Expecting and New Parents

I. Prenatal Care:

     i.   Appointment Help Line: 760 - 725-HELP (4357)
     ii.  OB Appointment Line: 760 - 725-4357
     iii. FP Appointment Line: 760 - 725-4357

II. FAQs:

1. Am I pregnant?
     If you think you may be pregnant, make an appointment for a simple pregnancy test with your primary care proved. Your provider will assist you with referral to Naval Hospital Camp Pendleton’s Obstetrics registration & resources.

2. When should I see my provider?
     Once you are confirmed pregnant you will receive a referral to “OB Registration” and receive a call to complete your initial health paperwork, choose your care center as Family Practice or OB, and have your initial lab work done. After that, your first appointment will come from your clinic of choice between your 8th and 10th week of pregnancy. Clinics are located on the 2nd floor of the hospital, east side.

3. What are the differences between providers?
     For a description of OB/GYN providers, midwifes, etc., please navigate to the Academy of Obstetrics & Gynecology (ACOG) homepage.

4. What over-the-counter medication can I take? Foods I can eat?
     Many over-the-counter medications are safe in pregnancy. See a list here. Avoid Aspirin, Ibuprofen, Naproxen. Consult your PCM if you have any questions regarding these or your regular prescription medications. Avoid unpasteurized dairy products, raw fish and other raw meats, due to the risk related to ingesting too much mercury. Consult your PCM at your next appointment regarding alcohol consumption or other foods you regularly eat.

5. What should I bring with me to triage?
     We recommend that you are seen at the facility where you normally receive your prenatal care for the best continuity of care. If you have your medical chart in your possession, please bring it with you.

6. What is Pre-term labor?
     Preterm labor is labor before 37 weeks gestation when your baby is considered “term”, though “full term” gestation is 40 weeks. Any of the following signs may signify preterm labor:
        A. Greater than 4 contractions in an hour that feels like abdominal cramping or intermittent low-back pain
            i. Timing: count the time from the beginning of one contraction to the end for duration, and the beginning of one to the beginning of the next for frequency.
                If you notice symptoms of pre-term labor, you should:
                   a. Empty your bladder
                   b. Alter your activity (if you are resting, begin activity; if you have been active, lie on your left side and feel your abdomen for tightening).
                   c. Drink 3-4 glasses of water.
                   d. Call the labor & delivery triage for further evaluation

7. Is my spotting or discharge normal?
     After a cervix exam or intercourse, small amounts are normal. May also be normal in third trimester, call for further evaluation. Small white or clear amounts of discharge throughout pregnancy or loss of mucus plug are all normal. If your discharge causes itching or pain, has a foul odor, or is discolored, call for further evaluation.

8. Did my water break?
     There are many changes in quality and quantity of vaginal discharge during pregnancy. If you are of term gestation (37 weeks+), and you think your water may have broken, note the time, color, and consistency of the fluid, place a pad to collect the fluid and evaluate the pad after one hour. If your pad is soaked through come to labor & delivery triage. If not, call for further evaluation.

9. What is a TOLAC?
     A TOLAC, or “trial of labor after cesarean”. Is choosing to labor for a vaginal birth for a mother that has already had a baby via cesarean section. There are multiple criteria that allow a mom to be able to TOLAC or not; discuss this with you provider. You can view more information "here".

10. My baby’s movement is abnormal. What should I do?
     For decreased fetal movement, not the time you last felt any movement and the time of last kick counts (10movements in an hour). Try drinking a glass of ice-water and/or juice and lie still on your left side for 1-2 hours.

11. Contractions: True vs False?
     • True Labor contractions:
        a. Regular
        b. Increase in frequency
        c. Increase in pain
        d. Usually felt back to front
        e. May or may NOT be associated with water breakage
        f. Spotting present    

     • False Labor contractions:
        a. Irregular
        b. Do not increase in frequency
        c. Do not increase in pain
        d. Often felt in lower abdomen
        e. No bleeding
        f. May or may not lose mucus plug

Immediately call Labor & Delivery Triage at 760 - 719-0242 if you have:
[Note: If you are less than 20 weeks pregnant, report to the Emergency Department, 1st floor, South Entrance, for evaluation, not Labor & Delivery triage.]

• Bright red vaginal bleeding
• Persistent, severe headaches unrelieved by Tylenol
• Visual changes such as bright white spots, blurred, double or loss of vision
• Sudden & severe increase in swelling of hands, feet, or face
• Sudden weight gain
• Severe nausea & vomiting, unable to keep down fluids
• Severe, persistent abdominal pain
• Decreased Fetal Movement (see above)

III. Sample Birth Plan

1st Stage of Labor

     Environment: You prefer to have:
       Dimmed lights
       Controlled noise
       Music played
       Wear your own clothes
       Bring aromatherapy
     
     Mobility:
       Desire to walk during my labor
       Walking is not as important, position changes ok
       
     Food & Fluids:
       Prefer a saline lock only, if possible
       Prefer to be able to eat and drink as long as possible

     Monitoring:
       Intermittent monitoring
       Don’t have a preference on monitoring

     Pain Relief:
       Would like to know what’s available for medical pain relief
       Prefer only comfort measures (walking, massages, heat/cold therapy, showering)
       Prefer an epidural
       Do/Don't ask about pain medication relief
       Would like to take photos during/after birth
       Would like to take a video

     Labor Support:
       Partner only and provide Name
       Family or support people to be present for labor/delivery

2nd Stage of Labor

     Pushing:
       Change positions during labor
       To use pushing assistive devices: i.e. squat bar, birthing ball/stool

     Perineal Care:
       Would like perineal support while pushing: massage, warm compress, or lubrication
       Would like to use a mirror
       Touch the baby’s head during crowning

     Baby Care:
       Would like partner to help as much as possible with the delivery
       Have the baby placed skin to skin after birth
       Have the baby placed on the warmer for cleaning right after birth

     Cord/Placental Care:
       Would like to cut the cord
       Partner to cut the cord
       To delay cord clamping
       To donate cord blood
       To keep placenta

     Infant Treatments:
       Standard treatments to be delayed for the first hour
       More information about Hepatitis B, Vitamin K, Erythromycin, or Decline (which ones/all)

     Infant Feeding & Care:
       To breastfeed, bottle feed, both, or pump
       No pacifiers
       Partner go with my infant if they have to leave the room for an exam/treatment
       Partner help with the bath

     Circumcision:
       Yes/No
       To delay for cultural/religious reasons

     Complications:
       If you were to have a cesarean section or other procedure done who would you like to be present with you.
       If your partner is not present, who have you designated as a proxy?

V. Pre-Natal Checklist

• 1st Trimester
• Schedule appointments; select clinic (OB/FP)
• Attend smoking cessation if applicable
• Attend New Parent Support Program if desired
• Make a family care plan for the care of my children during labor, or if any emergencies arrive
• 2nd Trimester and 3rd Trimester
• Attend Budgeting for Baby if desired
• Complete Pre-Admission paperwork (at 20-33 weeks pregnant)
• Attend Infant CPR &/or Baby Boot Camp
• Complete Birth Plan
• Purchase/install/Have inspected infant safety seat
• Pack labor bag
• Plan for transportation & support person if not spouse during labor
• Work on choosing a Name!
• After Discharge
• Call Tricare for follow-up
• Visit Birth Certificate office for finished paperwork
• Visit HRD to update SGLE, “page 2” /DD Form 93, enroll baby in Tricare Prime and DEERs (resources provided during hospital stay.
• Update DEERS enrollment once SSN card is received at HRD (3 months post-birth)

FAQs

1. When should I come to the hospital?
      There are many reasons to be seen in triage for pregnancy concerns, please see above. We will recommend that you come to the hospital for labor when (1) your water is broken or (2) when you have regular, painful, increasing contractions. See the above medical concerns for other reasons to be seen in L&D Triage.

2. What should I bring with me to the hospital?
      The hospital is well-equipped for all your basic care; however, feel free to bring a few personal effects like your desired hygiene items, 1-2 pillows, any music you desire to play during labor and clothes or newborn clothes you desire to use. We discourage bringing any valuables to the hospital and open flame candles are not allowed.

3. Where is Labor Triage?
      The triage rooms are located on the L&D unit, and staffed by triage nurse & the provider on staff 24/7. Check into Labor & Delivery Nurse’s station, which will be the 3rd nurse’s station as you walk down the aisle from the south entrance elevators.

4. What is the care a Labor and Delivery like?
      Labor & Delivery is staffed with nurses and corpsmen with physicians and midwifes present at all times, with 1-2 patient to nurse ration. Ancillary care such as Anesthesia, Lab, Pharmacy, & Radiology services are available as well.

5. What are my pain management options?
      There are numerous pain management options to discuss with your PCM prior to labor. We recommend you review options such as massage and acupressure, hot/cold therapy, and warm showers for relaxation as a few common options. Attending a labor class is also a good option. Intravenous pain medication and epidural blocks are the main medical options available for pain management. Discuss you questions, concerns, and desires with your PCM.

6. Where does my baby go after I deliver?
      Like most facilities, we are proud to have a family –centered care hospital and provide couplet care to minimize separation of the infant from your family as much as possible, unless prevented by the care needed for your baby prevents this. We suggest skin-to-skin bonding time right after delivery, and complete all of your infant care right in your arms or at the infant warmer in your room!

7. Who can stay with me at the hospital?
      We recommend that no more than 1 or 2 support people stay overnight with you during your labor stay. The rooms, though quite spacious, only have sleeping arrangements for one additional person.

8. What are the visiting hours?
      There are no visiting hours set for L&D due to the nature of our care; we do recommend visitor’s come during daylight hours.

9. Can my family call the hospital for updates?
      Due to Patient Privacy laws (PPA, HIPPA), we cannot given your personal information over the phone, besides confirming that you are a patient. We suggest you designate a person to relay info for your family who would like updates.

After the birth of your baby, you will generally recover in one of our Labor & Delivery suites for several hours before transferring to our Maternal Infant Unit, just down the Hall! There is a wealth of questions that come with the birth of a new child, from postpartum to breastfeeding and infant support.

FAQ’s

1. What does “Infant Security” refer to at the hospital?
      Infant Security is used to identify that the infant is safe & secure with their family or care provider at all times. Each parent or the mother and a designated second person (i.e. family member) will receive a band with the infant and mother’s info matching the infant’s bands and identifying them to the infant at the time of birth. As we practice “couplet care” and the infant stays in the same room with the mother or other banded person, or with a care provider (physician, nurse, corpsman, etc.), & must be in the crib if transported through the hall. Infants must sleep in their cribs if mom is also asleep, (“no co-bedding”). Infant security tags are placed on the infant’s lower leg when they transfer from L&D to MIU. These are used to prevent infant theft, and are tracked with the hospital’s security computer system. They will alarm if removed, and lock down doors if infant is attempted to leave the floor.

2. What treatment will my baby receive on Labor & Delivery?
      The standard of care for infants is administration of antibiotic eye ointment to prevent transmission of bacteria from the birth canal, Vitamin K injection to supplement the body’s normal production that is lacking at birth, & the first Hepatitis B vaccine, your child’s first pediatric vaccine, required by law for public schools. Ask your PCM if you have any questions regarding these treatments.

3. What is the SCN? Can I visit my infant there?
      The Special Care Nursery is a separate care space within Labor & Delivery for infants that exhibit the need for a higher level of care through constant monitoring. Some of the reasons for this include poor regulation of the infant to maintain its own blood sugar, body temperature, or breathing.

4. Does NHCP have a NICU?
      No, NHCP does not have a Neonatal Intensive Care Unit, or NICU, we have a step-down unit for less critical infants. Infants or mothers of infants needing or anticipated to need NICU care are transferred to our sister facility Naval Medical Center San Diego, or outside civilian center with NICU capability.

Welcome, the main function of the Birth Certificate Office is to type the original Birth Certificate for each child born aboard Naval Hospital Camp Pendleton. Once the Birth Certificate has been typed, it then is hand delivered to the San Diego County Recorder's Office to be certified within seven days of birth. Thus, the Birth Certificate office does not have access to any Birth Certificate after that time frame. If you are inquiring on how to obtain a Birth Certificate or need proof to enroll in DEER's and the person in question is more than one month of age, please call the San Diego County Administration Office at 619 - 237-0502 or visit their website at www.sdarcc.com to obtain a Certified Birth Certificate.

The Naval Hospital Camp Pendleton Birth Certificate Office is located in the Patient Admin Office located on the 1st floor, Room 1144.

Hours: 0800-1500
Seven days a week for your convenience.

Phone: 760 - 725-1316

You may contact the San Diego Assessor/Recorder/County Clerk.

Provided below are the County of San Diego locations to obtain information for the retrieval of birth certificates.
Chula Vista	619	498-2277
El Cajon	619	401-5750
San Diego	619	237-0502
Kearney Mesa	858	505-6226
San Marcos	760	940-6858

You can go directly to the San Diego Assessor/Recorder/County Clerk and order Online.