvaginal (with the probe inserted partially into your vagina, similar to the speculum exam), and allows us to see your baby at this early stage. The ultrasound may be slightly uncomfortable, but it is not harmful to the baby in any way.
- The blood tests are the ones recommended as a part of all obstetric care; additional tests may be ordered based on your specific risks and needs.
- An optional test which is offered to everyone is genetic screening for cystic fibrosis. A brochure concerning this testing will be given to you to read and consider prior to your visit.
- Prenatal genetic screening/testing is another option that is offered to everyone. We provide you with a pamphlet about this testing for chromosomal problems including Down Syndrome, and neural tube defects like spina bifida. Take time and read this. At your first visit, we will discuss whether you and your partner would like to pursue ‘non-invasive’ or First Look testing which consists of blood work and ultrasounds. While this testing is not 100% accurate, it does not change your risk of miscarriage. If you choose to pursue First Look testing, it must be performed between 11-14 weeks from your last menstrual period, so we need to know if you wish to pursue this testing soon after your first visit.
Prenatal Visit Schedule
- The other genetic testing options discussed in the pamphlet (Chorionic Villus Sampling or CVS, and genetic amniocentesis) are termed ‘invasive,’ they give a more accurate diagnosis, and may be appropriate for women who are high-risk by age or other factors. It may also be appropriate for you and your partner, if the results would change what you would choose for the pregnancy, i.e. termination. Most insurance companies will pay for First Look testing, CVS, and amniocentesis for patients over age 35; many will pay for First Look testing for patients of all ages. Almost all insurances will pay for Quad Screen testing for all patients. Please check with your insurance company about your coverage before your first visit, if you may want this testing.
Prenatal visits will be scheduled every 4 weeks until about 28 weeks from your last menstrual period. From 28-35 weeks we will see you every 2-3 weeks, depending upon your specific needs; then you will have weekly visits. These are general guidelines, which may be changed for more high risk or complicated pregnancies.
An ultrasound will be scheduled at approximately 20 weeks from your last menstrual period; this is an exciting ultrasound, and you may want to have loved ones present. In addition to measuring growth, the anatomy of your baby (or babies) is evaluated carefully by experienced professionals. Additional ultrasounds throughout the pregnancy are then only ordered to evaluate issues specific to that pregnancy (twins, smaller or larger growth than expected, etc.).
Nutrition and Weight Gain
Throughout the pregnancy, your job is to “grow a baby.” We will give you information on nutrition and weight gain during pregnancy -- specifically, amounts of fish you can/can’t eat during your pregnancy. If you have specific dietary constraints, are a vegetarian or a vegan, we will address these at your first visit in detail.
Exercise is always encouraged throughout uncomplicated pregnancies. Prenatal yoga, Pilates, walking, swimming, biking, elliptical, or jogging are good choices, and may make labor and pushing easier. We discourage any exercise regimen that could injure your abdomen, such as competitive volleyball or basketball, or skiing (snow or water). After about 22 weeks, you should refrain from lying flat on your back; we recommend sleeping on either side.
We also discuss a list of the most common medications safely used in pregnancy, and medications to avoid. It is important to understand that medical studies are rarely done on pregnant women. The list includes medications that are reasonably well-studied in pregnancy and have not been shown to cause harm; these medications are considered safe to take. At your first visit, let your doctor know all the prescribed and over-the-counter medications you are taking. If you have medications that you are concerned about prior to conception or your initial visit, please call and discuss it with one of our nurses, even before your visit!
Washington University Obstetric Consultants has sought the services of a childbirth educator who offers individualized classes and tours.
The classes include generalized childbirth education, Lamaze breathing and breastfeeding techniques. We will enclose her contact information in your folder. Many of the childbirth classes are available on Saturdays.
Beginning in 2011, Barnes-Jewish Hospital will be offering 'new grandparents' and 'sibling' classes to families of new moms.
We are also supportive of any other classes you are referred to by family or friends. These classes are not required, but patients often find them helpful. We recommend you take a tour of the labor and delivery, and postpartum areas prior to your delivery. A tour can be scheduled by calling 362-MOMS.
Circumcision and Breastfeeding
We provide pamphlets on circumcision and breastfeeding, as well as detailed information about Barnes Jewish and Children’s Hospitals.
"Expectant Mom" Folder
The Washington University Obstetric Consultant physicians feel that an educated patient is key to a safe and healthy pregnancy. The more informed you become, the better your experience will be. There are many materials that can provide interesting and important information throughout your pregnancy, and so we have prepared a special Expectant Mom folder as a convenient means for you to organize this wealth of information. The Expectant Mom folder includes our phone numbers and contact information.