Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
We offer many resources to help you and your partner prepare for your baby. Learn about what to expect during and after pregnancy including labor and delivery, breastfeeding, and when to call us.
The first trimester includes the first 12 to 14 weeks of your pregnancy. It starts with conception, including the period of time before you knew you were pregnant. Fetal development is rapid, and you will see many changes in your body as well. This includes many hormonal changes, so the first trimester can be a time of emotional fluctuation.
Do you think you may be pregnant? Some women can tell almost immediately because of certain changes in their body. The most common symptom is a skipped period. Other early signs include:
If you have any of these symptoms and you have not yet had a pregnancy test, please have one soon. You can stop by our lab for a pregnancy test. No appointment or lab order is needed.
The first trimester is a time of rapid growth for your baby. Your baby started out as a fertilized egg no bigger than the period at the end of this sentence. Arms and legs will develop in the first 14 weeks, and most vital organs will take shape as well.
During your pregnancy, there are many kinds of prenatal tests that can help you learn more about your baby's health. All prenatal testing is optional, though many kinds of tests are a routine part of every pregnancy. We can discuss your options and decide which tests might be appropriate for you.
These are tests that we recommend for all pregnancies to check the health and development of your baby. These routine prenatal tests are safe for you and your baby. During your first trimester we may recommend tests for:
In addition, we routinely offer an ultrasound test during your first trimester of pregnancy.
Certain blood tests can help you find out if you have a higher or lower chance of having a baby with certain birth defects, but they can't make a definitive diagnosis. These are optional prenatal tests, and they are very safe for you and your baby. Serum-integrated screening, sequential integrated screening, and quad tests are examples of optional screening tests. These tests are most effective when done at a certain stage of fetal development. Depending on which trimester you are in, we can discuss which screenings are available for you.
While there is no test that can detect all potential problems, these tests can diagnose certain kinds of birth defects. Prenatal diagnostic tests are more invasive than other prenatal tests, and there is a very small associated risk of miscarriage. Some women choose diagnostic tests based upon their family history or their age during their pregnancy. Examples of diagnostic tests are amniocentesis and chorionic villus sampling. These involve using a thin needle to collect a small amount of amniotic fluid or tissue from the placenta.
Breast milk is the perfect food for your baby. There are many health benefits for you and your baby. According to the American Academy of Pediatrics, breast milk is the only food that your baby will need during the first 6 months of life. We recommend that you continue to breastfeed your baby for up to 1 year if you are able to. Even after you introduce solid foods, you can continue breastfeeding for as long as you wish.
Breastfeeding decreases your baby's risk for many types of infections and allergies. Benefits include:
Benefits to you may include:
There are rare medical conditions where breastfeeding is not advised. We can talk further if this applies to you.
You and your baby will be more successful at breastfeeding if you are prepared. You can begin preparing now and continue throughout the last weeks of pregnancy. Suggestions for how to prepare include:
Take a class, read a book, or read our article on breastfeeding for more information. Talk to women who've had successful breastfeeding experiences. Remember, breastfeeding is a learned skill and takes practice.
To locate classes near you, search our health class directory or contact your local Health Education Center or department.
Breastfeeding does take time, but it is time well spent. You're giving your baby the best possible food, holding your baby close, and making a strong connection. Breast milk is the best food for your baby and has all the nutrition your baby needs for the first 6 months of life. The longer you breastfeed, the greater the benefits will be for you and your baby.
Get phone numbers of hospital lactation consultants, your local Pediatric Department, or members of your local La Leche League. Have these numbers ready so you can call after you and your baby go home from the hospital. For breastfeeding questions, call the 24-hour helpline at 877-4-LALECHE.
Expressing and storing your breast milk allows you to get extra milk from your breasts that can be given to your baby when you're not there.
All new mothers will need help in the beginning, so ask your friends and family to plan to help out. After the baby arrives, they can assist with meals, shopping, and the care of older children. This will allow you to spend plenty of time with your new baby.
Fatigue is due to high levels of the pregnancy hormone progesterone. It usually gets better by the second trimester as your body adjusts. Sometimes fatigue can be due to anemia. We will check this with your prenatal lab work and will let you know if you are anemic. What you can do:
The milk glands in your breast are enlarging so that you will be able to breastfeed your baby. You may notice some bluish veins on your skin. This is due to the increase in blood supply to your breasts. You might notice your nipples and the areolas (the dark skin around the nipple) getting darker. What you can do:
You are not alone. This is a common symptom of early pregnancy and often gets better by the second trimester. Even though this is commonly called "morning sickness," it can happen at any time during the day. What you can do:
Please call us if you have vomiting that is:
Frequent urination at this stage of pregnancy is caused by pregnancy hormones. Also, as your belly gets bigger your uterus presses on your bladder. What you can do:
Headaches may occur more frequently when you are pregnant for many different reasons. The most common types occur because of tension or from sinus/nasal congestion. If you have a prescription headache medication, please check with us before you use it. What you can do:
Pregnancy hormones cause the digestive tract to relax and function more slowly, which can cause constipation. As your uterus enlarges, this can also cause constipation. What you can do:
Heartburn (sometimes also called reflux) is caused by stomach acid coming up into your esophagus (the tube connecting your mouth to your stomach). Heartburn during pregnancy is caused by a hormone which relaxes the stomach sphincter that normally keeps the acid out of the esophagus. This same hormone causes a delay in stomach emptying so that more acid builds up. What you can do:
If your heartburn is still a problem, please let us know. There are prescription medications that you can use.
Spotting is not uncommon during the first trimester. It can happen because the cervix is very sensitive to touch during pregnancy. It can happen after a pelvic exam in the office or after having sex. Bleeding from the cervix does not hurt the baby. However, if you bleed every time you have sex, you may want to refrain from intercourse for a while so that you are not always wondering if everything is okay. There are many other ways to give and receive pleasure. Talk with your partner and decide together.
Spotting can also be a sign of a miscarriage. You should call us if you have:
We will do an ultrasound and/or blood work to determine if the pregnancy is progressing normally.
It is normal to have daily nausea or vomiting during the early part of pregnancy. However, some women can develop hyperemesis gravidarum (excessive vomiting). Symptoms could include:
If you have any of these symptoms, please call us as soon as possible. You may need IV fluids (to rehydrate you) and medications to help with the nausea and vomiting. This can be done in the office during office hours or in the Emergency Department after hours.
Urinary tract infections (UTIs) are more common during pregnancy. You may have a UTI and not know it, which is why we check your urine every time you come in to see us. You may have a UTI if you have:
If you have any of these symptoms, we will do a urinalysis and urine culture. If you have a UTI, we will prescribe medications that are safe to use during pregnancy. It is also important to drink plenty of fluids to help flush out the bacteria. After you have been treated for a UTI, you will need to provide another clean urine sample so that we can make sure that the UTI has cleared.
An untreated UTI could turn into a kidney infection, which is a more serious infection. Symptoms, in addition to UTI symptoms, include:
If you develop a kidney infection, you may have to be hospitalized for treatment with IV antibiotics and fluids.
An ectopic pregnancy is when the fertilized egg implants outside the uterus. The most common place is in the fallopian tube (a tubal pregnancy). Risk factors for an ectopic pregnancy include:
Signs of an ectopic pregnancy can include:
If you have any of these symptoms, you need to be seen right away. If you have had an ectopic pregnancy in the past, then you should be seen early in the current pregnancy to make sure that the pregnancy is developing normally in your uterus.
Please call our Appointment and Advice line right away if you’re experiencing:
If you're thinking of getting pregnant:
If you think you might be pregnant:
When you know you're pregnant:
If you have an unplanned pregnancy, let me know. We can talk about your options.
I will perform an exam to confirm your pregnancy and estimate your due date. I'll also recommend the first routine prenatal tests. Your visit may also address paperwork and lab work related to your pregnancy. My staff will also schedule you for your next visit at around 12 to 14 weeks.
Early in your pregnancy, we'll begin discussing your prenatal testing options. These tests are available to women who want to screen or test for certain birth defects and are different from the routine tests given to all pregnant women. Several of the tests need to be performed during the first trimester.
When you're learning about the different types of tests and choosing which tests you'd like to have, please review our health tool called Prenatal Testing Options to get additional information.
Subscribe to our Healthy Beginnings newsletter. The newsletter is delivered to your e-mail inbox every week of your pregnancy, and it has information and answers to common questions as your pregnancy progresses.
You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
As your personal physician, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.