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You are welcome to call our office with any questions or concerns you may have about your medical care. Please make all non-emergency calls during the day when the doctor is in the office.

 

If it is after hours and you do not have an emergency, the answering service will take your call. You may not receive a call back until the next day.

 

If you have an emergency, go straight to the Emergency room or to Labor and Delivery if you are pregnant and they will call the doctor.

The best way to get your prescription refilled is to call the pharmacy you previously used. If you do not have refills available, they will call, fax or electronically request your refill for you. We will respond within 24 hours.

 

If you do not have the pharmacy or medication information, we would like to encourage you to use this website for your refills. You may send us an electronic message. We will respond within 24 hours.

 

Please do not call for refills after 5 pm. We can only respond during office hours when our staff has access to your medical chart.

 

If you have not been seen by the doctor within the past 12 months, you will not receive a refill of any medication unless you have an appointment scheduled.

You will be notified by phone of all abnormal laboratory and radiological test results. For all normal results you are welcome to call our office and you can discuss them with one of our nurses. You can also see your results online by registering and obtaining a special password.

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Our office accepts multiple insurances, cash, checks and credit cards. You will be made aware of the cost of the visit. Payment is expected before being seen. It is your responsibility to verify your insurance and your co-pays before scheduling a visit. Without valid insurance, you will be expected to pay cash before being seen. You may then submit the bill to your insurance company. We are required to collect co-pays. You will be billed for any service not paid for by your insurance company.

 

Most infertility services are not covered by insurance and will require payment up front.

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Office hours are Monday thru Friday, 8:00am - 5:00pm.

Office hours are by appointment only. WE DO NOT ACCEPT WALK-INS. If you have an URGENT issue, please call the office during office hours and we will make every effort to get you in to be seen the same day. If you have an EMERGENCY, please go to the emergency department.

 

ADDITIONALLY, IF YOU OR YOUR CHILD IS SICK WITH A RESPIRATORY CONDITION, PLEASE DO NOT COME TO THE OFFICE. WE HAVE MANY PREGNANT WOMEN IN OUR OFFICE WHO MAY NOT BE ABLE TO COPE IF INFECTED.

Congratulations! Your baby deserves the best start in life that you can provide. We are pleased to be partners in your care during this special time of your life. To prepare for the big event, and help you know what to expect, Dr. Westford offers a comprehensive prenatal program that includes:

  • Prenatal Visits

  • Ultrasound Imaging

  • Screening Tests

  • Educational Information

  • Genetic Counseling/Amniocentesis

 

All deliveries are performed at DeTar Women and Children's Hospital and Citizens Medical Center, both of which have Level 2 NICUs and 24 hour Ob anesthesia.

This page is designed to answer the most common questions we hear on a daily basis and to familiarize you with what to expect in the coming months.

  • Prenatal Visits - What to Expect

  • Diet in Pregnancy

  • Alcohol Consumption

  • Drug Use in Pregnancy

  • Tobacco Use in Pregnancy

  • Exercise in Pregnancy

  • Personal Hygeine

  • Working while Pregnant

  • Travel Safety in Pregnancy

  • After Clinic Hours

  • Medication Use During Pregnancy

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Your prenatal visits will be conducted by your physician on the following schedule:

 

  • Every 4 weeks up to 28 weeks gestation

  • Every 2 weeks from 28 to 36 weeks

  • Every week from 36 weeks through delivery

 

At each visit, we will obtain an interim history, check your weight, blood pressure, and urine tests for protein, glucose and infection. You will then see the doctor.

8 weeks

  • Physical examination, family history, pap smear, cultures, lab work, sequential screen for Trisomies and Spina Bifida

  • If you will be 35 years of age or older at the time of delivery, you will be offered genetic counseling and an amniocentesis.

  • Ultrasound for dating

 

12 weeks

  • Fetal heart tones using handheld Doppler

  • Ultrasound for nuchal translucency

 

16 weeks

  • A Quad Screen blood test is offered to screen for Down's Syndrome and Spina Bifida if you missed the early screen

 

20 weeks

  • An ultrasound (anatomy scan) is scheduled for the same day as this visit

  • Fundal/uterine height measurements are taken at this and subsequent visits

 

24 weeks

  • Standard visit. Fundal height and fetal heart tones

 

28 weeks

  • Gestational diabetes screening with 1 hour glucose tolerance test (Be prepared to wait 1 hour)

  • Rhogam injection if your blood type is Rh negative

  • CBC, HIV testing

 

30-34 weeks

  • Standard visits of fundal height and fetal heart tones

 

36 weeks

  • Group B Strep culture. A cotton swab is used to culture the vaginal opening and the skin around the anus. If you are a carrier of GBS, you will be given antibiotics during labor to prevent your baby from becoming exposed to the bacteria. Your cervix will be checked for softening/dilation.

 

37-40 weeks

  • Standard visit plus vaginal exams for cervical dilation

  • Preparation for delivery

 

40-41 weeks

  • Antenatal surveillance

  • Preparation for delivery

  • You should plan to increase your caloric intake by about 300 calories per day

  • A balanced diet is important for the nutrition of you and your baby

  • The recommended weight gain is 25-30 pounds if you are normal weight,15-25 pounds if you are overweight and at least 35 pounds if you are underweight

  • Limit beverages with caffeine to 1-2 per day

  • Limit fish servings due to mercury concerns. Fish should be cooked; not raw

  • Take your prenatal vitamin every day

  • You need additional calcium (1,200 mg/day) and protein (60 grams/day)

  • Supplementation with omega-3 fatty acids (DHA, EPA) has been shown to help baby's brain and eye development. If you vitamin does not contain DHA and EPA, try adding the over-the-counter supplement, Expecta, which contains these fatty acids

DO NOT CONSUME ALCOHOL DURING PREGNANCY. Alcohol use in pregnancy has been associated with birth defects/fetal alcohol syndrome

DO NOT USE ILLEGAL SUBSTANCES/DRUGS OF ABUSE IN PREGNANCY. These include cocaine, amphetamines, heroin, marijuana, Xanax, and many others. These are associated with fetal death and multiple infant complications.

DO NOT SMOKE DURING PREGNANCY! Smoking cigarettes during pregnancy is harmful to your baby. Smoking has been shown to increase the risk of miscarriages, low birth weight infants, preterm delivery, preterm rupture of membranes, and placental abruption, all of which may cause fetal death.

  • You may continue your regular exercise regimen while you are pregnant.

  • Stop when you are fatigued.

  • Do not exercise to exhaustion.

  • Avoid exercises that increase your risk of falling or abdominal trauma such as horseback riding, biking, rollerblading, and skiing.

  • After the first trimester, avoid exercises that require you to lie on your back, or cause you to jump or bounce.

  • Yoga and stretching exercises are encouraged.

  • Drink plenty of water when exercising.

  • You may take tub baths or showers throughout the pregnancy. Balance may be difficult toward the end of your pregnancy, so be sure to have a non-slip surface in the tub.

  • Bowel habits may change during pregnancy. Hemorrhoids appear more frequently. Increasing the fiber in your diet and using stool softeners can help prevent constipation.

  • Cosmetics and hair products do not affect your baby and may be used during pregnancy

  • Dental care is important during your pregnancy and routine cleaning is recommended. If X-rays are required, please be sure your abdomen is shielded with a lead apron. Dental work can be done using local anesthetics while you are pregnant.

Pregnancy is not considered a disability unless there are complications. You may continue to work throughout your pregnancy as long as you are comfortable. There are no set guidelines for working during pregnancy as expectant mothers have different levels of capability and risks. We encourage you to discuss your pregnancy with your employer and request time for rest, elevation of feet, etc.

When traveling in a car, seat belts are recommended to decrease maternal and fetal trauma in case of an accident. Always use the shoulder harness and lap belt. The straps should be above and below the "bump" of pregnancy, not over it. The first and second trimesters are the ideal times to travel. On long trips, it is important to get up and walk around every 2-3 hours. It is generally recommended that you not travel outside the area after 32 weeks. Airlines do not usually allow travel in the last trimester of pregnancy.

Clinic hours are 8:00am to 5:00pm. The nurse will be available for urgent questions between 5:00pm and 8:00pm

  • If you have an emergency, you must go to the emergency department or call 911.

  • After hours calls to the physician should be for emergencies only.

  • Calls will be answered by the answering service.

  • If you cannot wait to speak to the nurse or the physician, go to the emergency room/labor and delivery or call 911.

  • Medications/Prescriptions will not be called in over the phone by the nurse after business hours as she will not have access to your medical records. It is better to call the pharmacy.

  • Allow at least 24 hours for routine prescription refills.

This list of medications has been carefully reviewed by Dr. Westford for her patients only. Please check with your own doctor if you are not a patient. This list of medications is felt to be safe for you to use during pregnancy and breastfeeding. You may use this as a guide to the medications that can be used. If the drug is on this list then you may use it without specifically being advised to do so. The goal in pregnancy and breastfeeding is always to try comfort measures first and limit the use of medications.

Do not use medicines that are not on this list unless you have spoken with your physician

 

ALLERGIES: Benadryl, Claritin, Zyrtec

 

ASTHMA: You may use prescribed inhalers if necessary for acute asthma attacks. If no improvement, call you doctor immediately.

 

CONSTIPATION: Increase fluids to 8-10 glasses/day, increase fresh fruits and vegetables, bran cereal, prunes or prune juice, warm juice. Use natural, bulk laxatives - (Metamucil, Fibercon) Milk of Magnesia - 2 tablespoons at bed time every other day. If no results, try a stool softener or Miralax daily. **DO NOT use stronger laxatives like Ex-lax, Correctol, Castor Oil

 

COLDS, CONGESTION, HAYFEVER: Increase fluid intake, rest as much as possible, humidifier, Vitamin C 500 mg. You may try Actifed, Sudafed, Tylenol Cold and Sinus, Dayquil.

 

COUGH: Robitussin DM, Vicks, Triaminic - may be used as directed on the label.

 

DIARRHEA: Drink lots of Gatorade. Call the office if stools become completely liquid and occur more than 10- times /24 hours in spite of using the above medications.

 

HEADACHE: Tylenol with caffeine. **Avoid Aspirin, Ibuprofen (e.g., Motrin), and Naprosyn

 

HEARTBURN / INDIGESTION: Try Maalox, Mylanta, Zantac, Pepcid, Tagamet, Prilosec. Avoid foods known to cause problems (spicy, greasy food, cabbage, beans, chocolate), avoid lying down for 30-45 minutes after eating, eat small, frequent meals. ** Avoid Rolaids, TUMS, Alka-Seltzer since these products contain more salt.

 

HEMORRHOIDS: Soaking in a tub of warm water 3-4 times daily. Use OTC preparations like Tucks Pads and Preparation H. Anusol HC - use occasionally as directed on label.

 

BODY ACHES with LOW GRADE TEMPERATURE to 100.6: Try resting, a warm tub bath or heating pad for aches and pains or a cool tub bath for mild fever. Take Tylenol - 1 or 2 tablets, every 4-6 hrs. Do not exceed 8 tablets in 24 hours. Notify physician" -If no relief in 72 hrs. or for fever is higher than 100.6.

 

LEG CRAMPS/"CHARLIE HORSE": Begin with massage and stretching. Soak legs in warm bath. Increase Calcium intake.

 

NAUSEA: Dietary changes as mentioned previously. May also use Vitamin B6 -50 mg., 2-3x daily. Try Emetrol, Maalox, Mylanta. Replace fluids lost with vomiting by using Gatorade. Notify physician if you are not able to keep anything (even fluids) in you stomach as dehydration is a risk. We can give you medication.

 

NASAL CONGESTION: Try saline nasal sprays and nasal flushes. May use Afrin every 12 hrs. if saline ineffective.

 

INDIGESTION: Emetrol, Maalox, Mylanta, TUMS, Rolaids.

 

PAIN: Tylenol, moist heat or ice.

 

PAINFUL URINATION: AZO, Increase fluid intake

 

RASH: 1% Hydrocortisone Cream, Benadryl Cream, Calamine Lotion, Benadryl by mouth

 

STRETCH MARKS: Any cream or lotion rich in cocoa butter or olive oil may help alleviate itching. Nothing will-prevent stretch marks completely if you are prone to them.

 

ROUND LIGAMENT PAIN: If you have been diagnosed with "Round Ligament Pain" you may use a Pregnancy Belt / Tummy Sling, abdominal support girdle or any other maternity girdle. Warm tub baths, moist heat or cold compresses may help. Limit pain medications during pregnancy and breastfeeding.

 

SORE THROAT: You may use Chloraseptic spray or lozenges, Cepacol, Halls sore throat, etc. Try warm saline gargles. Tylenol - As directed.

 

SWELLING: Increase rest (with feet propped up 1-2 hrs./day), wear firm support hose, limit salt intake, squeeze juice of 1/2 lemon in 8 oz. water (this is a natural diuretic). DO NOT USE PRESCRIPTION DIURETICS.(fluid pills). Swelling in your legs, ankles, feet and fingers in the last trimester of pregnancy is very common, especially at the end of the day. Generally this swelling will go away with rest and elevation of legs. Please notify us if you have severe swelling, especially in the face, abdomen and extremities.

 

UPPER RESPIRATORY INFECTION: Dimetapp, Contac, Sudafed, Actifed, Theraflu, Dayquil, Tylenol Cold & Sinus, Claritin-D. **Avoid Aspirin, Ibuprofen (e.g., Motrin), and alcohol-based medications such as Nyquil.

 

VITAMINS: You will be given a prescription for the prenatal vitamins. Occasionally, prenatal vitamins will cause nausea. If this happens, take the vitamins with food or at bed time. You may stop the vitamins until the nausea resolved, mostly by 12 weeks. You may also change to a different vitamin prescription. **It is not necessary to take extra vitamins or iron unless prescribed by your doctor.

 

YEAST INFECTION: OTC Monistat, Gyne-Lotrimin. Be careful with insertion into the vagina.

 

Yvette F. Westford, MD, FACOG Copyright © 2015, All Rights Reserved  |  Privacy policy  |  Site Hosted and Maintained by ChrisCoxWebDesigns Inc.

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