Melanie Cole (Host): Having a baby is a very exciting time. MIT Health obstetricians, gynecologists and nurse practitioners provide complete gynecological care during your pregnancy. Welcome to Conversations with MIT Health. I'm Melanie Cole. My guest today is Nicole Napier. She’s a nurse coordinator and obstetrics and gynecology at MIT Health. Welcome to the show, Nicole. Tell patients what they can expect with prenatal care at MIT Health. 

Nicole Napier (Guest):  Hello. Thanks for having me. A patient should expect to have a wonderful experience here with us at MIT Health. For most patients, it’s very convenient to have their pregnancy care here at MIT Health since we’re right on campus and you can choose to have your care with the midwives or the physicians, as we offer both. Patients should expect that they will see us often for their visits; first, starting monthly until about seven months of pregnancy and then, every two weeks and then, at the final month, weekly. We have a very caring, dedicated staff and the patient should expect that they will be in great hands with us. Patients have told us that they feel the care here is more personalized and that we work hard to make them feel that way. What’s also a plus is that we have a triage nurse who is available to answer questions during our normal business hours and our clinicians are on call for urgent questions after hours. I always recommend that patients have their babies with us. Our care is unlike any other – I promise it is.

Melanie:   What can patients expect from their first visit with ob/gyn?  What time frame do you tell them that they should come in once they realize that they’re pregnant and what about high risk patients?

Nicole:  People are generally very excited when they see their first positive pregnancy test and some might do up to six tests to make sure that they’re really pregnant and call right away to be seen. However, there’s very little that can be done or seen very early in pregnancy. At this point, it’s important to follow a healthy lifestyle and for us to assess if the patient is having any problems like bleeding. So, a patient should expect to receive a call from a nurse right away after scheduling her first pregnancy appointment to check if she’s taking her prenatal vitamins, find out how she’s feeling and answer any questions. In addition, a packet with lots of information regarding our pregnancy program is sent to the patient. Now, if there are no medical concerns, the first pregnancy with the clinician is scheduled at 8-10 weeks since we can do an ultrasound at that time and see the baby’s heartbeat. This is very exciting for parents-to-be. One week before that appointment, the patient will meet with a nurse to create a pregnancy chart and review the patient’s medical history and the patient receives a pregnancy folder at that visit to keep for the entire pregnancy. This folder is a great resource for patients as it has even more information about our pregnancy program. Now, as for high risk pregnancies, they will still receive a call from the nurse and she can guide them on whether or not they need to be seen earlier. Most times, we don’t find out that a patient is high risk until later in the pregnancy and not every hospital has maternal/fetal medicine specialists, which are doctors that specialize in high risk pregnancies. We can refer a patient to their service to help us determine the best way to care for the mother and her baby.

Melanie:   What would constitute a high risk pregnancy?  If someone calls you but they don’t know that they are high risk or maybe they have diabetes or some other chronic condition, what really constitutes a high risk pregnancy?

Nicole:  Well, that really depends. It varies. Your age could make you high risk, being 35 or older. Certain medical conditions, like having high blood pressure or, like you said, diabetes. If we know the patient, most likely that’s already going to be documented in her chart but even for these conditions, very early in pregnancy, there’s not a lot to do. When the nurse sees the patient at the first visit and we go over her medical history, this is how we identify who is high risk and who is not. But, like I said, sometimes we don’t know until later in pregnancy.

Melanie:   Then, throughout pregnancy there’s test that have to be done. Where to ob/gyn patients go for their bloodwork, for their ultrasounds or for other prenatal tests?

Nicole:  It depends. Most blood tests are done here at MIT Health in our laboratory. The ultrasounds could be done at a variety of places depending on the type of ultrasound we’re ordering. Some can be done a Brigham and Women’s Hospital, some done off-site in Brookline and some done at Mount Auburn Hospital.

Melanie:  How convenient for everybody. Now, tell us a little bit about Mount Auburn Hospital and where the deliveries take place.

Nicole:  Patients who receive care here at MIT Health will deliver their babies at Mount Auburn Hospital and their Bain Birthing Center. Mount Auburn Hospital is located in Cambridge and parents have told us that they’ve enjoyed their delivery experience there.

Melanie:  What concerns, what do you hear every day Nicole from patients that ask you things about their pregnancy, common concerns and things people ask you every day?

Nicole:  Great question. Well, the answer is there are a lot of questions. Most patients will ask if there are certain foods they should avoid or if they can exercise or travel during pregnancy. When they first call to inform us that they are pregnant, the call they receive from the nurse can address most of these types of questions. I would say another big question is, what is the difference between a doctor and a midwife, as we offer both pregnancy care with both of those people. Explaining the doctor is usually easy as everyone knows what care a doctor can provide. A certified nurse midwife is a licensed healthcare practitioner educated in nursing and midwifery. Midwives follow the principle that pregnancy and birth are normal and healthy until proven otherwise. So, midwives can provide prenatal and post-partum care for women who are low risk for complications during pregnancy. Now, just because you are high risk does not necessarily mean that you are not eligible for midwifery care. Our midwives have a very close relationship with our ob/gyn physicians here with whom they can consult as needed for pregnant or laboring patients.

Melanie:   It’s such great information. In just the last few minutes, Nicole tell the listeners what you really want them to know about your team at MIT Health.

Nicole:  We have a wonderful team. A very caring staff, very dedicated staff. Most of our team has been here for many years – myself since 2004. I think the care that my team provides is so personalized and, from my experience and from what patients have told me, very different from care they have received in other places. So, we take a lot of pride in that and we work hard to make sure the patients have that type of experience.

Melanie: Thank you so much for being with us today. Listeners can visit Health.mit.edu for more information and to get connected to one of our providers. That concludes this episode of Conversations with MIT Health. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. . I'm Melanie Cole. Thanks so much for joining us today.