The 36 week visit with your physician or the certified nurse midwife is an opportunity to discuss a number of issues including how to recognize true labor, pain control in labor, choosing your baby's pediatrician, choosing breast vs. bottle feeding, and birth control after delivery. Your provider will also collect vaginal cultures at this visit: one to check for Group B Strep and one to recheck for Chlamydia and Gonorrhea, if it is indicated. It is important to screen for these infections at this time so that, if positive, you can be treated and decrease the risk of transmission of these infections to your baby at the time of delivery. 

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FALSE VS TRUE LABOR

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Timing of Contractions

False Labor: Irregular and do not get closer together. Usually last 14-45 seconds.

True Labor: Come at regular intervals and, as time goes on, get closer together. Each lasts about 30-70 seconds.

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Change with Movement

False Labor: Contractions may stop when you walk or rest, or may even stop with change of position.

True Labor: Contractions continue, despite movement.

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Strength of Contractions

False Labor: Usually weak and do not get much stronger (may be strong and then weak).

True Labor: Increase in strength steadily. May become stronger with walking.

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Pain of Contractions

False Labor: Usually felt only in front. Rarely felt as back pressure.

True Labor: Usually starts as pressure or cramping in the back and moves to the front. Contraction will move down the abdomen in waves.

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Record the time each contraction starts for one hour. Labor is usually active when the contractions are 5 minutes apart for at least one hour and are steadily increasing in intensity.

• If the office is open, call the office (252-443-5941) when your contractions are 5-10 minutes apart for at least 1 hour.  If your symptoms indicate possible true labor, then you will be scheduled for an appointment in the office for evaluation.

• If the office is closed, then call the after-hours phone number (252-962-8822) and ask to speak with the physician on call for Nash Ob-Gyn. If your symptoms indicate possible true labor, then you will be advised to go to Nash UNC Women’s Center for evaluation.

 

Ruptured membranes (breaking of the “bag of water”) may be a gush or trickle of fluid from the vagina. Amniotic fluid is a clear, sticky fluid with a clean smell. If the fluid is greenish brown or bloody, notify the office immediately. Even if you have no other signs of labor, you should be evaluated. Call Nash Ob-Gyn during office hours at (252) 443-5941 or go to Nash UNC Women’s Center after hours. Once your water breaks, there is a risk of infection. DO NOT take any tub baths if you suspect your water has broken.

 

Do not eat solid foods if you suspect you are in labor. You may have clear liquids such as water, Sprite, Jello, and apple juice.

 

PAIN MANAGEMENT DURING LABOR

An epidural is one method used to ease the discomfort of labor contractions.  Epidurals make the contractions feel less strong and easier to manage. If you have questions about ways to decrease the need for pain medicines or about other choices of pain control, ask your nurse or physician.

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CHOOSING A PEDIATRICIAN

Before Delivery: Ask family members and friends for recommendations. Call the pediatrician’s office to tell them you are pregnant and who you would like to have for your child’s pediatrician. They will then tell you the process for establishing as a new patient.

 

After Delivery: The neonatologist at Nash UNC Healthcare will examine your baby after delivery and while you are in the hospital. After you are discharged, you will need to take your baby for an examination with his/her pediatrician.

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CHOOSING HOW TO FEED YOUR BABY

Breastfeeding: Breast milk provides every nutrient your baby needs not just to grow, but to be healthy. Breast milk is easy for your baby to digest; it changes to provide the exact nutrients your baby needs. Your milk has protective antibodies that help protect your baby from infections. There are Certified Lactation Consultants at Nash Women’s Center who can answer your questions and assist you after delivery with breastfeeding.

 

Formula: Some women are unable or do not wish to breastfeed. Commercial baby formulas are available and have been developed to provide the essential nutrients to your baby. We recommend discussing formula choices with your baby’s pediatrician.

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Our office has also partnered with McKesson Patient Care Solutions to provide you with your breast pump needs. Please inform your nurse at your 36 week visit if you plan to breastfeed. At that time, your nurse/doctor will send a prescription to McKesson Patient Care Solutions who will verify your insurance and contact you to ask which of the covered breast pumps you would like to use. Most insurance companies will cover the cost of a breast pump. There is no need for you to contact your insurance company. Let McKesson do the work for you!

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