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georganna is now seeing women for annual exams/well woman care/gynecology at thrive ob

currently not attending homebirths 

 

To make an appointment please visit Thrive OB at: https://www.thriveobgyn.com

Annual Exams/Well Woman Care

GeorgAnna still provides care, but now at Thrive OB. Please contact them to make an appointment at www.thriveobgyn.com

  • If you have any significant health history (abnormal paps, gynecological surgery, etc) please request records. Here is a record request form.




First prenatal visit.

(Please allow 2 hours for this first appointment. Feel free to bring snacks, family, etc.)

For your first prenatal visit, please fill out and bring the following documents with you:

Please read the following before your first prenatal visit:

Things to do:


16 – 20 week visit. 

(Please allow 20 – 45 minutes.)

Please read the following before your 16 – 20 week visit:

Things to do:

  • Have labs done if applicable.

  • Schedule ultrasound to be done at 18-24 weeks, if indicated or desired.

  • Practice daily relaxation.

  • Exercise daily. Consider joining the YMCA, take a yoga class (doesn’t have to be prenatal yoga), library DVD’s, swimming, belly dancing, walking (fast enough to not be able to sing), or dancing. Get that heart rate up every day and start early in pregnancy!

  • Make a nourishing pregnancy tea. Tea is also available for clients free from GeorgAnna. Ingredients can include red raspberry leaves, lemon balm, oatstraw, nettles, alfalfa, mint, and others if you are having other issues you'd like to address with herbs.

  • Try sprouting to support pregnancy and breastfeeding.


24 week visit.

(Please allow 20 – 45 minutes.)

Please read the following before your 24 week visit:

Things to do:


28 week visit.

(Please allow 20 – 45 minutes.)

Please read the following before your 28 week visit:

Things to do:

  • Ensure that you are getting enough iron. Consider cooking in cast iron (it’s only absorbable if you are severely anemic), supplementing with Floradix, a plant based liquid supplement, or Alfalfa tablets (alfalfa is best for Vitamin K and good for constipation that can sometimes be caused by taking an iron supplement). Both available locally at Brighter Day.

  • Ensure that you are getting enough calcium and magnesium. Taking a 1200mg supplement before bedtime can help. Magnesium is best absorbed through the skin. Consider a spray, lotion, or bath soak (Epsom or magnesium salts) for cramps, restless legs, and moodiness.

  • Begin a high quality omega supplement and continue until at least 6 months postpartum or as long as you are breastfeeding.

  • Begin practicing Optimal Fetal Positioning daily.

  • Start gathering the items on your Supply List. Everything should be ready and on hand no later than 36 weeks.

  • Continue to practice daily relaxation and exercise. You may enjoy the free yoga or meditation online videos at DoYogaWithMe

  • Pelvic tilt exercises! (AKA Cat/Cow yoga poses, pelvic rocks)


30 week visit.

(Please allow 20 – 45 minutes.)

Please read the following before your 30 week visit:

  • Plan for your postpartum recovery. Most cultures around the world have a 40 day postpartum time for the mother during which she is encouraged to stay in bed with her baby. This helps prevent depression and is great for bonding and breastfeeding success. Please give yourself 2 weeks in the bed, 2 weeks near the sofa, and 2 weeks to gently reengage with the world. You will feel better at 6 months, a year, and beyond. Stay in your pajamas! If you must go out - avoid crowds, WalMart, pharmacies, and anyone who might be sick. Your baby can get very sick if exposed to germs. Wash your hands constantly.

  • Start gathering supplies for your birth and postpartum. You may want to start stockpiling healthy frozen meals for postpartum busy days. Consider buying organic, handmade custom meals from SimplyHomegrown through the Savannah Co-Op.

  • Begin gathering birth supplies. If you are unable to purchase any of these or do not want to purchase certain items, please let me know.

  • Attend a La Leche League Meeting

  • Exercise! YogaGlo has some fantastic options.


32 week visit.

(Please allow 20 – 45 minutes.)

Birth control/family planning

At this visit we will discuss birth control for you after you give birth. I know its hard to think about when you are still pregnant, but its good to start thinking about your options and what you may be interested in exploring further to discuss at your next visit. Georgia also has a program to cover contraception for women up to a year postpartum, so if your insurance doesn't cover these services you may want to check with Peach Care. Here is a great link to an explanation of various options. Some options are:

  • Paragard copper IUD - non hormonal, compatible with breastfeeding, effective for up to 10 years yet immediately reversible (just take it out). Can be inserted immediately after you give birth and immediately effective. Here is info about insertion within 10 minutes of birthing your placenta.

  • Mirena IUD - has hormones, effective for up to 5 years.

  • Natural family planning/fertility awareness methods. Please see the "Resources" or "well woman/family planning" page on this website for lots of information about hormone free birth control methods.

  • Diaphragms, spermicides, cervical caps, and condoms (male and female condoms are available) are also hormone free options.

  • Birth control pills (combined hormonal methods are not compatible with breastfeeding, although progestin only pills are fine while nursing)

  • Nuva-Ring hormonal method that is easy to use, but not compatible with breastfeeding.

  • Diaphragms, spermicides, and cervical caps are also hormone free options.

If you want an IUD, please order your IUD directly from Paragard here, or for Mirena or Skyla here. Insurance often covers the costs. If you cannot afford a Paragard, here is the discount program application.  

Please read the following before your 32 week visit:

Things to do:

Common complaints

  • noticing swelling in your ankles/feet/lower legs? For mild to moderate swelling (edema) in your feet/ankles in late pregnancy I suggest compression socks (TED hose), funky ones here


34 week visit. 

(Please allow 20 – 45 minutes.)

Please read the following before your 34 week visit:

 Things to do:


36 week visit.

(Please allow 2 hours for this in-home visit and have ALL BIRTH SUPPLIES ON HAND.)

Please fill out and have the following documents with you:

Please read the following before your 36 week visit:

Things to do:


Postpartum

GeorgAnna will return to your home within the first few days (timing depends on how the birth went – if there were complications she may return sooner, if all was nice and easy then more likely closer to day 3 when hormones fluctuate and milk comes in and new mamas tend to need more support).

During that time, you are expected to check both your’s and your newborn’s temperature, check the breathing rate of your baby, check your fundus (GeorgAnna will show you how) and write it down on your Postpartum Care for Mothers and Babies & Home Care Checklist. If you are having breastfeeding concerns, also write down breastfeeding frequency and duration. GeorgAnna will also stay in touch via texting if you like. If you are having issues, don’t hesitate to call (don't text if you are really concerned about something!) day or night. The next visit (unless you have issues and want to be seen sooner) is around 2 weeks. Around 4-6 weeks is the final postpartum visit, when you decide your plans for family planning/contraception, if desired, and a complete physical exam with a pelvic exam/Pap Smear is offered.

Postpartum depression:

Postpartum depression is real. So are the “baby blues”, which typically last the first 2 weeks and can happen even though you feel you *should* be happy. Consider placenta encapsulation (which GeorgAnna offers) if you have had issues with depression or anxiety in the past. Continue taking omega supplements, vitamin D, get plenty of rest, and talk to your midwife about your feelings. If you notice feelings of self harm, hearing voices, feeling the baby is somehow evil, or urges to harm the baby, please reach out to GeorgAnna or the hotline 1-800-273-TALK (1-800-273-8255) immediately. Postpartum psychosis is rare but can happen to women who had no risk factors.

Breastfeeding:

Exercise:

Be gentle to your body for the first 6 weeks. Ligaments are still lax, its easy to injure yourself. Give yourself 9 months to lose what it took 9 months to gain! However, feel free to resume kegel exercises immediately after birth to help with continence and pelvic floor toning. 

Many women have a diastasis recti after birthing. Please do not do sit ups until GeorgAnna has checked for this. If you have one, you may want to try Tuppler Technique exercises or visit the only local pelvic rehab specialist in town – Cathy Neal, PT, MSPT.  Here are some gentle exercises that are good for everyone.

Newborn:

GeorgAnna will perform a thorough newborn exam soon after the birth (typically in your lap and with the help of siblings), and explain all findings. If there is anything unusual about your baby, it will be discussed and you will be encouraged to discuss it further with your pediatrician. GeorgAnna may call your pediatrician office to discuss the issue with your provider if she has concerns. GeorgAnna can do the Newborn Metabolic Screen (“PKU”, “Heel Stick”) but prefers this to be done at your pediatrician appointment so if the results are abnormal they can follow up more easily. Please see your pediatrician within 3 days of birth, or within the first week at the very latest (earlier especially if there were complications). You may opt out of the Newborn Metabolic Screen (info for Georgia residents, info for South Carolina residents), although it is strongly encouraged.

Vitamin K:

If you declined vitamin K and then had a difficult birth (significant molding [photos on the right] of the baby’s head), GeorgAnna may encourage a vitamin K shot (she always brings it to the birth anyway, just in case). You may decline if desired. Oral vitamin K is also an option, but less effective. Oral is given one drop on days 1, 7, and 28. 

More vitamin K information:

Sleep:

Decide where your baby will sleep. Co-sleeping and bed sharing is done safely worldwide, but please take note of these safety tips:

Weight Gain & Diapers:

Normal newborns may lose up to 7% of birth weight in the first few days. After mom’s milk comes in, the average breastfed baby gains 6 oz/week (170 g/week). Take baby for a weight check at the end of the first week or beginning of the second week. Consult with baby’s doctor and your lactation consultant if baby is not gaining as expected.

Expect the first few days of newborn poops to be like tar. This is normal! It helps to apply olive, coconut, or another edible oil to their bottom after diaper changes to make it easier to clean.

In the early days, baby typically has one dirty diaper for each day of life (1 on day one, 2 on day two…). After day 4, stools should be yellow and baby should have at least 3-4 stools daily that are the size of a US quarter (2.5 cm) or larger. Some babies stool every time they nurse or even more often–this is normal, too. The normal stool of a breastfed baby is loose (soft to runny) and may be seedy or curdy. Baby typically has one wet diaper for each day of life (1 on day one, 2 on day two…). Once mom’s milk comes in, expect 5-6+ wet diapers every 24 hours. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper. A piece of tissue in a disposable diaper will help you determine if the diaper is wet.

Jaundice:

Jaundice is fairly common in babies after the first couple of days. Breastfeed frequently (at least every 2 hours in the daytime, and at least every 4 hours at night….more often is always better!), expose the baby to indirect sunlight (dappled under a tree outside, in a sunny window inside – being very careful not to sunburn their delicate skin), and please talk with GeorgAnna or your pediatrician if you notice any yellowing of your baby’s skin. There is a level that can be harmful.

Babywearing:

GeorgAnna (certified Babywearing Educator through Babywearing International, with over 8 years of experience) is happy to help you find the right carrier (Mei Tai, sling, woven wrap, ring sling, pouch, etc) and strongly encourages you to attend a Savannah Slingers Babywearing Group (founded by GeorgAnna and a chapter of Babywearing International) meeting while you are pregnant. Meetings are held twice a month on the second Friday and fourth Saturday.

Vaccinations:

Vaccinating your child is your choice. If you choose not to vaccinate, you may need signed exemption forms for daycare, school, etc. Hepatitis B vaccine is typically given in the hospital around the first day of life, but GeorgAnna does not administer this vaccine. 

Information can be found here: