Pregnancy, Birth & Postpartum

Bring it on!

From elated to overwhelmed (and through all the emotions in between), we’re here to help you enjoy a happy, healthy pregnancy.

  • The Basics

  • First things first: what kind of care is right for you?
  • Care in the first trimester
  • Care in the second trimester
  • Care in the third trimester
  • Care in the fourth trimester
  • First things first: what kind of care is right for you?

    Maybe you’ve taken a pregnancy test (or three) at home, maybe you’ve missed a period and feel like something is just…different. Whatever the method of determination, now is a great time to start thinking about the type of pregnancy care you want.

    Midwifery Care

    Pregnancy care provided by a nurse-midwife is a wonderful option for healthy women with a low risk of complications. Nurse-midwives view pregnancy and childbirth as normal, healthy events that don’t necessarily require a lot of medical intervention. WHA’s midwives are certified nurse-midwives, which means they have bachelor’s degrees in nursing, master’s degrees in nurse-midwifery and have taken national board exams to become certified. They can prescribe many types of medication and care for you in the hospital—even if you’re thinking about having an epidural for pain management during labor. Nurse-midwives emphasize education, shared decision making and making sure your pregnancy—and YOU—are as healthy as can be. They also collaborate closely with our physicians to provide you with the best possible pregnancy care. Meet our nurse-midwives >

    Physician care

    Physician pregnancy care is provided by specialists who have completed four years of additional training in obstetrics and gynecology after finishing medical school. They are trained to care for normal, healthy pregnancies, but are also able to help you navigate complications that may arise along the way, such as gestational diabetes or high blood pressure. OB/GYN physicians are also trained surgeons, which means they can (among other things) perform C-section deliveries, if needed. Most of our physicians work together in a team with midwives to offer the best care to our patients in pregnancy and birth. Find an OB/GYN physician >

    Hospital or birth center?

    At WHA, you have the option of either! Our physicians and nurse-midwives attend births at seven Portland-area hospitals. We also offer pregnancy care and support for natural, out-of-hospital birth at our Midwifery Birth Center >

  • Care in the first trimester

    A pregnancy is divided into three trimesters, each one lasting 13 weeks or about three months. The fetus spends around 38 weeks in the uterus (womb), but the average length of gestation is calculated as 40 weeks from the date of your last period.

    The ideal time for your first visit with your doctor or nurse-midwife is usually between eight to 12 weeks because this timing allows us to confirm your due date more accurately. You may have an earlier visit with a nurse or medical assistant to provide the information you need to consider before your first visit with your provider. Topics for this first visit usually include common do’s and don’ts of pregnancy, early pregnancy self-care and any questions you have. Here’s what you can usually look forward to in the first trimester:

    • Blood and urine tests. (Note these days we don’t need to confirm your pregnancy with a blood test – your home pregnancy test is accurate!)
    • A limited ultrasound.
    • One or two office visits; usually one with a nurse or medical assistant and one with a doctor or nurse practitioner/nurse midwife.

    If you have a history of depression, anxiety or eating disorders—or if you’re concerned about normal weight gain, smoking or substance abuse during your pregnancy, we want to help. Talk to your provider about seeing one of our behavioral or mental health specialists. Learn more >

    Pathways Prenatal Care. At many of our locations, a number of our physicians and nurse-midwives pregnancy care in the Pathways model. If your provider is part of Pathways, you’ll have a combination of traditional, one-on-one visits and group visits during your pregnancy. Learn more about Pathways >

     

  • Care in the second trimester

    The middle part of your pregnancy (the 13th week through the 27th week) is called the second trimester. During this time, you’ll likely have one-on-one and/or group visits approximately once a month unless there’s a reason to see you more often. There is usually a detailed ultrasound at around 20 weeks to look at the baby’s anatomy. Sometimes we can’t see everything we need to evaluate during this ultrasound due to the baby’s position or other scanning challenges—so we may need to schedule a follow up ultrasound. Unless there’s a medical reason for ultrasounds later in pregnancy, this will probably be the last one. Learn more about ultrasound at WHA >

    Our care includes screening for gestational diabetes, usually between 24 and 28 weeks of pregnancy. Gestational diabetes rarely has symptoms but can cause complications for mom and baby during and after birth. Learn more about gestational diabetes >

  • Care in the third trimester

    The home stretch (literally)! The period beginning with your 28th week of pregnancy is known as the third trimester. During this time, visits generally increase in frequency to twice a month. At 36 weeks, you’ll typically come in weekly until you have your baby.

    The third trimester is a busy time with many things to do and consider, including:

    • Taking a birth preparation class or classes (If you’re part of Pathways, birth prep will be included in your group visit schedule.)
    • Considering your birth plan and putting it in writing
    • Choosing a pediatric provider
    • Getting a Tdap shot for you and other adults who will be living with the baby
    • Visiting and pre-registering at the hospital
    • Thinking about what kind of contraception you’ll use after giving birth; be sure to ask your provider if you want to discuss your options
    • Researching lactation resources at the hospital or in the community in case you need help with breastfeeding
    • Packing for you and the baby
    • Considering any decisions you’ll need to make around the care of your newborn, such as circumcision >

    When you arrive at the hospital in labor, you’ll meet the WHA nurse-midwife or OB/GYN physician on duty. Under normal circumstances when you go into labor spontaneously, there will be no way of knowing which provider will have the privilege of welcoming your baby into the world—but you can be confident that there will be a skilled and compassionate WHA clinician there to care for you.

  • Care in the fourth trimester

    Yup—you read that right. But don’t worry. The ‘fourth trimester’ refers to the first three months of your baby’s life outside the womb and the beginning your motherhood journey. While your pediatric provider will be caring for the new baby, we’ll be making sure you’re healing and adjusting to this new life physically, mentally and emotionally. If things are going well, this time usually includes two appointments: one about three weeks after birth (the postpartum visit) and one at about eight weeks—which is a complete women’s wellness visit. Of course, if you have any concerns before or between visits, our advice nurses are happy to help!

Midwifery Birth Center

Is out-of-hospital birth right for you?

There are many wonderful ways to bring a baby into this world. For some, a low-intervention, unmedicated birth feels right. Laboring in a familiar setting surrounded by a dedicated, supportive team can make all the difference. Where might one find such an awesome place? We were hoping you’d ask…

Learn more

Is this normal?

Answers you want, questions you may not want to ask

Additional Resources for You

ACOG Patient Information

Information from the American College of Obstetricians and Gynecologists on a wide variety of women’s health issues.

Office on Women’s Health

Articles, fact sheets, resources and infographics on staying healthy throughout your life from the U.S. Department of Health and Human Services. Excellent breastfeeding information!

Our Moment of Truth

Learn more about midwifery care and women's health during pregnancy and beyond on this site from the American College of Nurse-Midwives.

La Leche League

Information and support related to breastfeeding--including local support groups.

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