What to Expect
We know that having medical concern for you or your baby in pregnancy is a scary time. We will do our best to assure that you have all the information and help you need to become prepared for delivery.
What Types of Images or Testing May Occur?
Because issues can often cluster together, our team will reevaluate everything on your baby, not just the area where the finding was seen on your prior ultrasound. Additionally, the physicians may need more specialized views including more detailed heart views (fetal echocardiography) or tests of fetal wellbeing (Doppler assessments, biophysical profile, etc.) depending on what was found at your prior ultrasound, or what is found when you come to our office. Some people will be referred for fetal MRI.
How Does the Team Work With My Referring Provider?
When you have been referred to our care for the remainder of your pregnancy, you typically will no longer see your own OB/GYN physician. We will be performing all of your ultrasounds and any further diagnostic testing you may need.
After delivery, a summary of your care (delivery summary) can be sent to your primary or referring physicians’ offices if you would like (after a signed release). If they are in the Care Everywhere system, they can directly view this information at any time.
We also understand that travel to Rochester can sometimes be challenging. Depending on your particular clinical issues, your care may be able to be co-managed with your local OB/GYN physician, midwife or provider. Certain visits with our team can often be conducted by ZOOM to minimize travel but still provide you with the care you need. This “shared-care” or “co-management” model will allow you to continue to develop your relationship with your own OBGYN physician and with us and to be set up for delivery at Strong Memorial Hospital.
We also provide consultative services to provide your OB/GYN physician with a plan to help keep you and your baby safe.
Our Team
You may or may not have the opportunity to meet all of our providers during your care. Our physicians rotate between our Red Creek Drive offices and the other areas where we see patients and perform ultrasounds.
To assure consistency of care, our physicians meet weekly to discuss patients’ care plans and also to confer any treatments most beneficial to each pregnancy.
How does my first visit work?
For most new patients, the first visit is a long one! Plan to be at our office for at least two hours.
Ultrasound:
Typically, you will first receive a specialized, Level II ultrasound. If there are specific genetic or fetal concerns, some women may meet with a genetic counselor to review their pregnancy and family history, and discuss typical testing and screening options before their ultrasound.
For your ultrasound, depending on where you are in your pregnancy and the specific concerns, this may include a fetal echocardiogram, a cervical or transvaginal assessment, or other specialized imaging of your baby and placenta. A vaginal ultrasound is often needed to help image your cervix and lower part of your uterus.
The sonographer and physician on site will review the images. If further testing or procedures are needed, these will be discussed and possibly performed after.
Typically, first ultrasounds after 16 weeks will take 45 minutes or longer. If there are multiples, the ultrasound may take longer.
Nursing intake:
After your ultrasound, you will move to the office where a technician will complete your height and weight and settle you into a room. You will meet with a nurse to review your medical history and complete screening questionnaires. The nurse will answer questions about our practice and review any concerns that you may have.
New visit intake with providers:
One of our nurse practitioners will then perform a history, physical, and assessment of you and your baby(ies). They will review the results of any testing or ultrasounds that were performed that morning, offer and review further screening and testing options, complete consent forms, and order medications or further testing. For most first visits you will meet with the physician on site to review any further concerns.
Other supports and needed care:
We are pleased to provide a full service Diabetes in Pregnancy Program for our patients. If you have diabetes, you will have the opportunity to meet with our high risk providers and our specialized diabetes educator. All of your diabetes care during pregnancy will be specially coordinated by our Diabetes in Pregnancy advanced practice provider/nurse practitioner so that you have consistent visits with person who knows you well and can help coordinate your care. If you have diabetes or other nutritional needs, you will also meet with our nutritionist (either at a first or later visit depending on timing needs).
If you need a non-stress test (depending on your care needs), you might be scheduled for this as well.
Genetic counseling:
Depending on your age, risk factors, or other concerns with your pregnancy, we may offer you the opportunity to meet with our genetic counselors as part of this visit, or by telemedicine after this visit. They can help offer additional insights, and recommend further testing. Learn more about these services here.
Mental health and stress support:
We also recognize that a pregnancy with complications or uncertainties can be very stressful. We have a therapist in our office that will stop in during one of your first visits to discuss how we can best help support you and your families during this time. Learn more about these services that are in our office here. (will link to the new tab as above)
Learn more about the UR Medicine Program for Mental Health and Gender Wellness in Obstetrics and Gynecology here.
Who Should I Bring?
It is helpful to bring a support person to help you make decisions and ask questions. We ask that you limit visitors to no more than two during the visit.
Because these first visits for high-risk pregnancy care can be long, we ask that you leave small children at home if possible, or bring snacks/entertainment for them. Dress in clothing that makes access to your abdomen possible.
We will be reviewing complicated issues related to your pregnancy, including review of your medical concerns. For babies with medical concerns, we will be discussing these concerns and prognosis and testing options. If there are portions of your or your baby’s medical history you do not want others to be aware of, please keep this in mind when selecting your support people.
What About Planning for Delivery? How Can I Meet the Pediatric Specialists?
Planning for delivery when there are medical or fetal concerns is going to be a key portion of your care. Before we have you meet with specialists, we need to make sure that we have a complete assessment of your infant’s challenges to let the team give you the best and most complete information possible.
Our dedicated fetal care coordinator will help you navigate these appointments, answer questions, and make sure that you are as prepared as possible before delivery.
Learn more about the Golisano Children’s Hospital and how our fetal care team prepares for infants with complicated births.
Can I Film My Ultrasound or Delivery?
Please review the hospital policies regarding recording/imaging.
Where We Are
Our practice is located at 500 Red Creek Drive, Suite 210.
Follow-up appointments will be scheduled on a Monday morning 8:30 a.m. - 11:30 a.m., or Wednesday 8:30 a.m. - 3:30 p.m.
Every effort will be made to coordinate any ultrasounds or fetal monitoring with your office visit, but this can make appointments long.
What if I Live Really Far Away?
For some patients coming a great distance, it may be possible to share care until delivery with your primary OB/GYN’s office, but this is on a case-by-case basis depending on you and your baby's care needs and the care available closer to home. We will typically need to see you at least a few times to allow for delivery planning, have you meet the care teams, and make sure that your plan is set for delivery.
For some babies that are critically ill where delivery outside of Strong Memorial Hospital and UR Medicine's Golisano Children’s Hospital may be life-threatening, our fetal care team may work with you and your insurance to see if staying closer to the hospital for the last portion of your pregnancy is a possibility.
Both before and after delivery, staying at the Ronald McDonald house that is near the hospital may be helpful, but it depends on the availability and care needs for your and your pregnancy.
Delivery
You will deliver at University of Rochester Medical Center at Strong Memorial Hospital with the physician on-call. There is an in-house team of 24h/7d a week on the labor and delivery unit. The University of Rochester Medical Center is a teaching facility, and residents and students are vital part of our care team, but there is always an in-house OB/GYN faculty member in charge of every patient’s care.
Most of our patients need oversight and care from MFM for their pregnancy management and while setting the plan for pregnancy, but their labor and delivery care is similar to other pregnancies. We therefore share on-call responsibilities with a highly-trained group of faculty generalist obstetrics physicians.
A maternal-fetal medicine physician is present in the hospital during daytime hours (8:00 a.m. to 5:00 p.m., Monday - Friday). For all other times, a member of URMC obstetrical team is present in the hospital and will oversee your labor and delivery. There is an MFM on-call by phone 24 hours a day if patients have questions or concerns, and are available if complications arise.
Virtual Tour from UR Medicine on Vimeo.
Contacting Us After Hours
Please call (585) 487-3352 with emergencies and urgent concerns. Please use MyChart or leave a staff message for non-urgent questions, referral and refill needs, etc. A member of our team will answer your concerns within one business day.
MyChart
Our office strongly prefers that you use MyChart, which enables you to securely use the Internet to help manage and receive information about your health. MyChart allows us to communicate directly with you, fill refill requests, provide feedback on laboratory testing, and remind you of upcoming appointments.
Learn more about MyChart.