Erie County Community Health center

Prenatal Clinic

Who can come to the prenatal clinic? The clinic is for anyone in the Erie County General Health District who is pregnant.

Where is the clinic? Erie County Health Department, 420 Superior Street, Sandusky, OH

What is the cost for services? Fee is based on income and family size. You will need proof of income. Please bring pay stubs for the last 2 weeks before your appointment. Most Medicaid is accepted so bring your current card.

What are the clinic hours? Monday through Friday 8:00 a.m. to 11:00 a.m. and 1:00 p.m. to 4:00 p.m.

What if I have to miss my appointment? Please call the Prenatal Clinic at 419-626-5623 as soon as possible. We will schedule a new appointment for you. It is important the you keep all of your appointments.

What will happen during my first visit to the clinic? The nurse will take a detailed medical history. The nurse will teach you how to take care of yourself and your unborn baby. She will weigh you and take your body pressure. You will have blood drawn for laboratory testing, get a TB skin test and give a urine sample. This visit takes 1 1/2 to 2 hours.

When will I see the doctor? At your second visit the doctor will review your health history and give you a physical exam including a breast and pelvic exam. The doctor will answer any questions you have about your pregnancy. You will need to give another urine sample at this and each following visit.

How many visits will I have? We need to see you about once a month for the first seven months; every two weeks during the eight month; every week during the ninth month. During your pregnancy you will see a WIC nutritionist who will review your diet and assist you with your diet by providing nutrition counseling and supplemental WIC foods. You will be seen at approximately 2 weeks and 6 weeks after delivery. Please call for an appointment as soon as you get home from the hospital.

What should I use for birth control after the baby's born? You should discuss this with the doctor and nurse during your pregnancy. Several options are available. If you want to have a tubal ligation or use Depo-provera injections, we will need to complete the education and paperwork before your delivery.

Should I go to childbirth classes? Yes. The classes teach prenatal exercises and get you ready for labor and delivery. They help even if this is your second or third baby. Classes are available at several locations. Ask your nurse if you need help in scheduling them.

Who will deliver my baby? We will help you transfer to a doctor who will deliver your baby.

Call the clinic or go to the emergency room right away if any of the following signs occur:

• swollen face, hands, feet, or ankles;
• abdominal pain or cramping; pelvic pressure;
  chills or fever
• dizziness, fainting, or loss of consciousness;
• bad headaches; spots before your eyes or your eyes blur; pain or burning on passing urine; sudden weight gain;
• bleeding or discharge from the vagina;
• a sudden gush or steady leak of water from the vagina;
• you are nauseated or frequently vomit day after day;
• you've been around somebody with German measles, also called the "three day measles"; there is a decrease or change in the baby's activity

PHONE NUMBERS

Health Department 419-626-5623
Long Distance Toll Free 1-888-399-6065
Emergency Care: Firelands Community Hospital 419-557-7400
Rescue Squad: 911

If you have any questions or problems between appointments, call the Prenatal Clinic during the day, between 8:00 a.m. and 5:00 p.m. 626-5623 or long distance 888-399-6065.

If your water breaks or you think you are in labor, please go to the hospital of your choice to be checked.

If an emergency develops after 5:00 p.m. or on the weekend, please call or go to your local emergency department.

Hints to help you have a healthy pregnancy and a healthy baby

• Come to all your clinic appointments
• Eat a well balanced diet. Follow the advice of your WIC nutritionist or nurse
• Take your prenatal vitamins and folate
• Exercise in moderation, after checking with the doctor
  Don't Smoke. Don't drink alcohol, or take street drugs while you are pregnant
• Don't take prescription medications or over-the-counter drugs, unless a doctor who knows you are pregnant tells you to
• If you need x-rays tell the technicians you are pregnant

KNOW THE SIGNS OF PRETERM LABOR

Preterm or premature labor is when you go into labor 3 or more weeks before your due date. This is too early and your baby could be born too soon. Here are the warning signs:

• Contractions every 10 minutes or more often
• Clear, pink or brownish fluid (water) leaking from your vagina
• The feeling that your baby is pushing down
• Low, dull backache
• Cramps that feel like your period
• Cramps with or without diarrhea

KNOW WHAT TO DO

Call your health care provider (nurse, doctor or midwife) or go to the hospital right away if you think you are having preterm labor, or if you have any of the warning signs. Call even if you have only one sign.

HOW TO KNOW WHEN LABOR IS STARTING

Not all contractions mean that labor had begun. Mild contractions that never get stronger aren't a sign of labor. Here's how to know when you're really in labor:

• Your contractions become stronger and start
  coming closer together.
• A pink liquid drips out of the vagina.
• Clear fluid gushes or trickles from the bag of waters.

If you have any of these signs, call your doctor to find out when to go to the hospital.

What is Folic Acid?

It's a B vitamin that women should take every day if they might become pregnant.

Why Should I Take It?

Folic acid may help reduce the risk of having a baby with certain birth defects of the brain and spinal cord. It's most important to have enough folic acid in your system right before and early in pregnancy. So, if you start now to take it every day, you'll have the amount you need should you become pregnant. Remember, most pregnancies are unplanned.

How Much Folic Acid Do I Need?

The U.S. Public Health Service and the March of Dimes recommend that you consume 400 micrograms of folic acid every day. You should not take more than 1,000 micrograms unless your health care provider recommends it.

Where Do I Get Folic Acid?

Good natural sources of folic acid include orange juice, green leafy vegetables, beans, peas and liver. Some breakfast cereals are fortified with folic acid, and all "enriched" grain products will include folic acid by no later than January 1998. The surest way to get the recommended amount of folic acid is to eat a healthy diet and take a multivitamin supplement every day.

FACTS ABOUT INFECTIONS

Some illnesses are more dangerous during pregnancy Your baby won't be harmed by most infections you can get when you're pregnant. But there are some diseases that can hurt her. So if you have a fever, tell your doctor. Also, talk to your doctor about what vaccines you may need during pregnancy. These illnesses can be serious:

Toxoplasmosis
Toxoplasmosis (tox-oh-plaz-MOE-sis) is a disease that cats can give to people. If you have a cat, try to have someone else clean the litter box. If you must do it yourself, wear rubber gloves. Wash you hands after you handle your cat. This disease can also be in raw meat. Cook all meat well. Always wash your hands after you touch raw meat.

Chicken Pox
If you've never had chicken pox (or if you had a very mild case), stay away from children with rashes. Also avoid children who have been around someone with chicken pox. If you get chicken pox near the end of your pregnancy, your baby may need a shot when she is born.

Rubella (German Measles)
If you've been near someone who has this illness, tell your doctor. Also tell him if you get a strange rash. If you've already had German measles, or if you've had a shot for it, you and your baby are safe. You should not get a shot for this during pregnancy.

Diseases (STDs)
People can get some diseases by having sex with someone who has the disease. Doctors test for syphilis (SIFF-ill-us) and gonorrhea (gon-uh-REE-uh) early in pregnancy and treat them quickly. Herpes is another STD. It can't be cured. Tell your doctor if you have any of these signs of herpes:

• sores or blisters on your genitals
• pain when you urinate
• mild fever
• watery liquid from the vagina
• headache or muscle ache

If the sores or blisters are there when it's time for you to deliver, your doctor may do a cesarean (suh-ZAIR-ee-un).

AIDS
People who inject drugs into their veins or have sex with a person who has AIDS are at risk of this disease. Tell your doctor if you think you or the baby's father might have AIDS. Get tested to find out. If you have AIDS, your doctor will try to keep your baby from catching it.

ALL BABIES CRY
Babies cry because they are hungry, wet, tired, sick, or startled, or just need to be held.

• Babies cry an average of 2-3 hours in a 24-hour period.
• They often cry the most at around two months old.
• Crying can come and go anytime, for no apparent reason.
• Crying can continue even though you offer comfort.
• The baby can look like it's in pain even though it's not.
• Crying can last 30-40 minutes or longer.
• Crying occurs more often in the afternoon or evening.

SHAKEN BABY SYNDROME (SBS)
Crying is the number one reason people shake babies. SBS is a serious injury that occurs when a frustrated person shakes a baby. It is a form of child abuse.

Babies have large heads and weak necks. Shaking back and forth in a whiplash motion causes devastating injury. One third of the babies who are shaken die; those who survive may suffer from one or all of the following:

• Blindness
• Deafness
• Cerebral Palsy
• Seizures
• Paralysis
• Lifelong dependence on others
• Learning and behavior problems

COPING WITH A CRYING BABY
Caring for a baby who won't stop crying is very frustrating. What works to comfort the baby one day may not work the next. The baby is not trying to be difficult. Don't lose your cool. Once you feel the baby's basic needs are met, stay calm and try the following:

• Offer the baby a pacifier
• Take the baby for a ride in a stroller or a car. Always use a car seat
• Hold the baby close and walk or rock
• Sing to the baby, play soft music, run the vacuum, dryer, dishwasher or a fan - babies like consistent, rhythmic noise
• Lay the baby tummy down on your lap. Gently rub or tap the baby's back
• Put the baby in a windup swing
• Put the baby in a safe place and walk away. Turn up the radio or TV. Check the baby every 10-15 minutes. The crying will stop eventually.
• Call a trusted friend, relative or neighbor to relieve you - it's OK to ask for help.
• Call a health care provider if the crying continues - the baby may need medical attention.

HAVE A PLAN
When anyone cares for your baby, make sure you discuss what to do if the baby cries. This includes moms, dads, mom's boyfriend, grandparents, siblings, child care providers, babysitters, relatives and friends.