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Prenatal Visits

Frequency of Visits – Routine Prenatal Visits

  • Prenatal visits to Healthy Woman physicians will be once a month until your 28th week of pregnancy.
  • After 28 weeks, your visits will increase to every two weeks until the 36th week.
  • After 36 weeks, you will be seen once a week.
  • If you go past your due date, you will need to come to the office two times per week until the baby is delivered.
  • Our office performs basic OB ultrasounds in each location. Typically, you will have an OB ultrasound performed at your initial prenatal visit and your second prenatal visit.

Should you have a question at any time, during your pregnancy, please do not hesitate to contact our offices.

Meeting With Our Physicians

  • Your first two visits will be scheduled with the same physician.
  • After the first two visits, you will begin rotating through the other physicians in the practice. This will enable you to meet all of the doctors in the practice and be comfortable with each throughout your pregnancy.
  • At 24 weeks, you will meet with Healthy Woman Co-founders Dr. Rebecca Cipriano or Dr. Joseph Cipriano to put together a birth plan so we can be sure that your expectations are met and your birth is just as you want it to be.
  • Unless your delivery is a scheduled C-section or induction, the physician who is on call at the time you go into labor will be the physician who will deliver your baby. Please note that we do not use laborists! You will always be delivered by a Healthy Woman doctor.

Screening and Diagnostic Testing Information

Healthy Woman OB/GYN offers patients the option to undergo a variety of screening tests as well as diagnostic tests that are performed between 10 and 22 weeks gestation to help detect fetal chromosomal alterations.

Please Remember

Most babies (97%) are born without a major birth defect. Screening tests can give you an idea of your risk for having a baby with a birth defect. A normal test result does not guarantee that your child will not have any problems. It can reassure you that the risk is not increased. Also, an abnormal test result does not always mean that your child will have a birth defect. Whether or not you choose to have these tests performed are personal decisions. Remember, some people choose not to get this information. Also keep in mind that insurance plans may differ. Not all tests may be covered by your insurance provider. Please contact your insurance carrier for your specific benefits.

Screening Tests

A screening test is a test that is performed when there are no symptoms or known risk factors present. It may provide you knowledge of your baby having a specific birth defect. If your screening test shows a higher than average risk for your baby having a specific defect, further tests may be used for diagnosis. These screening tests have no known adverse outcome to you or your baby.

Please remember, these tests are optional. If any of these tests show you have an increased risk, it does not mean that your baby has a problem, only that further evaluation of your pregnancy may be indicated. Likewise, normal results from the screening test cannot guarantee a normal baby. Please discuss any questions or concerns you may have with our doctors.

The different types of screening test that you can have performed are a first trimester screening (which includes nuchal translucency ultrasound and blood tests), quad screen, AFP only and a level II (genetic) ultrasound.

  • First trimester screening (which includes a Nuchal translucency ultrasound and blood tests). The ultrasound measures the amount of fluid accumulation behind the neck of the baby, called nuchal translucency (NT). The blood specimen is analyzed for two chemicals called free Beta Human Chorionic Gonadotropin (free BetaTM), and Pregnancy Associated Plasma Protein-A (PAPP-A) which are normally found in the blood of all pregnant women.  The American College of Obstetrics and Gynecology recommends this screening be performed on all pregnant women, regardless of age.  (Please note: if you are under age 35, your insurance company may not cover the cost of these tests.  Please consult with your insurance provider for your specific coverage). These tests combined can estimate your specific risk for Down Syndrome & Trisomy 13/18. Women having this test performed will have a 3-5% “False Positive” rate.  This test is 85% to 92% accurate in detecting a chromosomal abnormality.   If you choose to have this test performed it is recommended that you also have an AFP test performed at 16 weeks to screen for spina bifida.
  • The quad screen (Alpha-Fetal Protein, Human Chorionic Gonadotropin, Estriol & Inhibin A) is a blood test taken at 16 to 18 weeks gestation.  This test has a “False Positive” rate of 5 – 10%. It will find about 60-70% of babies with Down syndrome or 60% with Trisomy 18.  The detection rate for open neural tube defects is approximately 80%.
  • An AFP (only) test is a blood test taken at 16 weeks gestation, and will calculate a risk for open neural tube defects. This will not adjust your risk for having a baby born with Down syndrome. This test is recommended if you choose to have the first trimester screening or CVS. The detection rates for open neural tube defects is approximately 80%.
  • A level II ultrasound is performed between 20 and 22 weeks gestation. A genetic ultrasound test is recommended for women who will be 35 or older at the time of delivery or have an abnormal blood screening test and choose not to have a diagnostic test performed. This ultrasound looks for different physical characteristics that can be associated with chromosomal abnormalities. This test is 60% to 80% accurate, depending on the institution performing the test, in detecting a chromosomal abnormality.
  • All nuchal translucency ultrasounds (done between 12 and 14 weeks) and all level II anatomy scans (done between 18 and 20 weeks) are read by a board certified MFM (maternal-fetal medicine specialist) or perinatologist (high risk obstetrician). Consults with the MFM are also done at those visits.

Diagnostic Test

A diagnostic test can determine whether or not your baby has a chromosomal alteration before delivery. These tests are recommended if you will be 35 years or older at time of delivery, have a family history of certain birth defects, have had a child with a birth defect, or have a blood test that is abnormal. There are risks involved in having these tests performed, including miscarriage or potential for preterm labor. There are two types of diagnostic testing to choose from, a CVS or Amniocentesis.

  • A Chorionic Villus Sampling (CVS) can be done between 11 and 13 weeks from the last menstrual period. A small sample of cells are taken from the placenta and sent to the lab. There, the cells are grown and tested. The results take 7 to 10 days. CVS detects most of the same defects as amniocentesis; however, it can not detect an open neural tube defect. If you have a CVS, you may want to have a blood AFP test done at 16 weeks. The risk of having a miscarriage with CVS is slightly higher than with an amniocentesis; about 1% (1 out of 100) of women will lose their pregnancy. This test is performed by a perinatologist.
  • An amniocentesis is done between 16 and 18 weeks of pregnancy in most cases. A sample of amniotic fluid is withdrawn through a needle from the sac surrounding the baby. The fluid is then sent to a lab for processing. The results take about 14 days. This test is performed by a perinatologist. The risk of pregnancy loss with amniocentesis is approximately 1 out of 200. An amnio is done to rule out most chromosomal abnormalities. The risk of chromosomal abnormalities increases with a woman’s family history or age. There are many other types of abnormalities which can be discussed with a perinatologist or a genetic counselor. They will be able to give you more detailed information on those risk factors.

Key Appointment Timeline and Locations

Below is a listing of important appointments you may be scheduled for during your pregnancy (in addition to your routine visits). Our doctors will discuss with you the benefits and appropriateness of each test performed by the maternal fetal medicine physicians, based on your specific situation.

Between 6.5 and 8 Weeks: New Pre-Natal Visit

Location: Healthy Woman office (Colts Neck or Freehold)

  • A pap smear and complete gynecological exam will be performed.
  • An obstetrical ultrasound will be performed.
  • Your physician will order blood work, including Blood Type and Antibody Titer, Rubella, Blood Count, Hepatitis Screen, HIV, Toxoplasmosis Titer, Varicella Titer, Cystic Fibrosis, and possibly Jewish genetic testing or Sickle Cell screen. You will be given a script for this bloodwork; you can have it done at any laboratory that participates with your insurance carrier.
  • Your physician will also discuss the various tests that are recommended and/or available to you during your pregnancy. Click here for a complete list of optional tests.

Between 11 – 13 Weeks: Optional Screenings

Location: Maternal Fetal Medicine Physician location

  • First Trimester Screening – includes a Nuchal Transluceny ultrasound and blood tests.
  • Chorionic Villus Sampling (CVS)

Around 12 Weeks: Routine Pre-Natal Check Up

Location: Healthy Woman office (Colts Neck or Freehold)

  • Includes checking weight gain, blood pressure and urine
  • Discuss prenatal laboratory test results
  • Listen to fetal heart beat
  • Discuss signing up for a pre-natal class

Around 16 Weeks: Routine Pre-Natal Check Up

Location: Healthy Woman office (Colts Neck or Freehold)

  • Includes checking weight gain, blood pressure and urine
  • Listen to fetal heart beat and check uterine size
  • Discuss problems or concerns

Between 16-18 Weeks

  • Quad Screen -If you choose to have a quad screen, a prescription will be written by our physicians for you to have the bloodwork done at a laboratory that participates with your insurance carrier. Location: Outside Laboratory
  • Alpha-Fetal Protein (AFP) only
  • Amniocentesis – The results take about 14 days. This test is performed by a perinatologist. Location: Maternal fetal medicine physician location
  • Genetic Counseling – This service is offered to patients 35 years of age or older or patients who have family history of genetic problems. Location: Maternal fetal medicine physician location

Around 20 Weeks: Routine Pre-Natal Check Up

Location: Healthy Woman office (Colts Neck or Freehold)

  • Includes checking weight gain, blood pressure and urine
  • Listen to fetal heart beat and check uterine size
  • Discuss results of optional testing already performed
  • Discuss problems or concerns

Between 20 – 22 Weeks:

Location: Maternal Fetal Medicine Physician location

Level II Ultrasound

Around 24 Weeks: Routine Pre-Natal Check Up and Birth Plan Creation With One of The Healthy Woman Co-Founders

Location: Healthy Woman office (Colts Neck or Freehold)

  • Includes checking weight gain, blood pressure and urine
  • Listen to fetal heart beat and check uterine size
  • Discuss results of optional testing already performed
  • Discuss problems or concerns
  • Prescription for one-hour glucose test is given
  • Discuss cord blood banking
  • Discuss your expectations for the birthing process
  • Explain the many options available to you so that you are empowered with the information you need to make the best decisions for yourself
  • Create a birth plan with our help to ensure that your birth is just as you want it to be

Begin Visits Every Two Weeks!

Around 28 Weeks: Routine Pre-Natal Check Up

Location: Healthy Woman office (Colts Neck or Freehold)

  • Includes checking weight gain, blood pressure and urine
  • Listen to fetal heart beat and check uterine size
  • Discuss results of optional testing already performed
  • Discuss problems or concerns
  • Prescription for one-hour glucose test is given (if not already)
  • Discuss C-section scheduling if you are a c-section candidate
  • Registration for cord blood (stem cell) banking. Our office recommends Cord Blood Registry for cord blood collection and storage. They can be reached at (888) CORD BLOOD.

Around 28 Weeks: Screening for Gestational Diabetes

Location: Outside Laboratory

  • The one hour glucose screening test will be done at a laboratory that participates with your insurance carrier.
  • Please consult your insurance carrier to determine which lab participates with your plan.

Around 28 Weeks: Rhogam Injection

Location: Call our practice for more details

  • If you are RH negative blood type you will need a Rhogam injection at 28 weeks and another after delivery. This injection is given to prevent antibody formation.

Around 30 Weeks: Routine Pre-Natal Check Up

Location: Healthy Woman office (Colts Neck or Freehold)

  • Includes checking weight gain, blood pressure and urine
  • Listen to fetal heart beat and check uterine size
  • Discuss results of glucose test
  • Discuss any questions or concerns

Around 32 Weeks: Routine Pre-Natal Check Up

Location: Healthy Woman office (Colts Neck or Freehold)

  • Includes checking weight gain, blood pressure and urine
  • Listen to fetal heart beat and check uterine size
  • Discuss any questions or concerns

Around 34 Weeks: Routine Pre-Natal Check Up

Location: Healthy Woman office (Colts Neck or Freehold)

  • Includes checking weight gain, blood pressure and urine
  • Listen to fetal heart beat and check uterine size
  • Check baby’s position
  • Discuss any questions or concerns

Begin Visits Every Week!

Around 36 Weeks: Routine Pre-Natal Check Up

Location: Healthy Woman office (Colts Neck or Freehold)

  • Testing for Group B Streptococcus (GBS). GBS is a type of bacteria that can be found in women. The test is a routine vaginal culture that is performed in our office by the physician.
  • Check cervix
  • Listen to fetal heart beat and check uterine size
  • Check baby’s position

Between 37 Weeks and delivery: Routine Pre-Natal Check Ups

Location: Healthy Woman office (Colts Neck or Freehold)

  • Non-stress tests if necessary
  • Group B Streptococcus test if not done before
  • Listen to fetal heart beat and check uterine size
  • Check cervix
  • Check baby’s position
  • Discuss any questions or concerns about delivery

Insurance Coverage and Pregnancy

We at Healthy Woman are devoted to making this a pleasurable experience for you during the next few months. In an effort to ensure your financial responsibilities are covered, we recommend that you call your Insurance Company so you are aware of your specific benefits.

Copays, Deductibles, and Co-Insurance

Your routine prenatal visits should be covered with only 1 co-pay. However, for ultrasounds, non-stress tests, Pap smears, cultures, and delivery you may be responsible for one or more of the following: co-payments, co-insurance, or plan deductibles. If we send you for any testing outside our office, we will verify and obtain precertification from your insurance company.

Please make sure that you inform the office when you are going for testing in advance so the proper steps are taken to obtain any pre-certification needed. If your insurance company requires a referral, please inform our office within 48 business hours. Failure to do so could result in a denial of claims for which you will be responsible to pay.

Please Note: The perinatologists who will perform your advanced ultrasound scans are not members of Healthy Woman and are unaffiliated with our practice. You may receive additional bills from the perinatology group or facility where scans are performed. These bills are not generated from our office; therefore, any billing issues or questions that arise in conjunction with these bills must be addressed to the office or lab sending the bill.

In Case of Emergency

If you experience bleeding, cramping, or severe pain during your pregnancy, call the office immediately. If after office hours, contact our main number to be connected to the answering service who will page the on – call doctor. In case of life-threatening emergency, dial 911 immediately and be transported to the nearest hospital. Emergency Room personnel will contact our physician on-call.