Dr. Brabson and Nurse Practitioners Sharon Davis and Leslie Piety Stone all see new patients.
When
you call the office, usually you will talk to Teresa, Jamie, Andrea, or
Jessica. They will make your appointment or direct your call to Denise,
Julie, Jennifer RN, or Maggie who are trained to answer many of your
medical questions. Billing and insurance questions are answered by
Stephanie or Jamie.
When you visit our office, you will get to
meet Maggie, Denise, Julie, Nancy, or Jennifer RN who will prepare you
to be seen by Dr. Brabson or Sharon or Leslie
If you call after
hours, The answering service will contact Dr. Brabson. You may be
called back by him directly or your call may be directed to the
physician on call. Often times you will talk to Gail who is an RN and
Dr. Brabson's wife.
We were all saddened in October 2008 by the
death of long term receptionist Gwen Lynn. She was a kind,
gentle-hearted person who will be missed by all.
Sharon
Davis is a Certified Nurse Practitioner in Women's Health. She has
worked with Dr. Brabson and Women's Health Specialist for many years.
In addition to seeing OB and GYN patients in the office, she performs
sonograms.
Leslie
is a Knoxvillian who graduated from Maryville College and received her
Nurse Practitioner degree from Vanderbilt. She is certified in OBGYN.
She served as a Captain in the Air Force.
OB Information
OBSTETRICAL INFORMATION
Our
office functions as a team. Headed by Dr Brabson, our group consists of
a nurse practitioner, nurses, medical assistants, insurance and
financial coordinators, and secretaries. Our primary goal is to serve
you. We hope that as you get to know us, it will become evident to you
that we derive a great deal of joy from attending to the needs of our
patient. We consider our professions to be a calling, not merely a job.
We have chosen to practice at St. Mary's Medical Center for a
variety of reasons, but primarily because their philosophy so closely
matches our own. Additional details concerning the hospital and its
programs are covered later in this pamphlet.
A great deal of
effort has gone into the development of this pamphlet. We ask that you
read it carefully and keep it close at hand so that you may refer to it
as often as necessary. Be assured that our staff will also be available
to you to answer questions, which may arise during the course of your
pregnancy. Please do not hesitate to call upon us.
CALLING THE OFFICE
Because
we encourage questions, our office receives many phone calls daily.
These calls are handled according to priority. If you feel that an
urgent or emergency situation exists, give that information at the
beginning of your call. Otherwise, your call will be returned as time
permits.
Our telephone is answered in the office between the
hours of 9:00 A.M. and 4:30 P.M. During the remaining hours our
answering service receives all calls to our office and promptly relays
them the doctor or nurse. Occasionally during high volume calling
hours, return calls may be delayed. Please inform the operator if your
call is urgent. If your call has not been returned within a reasonable
amount of time, do not hesitate to call back. If you do not have an
emergency situation, we ask that you call during business hours.
There
are occasions when Dr. Brabson will be away from the office. As you may
understand, continuing education and family time are vital if he is to
continue offering the highest quality care to his patients. During his
absence Dr. Kristy Newton, an excellent OB/GYN specialist, will be
available to assist with any medical need that may arise. If you wish,
you will be given opportunity to meet Dr. Newton. There may be
occasional instances when another physician will be on call. There is
always a doctor available 24 hours a day, 7 days a week.
Thank
you for choosing to come to our office for obstetrical care. It is the
philosophy of our office to offer compassionate and competent care with
an emphasis on family.
EDUCATION
Experience has
shown that expectant mothers who have been well informed about
pregnancy, labor, and delivery generally have a more positive
experience with the entire birthing process. Therefore, our philosophy
embraces proper education of our expectant parents and the dispelling
of incorrect information, which may have been given by well meaning
family members and friends.
In that spirit, we ask that you
please give your attention to the following resources, which we believe
to be very informative and helpful.
ACOG Guide to Planning for Pregnancy, Birth, and Beyond This is a well-written book, which should be your primary source of information.
CLASSES:
St. Mary's offers a wide variety of classes covering many pertinent
topics of interest for expectant parents. You will be given information
on each class and are encouraged to participate if at all possible.
Also offered for families wishing to take a more active part in the
process of labor and delivery are LAMAZE classes. This is especially
important for families interested in natural childbirth.
PRENATAL CARE
It
is well-established fact that good prenatal care contributes to the
health of the mother and infant. Your prenatal visits will be arranged
at four-week intervals during the first 28 weeks of pregnancy. Visits
will then be scheduled at two-week intervals until the 36th week, at
which time visits will become weekly. Expectant fathers and other
family members or friends are welcome to come with you. The following
is an outline of important features and options available during the
course of your prenatal care.
Initial examination: On your
first visit a complete physical examination will be performed. At this
time your baby's approximate date of birth will be calculated. We will
add 40 weeks to the first day of your last period. When we refer to
weeks of pregnancy, we will always be counting weeks from that time. A
Pap smear will be done if needed and blood will be drawn and sent to
the lab to establish a prenatal profile.
Prenatal Profile:
This is basic pregnancy lab work performed on all new pregnancies.
Tests include blood typing, complete blood count, testing for Rubella
immunity, any unusual antibodies in the blood, previous hepatitis, HIV,
syphilis, gonorrhea, and chlamydia. These initial tests are considered
standard as defined by the American College of Obstetrics and
Gynecology (ACOG). Other tests performed later in pregnancy will be
outlined below.
Prenatal Visits: Each time you come to the
office, we will check your weight, blood pressure, and uterine growth.
Your urine will be checked for infection, sugar, and protein. After the
11th week of pregnancy we should be able to hear the baby's heartbeat
at each visit. During the last month of pregnancy, a pelvic exam will
be done at each visit to determine the baby's position and the
condition of the cervix. We will be able to tell how low the baby is,
how thick the cervix is, and how much it has dilated.
Alpha-fetoprotein
(AFP) or Quad Screen: This is a blood test done between the 16th and
20th week of pregnancy. It is designed to identify abnormalities of the
brain and spine such as spina bifida. Additionally, in approximately
80% of cases, Down's syndrome can be identified. It is also a screening
test for Trisomy 18, another chromosome abnormality. This test is
considered optional. Though this test is optional, our office highly
recommends that you allow it to be performed. The cost is covered by
most insurances.
Glucose Screening: Because there are no
detectable symptoms of Gestational Diabetes (temporary diabetes
occurring during pregnancy), it is standard practice that all pregnant
patients can be tested for this condition. If unrecognized and
untreated, it can cause serious consequences for both mother and baby.
At 24-28 weeks gestation, you will be given a liquid preparation
containing sugar to drink. One hour after finishing that drink, a drop
of blood from your finger will be tested for sugar content. If you are
at an increased risk for diabetes, this glucose screening may be
performed during each trimester of your pregnancy. At the same time,
the level of iron in your blood will be tested to make certain that you
are not anemic.
Rh Negative: If your blood type is Rh
negative, at 28 weeks of pregnancy your blood will be tested to see if
antibodies are being formed. You will also be given a RhoGAM injection.
More information concerning Rh factor can be found in the prenatal book
given to you.
Amniocenteses: Certain risk factors become more
common in mothers who are 35 years old at time of delivery. If you fall
into this age range or have a history of some inherited family
conditions, this test will be suggested. Additionally, if you are over
the age of 35, Chorionic Villus Sampling (CVS) will be offered.
Group
B Strep Screen: We will obtain a swab of the vagina around the 36th
week of pregnancy. This will let us know if you are a carrier of the
Strep bacteria. If your culture is positive, you will receive
intravenous (IV) antibiotics at the hospital when you go into labor. If
you are a carrier and are not identified, it could be harmful to your
infant. Again, there is more information in your book on this test.
Cystic
Fibrosis: You may choose to be tested to see if you are a carrier of
this inheritable condition. Any one person has a 1/25 chance of being a
carrier. For your baby to be affected, both parents have to be carriers
of the same variety of Cystic Fibrosis. There are many different types.
To help you decide, an informational brochure is available in the
office or by visiting www.acoc.org.
Many patients find that
making a list of questions prior to each visit is helpful to ensure
that no issues will be overlooked or forgotten.
GENERAL INFORMATION
Activity:
Generally, you may continue activities you are accustomed to doing,
including most exercise programs. As the baby starts to show there are
some things that are obviously dangerous, for example skiing or
motorbike riding.
Some patients like using exercise videos.
Our favorite is Dr. Art Ulene and is available in the local maternity
shops or by mail. Also, there are ongoing pregnancy exercise classes
available at several locations.
Diet: It is very important that
expectant mothers eat a well balanced diet containing sufficient
amounts of protein and vitamins. Prenatal vitamins with iron are
suggested all maternity patients. The average weight gain during
pregnancy is 25-30 pounds.
Morning Sickness: Morning nausea is
a problem for many expectant mothers. The following are recommended
guidelines, which may be help control symptoms:
1. Avoid spicy foods or foods with strong odors. 2. Eat frequent small meals. It is sometimes helpful to separate dry foods from liquids. 3. Add ginger to teas or drinks. 4. You may try taking Vitamin B6 25 mg, three times a day. 5. You may try Doxylamine or Benadryl. Both are antihistamines and may cause drowsiness. 6. Seasick wristbands sold at boating and travel stores may help. 7. Accupressure or acupuncture may help in more difficult cases. 8.
There is a wrist type device for morning sickness that uses a small
electric current. This is called a "Relief Band". The cost is
approximately $150 and may be purchased at www.reliefband.com. 9. Keeping a slice of fresh lemon in a plastic bag to smell during times of nausea helps many.
INFECTIONS
Herpes:
This is a common virus (HSV) that affects the mouth or genitals. In
adults it only affects local tissues. However, newborns, lacking adult
defenses, can be severely injured if contact is made with an active
lesion at the time of the delivery. Because of the danger involved, we
are especially interested in identifying herpes outbreaks during the
last month of pregnancy. If you have a history of HSV you may be given
suppression medications after 36 weeks.
Rubella: Rubella is also
known as German measles and can cause harm to an unborn baby. If you
are not immune to this virus, avoid anyone who has a rash and fever.
After delivery, you will be offered a vaccination to prevent problems
during future pregnancies.
Chicken Pox: This is common
childhood illness, which if acquired during pregnancy can damage the
unborn baby. If you are not sure if you have had chicken pox, we will
do a blood test to see if you have immunity to the virus.
Toxoplasmosis:
This is a microscopic parasite that is found in cats and other animals.
In adults if often causes no symptoms. However, infants can be severely
affected. To avoid being contaminated with parasite, expectant mothers
should not change cat litter. Also, eating raw or rare meat should be
avoided.
Listeria: Listeria is a bacterium that can cause harm
to pregnancy. The Center for Disease Control recommends the following
in order to avoid contracting the bacteria: Avoid soft cheeses
such as Mexican, Feta, Brie, Camembert, and blue veined cheeses. Cream
cheese, cottage cheese, and yogurt are considered safe. Avoid raw, unpasteurized milk. Heat or cook deli meats and hot dogs. Wash raw vegetables and hands after handling any of the above.
Colds:
Colds are very common and are rarely considered to be a serious
problem. Medications for treatment of symptoms are listed in the
following section.
Medications
Most people are aware
that few, if any, medications should be taken during pregnancy. There
are, however, situations which arise that make it necessary for
expectant mothers to be medicated.
Tylenol may be taken for
mild aches and pains. One or two regular or extra strength tablets may
be taken as often as every four hours. Avoid Aspirin.
Sudafed tablets may be taken for sinus congestion according to package
directions. Sudafed is a mild decongestant and is safe to use during
pregnancy. Claritin and Benadryl are antihistamines and may be
used according to package directions. These are helpful to dry up the
sinuses. If symptoms persist and fail to improve, call the office for
further instructions. Robitussin or Mucinex may be taken
according to package directions for chest colds with cough. We suggest
that no cough syrup with "DM" in the name be used. Mylanta or
Tums May be used for heartburn. Chilling the Mylanta may help relieve
the symptoms quicker. Tums will also provide extra calcium for mother
and baby.
Drugs: As time goes on, more and more evidence
appears about tobacco. Smoking is extremely dangerous for mother and
baby. Now is a good time to eliminate this dangerous drug from your
body. Some doctors consider it child abuse to smoke while pregnant. It
is also suggested that the father-to-be stop smoking. It is very
unhealthy for a newborn to be in the same house with smoke. Children
who grow up in homes where one or both parents smoke end up being
admitted to the hospital 50% more often than children in nonsmoking
homes. Drugs such as marijuana, cocaine, and other illicit substances
are never safe. All of these are extremely harmful. If you think this
could ever be a problem, please discuss it with us. Alcohol should be
avoided during pregnancy. Caffeine is OK in reasonable quantities.
Nutrasweet is acceptable in small quantities (1-2 servings per day).
Toxins
Fish
are an important part of a healthy diet. However, chemicals in some
fish may be hazardous to your health. Eating large amounts of fish
containing chemical pollutants may cause birth defects, liver damage,
and other serious health problems. To reduce their risk from eating
fish containing chemical pollutants, patients should follow local
advisories, and/or the following advice from the Food and Drug
Administration:
1. Advise young women, those who may become
pregnant, nursing mothers, and young children, not to eat shark,
swordfish, king mackerel, or tilefish. 2. Advise young women of
childbearing age they can safely consume up to an average of 12 ounces
a week of cooked fish from a store or restaurant. 3. Advise women of childbearing age not to eat more than 6 ounces of cooked fish in a week that are caught in local Waters. 4. Advise young children not to eat more than 2 ounces of cooked fish in a week that are caught in local Waters.
Additional
guidance on the proper selection, cleaning, and cooking of
noncommercial fish is available in the brochure Should I Eat the Fish I
Catch? or A Guide to Healthy Eating of the Fish You Catch from the U.S.
EPA web site www.epa.gov/ost/fish or by calling 1-800-490-9198 and
requesting document number EPA 823-B-97-009.
Travel
Generally
you should stay close to home during your last month of pregnancy. This
is suggested to avoid the possibility of going into labor in unfamiliar
surroundings. Also, you would be without the benefit of having your own
obstetrician available to deliver your baby.
For long trips,
air travel is much more comfortable. Empty your bladder regularly when
traveling. Avoiding using bladder stops could result in bladder
infections.
While traveling and seated for long periods, the
circulation in your legs is decreased. This may increase your chances
of developing a serious blood clot. It would be helpful to exercise
your legs while seated. If would also be good to walk around for 3-5
minutes where stopping to empty your bladder. Whether traveling by car
or plane, please wear your seatbelt. Remember you have to lives to
protect.
Dental Care
You may have heard the old wive's
tale that you lose a tooth for every child you bear. Of course, this is
untrue. Even though you need extra calcium for pregnancy, your body
does not take it from your teeth. The main reason people have dental
problems is because they do not take proper care of their teeth.
Because
of hormone increases during the pregnancy, gums may become swollen and
tender, making brushing more difficult. It is important, however, to
brush at least twice a day and after eating sugary snacks. Use a soft
toothbrush. Also recommended is the daily use of dental floss, which
removes plaque. Plaque is the substance, which hardens on tooth
surfaces and below the gumline. Though not visible to the naked eye, it
provides a place where bacteria may grow and allow cavities to develop.
Continuing regular dental cleanings and check ups is
important. Some dentists prefer not to examine patients during the
first three months of pregnancy or during the last month. However, it
is quite safe to have regular visits as needed. Local anesthetics and
dental x-rays are acceptable while pregnant. A protective lead apron
should be worn during the X-ray. We do recommend that no Nitrous oxide
(laughing gas) be used during pregnancy.
In summary, we
recommend that you brush and floss daily and see your dentist regularly
for checkups or if dental problems arise. Please feel free to call our
office if you have more specific questions regarding dental care during
pregnancy.
Delivery
We only use St. Mary's Women's
Pavilion for delivery. St. Mary's has been a leader in maternity care
for years. They have a family centered unit that has Single Room
Maternity Care. This means that you have labor, delivery, and
postpartum all in the same room. The baby stays in the room with you
unless you ask for a break. Then the baby can go to an observation
nursery. With low risk deliveries you can have totally natural
childbirth without medications. If you desire, around the clock
anesthesia is available. For high risk situations, all of the state of
the art equipment & personnel are available, including a Level IIB
Nursery which can care for all but the extremely small or sick newborns.
AFTER DELIVERY
Ordinarily
an office visit is scheduled 4-6 weeks after delivery. At this time we
will check to see if things are getting back to normal. A Pap smear is
done if the bleeding has stopped. It is important that you have this
repeated on an annual basis.
Breastfeeding is highly
recommended. After delivery you will be given instructions for
breastfeeding. However, experience is the best teacher. If you
encounter any difficulties with nursing, please do not hesitate to call
our office. A lactation consultant is available at the Women's pavilion
of St. Mary's.
St. Mary's offers an excellent breastfeeding
class. There is a lactation consultant who works with the hospital. It
is her job to help you learn how to nurse in the hospital after
delivery. She is also available to help you after you go home.
Our
ultimate goal in providing your obstetrical care is to insure you
continued good health and the delivery of a healthy infant. If you have
questions, please feel free to discuss them with us. Again, thank you
for choosing us.
939 Emerald Avenue Suite 806 Clark Tower Knoxville, TN 37917
865-637-8231 or 865-470-0493 www.drBrabson.net nurse@drBrabson.net
