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TABLE OF CONTENTS
1
IMPORTANT PERSONAL INFORMATION
3 WELCOME TO OAKWOOD
44OAKWOOD HOSPITAL – WAYNE
45 Visitor parking
5 CHAPTER 1 SO, YOU’RE PREGNANT!
45 Labor-delivery-recovery-postpartum rooms
5Having a healthy pregnancy
46
7Medications during pregnancy
46 Pre-registration information
7When to call your healthcare provider
during pregnancy
47
8
47OAKWOOD HOSPITAL – SOUTHSHORE
First trimester (week 1 to week 13)
Neonatal support services
Tours of the OB unit
13 Second trimester (week 14 to week 27)
47 Visitor parking
15
48 Labor-delivery-recovery rooms
Third trimester (week 28 to week 40)
18Choosing a healthcare provider
for your newborn
48 Mother-baby unit
19
49
Preparing for labor and delivery
19 Prenatal education
20
Car seat program
49 Pre-registration information
Tours of the OB unit
50 CHAPTER 3 TIME TO GO HOME! 21
High-risk pregnancies —
Maternal-Fetal Medicine
50 Discharge instructions
50
When to call mom’s doctor
22 Genetic-counseling services
51
When to call baby’s doctor
23
51 Breastfeeding information
Newborn screening in Michigan
23 Transcultural services
55
Bottle-feeding your baby
24
56
Guide to mother and infant care
56
Mother care after delivery
59
Infant care after delivery
Group B strep
27 CHAPTER 2 THE BIG DAY
27
Think I’m in labor
28
Things to bring to the hospital
29 Informed consents
29
Stage one of labor
30 Pain-management options
32
Stage two of labor
32 Cesarean section
60 Sleeping 63 Immunization schedule
64 Developmental milestones
65 Feeding schedule
67 Child safety
68 Medicine cabinet
32
Stage three of labor
70
GLOSSARY OF TERMS
33
Insurance billing and payment
74
OAKWOOD TELEPHONE NUMBERS
34 Room service
34 Cord-blood preservation
35 Visiting guidelines
36
Baby’s first picture
77
COMMUNITY TELEPHONE NUMBERS
80
WOMEN’S HEALTH WEB SITE
oakwood.org/womens-health
37 Birth-certificate information
81
SUGGESTED RESOURCES
38 Paternity
84PREGNANCY WEIGHT GAIN CHART
39
Security instructions for parents
40
Gift shop, mail and flowers
85NOTES
40 OAKWOOD HOSPITAL –
DEARBORN
40 Visitor parking
40 Labor-delivery-recovery rooms
41 Mother-baby unit
42
Neonatology services 44 Pre-registration information
44
Tours of the OB unit
2
WELCOME TO OAKWOOD
We are very pleased that you have chosen a provider affiliated
with Oakwood Healthcare during this very special time in your life.
The OB Patient Resource Guide is designed to help you every step
of the way for the entire nine months of your pregnancy. And we even
give you some tips on how to take care of yourself and your baby after
going home from the hospital.
The information comes from various resources, most notable of which
is the vast expertise of our very own physicians and clinical staff at
Oakwood. This guide is targeted primarily for first-time parents; however,
it most certainly can be used by the experienced parent as well.
Please be advised that the issues addressed are common during a
TYPICAL or AVERAGE pregnancy. It is best to consult your provider
about specifics whenever you have a question or concern.
This guide is organized into three major chapters: 1) So, You’re
Pregnant, 2) The Big Day and 3) Time to Go Home. We have also
included a list of important Oakwood and community phone numbers,
along with a glossary of commonly used maternity terms. Should you
run across a word or phrase with which you are unfamiliar, refer to
the glossary at the back of this guide for the definition.
Lastly, if you have not already done so, we invite you to visit our awardwinning Women’s Health Web site at oakwood.org/womens-health
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for more information on all of the services mentioned within this guide.
View pictures of the hospital delivery rooms, the staff you will encounter
during your stay, babies born at each Oakwood Hospital and much more.
Our Web site contains hundreds of pages of content, just waiting for
you to explore.
You can also sign up online for our Friends of Oakwood e-newsletter
that contains health maintenance tips, notices of special events in
the community, a schedule of routine health screenings and exams,
descriptions of Oakwood Women’s Health services and more.
We hope you find this guide and our Web site helpful and enjoyable
to review. And we wish you and your baby a lifetime of happiness!
4
CHAPTER 1
SO, YOU’RE PREGNANT!
HAVING A HEALTHY PREGNANCY
By taking good care of yourself during
pregnancy, you’re also nurturing the new
life inside of you. Here are some dos and
don’ts for a happy and healthy pregnancy:
DOS
• Be sure to see your doctor and get
prenatal care as soon as you think you’re
pregnant. It’s important to see your doctor
regularly throughout your pregnancy,
so be sure to schedule and attend all
your prenatal care appointments.
note: Generally, a woman will have
about 12 – 13 total prenatal visits.
• Be sure to discuss needed vaccinations
(e.g., flu shot) with your provider.
• Have a discussion with your physician
about proper nutrition and weight gain.
Weight gain of 25 to
35 pounds during
pregnancy is appropriate
for most women. However,
weight-gain specifics
depend on your individual
circumstances and your
prepregnancy weight.
• Eat healthy foods to get the nutrients you
and your unborn baby need. Your meals
should include the five basic food groups.
• Have a discussion with your provider
about vitamins during pregnancy.
Your provider may suggest that you
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take a prenatal vitamin with folic acid
(important even before you become
pregnant), calcium, iron supplements
and/or omega 3 fatty acids. It is best
not to take your prenatal vitamin within
two hours of consuming dairy products
or antacids.
• Research breastfeeding versus bottlefeeding options. Talk to your doctor,
family and friends about how you will
choose to feed your baby and how
they can support you in your decision.
The American Academy of Pediatrics
recommends breastfeeding over
bottlefeeding from birth to at least
age one for most women.
•D
rink extra fluids (water is best)
throughout pregnancy. Drink 6 to
8 eight-ounce glasses of water
each day.
• Talk with your provider about your
personal and family history. Tell your
provider if you’ve experienced problems
with past pregnancies or have birth
defects that run in your family. Medical
conditions such as diabetes, epilepsy and
high blood pressure should be treated
and kept under control. Ask your provider
about any current medications that may
need to be changed or adjusted during
your pregnancy.
• Exercise. Physical activity during pregnancy
can benefit both you and your baby by
lessening discomfort and fatigue during
delivery. Always check with your doctor
before beginning any kind of exercise
program, especially during pregnancy.
• Wear a seat belt throughout your entire
pregnancy whenever you are driving or
riding in a car.
• B e sure to get plenty of rest. Resting
on your side, especially on your left
side, is advised because it provides the
best circulation to your baby and helps
reduce swelling. Try not to sleep on
your back or abdomen, especially later
in pregnancy.
• If you smoke, QUIT. Smoking during
pregnancy passes nicotine and cancercausing drugs to the fetus. Smoking also
keeps your baby from getting needed
nourishment while in your uterus. Tobacco
use raises the risk of fetal death, premature
birth (a low-weight baby born too early),
miscarriages and stillbirths. In fact, it is
estimated that smoking during pregnancy
accounts for approximately 10 percent of
all infant deaths.
1
• Check with your provider regarding
all prescription and over-the-counter
medications before taking them. Some
medications are not safe during your
pregnancy. See the “Medication” section
of this guide for more information.
• Continue getting regular dental care.
Having unhealthy teeth or gums during
pregnancy can increase your risk of
preterm labor and delivery. The American
Dental Association recommends twiceyearly dental visits. Make sure to tell
your dentist that you are pregnant.
• Continue getting regular eye exams
during pregnancy.
DON’TS
• Avoid exposure to toxic substances
and chemicals, such as harsh cleaning
solvents, lead, mercury, some insecticides
and paint. Pregnant women should avoid
exposure to paint fumes.
• Avoid or limit your use of food products
with chemicals and food additives,
including artificial sweeteners (e.g.,
saccharin) and nitrites (found in bacon,
deli meat, hot dogs and other products).
• Do not take Accutane (an oral acne
medication) if you may become or
are pregnant.
®
Also, sudden infant death syndrome
(SIDS) is more common in newborns of
mothers who smoke than in babies of
nonsmokers. If you need help quitting, call
Oakwood Healthline at 800.543.WELL or
the Michigan Department of Community
Health to obtain free smoking cessation
materials and class schedules. Visit the
“Community Telephone Numbers” section
of this guide for contact information.
• Avoid alcohol. A safe amount of alcohol
a woman can drink while pregnant has
NOT been established. Drinking during
pregnancy can cause physical birth defects,
growth problems and brain-development
delays in a baby.
• Limit caffeine found in tea, coffee, soft
drinks and chocolate.
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• Do not use any recreational drugs (such
as marijuana, cocaine, etc.). The use
of these drugs may cause very serious
birth defects and/or learning disabilities
in your infant. Visit the “Community
Telephone Numbers” section of this
guide for more information.
• Attapulgite (Kaopectate ) for diarrhea
continuing longer than 24 hours.
• Avoid saunas, hot tubs and steam rooms
during pregnancy. Excessive heat may be
harmful during your pregnancy.
• Simethicone (Mylicon ) for gas pains.
• Do not eat raw or rare meat or fish (e.g.,
sushi or rare beef). Do not eat soft-cooked
or raw eggs. Do not eat soft cheeses (such as brie or feta)
or unpasteurized milk
or juice/cider.
•C
hlorpheniramine antihistamine alone
(Chlor-Trimeton ) for allergies.
®
• Dextrose and levulose syrup (Emetrol )
for nausea.
®
•C
alcium carbonate (Tums ) for
stomach upset.
®
®
•H
emorrhoid creams (Preparation H )
for hemorrhoids.
®
®
•D
iphenhydramine (Benadryl ) for
insomnia.
®
AVOID medications or products that
contain aspirin (Bayer , Pepto Bismol )
or non-steroidal anti-inflammatory drugs
(NSAIDS), such as ibuprofen (Advil ,
Motrin ) or naproxen sodium (Aleve ).
®
• Do not handle
cat litter.
®
• Be sure to wear gloves
when gardening, to avoid contracting
toxoplasmosis. Toxoplasmosis is an
infection caused by a parasite that can
seriously harm an unborn baby.
• Avoid X-rays. If you must have dental
X-rays or radiology tests, tell your dentist or
physician that you are pregnant, so that
extra care can be taken to shield your
baby from X-rays.
MEDICATIONS DURING PREGNANCY
®
Although these may be good general
pregnancy tips, every pregnancy is different,
and each deserves the personal attention
of your provider.
Report the following immediately
(at any time during pregnancy):
• Persistent, severe vomiting
lasting longer than 24 hours.
• Any vaginal bleeding or spotting,
with or without pain.
consider having the following medications
on hand, although medication should
be taken according to your physician’s
specific instructions:
• Elevated temperature (fever)
above 100.6° F (38.1° C).
®
• Acetaminophen (regular Tylenol )
for aches, pains and temperatures
over 100.6° F.
®
•D
ocusate sodium (Colace ) for
constipation.
®
®
WHEN TO CALL YOUR
HEALTHCARE PROVIDER
DURING PREGNANCY
You should always check with your
physician before taking any over-thecounter or prescription medications
during pregnancy. You may want to
• Guaifenesin plus dextromethorphan
(Robitussin DM ) for coughs/colds.
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®
• Burning, urgent urination.
• Abdominal pain or painful,
persistent abdominal cramping.
• If you are experiencing more than
one contraction every 15 minutes before
your 37th week of pregnancy.
• Severe, continuous headache.
• Changes in eyesight or vision,
such as blurring spots.
1
• Sudden swelling of hands or face.
• Sudden weight gain of more than
five pounds in one week.
• Any trauma (such as falling or
auto accident).
• Loss of fluid or leaking from vagina.
• Any decrease in the amount of
your baby’s movements.
• Consistent, persistent heartburnlike pain.
FIRST TRIMESTER
(Week 1 to Week 13)
Congratulations! Your journey to
motherhood is under way. During the first
three months of pregnancy,
or the first trimester, many
changes are happening to
you. As your body adjusts to
the growing baby, you may
experience nausea, fatigue,
backaches, mood swings and
stress. Just remember that
these things are normal during
pregnancy. Most of these
discomforts will go away as
your pregnancy progresses, so try not to
worry too much about them.
HEALTH MAINTENANCE TIPS
Water
Water plays a key role in your diet during
pregnancy. It carries the nutrients from
the foods you eat to your baby, and also
helps prevent constipation, hemorrhoids,
excessive swelling, and urinary tract or
bladder infections. Most important,
drinking enough water, especially in your
last trimester, prevents you from becoming
dehydrated. Dehydration can contribute to
contractions and preterm labor. Pregnant
women should drink at least 6 to 8 eightounce glasses of water per day, and another
glass for each hour of activity. You can drink
juices for fluid, but juices also have a lot of
calories and can lead to extra weight gain.
Weight/Nutrition
Try to make healthy food choices. Limit
your consumption of sweets, junk food,
fast food and fried or fatty foods. What
you consume isn’t only important for your
own health anymore, but for the current
and future health of your baby! Appropriate weight gain during your pregnancy
depends on your height and how much
you weighed before you became pregnant. All weight gain during pregnancy
should be gradual, with most of the
weight gained in the last trimester. During
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the first trimester, it is normal to gain only
a small amount of weight, about one
pound per month. If you are at your ideal
weight before your pregnancy, you should
gain between 25 and 35 pounds during
your entire pregnancy. If you were
underweight before becoming pregnant,
your weight gain may need to be more.
If you were overweight, your weight gain
may need to be less.
How should my diet change now
that I am pregnant?
Even before pregnancy begins, nutrition
is a primary factor in the health of mother
and baby. If you are eating a well-balanced
diet before you become pregnant, you will
only need to make a few changes to meet
the nutritional needs of pregnancy.
Eating a well-balanced diet while you are
pregnant will help to keep you and your
baby healthy. Most physicians generally
agree that the Recommended Daily Allowances (RDAs) can be obtained through
a proper diet. Generally, a woman needs
approximately 300 more calories per day
during her pregnancy to ensure that the
baby gets enough nutrients. A plain baked
potato has 120 calories, for example, so
getting an extra 300 calories does not
require much more eating or drinking.
Make sure not to diet during your pregnancy because you might not be getting
the right amounts of protein, vitamins and
minerals that are necessary to properly
nourish your unborn baby.
What should I make sure to include
in my diet?
As a pregnant woman, you need extra
nutrients to help your baby grow and
be healthy.
• Calcium: Pregnant and lactating adult
women require about 40 percent more
calcium each day. Almost all of the extra
calcium goes into the baby’s developing
bones. To get this extra calcium, four total
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servings (four cups) of milk or other dairy
products (cheese, yogurt) are needed. If
you are lactose intolerant, you can still
get this extra calcium. Several low-lactose
or reduced-lactose products are available.
In some cases, your doctor might even
prescribe a calcium supplement.
• Iron: All women of childbearing age
should eat a diet rich in iron. Iron is
found in foods such as beef (red meat),
lima beans, peas, raisins, egg noodles
and kidney beans. Iron helps to reduce
the risk of anemia later in pregnancy
and is essential to the formation of
healthy red blood cells.
• Folic Acid: Folic acid (a.k.a. folate) is
found in many foods, including beans,
leafy green vegetables, peas, whole-grain
breads/cereals, orange juice and liver.
Folic acid is especially important even
before you become pregnant. Folic acid
helps build healthy cells and helps
prevent neural-tube defects.
• Sodium: Sodium is important during
pregnancy, to regulate the water in
the body. Because salt is in most foods,
the increased need for sodium during
pregnancy is not difficult to fulfill.
Pregnant women should avoid processed
or junk foods that are high in sodium.
To find out what other nutrients are
important during pregnancy and how
much you need, please ask your healthcare
provider.
Should I avoid caffeine?
Caffeine is a stimulant found in colas, coffee,
tea, chocolate, cocoa and some over-thecounter and prescription drugs. Consumed in
large quantities, caffeine may cause irritability,
nervousness and insomnia. Caffeine is also
a diuretic and can dehydrate the pregnant
woman’s body of valuable water. You
should have a discussion with your provider
regarding how to limit your caffeine intake.
Should I avoid fish?
Fish can be an important part of a
healthy diet, supplying protein and omega
3 fatty acids to promote your baby’s
brain development. The Food & Drug
Administration and Environmental Protection
Agency advise pregnant women and nursing
mothers to avoid eating shark, swordfish
and king mackerel, as well as mollusks or
fish from the Great Lakes. They recommend
eating up to 12 oz. (2 average meals) a week
of a variety of fish and shellfish that are
low in mercury, including shrimp, salmon,
pollock, catfish, crab, cod and tilapia. Light
canned tuna contains less mercury than
albacore (white) tuna, so when choosing
your two fish meals per week you may
choose 6 oz. of albacore tuna per week.
View michigan.gov/eatsafefish for
information regarding safe amounts of
freshwater fish consumption.
Why do pregnant women crave
certain foods?
“Pickles and ice cream” and other appetite
cravings of pregnant women may be
reflections of the changes in nutritional
needs. The fetus needs nourishment and
the mother’s body begins to absorb and
metabolize nutrients differently. These
changes help ensure normal development
of the baby and
fill the demands
of lactation
(nursing) after
the baby is born.
1
Do I really need to “eat for two”?
While you are pregnant, you will need
additional nutrients to keep you and your
baby healthy. However, that does NOT
mean you need to eat twice as much. To
keep track of your weight gain throughout
your pregnancy, see the “Pregnancy
Weight Gain” section in this guide.
What if I am diabetic?
If you are diabetic before you become
pregnant, you should be closely monitored
to make sure your blood sugar levels
are at or near normal. If maternal blood
sugar rises too high, the increased sugar
crossing the placenta can result in a
large, overdeveloped fetus, birth defects
or an infant with blood sugar level
abnormalities. Diabetic women may also
suffer from a greater loss of some nutrients.
It is important to maintain tight control of
blood sugar before and during pregnancy.
Can I become diabetic during pregnancy?
Your physician will probably have you
do a test at about seven months gestation
to test for gestational diabetes.
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Gestational diabetes is a form of diabetes
that begins during pregnancy and usually
goes away after the birth of the baby.
About five percent of pregnant women
get gestational diabetes. If you have
gestational diabetes, this means that you
have a high amount of sugar in your blood.
This form of diabetes may be controlled
through diet, medication and exercise. If
left untreated, gestational diabetes can
cause health problems for both you and
your baby. Your provider may ask you to
closely monitor and record your diet and
blood sugar if you have diabetes. Please
closely follow your physician’s requests
and recommendations.
Exercise
If you have no medical problems with
your pregnancy, regular physical activity
(30 minutes per day most days of
the week), can help you have a more
comfortable pregnancy and labor. It
also helps to lower your risk for having
pregnancy problems like high blood
pressure and gestational diabetes. And you
will have an easier time getting back into
a healthy body shape and weight after
the birth. Normal low-impact activities
that don’t involve a lot of bouncing, like
walking and swimming, are recommended.
11
If you haven’t exercised regularly before
becoming pregnant, you can still begin
an exercise program. Just start slowly
and progress gradually. Talk with your
healthcare provider first about what types
of exercise or activities are best for you.
One exercise that can help your muscles
prepare for delivery, help support your
uterus during pregnancy and help you to
control your urine flow is called the Kegel
exercise. It strengthens the pelvic floor
muscles, the same ones you use to stop
and start your flow of urine. You can do
this exercise standing, sitting or lying down.
To do this exercise, tighten the pelvic floor
muscles for five seconds and then relax.
Repeat 10 times. You can also talk with
your healthcare provider about how
to do this exercise.
What should I be careful about when
it comes to exercising?
Be careful to avoid activities that increase
your risk of falls or injury, such as contact
sports or vigorous sports. Even mild injuries
to the abdomen can be serious when you’re
pregnant. After three months of pregnancy,
it is best to avoid exercising while lying on
your back, since the weight of the baby
may interfere with blood circulation. Also
avoid long periods of standing. When the
• Brush teeth before eating (brushing
can stimulate the gag reflex).
1
• Eat more frequent, small meals rather
than a few large meals.
• Avoid going long periods without food.
Snack and drink beverages between
meals to avoid nausea prompted by an
empty stomach.
• Eat easy-to-digest foods: crackers, cereal,
rice, pasta, vegetables and fruit.
weather is hot, exercise in the early morning
or late evening to help you avoid getting
overheated. If you’re exercising indoors, make
sure the room has enough ventilation. Drink
plenty of fluids, even if you don’t feel thirsty.
DISCOMFORTS AND
HOW TO MANAGE THEM
“Morning” Sickness
Queasy when you wake up and/or
later in the day? That’s common in early
pregnancy as hormone levels change.
Between 50 and 70 percent of all women
experience nausea and/or vomiting during
the first trimester.
• Keep crackers by your bed. Eat them
before you get up to “jump start”
your digestive process.
• If you notice feeling nauseated after
taking your prenatal vitamin, try taking
it at bedtime.
•D
rink small amounts of clear fluids.
• Wear acupressure wristbands (sold at
most drugstores).
• Try sports beverages (Gatorade ). They
supply glucose and electrolytes.
®
• Sniff lemons or snack on lemon-flavored
foods and drinks.
• Avoid foods with strong aromas or flavors
if they bother you.
• Try driving (instead of riding as a
passenger) if being in a car makes you
feel nauseated.
• Avoid foods that are greasy, fried or
highly spiced.
• Enjoy an evening snack, such as nonfat
yogurt or cereal with milk.
• R est when you are tired.
• Talk to your provider
before taking antacid
products. Refer to the
“Medications during
pregnancy” section
of this guide for more
information.
• Ask your provider about various over-thecounter medications, vitamins and herbs
that may help with nausea.
• R emember, nausea usually ends by the
end of the first trimester, and it is a
normal sign of a healthy pregnancy.
Severe vomiting in pregnancy is rare, but
if it occurs, it may cause you to become
dehydrated. If you feel that your nausea or
vomiting is keeping you from eating right or
gaining enough weight, consult your doctor.
•D
rink at least eight glasses of water
each day.
• Exercise to help alleviate nausea.
12
Constipation
You may experience constipation during
pregnancy. To keep your digestive tract
moving:
your baby beginning to move (usually
somewhere between the 16th and 20th
weeks). Generally you will have one prenatal
visit per month during this trimester.
•D
rink plenty of fluids, at least 6 eightounce glasses per day.
HEALTH MAINTENANCE TIPS
Weight/Nutrition
You will begin to gain weight during this
trimester. A slow and steady weight gain is
best for you and your baby. Consult with
your healthcare provider concerning your
weight gain based on your body type. This is
not the time to diet. By the 26th week, your
baby will weigh almost 1.5 pounds and will
be about nine inches long. With this growth
comes the development of your baby’s
features, including fingers, toes, eyelashes
and eyebrows. By the end of this trimester,
all of your baby’s essential organs, including
the heart, lungs and kidneys, are formed.
Everyone gains weight at different rates, but
on average, it is normal to gain about onehalf pound per week during this trimester.
• Eat plenty of fiber-rich foods, such as
whole-grain products (at least three
whole-grain servings daily), cooked
dry beans and bran, and fruits and
vegetables with edible peels (at least
five servings daily). You can benefit
from natural laxatives in fruit, especially
prunes and figs.
• K eep active with a safe level of exercise,
such as a daily walk.
Stress/Work
Try to keep stress to a minimum and
practice relaxation techniques. Accept
that your normal routine is changing.
Most women continue working through
pregnancy. Staying active might help you
stay healthier. If you have a question about
the safety of your particular job, talk with
your healthcare provider.
Prenatal Visits
Visiting your physician
is very important during
these early stages. Your
physician will perform
several tests to check the
health of both you and
your baby. She will also be
able to answer questions
about any concerns you
might have, and she will tell you what
you can do to make your pregnancy as
easy as possible. Generally, you will have
one prenatal visit per month during your
first trimester.
SECOND TRIMESTER
(Week 14 to Week 27)
Most women find the second trimester of
pregnancy easier than the first trimester.
Before this trimester is over, you will feel
13
DISCOMFORTS AND HOW
TO MANAGE THEM
The second stage of your pregnancy
brings more noticeable changes to your
body, relief to problems caused in the first
trimester and more exciting experiences. As
your baby grows, you might notice that
your posture has changed or that you are
having backaches. Make sure to inform
your physician of any changes you might
have noticed. Morning sickness, fatigue
and many other things that may have
bothered you during the first three months
may disappear as your body adapts to
the growing baby. However, you may
experience new symptoms, including:
Aching Joints
Your abdomen will expand as you gain
weight and the baby continues to grow. You
might feel pains in your abdomen, groin
area or thighs. You also may feel backaches
or aching near your pelvic bone from the
pressure of the baby, your increased weight
and the loosening joints in these areas.
1
Lying down, resting or applying warm heat
on a low heat-pad setting can help resolve
some of these aches and pains. If pains do
not get better after rest, it is best to call your
healthcare provider.
Numbness and Swelling
Tingling and numbness of the fingers
and a feeling of swelling in the hands
are common during pregnancy. These
symptoms are due to swelling of tissues
in the narrow passages in your wrists,
and they should disappear after you
deliver your baby.
Itching
It also is common to feel itchy as your
pregnancy progresses. Pregnancy hormones
and your stretching skin, especially over
your abdomen, probably are to blame for
most of your discomfort.
About 20 percent of all pregnant women
have some kind of itching. Many pregnant
women experience red and itchy spots on
the palms of their hands and on the soles
of their feet. You should use gentle soaps
and lotions, and avoid hot showers or
baths that can dry your skin. Try not to
get overheated, since heat rash can make
the itching worse.
Shortness of Breath
As your baby gets bigger inside your body,
there will be increased pressure on all
of your organs, including your lungs. You
might begin to notice that you are short
of breath or might not be able to catch
your breath as easily. Try taking deep, long
breaths and try to maintain good posture
so your lungs have room to expand. You
might be able to breathe more freely
at night by using an extra pillow or by
sleeping on your side.
PRENATAL VISITS/CLASSES
You should be registering
for prenatal classes by your
28th week of pregnancy.
Oakwood offers a variety
of classes taught by
experienced registered
nurse educators who
specialize in childbirth,
infant care, infant/child
CPR and others. You can
be assured you will find
the answers you need to allow you to feel
more confident about the birth process
and parenting. Visit the perinatal eduction
section of this guide for more information.
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THIRD TRIMESTER
(Week 28 to Week 40)
You will probably be feeling a combination
of excitement and nervousness as the birth
approaches, mixed with an increasing desire
to hurry things along. It’s normal to feel
anxious, wanting to see and hold your new
baby, but you may feel very unsure about
the labor and delivery process. If possible,
avoid traveling during the last month of
pregnancy as labor might start early, and
naturally you would like to be near your
doctor and hospital at that time. Do not
indulge in heavy manual work in the last
trimester, but routine household chores
may be continued unless you are advised
otherwise by your doctor.
HEALTH MAINTENANCE TIPS
Body Changes
Your baby is still growing and moving,
but the conditions inside your uterus are
much more crowded now. The fetus is
moving around just as much but you may
notice the kicks and other movements
may feel less forceful. A sudden decrease
in movement could signal a problem. If
you notice any significant change in the
frequency of your baby’s movements,
you should contact your provider
IMMEDIATELY.
15
During this final stage of your pregnancy,
your baby is continuing to grow. Even
before your baby is born it will be able
to open and close its eyes, and might
even suck its thumb. As your body starts
to prepare for the birth, your baby will
start to move into its birth position. You
might notice the baby “dropping,” or
moving down lower in your abdomen.
This can reduce the pressure on your
lungs and rib cage, making it easier to
breathe. As you near your due date, your
birth canal (cervix) becomes thinner and
softer (effaces). This is a natural process
that helps the cervix to open during the
birthing process.
Weight/Nutrition
As you are now carrying a large amount
of weight around, you will experience a
number of symptoms related specifically
to your increasing size. Your uterus will
be carrying your baby, the placenta and
amniotic fluid, so it is not uncommon for
you to feel a bit uncomfortable. Everyone
gains weight at different rates, but on
average, it is normal to gain about one
pound per week during this trimester.
Typical weight distribution during
pregnancy (assuming ideal weight prior
to pregnancy):
Retained water
4 pounds
Breasts
2 pounds
Blood
4 pounds
Baby
7.5 pounds
Placenta
1.5 pounds
Amniotic fluid
2 pounds
Uterus
2 pounds
Fat and protein
7 pounds
Total 30 pounds
(25 to 35 pounds
is typical)
Is it difficult to lose weight
after pregnancy?
It can be if you gained too much weight
during your pregnancy. During pregnancy,
fat deposits may increase by more than
a third of the total amount a woman
had before she became pregnant. If the
weight gain was normal, most women
lose this extra weight in the birth process
and in the weeks and months after birth.
of chipped ice and sleep with extra pillows
to alleviate heartburn. If your heartburn is
severe and doesn’t improve with these tips,
talk with your healthcare provider. Also talk
with your healthcare provider before taking
an antacid medication. Calcium carbonate
(i.e., Tums ) is generally considered safe
during pregnancy.
®
Swelling
As you near the end of your pregnancy,
you might notice more swelling than
you had before, especially in your ankles.
Continue to drink lots of fluids (water is
best) and rest when you can with your
feet elevated. Swelling of your face and
hands or excessive swelling in your ankles
needs to be reported to your doctor
immediately.
DISCOMFORTS AND HOW
TO MANAGE THEM
The next three months will bring many
changes. Your baby is growing and
developing rapidly.
You may still experience many of the same
discomforts of the second trimester, as well
as start to experience other discomforts of
pregnancy, including:
Heartburn
As your baby gets bigger, your uterus
pushes up on your stomach and can cause
heartburn, especially after bedtime or right
after you eat. Continue to avoid greasy,
fried foods and try to eat six to eight smaller
meals instead of three large meals. Try not
to eat immediately before going to bed.
You also can
take small sips
of milk, eat
small pieces
Hemorrhoids
You might begin to experience more
discomfort from hemorrhoids now from the
increased pressure of your growing baby
on the veins in your rectum. You might also
be constipated, which makes hemorrhoids
worse because you might strain for a bowel
movement. Try to avoid these problems by
drinking lots of fluids and eating plenty of
whole grains, raw or cooked leafy green
vegetables, and fruits.
16
Frequent Urination
Frequent urination occurs when your uterus
presses down on your bladder. Restrict
your fluid intake in the evening to reduce
the number of times you get up at night.
But remember, it is important to drink 6-8
glasses of fluids daily.
Urine Leaks
A weakened pelvic floor below and the
uterus pressing from above could cause
occasional urine leaks, especially while you
are coughing, laughing or sneezing. Take
care of this problem by:
• Doing your pelvic (Kegel)
exercises regularly.
• Emptying your bladder frequently.
• Preventing constipation.
• Avoiding heavy lifting.
Energy
Many pregnant women feel great in the last
trimester and have lots of energy. But your
energy may lessen as you enter your ninth
month, and you may begin to slow down.
This is completely normal. It’s important to
get enough rest now, even though it might
seem difficult to sleep as you get larger.
Resting
Your baby’s stretching movements,
having to urinate often, leg cramping
and an increase in your
body’s metabolism might
interrupt or disturb your
sleep. You might have a
better night’s sleep if you
try to avoid eating large
meals before going
to bed. You can also try
some mild exercise like
walking, which can help relieve stress and
may improve sleep. Avoid long naps during
the day. If you can’t sleep because you
are anxious about becoming a mother or
about your labor and delivery, try talking
with friends who’ve been through this. You
17
can also share your concerns with your
healthcare provider. Try to sleep on your
side for maximum comfort for both you
and your baby. Talk to your provider before
taking any sleep aids.
PRENATAL VISITS
Usually around week 28, your healthcare
provider will change the schedule of your
prenatal visits from monthly to every two to
three weeks. After week 36, your prenatal
visits will likely be scheduled once every
week until delivery. Toward the later weeks
of the pregnancy, a pelvic examination may
be performed to determine the dilation and
effacement of the cervix. Your healthcare
provider will also ask you about BraxtonHicks contractions (a periodic or sporadic
tightening of the abdomen that comes
and goes in your third trimester), preterm
labor and your delivery wishes.
Other reminders:
• Your childbirth classes should be
scheduled or you should be calling to
schedule soon.
• If a hospital tour is not included in your
class, be sure to schedule one.
• S hop for baby furniture, a car seat and
clothing for your new son or daughter.
• Babyproof your home. See “Child
Safety” section.
• P repare your labor bag for the hospital.
See “Things to Bring” section.
• Finalize your plans to breastfeed or
bottle-feed your baby.
•C
hoose a physician for your baby.
Remember to keep in mind:
• If the office is convenient and
close to home.
• If the physician is easily reachable
in case of emergencies.
1
CHOOSING A HEALTHCARE
PROVIDER FOR YOUR NEWBORN
If you haven’t chosen a physician for your
baby, you can ask your obstetrician, friends
and neighbors for recommendations. A visit
to children’s doctors during the pregnancy
is recommended, preferably when both
parents can attend, to help make an
informed selection. Many offices will
offer a predelivery visit at no charge.
Quick Tip! You can call
Oakwood Healthline for a
physician referral at 800.543.WELL
or go online to view a list of
physicians with a specialty in
pediatrics or family practice. We can
match your location preference and
insurance coverage to help you find a
physician for your baby.
The purpose of a prenatal visit with a child
healthcare provider is to help you select a
physician for your baby and to establish a
long-term, supportive relationship. Physicians
will introduce themselves and their staff to
you to outline their child-care practices and
philosophy. While individual styles may vary,
all will emphasize family-centered care,
continuity and accessibility.
Physicians will outline schedules for wellchild visits and immunizations. You should
feel comfortable discussing your concerns,
anxieties and expectations for labor, delivery
and the newborn baby. You may wish to
take this time to discuss:
• The advantages of breastfeeding.
•C
ircumcision.
•H
ow to reach the physician if your
child is ill or if you have questions
about the baby’s care.
• P hysician’s office hours, after-hours
arrangements, insurances accepted,
fees, etc.
• Timing and frequency of office visits
and immunizations.
Physicians caring for infants emphasize
preventive healthcare. They will discuss
ways to prepare older children for the new
baby. They can also recommend books and
community resources to help you gather
information for your challenging new role
as parents.
18
PREPARING FOR LABOR
AND DELIVERY
Toward the end of your pregnancy, you
eagerly await the arrival of your child.
If this is your first child, you may feel a
mixture of excitement and nervousness
when you think about the delivery. This
jumble of emotions is completely normal
and natural.
As your due date draws near, you’ll want
to know exactly when labor will start and
when your baby will be born. Although
the process of labor is well understood,
no one knows exactly how it starts, and
your healthcare provider won’t be able
to predict either the start of labor or how
long it will last.
It’s helpful to know that only 5 percent of
babies are actually born on their estimated
due dates. Many are born before and many
are born after.
Many women are concerned about the
pain involved in labor and delivery. Talk
to your provider about the many options
of pain control that exist and review the
“Pain Management” section of this guide
for more information. Be sure to ask
questions in your childbirth classes for
more information.
MY PROVIDER SAYS THAT I MAY
NEED TO HAVE MY LABOR INDUCED
Sometimes your healthcare provider may
have concerns about the baby’s and/or
your health, and may think that labor
needs to be induced. An elective induction
means that there is no medical reason
to have the procedure done right now.
Elective deliveries should be done no more
than one week before the due date (two
weeks for twins). This gives the baby or
babies the best chance to do well after
birth. Inducing labor means that your
healthcare provider will start your labor
through artificial means.
PRENATAL EDUCATION
(CLASSES AND TOURS)
Many parents enroll in Oakwood prenatal
classes, wanting to learn all they can about
their impending delivery and the days
afterward. Prenatal classes will help
parents understand the labor and delivery
process. You will learn how mom’s
position can help with labor and delivery,
along with coping techniques for pain
management, including breathing methods
Growing Up Safe: It’s a four-step process.
As children grow, how they sit in your car, truck or SUV should change.
Save your child from injury or death by observing all four steps.
19
1
Rear-facing Seats: For the best possible protection keep infants in the
2
Forward-facing Seats: When children outgrow their rear-facing seats
3
Booster Seats: Once children outgrow their forward-facing seats (usually
4
Seat Belts: When children outgrow their belt-positioning booster seats,
back seat, in rear-facing child safety seats, as long as possible up to the height
or weight limit of the particular seat. The American Academy of Pediatrics recommends infants and toddlers should ride in a rear-facing car seat until they are two
years old or reach the weight and height limits for their car seats.
(at a minimum age 1 and at least 20 pounds) they should ride in forward-facing
child safety seats, in the back seat, until they reach the upper weight or height
limit of the particular seat (usually around age 4 and 40 pounds).
around age 4 and 40 pounds), they should ride in booster seats, in the back seat,
until the vehicle seat belt fits properly. Seat belts fit properly when the top lap
belt lays across the upper thighs and the shoulder belt fits across the chest
(usually at age 8 or when they are 4'9" tall).
(usually at age 8 or when they are 4'9" tall) they can use the adult seat belt in the
back seat, if it fits properly (lap belt lays across the upper thighs and the shoulder
belt fits across the chest).
and relaxation techniques. Coaches will learn
different ways to encourage and support the
laboring mother, along with other valuable
information that will make you both feel
more confident in your birth journey.
Quick Tip!
Visit us on the Web at
oakwood.org/womens-health to
register for classes, print class
descriptions and schedules and
delivery date. We require that you bring
your car seat to the hospital immediately
following the birth of your baby to ensure
that your baby has a safe ride home. State
law requires that you ALWAYS use a car
seat when traveling in a car with your
baby or child under eight years of age.
You should follow the manufacturer’s
expiration date that may be printed on
the seat and never use a car seat that
has been in a crash, even a minor crash.
obtain cost information.
Classes offered at various
Oakwood locations:
•C
hildbirth Preparation (includes
information on cesarean section)
• Refresher Childbirth Class
• Infant Care Class
• Breastfeeding Class
• Infant/Child First Aid
• Infant/Child CPR and Airway
Obstruction Class
For more information on class offerings
and hospital tours, please call:
Oakwood Hospital – Dearborn
313.593.7694
INFANTS
Oakwood Hospital – Wayne
734.467.5588
• S hould always travel in a car seat (infantonly seat [preferred] or convertible seat).
Oakwood Hospital – Southshore
734.671.3950
• Should be in the back seat facing the
rear of the car.
During your stay in one of the Oakwood
hospitals, a nurse will be available to assist
you in your room with breastfeeding and
other infant-care concerns. We also offer
a 24-hour “Newborn Channel” on your
hospital TV that addresses many different
parenting topics.
• S hould be in the middle of the back seat
(if vehicle allows).
CAR SEAT PROGRAM
Keep children rear-facing until at least age
two. It is five times safer than front-facing.
Convertible seats fit up to 30-45 lbs.
rear-facing.
We strive to ensure that all parents are
fully informed about car seat use. Studies
show that most parents do NOT install
car seats correctly, so we are happy to
check it for you. Just call 313.586.5488
to schedule an appointment before your
• Should be semi-reclined (at a 45-degree
angle).
• S hould NEVER be placed in the front
passenger seat.
20
TODDLERS
• S hould always travel in a car seat
(convertible seat).
• Should be in the back seat facing
the front of the car.
• Should be in the middle of the
back seat (if vehicle allows).
• Should NEVER be placed in the front
passenger seat.
• Convertible seats with a five-point
harness system are preferred.
• Place car seat in the upright position.
Quick Tip! Call 313.586.5488
to schedule an appointment
to help you install your car seat
before your baby is born.
Go to www.NHTSA.gov
for more tips.
HIGH-RISK PREGNANCIES—
MATERNAL-FETAL MEDICINE
(MFM)
“High-risk” can mean anything from a
multiple pregnancy to placenta previa (the
implantation of the placenta at least partially
covering the cervix). In those instances, both
mother and child may need specialized care
to ensure good health.
FETAL DIAGNOSTIC UNIT (FDU)
The Fetal Diagnostic Unit provides a wealth
of services to support you and your baby.
Services include preconception counseling,
amniocentesis, fetal echo, nonstress testing,
genetic counseling and screening, 3D/4D
ultrasound scans, perinatal consultations,
at the end of pregnancy-complications,
follow-up, genetic testing, and first trimester
screening just to name a few. Please visit
oakwood.org/womens-health for a full
listing of FDU services available to you.
KIDS
(usually four to eight years old AND
between 40 and 80 pounds):
• Should always travel in a booster seat.
• Should be in the back seat facing the
front of the car.
• The backseat is always the safest place
for children to ride. Children ages 13 and
under should ride buckled up in the
back seat.
• Booster seats must be used with both
lap and shoulder belts.
Remember, it is important for many reasons
that all passengers — adult and children —
use their seat belts at all times.
21
Depending on your own situation, your
provider may refer you for testing at the
FDU office, after which you will return to
your original provider. Or, in certain cases,
your care may be transferred entirely to
MFM. Talk to your provider about what
is best for you and your baby.
Locations/Hours
Fetal Diagnostic Unit
Oakwood Medical Office Building
Suite 306
18181 Oakwood Blvd.
Dearborn, MI 48124
313.593.7521
Monday – Friday
8 a.m. – 4:30 p.m.
MFM Physician Office
Oakwood Medical Office Building
Suite 302
18181 Oakwood Blvd.
Dearborn, MI 48124
313.593.5957
Monday – Friday
8 a.m. – 4:30 p.m.
Quick Tip! A printable map,
a glossary of commonly used terms,
a list of tests that may be performed
during your visit to MFM
and pre-registration forms are
available online. Just go to
oakwood.org/womens-health.
GENETIC COUNSELING SERVICES
WHAT IS GENETIC COUNSELING?
Genetic counseling is an educational process
of providing information and support to
individuals and families who have members
with birth defects or genetic disorders,
or who are at risk for a variety of medical
disorders based on their family history
or prenatal screening tests.
GENETIC COUNSELING SERVICES
• Family history/pedigree construction
• Analysis of family history and
risk assessment
• Information on DNA testing options
• Information on prenatal testing options
• 1 st trimester screening before
maternal serum screening
• Maternal serum screening
• Fetal ultrasound
• Amniocentesis
• Chorionic villus sampling (CVS)
People who may benefit from genetic
counseling are:
Individuals who …
•H
ave, or are concerned that they have
or might have, an inherited condition.
•H
ave a family history of a
genetic condition.
Expectant parent(s) or couples who …
• Are 35 years or older at the
time of delivery.
•H
ave an abnormal maternal serum
screening result.
•Have had an abnormal ultrasound
examination.
• Have an abnormal 1st trimester
screening.
•H
ave experienced multiple miscarriages.
•H
ave concerns regarding a
family and/or personal history
of a genetic condition.
• Are carriers of a genetic disease,
such as cystic fibrosis or sickle
cell anemia.
•H
ave a newborn diagnosed
with a genetic condition.
• Are concerned that their lifestyles,
jobs or medical history may pose
a risk to pregnancy, including
exposure to drugs, radiation,
chemicals, infection or medications.
• Would like more information about
genetic diseases that occur more
frequently in their ethnic group.
For further questions about genetic
counseling services, call 313.593.8483.
• Interpretation of genetic test results
• Patient support/resources
22
TRANSCULTURAL SERVICES
Quick Tip! Visit
oakwood.org/womens-health
to view more information on what to
expect during your genetic counseling
visit, test and procedure descriptions,
or to view pictures of the staff.
NEWBORN SCREENING
IN MICHIGAN
The Michigan Department of Community
Health administers a state-mandated
screening program for all babies born
in Michigan. The screening program is
designed to identify rare but treatable
diseases. Presently, 49 disorders are
screened for in Michigan’s program. The
complete list of disorders is available at
www.michigan.gov/newbornscreening.
With early identification and treatment
of these disorders, serious health problems
can be prevented.
Your baby will have a few drops of blood
removed from her heel to screen for these
particular disorders. The results will be
sent to your baby’s doctor. Normal results
are found in most babies; however, if a
concern is identified, your baby’s doctor
will be informed of the steps necessary
to provide optimal care for your child. All
infants are also screened for hearing loss
prior to discharge.
You will also be given information regarding
Michigan’s Bio Trust For Health program.
You will be asked to sign a consent to allow
any unused blood spots, obtained from the
newborn screening, to be used for research
purposes. Blood spot research is used to
• B etter diagnose childhood and adult
diseases
• B etter treat childhood and adult diseases
• S tudy the effects of toxic chemicals
Speak to your mother/baby nurse and refer
to your booklet for more information.
23
Oakwood provides care for a diverse
patient group. English may be a second
language for some individuals, and they
might need help understanding the
American healthcare system.
To help all patients make informed
decisions about their care, Oakwood’s
free interpretation services are available
24 hours a day, seven days a week by
phone and in person. If you are a patient
in need of translation, please advise
your healthcare provider at registration
or at admission. We will provide an
interpreter for your visit, diagnosis,
treatment or medical procedure. For further
information, please call 800.543.WELL.
GROUP B STREP
WHAT IS GROUP B STREP?
Group B strep (streptococcus) is a type of
bacteria that can cause serious illness and
death in newborns.
WHY DO I NEED TO GET TESTED
FOR GROUP B STREP DURING
EACH PREGNANCY?
Group B strep bacteria can be passed from
a mom who is a carrier for the bacteria
(tests positive) to her baby during labor.
You need to be tested for group B strep
every time you are pregnant.
Toward the end of the pregnancy
(35 – 37 weeks), the doctor will swab your
vagina and rectum. This is sent to a lab,
where they test for group B strep bacteria.
The bacteria take a few days to grow, and
the results are sent to your doctor.
HOW CAN GROUP B STREP DISEASE
IN BABIES BE PREVENTED?
Most early-onset group B strep disease
in newborns can be prevented by giving
antibiotics (medicine) through the vein
(IV) during labor to women who tested
positive during their pregnancy. Because
the bacteria can grow quickly, giving the
antibiotics before labor has started does
not prevent the problem. Any woman who
has a positive test for group B strep during
this pregnancy should get antibiotics. Also,
any pregnant woman who has had a baby
in the past with group B strep disease, or
who has a bladder (urinary tract) infection
caused by group B strep, should get
antibiotics during labor.
gastrointestinal tract (guts) and may
move into the vagina and/or rectum.
It is not a sexually transmitted disease
(STD). About one in four women carry
these bacteria. Most women never have
symptoms or know that they had these
bacteria without a test during pregnancy.
WHAT DO I NEED TO DO DURING
PREGNANCY OR LABOR IF I’M
GROUP B STREP POSITIVE?
Talk with your doctor and create a labor
plan that includes getting antibiotics for
group B strep prevention in your newborn.
When your water breaks, or when you go
into labor, make sure to get to the hospital
at least four hours before delivery, to make
sure there is enough time for the antibiotics
to start to work. When you get to the
hospital, remind the staff that you are
group B strep positive.
WHAT IF I’M ALLERGIC TO
SOME ANTIBIOTICS?
Women who are allergic to some
antibiotics, such as penicillin, can still
get other types of antibiotics. If you think
you are allergic to penicillin, talk with
your doctor.
HOW DOES SOMEONE GET
GROUP B STREP?
Anyone can be a “carrier” for group B
strep. The bacteria are found in the
24
25
26
CHAPTER 2
THE BIG DAY
THINK I’M IN LABOR
The beginning of labor is a very individual
thing. Some women don’t even realize they
are in the first stage of labor, mistaking it
for gas, heartburn, backache or indigestion.
Even though there are signs that labor has
begun, they do not necessarily occur in any
particular order, and they may occur in a
different order with each pregnancy.
SIGNS OF LABOR
• E nergy burst — You may have a burst of
energy several days before labor begins.
• L ightening of abdomen — This is when
your baby “drops.’’ You may feel as if
your baby has dropped lower into your
abdomen. Your clothes may fit differently.
You may find it easier to breathe, but you
may need to urinate more often. This can
happen a few weeks to a few hours
before labor starts.
• B loody discharge — This can be in the
form of “show’’ or “mucous plug,’’ a thick
plug of mucus that forms
in your cervix (bottom
part of your uterus) during
pregnancy. As your cervix
gets softer and starts to
open, this mucous plug
will come out. You will
see clear, pink or slightly
bloody mucus coming
from your vagina. This may happen long
before labor begins or at the start of
27
labor. You shouldn’t be alarmed if this
doesn’t happen, as some women never
experience the loss of their mucous
plug before delivering. If you feel you
are losing your mucus plug prior to your
37th week of pregnancy, contact your
physician immediately.
• R upture of membranes — This is when
your “water breaks.’’ The bag of water
is the amniotic-fluid–filled sac that
surrounds your baby during pregnancy.
When it leaks or breaks, you may feel
a slow trickle from your vagina or a
sudden gush of warm fluid. This may
happen before labor starts or any time
during labor. Call your doctor or come
to the hospital IMMEDIATELY when
your bag of water breaks.
• Contractions — Call your provider when
your contractions are regular and you
think you’re in labor. For the first child,
the doctor will probably tell you to come
to the hospital when they are about five
minutes apart for one hour.
Generally speaking, if you have had at least
one baby, your labor will likely be shorter
than with the first.
When you notice the first signs of labor,
complete the following:
•C
all your OB provider to get
specific instructions.
FOR YOU
• P icture identification and health
insurance cards
• Advance directive (if you have one)
• If necessary, finalize plans for
the care of other children.
• R obe and slippers
• Arrange your transportation to
the hospital.
• B ras or nursing bras (2)
• Try to conserve as much energy
as possible.
•U
nderpants/panties (3 – 4)
•C
arefully get in the car for the ride
to the hospital. Don’t forget to bring
your hospital suitcase. (See below.)
• Deodorant
• Your driver should remain calm, driving
slowly and safely. Your driver should
not be nervous about getting you to the
hospital in an overly hasty fashion … you
may be in labor for many hours! Be sure
to wear your seat belt.
2
•N
ightgowns (1 – 2)
• Toothbrush and toothpaste
•C
omb and hairbrush
•C
lothes to wear home
• Watch
• S lippers or socks (preferably with
no-skid bottoms)
THINGS TO BRING
TO THE HOSPITAL
Since trying to pack your suitcase between
labor contractions can be difficult, we
advise you to pack your suitcase about
two weeks before your baby is due.
Quick Tip!
Visit us at
oakwood.org/womens-health
for a printable checklist of things you
will need at the hospital.
Pack one suitcase with the things you
will need during your hospital stay. As a
reminder to you or whomever may help
you pack, tape to your suitcase a list of
things that will have to be packed at the
last minute (toothbrush, toothpaste, etc.).
Also pack a small overnight bag with
anything you will need during the actual
labor process.
FOR BABY
• Warm blanket during cool weather
•C
ar seat
•U
ndershirts
• L ight weight receiving blankets for the
baby’s car seat
• S weater and hat
• S leeper with legs/sleep sack
• S pecial outfit for first picture*
*Read more in the “Baby’s First Picture”
section of this guide.
28
OPTIONAL ITEMS
• Soap/cleansers
• Shampoo
• Makeup
• Hair dryer
• Lip balm
• Camera
• WiFi available
baby’s head to pass through). For the
second-time mom, the cervix may begin
to dilate in the last weeks of pregnancy;
therefore, the first stage of labor may not
last as long.
Contractions are the strongest near the end
of the first stage of labor. They will last for
about a minute and may be only a minute
apart, hardly leaving you time to recoup.
You may feel like you have to urinate often
or have a bowel movement. You feel this
way because the baby’s head is pressing
down on your rectum and bladder. Near
the end of this stage, you have a strong
desire to push the baby out (bearing down).
It is very important not to push until your
provider tells you to do so. Trying to push
the baby out through a partially opened
cervix makes the cervix swollen and less
stretchable, thus making it more difficult
to open and liable to tear during delivery.
Will I need an IV?
Almost all moms will have an IV placed
sometime during labor. It is important to
discuss this question with your provider.
INFORMED CONSENTS
On admission to Labor and Delivery, you will
be asked to sign several hospital consents.
Advance directives: By state law, we are
required to ask our patients if they have an
advance directive. If you have an advance
directive, please bring it to the hospital with
you. If you don’t have one, you will be given
a copy of a brochure called My Voice My
Choice on admission to Labor and Delivery.
It explains advance directives and Patient
Advocate Designation or Durable Power of
Attorney for Health Care and
how to obtain copies of the necessary
forms. Visit us online to print a copy of
the My Voice My Choice brochure.
STAGE ONE OF LABOR —
TIME TO GO TO THE HOSPITAL
During the first stage of labor, your
physician is waiting for your cervix to dilate
to 10 cm (wide enough for an average-sized
29
Will I be able to get up and go
to the bathroom?
The ability to get up and move is affected
by the method of pain control you choose.
Alternative therapies and IV medications
usually allow you to get up safely with
assistance; an epidural or spinal block
will require you to remain in bed.
If you cannot empty your bladder, you may
need to have a small catheter inserted in
your bladder to empty it because you may
not feel the urge to urinate.
What kind of equipment will
I need to have?
This varies depending on your labor progress
and you and your baby’s well-being. Most
mothers will have an IV, a blood pressure
monitor and a fetal monitor. If you and
your provider choose an epidural, you will
also have a tiny catheter in your back
attached to a pump to deliver continuous
medication, a
pulse oximeter
and a catheter
for emptying your
bladder.
• Showers
PAIN-MANAGEMENT OPTIONS
Some women find the comfort techniques
are all they need to cope with the pain of
childbirth. Other women find they desire
pain medications in addition to the comfort
techniques. There are two main types of pain
relief choices for birth: systemic and regional.
Most pregnant women are concerned
about how they will cope with the pain
of childbirth. Planning ahead for how you
want to approach pain relief will be helpful
when the time comes.
The following information is designed to
give you some facts about different types
of pain management — what they are, how
they are given, what they do and what
possible side effects might result. We have
also included a short list of commonly asked
questions regarding pain management.
Keep in mind that usually your provider
will not be able to choose exactly what
type of pain relief will be best for you
until you are in labor or ready to give
birth. However, discussing this issue with
her ahead of time will help your provider
know what your wishes are.
TYPES OF PAIN RELIEF AT OAKWOOD
Each person’s perception of pain is unique.
Labor sometimes hurts more or less than
you might have expected. There are many
techniques and medications available to
you, but no perfect method for eliminating
the pain of childbirth from beginning to
end has been developed.
Alternative Therapy or Comfort
Measures can lessen the pain of childbirth.
Many of these natural methods are taught
in childbirth education classes. You will be
encouraged to try these comfort measures if
you choose to:
• Relaxation techniques
• Healing touch
• Visual imagery and focusing
• Music therapy
• Breathing techniques
• Birthing balls
• Heat and cold therapy
2
Systemic Medications or Narcotics are
generally given intravenously (although
they sometimes may be given in the muscle)
to provide pain relief. This medication will
often cause drowsiness.
Regional Medications or Anesthesia
provide comfort by reducing or eliminating
pain sensation. Below you will find a
brief description of the various forms of
anesthesia used during labor and delivery.
• L ocal Anesthesia: A physician will inject
a local anesthetic into your vagina or
the area surrounding it to ease the pain
during delivery. These pain medications
usually affect a small area and are
especially useful before an episiotomy or
the repair of a laceration. One advantage
of a local anesthetic is that it does not
affect the baby. After it wears off, there
are usually no lingering effects. The main
limitation is it does not relieve the pain
of contractions during labor.
• S pinal Block: A spinal block is given as
an injection into the lower back (does
not touch the spinal cord itself). Spinal
blocks are most often used for cesarean
births. This is because the medication
is short-acting and is usually given only
once. A spinal block numbs the lower
half of the body. It provides good relief
from pain, starts working quickly and
is effective in small doses. It also has
the same possible low-occurrence side
effects as an epidural block.
• Position changes 30
•G
eneral Anesthesia: This is a
medication that causes temporary
loss of consciousness for the mother
(i.e., a deep sleep). It is rarely used for
routine deliveries but may be used for
an emergency delivery. These drugs are
given in one of two ways: through a face
mask or injected through an IV line. Once
the drug is given, it works very quickly
and is usually given just before delivery.
After general anesthesia wears off, you
may feel tired and slightly sick to your
stomach. This feeling usually fades in less
than 24 hours. Your throat may also feel
sore from the tube that was inserted to
provide oxygen.
• E pidural: Epidural anesthesia is
performed by an anesthesiologist or
a certified registered nurse anesthetist
(CRNA) and involves the placement of a
small tube into the lower back through
which anesthetic is given. This kind
of anesthesia is helpful for easing the
pain of uterine contractions, the pain of
delivery and the pain of an episiotomy.
You may lose slight muscle control in
your legs, but you should still be able
to push during contractions. Epidural
blocks are also effective during cesarean
birth. Epidural blocks can have some
31
side effects. In very few cases, it may
cause the mother’s blood pressure to
drop, which in turn may slow the baby’s
heartbeat. It is important to understand
that these side effects are reversible.
With epidural anesthesia, the mother’s
blood pressure and heart rate, as
well as the baby’s heart rate, will be
continuously monitored.
When can I have an epidural?
While the decision lies with each
individual provider and depends on
the clinical situation, most support an
epidural when your cervix is somewhere
between 3 and 5 cm dilated.
Can I choose to have an epidural
at the last minute?
You can ask to have an epidural late in
your labor; however, your provider may
tell you that it may not have time to take
effect before delivery. They may suggest
other methods to help with pain relief
at that late stage of labor.
PAIN MANAGEMENT IS CUSTOMIZED
Be prepared to be flexible. Some of the
techniques may be more appealing than
others. Your health and the health of your
baby must be considered when it comes
time to decide if a pain medication is needed
and, if so, which one will work best.
STAGE TWO OF LABOR —
ARRIVAL OF THE BABY
The second stage of labor occurs from the
time your cervix has dilated to 10 cm until
the baby is born. Many moms will feel an
urge to push once their cervix has fully
dialated. Your physician will tell you
when it is safe to begin pushing. Your
labor and delivery nurse will be with you
to guide you through the process. If you
took childbirth classes, be sure to use
what you learned regarding breathing
and positioning for pushing. Push smooth
and steady during contractions and relax
and try to conserve energy in between
contractions. Do not worry about trying to
control your bowels or about the leakage
of urine as you push.
As the baby’s head is emerging, your
physician will tell you to stop pushing so
that the head slides out slowly under the
support of your doctor’s hand. If it seems
that the emerging head may tear the
surrounding skin, a small cut, called an
episiotomy, may be made in the skin at the
lower end of the opening, to prevent a tear.
The baby’s eyes, nose and mouth are gently
cleared. The shoulders and the rest of the
body will follow, and the umbilical cord will
be clamped and cut (this is not painful for
the baby because there are no nerves in
the cord). The change in temperature and
touch provide enough stimulation for the
baby to start breathing.
The baby is cleaned, dried and wrapped
up in a blanket.
What should my labor partner do
during the delivery?
• E ncourage and praise you during
this time.
•U
nderstand that you might be a
little irritable!
•H
elp you with relaxation and
breathing exercises.
•G
ive you sips of water, wipe your face,
massage your back, hold your hand or
hold your legs back while you push.
•C
ount off during pushes from one to 10.
CESAREAN SECTION
Should you require a cesarean section
(also called a C-section) for the delivery,
you should not worry. C-sections are
done with minimal risk to mother or
baby. About 25 percent of all deliveries
occur via C-section. A C-section occurs
when the baby is delivered through an
incision in the abdomen. Your provider
will explain what will happen to you
during this process, should this be the
determined plan of delivery.
2
In certain known conditions, a C-section is
planned ahead. You should remember that
having one C-section does not necessarily
mean that subsequent pregnancies have
to end in cesarean delivery. Talk to your
provider about the option of vaginal birth
after cesarean section (VBAC).
STAGE THREE OF LABOR —
THE NEWEST ADDITION
The third stage of labor occurs from the
birth of the baby to the delivery of the
placenta (also known as the afterbirth).
Although the baby has been born, the
placenta is still inside. With much milder
32
contractions, the placenta and the
membranes are pushed out. After the
delivery of the placenta, you may receive
an injection to prevent unnecessary loss
of blood. You can now lie back and relax,
or begin to hold your baby in your arms.
Skin to skin contact will encourage your
baby to initiate breastfeeding. Research
confirms that mothers who put their babies
to breast within the first hour of life are
most successful with breastfeeding.
AFTER THE DELIVERY
It is not uncommon for some women to have
a slight temperature or to shiver immediately
after delivery, due to the tremendous physical
effort put forth during the delivery. If you
had a C-section or received an episiotomy,
you may be given pain medication after the
delivery. The vital signs of both you and your
baby will be monitored closely.
Postpartum recovery means different things
for different women. Read more information
on postpartum recovery in the “Mother
Care” section of this guide.
HOW LONG CAN I EXPECT TO BE IN
THE HOSPITAL?
Women who have a vaginal birth
stay approximately 24 to 48 hours.
Women who have a cesarean birth stay
approximately 72 hours.
INSURANCE
BILLING
AND PAYMENT
Oakwood will bill
your insurance
company for you. Please bring a picture
ID and all health insurance cards to the
hospital. If you have multiple insurances,
we will bill both primary and secondary
payers, as long as we have adequate
insurance information. If your insurer
requires authorization for your hospital
care, we will make sure that a referral
has been obtained before billing. There
may be separate bills for your maternity
hospitalization and your baby’s care,
depending on your specific insurance
coverage.
After your insurance company has paid its
portion of the charges, you will receive a
statement that identifies any outstanding
balance still due at that time. You will
be responsible for that amount owed. If
you have difficulty paying an outstanding
balance due reflected on your statement,
please call the hospital patient-account
specialist at your delivering hospital to
make specific payment arrangements or
to obtain assistance. If you are unable to
pay your portion within three months, we
offer a H.E.L.P. Loan Program if you meet
the necessary qualifications. The H.E.L.P.
Loan Program offers an easy payment plan
with low interest rates.
Uninsured Patients: Financial assistance
may be available to you and your baby
by the State of Michigan if you meet the
necessary qualifications and requirements.
During your stay at Oakwood, you can
request that a patient-account specialist
visit you to help determine your eligibility
for state assistance. Or you can directly
contact the Michigan Department of
Community Health at 517.373.3500 or
the Family Independence Agency at
517.373.2035 to inquire about free or
low-cost healthcare coverage for both you
33
2
and your baby. Plans cover prenatal care,
labor and delivery, newborn care and
pediatric care. We encourage you to inquire
about these plans early in pregnancy.
QUESTIONS REGARDING YOUR BILL
Should you have questions regarding
hospital costs related to maternity and
newborn care, please call the Patient
Accounting Office of your delivering
hospital so that we may assist you.
Oakwood Hospital – Dearborn
313.593.7136
Oakwood Hospital – Wayne
734.467.4161
Oakwood Hospital – Southshore
734.671.3831
note:
Most insurance plans require you to
add your new baby to your insurance within
the first 30 days after birth. Many plans
also require a Social Security number
for your baby and/or that you choose a
physician for your baby. Please verify with
your insurance company its requirements.
COST OF DELIVERY AT
AN OAKWOOD HOSPITAL
All hospital stays include two components:
1) professional (doctor) bills, and 2) facility
(hospital) bills. In terms of facility costs, your
delivering hospital will bill your insurance
company for costs associated with delivery,
mother care, baby care and circumcision
(if performed). In terms of professional
costs, your OB provider, your baby’s provider
and the anesthesiologist (if an epidural
or C-section is performed) will send bills
to your insurance company.
ROOM SERVICE
During your stay at Oakwood, you will
receive your meals through room service
during open cafeteria hours. This allows you
more choices in food selection and meal
times. A menu, found at bedside, will have
the direct-dial extension to the kitchen of
your delivering hospital. We offer a choice
of hot or cold trays to satisfy your appetite.
After placing your order, your selection will
be delivered to your room in approximately
45 minutes or less. Your nurse or physician
may place some restrictions on your diet
(amount, timing, selection) based on your
condition or status. Room service generally
is available to you between the hours of
6 a.m. and 7 p.m.
CORD-BLOOD COLLECTION
OPTIONS
Oakwood Healthcare System supports
various options when it comes to
collection and ultimate storage of
umbilical cord blood. This blood may be
34
used at a future date to help treat patients
afflicted with cancers of the blood and
other diseases. Oakwood offers three
options to patients:
•Collect umbilical cord blood for storage at a private cord blood bank for
potential future personal use. Cord
banks should be contacted in advance
of the delivery so that enrollment and
fees can be processed.
•Donate umbilical cord blood for public
listing on the National Marrow Donor
Program registry. The CORD: USE Cord
Blood Bank coordinates this process to
help anyone in need of life-saving stem cell transplantation. This Oakwood Hospital & Medical Center option is free, however it does require patient signature of consent prior to delivery.
•Discard umbilical cord blood as medical waste. This option is the default unless you notify your physician of one of the above choices during your pregnancy, and then notify the staff upon arrival for labor and delivery.
been immunized (chicken pox, polio,
measles, mumps, etc.)
• An adult other than their mother must
accompany minor siblings of the baby
at all times.
• P lease remember, all Oakwood campuses
are tobacco-free.
DAILY VISITING HOURS FOR
OAKWOOD BIRTHING CENTERS
Father/Significant-Other Visiting Hours
24 hours
General Visiting Hours
11 a.m. to 8 p.m.
Who can be in the room during delivery?
• F or a vaginal delivery, one coach
and two other visitors may be in the
delivery room.
• F or a C-section delivery, only one person
in the operating room.
• In triage and the recovery room,
only one person may be with you.
• S iblings must be at least 14 years
of age to attend a delivery.
What about visitors after the delivery?
note: Visiting
hours and number of visitors
for the Birthing Center may be changed at
the discretion of the nurse or physician due
to patient’s request or a change in patient’s
medical condition.
Other Labor and Delivery
Visitor Guidelines
• Visitors are allowed to eat in the patient’s
room; however, patients should check
with the medical personnel before
eating anything.
VISITING GUIDELINES
In order to protect the health of our mothers
and babies, we ask that you adhere to the
following guidelines:
•Family and friends should not visit if they
have or have been exposed to contagious
illness, communicable disease or recently
35
•Since mom and baby’s health and safety are primary concerns during the actual delivery, family and visitors are asked
to take photographs and/or videotape
only during antepartum and postpartum
periods, and from the exterior of the
nursery, unless the attending physician
or staff request otherwise.
• Children of visitors are not allowed in
the labor rooms. Only the children of
the patient may visit the labor-deliveryrecovery room. If children are in the room,
an adult must be present for each child.
Each child counts as a visitor. Children may
be asked to leave based on the situation.
• Visitors are asked not to congregate in
the hallways outside the delivery room.
For more detailed information regarding
visiting hours, please call the Labor and
Delivery unit at your delivering hospital.
Oakwood Hospital – Dearborn Labor and Delivery
313.593.7500
Oakwood Hospital – Dearborn,
a partnership between the hospital and
Our 365 allows family and friends near
and far to view your baby’s photo online,
if you choose, via the Oakwood Baby
Gallery at oakwood.org/womens-health.
2
HERE IS HOW THIS FREE SERVICE
WORKS. IT IS AS EASY AS 1-2-3!
1. Your baby’s photo will be taken at the
hospital the day after their birth. Your
Quick Tip! If you desire your child to
have a specific outfit on in the picture,
you should put it in the crib that
morning and notify the nursery nurse.
Oakwood Hospital – Dearborn Mother Baby Unit
313.593.7630
photographer will come to your room and
ask you to sign a consent that will allow
Our 365 to gather your information and
Oakwood Hospital – Wayne
photograph your baby. Pictures will then
Labor and Delivery be taken in your room right at your bedside
734.467.4266
and you will be able to select the poses you
Oakwood Hospital – Southshore
want to purchase. The photographer can
Maternal Care Unit accept cash, checks, credit card or money
734.671.3950
order for payment. Look for the order to
arrive at your home via first class mail
BABY’S FIRST PICTURE
approximately seven days after your order
Oakwood Healthcare would like to thank
was purchased.
you for allowing us to share in this very
Your photographer will also ask if you
special time in your life. Your baby has
would like to have your baby’s picture
finally arrived, and family and friends are
posted in the Oakwood Baby Gallery online
anxiously waiting for a glimpse of your
at oakwood.org/baby-gallery. If you say yes,
newest addition. If your baby is born at
36
your baby’s picture will be available online
within a few days. Only your baby’s first
name and last initial will accompany the
online photo.
How do family and friends find your baby’s
picture on the Oakwood Baby Gallery?
Just point and click!
• L og on to
oakwood.org/womens-health.
•C
lick on the Patients and Families.
• Click on Baby Gallery.
•C
lick on the hospital where your baby
was born.
• F ollow the easy online instructions
to search for a particular baby (and
enter password, if requested).
Now that you’ve found your baby’s first
photo on our Web site, you have the option
to personalize/password protect it.
•C
lick on Parents Personalize My Baby’s
Page (to the left of your child’s photo).
• You will be asked for your password.
Enter the mom’s last name and the
receipt number from your order form.
Now that you’ve gained access to
your child’s Web page, you have
several options:
37
• You can change your original
password from your last name to
a secret password of your choice.
• You can also add a visitor password
so only those with this password
can view the photo.
• You have the option to remove your
child’s photo from the Web site
at any time by clicking the “page
unavailable” icon after entering
your password.
Lastly, while online you can view notes
of congratulations posted by your family
and friends!
Your satisfaction is guaranteed. If for
any reason you are not satisfied with
your order, forget your password or
have questions, just call Our 365 at
800.433.0855.
We hope you take advantage of this easy,
fun and free opportunity to share your
baby’s picture with family and friends!
BIRTH CERTIFICATE
INFORMATION
You will receive a registration worksheet
after your baby’s birth.
Fill it out as quickly and
accurately as possible
and return it to the unit
secretary. Someone will then bring a typed
copy of the form to your room to verify
the information and obtain your signature.
Please read the document carefully
to check for errors (spelling of names,
dates, etc.) before signing. After the birth
certificate is signed, it will be sent to
Dearborn City Hall for processing.
note: There
is a charge to have any changes
made thereafter.
The unit secretary will give you an order
form for your baby’s birth certificate that
can be taken or mailed to city hall. Birth
certificates can be purchased from the
city hall of your delivering hospital’s city
approximately three to six weeks after birth.
Security representative, you can call
800.772.1213. If a Social Security number
is needed sooner than two months, you
may obtain it yourself in approximately
two weeks by presenting a certified copy
of the birth certificate at a Social Security
branch office.
2
PATERNITY
For unwed parents, an Acknowledgment
of Paternity can be signed at the hospital.
This is a special form that needs both
parents’ signatures and is notarized at
the time it is signed. Both parents must
have current, valid, government issued
picture identification with them at the time
of signing. Proper identification includes
Oakwood
Hospital – Dearborn
Dearborn City Hall 313.943.2012
akwood Hospital – Wayne
O
Wayne City Hall 734.722.2204
akwood Hospital – Southshore
O
Trenton City Hall 734.675.8600
If you should leave the hospital before
the birth certificate has been completed,
you should call your delivering hospital
to make an appointment to review and
sign it. Phone numbers for the appropriate
units are listed below.
Oakwood
Hospital – Dearborn
Mother-Baby Unit 313.593.7630
akwood Hospital – Wayne
O
Health Information Management 734.467.4378
Oakwood Hospital – Southshore
Medical Records 734.671.3846
At the bottom of the birth certificate work
sheet you can request to have the state
send the information to social security to
initiate the process for issuing your child’s
social security number. This is the state’s
preferred way to obtain a social security
number. This process can take two months
or more. If you wish to speak to a Social
a current driver’s license, identification
card or record issued by a federal or state
government that contains both the person’s
photograph and signature. A notary may
be available as a complimentary service
provided by the hospital.
The law specifically stipulates the process
for naming the father on a child’s birth
certificate.
According to the law, if a child is conceived
or born when the mother is legally married,
the husband is the legal father of the baby,
even if he is NOT the biological father,
unless a court decides that it is not the
husband’s child. If the child is born less
38
than ten months after the divorce is final,
it may be necessary to re-open the divorce
case. Please refer to michigan.gov for
further information. If you were not married
at either time, the father’s name may not
be entered without the written consent
of the individual to be named as the
father (this can be done by completing
an Acknowledgment of Paternity). This
document can be completed at the hospital
at the time of your baby’s birth. The last
name of the child may be the last name
of the mother or father. You may give the
father’s last name even if he does not file
an Acknowledgment of Paternity.
SECURITY INSTRUCTIONS
FOR PARENTS
Your baby’s safety is a high priority at
Oakwood. We take many precautions to
be sure your baby is secure. You can help
in the following ways:
• Become familiar with the personnel who
work on the OB unit at your delivering
hospital. Your nurse, nurse assistant,
OB provider, OB/GYN resident, nurse
educator and your baby’s physician are
the only persons who have any reason
to take your baby anywhere.
• You may encounter other hospital staff,
such as housekeeping, who will be
cleaning your room; lab and dietary
personnel, who may enter your room for
consultations and/or tests; and auxiliary
workers, who may drop by to deliver
flowers. Feel free to question anyone who
comes into your room.
• If you have questions or are unsure about
any of the hospital staff, press your call
light and someone from the nurses’
station will assist you.
• Always check for proper identification
before giving your baby to anyone. All
OB staff members wear pink hospitalissued ID badges.
• Never leave your baby alone or
unsupervised in the room. If you leave
your room, please take the baby with
you in the crib or return your baby to
the nursery. Newborns are continuously
observed in the nursery.
• As an added measure of security, a small
Hugs band will be placed on your baby’s
ankle to monitor his or her location
at all times. Your nurse will give you
instructions regarding the Hugs band.
Do NOT remove the band. Your nurse
will remove it prior to discharge.
note:
Each unit is locked down and under
24-hour video surveillance. All patients
and visitors will need to be identified
before being let into or out of the unit.
Corresponding wrist bands will be worn
by the baby, mother and father.
GIFT SHOP HOURS AND DELIVERY INFORMATION
Oakwood Hospital
– Dearborn
Oakwood Hospital
– Wayne
Oakwood Hospital
– Southshore
Monday – Friday
9:00 a.m. – 8 p.m.
10 a.m. – 6 p.m.
9 a.m. – 7 p.m.
Weekends
and holidays 12:30 p.m. – 5 p.m.
1 p.m. – 5 p.m.
11 a.m. – 3 p.m.
The patient’s name
The patient’s name
The patient’s name
3rd Floor
Skillman Building
2nd Floor
Maternal Care Unit
2nd Floor
Maternal Care Unit
Oakwood Hospital
– Dearborn
Oakwood Hospital
– Wayne
Oakwood Hospital
– Southshore
18101 Oakwood Blvd.
P.O. Box 2500
Dearborn, MI 48123
33155 Annapolis St.
Wayne, MI 48184
5450 Fort St.
Trenton, MI 48183
313.593.7190
734.467.4169
734.671.3692
Address family and friends should use to send mail, gifts or flowers
Phone number
39
GIFT SHOP, MAIL AND FLOWERS
Oakwood Healthcare gift shops offer a
wide choice of flowers, magazines, toys,
baby clothes and other unique gift items
to keep our patients connected with their
greatest support system — their family
and friends.
Oakwood employees and volunteers
distribute the U.S. mail and flowers
delivered by florists each day. The
Oakwood gift shops are open seven days
a week. Family and friends are able to send
flowers and notes via Oakwood’s online
store by visiting www.oakwood.org/store.
2. Leave obstetric patient in Emergency
Room area. Patient will be transported to
the Third Floor, Skillman Building, Labor
and Delivery Triage Unit.
3. S ecurity can advise you where to park.
2
Visitor Parking
Visitors may park in a visitor-parking
structure for a small fee.
What Happens Next?
Once you have been examined in the
Triage Unit to determine that you are
Special note regarding balloons: We don’t
recommend latex balloons on the OB units.
Babies, patients or visitors may have an
allergic reaction to latex.
MATERNITY SERVICES
OFFERED AT OAKWOOD
HOSPITAL – DEARBORN
Oakwood Hospital – Dearborn (OH-D)
is a full-service healthcare facility.
Oakwood is one of the leading, most
comprehensive birthing centers in
southeastern Michigan, due to our
outstanding physicians and exceptional
care team’s family-centered approach
to childbirth.
Location/Directions
Our address is:
18101 Oakwood Blvd.
Dearborn, MI 48124
313.593.7000
We are located at the intersection
of Oakwood Blvd. and Michigan Ave.
(just off Southfield Freeway).
GIVING BIRTH AT OH-D
When it’s time to come to the hospital,
we’d like you and your support person to
be aware of some important details that
will help ensure a smooth arrival.
Tips for Your Driver
1. Drive vehicle to Emergency Room (ER)
entrance.
in labor, you will be transferred to a
labor-delivery-recovery (LDR) room. Your
husband or support person may join you
and remain with you during all phases of
labor, delivery and recovery.
Labor-Delivery-Recovery Rooms
Our private LDR rooms are designed to
offer you an alternative to the standard
delivery room.
Here you’ll have all the comforts of home,
plus the added security of well-trained
hospital personnel and sophisticated
equipment. The LDR rooms allow you
to labor and deliver in one room and
in one bed. After your baby is born, we
encourage you to take some time to
hold and become acquainted with your
new son or daughter. After you have
spent this special time together, you
will be moved to the mother-baby unit.
40
Transition Nursery
Close observation is important for a
newborn baby. After the initial recovery
period, your infant will be taken to our
Transition Nursery for further evaluation.
Here he or she will have their first bath
and your pediatrician will be notified of
your baby’s birth. The length of stay in this
nursery depends upon how well your baby
is adapting to her new world.
Mother-Baby Unit
We want you to know that Oakwood
Hospital – Dearborn provides a
Your nurse will provide care for both you
and your baby. You will be asked to sign
consents for the hepatitis B vaccine and
circumcision if you choose to have these
completed at the hospital. She will also
teach you many of the things you will
need to know to begin caring for your
baby and yourself.
OB/GYN Residents
When obstetrics and gynecology patients
are admitted to Oakwood Hospital –
Dearborn, they are cared for by their
attending physician; however, they also have
access to OB/GYN residents. The OB/GYN
residents work closely with the patients and
attending physicians.
Oakwood Lactation Center
Certified lactation consultants staff the
Oakwood Lactation Center. All have
extensive experience working with
breastfeeding mothers and are well
prepared to help with questions or
concerns while you are still in the hospital.
Shortly after you leave the hospital, a
consultant may call you to make sure you
are adjusting comfortably. If necessary,
you can arrange a personal consultation
for additional support and guidance.
note:
Refer to the “Breastfeeding” section
of this guide for more information.
very supportive way of giving nursing
care to you, your infant and family. This
method of nursing is called “Mother-Baby
Care Giving.” After your baby’s stay in
the Transition Nursery, you and your baby
will not be separated again, except for
exams such as a hearing screening or upon
your specific request. Your newborn will
sleep right next to you in a bassinet located
in your mother-baby room. This will give
you a chance to get to know your baby
and ask specific questions regarding his
unique qualities.
41
Inpatient Nurse Educators
Prior to your discharge you may be visited
by an inpatient nurse educator who will
review mom and baby discharge care
instructions and be sure you have received
your patient information folder. You may
want to make a list of questions you
want to ask before you go home. Your
nurse educator will be happy to spend
the time with you to be sure you are
feeling confident and ready to go home
with your new baby.
2
Nursery Pictures
Your baby’s photo will be taken at the
hospital the morning after her birth.
Newborn pictures are taken at the
mother’s bedside so they can see the
photos and choose the ones they like.
Our photographer goes room to room
and has the parents dress the infant in
their choice of outfits. Refer to the “Baby’s
First Picture” section of this guide for
more information.
NEONATOLOGY SERVICES
The Neonatal Intensive Care Unit (NICU)
at OH-D is a 30-bed Regional Level III
inpatient unit.
We provide multidisciplinary care
for the preterm and term neonate
requiring a high level of technical
support and observation. Approximately
500 babies are admitted to our NICU
each year with a variety of medical
and/or surgical conditions. The NICU
Transport Team provides transport
services for many area hospitals, including
Oakwood Hospital – Wayne and Oakwood
Hospital – Southshore.
Along with the multidisciplinary team, the
NICU staff provides compassionate, holistic
care to all neonates, while promoting a
supportive learning environment for their
families. The unit is staffed in-house 24
hours a day with nurses, a neonatal nurse
practitioner, a neonatologist and support
staff. Our team also includes professionals
such as social workers, respiratory therapists,
neonatologists, a perinatal coordinator,
care managers, nurses, physical therapists,
lactation consultants and dietitians. Family
conferences are arranged in response to
complex care needs, to enhance family
participation or are available at the family’s
request. We promote family bonding in
the NICU by having 24-hour visitation,
Kangaroo care, infant CPR classes and
rooming-in options.
Our staff is specially trained to provide
complex care for the NICU patient and
to teach the family about discharge
and potential home needs. Oakwood
understands that parents and families of
NICU babies may experience significant
stress. The caring, competent staff in our
state-of-the-art NICU will work with you
to ensure the best care for your baby.
42
Visitation Guidelines for NICU
• P arents may be with their baby at any
time. It is best to come at feeding times.
Please call first if you are coming to
feed your baby. We can be reached at
313.593.7435.
• All visitors must wash their hands
with soap for three minutes before
entering the NICU. If any visitor has
a cold or other illness, please discuss
visiting your baby with a nurse before
entering the NICU.
•O
nly two visitors per baby, one of
which is a parent, are allowed in
the NICU at one time.
• An adult must supervise all children
in the NICU, the family waiting room
and the hallway.
• B rothers and sisters of the NICU patients
who are 3 years of age or older may
visit under certain conditions and days/
times. Arrangements must be made with
the NICU staff prior to visit. Just call
313.593.7435.
• An immunization card must be brought in
for each visiting child.
43
•Visitation will be suspended if there is a community outbreak of disease or if
the activity in the NICU prohibits it.
• P lease respect other families’ privacy
and do not wander about the NICU
or ask questions about another baby.
• P lease photograph your infant only.
The NICU staff does not allow taping
or pictures while they are caring for
a baby.
• A family waiting room is available for
you. Please help us keep it tidy.
• We offer a lending library with books
you may find helpful. Please ask your
nurse if you are interested in a book.
Books are to be returned after two
weeks or before discharge.
• We offer a parent support program
for NICU families. Parents Supporting
Parents (PSP) links volunteer parents
who have had a baby in the NICU with
new NICU parents. This program is a
free service. You can contact PSP at
313.593.8750.
•O
ften babies are moved from one
area of the NICU to another. Don’t
be alarmed if your baby is not in the
same location when you arrive. We will
direct you to your baby’s new location.
• P lease ask your baby’s nurse any
questions that you may have.
• S tuffed animals are not allowed in
the NICU.
Please call the NICU at any time with
questions at 313.593.7435. Please identify
yourself by your last name and the ID
number on your wristband. Ask to speak
to the nurse taking care of your baby.
Quick Tip! Visit
oakwood.org/womens-health
to meet the NICU staff, view screening
tests that will be performed on your
baby, read about parent-to-baby
bonding details and gather parent
support group information.
Breastfeeding Instructions for
Mothers Whose Babies Are in NICU
• B reastfeeding will be initiated when
the infant’s condition allows.
• It is important that your milk supply
be established by using a breast pump.
• Your nurse and/or lactation consultant
will help you begin the pumping process
and answer any questions you may have.
PRE-REGISTRATION INFORMATION
Pre-registration will help minimize
the amount of paperwork that needs
to be done when you are admitted.
Pre-registration may be completed online
at oakwood.org/womens-health.
2
Should you have any questions about
your upcoming admission, please contact
OH-D admitting office at 313.593.8525.
CAFETERIA HOURS FOR VISITORS
Oakwood Hospital – Dearborn offers
a walk-in cafeteria for your visitors to grab
a snack. The hospital cafeteria vending
area is open 24 hours a day, seven days
a week with a few exceptions.
TOURS OF THE OB UNIT
We would love to show you our beautiful
Birthing Center. Tours are held at Oakwood
Hospital – Dearborn on the second
Wednesday and fourth Thursday of
each month from 5 p.m. to 6:30 p.m.
Registration is not required for tours;
just meet in the main lobby of the
hospital. For more information, please
call 313.593.7694.
MATERNITY SERVICES
OFFERED AT OAKWOOD
HOSPITAL – WAYNE (OH-W)
Oakwood Hospital – Wayne is a fullservice community hospital located in
Wayne, Michigan. Oakwood Hospital –
Wayne’s Family Birthing Center Unit offers
• The neonatologist or the nurse clinician
will let you know when they want you
to begin bringing breast milk to feed
your baby.
If you need assistance breastfeeding
the baby in NICU, you can call or have
the nurse call the lactation consultant
at 313.593.5929 for help. Lactation
consultants are available daily.
44
a full range of obstetrical services
to care for both mom and the newest
addition to the family. We offer families
the most advanced, specialized healthcare
available with the personal touches of
a community hospital.
Our family-centered philosophy, combined
with our medical and technical expertise
in childbirth, will help ensure a safe and
happy birth experience for you and your
family.
2. L eave obstetric patient in Emergency
Room area or West Lobby area.
3. The patient will be transported to
the Second Floor, Family Birthing
Center Unit.
4. P ark vehicle in Emergency Room
parking lot or West Lobby parking
lot. If you arrive between 8 p.m.
and 5 a.m., park your vehicle in the
Emergency Room parking lot only.
Visitor Parking
The parking at Oakwood Hospital – Wayne
is free. Your visitors may park in the main
entrance parking lot (located in front of the
hospital) or the West Lobby parking lot.
What Happens Next?
Once you arrive in the Oakwood Wayne
Family Birthing Center, you will be
evaluated in our triage center and then
taken to a private labor-delivery-recoverypostpartum (LDRP) room if you are in labor.
Your husband or support person may join
you and remain with you during all phases
of labor, delivery and recovery.
Location/Directions
Our address is:
33155 Annapolis St.
Wayne, MI 48184-2493
734.467.4000
Labor-Delivery-Recovery-Postpartum
Rooms (LDRP)
Our private LDRP rooms are designed to
offer you an alternative to the standard
delivery room.
We are located at the intersection of
Venoy Rd. and Annapolis St.
Here you’ll have all the comforts of home,
plus the added security of well-trained
hospital personnel and sophisticated
equipment. The LDRP rooms allow you to
labor and deliver and recover in one room.
After your baby is born, we encourage you
to take some time to hold and become
acquainted with your new son or daughter.
After you have spent this special time
together, your baby will be transferred to
the nursery. Throughout your stay with
us, you will have a chance to get to know
your baby and ask specific questions about
your baby. The nurses who care for you
will also teach you many of the things you
will need to know in order to begin caring
for your baby and yourself.
GIVING BIRTH AT OAKWOOD
HOSPITAL – WAYNE
When it’s time to come to the hospital,
we’d like you and the individual bringing
you to be aware of some important details
that will help ensure a smooth arrival.
Tips for Your Driver
Relatives or other individuals bringing
obstetric patients to Oakwood Hospital
– Wayne should follow this procedure:
1. D
rive vehicle to Emergency Room (ER)
entrance or West Lobby Entrance.
45
Lactation Education
Your nurse will show you how to
breastfeed your baby before you leave the
hospital. Please inform your nurse if you
are uncomfortable with your ability to
breastfeed your newborn. She is available
to address any of your questions and/or
concerns. If necessary, you can arrange
a personal consultation for additional
support and guidance by calling the
lactation department at Oakwood Hospital
– Dearborn at 313.593.5929.
note:
Refer to the “Breastfeeding” section
of this guide for more information.
Nursery Pictures
Your baby’s photo will be taken at the
hospital the morning after her birth. If
you desire your child to have a specific
outfit on in the picture, you should put
it in the crib that morning and notify
the Nursery nurse. Refer to the “Baby’s
First Picture” section of this guide for
more information.
FAMILY PANTRY
To help keep your family comfortable as
they await the arrival of the newest member
of their family, Oakwood Hospital – Wayne
offers a waiting area with comfortable
seating and a TV. We also offer a Family
Pantry area — a mini kitchenette that is
shared by the entire
maternity unit. It
offers
complimentary hot
and cold beverages,
snacks and basic kitchenette amenities,
such as a refrigerator, microwave oven
and coffeemaker. The pantry is accessible
24 hours a day.
2
note: The
Family Pantry is for the patient,
support person and immediate family.
A cafeteria located on the first floor is
available for other visitors who may want
to purchase something to eat or drink.
CAFETERIA HOURS
FOR YOUR VISITORS
The Oakwood Hospital – Wayne offers
a walk-in cafeteria and 24-hour access
to vending machines for your visitors to
grab a snack.
TOURS OF THE OB UNIT
We would love to show you our beautiful
Birthing Center. Please call 734.467.4266
to schedule a tour.
46
MATERNITY SERVICES OFFERED
AT OAKWOOD HOSPITAL –
SOUTHSHORE (OH-S)
The new Oakwood Hospital – Southshore
is a full-service community hospital
committed to providing excellent
healthcare for you and your family.
Our family-centered philosophy, combined
with our medical and technical expertise in
childbirth, will help ensure a safe and happy
birth experience for you and your family.
Location/Directions
Our address is:
Oakwood Hospital – Southshore
5450 Fort St.
Trenton, MI 48183-4625
734.671.3800
We are located at the intersection of
Fort St. and Vreeland Rd.
GIVING BIRTH AT OAKWOOD
HOSPITAL – SOUTHSHORE
When it’s time to come to the hospital,
we’d like you and the individual bringing
you to be aware of some important details
that will help ensure a smooth arrival.
Tips for Your Driver
Relatives or other individuals bringing
obstetric patients to Oakwood Hospital –
Southshore should follow this procedure:
1. D
rive vehicle to Emergency Room (ER)
entrance.
2. L eave obstetric patient in Emergency
Room area.
3. The patient will be transported to the
Second Floor, Maternal Care Unit.
4. P ark vehicle in Emergency Room parking
lot or Main Lobby parking lot.
Visitor Parking
Parking at the Oakwood Hospital –
Southshore is free. Your visitors may park in
the Emergency Room or Main Lobby
entrance parking lots.
What Happens Next?
Once you arrive in the Oakwood Southshore
Emergency Room, you will be taken to our
triage center. Once it is confirmed that you
are in labor, you will be taken to a private
labor-delivery-recovery (LDR) room. Your
support person may join you and remain
with you during all phases of labor, delivery
and recovery.
Labor-Delivery-Recovery Rooms
Our private LDR rooms are designed to
offer you an alternative to the standard
delivery room.
Here you’ll have all the comforts of home,
plus the added security of well-trained
hospital personnel and sophisticated
equipment. The LDR rooms allow you
to labor and deliver in one room. After
your baby is born, he can remain with
you in your room during your stay.
47
2
However, you have the option of
asking your nurse to care for your infant
in the nursery while you shower, take
a nap or sleep through the night, if
you wish. Normally, one nurse will take
care of both you and your baby during
your stay.
Transition Nursery
Once your infant arrives, she will be
evaluated in the nursery. This will include
a hearing screening. After evaluation,
your baby can stay with you in your room
as long as you want. At Oakwood Hospital
– Wayne, infants recover in the LaborDelivery Rooms, unless there is a c-section,
in which case the infant recovers in the
nursery.
Mother-Baby Unit
After your delivery, you may be transferred
to our Maternal Care Unit. In the Maternal
Care Unit, you will have a chance to get
to know your baby and ask us specific
questions regarding his uniqueness. The
nurses will provide care for you and will
also teach you many of the things you
will need to know
in order to begin
caring for your
baby and yourself.
Lactation Education
Your nurse will show you how to
breastfeed your baby before you leave
the hospital. Please inform your nurse if
you are uncomfortable with your ability to
breastfeed your newborn. She is available
to answer any of your questions and/or
concerns. If necessary, you can arrange
a personal consultation for additional
support and guidance by calling the
lactation department at Oakwood Hospital
– Dearborn at 313.593.5929. For further
details, refer to the “Breastfeeding” section
of this guide.
Nursery Pictures
If you choose to have your baby’s picture
taken, please dress them in the outfit of
your choice and our staff will gladly take
their pictures.
If you desire your child to have a specific
outfit on in the picture, you should put it
in the crib that morning and notify the
Nursery nurse. Read the “Baby’s First
Picture” section of this guide for more
information.
NEONATAL SUPPORT SERVICES
Occasionally, unexpected events may
happen in a newborn’s life, which require
advanced medical care. If a baby is born
48
prematurely
or develops
complications
that need
additional
medical supervision,
a “high-risk” pediatrician is available
24 hours a day. Should a baby require
more intensive care, he or she will
be transferred to the nearby NICU
at Oakwood Hospital – Dearborn,
where he will be under the expert
care of our neonatology team. Refer
to the “Neonatology Services” section
of this guide for more information.
PRE-REGISTRATION AT SOUTHSHORE
Pre-registration will help minimize
the amount of paperwork that needs
to be done when you are admitted.
Pre-registration may be completed online
at oakwood.org/womens-health.
Should you have any questions about your
upcoming admission, please contact the
Oakwood Hospital – Southshore Admitting
Department at 734.671.3828 or the
patient-account specialist at 734.671.3831.
49
CAFETERIA HOURS
FOR YOUR VISITORS
Oakwood Hospital – Southshore offers
a walk-in cafeteria for your visitors to grab
a snack.
TOURS OF THE OB UNIT
We would love to show you our beautiful
Birthing Center. Please call 734.671.3950
to schedule a tour.
3
CHAPTER 3
TIME TO GO HOME!
DISCHARGE INSTRUCTIONS
After your discharge orders have been
written, the following MUST occur before
you and your child depart from the hospital.
•M
others and babies both must have
discharge orders written by their
physicians.
• F ootprint sheet signed and ID bracelet
removed.
• B irth certificate must be completed.
•C
ircumcision, if applicable. If you desire
circumcision for your newborn son, he
will require additional observation and
you will need additional teaching.
• Infant cord clamp will be removed if
it is completely dry and not moist.
•N
ewborn screening and blood tests
required by the State of Michigan.
• P lease bring your baby’s car seat —
not the base — into the hospital before
discharge). The infant must be properly
secured in a car seat when leaving the
mother-baby unit.
•M
om’s discharge instructions will be
reviewed and signed. You will receive
a copy.
For further information regarding care
for you and your baby once you return
home, refer to the “Guide to Mother
and Infant Care” section of this guide
or your Patient Information Folder, given
to you at the hospital.
Your physician will give you specific
discharge instructions regarding your
activity, diet and self-care. Your physician
will answer any questions that you may
have at this time.
WHEN TO CALL MOM’S DOCTOR
Call your OB provider if MOM experiences
any of the following:
• F oul odor and drainage from episiotomy
• B leeding or drainage from
abdominal incision
• F ever and chills — more than 100.5° F
• S evere abdominal, chest or back pain
• Inflamed or tender breasts
• S hortness of breath
• S welling, pain, redness or
inflammation in one of your legs
•D
ifficulty urinating or burning
during urination
• The transport team will transport you
via wheelchair to your vehicle.
•D
izziness, light-headedness
or fainting
• After you arrive home, you may have
questions about you and your baby.
• R edness, warmth, separation
or foul odor at an incision site
50
• F eeling very sad, depressed, nervous or
anxious for more than two weeks, and/or
difficulty caring for self and/or baby
WHEN TO CALL BABY’S DOCTOR
Call your BABY’S provider if BABY
experiences any of the following:
• An underarm temperature above 99.5
or under 97.5 call MD (We discourage
rectal temperature-taking and only teach
underarm temperature-taking to parents.)
• B reathing problems
• Turning blue
•U
nusual rash
the first five days of life for a formula
fed baby or 3-4 seedy yellow stools per
day for a breastfed baby, by day 4
•M
om and/or dad’s emotions are
getting out of control and you are
worried about the safety of your child
OAKWOOD LACTATION
CENTER — BREASTFEEDING
INFORMATION
As professionals in the field of mother-baby
care, we understand that the birth of your
baby opens up a new world for women,
complete with joys and fears, questions
and concerns. One of the most sensitive
issues new mothers face is learning how
to breastfeed their babies.
STAFFED BY CERTIFIED CONSULTANTS
Certified lactation consultants staff the
Oakwood Hospital – Dearborn Lacation
Center. All have extensive experience
working with breastfeeding mothers and
are well prepared to help with questions
or concerns. Breast feeding mothers who
deliver at Oakwood Hospital – Dearborn
will be seen by a certified lactation
consultant after delivery.
•C
onstant crying or extreme fussiness;
high-pitched cry
•C
hange in normal daily habits (sleeps
a lot more or less; a good eater
becomes a poor eater; poor sucking)
• E xtreme lack of energy
•C
onstant cough
• Yellowness of skin or whites of eyes
•D
rainage from eyes, nose, cord or
circumcision area
• Vomiting more than the usual
spitting up
• Vomiting blood or blood in stool
• Watery stools (all of stool soaks
through diaper like urine) or not
having a stool at least once a day
51
PRENATAL SUPPORT
You don’t have to wait until after you have
your baby to visit the Oakwood Lactation
Center. We provide support throughout
your entire pregnancy by offering prenatal
breastfeeding classes and personal
consultations to prepare you before your
baby is born.
BREASTFEEDING
GENERAL INFORMATION
This section is intended to supplement the
breastfeeding education you will receive
during your postpartum stay. We encourage
you to attend the Breastfeeding Class,
as explained in the “Prenatal Education”
section, and to ask the nurses taking care
of you and your baby any questions you
may have. After you are discharged from
the hospital, you can call our Breastfeeding
Helpline with your breastfeeding concerns.
Breastfeeding Helpline
In addition to followup calls and personal
consultations, we have a Breastfeeding
Helpline staffed by the lactation consultants.
If you have any questions or concerns, you
can call the free helpline at 313.593.5929.
The helpline is answered:
Monday through Friday
8 a.m. to 2 p.m.
Personal Consultation Office Hours
Consultants are available at the Oakwood
Hospital – Dearborn campus. Please call
313.593.5929 to schedule an appointment
Monday through Friday.
Oakwood Personal Lactation
Consultant Fees
We also offer one-on-one consultations
for interested mothers.
• $ 55 for mothers who deliver their babies
within the Oakwood Healthcare System
• $ 70 for those outside of the
Oakwood system
• $ 30 for return visits
Breast Pumps
Oakwood Pharmacies with Medela
Breast Pumps for PURCHASE
®
Oakwood Hospital – Dearborn
313.593.7273
Oakwood Locations with Electric Breast
Pumps For RENT
Oakwood Hospital – Dearborn
313.593.7273
Breastfeeding Instructions
• B reastfeeding can begin immediately
following delivery. Colostrum is a thick,
yellowish-colored breast secretion that
is present during late pregnancy and for
24 – 72 hours after delivery. It is high in
protein and antibodies. These antibodies
help give the baby immunity to many
illnesses. The production of breast milk
follows the colostrum.
3
• Breastfeeding provides an opportunity for
physical and emotional contact with the
infant. During the first 24 – 48 hours,
try to feed your baby at least every two
hours. Mom should begin to monitor the
length of time between feedings. Time
from the beginning of a feeding to the
beginning of the next feeding should be
about two hours (e.g., The first feeding
starts at 1 p.m., so the next feeding should
begin on or before 3 p.m.). Interruptions
and distractions should be minimized.
• If your baby is sleeping when it is time
to breastfeed, you can try to arouse the
baby by opening her blanket, opening
the diaper to see if a change is needed.
Placing your baby skin to skin will
encourage your baby to wake up and
breast feed. Undress your baby down to
their diaper, placing them on your bare
chest and covering your baby with two
receiving blankets to keep them warm.
Soon you will be able to tell your baby’s
52
hunger signs: look for hand, eye and
mouth movements.
• It is very important to position your baby
properly (you and your baby should be
chest-to-chest) to prevent nipple soreness.
It is recommended that you change nursing
positions every few feedings.
• You should support your breast with
your fingers below the breast and your
thumb above. Your fingers and thumb
should not touch the areola (dark area
surrounding nipple).
• Gently touch your nipple to baby’s upper
lip repeatedly until he opens mouth wide,
then draw baby to breast.
• Make sure that the baby is grasping
most of the areola, not just the nipple.
• Try to nurse on both breasts at each
feeding, and begin each feeding on
the breast on which you ended the
previous feeding.
•Before removing the baby from the
breast, break suction on the nippple by slipping your finger into the corner of the baby’s mouth between the gums.
53
• Attempt to burp
your baby before
changing breasts
and at the end of
the feeding.
• You may notice an increase in uterine
cramping and vaginal discharge during
breastfeeding. This is normal.
• When showering or bathing, wash breasts
with a clean washcloth, using plain water.
Do not use soap.
• Wear a properly fitted supportive nursing
bra. Insert clean breast pads as needed.
Do not use an underwire bra.
• P lastic-lined breast pads have been
associated with sore and/or cracked
nipples and should therefore be avoided.
Breastfeeding Discharge Instructions
Once an adequate milk supply is established,
allow the infant to feed for 10 to 20 minutes
(or until infant has slowed swallowing)
on the first breast and for as long as
the infant desires on the second breast.
Limiting nursing time may frustrate the
infant and lead to engorgement.
BREAST MILK STORAGE GUIDELINES
(FOR A FULL-TERM, HEALTHY INFANT)
Breast Milk Storage Method
Length of Time Before Spoiling
Freshly pumped or room temperature
Up to 1 hour
Refrigerated (never been frozen)
Up to 48 hours
Freezer inside of a refrigerator
3 weeks
Freezer with a separate door
from the refrigerator
3 months
If milk is frozen in a separate
freestanding deep freezer
5 – 6 months
3
Indicators you can use to determine an
adequate intake of breast milk by your
baby include:
• B y day four, the baby’s urine should
be pale amber, and there should be
at least six to eight wet diapers in a
24-hour period.
• B y about day four, breastfed babies
should have at least three to four yellow
seedy stools each day. Some babies
pass a soft or liquid stool with each
feeding, while others have bowel
movements less frequently.
• S wallowing is heard as the baby nurses.
It may sound like a puff of air. Breasts
should feel softer after feedings.
Engorgement
On the third or fourth day after delivery,
the breasts may become hard, hot and
uncomfortable. This swelling and discomfort
is due to an abundance of breast milk and
other fluids. Early and frequent feedings will
help prevent engorgement. Sometimes it is
necessary to remove a small amount of
milk from the breasts in order to soften
the areola so that the infant can latch
onto the breast properly. To reduce the
swelling of engorgement, you can:
• Wear a supportive bra (no underwire).
• F eed your baby or pump every two hours.
To assist with milk let down prior to
feeding or pumping.
• If breasts are leaking, place warm
compresses on them or take a warm
shower for two minutes and/or massage
breasts for five minutes.
• If you are unable to express milk, apply
cool compresses (ice, bags of frozen
vegetables) no longer than 20 minutes.
We discourage using frozen cabbage.
Contact your physician regarding
acetaminophen or ibuprofen for pain.
Quick Tip! If you have any concerns
regarding your baby’s intake,
call the Breastfeeding Helpline at
313.593.5929 and/or baby’s doctor.
Helpful Tips
•D
rink to thirst and eat a wellbalanced diet.
•M
ilk is produced on a “supply and
demand” basis. Feed the baby on
demand, initially every two hours
(at least eight feedings in 24 hours).
• B reastfeeding is not an effective
means of contraception. You can
get pregnant while nursing.
Consult a physician when
breastfeeding ...
• B efore taking any medication
(over-the-counter or prescription).
Some medications can be passed
to baby through breast milk.
• If your breasts become red, warm
or tender, and fever or flu-like
symptoms develop.
54
• If nipples are cracked and bleed
while breastfeeding and/or pumping.
•N
ever prop the baby’s bottle because she
might choke as a result.
• If baby does not have at least six
wet diapers and three yellow seedy
stools each day by four days.
• B oth in the hospital and at home, discard
any unused formula in the bottle after
each feeding. Don’t store or add new
formula to the same bottle.
BOTTLE-FEEDING YOUR BABY
• Your infant’s physician may recommend
a specific formula for your baby.
•D
uring the first few days, most infants
take about 1.0 to 1.5 ounces at each
feeding. As the baby tolerates more
formula, advance feedings by 0.5 ounce
according to the infant’s needs (every
three to four hours).
• The bottle should be held so that the
nipple and the neck of the bottle are
kept full of formula. This helps prevent
the baby from swallowing air.
• If babies eat too much or too fast, they
may spit up. If this happens, slow down
the feeding by periodically removing the
bottle from the infant’s mouth and by
burping the baby more frequently.
• B abies should be burped after taking
each 0.5 to 1.0 ounce of formula. To
burp, infant may be placed on your lap
in a sitting position or in an upright
position over your shoulder.
55
• After discharge, prepare the formula
in accordance with the manufacturer’s
instructions.
• S terilization of bottles and nipples should
be done in accordance with instructions
from your infant’s physician.
•N
ever warm bottles in a microwave,
because heating is not uniform and may
result in hot spots or exploding bottles.
• P repared formula should be refrigerated
and used within the following time frames:
• Formula prepared from powder
should be refrigerated and used within
24 hours.
• F ormula prepared from concentrated
liquid or ready-to-use liquid should be
refrigerated and used within 48 hours.
• If a prepared formula bottle is
unrefrigerated (left out at room
temperature), it should be used
immediately.
• Always check expiration date on can
of formula.
•M
any formula companies offer clubs for
new parents. Check the manufacturer’s
Web site for money-saving coupons.
COLIC
About one-fifth of all babies develop colic,
typically between the second and fourth
weeks of life.
have someone else look after baby while
you take a break and leave the house.
No matter how frustrated you feel, never
shake your baby. Shaking may cause
blindness, brain damage or even death.
GUIDE TO MOTHER
AND INFANT CARE
All of us at Oakwood extend our sincere
congratulations on the birth of your little
one! Use the following mother and infant
care information as a guide during your
transition as a new mother. However, it
should not replace the instructions of your
healthcare provider.
3
Colic is defined as crying that is intense
and persistent (lasting more than a few
consistent hours). It generally occurs in
the evening hours and usually resolves
or improves during the day. It can be
accompanied by screaming, extending
or pulling up legs, gas and distended
stomach. As your baby matures, colic
generally stops by three months.
If you think your baby has colic, consult his
doctor to rule out any medical reason for
the crying. Your baby’s doctor may suggest
one or more of these ideas.
• If nursing, eliminate milk products,
caffeine, onions, cabbage and other like
foods from your diet. If bottle-feeding,
baby’s doctor might suggest using a
formula that does not contain cow’s milk.
• Walk your baby in a body carrier to
soothe her.
• R ock him gently in your arms.
• Introduce an orthodontic-friendly
pacifier to your baby.
• L ay your baby tummy down across your
knee and gently rub the baby’s back.
• Swaddle baby in a blanket.
• Take her for a ride in the car, with your
baby safely secured in her car seat.
• When you are feeling tense or anxious,
MOTHER CARE AFTER DELIVERY
Immediately after the delivery of your baby,
your body will begin working to return to
its prepregnancy state. Following is a list of
issues you can expect to experience as your
body goes through this natural process.
Nutrition and Breastfeeding
It is important to eat a well-balanced
meal with foods from all four food groups.
If you are breastfeeding, you will need to
add about 300 to 500 calories per day
to your diet in addition to what you were
eating before you were pregnant. Give
your body time to get back to normal
before worrying about shedding that
pregnancy weight. Remember if you are
56
breastfeeding, what you ingest may be
passed along to your baby in your breast
milk. Therefore, please contact your
provider if you have any questions about
what is safe. Your physician will advise you
regarding the use of vitamins.
Weight
Postpartum weight loss varies from woman
to woman, but a 10-pound weight loss after
delivery is about average. It may take up to
six months to return to your prepregnancy
weight. This is not the time to start dieting.
Consult with your healthcare provider before
trying to lose weight. If you want to diet
and are breastfeeding, it is best to wait
until your baby is at least three months old.
During those first two months, your body
needs to recover from childbirth and establish
a good milk supply. Breastfeeding helps to
deplete the fat deposited during pregnancy.
Women who nurse their infants burn about
500 more calories per day than those who
don’t. The woman who nurses her baby also
has increased needs for specific nutrients.
Rest Periods for Mom
After hospital discharge, try to have someone
to help with the cooking, housework and
care of other children, when possible. It is
important to get as much rest as possible
to aid in your recovery. A good rule of thumb
is to SLEEP WHEN YOUR BABY SLEEPS.
A full return to normal activity should be
restricted until at least six weeks. During this
time, you should rest as much as possible
and avoid strenuous work.
Constipation
To avoid constipation, an adequate fluid
intake, along with proper diet and exercise
(when permitted by your physician), are
important. Your physician may order a stool
softener while you are in the hospital. Be
aware that pain medication that contains
codeine can also be constipating.
Urination
The postpartum woman may find she is
urinating frequently and in large amounts.
This increased urinary output may last up
to five days.
Perspiration
Episodes of profuse perspiring, which
frequently occur at night, gradually subside
and do not require any specific treatment.
Postpartum perspiring can last as long as
three weeks.
Vaginal Discharge
Your uterus will shed its thick lining in a
discharge called lochia. This is similar to
the flow during a menstrual period. Initially,
the flow is red. After about three days, the
flow lessens and becomes a pale pink or
brown color. About 10 to 14 days (two
weeks) after the delivery, the flow will
turn a yellow-white color.
Fluid Intake
Nursing mothers should drink about 8 to
10 glasses of liquid (preferably water) per
day, avoiding caffeine. Non-nursing mothers
should also increase their fluid intake during
the postpartum period.
57
Return of Menstruation
If you are bottle-feeding, your menstrual
periods will usually return in six to eight
weeks after delivery. If you are breastfeeding, your periods may not return
for several months, possibly not until you
3
stop breastfeeding. Breastfeeding is NOT
a reliable source of birth control.
Episiotomy Care
A small incision may be made between
the vagina and the rectum to enlarge the
vaginal opening, so the baby can pass
through the birth canal more easily. The
episiotomy is repaired with stitches that
dissolve in about four to five weeks. While
in the hospital, the episiotomy site will be
checked daily by your nurse to ensure that
the incision is healing properly. During the
first 24 hours, an ice pack may be used to
decrease the discomfort and swelling of
the incision site. You may be given Tucks
pads (witch hazel) and Dermoplast spray
to decrease discomfort of the episiotomy
and/or hemorrhoids.
®
®
Sitz Bath
Your nurse will give you instructions on
how to use the portable sitz bath. Written
instructions from the manufacturer
are included. You should start using
it 24 hours after delivery. It is usually
recommended that a sitz bath be used
at least twice a day to promote healing
and to decrease the discomfort of sutures
and/or hemorrhoids.
Peri-Bottle
A peri-bottle is a plastic squeeze bottle used
to direct a stream of warm water over the
perineum (located near the vagina) each
time you urinate or have a bowel movement.
The bottle is held at a 45-degree angle
above and two to three inches away from
the perineum. Remember, the flow of water
should go from the front of the perineum
to the back.
Sanitary Pads
Sanitary pads should be changed often ­—
each time you use the bathroom, after
breastfeeding and whenever they are soiled.
Baby Blues
Sixty to 80 percent of new mothers
get the “baby blues.” Symptoms include
weepiness, irritability and fatigue (similar
to PMS symptoms) and are related to
shifting hormones. These symptoms can
last up to two weeks. If these symptoms
continue after two weeks, please consult
with your physician. Ten to 20 percent of
new mothers experience a more serious
reaction called postpartum depression.
Postpartum depression is treatable, so
call your OB provider if you think you are
experiencing any symptoms of depression.
Symptoms can include fatigue, hopelessness,
58
irritability, sleep or appetite disturbances,
poor concentration, confusion, agitation
and being overly concerned for the baby.
If you should experience feelings of
harming yourself or your baby, go to the
emergency department immediately.
a reddened area with a yellow or white
raised center. About 30 percent of newborns
will develop a red bumpy rash on their
face. It is normal in newborns and will
disappear without treatment after a few
weeks or months.
INFANT CARE AFTER DELIVERY
Diaper Rash
Diaper rash often may be avoided by
changing the infant’s diaper as soon as
possible after each bowel movement or
urination. When soiled, cleanse diaper
area with very gentle soap and water
or infant diaper wipes. If a diaper rash
should develop, many physicians will
recommend using soothing products,
such as Desitin or A+D Original
Ointment. If a diaper rash persists or
becomes severe, contact your physician.
Skin Care
• When bathing, use a mild soap on
infant’s body only; wash face with plain
water. Powder, oils and creams are
not recommended.
®
®
Mongolian Spots
Mongolian spots are dark blue or purple
irregular spots usually located on the lower
back and/or buttocks of dark-skinned infants
of all races. These marks will disappear or
lighten within the first four years on their
own. Not all spots disappear.
Milia
Milia are tiny oil glands that are pinheadsized white spots mainly on the infant’s nose
and/or chin. Do not pinch the spots or apply
any harsh chemical or special soap. They
disappear spontaneously within a few weeks.
Erythema Toxicum
Erythema toxicum, also called newborn
rash, is a temporary rash that appears as
•D
ry, peeling skin is common for most
babies. If your baby’s skin is very dry, you
can use small amounts of nonperfumed,
hypoallergenic lotions, although peeling
may continue. If you see deep cracks in
the skin, petroleum jelly works best on
those areas.
• Jaundice is the yellow color to the skin
that is often seen in the first few days
after birth. The yellow color is due to
high amounts of bilirubin in the blood.
It usually reaches the greatest intensity
at two to four days of life. Please see
your baby’s physician should visible
jaundice increase after he has been
discharged from the hospital.
Sleeping
Most newborns sleep at least 16 hours a
day, though some sleep more and some will
sleep less. As your baby grows older, the
amount of sleep required will decrease. You
may encourage longer periods of sleep at
night by keeping your baby awake in
the evening.
HOW MUCH SLEEP BABIES AND TODDLERS NEED
59
Age
Hours
When
1 week
16 ⁄2Anytime
1 month
151⁄2Anytime
3 months
15
6 months
141⁄4101⁄2 at night, 33⁄4 during the day (3 naps)
9 months
14
12 months
13 ⁄4101⁄2 at night, 31⁄4 during the day (1 – 2 naps)
18 months
13
101⁄2 at night, 21⁄2 during the day (1 – 2 naps)
2 years
13
101⁄2 at night 21⁄2 during the day (1 nap)
1
10 at night, 5 during the day (3 naps)
101⁄2 at night, 31⁄2 during the day (2 – 3 naps)
3
The safest sleeping position for your
baby is on the back — NOT on the
stomach. Sleeping on the stomach
increases the chance of sudden infant
death syndrome (SIDS). Do not put any
thick blankets or stuffed animals in the
crib with the baby while she is sleeping.
It is not recommended that baby sleep
in the same bed with mom and/or dad.
3
In fact, recent studies found that the
risk of baby’s suffocating is 40 times
Safe Sleep Recommendations
• In a crib, portable crib or bassinet, the
mattress should be firm and tight-fitting.
Only a tight-fitting sheet should cover
the mattress.
• Always place your baby on their back
to sleep, even when they can roll over.
•D
o NOT place anything in the sleep area
(no pillows, blankets, comforters, soft
bumper pads, stuffed animals or toys).
• K eep your baby’s face uncovered during
sleep for easy breathing. Use a wearable
sleeper or sleep sack to keep the baby
warm and safe.
•D
o NOT smoke while you are pregnant
and do not expose your baby to secondhand smoke after they are born.
•D
o not overheat the baby by dressing him
or her in too much clothing or keeping the
room too warm.
•U
se a pacifier at nap and night time for
the first year. If you are breast feeding,
delay pacifier use until good breast
feeding has been established (usually
about one month).
• Allow for “tummy time” daily when your
baby is awake and alert and you are
watching them. If your baby falls asleep
on their tummy, place them on their back
in a safe place.
higher if she sleeps in a bed with an
adult rather than a crib. Also, keep
the baby’s room on the cool side for
sleeping (67° to 71° F).
Cord
• The infant cord clamp will be removed
if it is completely dry and not moist. You
likely will be advised to apply a cotton ball
dipped in alcohol to the stump at least
once or twice daily. Your physician will
instruct you if he wishes you to care for
the cord in a different way.
• The infant’s diaper should be folded
below the cord, to prevent rubbing and to
promote drying. The skin around the cord
should not be red, swollen or inflamed.
There should be no yellow, green or
foul-smelling drainage from the cord site.
Report any of these signs of infection to
baby’s physician. The
cord usually falls
off in ten days to three
weeks. There may be
a few drops of blood
on the diaper when
the cord falls off. Don’t
worry; this is a normal
occurrence for newborns.
A sponge bath can be given until the cord
falls off and the area is healed.
60
•D
on’t be afraid to touch or move the cord;
this will not hurt your baby. Your baby may
fuss only because the alcohol feels cold.
The cord usually falls off in approximately
two weeks. Notify your baby’s doctor if
it hasn’t fallen off by one month after
delivery.
• Anterior Fontanel: The “soft spot”
is found on the top of the head, near
the forehead. It is present to allow
the brain to grow rapidly during the
first year of life. This area normally
closes over with bone between nine
and 15 months of age.
Head
•M
olding: During the birth process, to
pass more easily through the birth canal,
the head is molded due to the overriding
of its soft, moveable bones. This molding
often creates a temporarily elongated
head. The normal shape of the head is
usually regained after several weeks.
Thrush
Some babies develop a yeast infection
in the mouth known as thrush. The baby
will have white patches in the mouth,
on her tongue and/or inside the cheeks.
These white patches may appear to be
formula but will not be easily removed.
Contact your baby’s physician if you are
unsure. If you are breastfeeding, contact
your OB physician as well, because you
will need to be treated also.
• F acial Asymmetry: The uneven
appearance of the face of some infants
is caused by the position of the baby
before birth. The lopsided appearance
usually disappears spontaneously in a
few weeks.
•C
ephalhematoma: Occasionally,
a black and blue discoloration and
swelling will be noted on the infant’s
head several hours after birth. This is
above the skull bones and does not
affect the brain. This cephalhematoma
takes a few weeks to disappear.
61
Burping
Burping your baby helps to remove any
swallowed air from his stomach. You can
burp your child in the middle and at the
end of the feeding, or just at the end,
depending on how he is doing with
feeding. To burp your baby you can either
place him face down across your lap or
you can put his head on your shoulder.
Then rub or pat his back. It is not unusual
to see a small amount of spitting up when
the baby burps.
Crying
Crying is your baby’s way of saying she is
hungry, tired, wet, too hot or cold, bored
or frustrated. You may learn what each cry
means for your baby.
Nails and Ears
Most babies need their nails cut or filed
soon after birth. After you get home, you
can trim your baby’s nails. You can use a
soft emery board or baby manicure scissors
with rounded tips. A good time to do this
is when the baby is sleeping. Nails should
be cut straight across (not rounded at the
edges) to prevent infection. Clean your
infants’ ears with a corner of washcloth —
never use a cotton-tipped swab.
Eyes
•D
rainage: The eye treatment given to
the baby shortly after birth occasionally
may irritate the infant’s eyes and result
in some lid swelling or eye discharge.
This usually lasts only a day or two
and does not require treatment. When
cleaning the infant’s eyes, wipe from the
inside to the outside of the eye, using a
clean area of the washcloth for each eye.
•M
ovements: Infants can see quite well
at 12 to 18 inches. They can follow a
face for a short distance after they have
focused on it.
• Subconjunctival Hemorrhage:
Occasionally a small, curved, reddened
area may be seen in the whites of the
eyes as a result of the birth process. This
is common and of no significance. The
redness usually disappears within a
week to 10 days. After discharge from
the hospital, if your baby develops a
yellow or greenish eye discharge, contact
your physician.
•C
olor: Some babies will be born
with either blue, brown or gray eyes
depending on their skin color. Final eye
color is not certain until the child is at
least six months old.
3
Stools
The dark, thick, tar-like
substance in
the newborn’s intestinal
tract is called meconium.
The baby will usually
have this type of stool
during the first several
days of his life. The stool will then begin
to turn a brownish-green color and by
the fourth or fifth day will be a yellowish
color. Breast-feeding babies normally have
frequent, yellow, seedy stools that have
little odor. Formula-fed infants have more
of a formed stool than breastfed babies
and usually have fewer bowel movements,
about once or twice a day. Notify your
baby’s doctor if baby seems to strain
uncomfortably when passing a stool.
Genitalia
• Female: Baby girls often have swollen
labia and may have a white mucous
discharge from the vagina for several
days after birth. Occasionally the
discharge is blood-tinged from the
effects of the mother’s hormones and
is of no concern.
•U
ncircumcised Male: When cleaning
baby boys, be sure to lift the scrotum
and penis and remove any stool. No
special care is needed for the newborn
uncircumcised infant. Do not retract the
foreskin. Your physician will instruct you
when the foreskin can be retracted when
the infant is older.
62
sleeping. NEVER put
an infant to sleep on
her stomach. Your
infant should never be
left unattended on any
surface from which
she might fall (such as a changing table).
Remember, your baby needs “tummy time”
everyday while she is awake. This helps her
back and abdomen muscles develop equally
and to reduce the likelihood for the head
to develop a flat spot from always lying on
her back.
•C
ircumcised Male: Wash the
circumcised penis by gently sprinkling
soapy water over the penis followed by
clean rinse water. Typically you will be
advised to apply petroleum jelly and
a gauze pad to the penis after each
cleaning and/or diaper change for a
few days. A yellow substance may form
on the tip of the penis and is part of
the healing process. If your baby had a
plastic ring applied to his penis during
circumcision, it usually drops off five to
eight days after the circumcision. Notify
baby’s doctor if the ring does not fall off
after 10 days.
IMMUNIZATION SCHEDULE
Below is a commonly used immunization
schedule. Discuss needed immunizations
with the baby’s physician. Please visit http://
www.immunize.org/cdc/schedules
for the most current and detailed
immunization schedule.
Nose
The bulb syringe is used to remove
secretions from the infant’s nose and
mouth. Your nurse will instruct you
in its use.
Infant Safety
After discharge from the hospital, your
infant should be placed on her back while
DEPARTMENT OF HEALTH AND HUMAN SERVICES • CENTERS FOR DISEASE CONTROL AND PREVENTION
Recommended Immunization Schedule for Persons Aged 0-6 Years – UNITED STATES 2012
Age 
Vaccine 
Hepatitis B
Rotavirus
Birth
HepB
1
2
4
6
9
12
15
18
19–23
2–3
month months months months months months months months months years
HepB
4–6
years
HepB
RV
RV
RV
Diptheria, Tetanus,
Pertussis
DTaP
DTaP
DTaP
Haemophilus
influenzae type b
Hib
Hib
Hib
Hib
Pneumococcal
PCV
PCV
PCV
PCV
Inactived Poliovirus
IPV
IPV
DTaP
DTaP
PPSV
IPV
Influenza
IPV
Influenza (Yearly)
Measles, Mumps,
Rubella
Varicella
Hepatitis A
MMR
MMR
Varicella
Varicella
HepA Dose 1
Meningococcal
HepA Series
MCV4
Va
M
s
Range of recommended
ages for all children
Range of recommended ages for
certain high-risk groups
Range of recommended ages
and certain high-risk groups
Visit http://www.cdc.gov/vaccines/recs/schedules for up-to-date immunization information.
63
DEVELOPMENTAL MILESTONES
FOR YOUR CHILD
By 18 months, most infants:
•C
an walk alone
Each child varies in speed of achieving
certain milestones. Average development
for an infant or toddler is as follows:
•D
rink from a cup
By 3 months, most infants:
•M
ake cooing sounds
• S mile back at you
• R espond to sounds
•M
ove limbs symmetrically
• L ift head and chest when
lying on stomach
By 6 months, most infants:
• R oll over
• S ay 5 – 10 words
• S cribble with crayons
•C
an stack 2 blocks
By 24 months, most infants:
• K ick large balls
• S ay 2 – 3 word sentences
•C
an climb steps
• Turn pages in a book
• S it with a little help
By 36 months, most infants:
• Walk up stairs
• B abble — make 2 sounds
• Wash and dry hands
• Transfer objects from hand to hand
• R ide a tricycle
• Turn their head toward sound
•O
pen doors
By 9 months, most infants:
• S it alone
• Verbalize toilet needs
•C
rawl
• S ay mama or baba
3
• P oint to familiar objects
Please contact your child’s physician
if you have concerns regarding baby’s
development.
• F eed self with fingers
• R espond to their name
By 12 months, most infants:
• P ull themselves to
a standing position
• Walk with support
• S ay 2 – 3 words
• Wave bye-bye
• F ollow simple directions
64
FEEDING SCHEDULE
The following is an example feeding
schedule for the introduction of food.
There is some variability in advice among
physicians and recommendations may
vary with individual circumstances.
Between four to six months is the ideal
time to begin introducing solid foods to
your infant. Food should not be introduced
until a baby is at least 4 months old
unless specifically directed by your baby’s
physician. It may take a few days for your
infant to become accustomed to the
texture and taste of food.
Remember, the amounts shown below are
simply averages. You should always seek
the advice of your baby’s physician if you
have specific questions.
1– 4 Months:
• B reast milk (preferable) or formula
with iron
• B reastfed newborns need to eat 8 to
12 times in a 24-hour period (usually
once every 1.5 to 3 hours) with one
longer interval of 4 to 5 hours
•N
ewborns will generally feed about
20 minutes on each breast
4 Months:
• B reast milk (preferable) or formula
with iron
• Infant cereal (start with rice), 2 – 4
tablespoons (25 – 50 grams) per day.
Add breast milk or formula to the
cereal. Use a spoon. It’s best to wait
until 12 months of age to introduce
wheat-based cereals
• Wait 4 – 5 days and then go to a
different variety of cereal (oatmeal,
barley)
6 – 7 Months:
• B reast milk (preferable) or formula
with iron
•C
ereals: (oatmeal, rice, barley) average
4 – 6 tablespoons (50 – 75 grams)
per day
• Vegetables: average 4 – 6 tablespoons
(50 – 75 grams) per day. Begin with
yellow and orange vegetables, then
proceed on to other vegetables and
noncitrus fruit
SAMPLE FEEDING SCHEDULE FOR FORMULA-FED BABY
65
Age
Amount Per Feeding
Feeding Frequency
Newborn
2 – 3 ounces
On demand
1 month
4 ounces
Every 3 to 4 hours
2 months
4 – 6 ounces
6 to 7 feeds every 24 hours
4 months
6 – 8 ounces
4 to 5 feeds every 24 hours
6 months
8 ounces
3 to 4 feeds every 24 hours
9 months
8 ounces
3 to 4 feeds every 24 hours
1 year
Can replace formula with whole milk
3
• F inger foods, such as crackers or teething
biscuits, may be started
• K eep a bottle handy. A mouthful of dry
snacks can cause a choking incident
• F ruit or fruit juices: average 2 – 4
tablespoons (20 – 25 grams) of fruit
and 2 ounces (60 mL) of noncitrus
juice per day
• Introduce baby to a “sippy” cup
9 – 10 Months:
• B reast milk (preferable) or formula
with iron
•C
ereals: average 6 – 10 tablespoons
per day
• Vegetables: average 10 – 12 tablespoons
per day
• F ruit: average 6 – 10 tablespoons
per day
7 – 9 Months:
• B reast milk (preferable) or formula
with iron
• J uice: 4 ounces per day
•C
ereals: average 6 – 10 tablespoons
per day
• S tarches (potato, rice, noodles, spaghetti):
1
⁄4 cup a day
• Vegetables: average 6 – 10 tablespoons
per day
• F inger foods, such as Cheerios , cheese,
smooth yogurt
•N
oncitrus fruit: average 6 – 10
tablespoons per day
• J uice: 2 ounces (60 mL) per day
• E gg yolk (whites after 1 year of age)
scrambled with breast milk or formula
at an average of 2 tablespoons per day
• F inger foods such as crackers, teething
biscuits, bananas or toast
• P uréed meat: 1 – 4 tablespoons
• E gg yolk: on average 1 egg per day
• P uréed meat: 1 – 4 tablespoons
®
10 – 11 Months:
• B reast milk (preferable) or formula
with iron
•C
ereal: average 8 tablespoons per day
• Vegetables: average 12 – 14 tablespoons
per day
• F ruit: average 7 tablespoons per day
• J uice: average 4 ounces per day
66
• E gg yolk: average 1 egg per day
• R aisins
•M
eat: average 1 ounce ground meat
per day
• Whole peas and corn
• Starches, such as potato, rice, noodles,
and spaghetti, at an average of 1⁄4 cup
per day
• F inger foods, such as cheese, cottage
cheese, Cheerios and smooth yogurt
®
•C
ontinue use of a “sippy” cup
1 Year:
• B reastfeed as long as you and your
baby are comfortable
• F ormula can be replaced with whole milk
(supplemented with vitamin D)
• Any healthy food is
usually fine as long as
a child cannot choke on
it. Keep a balanced diet
•C
ontinue to wean baby
from bottle to “sippy”
cup. The goal is to be
fully weaned by 15
months of age
Be sure to avoid potential CHOKING
HAZARDS, such as:
• P opcorn
• Whole grapes and olives
• P eanut butter
• Sausage/hot dogs
• Raw carrots or celery
•N
uts
• Jelly beans
•H
ard candies
• Apple chunks
•C
heese cubes
• Untoasted bread
•G
um
• Ice cubes
•M
arshmallows
67
These items should be avoided until your
baby’s doctor advises you that these items
are safe.
Also, many physicians may recommend
that you wait until your baby is at least
12 months old to feed him foods that
could cause an allergic reaction. Common
foods in this category are:
• E gg whites
• Wheat
• Corn
• S oy products
•C
itrus products (such as orange and
lemon juice)
• Dairy products (including milk)
• F ish
• S hellfish
• P eanuts and peanut products
• Tree nuts
• F resh strawberries
CHILD SAFETY
BABYPROOFING YOUR HOME
Over two million children are injured or
killed by hazards in the home each year
across the country. Many of these incidents
can be prevented by using simple childsafety devices (see suggestions below).
But remember that no device is completely
childproof and that the best protection is
to watch your child closely at all times.
• S afety latches and locks (placed on
cabinets and drawers). These help prevent
children from gaining access to medicines
and household cleaners, as well as knives
and other sharp objects
• B uy a crib that meets current safety
standards, including slats no more than
23⁄8 inches apart. Cribs built after 1985
should meet this standard. Be sure
your crib has not been recalled. New
federal safety standards prohibit the
manufacturing or sale of drop side rail
cribs. Drop side rail cribs have been
associated with infant suffocation and
strangulation deaths. Please consider
getting a new crib for your baby. If
that is not possible, the AAP and
CPSC encourage you to check the crib
frequently to be sure all hardware is
secured tightly and that there are no
loose, missing or broken parts.
•N
ever put a baby to bed with a bottle
since it’s possible she could choke
• S afety gates. These keep children away
from stairs and rooms that have hazards
in them. Do not purchase accordion-style
gates, however
• Window-blind cord shortener. Use on any
window-covering cord to help prevent
strangulation from the loop of the cord
(especially if you have a window near
the crib)
•D
oor stops and door holders. Help
prevent small fingers from being pinched.
Make sure the rubber end of the door
stop is securely fastened and cannot
be removed (choking hazard)
•C
ooktop/stove protectors. Knob covers
and stovetop shields help prevent burns
• Toilet lock. Prevents child from obtaining
access to the toilet (for drowning and
sanitation purposes)
• L earn how to introduce your baby to
your pet(s)
• P rominently display the number of Poison
Control Center (800.222.1212)
• WATCH YOUR BABY! The best defense
is to watch your baby closely at all times
•D
oorknob covers and door locks
MEDICINE CABINET
• Anti-scald measures. Set water heater no
hotter than 120° F to prevent burns from
hot water. A bath thermometer ensures
bath water is a safe temperature (or use
your wrist to check temperature before
placing child in the tub). Never fill the
tub while the baby is inside. Keep your
child away from hot beverages (don’t
hold your baby while also drinking a
cup of coffee)
• S moke and carbon monoxide detectors.
Essential safety devices for protection
against fire-related injuries and furnace
malfunctions. Alarms can double your
chance for survival
• Window guards and safety netting. These
prevent falls on balconies and decks
•C
orner and edge bumpers. Use on tables
and fireplace hearths to soften falls
•O
utlet covers or plates. Protect children
against electrical shock. Watch children
to make sure they do not remove
individual plug covers
3
It is important to contact your baby’s
physician before giving any medication.
The following is a list of items that you
might want to have readily available:
• Infant/children’s acetaminophen (such as
Tylenol ) or ibuprofen (Advil , Motrin )
®
®
®
Caution: In May 2011, a move to one
standard concentration of acetaminophen
(160 mg/ 5 ml) medication for infants and
children was announced. Up to this point,
two concentrations have been available
(children’s syrup and infant drops). Both old
and new concentrations may be found on
store shelves and in homes. Please double
check packaging carefully to find the
correct concentration and dosage or contact
your physician before dosing your child.
Never give any medication without your
physician’s permission.
• R ehydration fluid (such as Pedialyte ) for
treatment of diarrhea and/or vomiting
®
•D
igital thermometer
68
• Antibiotic cream for scrapes, etc.
(such as Bacitracin or Neomycin )
®
®
•H
ydrogen peroxide (for cleaning cuts)
•C
alamine lotion for itchy rashes
• R ubbing alcohol, to clean thermometers
and to dab on umbilical cord
•C
alibrated spoon or dropper for
administering medicine (important to
clean thoroughly with soap and water
after each use)
• P ABA-free sunscreen (high SPF)
• S terile, easy-release bandages
•N
asal aspirator (bulb) to clear a
stuffy nose
• B aby teething-pain reliever gel
•O
ther items as recommended by
your baby’s doctor
69
GLOSSARY OF TERMS
AFTERBIRTH The vascular structure
developed in pregnancy through which
nutrition and excretion takes place
between mother and baby. Also
known as the placenta.
AFTERPAINS The cramping discomfort
felt by some women after the birth of a
child, which is caused by contractions of
the uterus.
AMNIOCENTESIS Procedure to screen
for Down’s syndrome, trisomy 18 and
other chromosomal abnormalities.
AMNIOTIC FLUID The water-like fluid
contained in the amniotic sac (bag of
water) surrounding the baby. It permits
movement of baby, absorbs shock and
prevents loss of heat.
ANALGESIA Relief of pain without loss
of consciousness.
ANESTHESIA Loss of sensation in part
or all of the body.
ANESTHESIOLOGIST Physician who
specializes in administering local and
general anesthetics to produce varying
types of anesthesia.
ANTEPARTUM The period of pregnancy
from conception to birth.
ute and five minutes of age. A rapid
assessment is made of color, respiratory
effort, heart rate, muscle tone and reflexes.
AREOLA The pigmented tissue around
the nipple.
BLADDER An organ that collects and
discharges urine.
BRAXTON-HICKS CONTRACTIONS
Intermittent, irregular, painless contractions
of the uterus occurring after the third
month of pregnancy, which do not establish a pattern of regularity. They may be
unnoticeable until near your due date.
CATHETERIZATION Emptying of the
bladder by insertion of a small, pliable
tube through the urethra.
CENTIMETERS Unit of measure used
to describe progression in dilation of
the cervix.
CERVIX The neck of the uterus (womb),
which thins (effaces) and opens (dilates)
during the labor process.
CESAREAN SECTION Surgical removal
of the baby through the abdominal and
uterine walls.
ANUS Outlet of rectum located directly
behind/below the birth outlet.
CHLOASMA Areas of pigmentation that
sometimes appear on the cheeks and
forehead of the pregnant woman. Also
called “mask of pregnancy.”
APGAR Numeric expression describing
the condition of the newborn at one min-
CIRCUMCISION Surgical removal of the
foreskin of the penis.
70
COCCYX Tailbone. The small bone at the
end of the spinal column.
COLOSTRUM The first secretions of
the breast that may be expressed during
pregnancy and a few days after delivery
until milk comes in. It has a high protein
content and provides some immunity
properties for the baby.
COMPLETE Refers to complete dilation
of the cervix. A woman is said to be
complete when the cervix is dilated to
10 centimeters. In terms of inches, the
completely dilated cervix usually measures
about four inches in diameter.
CONTRACTION Tightening and shortening
of the uterine muscles during labor causing
effacement and dilation of the cervix and
contributing to the downward and outward
descent of the baby.
CROWNING Appearance of the presenting
part of the baby at the perineum during
the second stage of labor.
DELIVERY Expulsion, or birth, of the fetus
with the placenta and membranes from
the mother.
DILATION Gradual opening and drawing
up of the cervix to permit passage of
the baby.
EDC Expected Date of Confinement
(due date).
EFFACEMENT The flattening or thinning
and shortening of the cervix during labor.
EMBRYO The developing infant from
conception to the end of the eighth week.
ENDOMETRIUM The mucous membrane
that lines the uterus.
ENGAGEMENT The entrance of the
presenting part of the fetus into the
pelvic cavity.
ENGORGEMENT An excessive fullness —
usually referring to the breasts at the time
a nursing mother’s milk comes in.
71
EPISIOTOMY An incision made into
the perineum prior to delivery to enlarge
the opening of the vagina for delivery
of the baby.
FALLOPIAN TUBES The two small tubes
extending from either side of the uterus
toward the left and right ovary. These
tubes receive the ripened ovum from the
ovary. Fertilization occurs here.
FALSE LABOR Irregular uterine contractions
that are not associated with progressive
stages of labor.
FERTILIZATION Fusion of the sperm
and ovum normally occurring in the
fallopian tubes; conception.
FETAL HEART TONES (FHT) The baby’s
heartbeat as heard through the abdominal
wall in the later part of pregnancy.
FETUS The developing infant from the
ninth week after fertilization through
the 40th week or until birth.
FOCAL POINT A tool used during labor,
which enables the laboring patient to
externalize her attention, thereby reducing
perception of pain.
FONTANEL Soft spot on the head of
all newborn babies, which allows for
the molding necessary during birth.
FORCEPS Obstetrical instrument used
occasionally to aid in delivery.
FUNDUS The portion of the uterus
farthest from the opening.
GBS Group B Streptococcus (GBS) is a
type of bacteria present in the vagina or
digestive tract in about 20 percent of
pregnant women.
GESTATION The condition or period
of carrying a baby in the uterus.
GLUCOSE SCREEN Test given to pregnant
women between weeks 24 and 28 to test
for gestational diabetes.
GRAVID Pregnant.
GROUP B STREPTOCOCCUS (GBS)
This is a type of bacterium that is present
in the vagina or digestive tract in about
20 percent of pregnant women. Usually
the bacteria do not cause serious illness;
however, they can be passed on to the
fetus during delivery.
HEMORRHOIDS Varicose veins of
the rectum.
HYPERVENTILATION Over breathing
resulting in an increased amount of air
and a reduction of the carbon dioxide level.
IMPLANTATION The attachment of the
fertilized ovum (egg) to the uterine wall.
INDUCTION Initiation of labor by the
use of medications.
INVOLUTION Return of the female organs
to their non-pregnant state after delivery.
It takes approximately six weeks.
IV Hospital abbreviation for intravenous.
To give a sterile fluid into a vein for the purpose of nutrition, hydration or medication.
JAUNDICE The yellow color to the skin
that is often seen in the first few days
after birth. The yellow color is due to
high amounts of bilirubin in the blood.
LIGHTENING The relief of pressure
upon the diaphragm and upper abdomen
as a result of the descent of the presenting
part of the fetus into the pelvic cavity.
May occur from two to three weeks
before the onset of labor.
LINEA NEGRA A dark pigmented line
extending upward along the middle
of the abdomen, found frequently in
pregnant women.
LOCHIA The vaginal discharge of blood
and mucus following the delivery of the
baby. It becomes paler and diminishes in
quantity and finally ceases.
MATERNAL SERUM SCREENING
Screening available in the first or second
trimester of pregnancy to evaluate risk of
Down syndrome, trisomy 18/13, and spina
bifida.
MECONIUM The dark green or black
substance present in the baby’s large
intestine at birth that the baby passes
for the first few days of life.
MOLDING The shaping of the baby’s
head to adjust itself to the size and
shape of the birth canal.
LABOR A three-stage process of childbirth.
OBSTETRICS Branch of medicine covering
care of women in pregnancy, childbirth
and postpartum.
FIRST STAGE OF LABOR From onset
until the cervix has thinned (effaced)
and opened (dilated) to 10 centimeters.
OVARY The female glands of reproduction in which the ovum is developed
and released.
SECOND STAGE OF LABOR From full
dilation of the cervix to birth of the baby.
OVULATION Monthly release of ripe
ovum from the ovary.
THIRD STAGE OF LABOR From delivery
of the baby to delivery of the placenta.
OVUM The female egg cell.
LACTATION Process of producing and
supplying milk.
LET-DOWN REFLEX The baby’s sucking
causes the release of a hormone and results
in muscle contractions that force milk into
the ducts leading to the areola and nipple
area of the breasts; milk is let down.
OXYTOCIN Drug useful in starting or
aiding in labor. Also used to stimulate
uterine contractions.
PARA The term used to refer to past
pregnancies that have produced a viable
infant whether or not the infant survived.
72
PELVIS The bony ring that joins the
spine and legs. Its central opening forms
the walls of the birth canal.
PERINEUM External tissues surrounding
the anus and vulva.
PLACENTA The vascular structure developed in pregnancy through which nutrition
and excretion takes place between mother
and baby. Also known as the afterbirth.
POSTMATURE Infant born at the beginning
of the 43rd week of pregnancy or later.
POSTPARTUM Following childbirth,
usually referring to the first six to eight
weeks after delivery.
PREMATURE INFANT An infant born
before the 37th week of gestation.
PRENATAL Before giving birth.
PRESENTATION The part of the baby’s
body that appears at the cervix at the
beginning of labor.
PRIMIPARA Woman having her first baby.
PUERPERIUM The period from delivery
until the uterus has regained its normal
size — usually about six weeks.
QUICKENING The first feeling by the
mother of fetal movement, usually occurring between the fourth and fifth month
of pregnancy.
RH FACTOR An additional blood factor
that is present in 85 percent or more of
the population. When it is absent, the
person is said to be Rh negative.
Rho GAM An injection given to certain
mothers at 28 weeks of pregnancy AND
within 72 hours after a birth, miscarriage
or amniocentesis to prevent Rh sensitization in mother.
SHOW A blood-tinged discharge from
the vagina prior to labor.
73
SPERM A spermatozoon, the mature
male cell.
STATION Term used in labor to denote
position of baby relative to mother’s
bony pelvis (a measurement of the
progress of labor).
STRIAE GRAVIDUM White lines seen in
the skin of the abdominal wall and, at
times, in the upper thighs and breasts of
the pregnant woman.
TERM Completed cycle of pregnancy.
TRANSITION The shortest and most
difficult phase of the first stage of labor.
It is characterized by long and strong
contractions.
TRIMESTER A stage or period of three
months duration.
UMBILICAL CORD Cord connecting
umbilicus of baby to placenta.
UMBILICUS Naval, belly button.
URETHRA A tube that carries the urine
from the bladder to the outside of the body.
UTERUS Organ of gestation — consists
of a pear-shaped fundus and a narrower,
lower portion called the cervix or neck.
VAGINA The curved canal, five or six
inches long, from the vulva to the uterus.
VERNIX CASEOSA A cheesy substance
covering the skin of the baby. It provides
protection and lubrication of the baby’s skin.
VERTEX Top or crown of head.
VIABLE Applies to the child at birth or
at the point in fetal development when
there is a possibility of survival outside
the uterus.
OAKWOOD TELEPHONE NUMBERS
Apnea Clinic for Infants & Children
313.593.7135
Infant Bereavement
Breast Pumps (Electric) for Rent
734.467.5588
Oakwood Hospital & Medical Center
Oakwood Hospital & Medical Center
313.593.7273
313.593.7167
Breast Pumps (Medela) for Purchase
Oakwood Southshore Medical Center
Oakwood Hospital & Medical Center
313.593.7273
Car Seat Checks
313.586.5488
Center for Exceptional Families
(program for children with special
developmental needs)
313.966.1960
Development Assessment Clinic (DAC)
for Infants and Children
313.593.7135
Oakwood Annapolis Hospital
734.671.3950
Lactation Center (Breastfeeding Helpline)
313.593.5929
Michigan Perinatal Associates, P.C.
313.593.5957
Midwest Medical Center – Dearborn
313.581.2600
“New Mom” Blues Program
313.436.2932
Oakwood Annapolis Hospital
Durable Medical Equipment
800.752.2273
Administration
Fetal Diagnostic Unit
313.593.7521
Admitting
Foundation
Billing and Patient Accounting
(to make a donation to Oakwood)
734.467.4161
313.586.5234
Cafeteria
Genetic Counseling
313.593.8483
734.467.4179
Our 365
734.467.4000
(baby pictures)
800.433.0855
Health Link Emergency Transportation
313.292.9981
Home Health Care Services
800.757.7711
734.467.4175
734.467.4062
General Information
Gift Shop
734.467.4169
Guest Relations
734.467.4111
Labor and Delivery
734.467.4266
74
Maternal Care Unit
Spiritual Support
734.467.4200
313.593.7200
Medical Records/
Birth Certificate Information
Volunteer Services
734.467.4375
Nursery
734.467.4261
Pediatric Unit
734.467.4399
Spiritual Support
734.467.4057
Volunteer Services
734.467.4171
Oakwood Health Line/Physician Referral
800.543.WELL
Oakwood Hospital & Medical Center
Administration
313.593.7125
Admitting
313.593.8525
Billing and Patient Accounting
313.593.7136
Birth Certificate Information
313.593.7630
Cafeteria
313.593.3047
Oakwood Laboratories
800.245.3725
Oakwood Southshore Medical Center
Administration
734.671.3802
Admitting
734.671.3828
Billing and Patient Accounting
734.671.3831
Cafeteria
734.671.3812
General Information
734.671.3800
Gift Shop
734.671.3692
Guest Relations
734.671.3643
Labor and Delivery
734.671.3950
Medical Records/
Birth Certificate Information
734.671.3846
General Information
Mother-Baby Unit
313.593.7000
734.671.3950
Gift Shop
Nursery
313.593.7190
734.671.3621
Guest Relations
Spiritual Support
313.593.7160
734.671.3647
Labor and Delivery
Volunteer Services
313.593.7500
734.467.4183
Medical Records
Parents Supporting Parents
313.593.7781
Mother-Baby Unit
(NICU support program)
313.593.8750
313.593.7630
Prenatal Education Classes & Tours
NICU
313.593.7435
Oakwood Annapolis Hospital
734.467.5588
Nursery
Oakwood Hospital & Medical Center
313.593.7855
313.593.7694
Pediatric Unit
Oakwood Southshore Medical Center
313.593.7600
75
313.593.5865
734.671.3950
Transcultural & Interpreter Services
800.543.WELL
The Center for Women’s Health
800.543.WELL
Breast Care Center
313.438.7715
Children’s Services
313.593.5885
Fetal Diagnostic Unit
313.593.7521
Genetic Counseling
313.593.7521
Gynecology Oncology
313.593.8620
Healthy Hearts for Women 313.586.5496
Infertility Services
313.299.6650
Michigan Perinatal Associates, P.C.
313.593.5957
Neonatology
313.593.7490
NICU
313.593.7435
OB/GYN Medical Education
313.593.7819
Program for Minimally Invasive
Gynecology
734.454.8001
Reproductive Endocrinology
313.299.6650
Urogynecology
313.982.0200
Women’s Health Web Site
oakwood.org/womens-health
76
COMMUNITY TELEPHONE NUMBERS
BIRTH CERTIFICATE/LEGAL AID/
PATERNITY
City Clerk Office
DEARBORN
313.943.2012
CHILD & INFANT SERVICES
Autism Society of Michigan
517.882.2800
Baby Hotline
313.961.BABY
WAYNE
734.722.2204
Child Care Coordinating Council
313.259.4411
TRENTON
734.675.8600
Children’s Special Health Care Services
800.359.3722
Social Security Administration
800.772.1213
DNA — Diagnostics for Paternity
800.613.5768
Family Medical Leave Act
866.487.9243
Friend of the Court Legal Aid
313.224.5300
(free to low-cost legal information)
313.964.4111
BREASTFEEDING
Cord Blood Registry (cord blood preservation)
888.932.6568
Cord: Use (cord blood donation)
888.267.3873
Early On Program Referral
(screening for children birth to three years)
800.EARLY-ON (327.5966)
Family Parenting Helpline
313.961.BABY (2229)
Great Start
866.667.8278
Oakwood’s Breastfeeding Helpline
313.593.5929
Head Start Program
LaLeche League
800.525.3243
734.727.7612
Medela Breast Pumps
800.835.5968
NWHIC Breastfeeding Helpline
800.994.9662
(educational support for children three to four
years old)
National Association for the Education
of Young Children (daycare referrals)
800.424.2460
Parent Help Line
(answers questions about parenting issues)
800.942.HELP
Viacord (cord blood preservation)
877.343.4698
77
COUNSELING AND SUPPORT
DOMESTIC VIOLENCE
Alcoholics Anonymous
313.831.5550
Family Violence Help Line (24 hour)
800.996.6228
Alcohol Treatment Hotline (24 hour)
800.ALCOHOL
First Step
American Cancer Society
800.227.2345
Big Brother Big Sister of Metro Detroit
313.309.0500
Depression After Delivery
800.944.4773
Development Centers, Inc.
313.531.2500
(shelter, crisis intervention, 24-hour help)
734.722.6800
Haven Crisis Line
248.334.1274
Child Protective Services
800.716.2234
EDUCATION AND
UNEMPLOYMENT
EVENSTART (tutoring for GED)
Guidance Center
9 to 5 JOB PROGRAM HOTLINE
800.522.0925
734.785.7700
Downriver
734.785.7705 (ext. 7112)
(postpartum support)
Michigan Department of
Community Health
(general information)
800.537.5666
(phone counseling for smoking)
800.834.4781
Western Wayne County
734.728.3400
FOCUS HOPE (GED and training)
313.494.4600
Narcotics Anonymous
248.543.7200 or 800.543.HELP (4357)
MEDICAL INSURANCE
National Council on Alcoholism and
Drug Dependence
800.622.2255
(low-cost or free health insurance for
uninsured children and pregnant women)
Postpartum Support International
805.967.7636
Pregnancy & Newborn Health
Education Center
888.MODIMES
SIDS — Michigan SIDS Alliance
800.331.7437
SIDS Institute
800.232.SIDS
Smoking Cessation Material
(free information to help individuals
stop smoking)
800.537.5666
Starfish Family Services
(counseling, crisis intervention)
734.728.3400
Healthy Kids/Pregnant Women/MI Child
888.MI.CHILD (888.988.6300)
313.961.BABY (2229)
Medicaid Ombudsman for Wayne County
734.284.6999
Medicaid Assistance Program
(free counseling and resources)
800.803.7174
Michigan Department of
Community Health
(low-cost/free health insurance for
pregnant women)
517.335.8024 or 517.373.3500
Michigan Family Independence Agency
(low-cost/free health insurance for
pregnant women)
517.373.2035
Wayne County Health Department
734.727.7000
Wayne County Community
Behavioral Health
(24-hour mental health support)
313.224.7000
78
NUTRITION
FOCUS HOPE
(free food for children up to 6 years old)
313.291.4888
Women, Infants & Children Nutritional
Service (WIC)
800.262.4784
RECREATION
Positive Parenting infant massage
313.593.7694
Twins Magazine
888.558.9467
SAFETY
Consumer Product Safety Commission
800.638.8095
Poison Control Center (24 hour)
800.222.1222
U.S. Product Safety Commission (recalls)
800.638.2772
TRANSCULTURAL
Arab Community Center for Economic
& Social Service (A.C.C.E.S.S.)
313.842.7010
English Language Institute
(learn English as a second language)
313.577.2729
79
WOMEN’S HEALTH WEB SITE
WHAT IS ON THE AWARD-WINNING OAKWOOD
WOMEN’S HEALTH WEB SITE?
OAKWOOD.ORG/WOMENS-HEALTH
View these features:
•O
akwood Baby Gallery
(newborn pictures of babies born
at any Oakwood hospital)
• Interactive tools and calculators
(pregnancy weight gain, estimated
due date, women’s cancer and
cardiac risk assessments, ovulation
timing estimator, etc.)
• S ign up for the free monthly
Friends of Oakwood eNewsletter
•O
rder flowers online and view
Oakwood Gift Shop hours
• F ind a Women’s Health physician —
links to individual physician Web pages
• S ee pictures of our OB units and staff
• F requently asked pregnancy-related
questions and answers
• Ask us a question or contact us
•G
lossary of frequently used women’s
health terms
•N
otice of special events sponsored
by Oakwood
•D
escription of Oakwood Women’s
Health programs and services
•C
hecklist of recommended annual
Women’s Health exams and screenings
•O
nline preregistration for an
admission, procedure, exam, test, etc.
at the hospital
•C
hildhood immunization schedule
• F ind a children’s physician at Oakwood
• P renatal class offerings and schedules
•M
aps of Oakwood facilities
(internal and external)
•O
B unit visiting hours and guidelines
80
SUGGESTED RESOURCES
Title
Planning Your Pregnancy
and Birth
Author American College of
Obstetricians and Gynecologists
Title
Caring for Your Baby and
Young Child (birth to age 5)
Author American Academy of Pediatrics
Title
Baby Care for Beginners
Author Frances Williams
www.aap.org
American Academy of Family Physicians
800.274.2237
www.aafp.org
American College of Obstetricians
and Gynecologists
800.762.2264
www.acog.org
Title
Baby Bargains (ways to save
up to 50% on items for children
ages 0 – 2)
Author Denise and Alan Fields
Car Seat Safety
Title
Toddler Bargains (ways
to save up to 50% on items
for children ages 2 – 5)
Author Denise and Alan Fields
Club Mom
T he Nursing Mother’s
Companion
Author Kathleen Huggins
Consumer Product Safety Commission
Title
Title
Detroit Kids Catalog ­—
A Family Guide for the
21st Century (family activities
in southeast Michigan)
Author Ellyce Field
81
American Academy of Pediatrics
847.434.4000
www.nhtsa.org/cps
•G
eneral information and
installation tips.
www.clubmom.com
• F REE program to recognize and reward
moms for what they do every day.
www.cpsc.gov/cpsclist.asp
• B e among the first to know about
new recalls and consumer news
(can designate children’s products
only). Sign up here to get free
notices delivered electronically.
Cord Blood Registry
888.932.6568
www.cordblood.com
Cord: Use
Cord Blood Donation
(free, for listing on National registry)
877.826.7387
www.corduse.com
Viacord Cord Blood Preservation
866.565.2241
www.viacord.com
Family Medical Leave Act
www.dol.gov/esa/whd/fmla
•C
overed employers must grant
an eligible employee up to a total
of 12 workweeks of unpaid leave
during any 12-month period for
the birth and care of the newborn
child of the employee.
Free Magazines for Expectant
Mothers/Parents
• B aby Talk Magazine
www.babytalk.com
• American Baby Magazine
www.americanbaby.com
The Humane Society
www.hsus.org/ace/13946
• Tips on introducing your baby to a pet.
Michigan Education Savings Program
www.misaves.com
•O
ffered through the Michigan
Department of Treasury, provides
families a smart and flexible way
to save for their children’s futures.
Program benefits include tax
advantages, flexible, low-cost
and experienced managers.
National Women’s Health
Information Center
800.994.WOMAN
www.4women.gov
• F ree support and information for
women. Request a free women’s
wellness datebook.
Upromise
www.upromise.com
• A free program to earn dollars
toward a tax-free college savings
account just by shopping at
local stores.
You and Your Family
www.youandyourfamily.com
• F ree coupons and product discounts
related to pregnancy and infants.
82
PREGNANCY WEIGHT GAIN
83
Keep track of your weight gain throughout your pregnancy (use same scale
each week). Call your doctor if you experience sudden weight gain (more
than five pounds in one week).
Week
Prepregnancy
4*
5
Weight
FIRST TRIMESTER (week 1 – 13)
Gain about 1 pound per month.
6
7
8
9
10
11
12
13
14
15
16
SECOND TRIMESTER (week 14 – 27)
Gain about 0.5 pound per week.
17
18
19
20
21
22
23
24
25
26
27
28
29
30
THIRD TRIMESTER (week 28 – 40)
Gain about 1 pound per week.
31
32
33
34
35
36
37
38
39
40
* Positive pregnancy test.
84
NOTES
85
86
87